Opinion of health professionals and drug users before the forthcoming opening of the first drug consumption room in Paris: a quantitative cross-sectional study

Background

On the brink of the opening of the first French drug consumption room in Paris, the general opinion of the local involved health care professionals and drug users was not known. The objective of this study was to determine their expectations and to search for influencing factors.

Method

We carried out a quantitative cross-sectional study. A multiple choice questionnaire was proposed to the surrounding willing general practitioners (GPs) and pharmacists, to the emergency doctors of Lariboisière hospital, and to the professionals of the harm reduction facilities and their drug users (PWUD). For each question, there was a choice between seven answers, from “??3” (very negative impact) to “+?3” (very positive impact). The influence of the characteristics of each group on its mean answers was explored by Mann-Whitney, Kruskal-Wallis, and Spearman’s tests.

Results

The median expectations among the groups of responding GPs (N =?62), other health care professionals (N =?82), and PWUD (N =?57) were mainly positive. They thought that the drug consumption room (DCR) would improve the health of PWUD, reduce their at-risk behaviors, would not increase drug use or drug dealing in the neighborhood, and would reduce nuisance in the public space. Only the group of GPs expressed that the DCR could decrease the quietness of the neighborhood, and only the group of PWUD had higher expectations that the DCR would decrease the number of arrests and the number of violent behavior. GPs’ expectations were significantly better in terms of health improvement of PWUD and reducing their precariousness if they had a previous experience in addiction medicine (Mann-Whitney, p =?0.004 and p =?0.019), with a longer practice (Spearman’s rho, p =?0.021 and p =?0.009), and if they were currently prescribing opioid substitution treatments (Mann-Whitney, p =?0.030 and p =?0.002).Among non-GPs, those who were working in addiction medicine centers had significantly better expectations than pharmacists, and the professionals of the local emergency department had intermediate expectations.

Conclusions

Health care professionals and drug users had a positive opinion of the to-be-created Parisian drug consumption room. Experience in addiction medicine influenced positively health professionals’ expectations.

     

Prevalence and factors associated with hypertension among school children and adolescents in urban and semi‐urban areas in Cameroon

Few data to date exist on pediatric hypertension (PH) prevalence and risk factors in semi‐urban areas in Cameroon, and they are believed to be the same as urban areas. These data are needed to design targeted preventive strategies and contribute to reducing the burden of PH in Cameroon and countries with equivalent standards of care. The authors conducted a cross‐sectional study, from November, 2017 to June, 2018, in primary and secondary schools, from semi‐urban (Bamboutos, West Region) and urban (Mfoundi, Center Region) settings in Cameroon, including children and adolescent aged between 3 and 19 years, recruited on a stratified probability sampling. PH was defined according to the American Academy of Pediatrics 2017. Overall, 1001 and 842 participants were, respectively, included in urban and semi‐urban areas. The overall average age was 13.9 ± 4.03 years, and two‐thirds were girls. Overweight and obesity were more prevalent in urban area (overweight: 17.1%; obesity: 5.9%), compared to semi‐urban (overweight: 1.1% and obesity: 0.8%) (p < .001). The prevalence of hypertension was higher in urban (12%) than semi‐urban areas (8.6%) (p = .01). We have identified as factors associated with PH: age > 14 years (OR = 3.18 [1.6; 6.2]) and secondary level of education (OR = 2.5 [1.2; 5.5]) in urban areas; family history of hypertension (OR 1.93 [1.1; 3.4] in semi‐urban areas. PH prevalence is higher in urban than semi‐urban areas, and the associated factors are not the same. Policies to address hypertension in the pediatric population must be targeted and tailored to the different population profiles.     

Vegetable Education Program Positively Affects Factors Associated With Vegetable Consumption Among Australian Primary (Elementary) Schoolchildren

Objective

To measure the effectiveness of a new sensory education program for Australian primary (elementary) schoolchildren (Vegetable Education Resource to Increase Children's Acceptance and Liking [VERTICAL]) designed to increase vegetable enjoyment and positively predispose to vegetable consumption.

Multiple vs Single Target Vegetable Exposure to Increase Young Children's Vegetable Intake

ObjectiveTo evaluate the effectiveness of repeated exposure to multiple vs single target vegetables in increasing young children's vegetable intake.MethodsA pilot randomized controlled trial (children aged 4–6 years, n = 32) was conducted, which exposed children at home 15 times over 5 weeks to either 1 (single target) or 3 (multiple target) vegetables. A comparison group did not change eating habits. Vegetable intake was measured by (1) a dinner meal consumed at research facilities, (2) 3-day weighed food records, and (3) usual vegetable intake (parent report). Measures were collected at baseline and either immediately after intervention (1), at 3-month follow-up (3) or both (2).ResultsThere were no differences between groups at baseline in vegetable intake. Usual vegetable intake increased in the multiple target group from .6 to 1.2 servings/d and did not change in other groups (P = .02). Food record data were not significant but underpowered. Vegetable intake from dinner meals was not significantly different between groups.Conclusions and ImplicationsExposure to multiple vegetables simultaneously may be more effective than a single vegetable to increase young children's intake. Larger scale research is recommended to confirm the effectiveness of offering variety in exposure and to enhance the understanding of the mechanisms involved.     

Expression of HER2 and bradykinin B₁ receptors in precursor lesions of gallbladder carcinoma

AIM: To determine the expression of HER2 and bradykinin B₁ receptors (B₁R) in the two pathogenic models of gallbladder cancer: the metaplasia-dysplasia-carcinoma and the adenoma-carcinoma pathways.METHODS: Receptor proteins were visualized by immunohistochemistry on 5-μm sections of paraffin-embedded tissue. Expression of both receptors was studied in biopsy samples from 92 patients (6 males and 86 females; age ranging from 28 to 86 years, mean 56 years). High HER2 expression in specimens was additionally investigated by fluorescence in situ hybridization. Cell proliferation in each sample was assessed by using the Ki-67 proliferation marker.RESULTS: HER2 receptor protein was absent in adenomas and in normal gallbladder epithelium. On the contrary, there was intense staining for HER2 on the basolateral membrane of epithelial cells of intestinal metaplasia (22/24; 91.7%) and carcinoma in situ (9/10; 90%), the lesions that displayed a significantly high proliferation index. Protein up-regulation of HER2 in the epithelium with metaplasia or carcinoma in situ was not accompanied by HER2 gene amplification. A similar result was observed in invasive carcinomas (0/12). The B₁R distribution pattern mirrored that of HER2 except that B₁R was additionally observed in the adenomas. The B₁R appeared either as cytoplasmic dots or labeling on the apical cell membrane of the cells composing the epithelia with intestinal metaplasia (24/24; 100%) and carcinoma in situ (10/10; 100%) and in the epithelial cells of adenomas. In contrast, both HER2 (4/12; 33%) and B₁R (1/12; 8.3%) showed a low expression in invasive gallbladder carcinomas.CONCLUSION: The up-regulation of HER2 and B₁R in precursor lesions of gallbladder carcinoma suggests cross-talk between these two receptors that may be of importance in the modulation of cell proliferation in gallbladder carcinogenesis.