Even a Previous Light-Active Physical Activity at Work Still Reduces Late Myocardial Infarction and Stroke in Retired Adults Aged>65 Years by 32%: The PROOF Cohort Study

Background: Work may contribute significantly to daily physical activity (PA) and sedentary behavior (SB). Physical inactivity and SB at work might be two major risk factors for premature morbidity. Therefore, the aim of this research was to describe self-reported past PA and SB at work and during leisure time within the PROOF cohort subjects, and to determine consequences of PA and SB on late health of these now retired workers.Material and Methods: The PROOF cohort study was used to prospectively allow assessment of the predictive value of PA and SB at work and during leisure time among a healthy retired French population, with regard to cardiovascular and cerebrovascular events. PA (MET-h/week) and SB (h/d) were assessed using the Population Physical Activity Questionnaire (POPAQ) and the modified Global Physical Activity Questionnaire (GPAQ). Odds ratios (ORs with 95% CIs) for cardiovascular and cerebrovascular events were associated with each level of PA at work: light (<3 METs), moderate (3–5.9 METs), vigorous (≥6 METs) and were compared to SB at work.Results: Out of the 1011 65-year-old subjects initially included, the 15-year follow-up has been currently completed for 688 (68%) subjects; 89 deaths (all-cause mortality, 9%) and 91 fatal and non-fatal cardiovascular and cerebrovascular events (9%), were reported. An active work (light, moderate, or vigorous intensity) was associated with a 21% reduced risk of cardiovascular (myocardial infarction) and cerebrovascular events (stroke) (OR = 0.79, 95% CI: 0.32–0.91, p < 0.02) compared to sedentary work. This relationship was already significant for light intensity work (32%; i.e., OR = 0.68, 95% CI: 0.31–0.87, p < 0.02).Conclusion: There is strong causal evidence linking PA and SB at work with late cardiovascular and cerebrovascular disease. All in all, the risk for onset of myocardial infarction and stroke was lower among those who had a previous active work compared to those with previous sedentary work. Even previous light active work produced substantial health benefits.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT00759304

Relationship between moderate-to-vigorous, light intensity physical activity and sedentary behavior in a prospective cohort of older French adults: a 18-year follow-up of mortality and cardiovascular events ─ the PROOF cohort study

BackgroundIt is well documented that moderate-to-vigorous intensity physical activity (MVPA) is effective in the prevention of major chronic diseases. Even though the current international physical activity (PA) guidelines still mainly focus on MVPA, the topic of the most recent epidemiological studies has shifted from MVPA to light intensity physical activity (LPA), owing to the necessity of promoting all activities vs. sedentary behavior (SB). However, the evidence remains currently limited. Thus, the clarification of the effects of LPA and the close relationship with SB is crucial to promote public health.MethodPA and SB were assessed by a validated self-administered questionnaire (POPAQ) investigating 5 different types of PA during the 7 previous days. PA was measured in metabolic equivalent of task (MET)-h, which refers to the amount of energy (calories) expended per hour of PA. SB was measured in hour/day. Medical histories and examinations were taken during each clinical visit to determine clinical events. All-cause mortality was established using the same procedure and by checking local death registries. The relationships between the intensity of PA (light, moderate to vigorous) and mortality and between the periods of SB and mortality or CV events were analyzed by splines and COX models, adjusted for sex and year of birth.ResultsFrom the 1011 65-year-old subjects initially included in 2001 (60% women), the last 18-year follow-up has been currently completed since 2019. A total of 197 deaths (19.2%, including 77 CV deaths) and 195 CV events (19.3%) were reported. Averages (standard deviation) of MVPA, LPA and SB were, respectively, 1.2 h/d (0.3), 5.8 h/d (1.1), and 6.6 h/d (2.3). For all-cause deaths, as well as CV deaths, the splines were significant for LPA (p = 0.04 and p = 0.01), and MVPA (p < 0.001 and p < 0.001), but not for SB (p = 0.24 and p = 0.90). There was a significant reduction in CV events when SB was decreasing from 10.9 to 3.3 h/d.ConclusionThe PROOF cohort study shows a clear dose–response between the dose of LPA, MVPA, SB and risk of mortality. These findings provide additional evidence to support the inclusion of LPA in future PA guidelines

Association between periodontal diseases and cardiovascular diseases in Cameroon

To assess the association between periodontal diseases and cardiovascular diseases in dental patients in Cameroon, a prospective observational study was carried out in 3 hospitals in Cameroon from January 2013 to December 2015. Data on general condition, age, gender and lifestyle were collected during medical history taking. The Dutch Periodontal Screening Index assessed periodontal health during oral examination. The Wilcoxon test, the Fisher test and logistic regression analysis were performed. 558 patients (53.9% women) were included in the study. The mean age was 44±13 years (30 to 85). In terms of overall health, 161 (28.9%) had cardiovascular diseases (CVD) and 73 (13.1%) had diabetes. Hypertension accounted for 87.6% of CVD. In terms of periodontal diseases (PD), 431 (77.2%) patients had PD, the break-down by PD was 347 (62.2%) gingivitis and 84 (15%) periodontitis. Statistical associations were found between CVD and gingivitis [OR=4.30 (1.85-10.00), P=0.001], and CVD and periodontitis [OR=2.87 (1.04-7.93); P=0.04]

Schoolbag Weight and Low Back Pain: A Cross-Sectional Study among Children of Public and Private Primary Schools in Cameroon

Background: The issue of excessively heavy schoolbags remains a public health concern in Africa. This study aimed to determine the weight of schoolbags among students in the public and private sectors of Yaoundé city, Cameroon and identify factors associated with low back pain.Methods: A cross-sectional study was conducted during the first term of the 2020/2021 academic year in French-speaking private and public primary schools in Yaoundé city, Cameroon. The study involved 2000 pupils (8.41±2.11 years), with 1000 from the public sector and 1000 from the private sector. The variables analyzed included weight, height, and schoolbag weight. A questionnaire, developed specifically for this study and based on the Standardized Nordic Body Map Questionnaire, was used to collect socio-demographic information and assess potential musculoskeletal low back pain. A diagram was included to indicate the lower back area for reporting pain. The questionnaire was administered, and each student answered it, with assistance from the investigator if needed. Descriptive and inferential statistics, as well as multiple logistic regressions, were employed for data analysis.Results: The average weight of the children and their schoolbags was 28.51±8.04 kg and 4.04±1.72 kg, respectively. Nearly 45% of the pupils were carrying a schoolbag weighing more than 15% of their body weight, and 23% reported experiencing low back pain. Schoolbag weights ranging from 10-15% of body weight were associated with a threefold higher risk (OR=2.66; 95% CI=1.65 – 4.31; P<0.0001) of developing low back pain. Pupils in the public sector had a lower risk (OR=0.28; P<0.0001) of developing low back pain.Conclusion: Children in the private sector experience low back pain more frequently. Carrying heavy schoolbags is associated with low back pain among pupils

Musculoskeletal disorders among secondary school teachers in Douala, Cameroon: The effect of the practice of physical activities

IntroductionMusculoskeletal disorders (MSDs) represent an important threat to public health in both developed and developing countries, and are present in many occupational sectors including education. Regular practice of physical activity (PA) is known elicit preventive effects on the occurrence of MSDs.ObjectiveThis study aimed at determining the prevalence of MSDs and the preventive impact of PA on their occurrence among secondary school teachers.Participants and MethodsA cross-sectional study was conducted among 179 teachers in five government secondary schools in Douala, Cameroon. The Nordic and Ricci-Gagnon questionnaires were used to determine MSDs and to assess the level of PA, respectively.ResultsThe 12-month and 7-day prevalence of MSD (PMSD-12m and PMSD-7d) were 84.3% and 69.3%, respectively. The most affected body regions by MSDs were neck (PMSD-12m = 54.2%, PMSD-7d = 33.5%), lower back (PMSD-12m = 43%, PMSD-7d = 33%), and shoulders (PMSD-12m = 35%, PMSD-7d = 22.9%). Compared to female, males were protected against MSDs during the last 12 months (OR = 0.37; 95% CI 0.16–0.93; p = 0.04). The risk of MSDs during the last seven days was higher in teachers aged 30-40 years (OR = 2.86; 95% CI 1.14–7.14; p = 0.02) and 40-50 years (OR = 4.28; 95% CI 1.49–16.29; p = 0.008) than those under 30 years. This risk was tripled in inactive teachers (OR = 3.07; 95% CI 1.40–6.78; p = 0.005), compared to their active counterparts.ConclusionMSDs are prevalent among secondary school teachers and associated with aging, gender, and lower level of P

Screening a portfolio of pathologies by subject profiling and medical test rationing

International audienc

A Decision-Tree-Based Bayesian Approach for Chance-Constrained Health Prevention Budget Rationing

International audienc

Predictive performance of four frailty screening tools in community-dwelling elderly

Abstract Background This study compares the performance of four frailty screening tools in predicting relevant adverse outcome (disability, institutionalization and mortality) in community-dwelling elderly. Methods Our study involved a secondary analysis of data from the FréLE cohort study. We focused on the following four frailty screening tools: the abbreviated Comprehensive Geriatric Assessment (aCGA), the Groningen Frailty Indicator (GFI), the Vulnerable Elders Survey-13 (VES-13) and the Fried scale. We used the Barberger-Gateau scale to assess disability. For comparison, we determined the capacity of these tools to predict the occurrence of disability, institutionalization or death using the receiver operating characteristic (ROC) curve. We also determined the threshold at which an optimal balance between sensitivity and specificity was reached. Odds ratios (ORs) were calculated to compare the risk of adverse outcome in the frail versus non-frail groups. Results In total, 1643 participants were included in the mortality analyses; 1224 participants were included in the analyses of the other outcomes (74.5% of the original sample). The mean age was 77.7 years, and 48.1% of the participants were women. The prevalence of frailty in this sample ranged from 15.0% (Fried) to 52.2% (VES-13). According to the Barberger-Gateau scale, 643 (52.5%) participants were fully independent; 392 (32.0%) were mildly disabled; 118 (9.6%) were moderately disabled; and 71 (5.8%) were severely disabled. The tool with the greatest sensitivity for predicting the occurrence of disability, mortality and institutionalization was VES-13, which showed sensitivities of 91.0%, 89.7% and 92.3%, respectively. The values for the area under the curve (AUC) of the four screening tools at the proposed cut-off points ranged from 0.63 to 0.75. The odds (univariate and multivariate analysis) of developing a disability were significantly greater among the elderly identified as being frail by all four tools. Conclusion The multivariate analyses showed that the VES-13 may predict the occurrence of disability, mortality and institutionalization. However, the AUC analysis showed that even this tool did not have good discriminatory ability. These findings suggest that despite the high number of frailty screening tools described in the literature, there is still a need for a screening tool with high predictive performance

Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature

Erratum : Lien vers la correction dans Voir aussi.The Correction to this article has been published in BMC Public Health 2020 20:1622International audienceBackground: Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over. Methods: Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success. Results: The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach. Conclusion: Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population

COVID-19 Bed Management Using a Two-Step Process Mining and Discrete-Event Simulation Approach

International audienceThe sudden admission of many patients with similar needs caused by the COVID-19 (SARS-CoV-2) pandemic forced health care centers to temporarily transform units to respond to the crisis. This process greatly impacted the daily activities of the hospitals. In this paper, we propose a two-step approach based on process mining and discrete-event simulation for sizing a recovery unit dedicated to COVID-19 patients inside a hospital. A decision aid framework is proposed to help hospital managers make crucial decisions, such as hospitalization cancellation and resource sizing, taking into account all units of the hospital. Three sources of patients are considered: (i) planned admissions, (ii) emergent admissions representing day-to-day activities, and (iii) COVID-19 admissions. Hospitalization pathways have been modeled using process mining based on synthetic medico-administrative data, and a generic model of bed transfers between units is proposed as a basis to evaluate the impact of those moves using discrete-event simulation. A practical case study in collaboration with a local hospital is presented to assess the robustness of the approac