Suffering at work among medical students Qualitative study using semi-structured interviews [Souffrance au travail des étudiants en médecine étude qualitative par entretiens semi-dirigés]

National audienceIntroduction - Suffering at work among health professionals is a hot topic. Medical students, doctors of tomorrow, are far from being spared. Prevalence of anxiety and mood disorders range from 20.3 to 69 % for the former and from 12 to 30 % for the latter. The purpose of this article is to determine these factors by qualitative research, according to medical students' points of view. Methods - It is a qualitative study using semistructured interviews. The analysis is done according to the Grounded Theory. Results - 12 medical students are interviewed. They expressed difficulties at work and positive factors. Three major themes are identified in selective coding: occupational factors, " study " factors and individual factors. All themes are both a source of well-being and ill-being according to the situations specified in the results. Conclusion - Studying medicine includes positive and negative aspects. Abandonment issues, lack of recognition and insufficient coaching emerge from our study. Screening of suffering at work should be systematic for medical students

Prévalence du déficit en vitamine D chez les enfants âgés de 5 a 10 ans en Bretagne Occidentale.

International audienceFrench guidelines do not recommend systematic supplementation of vitamin D in children aged 5-10 years old owing to the lack of data on vitamin D status in this age group. Our objective was to assess the prevalence of vitamin D deficiency in these children. Single-center, prospective, epidemiological study including 358 children aged 0-15 years. The endpoint was the concentration of vitamin D. In all, 316 children were divided into four groups according to age: 0-18 months (n=113); 18 months to 5 years (n=103); 5-10 years (n=62); and 10-15 years (n=38). The median concentration of vitamin D decreased with age (P<0.001): 90.2 nmol/L in the group aged 0-18 months; 56.7 nmol/L in the group aged 18 months to 5 years; 49.05 nmol/L in the group aged 5-10 years; and 42.45 nmol/L in the group aged 10-15 years. This corresponds to an increase in the prevalence of vitamin D deficiency in children aged 5-10 years (51.6% vs. 8.8% in the group aged 0-18 months, P<0.001). For children aged 5-10 years, the prevalence of deficiency was greater in the non-supplementation group (75%) compared with the supplementation group (13%; P<0.001). This study demonstrates the high prevalence of vitamin D deficiency in children aged 5-10 years and the relationship between supplementation and vitamin D status. It provides an argument in favor of supplementation in children aged 5-10 years in this region and a reconsideration of the French recommendations.Les recommandations françaises ne préconisent pas la supplémentation systématique en vitamine D chez les enfants de 5 à 10 ans du faitde l’absence de données sur leur statut en cette vitamine. Méthode. Notre objectif était d’évaluer la prévalence de ce déficit chez ces enfants. Il s’est agi d’une étude épidémiologique, monocentrique, prospective incluant 316 enfants âgés de 0 à 15 ans. Le critère d’évaluation était la concentration sérique en vitamine D. Résultats. Trois cent seize enfants, répartis en 4 classes d'âge, ont été inclus : 0–18 mois (n = 113) ; 18 mois–5 ans (n = 103) ; 5–10 ans (n = 62) ; 10–15 ans (n = 38). La médiane des concentrations de vitamine D diminuait avec l’âge (p < 0,001) : 90,2 nmol/L dans le groupe 0–18 mois ; 56,7 nmol/L dans le groupe 18 mois–5 ans ; 49,05 nmol/L dans le groupe 5–10 ans et 42,45 nmol/L dans le groupe 10–15 ans. Ceci correspond à une augmentation de la prévalence du déficit en vitamine D chez les enfants de 5 a` 10 ans (51,6 % versus 8,8 % dans le groupe 0–18 mois [p < 0,001]). Pour les enfants de ce groupe, la prévalence du déficit était supérieure dans le groupe non supplémente´ (75 %) par rapport au groupesupplémente´ (13 %) (p < 0,001). Conclusion. La prévalence du déficit en vitamine D est importante chez les enfants âgés de 5 a` 10 ans et il existe un lien entre supplémentation et statut en vitamine D. Elle apporte un argument en faveur d’une supplémentation systématique des enfants de 5 a`10 ans dans notre région et d’une reconsidération des recommandationsfranc¸aises

Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: results from a prospective randomized study.

International audiencePURPOSE: Antibiotic prophylaxis is given to children at risk for urinary tract infection. However, evidence concerning its effectiveness in grade I to III vesicoureteral reflux is lacking. The objective of this study was to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infection in young children with low grade vesicoureteral reflux. MATERIALS AND METHODS: Children 1 month to 3 years old with grade I to III vesicoureteral reflux were assigned randomly to receive daily cotrimoxazole or no treatment, and followed for 18 months. A urinary tract infection constituted an exit criterion. Infection-free survival rates were calculated using the Kaplan-Meier method and compared using the log rank test. RESULTS: A total of 225 children were enrolled in the study. Distribution of gender, age at inclusion and reflux grade were similar between the 2 groups. There was no significant difference in the occurrence of urinary tract infection between the 2 groups (17% vs 26%, p = 0.2). However, a significant association was found between treatment and patient gender (p = 0.017). Prophylaxis significantly reduced urinary tract infection in boys (p = 0.013), most notably in boys with grade III vesicoureteral reflux (p = 0.042). CONCLUSIONS: These data suggest that antibiotic prophylaxis does not reduce the overall incidence of urinary tract infection in children with low grade vesicoureteral reflux. However, such a strategy may prevent further urinary tract infection in boys with grade III reflux

[Recommendations for management of patients from pediatrics unit to adult unit: Transition and transfer program]

International audienceNo abstract availabl