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• Gaps in knowledge about the role of HPV in head and neck cancers and anal cancers, • Most of health students would recommend the HPV vaccine to friends and relatives. • Positive attitudes were more frequent in medical/pharmacy versus nursing students. • After adjustment, educational health program didn't remain associated with attitudes. Despite documented effectiveness in preventing several cancers, genital warts and safety of Human Papillomavirus (HPV) vaccine, immunization coverage among French adolescents remains far from the 80 % target. University health students (HS) in France may promote HPV vaccine through a national service (Service Sanitaire des Etudiants en Santé). We aimed to evaluate intentions to recommend the HPV vaccine to friends and relatives, to receive HPV vaccine, and to identify factors associated with these attitudes. We conducted a cross-sectional survey in five French Universities from October 2019 to February 2020, using a self-administered online questionnaire. We used bivariable and multivariable logistic regression models to identify determinants of behavior around HPV vaccine: (i) individual intention for vaccination, and (ii) vaccine recommendation to friends and relatives. Among the 732 respondents (180 men, 552 women), 305 (41.7%) reported previous HPV vaccination (54.5 % among women), 504 (68.9%) would recommend the HPV vaccine to friends and relatives, 532 (72.7%) respondents would be vaccinated today if it was recommended for them. Intentions to recommend or to receive the HPV vaccine were less frequent in nursing students compared to medical and pharmacy students. After adjustment for demographical factors, HPV vaccine knowledge was associated with intention [aOR 1.30 (95%-confidence interval, 1.15–1.47)] and recommendation [1.26 (1.10–1.45)], respectively. Additionally, adjusting for knowledge about HPV infections, and confidence in vaccines in general was associated with vaccine intention [1.55, (1.30–1.84)] and recommendation [1.52 (1.24–1.86)]. HPV-vaccinated HS were more prone to recommend the HPV vaccine to friends and relatives [10.9 (6.6–17.9)]. A majority of HS would accept and/or recommend HPV vaccines. HS with greater knowledge about the HPV vaccine were more prone to recommend it. Strengthening knowledge about HPV and its vaccination is probably necessary before their Involvement in a HPV immunization program. [ABSTRACT FROM AUTHOR]

Objectives: Healthcare workers are more likely to be infected by SARS-CoV-2. In order to assess the infectious risk associated with working in a hospital, we sought to estimate the proportion of healthcare professionals infected with SARS-CoV-2 by screening staff in a University Medical Center in France., Setting: A hospital-wide screening campaign (comprising a serological test and a questionnaire) ran from 18 May to 26 July 2020., Primary and Secondary Outcome Measures: The seroprevalence rate was analysed in a multivariate analysis according to sociodemographic variables (age, sex and profession), exposure to SARS-CoV-2 and symptoms., Results: A total of 4840 professionals were included, corresponding to 74.5% of the centre's staff. The seroprevalence rate (95% CI) was 9.7% (7.0% to 12.4%). Contact with a confirmed case of COVID-19 was significantly associated with seropositivity (OR (95% CI: 1.43, (1.15 to 1.78)). The seroprevalence rate was significantly higher among nursing assistants (17.6%) than among other healthcare professionals. The following symptoms were predictive of COVID-19: anosmia (OR (95% CI): 1.55, (1.49 to 1.62)), ageusia (1.21, (1.16 to 1.27)), fever (1.15, (1.12 to 1.18)), myalgia (1.03, (1.01 to 1.06)) and headache (1.03, (1.01 to 1.04))., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: The main objective of this study was to estimate prevalence on the liberal general practitioners. The secondary objectives are to identify the possible brakes with the declaration in the monitoring observatory for security of the doctors as well as to determine if the feminization of the profession was associated with the situations violence., Methods: A questionnaire in 5 parts was submitted by telephone to 146 drawn lots liberal general practitioners. It approached the undergone physical and verbal attacks, the infringements on the properties arisen during their career, and the proven feeling of insecurity., Results: The rate of participation was 63% (93/146). In all 171 incidents were reported among which 96 physical and verbal attacks (56%), and 75 infringements on the properties (44%) without difference according to the sex. The main motive for the attacks was the refusal of prescription (44%). Practically, no concerned doctor made declaration for the monitoring observatory for the security of the doctors, for lack of interest for 5 of them or the ignorance of its existence for 10 on 32 practitioners having undergone an aggression after the creation of the monitoring observatory., Conclusion: We observed an under-reporting of the attacks or of the infringements on the properties by the doctors victims. Our study did not highlight difference between men and women., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Alcohol consumption in itself is not forbidden in France. Two situations are reprehended by the law: public drunkenness - where only the behavior is sanctioned and not the alcohol level - and driving with a level of alcohol superior to 0.5g per liter. The management of a severe state of drunkenness - even though frequent - is on the one hand poorly managed and on the other hands badly mastered by doctors. The management of drunken patients lies essentially in a strong monitoring of the possible complications. The inherent question of the returning-back-home for a drunken patient should be approached according to the state of consciousness rather than the alcohol rate in the blood. No matter what the rate is, the authorization to release a patient depends on the preservation of his judgmental capacities. If those are altered, the doctor can then decide to keep - even against his will - the patient temporarily and until he has recovered his discernment. Patients still keep their right to refuse any medical treatment. Indeed, the law does not provide any answer concerning the particular issue of the refusal of medical care by the patient, especially in case of a severe alcoholic intoxicated state that let the patient incapable to express his will and to understand the range of the given information. There is no legal measure that can able a doctor to firmly forbid a drunk patient to be released and to take the wheel. Doctors have to try to dissuade them by proposing other alternatives but they cannot physically oppose themselves to the patient decision. However, proofs that the doctor tried his best to convince the patient not to drive while under the influence of alcohol can be demanded. Doctors have the duty to inform patients on every risk that alcohol can bring while driving but do not have any measure of pressure., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Violence against health care workers impairs the quality of care. In one university medical center in France, 46% of the health care workers were physically assaulted at some point in the previous 12 months and 79% were verbally insulted. This article describes a participatory approach that was used to ensure health care workers take an active role in designing and implementing anti-violence measures. In each unit, a working group of health care professionals and managers developed an action plan for reducing violence-generating practices. This proactive approach is a powerful tool for motivating health care professionals to improve quality of care., (Copyright 2014, SLACK Incorporated.)

Objective: The purpose of this study was to assess patient understanding of ED discharge instructions. It is essential for ED patients to understand their discharge instructions. ED staff face unique challenges when providing information in a distraction-filled, limited-time setting, often with no knowledge of the patient's medical history., Methods: A qualitative study was conducted with a sample of patients discharged from our emergency department. Data were collected via a semi-structured interview., Results: A total of 36 patients participated in the study; 29 patients were discharged with a drug prescription, and complementary investigations were scheduled for 3 patients. Most patients were satisfied with the time staff spent explaining the discharge instructions. However, some patients admitted that they did not intend to fully comply with the medical prescription. Nearly half of the patients reported difficulties understanding their drug prescription (the dose or purpose of the treatment). Most patients said that their poor understanding primarily was related to lack of clarity of the written prescription., Discussion: Even the most comprehensive instructions may not be clearly understood. Despite the patients' high stated levels of satisfaction with communication in the emergency department, more than half of patients failed to comply with important discharge information. Health care staff must be aware of the importance of discharge information. Further research is needed to improve the patient discharge process., (Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.)

Cardiovascular implantable electronic devices (CIED) are implanted increasingly frequently. CIEDs are indicated for the treatment of bradycardia, tachycardia and heart failure and therefore improve quality of life and life expectancy. CIED can treat ventricular arrhythmias that would be fatal without immediate care. However, CIEDs raise several patient education, medico-legal, and ethical questions that will be addressed in this article. Information is a patient's right, and necessary for informed consent. When implanting a CIED, the patient must be educated about the need for the device, the function of the device, any restrictions that apply postimplant, and postimplant follow-up methods and schedules. This transfer of information to the patient makes the patient responsible. The occupational physician can determine whether a patient wearing a CIED is able to work. Under current French law, patients are not prohibited from working while wearing a CIED. However, access to certain job categories remains limited, such as jobs involving mechanical stress to the chest, exposure to electromagnetic fields, or jobs requiring permanent vigilance. Pacemakers and defibrillators are medical treatments and are subject to the same ethical and clinical considerations as any other treatment. However, stopping a pacemaker or a defibrillator raises different ethical issues. Implantable Cardioverter Defibrillator shocks can be considered to be equivalent to resuscitation efforts and can be interpreted as being unreasonable in an end-of-life patient. Pacing is painless and it is unlikely to unnecessarily prolong the life of a patient with a terminal disease. Patients with a CIED should live as normally as possible, but must also be informed about the constraints related to the device and must inform each caregiver about the presence of the device. The forensic and ethical implications must be assessed in relation to current legislation.

Consumption of psychoactive substances is widespread among prison detainees. This represents not only a public health problem but also a barrier to rehabilitation. Too few resources are devoted to this issue in France. We conducted a pilot study of psychoactive substance use among new prison entrants, in order to guide their therapeutic management. Tobacco, alcohol, cannabis, opiates and medicinal drugs were used daily by respectively 81%, 29%, 23%, 14% and l3% of study participants. Brief interventions targeted users of tobacco (92%), alcohol (25%), cannabis (65%), cocaine (67%) and opiates (56%)? These results encourage us to systematically identify substance use among new detainees in order to offer optimal support aimed and to facilitate their rehabilitation. Given the lack of specialized care, brief interventions may be an interesting option but they must be adapted to the specificities of this population.

In France, the physician can inform the prefect that a patient, detaining weapon and followed for a pathology (psychiatric notably), is dangerous. Then, it comes back to the prefect to appreciate the appropriate measurements to take, notably to order the delivery of weapon and ammunitions. In France, the doctor can be solicited to establish the necessary medical certficates during requests of approval or acquisition and having guns for hunting and sports shooting, or to obtain the licence of hunting. The acquisition and the possession of certain weapon cannot be granted if the applicant is a protected person over 18, was or is hospitalized, without his consent, owing to mental disturbances or, is in a physical or psychical state apparently incompatible with the possession of weapon. But it appears that the access to this information by the prefects is made difficult by the absence of files centralizing these data. Question settles to institute an automated national file of hospitalizations under pressure, which could be consulted prior to the deliverance or the approval of possession of weapon for hunting and as sports shooting. In our opinion, this should be made, in a strictly supervised manner, through a sworn doctor, systematically solicited as part of the licence of hunting and licence of shooting, to liberate the family practitioners of an expertise role.

The demand for bariatric surgery is expected to increase. It is a procedure that carries a high surgical risk, and a risk of postoperative complications due to the pathologies associated with obesity. Obesity surgery is not classified as plastic surgery, but may subsequently lead to plastic surgery-type operations. Malpractices in the field of obesity surgery are most frequently at the pre-operative stage. In the absence of any fault, a patient may obtain indemnification by "national solidarity". Physicians and surgeons have an obligation to be able to prove that they informed their patients properly.

The law provides for an evaluation and a five-year review of the French Public Health Act. Among its five strategic plans, the law of August 9, 2004 provided for a "national plan to limit the health impact of violence, risk behavior and addictive behavior." Under the impetus of the World Health Organization's World Report on Violence and Health in 2000, a rich reflection was conducted in France on this issue establishing some key axes for implementation. Although we can link several actions related to this field within the framework of specific policies since 2004 (road violence, addictions, violence against women, etc.), we note that a plan on violence and health has not emerged. The lack of enforcement and application of this part of the law raises questions about the quality of the law as well as the in the role and place for the theme "violence and health" in an upcoming law.

Law 98-468 of 17th June 1998 enables hearings for minor victims of aggression or sexual assault to be filmed. This legal procedure can sometimes be traumatic. In the region of Picardie, units dedicated to underage victims have been developed. These units bring together all the relevant professionals in a reassuring environment suitable for children, in order to encourage the child to talk and to help make the whole procedure easier.

Violence is too often considered an inevitable part of human existence. Physical, psychological and behavioural trauma has an impact not only on the health of the individual but also on the healthcare system. Largely perceived as a social problem, violence is also a public health issue. Promoted by the World Health Organisation and developed in France by Prof Henrion, the National Authority for Health and the mission led by Dr. Tursz, the public health dimension of "Violence and health" is now better defined. The Public Health law of 2004 provided for a national plan on "Violence and Health". After an initial action study, we developed a tool to coordinate public actions in this field. The group "For health, against violence in Picardy" was created to implement expert recommendations by building knowledge, promoting training and networking, and developing services to support and guide victims of violence.

Healthcare networks which purpose is to manage patients through better coordination of the care, need to develop a communication strategy to be recognized by the public and by healthcare professionals and to be inserted in the healthcare landscape. We firstly will present legal requirements related to external communication of healthcare networks. Then, we will describe the different tools which can be used to communicate about healthcare networks in its area, with the example from a healthcare network for health services accessibility. In the French Public health code, the legal status and the ethical charter of the healthcare network have to be delivered to the healthcare professionals in its area and to the patients. Moreover, the example healthcare network informed collectively and individually the healthcare professionals of its area about its activities. It made it known to the public by the way of departmental prevention manifestations and health education sessions in community social associations. From these examples, we will conduct an ethical reflection on the modalities and stakes of the external communication of healthcare networks.

Background: At present, clinical practice guidelines for prostate cancer screening are controversial in France. The French National Agency for Health Care Quality does not recommend screening for prostate cancer. In contrast, since 2002 the French Urological Association has been supporting screening. However, both support selected screening for men with risk factors, despite there having been no assessment to date of whether the screening is justified. In 2002, Prostatic Specific Antigen prescriptions increased by 22% over one year and PSA was the first prescription for cancer markers. The history of the pros and cons for prostate cancer screening is summarized. Prostate cancer does not qualify under the World Health Organization's criteria for screening., Conclusion: At the present time, prostate cancer mass screening cannot be recommended. Pitfalls for Clinical Guidelines enforcement are discussed.

Objective: Law no. 2004-800 dated August 6, 2004, establishes new legal measures to facilitate live organ donation, in view of the shortage of organs for transplantation. We sought to assess the knowledge of this statute among hospital personnel., Method: We sent an e-mail questionnaire to 1015 persons working at Amiens university hospital center. It contained eleven closed questions (yes/no/don't know) about permissible live organ and tissue donation and two questions requesting personal opinions about live donation. We compared responses according to profession and department., Results: Questionnaires were returned by 245 respondents. The questions for which more than 70% provided correct answers concerned the fundamental principles of bioethics (consent revocable at any time, donations by adults, donations between spouses, bone marrow donations by minors). Fewer than half the respondents knew the correct answers about the new legal measures adopted in the statute (extension of the circle of potential donors, possible exceptions for donations by minors and incompetent adults). Knowledge of the law concerning assisted reproduction techniques was much poorer: fewer than 30% knew that sperm or oocyte donation requires spousal consent. Three quarters of the respondents have discussed their wishes with their family; 65% would provide a live kidney donation, although some only for a family member. In all 31% have organ donor cards., Discussion: Donations by live donors raise psychological as well as ethical and legal issues. This survey increased the awareness of hospital staff, provided them with information about the relevant law and, we hope, stimulated their thinking about the topic of live donations.