French Population Research Articles

Management of Melanoma in Elderly Patients over 80 Years.

Melanoma is a malignant tumour with a poorer prognosis in stage III and IV patients. Development of effective therapies for the treatment of advanced melanoma has led to an improvement in survival. Furthermore, the French population is ageing, and treatment of melanoma in this population has several specific limitations. This descriptive, retrospective, single-centre study collected data on the diagnostic and therapeutic management of patients with melanoma of Breslow ≥ 1 mm or of unknown primary and metastatic spread, at Limoges University Hospital, between 2018 and 2022, and compared the results obtained between 2 groups: under 80 and over 80 years of age; 344 patients were included. The extension work-up was more frequently complete and the sentinel lymph node technique more frequently performed in patients under 80. Wide excision was more frequently in accordance with guidelines in patients over 80. Adjuvant or first-line metastatic treat-ment was more frequently instituted in patients under 80, but no difference was found as regards the second and third lines, the frequency of adverse events, and the reason for stopping treatment. Our study supports similar management of elderly and young subjects, given the safety profile and efficacy of treatments.

Cancer Risk Among Patients With Multiple Sclerosis: A 10-Year Nationwide Retrospective Cohort Study.

Previous literature has been diverging on cancer risk in people with multiple sclerosis (PwMS). Therefore, this study compared the risk of cancer in PwMS and a matched sample from the French general population. This 10-year nationwide retrospective matched cohort study (2012-2021) used data from the national French administrative health care database (99% coverage of the French population) to determine the time to the first incident cancer. PwMS were identified using their long-term disease (LTD) status, hospitalizations, and multiple sclerosis (MS)-specific drug reimbursements. The control population was matched 4:1 on age, sex, residence, insurance scheme, and cohort entry date. Participants were included if they had no history of cancer in the 3 years before inclusion. Patients with cancer were identified through LTD status, hospitalizations, chemotherapy, radiotherapy, or prostate cancer-specific drug reimbursements. Overall and cancer location-specific hazard ratios (HRs) for the first incident cancer were obtained from Fine and Gray models, and age- and sex-stratified estimates were reported. Participation in cancer screening through the 3 national programs (breast, colorectal, and cervical) were compared between groups. Cancer incidence was 799 per 100,000 person-years (PYs) (n = 8,368) among the 140,649 PwMS and 736 per 100,000 PYs (n = 31,796) among the 562,596 matched controls (70.8% of women; follow-up: 7.6 ± 3.2 years). A small overall risk increase was observed for PwMS (HR 1.06, 95% CI 1.03-1.08), mostly in women (HR 1.08, 95% CI 1.05-1.11). Risk varied by cancer types and was lower for prostate (HR 0.80, 95% CI 0.73-0.88), breast (HR 0.91, 95% CI 0.86-0.95), and colorectal (HR 0.90, 95% CI 0.84-0.97) cancer and higher for bladder (HR 1.71, 95% CI 1.54-1.89), brain (HR 1.68, 95% CI 1.42-1.98), and cervical (HR 1.24, 95% CI 1.12-1.38) cancer in PwMS. Cancer risk was higher in PwMS younger than 55 years (HR 1.20, 95% CI 1.15-1.24) but decreased in PwMS aged 65 years and older (HR 0.89, 95% CI 0.85-0.94). This trend was found in all cancer locations. There were fewer PwMS getting screened than controls (all programs), with a particularly pronounced difference among those aged 65 years and older. Cancer risk was slightly increased in PwMS, particularly for urogenital cancers, possibly due to surveillance bias. Risk fluctuated depending on age, perhaps due to varying generational screening practices (i.e., diagnosis neglect in the older PwMS) and risk factors.

“A Place of Refuge to Republicans and Royalists”: The French Revolution in British Dominica

Abstract During the French Revolution, thousands of revolutionaries and royalists fled the turmoil in French islands. Many went to nearby islands, from which they could observe events. Situated between Martinique and Guadeloupe, Dominica had a majority French population and a long history of connection with its French neighbors. This article uses the case of Dominica to explore the effects of the French Revolution on a non-French island in the Eastern Caribbean. From the start, its proximity to the French islands led to its entanglement in revolutionary politics. It was the first British island to receive refugees, and the influx of people of all racial, social, and political backgrounds into Dominica posed challenges for island officials. Officials had to determine on what terms to admit emigrants, whether they posed a threat to the colony, and how to feed and house them. They also worried about the influences of foreigners and revolutionary ideas on their own disaffected free and enslaved populations. This article argues that Dominica's location, heterogeneous population, and internal instability allowed it to become a node for regional migration and information networks that embroiled it in the turmoil that engulfed its neighbors and ultimately threatened British control of the island.

First detection of Trissolcus japonicus (Ashmead) (Hymenoptera, Scelionidae) in southwestern France

We report the first detection of Trissolcus japonicus in southwestern France. A total of almost 3000 sentinel and 700 field-laid egg masses of Halyomorpha halys were exposed or collected in the administrative region of Nouvelle-Aquitaine in 2022 and 2023. A total of 12 and 44 specimens of T. japonicus emerged from one and two egg masses in 2022 and 2023, respectively. Morphologic analysis confirmed the identification of this egg parasitoid, while molecular analysis of COI matched the haplotype of the French population to the population of T. japonicus released in Italy. Trissolcus japonicus may have arrived in Nouvelle-Aquitaine from introduction pathways similary to T. mitsukurii, detected in 2020, although these pathways cannot be clearly defined. The co-occurrence of these two major parasitoids of BMSB should now be surveyed as possible competition can arise. In the frame of the biological control program currently running in France against BMSB, the use of one or two parasitoid species is also considered.

Effectiveness evaluation of an organisational intervention, targeting pregnancy and addiction care professionals, among women who have just given birth in maternity wards and smoked tobacco during pregnancy (5A-QUIT-N): study protocol for a stepped-wedge cluster randomised trial

IntroductionIn 2021, among French women who smoked when they knew they were pregnant, 59% still smoked at the end of pregnancy. Support for pregnant women to stop smoking must include...

Affiliation in times of pandemics: Determinants and consequences.

Affiliation is a basic human need, especially during difficult times. To what extent did the need to affiliate limit our capacity to abide by health guidelines, in particular regarding social distancing, during the COVID-19 pandemic? We investigated this issue using questionnaire data from two samples of the French population collected during the first French lockdown (April-May 2020). We found that in men, higher social comparison orientation (sensitivity to the needs of others and inclination to help) and higher perceived threat increased the frequency of reported affiliative activities. At the same time, men's reported affiliative activities were associated with a lower reported intention to abide by lockdown and protective measures and lower levels of reported compliance. This pattern was not found in women. The women in our samples, as has been observed elsewhere, were largely compliant, potentially precluding any effects of affiliative needs. Basic though they may seem, affiliative needs and reported affiliative activities may have played a significant role in the implementation of sanitary guidelines during the COVID-19 pandemic.

Intellectual Differences Between Boys and Girls, 35 Years of Evolution in France from WISC-R to WISC-V

The French adaptation of the Wechsler Intelligence Scale of Children, 5th edition (WISC-V) was an opportunity to examine if some common representations of gender differences in intellectual abilities are supported by empirical evidence. The WISC-V standardization sample provided data on a wide range of cognitive tests in a large sample of 6- to 16-year-old children representative of the French population. This sample included 517 boys and 532 girls. The WISC-V data were compared to those of the French standardization samples of three previous versions of the WISC (WISC-R, WISC-III, and WISC-IV). These four standardization samples span a 35-year period. The data analysis of the WISC-V standardization sample and the three previous versions of this intelligence scale showed that the performance gaps on intellectual tests between girls and boys have gradually narrowed over time. Almost no gender differences were observed in the WISC-V standardization sample, not only in IQ but also in key facets of intelligence. Data do not support the stereotype that girls are better at verbal tasks and boys are better at visuospatial tasks. However, some statistically significant differences remain, but the magnitude was generally small with no practical implications. The only important difference is in favor of girls and concerns performance on processing speed tasks that require visual discrimination, attentional control, and writing.

Association between fish consumption and mortality in the E3N French women's cohort.

Western studies have shown a non-linear association between fish consumption and mortality, which might be explained by exposure to chemical contaminants. This study aims to explore the associations between fish consumption or omega-3 polyunsaturated fatty acids (n-3 PUFA) and mortality within the prospective E3N French cohort, and to investigate the role of dietary exposure to contaminants in these associations. In the E3N cohort composed of 72,585 women, we assessed fish consumption and n-3 PUFA intake through a food questionnaire sent in 1993. To estimate the dietary exposure to contaminants, we used the food contamination database of the second French total diet study. Cox proportional hazard models were used to estimate the association between fish, lean fish, fatty fish, and n-3 PUFA intake, with the risk of all-cause or cause-specific mortality. During the follow-up (1993-2014), 6,441 deaths were recorded. A U-shaped association was observed between fish consumption and all-cause mortality (Poverall_association = 0.017). A similar association was observed with lean fish consumption, while the non-linear association between fatty fish consumption or n-3 PUFA intake and all-cause mortality did not reach statistical significance. A non-linear association was observed between fish consumption and lung cancer mortality (Poverall_association = 0.005). A positive and linear association was observed between fatty fish consumption or n-3 PUFA intake and breast cancer mortality (HR [CI95%]: 1.07 [1.01-1.15] and 1.08 [1.01-1.15]). Our results remained unchanged when further adjusting on dietary exposure to contaminants. Our results showed a U-shaped association between fish consumption and all-cause mortality and suggest a notable role of lean fish consumption in this association, but no role of dietary exposure to contaminants. Further studies are needed to better clarify this U-shaped association and the different impacts of fatty and lean fish consumption on health.

Quality of life of inflammatory bowel diseases patients in france with EQ-5D-5L: the QALY-MICI study.

This study aimed to document utility values and the Visual Analog Scale (VAS) with the 5-level version of the EQ-5D questionnaire in a large sample of patients with inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). QALY-MICI was a cross-sectional survey across three sources in France. Data were collected between 2019 and 2022 for patients 18 and over. The EQ-5D-5L, the EQ-VAS, the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), the Harvey-Bradshaw Index (HBI) for CD, and the Walmsley Index for UC (SCCAI) were collected. A total of 2,841 patients aged over 18 were recruited (1785 with CD, 1056 with UC). The mean age was 40.2 (SD 14.3). The time since diagnosis was 6 years and over for 61.9% of patients. The most impacted dimensions were usual activities, anxiety/ depression, and pain/ discomfort. The mean utility value was 0.863 (SD 0.172) versus 0.905 (SD 0.158) in the French population (p = 0.007). The mean VAS value was 68 (SD 19.2) versus 73.4 (SD 22.2) in the general population (p = 0.016). Utility values and VAS were similar for CD and UC and higher for men. There was a strong positive correlation between utility values, the VAS, and the SIBDQ score, and a negative correlation between the HBI and the SCCAI. The SIBDQ score and disease activity were the main predictors of utility and VAS. The QALY-MICI is, to our knowledge, the first study documenting utility values and VAS using the EQ-5D-5L questionnaire on a large sample, with a comparison to the general population.

THE EVENT: ON SCREEN, REPRODUCTIVE RIGHTS

This article analyzes the feature film The Happening (Audrey Diwan, 2021) based on the journey and experiences of its protagonist, a young French woman in the 1960s who seeks a safe abortion despite living in a patriarchal context marked by oppression, condemnation of women's bodies, and violence. The aim is to relate the aesthetic, visual, and sound analysis to the current and urgent debate on women's reproductive rights, with an emphasis on abortion. The theoretical framework is anchored in contemporary feminist theory and criticism, especially Federici (2018) and Diniz (2020), and the methodology of film analysis is understood here as a recreation of the original narrative, an exercise that prioritizes passages and frames allied to interlocutions with the theme addressed.

Digital health literacy and associated socio-demographic characteristics in the French population

Abstract Background With the development of digital devices in the health field, digital health literacy has become an important issue in promoting and protecting people’s health. Digital health literacy was measured in a representative sample of the French adult population in order to assess its level and to identify the socio-demographic characteristics of individuals with the lowest literacy levels. Comparisons with works carried out in other European countries as well as implications for the implementation of digital interventions will be discussed. Methods Digital health literacy was assed using the HLS19-DIGI-HI Instrument. This 8-item scale measuring the skills related to dealing with digital health information was introduced in the 2023 Health Barometer survey, conducted by the French national public health agency. The survey included French-speaking individuals living in France, aged 18-85, selected through randomly generated phone numbers. 3007 persons were interviewed using a computer assisted telephone interview. A continuous score and categories were calculated to determine the level of Digital Health Literacy. Their associations with sociodemographic characteristics were studied using univariate and multivariate analysis. Results 1902 persons declared they used internet to search information or advice on health on internet in the last 12 months and completed the Digital health literacy questionnaire. 61 % of these individuals have a low level of digital health literacy (29 % “inadequate” and 32% “problematic”). Multiple sociodemographic characteristics were associated with lower levels of literacy in univariate and multivariate analysis. Conclusions These results are useful to better understand and assess the digital health literacy of the population according to their socio-demographic characteristics. They will provide a knowledge base to implement web-based interventions for promoting targeted digital health interventions, according to targeted audiences. Key messages • This study in large random sample of the French population showed frequent difficulties to deal with online health information. • Multiple sociodemographic characteristics were associated with digital health literacy and can help to support implementation of targeted digital health interventions.

Trends in influenza vaccination and its determinants among pregnant French women between 2015 and 2020: A single-center study

ABSTRACT In 2016, only 7% of French women had received an influenza vaccination during their pregnancy. In this vaccine-averse country, the possibility of reaching the rates of 50% observed in other countries remains unknown. To measure the rate of influenza vaccination in a French university maternity. To study its evolution and determinants over the last 5 years. Single-center observational study of all women who gave birth during March 2020 in this maternity. Comparison with rates observed in 2015 in the same conditions. Of the 337 women included in the study, 202 received a vaccination during pregnancy (59.9%). After logistic regression, the factors significantly associated with achieving vaccination were the offer of vaccination during pregnancy, odds ratio (ORa) 26.2 [7.0; 98.2]; previous vaccination, ORa 20.3 [9.6; 42.6]; high education level, ORa 2.9 [1.3; 6.2]; delivery of a CERFA government reimbursement form, ORa 2.5 [1.3; 4.8]; a vaccination offer made by a general practitioner, ORa 2.1 [1.0; 4.4] and not by a hospital midwife, ORa 0.3 [0.1; 0.6]. The rate of vaccination increased from 35% to 59.9% between 2015 and 2020 ( p < .001), with a significant increase in the offer of vaccination during pregnancy (+14.6%) - especially by a general practitioner (+17.2%) - and in the rate of women with earlier vaccination (+13.6%). In France, vaccination rates above 50% are possible at a center level. A proposal of vaccination during pregnancy – especially by the general practitioner – seems to be a determining factor in this development.

Difference in long COVID prevalence due to different definitions and long COVID related risk factors

Abstract Several definitions of long COVID are used in research and practice what challenges epidemiological investigations. Here we present differences in long COVID prevalence accounting for several definitions and concordance between the definitions, as well as the risk factors associated with long COVID. Definitions considered were WHO post-COVID19 condition (PCC) definition with several thresholds (at least low - standard definition, moderate or strong impact on daily activities), NICE1 and NICE2 definitions (reported at least one or at least two symptoms), United States National Centre for Health Statistics, and United Kingdom Office for National Statistics definitions and perceived long COVID. Prevalence of long COVID among French adult population (N = 10 615) in autumn 2022 ranged from 1.2% to 13.4%, conditional of the definition. The concordance between the definitions was at best moderate. Next, on a smaller representative sample of a French adult population (N = 1 813) eight potential risk factors groups for long COVID were assessed in a systematic epidemiological investigation, following a conceptual model. Fifteen factors from seven groups were associated with long COVID including early-defined sociodemographic characteristics, pre-existing chronic conditions, short-term work-related factors, current socioeconomic position, health behaviours, infection-related factors, and perception of COVID-19 severity and long COVID. The likelihood of long COVID was higher for individuals with higher number of diseases and for nineteen out of twenty-six most prevalent dyads and a triad. A more standardized definition would facilitate research and surveillance of long COVID. Furthermore, long COVID should be observed as an interplay of social, medical and contextual factors rather than a mere complication of SARS-COV-2 infection, while patients with multimorbidity may present some of the particularly vulnerable population groups.

Evolution of online health-related information seeking in France from 2010 to 2023

Abstract Background Given the rapid ongoing progression of the internet and increase in health information available online since 2010, it is important to understand how these changes impact online health information-seeking behaviour of the population and the way of managing one’s health. This study aims to describe the evolution of the use of internet to seek health-related information as well as the characteristics of online health information seekers. Methods We used data from the French nationally representative surveys Health Barometers. It is a cross-sectional repeated survey of random representative samples of the French population conducted by the French national public health agency since 1992 using computer-assisted telephone interviewing. It serves to measure the evolution of key indicators regarding health-related behaviors, attitudes, and opinions in the general population and includes individuals aged 18-75 years old selected through randomly generated phone numbers. In the 2010, 2014, 2017 and 2023 editions, the same question was asked about the internet use as a source of health information. Evolutions over time were assessed using chi-square tests. Associations with sociodemographic characteristics and health status were evaluated using logistic regression models. Results Although internet access increased steadily during this period, from 72.8% in 2010 to 95.2% in 2023, the use of the internet as a source of health information rose between 2010 and 2014 (from 37.3% to 67.9%), decreased significantly in 2017 (60.3%) and rose again in 2023 at 65.3 %. The study describes the characteristics of the online health information-seekers trough time. Conclusions The past decade was marked by a breakthrough of the use of internet in the general population and the use of internet to seek health information. The analysis of the digital health information-seekers serves the public health authorities in their mission to provide accessible information on public health. Key messages • This study aims to describe the evolution of Online Health-Related Information Seeking in France from 2010 to 2023 and the characteristics of digital health information-seekers. • The analysis of the digital health information-seekers serves the public health authorities in their mission to provide accessible information on public health.

Factors associated with mosquito-borne disease protective behaviour in metropolitan France

Abstract Background Mosquito-borne diseases (MBD) are increasing and expanding their range throughout metropolitan France. Promoting individual protective behaviour is imperative, but research on its determinants is limited to southern regions. This study examines factors influencing MBD protective behaviour in the metropolitan French population. Methods 2,087 subjects responded to a self-administered online questionnaire in November 2023. The analysis plan was pre-registered. We fitted two mixed effects models to estimate the frequency and count of protective behaviours across sociodemographic groups and to identify which factors predict protective behaviour. Results Frequency of protective behaviour is significantly positively associated with getting bitten by mosquitoes often (β = 3.39; 95% CI: 3.10, 3.69) and sometimes (β = 1.54; 95% CI: 1.31, 1.76) compared to almost never, perceived MBD threat (β = 0.11; 95% CI: 0.06, 0.15), and having financial difficulties (β = 0.23; 95% CI: 0.02, 0.43). Count of protective behaviours is associated with getting bitten by mosquitoes often (β = 0.39; 95% CI: 0.30, 0.49) and sometimes (β = 0.14; 95% CI: 0.05, 0.23), perceived MBD threat (β = 0.02; 95% CI: 0.00, 0.03), MBD knowledge (β = 0.06; 95% CI: 0.04, 0.08), and having a chronic disease (β = 0.08; 95% CI: 0.02, 0.14). Models were adjusted for place of residence, education, and age. No associations were found between sex, having experienced an MBD, or confidence in public authorities to manage health crises. Conclusions This study provides the first insights into MBD protective behaviour and its associated factors considering all metropolitan French regions. Our results highlight several factors which may inform MBD prevention communication and policies focused on increasing individual protective behaviour. Key messages • People often bitten by mosquitoes are more likely to engage in more frequent and a higher number of mosquito-borne disease protective behaviour than people almost never bitten by mosquitoes. • Higher perceived mosquito-borne diseases threat is associated with more frequent and a higher number of mosquito-borne disease protective behaviour.

Health status, healthcare use and prevention in Travellers in Nouvelle Aquitaine, France, 2019-2022

Abstract Background The poor health status of underserved populations is compounded by low vaccination uptake, leading to a greater risk of epidemics. On October 2017, a measles outbreak started in the southwest of France among under-vaccinated social groups, including Travellers. We aimed to describe the health status, healthcare use and child measles-mumps-rubella (MMR) vaccination coverage in Travellers according to their environmental and living conditions. Methods A cross-sectional study with a three-stage random sample design was conducted between October 2019 and March 2022 in the Nouvelle-Aquitaine region in France. Trained social workers administered face-to-face questionnaires to collect data on adults and children. Anthropometric measurements, vaccination records, and data using an environmental exposure questionnaire were also collected. Results The participation rate was high (73.6%), with 1030 adults and 337 children included. Concerning the adults, 36.6% had obesity, 14.4% reported diabetes, 24.7% hypertension, and 14.4% major depression. The prevalence of major depression was significantly higher in adults living in precarious and unauthorized housing than in those with adequate housing (19.8 vs. 14.7%, p = 0.03). The unmet health care needs in the last 12 months was 48.4%. With regard to children, 45.3% had full (i.e., 2-dose) MMR vaccination coverage at 24 months and 17.9% had obesity. Finally, 74.5% of the households experienced housing insecurity, and 22.2% did not have a supply of drinking water. Conclusions Traveller children and adults faced deleterious environmental and living conditions potentially affecting their health, healthcare use, and vaccination coverage. These results demonstrate the need for urgent interventions for underserved populations which take into account their difficult living conditions. Key messages • Travellers have a greater burden of chronic diseases than the general French population and measles-mumps-rubella vaccination coverage among Traveller children is lower than in the general population. • The more precarious the housing, the more likely Travellers are to report having a chronic disease (social exclusion gradient).

Increased cancer incidence in patients with pre-existing heart failure: results from a French Nationwide Cohort study

Abstract Background It is unclear whether patients with a history of heart failure (HF) have an increased risk of developing cancer. Purpose To assess the incidence of cancer (all types) in patients with pre-existing HF compared with patients without known HF at a nationwide level. Secondary objectives include analysis by cancer site and impact on all-cause mortality. Methods We used the French National Administrative Health Data System (SNDS), a comprehensive database containing all health care information (outpatient and hospital) for 99% of the French population, to identify adult patients with a first diagnosis of HF (ICD-10 diagnosis code I50) between 2010 and 2019 and without a personal history of cancer before HF diagnosis. HF patients were matched for sex and age to HF-free and cancer-free individuals (3:1 ratio), randomly identified in the SNDS. Incident cancers were identified by corresponding ICD 10th codes. Results We found 330,867 adult patients with a first diagnosis of HF between 2010 and 2019, and 992,601 matched controls (54.7% women, mean age 77.7±13.5 years in both groups). There was an increased risk of a first cancer in HF patients as compared to controls: 28,151 (8.5%) in HF patients over a mean follow-up of 4.3±2.8 years vs. 77,325(7.8%) in controls over a mean follow-up of 4.9±2.8 years (unadjusted HR: 1.12 [1.11-1.13], P&amp;lt;0.001). The higher risk of new cancer in HF patients remained after adjustment for major comorbidities (i.e., ischemic heart disease, diabetes, arterial hypertension, renal dysfunction, morbid obesity), age, sex, year of diagnosis, region of residence, tobacco use and alcohol consumption (adjusted HR=1.06, [1.04-1.07]; P&amp;lt;0.0001). Overall, the estimated attributable risk of new cancer after HF was 16.53% (9.88-16.76%). This increased risk was observed for most solid malignancies (especially colorectal and lung cancer), and for multiple myeloma. We finally observed that the risk of all-cause mortality after cancer diagnosis was significantly higher in patients with pre-existing HF compared to controls (adjusted HR: 1.36 [1.33-1.39], P&amp;lt;0.001). Conclusions People with a history of HF have a higher risk of developing cancer than the general population. These findings suggest that cancer screening strategies should be encouraged in patients with HF.

Red Wine Consumption and the Impact on Cardiovascular Health: The Methodological Barriers of Observational Study Design.

Cardiovascular disease (CVD) is the leading cause of death among communicable and noncommunicable diseases, and its prevalence is going to rise even more by 2030. The discovery of different "functional" foods containing a plethora of bioactive compounds is considered an ally in the effort to reduce the global CVD burden in the context of primary prevention. It has been about 3 decades since the observation that red wine consumption in French population could lead to lower coronary heart disease risk despite the high dietary consumption of saturated fats, known as the "French paradox." Since then, numerous epidemiological studies, mainly observational, have emerged in order to investigate this association with great enthusiasm. However, due to the nature of these studies, the scientific community has raised concerns about the methodological approach of the studies and thus the generalization of their results. Therefore, the current review aims to summarize some of the major methodological issues deriving from observational studies on the association between red wine consumption and cardiovascular health and to highlight the importance of higher quality study design in the general effort of drawing safer conclusions on this topic.

Open versus mini-invasive partial and radical nephrectomy complications: results from the French national health database

BackgroundLaparoscopic surgery is associated with a lower morbidity than open surgery. No recent data compared kidney cancer surgery in the French population using the National Health Insurance database (PMSI-MCO).AimsWe explore and compare the surgical morbidity rates between laparoscopic and open laparotomy for kidney cancer.MethodsThe initial length of stay and complications parameters during the three postoperative months were described for renal cancer in every French center in 2018. We compared Relative Risks (RR [95% CI]) between laparoscopic and open surgery for both radical and partial nephrectomy.ResultsAmong 8,162 patients, 3,525 had a radical nephrectomy, 978 open, 2,547 laparoscopic surgeries; 4,637 patients had partial nephrectomies, 1,778 open 2,859 laparoscopic surgeries. For radical surgery, the most common complications were urinary infections (7.8%), acute renal failure (8.9%), sepsis (8.4%), bleeding (9.3%), and postoperative anemia (5.9%); the RR for laparoscopic versus open surgery were respectively 0.68 [0.54;0.86], 0.71 [0.57;0.88], 0.69 [0.55;0.86], 0.83 [0.66;1.03], 0.56 [0.43;0.73]. For partial nephrectomies, the most common complications were urinary infections (7.7%), bleeding (11.6%), and postoperative anemia (5.8%), with RR of 0.71 [0.58;0.87], 0.61 [0.52;0.71], and 0.64 [0.51;0.81]. The mean length of stay was 7.7 for open radical nephrectomy, 6.3 for laparoscopic radical nephrectomy, 7.5 for open partial nephrectomy, and 5 for laparoscopic partial nephrectomy.ConclusionsThe laparoscopic approach had fewer postoperative complications and a shorter length of stay than open surgery for partial and radical nephrectomy. The PMSI analysis provided an exhaustive description of surgical practice for kidney cancer and surgical complications in France.Clinical trial numberNot applicable.

Cultural Barriers to Women's Progression in Academic Careers: A France-Brazil Comparison Through the Lens of the Queen Bee Phenomena.

Despite significant improvements, women are still underrepresented at high levels in academia. Most research on these inequalities is conducted within a specific national academic system, without taking into account its cultural roots. The aim of the present study was to analyze the extent to which the cultural context acts as a barrier on women's career progression. Specifically, we focused on psychological processes described under the metaphor of Queen Bee Phenomenon that may reflect the ways in which female academics conform to male-gender roles encoded in androcentric social and academic culture. Two samples of women academic, one French (N = 73), the other Brazilian (N = 88), were compared through the lens of two dimension of the Queen Bee Phenomena: self-group distancing and gender hierarchy legitimation. Brazilian women identify more with their female peer group than their French counterparts. French women are more hostile to quotas and more inclined to adhere to meritocratic discourses than their Brazilian counterparts. Both academic contexts tend to perpetuate gender inequalities, but in different ways: by maintaining gender-stereotypical expectations in Brazil and meritocratic ideology in France. The implications for policies to promote a more egalitarian university context are discussed herein.