The Third French Alzheimer Plan: analysis of the influence of a national public health initiative on scientific research productivity and impact.

INTRODUCTION: The Third National Alzheimer Plan (2008-2012) was a major public health initiative in France that included €200 million of funding for research in Alzheimer disease and related disorders (AD). The aim of this study was to document trends in French academic output in AD following the implementation of the plan. METHODS: Academic output (i.e., number of original articles) and scientific impact (i.e., article citations) of French research in AD were obtained from the Web of Knowledge core collection database. Analyses compared the 5-year period immediately before (2004-2008) and after (2009-2013) initiation of the plan. Comparisons were made with stroke, Parkinson disease, AIDS, and diabetes in the 14 leading countries worldwide and regionally within France. RESULTS: Worldwide production of original scientific articles between the periods 2004-2008 and 2009-2013 increased by 39%, and that for AD increased by 46%. China showed the largest increase and Japan the smallest. The absolute increase in French output on AD (54.6%) was larger than that for stroke, Parkinson disease, AIDS, or diabetes. Globally, France had the third largest relative increase in output in AD (1.7-fold), behind only India (2.5-fold) and China (1.9-fold). There was a relative 2.3-fold increase in the proportion of French AD articles in the top 1% globally most cited, larger than that for French articles on stroke, Parkinson disease, AIDS, or diabetes. At the national level, university hospitals participated in nearly 50% of French AD publications. Analyses by geographical area demonstrated marked heterogeneity. We observed a strong correlation between level of funding and volume of output (R2 = 0.70), but not between funding and article impact (proportion of top 10% globally cited articles; correlation R2 = 0.03). CONCLUSIONS: Our study provides evidence of a specific positive impact of the funding provided by the Third National Alzheimer Plan in nearly doubling the global academic scientific output and increasing by 2.3-fold the top 1% globally cited articles of France in AD research. Our bibliometric analyses provide objective and transparent information for policy makers on the relationship between research funding and academic output.

An overview of the use of music therapy in the context of Alzheimer's disease: a report of a French expert group.

OBJECTIVES: The aim of this overview is to present the developments of music therapy in France, its techniques, mechanisms and principal indications, mainly in the context of Alzheimer's disease. METHODS: An international review of the literature on music therapy applied to Alzheimer's disease was conducted using the principal scientific search engines. A work group of experts in music therapy and psychosocial techniques then considered the different points highlighted in the review of literature and discussed them. RESULTS AND DISCUSSION: Clinical and neurophysiological studies have enlightened some positive benefits of music in providing support for people with Alzheimer's disease or related disorders. Music therapy acts mainly through emotional and psycho-physiological pathways. It includes a series of techniques that can respond to targeted therapeutic objectives. Some studies have shown that music therapy reduces anxiety, alleviates periods of depression and aggressive behaviour and thus significantly improves mood, communication and autonomy of patients. CONCLUSION: Psychosocial interventions, such as music therapy, can contribute to maintain or rehabilitate functional cognitive and sensory abilities, as well as emotional and social skills and to reduce the severity of some behavioural disorders.

Predictive factors of the number and the dose of anti-psychotics in a cohort of schizophrenic patients.

BACKGROUND: Anti-psychotic prescription in schizophrenia is characterised in Europe by frequent associations and high doses. Nevertheless, few longitudinal epidemiological studies have explored anti-psychotic prescriptions. AIM: (1) To describe the evolution of prescription patterns across time; (2) to determine risk factors for prescription of high doses of anti-psychotics and for anti-psychotic combinations. MATERIALS AND METHODS: Three thousand four hundred seventy three subjects were included in 1993. Data collected in 1993 and subsequently in 1996 and 1999, provided information on demographics, clinical status and prescription. In 1996, the response rate was 68.5% and 56.7% in 1999. RESULTS: The number of anti-psychotics prescribed slightly decreased across time, while doses remained high for one-third of the patients. The factors predicting dose were: dose at previous evaluation, class of anti-psychotic and clinical severity. The factors predicting the number of anti-psychotics were: previous number and class of anti-psychotic and clinical severity. CONCLUSION: Higher dosage and combinations were related more to physicians' habits than to patient characteristics, as is frequently observed in chronic disease.

Is alcohol, tobacco, and cannabis use as well as polydrug use increasing in France?

Two school surveys measured the consumption of alcohol, tobacco and cannabis among French adolescents (7-12th grades), one in 1993 (N=8435, 48.8% males), another in 1999 (N=11,331, 47.9% males). Increase in all substance use and polydrug use was observed (total sample, by gender and by age). The increase was important (1) for lifetime consumption of cannabis, "tobacco+cannabis," "alcohol+tobacco" and "alcohol+tobacco+cannabis" (OR=3.0); (2) for regular consumption of cannabis and "tobacco+cannabis" (OR=3.0); (3) among girls; (4) among youngsters aged 15 and more. In summary, these patterns of increase were quite different from those we expected for France, a wet and masculine culture.

Family structure, parent-child relationships, and alcohol and other drug use among teenagers in France and the United Kingdom.

This paper compares samples of 15-16-year-olds from the UK and France on their usage of alcohol, tobacco and illicit drugs and also seeks to describe the associations between alcohol and other drug use with "family variables" within the two countries. Compared to UK adolescents, French adolescents showed a slightly higher rate of cigarette smoking, were almost identical on cannabis use, rather lower on the use of other illicit drugs and very considerably lower on alcohol use. Family variables were related to substance use. In the two countries, children from non-intact families, those who were not satisfied with their relationships with their father or mother and those who were less closely monitored, were more likely to be heavy substance users than other students. Logistic regressions showed that parental knowledge of the whereabouts of their offspring on Saturday evenings was the strongest factor, in both countries, that family structure is frequently still significant in the UK, and that paternal relationships are highly significant among French students. Differences in national drinking culture, urbanization and parental practices are discussed in an attempt to interpret some of these findings.

Consumo de sustancias psicoactivas en la adolescencia. análisis de los estudios de cohorte / Use of drugs in adolescence. A review of longitudinal studies

Objetivo: Establecer un repertorio de los estudios longitudinales sobre el consumo de sustancias psicoactivas entre los adolescentes y realizar una síntesis de los métodos utilizados y de los resultados obtenidos. Métodos: Se siguieron dos estrategias de investigación documental: investigación bibliográfica retrospectiva y vigilancia bibliográfica mediante la interrogación de bases de datos a través de palabras clave, títulos, nombres de autor. Resultados: Se llegaron a identificar 69 estudios, la mayoría de ellos realizados entre la población escolar. Los porcentajes de atrición, instrumentos y factores de riesgo analizados varían enormemente de un estudio a otro. Los resultados confirman la naturaleza predictiva de factores como la calidad de las relaciones interpersonales, la personalidad, los antecedentes de problemas psicopatológicos, el consumo de padres y de compañeros, en la utilización de las sustancias psicoactivas. Sin embargo, los modelos multifactoriales utilizados muestran que el impacto de esos factores varía ligeramente, dependiendo de las sustancias tomadas en consideración y del momento exacto del proceso (iniciación, consumo habitual, abuso). Conclusión: Ciertas líneas de investigación requieren seguir profundizando en su estudio: los factores específicos de un consumo precoz, los factores de protección y la evolución del consumo en la edad adulta (AU)