Does legislative framework favors prescription of physical activity in primary care ? The French experience.

OBJECTIVE: Regular physical activity (PA) is a key element in chronic disease management. We studied the effect of a recent legislative framework given to physical activity prescription (PAP) on practices, motivations, barriers, and needs for PAP in primary care among general practitioners (GP) of the Auvergne-Rhône-Alpes region, France. METHODS: Our cross-sectional survey used a self-administrated questionnaire through two recruitment methods: e-mail address (online group) and face-to-face (office group). Based on the data pertaining to demography, motivation scores, needs, and barriers, we analyzed the profiles of participating GPs. RESULTS: Among the 283 GPs, online participants (n = 250) were younger than office participants (n = 33) (46 ± 11 vs. 51 ± 12 years, p = 0.0083), and were physically more active (80% vs 51%, p = 0.0006). Regular PA was also critical in the profile of current prescribers (OR = 2.83 (95%CI [1.28, 7.00]), p = 0.015). The motivation score for PAP was high and equal in both groups (10.5 ± 3.3 in a maximum of 15), but multiple barriers emerged, which demonstrated age-dependent variations in the score. Young GPs mostly identified self-imposed barriers (exercise referral, PAP training), while for older GPs these barriers were equally attributable to patients. CONCLUSION: Although the legislative framework given to PAP in France was associated with a 12% increase in the number of prescribers, PA remains poorly prescribed in primary care, even among the most motivated physicians.

Measuring the effects of in vitro mastication on bolus granulometry of shredded meat: A proposal for a new methodological procedure.

People with poor oral status and/or neuromuscular deficiencies avoid eating meat because of chewing and swallowing difficulties. Consequently, they expose themselves to the risk of malnutrition and sarcopenia or nutrient deficiencies. To develop a new process for meat preparation, it is necessary to understand how meat is broken down during food oral processing to become a swallowable bolus. However, it is unknown whether the initial texture of meat impacts the meat bolus granulometry. As meat particles are fibrous, making the granulometry analysis with sieving methods is difficult. As the approach of meat bolus granulometry is necessary, it is of importance to control the methodological parameters that affect the measures. This study describes a procedure that allows granulometry analysis of shredded meat before and after in vitro mastication. Meat particles were dispersed in glycerol before image analysis. Granulometry curves were then drawn using generalized linear models, particle by particle, or after applying virtual sieves. Artificial meat bolus granulometry was also analyzed by manual sieving and the different methods were compared through several characteristics, including D50. Image analysis in glycerol preserves meat particles and allows particle distribution characterization and shape descriptors analysis. This method is well adapted to shredded meat and could be performed to evaluate the mastication of meat preparations adapted for deficient mastication.