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Background: Interprofessional relationships between general practitioners (GPs) and dental surgeons with a doctorate in dental surgery are essential for the optimal management of the oral health of patients. The objectives of this study were to describe the factors associated with the referral of patients from GPs to dental surgeons in France, and to improve referral practices by establishing a standardized set of items to be included in a referral letter. Methods: A nationwide, observational, survey-based, cross-sectional study was conducted from 9 February 2023 to 6 April 2023. Two 13-item questionnaires were sent to GPs and dental surgeons. Data on practitioner characteristics, frequency, and perceived usefulness of medical correspondence between the two healthcare professionals were collected. Candidate items selected by expert medical opinion for a standardized referral letter template were appraised by the responding oral surgeons. Results: A group of 245 dental surgeons (mean age: 38.2 ± 11.1 years, 64.5% female) and 235 GPs (mean age: 36.8 ± 9.8 years, 71.9% female) participated in this study. Medical correspondence between GPs and dental surgeons was reported to be insufficient by most dental surgeons (91.4%). Dental surgeons agreed that GP correspondence could decrease the occurrence of adverse events linked with dental care (mean score: 7.36 ± 2.4, for a maximum of 10). Only 20% of GPs indicated that they had regular communication with dental surgeons. The physician characteristics under study were not statistically associated with initiating referrals. The items most frequently selected by dental surgeons for inclusion in a template referral letter were the presence of diabetes (99.6%), of immunosuppression (98.8%), and medication by anticoagulant or antiplatelet agents (98.3%). Conclusions: Despite known links between oral and general health, most healthcare professionals did not engage in correspondence or referrals with the other specialty. Standardized referral letters could include the list of items for which interest was confirmed by dental surgeons (including presence of diabetes, immunosuppressants and anticoagulants or antiplatelet agents). [ABSTRACT FROM AUTHOR]

Background: Delays in detection and treatment of breast cancer can lead to increased mortality. To date, participation in organized breast cancer screenings (OBCS) has been suboptimal worldwide. The objective of this study was to investigate the factors associated with deferral or non‐performance of mammography during the COVID‐19 pandemic for women who had previously participated in OBCS. Methods: A retrospective observational study was conducted on a cohort of 6282 women from the Aube Department of France, who were invited to an OBCS in 2020. Participants were divided into women who promptly underwent screening after receiving an invitation (between 22 and 25 months elapsed since the last mammogram), women who underwent late screening (≥26 months since the last mammogram), and those who were never screened. Data were collected from a self‐reported questionnaire. Comparative and multivariable analyses modeling the probability of each type of attendance were performed using these data. Results: In total, 2301 women (aged 50–74 years) returned a valid questionnaire. Compared to women who promptly underwent mammography, non‐ and late‐screening participants were younger, had less frequent gynecological follow‐up and a less frequent history of colorectal cancer screening. Women with higher education status and those residing in socially disadvantaged areas were more likely to attend late. Conclusion: The absence of regular gynecological follow‐up and the absence of colorectal cancer screening were significant factors associated with deferral of or non‐attendance at OBCS. [ABSTRACT FROM AUTHOR]

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Résumé: Introduction: Face aux besoins liés à la perte d'autonomie des personnes âgées vieillissantes, des alternatives à l'institutionnalisation doivent être imaginées. Dans ce contexte, notre étude visait à évaluer l'effet d'un modèle de maintien à domicile renforcé sur l'évolution de la fragilité de personnes âgées dont l'état de santé aurait pu justifier une institutionnalisation. Méthodes: Étude observationnelle rétrospective s'intéressant à l'évolution du score SEGA et d'autres variables reflétant la fragilité de personnes âgées de plus de 75 ans en fonction d'un maintien à domicile classique, une institutionnalisation, ou un maintien à domicile renforcé. Résultats: Les score SEGA moyens des groupes Ehpad-@-Dom (maintien à domicile renforcé) et SAD (maintien à domicile classique) sont significativement meilleurs que celui du groupe Ehpad après 6 mois (T6 : Ehpad-@-Dom vs Ehpad, p = 0,01 et SAD vs Ehpad, p = 0,039) et 12 mois (T12 : Ehpad-@-Dom vs Ehpad, p = 0,021). Conclusion: Le « maintien à domicile renforcé » semble être une alternative à l'entrée classique en Ehpad. Introduction: The growing needs related to the loss of autonomy of elderly people should be the opportunity to imagine alternatives to nursing homes. In this context, our study aimed to assess the effect of a reinforced home care model on the evolution of frailty in elderly people whose health conditions could have justified entering a nursing home. Methods: A retrospective observational study focusing on the evolution of the SEGA score and other variables reflecting the frailty of people over 75 years old according to classic home care, institutionalization, or reinforced home care. Results: The average SEGA scores of the Ehpad-@-Dom (reinforced home care) and SAD (classic home care) groups are significantly better than that of the Ehpad group after 6 months (T6: Ehpad-@-Dom vs Ehpad, p =0.01 and SAD vs Ehpad, p=0.039) and 12 months (T12: Ehpad-@-Dom vs Ehpad, p=0.021). Conclusion: "Reinforced home care" seems to be an alternative to the classic nursing home model. [ABSTRACT FROM AUTHOR]

Résumé: Introduction: Peu de personnes âgées participent à la recherche, notamment en Établissement d'hébergement pour personnes âgées dépendantes (Ehpad). L'absence de données scientifiques limite notre capacité à proposer des soins basés sur les preuves. L'explication est en partie liée à la difficulté à faire adhérer cette population aux interventions, surtout lorsqu'il s'agit de la pratique d'une activité physique. À partir de données de l'étude interventionnelle LEDEN (Effects of a Long-term Exercise Program on Functional Ability in People with Dementia Living in Nursing Homes : A Cluster Randomised Controlled Trial) évaluant l'effet de la pratique d'une activité physique chez des résidents d'Ehpad, nous étudions, dans ce travail, les déterminants de l'observance au protocole d'étude. Méthodes: Il s'agit d'une analyse secondaire de l'essai contrôlé randomisé LEDEN. L'intervention consistait en des séances bi-hebdomadaires d'activité physique. Les facteurs prédictifs d'une présence à 75 % des séances ont été évalués par une analyse multivariée par régression logistique. Résultats: Seul l'âge ≥ 95 ans était associé à une moins bonne observance des séances : odds ratio 0,121 (IC95% 0,006–0,982). Conclusion: Chez les résidents d'Ehpad, seul l'âge très élevé (≥ 95 ans) est apparu comme un facteur limitant l'observance au programme d'activités de la recherche. Summary: Introduction: Few older people participate in medical research, especially in the nursing home setting. The lack of evidence in this population may limit our ability to provide evidence-based treatments. This can partly be explained by difficulties in obtaining a satisfactory adherence to research in this population, especially when the practice of a physical activity is needed. In this study data from the LEDEN trial (Effects of a Long-term Exercise Program on Functional Ability in People with Dementia Living in Nursing Homes: A Cluster Randomized Controlled Trial) was used to determine the predictors of adherence to the study protocol. Methods: Retrospective cohort study based on the data from the cluster randomized, controlled LEDEN trial. The LEDEN trial aimed to compare the effects of an exercise intervention with a nonphysical intervention on the ability to perform activities of daily living. Predictors of adherence (being present at ≥ 75% of sessions of the LEDEN trial) were identified by multivariable logistic regression. Results: By univariate analysis, the EVIBE scale (EValuation Immédiate du Bien-Être – evaluation of instantaneous well-being) measured at baseline was associated with study adherence, whereby higher scores were associated with higher adherence: 16.7% (1/6), 44.4% (4/9), 56.5% (13/23), 48.1% (13/27) and 75.0% (15/20) respectively for EVIBE scores from 1 to 5 (P = 0.02 for trend). By multi-variable analysis, an EVIBE scale score ≥ 4 did not predict clinical trial adherence (odds ratio [OR] 1.554, 95% confidence interval [CI] 0.619–3.942). Adherence was found to be lower among persons aged ≥ 95 years (OR: 0.121, 95%CI: 0.006–0.982). Conclusion: Older age (≥ 95 years) was associated with lower adherence to the study protocol. Further studies are needed to better understand and anticipate obstacles to adherence in research, while respecting consent procedures and patient autonomy. [ABSTRACT FROM AUTHOR]