Interpenetration Phenomena via Anion Template Effects in Fe(II) and Co(II) Coordination Networks with a Bis-(1,2,4-triazole) Ligand.

Seven new coordination networks, [Fe(tbbt)3](BF4)2 (1), [Co(tbbt)3](BF4)2 (2), [Fe(tbbt)3](ClO4)2 (3), [Co(tbbt)3](ClO4)2 (4), [Fe(NCS)2(tbbt)2] (5), [Co(NCS)2(tbbt)2] (6), and [Fe(H2O)2(tbbt)2]Br2·2H2O (7), were synthesized with the linker 1,1'-(trans-2-butene-1,4-diyl)bis-1,2,4-triazole (tbbt) and structurally investigated. The structure of complexes 1-4 is composed of three interpenetrating, symmetry-related 3D networks. Each individual 3D network forms a primitive, nearly cubic lattice (pcu) with BF4- or ClO4- anions present in the interstitial spaces. The structure of compounds 5 and 6 is composed of two-dimensional sql layers, which are parallel to each other in the AB stacking type. These layers are interpenetrated by one-dimensional chains, both having the same formula unit, [M(NCS)2(tbbt)2] (M = Fe, Co). The structure of compound 7 consists of parallel, two-dimensional sql layers in the ABCD stacking type. The interpenetration in 1-6 is not controlled by π-π-interactions between the triazole rings or C=C bonds, as could have been expected, but by (triazole)C-H⋯F4B, C-H⋯O4Cl, and C-H⋯SCN anion hydrogen bonds, which suggests a template effect of the respective non-coordinated or coordinated anion for the interpenetration. In 7, the (triazole)C-H⋯Br anion interactions are supplemented by O-H⋯O and O-H⋯Br hydrogen bonds involving the aqua ligand and crystal water molecules. It is evident that the coordinated and non-coordinated anions play an essential role in the formation of the networks and guide the interpenetration. All iron(II) coordination networks are colorless, off-white to yellow-orange, and have the metal ions in the high-spin state down to 77 K. Compound 5 stays in the high spin state even at temperatures down to 10 K.

COMT Val158Met Polymorphism and Social Impairment Interactively Affect Attention-Deficit Hyperactivity Symptoms in Healthy Adolescents.

The dopaminergic system has been shown to have substantial effects on the etiology of attention-deficit hyperactivity disorder (ADHD). However, while some studies found a significant direct effect, others did not. In this context, social behavior might play an important role as a factor that is related both to the dopaminergic system and ADHD. In a large epidemiological sample of adolescents (N = 462; 16-17 years), we assessed the level of ADHD symptoms using the Strengths and Difficulties Questionnaire, social behavior using the Social Responsiveness Scale, and the allelic distribution of the dopaminergic catechol-O-methyltransferase (COMT) Val158Met polymorphism. We found a significant association between COMT and social impairment, insofar as Met-allele carriers showed increased levels of social impairment. Moreover, social impairment significantly determined an association between COMT and ADHD (explained variance: 19.09%). This effect did not significantly differ between males and females. COMT and social impairment might interactively affect ADHD symptomatology, and could thus represent significant gene-phenotypic risk factors for ADHD symptomatology. This might have interesting implications for prevention and intervention strategies with a focus on social behavior in genetically at-risk individuals.

Exploring the clinical approach to the bimodal fitting of hearing aids and cochlear implants: results of an international survey.

CONCLUSIONS: The results show that the fitting of a contralateral hearing aid (HA) in the non-implanted ear of cochlear implant (CI) recipients is now well established as standard clinical practice. However, there is a lack of experience in HA fitting within the CI centres and the use of published bimodal fitting procedures is poor. The HA is often not refitted after CI switch-on and this may contribute to rejection. Including a bimodal fitting prescription and process in the CI fitting software would make applying a balancing procedure easier and may increase its implementation in routine clinical practice. OBJECTIVE: This survey was designed to investigate and understand the current approach to bimodal fitting of HAs and CIs across different countries and the recommendations made to recipients. METHODS: Clinicians working with HAs and/or CIs were invited to participate in an international multicentre clinical survey, designed to obtain information on the various approaches towards bimodal hearing and CI and HA device fitting. Forty-one questions were presented to clinicians in experienced CI centres across a range of countries and answers were collected via an online survey. RESULTS: In all, 65 responses were obtained from 12 different countries. All clinicians said they would advise a CI user to wear a contralateral HA if indicated. However, a significant number (45%) had either never fitted HAs before or had less than 1 year of experience. In general, there were no specific criteria for selecting candidates to fit with an HA. A strategy to balance the HA with the CI was not used as a standard practice for any of the adults and was used in only 12% of the children. Only half the respondents were aware of the bimodal literature. The majority of professionals (18/30) did not refit the HA after CI switch-on. However, if users complained of sound quality or loudness issues or had poor test results, a follow-up session was provided. The main benefit reported by recipients was improvement in overall sound quality.

[Health of adolescents restricted under court order: self-esteem, perceived parental support, projects]. / Santé des jeunes sous main de justice : estime de soi, soutien parental perçu, projets.

OBJECTIVE: To describe certain aspects of the physical and mental health of adolescents with restricted or deprived liberty as ordered by the court within the Youth Judicial Protection Service (YJP), and their ability to project themselves into the future. METHODS: Survey by on-line self-administered questionnaires. POPULATION: Among the adolescents, 373 were randomly selected with restricted or deprived liberty, in the Lorraine region (eastern France). STATISTICAL ANALYSIS: The data were managed and analyzed using the Modalisa(®) 7.0 (Kynos, Paris, France) survey processing software. Depending on the type of variable, comparisons were made using the chi-square test or analysis of variance. The significance threshold used was P<0.05. MAIN RESULTS: The response rate was 47%. The respondents included 820% boys and 18% girls, with a mean age of 16.4±1.5 years. More than nine out of ten stated that they were satisfied with their health. Among the girls, 16.7% stated that they had already had thoughts of suicide (boys, 3.8%; P<0.05). Of the total population, 24% said that during the last 12 months, they had needed to see a doctor (or healthcare professional), but they had had to give up the consultation at least once (too far, too expensive, etc.). Their average overall Rosenberg self-esteem score was 32.4±6.4, roughly the same as their peers in the general population (girls, 28.2; boys, 33.2; P<0.05). They said that they had projects for the future and nearly eight out of ten stated that they were confident in their own ability to succeed in their life, especially those who felt supported by their parents. DISCUSSION: To our knowledge, these facts had never been explored among adolescents with restricted or deprived liberty. This study shows results that do not match the usual representation of these adolescents by healthcare or education professionals. The quality of the work during the educational support given by the YJP Service could help explain these results. CONCLUSION: These findings need to be explored further by additional studies, which could also aim to measure the impact on physical and mental health of the educational support given by Youth Judicial Protection Service.

[Sleep and academic performance in young elite athletes]. / Sommeil et résultats scolaires chez les jeunes sportifs de haut niveau.

RATIONALE: In French law (Code du Sport), the status of elite athlete is allowed for young athletes beginning at the age of 12 years. For these young athletes, the aim is to reach the highest level of performance in their sport without compromising academic performance. Training time is therefore often substantial and sleep patterns appear to play a key role in performance recovery. The aim of this study was to assess sleep patterns and their effects on academic performance in young elite athletes. MATERIAL AND METHODS: Sleep patterns were assessed using questionnaires completed during a specific information-based intervention on sports medicine topics. The academic performance of young elite athletes was assessed by collecting their grades (transmitted by their teachers). RESULTS: Sleep patterns were assessed for 137 young elite athletes (64 females, 73 males; mean age, 15.7 years) and academic performance for 109 of them. Daily sleep duration during school periods (8h22 ± 38 min) were shorter compared to holidays and week-ends (10h02 ± 1h16, P<0.0001). Fifty-six athletes (41 %) subjectively estimated their sleep quality as poor or just sufficient. Poor sleep quality was correlated with poor academic performance in this specific athlete population. DISCUSSION: Sleep is the most important period for recovery from daily activity, but little information is available regarding the specific population of young elite athletes. The results reported herein suggest insufficiency (quantitatively and qualitatively) of sleep patterns in some of the young athletes, possibly leading to detrimental effects on athletic performance. Moreover, disturbed sleep patterns may also impact academic performance in young elite athletes. CONCLUSION: Teachers, athletic trainers, physicians, and any other professionals working with young elite athletes should pay particular attention to this specific population regarding the possible negative repercussions of poor sleep patterns on academic and athletic performance.

Advising parents on physical activity for children between 0 and 5 years.

AIM: Physical activity is thought to have a crucial role to play in health, psychomotor development and habit formation for children between 0 and 5 years old. However, all children under 6 are not as active as recommended in the literature. OBJECTIVE: to provide physicians with some guidelines, based on the principle of Early Screening and Brief Intervention, in order to encourage parents with young sedentary children to be more active. METHODS: Literature review, development of a decision algorithm, analysis by professionals. Results: Data were gathered from Medline Pubmed, Cochrane Library, and the French Database in Public Health (any date to November 2009). Papers which did not give enough details (length, nature, etc.) on the advice were rejected and papers which dealt with a brief consultation, or with advice that was given either to a whole group of people, or that was given by several health professionals during the course of a personal coaching program. RESULTS: For instance, 1 492 hits were found after researching the terms screening and brief intervention on Medline, but there were only 12 when the research was run together with the terms (physical activity or active play or exercise) and primary care. A decision algorithm to advise parents was developed, based on Early Screening and Brief Intervention principle. This tool should be usable by every doctor in primary care. "Early screening" starts with the parents being asked questions concerning their young child's physical activity, and "Brief Intervention" is based on existing recommendations, as well as recent studies on the key factors linked to physical activity in very young children. CONCLUSION: The ESBI approach proved successful when applied to psychoactive substances and merits testing in the field of physical activity. Further studies are needed to provide doctors with efficient tools to evaluate physical activity during a consultation.

[General practioners and medical guidelines: a sociological approach]. / Médecins généralistes et recommandations médicales : une approche sociologique.

BACKGROUND: While designed to help physicians in their account of the changing state of the art and of the evidence-based medicine, the situation of the medical guidelines seem to be critical: they need time, they are too complex, they deal with pathologies as if they were isolated from the whole context. METHODS: In the survey, 279 general practioners were asked to answer a scenario dealing with these difficulties. RESULTS: More than a half of the practitioners interviewed approve the increasing role of guidelines in medical practice and say they try to take them into account, but they also say they generally rely on their own medical experience to operate a selection among the impressive set of guidelines they receive. The more they agree with an evidence-based medicine, the more they tend to accept the guidelines as a necessary dimension of their art. CONCLUSION: The inquiry leads to a contrasted opinion: on the one hand, it incites to ameliorate the whole guidelines making process (paying attention to let the bottom up informations penetrate the process), and on the other hand, to admit that the imperfect appropriation of these norms is the presently best way to match the "saintly models" of medicine with the unescapable "dirty work" of everyday practice (as in the "strength of weak ties" effect).

Doping prevalence among preadolescent athletes: a 4-year follow-up.

OBJECTIVE: To describe the prevalence of doping and its progression in a cohort of preadolescent athletes during a 4-year follow-up. DESIGN AND SETTINGS: Prospective cohort study. Self-questionnaire survey. PARTICIPANTS: All of the pupils entering the first year of secondary school (sixth grade) in the Vosges Département (east France) and followed for 4 years. MAIN OUTCOME MEASUREMENTS: Drug use (prohibited substances, tobacco, alcohol, cannabis), intention to use, reported health hazards, perceived drug effectiveness, self-esteem, trait anxiety. RESULTS: At the beginning of the study, 1.2% (95% CI 0.8 to 1.6) stated that they had taken doping agents at least once in the preceding 6 months, and this had risen to 3.0% (95% CI 2.3-3.7) 4 years later (p<0.001). Of those who had used doping agents, 4% reported that they had experienced a health problem related to doping, and 44% reported that they had won at least one sports event as a result of using the drug. Use of doping agents is linked to the number of hours of practice per week, intention to use, use of other drugs, self-esteem and trait anxiety. CONCLUSIONS: The results show that doping does exist in preadolescent athletes who train every day. This fact should to be taken into account in preventive actions.

[Representations of clinical practice guidelines by general practitioners]. / Représentations des recommandations professionnelles par les médecins généralistes.

The objective of this study is to understand the representations of general practitioners in regards to clinical practice guidelines. Two general practitioners samples have been studied according to two analytical methods: the method of scenarios, sent by e-mail to doctors belonging to a network, and a round table gathering volunteers having answered the scenario and drawn lots. 279 answers were received from 252 men and 27 women (response rate of 80%); eleven doctors (4 women) participated in the round table. Results analysis shows that the credibility of the scenario is judged as very good. Only 39% of the referees estimated that practice guidelines are little useful. The ideal type of answers was established. Five themes appeared from the debate, the main two being the elaboration of the guidelines and the measured opposition between medicine applied to individuals and epidemiology. The majority of the physicians considered clinical guidelines as a trump card, at the same moment as a tool and as an instigation, but found them difficult to hold and asked for their improvement.

Drugs, recreational drug use and attitudes towards doping of high school athletes.

The purpose of this investigation was to determine the substances used, and the attitudes towards doping of high school athletes. A four-page, self-completed questionnaire was designed to determine the drugs used (licit, illicit and doping substances) along with beliefs about doping and the psychosociological factors associated with their consumption. The questionnaire was distributed to all the high school students enrolled in a school sports association in the Lorraine region in Eastern France. The completed forms were received from 1459 athletes: 4 % stated that they had used doping agents at least once in their life (their main source of supply being peers and health professionals). Thirty-four percent of the sample smoked some tobacco, 66 % used alcohol, 19 % cannabis, 4 % ecstasy, 10 % tranquillizers, 9 % hypnotics, 4 % creatine and 41 % used vitamins against fatigue. Beliefs about doping did not differ among doping agent users and non-users, except for the associated health risks which were minimized by users. Users of doping agents stated that the quality of the relations that they maintain with their parents is sharply degraded, and they reported that they are susceptible to influence and difficult to live with. More often than non-doping agent users, these adolescents are neither happy, nor healthy, while paradoxically, they seem less anxious and they are more self-confident. Our findings suggest that doping prevention among young athletes cannot be limited uniquely to the list of banned drugs.

General practitioners and doping in sport: attitudes and experience.

OBJECTIVES: To examine the attitudes to, and knowledge of, doping in sport of French general practitioners (GPs), and their contact with drug taking athletes on an everyday basis. METHODS: A total of 402 GPs were randomly selected from all over France and interviewed by telephone, using a prepared script. RESULTS: The response rate was 50.5% (153 men and 49 women; mean (SD) age 45.6 (5.6) years). Of the respondents, 73% confirmed that they had the list of banned products, and only 34.5% stated that they were aware of the latest French law, brought into effect in March 1999, concerning the fight against doping. Some 11% had directly encountered a request for prescription of doping agents over the preceding 12 months (the requested substances were mainly anabolic steroids, stimulants, and corticosteroids), and 10% had been consulted by an athlete who was using doping drugs and was frightened of the health risks (the substances used were mainly anabolic steroids). Over half (52%) of the GPs favoured the prescription of drug substitutions to athletes who used doping agents. According to 87.5% of respondents, doping is a public health problem, and 80% stated that doping is a form of drug addiction. Most (89%) said that a GP has a role to play in doping prevention, but 77% considered themselves poorly prepared to participate in its prevention. CONCLUSION: The results suggest that (a) GPs have limited knowledge of doping and (b) are confronted with doping in their daily practice, at least occasionally.

Attitudes of coaches towards doping.

BACKGROUND: Coaches are usually held to be among the main actors of doping prevention campaigns. The aim of this study was to document certain attitudes of professional coaches faced with doping, and to evaluate how they confronted it on an everyday basis. EXPERIMENTAL DESIGN: prospective study by self-reporting questionnaire. SETTING AND PARTICIPANTS: the questionnaire was mailed to the last 800 graduated coaches (1994-1997) in the Lorraine region, Eastern France. The 260 responding coaches comprised 77 women and 183 men, the average age being 30.8 +/- 8.0 years (mean +/- standard deviation). RESULTS: 10.3% of coaches consider that an athlete may use doping with no health hazard with the help of a physician, and 30.0% that an athlete who declines doping has little chance of succeeding. 5.8% had used doping drugs in the last twelve months (1 to 6 times). 13.5% of coaches mention that athletes (1 to 5 per coach on average) told them they had been prompted to use doping drugs during the previous 12 months. 80.7% consider that the current methods of preventing doping in sport are ineffective, and 98.1% of them consider that they have a role to play within this context, but 80.3% consider themselves badly trained in the prevention of doping. Only 10.4% have organized a doping prevention action during the last 12 months. CONCLUSIONS: In this study, professional coaches do not seem to be efficient in the prevention of doping. Further education and training for coaches on doping is advisable.

[Consumption of performance-enhancing drugs by medical students in Nancy]. / Consommation de produits aux fins de performance par les étudiants en médecine de Nancy.

Medical students, who deal routinely with difficult studies and with patients, are not always prepared for this challenge. This may produce a specific and important source of stress. As a consequence, medical students may sometimes develop maladaptive responses, such as substance abuse. This study aimed to evaluate performance-enhancing drug use among medical students at the University Hospital of Nancy, France. A self-administered anonymous questionnaire was given to all 104 eighth-year residents. The 93 responding students (37 female and 56 male), were aged 28.0 +/- 2.2 years (mean +/- SD); 53 per cent of the subjects reported enhancing-substance use in their first year of medical studies (72 per cent during preparation for their difficult examinations and 28 per cent throughout the year). The main substances were vitamins, anti-fatigue capsules, betablockers, marijuana (illicit drug) and benzodiazepines; 46 per cent of them were still using these drugs during the second to sixth years of their medical course. The main sources of drugs were retail pharmacists, with or without medical prescriptions. Could this use persist and lead to doctors with substance problems?

[Doping: epidemiological studies]. / Le dopage: données épidémiologiques.

PREVALENCE: Whatever method is used (observation, interviews, questionnaire, laboratory tests), it is difficult to collect epidemiological data on doping. Particularly difficult problems are related to the definitions of sports players and the drugs involved as well as the often illicit nature of drug use. RESULTS: The prevalence of doping in children and adolescents participating in sports is estimated at 3% to 5% with higher percentages in boys, older adolescents and those playing at a competition level. Use of anabolic steroids, as early as 8 years of age, has increased since 1990, especially in girls. All studies have emphasized how easy it is for adolescents to procure any prohibited drug. In adults participating in amateur sports, the prevalence of doping would be 5% to 15%. All sports are involved with higher prevalence in men, age ranges 20-25 years and 35-39 years, and competitive level players. The main drugs used are stimulants, narcotics, corticosteroids and anabolic steroids. Combination of at least 2 drugs is frequent with an increase of mean daily dose over the last 15 years. According to users, the drugs are obtained with a medical prescription, on the underground market, or from other participants. Few data are available on doping outside sports activities. In the French department Meurthe-et-Moselle, 15% of the inhabitants use drugs to improve their occupational performance. CONCLUSIONS: Doping is more widespread than would be expected from antidoping control data. Other studies are needed to acquire more precise epidemiological data.

[Prevention of doping in sport in adolescents: evaluation of a health education based intervention]. / Prévention du dopage sportif chez les adolescents: à propos d'une action évaluée d'éducation pour la santé.

BACKGROUND: The extent of sport doping and its potential risks for health is to be considered as a problem of public health. Until now, only a very few number of prevention programs have been shown to be efficient. The aim of this prospective study was to test the benefit of a specific educational intervention to reduce the intent of adolescent athletes to use drugs. PATIENTS AND METHODS: The participants were 476 adolescent athletes involved into high-level events, 238 were included in the experimental group and 238 as control group. The intervention was divided in four stages: information on epidemiology of doping in sport, discussions about nutritional supplement and other authorized products, a drug simulating role play, and information on self-medication. The program was evaluated by a self-administrated questionnaire before, just after the intervention, and three months later. RESULTS: A significant decrease in the intention to use doping drugs, and an increase in the perception of being able to refuse doping was found in the experimental group three months after the intervention. CONCLUSIONS: This work suggests that health education based interventions are effective in preventing drug use among adolescent athletes.

[Value of pulmonary gas exchange study during exercise in the diagnosis of a muscular glycogenosis]. / Apport de l'étude des échanges gazeux respiratoires au cours de l'exercice dans le diagnostic d'une glycogénose musculaire.

BACKGROUND: The diagnosis of muscular glycogen storage disease is usually difficult to demonstrate as symptoms normally consist of muscular cramps and exercise intolerance. Informations obtained from the study of the pulmonary gas exchange during exercise in a young patient with a glycogen storage disease are reported. CASE REPORT: The ventilatory and gas exchange responses to a cyclo-ergometer exercise were studied in a 17-year-old girl during a ramp-like test (5 W/min). The temporal profile of CO2 production (VCO2) response was clearly abnormal: VCO2 was always lower than oxygen consumption throughout the test, reflecting the lack of lactate buffering by the bicarbonates due to the absence of lactate production. The respiratory ratio was still around 0.75 at the peak of the test. In contrast, responses were perfectly normal in the other members of the family, allowing rejection of the diagnosis of glycogen storage disease without any blood sampling. CONCLUSION: This case illustrates the benefit of studying pulmonary gas exchange during exercise for a non-invasive diagnosis of muscular glycogen storage disease and detection of the disease in the other members of family.

[Investigation on self-medication: from disease to performance]. / Enquête sur les usagers de l'automédication: de la maladie à la performance.

UNLABELLED: Self-medication is widely practised and could be defined as taking drugs without the advice of a physician. The present survey documented self-medication users' profile and their drug-taking behaviour. EXPERIMENTAL DESIGN: prospective study by self-report questionnaire. PARTICIPANTS: 600 residents of the Meurthe et Moselle subdivision (eastern France), ranging in age from 15 to 85 years, including 288 males and 312 females. MEASURES: use and impressions of self-medication, based on the subjects' own experience. DATA ANALYSIS: questionnaires were coded and put on computer. The data were analysed and compared by chi-square and analysis of variance. Statistical significance was accepted at p < 0.05. RESULTS: 313 subjects (52.2 per cent) reported having used self-medication. The three main motives for this practice were: headache (46.9 per cent), nose, throat or respiratory tract diseases (22.1 per cent) and abdominal pain (7.3 per cent). Self-use of drugs usually involved left-over past prescribed treatment (76 per cent), or were bought without the advice of a pharmacist (28 per cent). The self-medication user tends to be a woman, ranging in age from 20 to 39 years, living in a marital relationship and resident in an urban zone. The behaviours leading to self-medication were studied. Five groups are described, probably associated with five different attitudes towards self-medication. One of them shows subjects who essentially use drugs not to treat a disease but to enhance their performance.

[General practitioners and doping in sports: knowledge and attitudes]. / Médecins généralistes et dopage sportif: connaissances et attitudes.

Most campaigns of prevention from doping (use of certain substances by athlete that could have an effect like an artificial improvement of his (or her) physical and/or mental conditions) have been relied on the physicians considered as main actors in this field. However do the physicians have the necessary knowledge and attitudes and do they simply wish to take part pertinently in actions of doping prevention? This study has been conducted in order to examine their knowledge and attitudes in front of doping, to evaluate their role in the prevention campaign. So 280 french physicians have randomly been selected and interviewed by telephone. The response rate was about 62%. The selected population was made up of 173 physicians in which were 122 males and 51 females, the average age was 44.5 +/- 6.5 years. The questioned physicians seemed to have a few knowledge about doping, in particular through the eight families of prohibited substances in which they only mentioned anabolic steroids and amphetamines. Only 50% of them think doping can also concern children, therefore 33.6% had have to face this problem in the latest 12 months. For 86.5% of the questioned physicians, doping is a serious public health problem and 60% of them consider it as a kind of drug addiction. According to 60.9% of them, campaigns of prevention from doping are inefficient; and 92.5% would like to take part in it but 83.3% of them do not feel themselves prepared enough. The results are always similar with or without sports medicine diploma. Three different families of the physicians' attitudes are described. The physicians' involvement in doping prevention claims an action in two parts: to change their behaviours facing to doping they have to consider as any health issue, to provide them with prevention efficient "tools" for their sports patients. At last, considering doping as a public health issue and not only as a marginal practice restricted to the athletic elite is really essential.