Perceptions of barriers and levers of health-enhancing physical activity policies in mid-size French municipalities.

BACKGROUND: Policy is one of the levers for initiating structural change to foster the promotion of health-enhancing physical activity (HEPA). To this end, policy-makers have to deal with complex ecosystems embedded in specific contexts. However, limited research has been conducted on this topic at the local level. The purpose of this study was to identify the perceived barriers and levers of HEPA policies according to department heads and elected officials across various sectors in mid-size French municipalities. METHODS: This study used a mixed method primarily based on an adaptation of the concept mapping approach. A list of statements completing the sentence: 'In a mid-size municipal context, to develop HEPA policies, it is necessary to …' was submitted to key informants of 17 mid-sized French cities. Key informants in each municipality first rated the importance of each statement without considering their local context; they then rated the feasibility of each statement given their local context. In both cases, they used a Likert scale ranging from 1 to 6. RESULTS: A total of 23 municipal department heads and 10 elected officials from the sport (n = 14), health (n = 10) and social (n = 9) sectors in 11 mid-size French cities participated in this study. A list of 84 statements, sorted into 16 categories, was rated by participants according to their importance (M = 4.52, SD = 0.86) and their feasibility (M = 3.77, SD = 0.74). Potential barriers to (n = 10) and levers of (n = 38) HEPA policy development were identified. These results varied according to the position and sector of the participants. CONCLUSIONS: The results suggest that local contextual factors can affect the development of HEPA policies in mid-size French municipalities. The different perceptions of the potential levers and barriers according to sector might affect intersectoral collaboration. This study contributes by enhancing understanding of how local HEPA policies are developed in the French context.

Impact of improved urban environment and coaching on physical condition and quality of life in elderly women: a controlled study.

BACKGROUND: Physical activity can slow the ageing process and preserve autonomy in the elderly. The aim of this study was to assess the combined impact of an organized urban walking circuit and individual coaching on women senior citizens' physical well-being and quality of life. METHODS: Insufficiently physically active women >65 years were included in a quasi-experimental trial. Active arm: District with improved urban environment (IUE). Control arm: District without improved urban environment (WIUE). In each district, subjects were randomly allocated to receive coaching (C+ vs. C-). The main outcome measures were endurance, physical activity score, flexibility, quality of life, physical self-esteem, ageing exercise stereotypes, functional health and perceived health at baseline, three (M3) and six (M6) months. RESULTS: Fifty-two insufficiently physically active women were included, 23 in IUE and 29 in WIUE. Groups were comparable at baseline. At M3, endurance and physical activity score significantly improved compared with baseline in the IUE group and in the C+ group while no statistically significant change was observed for the WIUE group and the C- group. Moreover, endurance score was higher in the IUE group, whether coupled with coaching or not. After the coaching was removed, the IUE group regresses to baseline overall and the WIUE shows a decrement in endurance. CONCLUSION: Our study highlights the positive impact of an improved environment and of individual coaching on the level of physical activity and quality of life of insufficiently physically active elderly women.

Prospective evaluation of a high multiplexing real-time polymerase chain reaction array for the rapid identification and characterization of bacteria causative of nosocomial pneumonia from clinical specimens: a proof-of-concept study.

The purpose of this study was evaluation of the VAPChip assay based on the "Rapid-Array-PCR-technology" which targets 13 respiratory pathogens and 24 ß-lactam resistance genes directly on respiratory clinical specimens. The first step included analysis of 45 respiratory specimens in order to calibrate and determine the threshold for target genes. The second prospective step involved 85 respiratory samples from patients suspected of nosocomial pneumonia collected in two academic hospitals over an 8-month period. Results of the VAPChip assay were compared to routine methods. The first step showed a large proportion of positive signals for H. influenzae and/or S. pneumoniae. For identification, discrepancies were observed in seven samples. Thresholds were adapted and two probes were re-designed to create a new version of the cartridge. In the second phase, sensitivity and specificity of the VAPchip for bacterial identification were 72.9% and 99.1%, respectively. Seventy (82%) pathogens were correctly identified by both methods. Nine pathogens detected by the VAPChip were culture negative and 26 pathogens identified by culture were VAPChip negative. For resistance mechanisms, 11 probes were positive without identification of pathogens with an antimicrobial-susceptibility testing compatible by culture. However, the patient's recent microbiological history was able to explain most of these positive signals. The VAPChip assay simultaneously detects different pathogens and resistance mechanisms directly from clinical samples. This system seems very promising but the extraction process needs to be automated for routine implementation. This kind of rapid point-of-care automated platform permitting a syndromic approach will be the future challenge in the management of infectious diseases.

Testing the effect of text messaging cues to promote physical activity habits: a worksite-based exploratory intervention.

This study aims to test the efficacy of text messaging cues (SMS) to promote physical activity (PA) habit formation in the workplace. Employees (N = 49; 28 females and 21 males, Mage = 47.5 ± 8.29 years) were randomized into two parallel groups: a PA group enrolled in a 28-week supervised PA program and a PA+SMS group enrolled in the same PA program with text messaging cues received before their PA sessions. The exercise habit was assessed every week from self-reports on an online application. PA maintenance and several physical fitness measures were also assessed prior to and after the intervention to evaluate its general impact. Mixed model analysis of the 603 observations indicated a small but significant effect of the SMS cues on the speed at which participants engaged in PA behaviors, as the significant interaction effect revealed that the slope of the exercise habit over time was slightly steeper in the PA+SMS group (B = 0.0462, P = 0.0001) than in the PA group (B = 0.0216, P = 0.01). SMS delivery had a marginal effect on the maintenance of PA behaviors 1 year after the intervention. The results suggest that text messaging can help to form PA habits at the workplace and might facilitate long-term maintenance of PA behaviors.

Is motivation for marathon a protective factor or a risk factor of injury?

This research investigated whether and how self-determined motivation predicts perceived susceptibility to injury during competition (marathon). Two correlational studies including 378 (Study 1) and 339 (Study 2) marathon runners were conducted. Participants filled out a questionnaire the day before the race measuring self-determined motivation, perceived susceptibilities to marathon-related injury and to keep running through pain, and control variables. Study 1 showed that self-determined motivation was negatively related to perceived susceptibility to marathon-related injury. Study 2 replicated this finding and showed that this relationship was partially mediated by perceived susceptibility to keep running through pain during the race. Moreover, results indicated that the predictive role of self-determination was mostly driven by controlled forms of motivation, and more particularly external regulation. These results suggest that self-determined motivation for sport is a protective factor of injury.

[External and internal validity of a multidimensional Locus of control scale of eating attitudes for athletes (LOCSCAS)]. / Étude de la validité interne et externe d'une échelle multidimensionnelle de Locus de contrôle spécifique aux comportements alimentaires des sportifs (LOCSCAS).

In the field of health psychology, the control has consistently been considered as a protective factor. This protective role has been also highlighted in eating attitudes' domain. However, current studies use the one-dimensional scale of Rotter or the multidimensional health locus of control scale, and no specific eating attitudes' scale in the sport context exists. Moreover, the social influence in previous scales is limited. According to recent works, the purpose of this study was to test the internal and external validity of a multidimensional locus of control scale of eating attitudes for athletes. One hundred and seventy-nine participants were solicited. A confirmatory factorial analysis was conducted in order to test the internal validity of the scale. The scale external validity was tested in relation to eating attitudes. The internal validity of the scale was verified as well as the external validity, which confirmed the importance of taking into consideration social influences. Indeed, the 2 subscales "Trainers, friends" and "Parents, family" are related respectively positively and negatively in eating disorders.

Can exercise change the stereotypes associated with individuals with cancer?

The purpose of this study was to examine whether exercising can positively influence the stereotypes associated with individuals with cancer and, more specifically, have an effect on the impression formation related to warmth and competence. A total of 193 French college students (Mage = 21.08, SD = 1.44 years; 88 females and 105 males) were randomly assigned to one of the conditions of a 2 (participant sex) × 2 (target health status: cancer vs no information) × 3 (target exercise status: exerciser vs non-exerciser vs no information) experimental design. Results indicated that exercising target with cancer was perceived as the most competent compared with targets with cancer and those without information about cancer. These results suggest that exercising could be an effective way to undermine cancer stereotypes and reduce discrimination against people with cancer.

Analytical validation of a novel high multiplexing real-time PCR array for the identification of key pathogens causative of bacterial ventilator-associated pneumonia and their associated resistance genes.

OBJECTIVES: Rapid diagnosis and appropriate empirical antimicrobial therapy before the availability of conventional microbiological results is of pivotal importance for the clinical outcome of ventilator-associated pneumonia (VAP). We evaluated the VAPChip, a novel, closed cartridge molecular tool aiming to identify directly from clinical samples and within a working day the principal bacteria causative of VAP as well as clinically relevant ß-lactam resistance genes. METHODS: The Real-time Array PCR for Infectious Diseases (RAP-ID) is a novel technology that combines multiplex PCR with real-time microarray detection. The VAPChip is a closed cartridge kit adapted to the RAP-ID instrument that targets 13 key respiratory pathogens causative of VAP and 24 relevant antimicrobial resistance genes that mediate resistance to ß-lactam agents, including extended-spectrum cephalosporins and carbapenems. Analytical validation of the VAPChip was carried out blindly on a collection of 292 genotypically characterized bacterial reference and clinical isolates, including 225 isolates selected on the basis of their species identification and antimicrobial resistance profiles and 67 bacterial isolates belonging to the oropharyngeal flora not targeted by the array. RESULTS: The limit of detection of the assay lies between 10 and 100 genome copies/PCR and the dynamic range is five orders of magnitude permitting at least semi-quantitative reporting of the results. Sensitivity, specificity and negative and positive predictive values ranged from 95.8% to 100% for species identification and detection of resistance genes. CONCLUSIONS: VAPChip is a novel diagnostic tool able to identify resistant bacterial isolates by RAP-ID technology. The results of this analytical validation have to be confirmed on clinical specimens.

[Development and factorial validity of a moral disengagement in Sport Short Scale]. / Développement et validation d'une échelle courte mesurant le désengagement moral en sport (ECDMS).

BACKGROUND: According to Bandura, individuals are able to violate their personal standards, without self-sanction, by using the psychological operations of moral disengagement. For Bandura et al., moral disengagement is characterized by eight mechanisms belonging to one of the following four groups: (a) reconstructing conduct; (b) reconsideration of negative effects; (c) disqualification of the victim; and (d) obscuring of personal causal agency. Other researchers have measured moral disengagement in various contexts of everyday life using Bandura et al.'s scale and suggested that moral disengagement mechanisms would fall into two or three groups according to context. One context in which moral issues have a major role is sport. METHODS: Three complementary studies were carried out on a total of 1305 young French adult athletes to develop and validate a Short French Questionnaire of Moral Disengagement in Sport (SFQMDS) and to test its invariance according to gender. STUDY 1: With reference to the existing literature, an initial French version of the SFQDMS was developed. French university students (n=220) then voluntarily completed the questionnaire. The validity of this preliminary version and the clarity of the items were examined and ascertained, and factorial analyses identified 10 items that loaded onto two factors (i.e., projecting fault onto others or sharing of responsibility; minimization of transgression and their consequences). Each factor displayed good internal consistency. STUDY 2: Confirmatory factor analysis (CFA) was conducted using AMOS 7.0 software. The sample included 1021 French university students (M(age)=21.52; SD=2.34). The first analysis of the data from 298 French students suggested that four items should be eliminated. The six-item model was then tested with a CFA of the data from 723 other participants (M(age)=21.51; SD=2.34) and exhibited acceptable fit indices: (χ² [8, 723]=1.54; p>0.09; GFI=0.97; TLI=0.97; CFI=0.97; RMSEA=0.03; RMSEA LO/HI=0.01/0.05). These results confirmed the bifactorial structure of the instrument, as well as its partial invariance across genders at the most complex level (i.e., strict) of its factorial structure. These statistical analyses demonstrated the excellent internal consistency and very good construct validity of the SFQDMS. STUDY 3: The third study examined the temporal stability of the SFQDMS and its theoretical validity with a sample of 221 French students (M(age)=21.00; SD=2.05). Our results were found to be stable over time. From a theoretical standpoint, the SFQDMS was related to existing instruments that measure individuals' affective self-regulatory efficacy and prosocial behavior. These results demonstrated the external validity of the instrument. CONCLUSION: The overall results presented in these studies confirmed the good psychometric properties of the SFQDMS. This questionnaire consists of two subscales of three items measuring two groups of moral disengagement. The first involves projecting the fault for one's own transgressions onto others or sharing of responsibility (e.g., "It's not my fault if I behave badly [cheating or aggression] because it's my opponent who started it"). The second subscale involves the minimization of transgressions and their consequences (e.g., "It's not serious if I behave badly [cheating or aggression] because I do it to keep the advantage"). This instrument is a reliable tool that could be fruitfully used in future research addressing the moral disengagement of French adolescents or adults in sport. A deeper understanding of the processes involved in moral disengagement would facilitate the development of strategies to prevent or remediate transgressive behavior in the sport domain.

Effect of locus of control on disordered eating in athletes: the mediational role of self-regulation of eating attitudes.

This study examined the influence of locus of control on disordered eating as mediated by the self-regulation of eating attitudes. The assessment instruments were adapted for athletes as the entire sample of 179 volunteer University students (M(age)=21.12; SD=2.87) were all regularly involved in competition. The results showed that (a) an internal locus of control had a positive influence on the self-regulation of eating attitudes in social interaction contexts; (b) self-regulatory eating attitudes had a negative influence on disordered eating in contexts of negative affect, social interaction, and lack of anticipation of consequences on performance; and (c) an internal locus of control had an influence on disordered eating through the mediation of self-regulatory eating attitudes in social interaction contexts, and an external locus of control attributed to the coach and sports friends had an influence on disordered eating through the mediation of self-regulatory eating attitudes in contexts of negative affect, social interaction and lack of anticipation of consequences on performance. This study, combined with an earlier study from Scoffier, Maïano, and d'Arripe-Longueville (2009) on the antecedents of athletes' eating disorders, suggests the powerful impact of the social environment on the development of disordered eating in athletes.

Development and validation of the French Self-Regulatory Eating Attitude in Sports Scale.

In this study, the French Self-Regulatory Eating Attitude in Sports Scale (SREASS) was developed and then validated. Five subscales measure the control of eating attitude in contexts of: (a) food temptation, (b) negative affects, (c) social interaction, (d) lack of compensatory strategy, and (e) lack of anticipation of consequences on performance. The validation procedure required the participation of 527 student athletes and four successive studies to develop and present a preliminary scale and assess the clarity of the items (study 1), evaluate the factorial structure validity of the scale and test the invariance across gender (study 2), assess the time stability (study 3), and assess the external validity of the instrument (study 4). The present results provide preliminary evidence for the appropriateness of the SREASS for French student athletes. Nevertheless, further evaluation of this instrument is warranted to establish the robustness of the present findings.

Comparative clinical and transcriptomal profiles of breast cancer between French and South Mediterranean patients show minor but significative biological differences.

BACKGROUND: In Western countries, breast cancer incidence and mortality are higher than in Mediterranean countries. These differences have been ascribed to environmental factors but also to late-stage diagnostic and biological specific characteristics. PATIENTS AND METHODS: Between September 2002 and September 2005, we collected clinical data by phone counselling 180 French and Mediterranean breast cancer patients and performed microarray experiments. RESULTS: Characteristics of breast cancer in patients from Lebanon, Tunisia and Morocco were more aggressive (more SBR grade III and positive node invasion) and patients were 10 years younger at diagnosis. Sixteen differentially expressed genes such as MMP9, VEGF, PHB1, BRCA1, TFAP2C, GJA1 and TFF1 were also found. Additionally, an up-regulation of cytokeratins KRT8 and KRT18 may indicate a luminal B subtype in "South" (Lebanon, Tunisia and Morocco) tumors while "North" (France) tumors may more frequently be luminal A type. CONCLUSION: This study allowed the identification of specific clinical and transcriptomic parameters in patients from South Mediterranean countries.

Gene expression profiling of LPS-stimulated murine macrophages and role of the NF-kappaB and PI3K/mTOR signaling pathways.

Lipopolysaccharide (LPS), a major component of the outer membrane of Gram-negative bacteria, activates a broad spectrum of signaling pathways in immune cells. In this article, RAW264.7 cells have been stimulated for 4 h with 1 microg/mL of LPS in the presence or not of specific inhibitors of the NF-kappaB pathway (BAY 11-7082) and the PI3K pathway (LY294002). Gene expression profiles were characterized using the DNA microarray "Dual Chip Mouse Inflammation." This array monitors the expression of 233 genes encoding proteins playing a role in inflammation. Both signaling pathways exert an important role in the response to LPS, but they are not completely overlapping. For example, genes encoding the PAF receptor, PAI-1, PlA2 (group V), IL-13 receptor (alpha2), and GTP cyclohydrolase 1, were upregulated after LPS treatment, but this upregulation was counteracted by LY294002. The same was observed for BAY 11-7082: genes encoding the kit ligand, TLR2, or TNFRSF5 were mainly under the control of NF-kappaB. NF-kappaB plays an important role in the macrophage response to LPS, but we have also shown that the PI3K pathway partially contributes to it. Further experiments with the specific inhibitor of mTOR (rapamycin) will provide more information on the specific contribution of the PI3K/mTOR pathway in the inflammatory response in LPS-stimulated macrophages.

DNA microarrays as a tool in toxicogenomics.

Toxicogenomics is an emerging technology that defines the use of novel genomic techniques to investigate the adverse effects of xenobiotic on gene expression. Toxicogenomics is based on the fact that most of relevant toxicological effects of a compound affect directly or indirectly the gene expression. The most common methods to profile gene expression at the transcript level are Northern Blotting and the real-time PCR. While commonly used and well accepted, these techniques are now superseded by new technologies allowing the analysis of the expression for multiple genes simultaneously. DNA microarrays are now developed for simultaneous gene analysis but inherent to such multiple assays, their quantitative aspect and their relevance for toxicogenomics have been questioned. We will review here recent studies on their use for toxicogenomics and examine the possible future of such technology in complementation with the other toxicology methods.

Colorimetric silver detection of DNA microarrays.

Development of microarrays has revolutionized gene expression analysis and molecular diagnosis through miniaturization and the multiparametric features. Critical factors affecting detection efficiency of targets hybridization on microarray are the design of capture probes, the way they are attached to the support, and the sensitivity of the detection method. Microarrays are currently detected in fluorescence using a sophisticated confocal laser-based scanner. In this work, we present a new colorimetric detection method which is intented to make the use of microarray a powerful procedure and a low-cost tool in research and clinical settings. The signal generated with this method results from the precipitation of silver onto nanogold particles bound to streptavidin, the latter being used for detecting biotinylated DNA. This colorimetric method has been compared to the Cy-3 fluorescence method. The detection limit of both methods was equivalent and corresponds to 1 amol of biotinylated DNA attached on an array. Scanning and data analysis of the array were obtained with a colorimetric-based workstation.

Spinal proerectile effect of oxytocin in anesthetized rats.

The spinal cord contains the neural network that controls penile erection. This network is activated by information from peripheral and supraspinal origin. We tested the hypothesis that oxytocin (OT), released at the lumbosacral spinal cord level by descending projections from the paraventricular nucleus, regulated penile erection. In anesthetized male rats, blood pressure and intracavernous pressure (ICP) were monitored. Intrathecal (it) injection of cumulative doses of OT and the selective OT agonist [Thr(4),Gly(7)]OT at the lumbosacral level elicited ICP rises whose number, amplitude, and area were dose dependent. Thirty nanograms of OT and one-hundred nanograms of the agonist displayed the greatest proerectile effects. Single injections of OT also elicited ICP rises. Preliminary injection of a specific OT-receptor antagonist, hexamethonium, or bilateral pelvic nerve section impaired the effects of OT injected it. NaCl and vasopressin injected it at the lumbosacral level and OT injected it at the thoracolumbar level or intravenously had no effect on ICP. The results demonstrate that OT, acting at the lumbosacral spinal cord, elicits ICP rises in anesthetized rats. They suggest that OT, released on physiological activation of the PVN in a sexually relevant context, is a potent activator of spinal proerectile neurons.

Oxytocinergic innervation of autonomic nuclei controlling penile erection in the rat.

In the rat, spinal autonomic neurons controlling penile erection receive descending pathways that modulate their activity. The paraventricular nucleus of the hypothalamus contributes oxytocinergic fibers to the dorsal horn and preganglionic sympathetic and parasympathetic cell columns. We used retrograde tracing techniques with pseudorabies virus combined with immunohistochemistry against oxytocin and radioligand binding detection of oxytocinergic receptors to evidence the oxytocinergic innervation of thoracolumbar and lumbosacral spinal neurons controlling penile erection. Spinal neurons labelled with pseudo-rabies virus transsynaptically transported from the corpus cavernosum were present in the intermediolateral cell column and the dorsal gray commissure of the thoracolumbar and lumbosacral spinal cord. Confocal laser scanning microscopic observation of the same preparations revealed close appositions between oxytocinergic varicosities and pseudorabies virus-infected neurons, suggesting strongly the presence of synaptic contacts. Electron microscopy confirmed this hypothesis. Oxytocin binding sites were present in the superficial layers of the dorsal horn, the dorsal gray commissure and the intermediolateral cell column in both the thoracolumbar and lumbosacral segments. In rats, stimulation of the paraventricular nucleus induces penile erection, but the link between the nucleus and penile innervation remains unknown. Our findings support the hypothesis that oxytocin, released by descending paraventriculo-spinal pathways, activates proerectile spinal neurons.

Expression of alpha 1 adrenoceptor subtypes in rat corpus cavernosum.

Norepinephrine mediates the antierectile role of the sympathetic nervous system. It binds to postsynaptic alpha 1 adrenoceptors present on smooth muscle fibers of the corpus cavernosum. Receptor cloning studies have evidenced three alpha 1 adrenoceptor subtypes: alpha 1A, alpha 1B and alpha 1D. We searched for the presence of these three alpha 1 adrenoceptor subtypes in the rat corpus cavernosum using in situ hybridization with specific oligonucleotide probes. Brain tissue was used as the reference of probes specificity. Autoradiographic films were studied with light illumination and computer-assisted densitometry using an image analyser. We provide evidence that the three alpha 1 adrenoceptor subtypes are expressed in the rat corpus cavernosum. These three subtypes appear to be more expressed in the trabecular smooth muscle fibers than in vascular smooth muscle fibers. Further experiments are needed to determine whether the proportion of alpha 1 adrenoceptor subtypes changes according to the etiology of erectile dysfunction. This morphological approach provides a basis for future pharmacological research of specific alpha 1 adrenoceptor subtypes blocking agents designed to treat erectile dysfunction.