[Health anxiety: Another epidemic to prepare for]. / L'anxiété centrée sur la santé : une autre épidémie à laquelle il faut se préparer.

Health anxiety (HA) is a frequent problem (up to 20% of consultants in the context of secondary care) responsible for decreased well-being, disability, somatic and psychiatric complications, which contributes to high healthcare expenditures at the population level. It is likely, if not definitely established, that the prevalence of ACS is increasing, and this can partly be explained by the growing medicalization of society in general, the appetite of Media for health issues, and the uncontrolled use of the Internet (which can lead certain vulnerable subjects to cyberchondria). The pandemic of COVID-19 could have contributed to it, at least by the significant increase in the overall level of psychological distress in the population it has caused, although this has not formally been demonstrated to date. The diagnosis of ACS is easy, as soon as its assessment is considered as a mandatory part of any medical consultation. Certain intuitive attitudes of doctors, such as reassurance, prove to be iatrogenic for the patient with HA. The management of HA can be facilitated by an acculturation of physicians to cognitive conceptions of anxiety in general and HA in particular. HA is effectively treatable by certain psychotherapy and in the first place cognitive and behavioral therapies (CBT), but the availability of trained therapists and accessible at a lower cost is sorely lacking, particularly in France.

[Clinical path and life quality of women under 75 years with an urinary incontinence relevant to surgical treatment]. / Parcours de soins et qualité de vie des femmes de moins de 75 ans relevant d'une prise en charge chirurgicale pour incontinence urinaire.

OBJECTIVES: Urinary incontinence has a high prevalence and a significant impact on quality of life, especially for women. Surgery is possible after failure of lifestyle changes, physiotherapy. Analyzing the care pathway of women under 75 years of age who have undergone surgery for urinary incontinence in link with recommendation and suggest possible improvements. METHODS: Quantitative, multicentric, retrospective survey carried out between 10/09/2019 and 25/11/2019, based on anonymous self-report questionnaire, among women aged between 32 and 75 and operated in different hospitals in Loire (France). RESULTS: Ninety-three answers were exploited out of 204. Among the women, 49.5 % had stress, 50.5 % mixed incontinence. Before the intervention, it had evolved for 5 years on average and caused discomfort evaluated at an average 7.5/10. Eighty percent frequently used protective pads and bladder training. Lifestyle changes and the voiding diary were not used much. Eighty-six percent of women felt comfortable to speak to a physician. Seventy-three percent had performed a urodynamic test, 47 % an abdominal ultrasound and 40 % a urinalysis. Seventy-seven percent performed physiotherapy, 39 % self-administered physiotherapy, 7 % used medication. The postoperative quality of life was evaluated at 7.8/10; 58 % felt healed and 69 % considered their sex life had improved. CONCLUSIONS: The care pathway could be improved through systematic screening for urinary incontinence and its impact. The development of a care plan to coordinate and propose quick care could help patients to improve their life.

Care through cohort studies: sociological survey of the PROOF cohort study on vascular and cognitive aging.

BACKGROUND: The success of health research depends on the involvement of participants. Few studies have examined the participation of subjects in cohorts. Drawing on a sociological survey on a French cohort around aging, this study proposes to question the nature of interactions between researchers and subjects that would help to understand the motivations of subjects to participate and remain in health research studies. METHODS: Qualitative study combining participant observation within the research laboratory that conducted the cohort and semi-structured interviews with subjects included in the cohort and with members of the research team. RESULTS: This study highlights the existence of two-way care: from the laboratory to the subjects and from the cohort to researchers. Health research seems to correspond to a complex association between subjects concerned with aging and the expected benefits of exceptional monitoring. Research is incorporated into subjects' daily lives, allowing a shift in the purpose of research from overmedicalization to medical safety that subjects experienced as a form of care. CONCLUSIONS: In cohort studies, care is understood as a form of attention to the person through high-quality medical follow-up. Aging is turned into a matter of concern that subjects, in collaboration with researchers, strive to control.

Human papillomavirus (HPV) vaccination: What can be found on the Web? Qualitative analysis of the Doctissimo.fr forum data.

BACKGROUND: Vaccine hesitancy is a major issue in general practice. Regarding human papillomavirus, less than 20% of young French girls are vaccinated. With widespread availability of health information, the Internet seems to be a place of choice to discuss this reluctance. The main objective of this study was to explore perceptions of human papillomavirus vaccination through an analysis of the Doctissimo.fr forum data. METHODS: Using Nvivo software, a qualitative study was carried out from October 2017 to May 2018 on the Doctissimo.fr discussion forum. Online discussion threads not having any message since 2010 were excluded. All threads were analyzed by two independent evaluators. RESULTS: Faced with the doubt that emanated from the discussions and the confusion about the role of the vaccine, Internet users used multiple references in order to develop a reliable discourse. The general practitioner remained a trusted person. While the vaccine was perceived as risky, the cervical smear was approved and encouraged. Although the vaccine remained a feminine concern, males also entered this debate. Through their shared experiences, Internet users tried to influence others about whether or not to get vaccinated. CONCLUSION: Changing the sexual image of the vaccine could help to establish a collective vaccination policy. Public health policies play an essential role by working with general practitioners and by increasing visibility on the web. The usefulness of the vaccine in 2019 seems to be questioned by Internet users as shown by their major approval of cervical smears. However, these two methods remain complementary in the fight against cervical cancer.

[One or more functional somatic syndromes? Comparison of the health status of fibromyalgia and electro-hypersensitive people]. / Un ou plusieurs syndromes somatiques fonctionnels ? Comparaison de l'état de santé de personnes fibromyalgiques et électro-hypersensibles.

INTRODUCTION: Functional somatic syndromes, grouping somatic symptoms without an organic explanation, are defined either by their predominant symptoms or by an attribution to an, often hypothetical, cause. Due to many similarities, some authors consider that there is only one FSS due to a general phenomenon of "somatization". The objective of this work was to compare two functional somatic syndromes, one defined by its symptoms, fibromyalgia, and the other by a specific contested attribution, electro-hypersensitivity. METHOD: Fibromyalgia or electro-hypersensitive participants (EHS) were recruited from September 2016 to April 2017 through associations of patients in Auvergne-Rhône-Alpes. Home interviews included the collection of medical, psychopathological, and symptom histories. The assessment of psychological distress, quality of life and the search for other functional somatic syndromes was performed through structured questionnaires, self-administrated scales, and clinical examination. RESULTS: Sixteen fibromyalgia subjects and sixteen EHS subjects were included. There are differences in symptomatology, although many symptoms are common to both conditions. Lifetime history of psychiatric disorders and current psychological distress and psychopathology are frequent in both groups but more prevalent in fibromyalgia subjects. The experience of the symptoms, their interpretation, the diagnostic itineraries and the therapeutic behaviours differ radically according to the group, even if for all socio-professional impact is high and quality of life are altered. CONCLUSION: The health status of fibromyalgia persons is overall worse than the health status of electro-hypersensitive individuals in this small sample. Despite the overlap in symptoms and a similar impact on daily functioning, this exploratory study suggests that heterogeneous mechanisms of "somatization" may be at stake in functional somatic syndromes.

Treatment of dilute methylene blue-containing wastewater by coupling sawdust adsorption and electrochemical regeneration.

In the present work, the coupling of adsorption and electrochemical oxidation on a boron-doped diamond (BDD) electrode to treat solutions containing dyes is studied. This coupling may be convenient for the treatment of diluted pollutant that is limited by the low rate of electrooxidation due to mass-transfer limitation. A pre-concentration step by adsorption could minimize the design of the electrochemical reactor. The adsorbent chosen was mixed with softwood sawdust, and methylene blue was chosen as the model dye molecule. Isotherms of adsorption and kinetics were investigated as well as the effects of current density and regeneration time. The BDD electrochemical oxidation of methylene blue adsorbed onto sawdust led simultaneously to its degradation and sawdust regeneration for the next adsorption. It was observed that multiple adsorption and electrochemical regeneration cycles led to an enhancement of adsorption capacity of the sawdust. This study demonstrated that adsorption­electrochemical degradation coupling offers a promising approach for the efficient elimination of organic dyes from wastewater.