Diet diversity and the risk of laryngeal cancer: a case-control study from Italy and Switzerland.

Diet diversity (defined as the number of different foods consumed) has been considered an indicator of a healthy diet, and favorably related to the risk of several digestive tract cancers. We analyzed the relation between diet diversity and the risk of laryngeal cancer using data from a case-control study carried out between 1992 and 2000 in Italy and Switzerland. The subjects of the study were 527 patients with histologically confirmed incident cancers of the larynx and 1297 patients admitted for acute, non-neoplastic diseases, unrelated to tobacco or alcohol consumption. Total diversity was computed as the number of different foods (overall and within four food groups, i.e., vegetables, fruit, meat, and cereals) consumed at least once per week. A significant inverse association was observed for vegetable diversity (OR=0.41, 95% CI: 0.28-0.59, for the highest versus the lowest quartile) and fruit diversity (OR=0.40, 95% CI: 0.27-0.59). Conversely, a direct association was found for meat diversity (OR=1.67, 95% CI: 1.11-2.50), while no meaningful association was found for total diet and cereal diversity. The results were consistent across strata of age, alcohol drinking and tobacco smoking. This study suggests that a diet not only rich but also varied in fruit and vegetables is related to a decreased risk of laryngeal cancer risk.

Reproducibility and relative validity of a food-frequency questionnaire for French-speaking Swiss adults.

BACKGROUND: Due to the distinct cultural and language differences that exist in Switzerland, there is little information on the dietary intake among the general Swiss population. Adequately assessing dietary intake is thus paramount if nutritional epidemiological studies are to be conducted. OBJECTIVE: To assess the reproducibility and validity of a food-frequency questionnaire (FFQ) developed for French-speaking Swiss adults. DESIGN: A total of 23 men and 17 women (43.1+/-2.0 years) filled out one FFQ and completed one 24-hour dietary recall at baseline and 1 month afterward. RESULTS: Crude Pearson's correlation coefficients between the first and the second FFQ ranged from 0.58 to 0.90, intraclass correlation coefficient (ICC) ranged between 0.53 and 0.92. Lin's concordance coefficients ranged between 0.55 and 0.87. Over 80% of participants were classified in the same or adjacent tertile using each FFQ. Macronutrient intakes estimated by both FFQs were significantly higher than those estimated from the 24-hour recall for protein and water, while no significant differences were found for energy, carbohydrate, fats (five groups), and alcohol. De-attenuated Pearson's correlation coefficients between the 24-hour recall and the first FFQ ranged between 0.31 and 0.49, while for the second FFQ the values ranged between 0.38 and 0.59. Over 40 and 95% of participants fell into the same or the adjacent energy and nutrient tertiles, respectively, using the FFQs and the 24-hour recall. CONCLUSIONS: This FFQ shows good reproducibility and can be used determining macronutrient intake in a French-speaking Swiss population in an epidemiological setting.

Validity, reliability and responsiveness of the French language translation of the Western Ontario Shoulder Instability Index (WOSI).

BACKGROUND: The WOSI (Western Ontario Shoulder Instability Index) is a self-administered quality of life questionnaire designed to be used as a primary outcome measure in clinical trials on shoulder instability, as well as to measure the effect of an intervention on any particular patient. It is validated and is reliable and sensitive. As it is designed to measure subjective outcome, it is important that translation should be methodologically rigorous, as it is subject to both linguistic and cultural interpretation. OBJECTIVE: To produce a French language version of the WOSI that is culturally adapted to both European and North American French-speaking populations. MATERIALS AND METHODS: A validated protocol was used to create a French language WOSI questionnaire (WOSI-Fr) that would be culturally acceptable for both European and North American French-speaking populations. Reliability and responsiveness analyses were carried out, and the WOSI-Fr was compared to the F-QuickDASH-D/S (Disability of the Arm, Shoulder and Hand-French translation), and Walch-Duplay scores. RESULTS: A French language version of the WOSI (WOSI-Fr) was accepted by a multinational committee. The WOSI-Fr was then validated using a total of 144 native French-speaking subjects from Canada and Switzerland. Comparison of results on two WOSI-Fr questionnaires completed at a mean interval of 16 days showed that the WOSI-Fr had strong reliability, with a Pearson and interclass correlation of r=0.85 (P=0.01) and ICC=0.84 [95% CI=0.78-0.88]. Responsiveness, at a mean 378.9 days after surgical intervention, showed strong correlation with that of the F-QuickDASH-D/S, with r=0.67 (P<0.01). Moreover, a standardized response means analysis to calculate effect size for both the WOSI-Fr and the F-QuickDASH-D/S showed that the WOSI-Fr had a significantly greater ability to detect change (SRM 1.55 versus 0.87 for the WOSI-Fr and F-QuickDASH-D/S respectively, P<0.01). The WOSI-Fr showed fair correlation with the Walch-Duplay. DISCUSSION: A French-language translation of the WOSI questionnaire was created and validated for use in both Canadian and Swiss French-speaking populations. This questionnaire will facilitate outcome assessment in French-speaking settings, collaboration in multinational studies and comparison between studies performed in different countries. TYPE OF STUDY: Multicenter cohort study. LEVEL OF EVIDENCE: II.

Présentation de l'adaptation française de « l'échelle de coparentage » de McHale pour familles avec jeunes enfants [Presentation of the french adaptation of McHale's coparenting scale for families with young children.]

The aim of this paper is to present McHale's coparenting scale,a self-administered questionnaire enabling assessment of the quality of coparenting, and first steps in structural and construct validation of the French version. A total of 41 French speaking Swiss families and 84 US families completed this questionnaire and the Dyadic Adjustment Scale, a measure of marital satisfaction. The results of the Swiss families correspond to those of US families: first, items distributed into four factors (family integrity, conflict, affection and disparagement) and second, a partial link was found between quality of coparenting and marital adjustment. This finding supports the construct validity of the questionnaire, reflecting the established link between these two family sub-systems. Given that coparenting quality has a major influence on children's socio-affective development, the questionnaire will find great use in assessing not just negative features of coparenting, such as conflicts and disparagement, but also positive components such as warmth and support. This will be an important asset for research as well as clinical purposes.

Substance use among sportive adolescents in the French-speaking part of Switzerland

CONTEXTE: Pour diverses raisons, les adultes et en particulier les parents croient que la pratique sportive à l'adolescence est un facteur de protection contre les comportements à risque tels que la consommation de substances. Les preuves présentes à l'intérieur de la littérature ne sont toutefois pas concluantes à ce sujet. Le principal objectif de notre étude était donc de comparer la prévalence de la consommation de substances psychoactives (licites et illicites) et de substances ergogéniques et dopantes entre les jeunes de Suisse Romande pratiquant un sport et ceux n'en pratiquant pas.METHODES: À l'aide de plusieurs méthodes de recrutement, des adolescents sportifs et non sportifs âgés de 16 à 20 ans furent invités à répondre à un questionnaire anonyme en ligne sur leur consommation de substances. Les substances psychoactives étudiées furent principalement le tabac, l'alcool, et le cannabis. Le dopage a été limité à la volonté d'améliorer les performances tout en utilisant des produits interdits selon l'Agence Mondiale Antidopage (liste 2009). Plusieurs produits légaux liés à la pratique sportive ont également été étudiés. Sur une période de 10 mois, un total de 1303 questionnaires ont été complétés. De l'échantillon final pondéré, les réponses de 1247 sujets éligibles ont été analysées.RESULTATS ET CONCLUSIONS: Dans l'ensemble, l'effet protecteur d'une pratique sportive contre l'utilisation de substances psychoactives semble dépendre de la substance à l'étude.Les jeunes non-sportifs sont plus susceptibles de fumer que les sportifs, et, parmi ces derniers, ceux évoluant dans un contexte de loisir sont plus susceptibles de fumer que ceux en pratique compétitive. Au contraire, aucune différence concernant l'abus d'alcool n'a été observée entre les adolescents sportifs et non-sportifs, indiquant que la pratique sportive ne représente pas une protection contre l'abus d'alcool. Bien que les jeunes non-sportifs soient deux fois plus susceptibles d'être utilisateurs actuels de cannabis, un jeune sportif sur neuf en a néanmoins consommé dans le dernier mois.Les trois quarts des jeunes sportifs interrogés indiquent utiliser activement des produits pour améliorer leurs performances, confirmant la tendance actuellement perçue. Parmi les substances utilisées pour améliorer les performances sportives, les produits contenant de la caféine, les boissons sportives et les suppléments alimentaires sont les trois plus souvent signalés.Peu de jeunes sportifs en Suisse Romande semblent utiliser des substances bannies par l'Agence Mondiale Antidopage, le cannabis étant celui le plus fréquemment cité.Parmi les jeunes sportifs, ceux en pratique compétitive semblent plus susceptibles d'utiliser des produits pour améliorer leurs performances que ceux évoluant dans un contexte de loisir. En outre, Un lien entre les substances psychoactives et celles prises pour améliorer les performances sportives semblent exister: tous les jeunes sportifs signalant soit fumer, avoir abusé de l'alcool récemment ou consommer actuellement du cannabis ont démontré une consommation plus élevée de produits dopants. L'usage du cannabis comme un moyen d'améliorer les performances sportives semble assez fréquent chez les consommateurs récréatifs de cette substance.Les jeunes sportifs évoluant au niveau international ont montré des taux plus bas d'abus d'alcool et de cannabis.

A cross-cultural study of the higher-order structures underlying personality disorders in French-speaking Africa and Switzerland

Most studies about the higher-order dimensions to be considered in order to parsimoniously describe Personality Disorders (PDs) have identified between two and four factors but there is still no consensus about their exact number. In this context, the cultural stability of these structures might be a criterion to be considered. The aim of this study was to identify stable higher-order structures of PD traits in a French-speaking African and Swiss sample (N = 2,711). All subject completed the IPDE screening questionnaire. Using Everett's criterion and conducting a series of principal component analyses, a cross-culturally stable two- and four-factor structure were identified, associated with a total congruence coefficient of respectively .98 and .94 after Procrustes rotation. Moreover, these two structures were also highly replicable across the four African regions considered, North Africa, West Africa, Central Africa, and Mauritius, with a mean total congruence coefficient of respectively .97 and .87. The four-factor structure presented the advantage of being similar to Livesely's four components and of describing the ten PDs more accurately.

Zuckerman's reivsed alternative five-factor model: Validation of the Zuckerman-Kuhlman-Aluja Personality Questionnaire in four French-speaking countries

The aim of this study was to analyze the replicability of Zuckerman's revised Alternative Five-factor model in a French-speaking context by validating the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ) simultaneously in 4 French-speaking countries. The total sample was made up of 1,497 subjects from Belgium, Canada, France, and Switzerland. The internal consistencies for all countries were generally similar to those found for the normative U.S. and Spanish samples. A factor analysis confirmed that the normative structure replicated well and was stable within this French-speaking context. Moreover, multigroup confirmatory factor analyses have shown that the ZKA-PQ reaches scalar invariance across these 4 countries. Mean scores were slightly different for women and men, with women scoring higher on Neuroticism but lower on Sensation Seeking. Globally, mean score differences across countries were small. Overall, the ZKA-PQ seems an interesting alternative to assess both lower and higher order personality traits for applied or research purposes.

Party drug use in techno nights: a field survey among French-speaking Swiss attendees.

This study was designed to investigate the lifestyle and substance use habits of dance music event attendees together with their attitudes toward prevention of substance misuse, harm reduction measures and health-care resources. A total of 302 attendees aged 16-46 years (mean=22.70, S.D.=4.65) were randomly recruited as they entered dance music events. Rates for lifetime and current use (last 30 days) were particularly high for alcohol (95.3% and 86.6%, respectively), cannabis (68.8% and 53.8%, respectively), ecstasy (40.4% and 22.7%, respectively) and cocaine (35.9% and 20.7%, respectively). Several patterns of substance use could be identified: 52% were alcohol and/or cannabis only users, 42% were occasional poly-drug users and 6% were daily poly-drug users. No significant difference was observed between substance use patterns according to gender. Pure techno and open-air events attracted heavier drug users. Psychological problems (such as depressed mood, sleeping problems and anxiety attacks), social problems, dental disorders, accidents and emergency treatment episodes were strongly related to party drug use. Party drug users appeared to be particularly receptive to harm reduction measures, such as on-site emergency staff, pill testing and the availability of cool water, and to prevention of drug use provided via counseling. The greater the involvement in party drug use, the greater the need for prevention personnel to be available for counseling. General practitioners appeared to be key professionals for accessing health-care resources.

Psychometric evaluation of the French version of the questionnaire attitudes towards morphine use; a cross-sectional study in Valais, Switzerland.

BACKGROUND: In Switzerland, nurses are allowed to prescribe and administer morphine in emergency situations without a doctor. Still, nurses and other health professionals are often reluctant to prescribe and administer morphine for pain management in patients. No valid French-speaking instrument is available in Switzerland to assess the attitudes of nurses and other health professionals towards the prescription and administration of morphine. In this study, we evaluated the psychometric properties of the French version of the questionnaire "Attitudes towards morphine use". METHODS: The instrument was derived from an Italian version. Forward and back translations of the questionnaire were performed. Item analysis and construct validity were assessed between April and December 2010 in a cross sectional study including five Swiss hospitals in a sample of 588 health professionals (533 nurses, mean age 38.3 ± 10.2 years). Thirty subjects participated in test-retest reliability. RESULTS: The time to complete the instrument ranged between 12 and 15 minutes and neither floor nor ceiling effect were found. The initial 24-item instrument showed an intraclass correlation (ICC) of 0.69 (95% CI: 0.64 to 0.73, P < 0.001), and a Cronbach's α of 0.700. Factor analysis led to a six-component solution explaining 52.4% of the total variance. After excluding five items, the shortened version showed an ICC of 0.74 (95% CI, 0.70 to 0.77, P < 0.001) and a Cronbach's α of 0.741. Factor analysis led to a five-component solution explaining 54.3% of the total variance. The five components were named "risk of addiction/dependence"; "operational reasons for not using morphine"; "risk of escalation"; "other (non-dependence) risks" and "external (non-operational) reasons". In test-retest, the shortened instrument showed an ICC of 0.797 (95% CI, 0.630 to 0.911, P < 0.001) and a Cronbach's α of 0.797. CONCLUSIONS: The 19-item shortened instrument assessing attitudes towards the prescription and administration of morphine showed adequate content and construct validity.

A cross-cultural shortened form of the ZKPQ (ZKPQ-50-CC) adapted to English, French, German, and Spanish languages.

The aim of the present study was to develop a short form of the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) with acceptable psychometric properties in four languages: English (United States), French (Switzerland), German (Germany), and Spanish (Spain). The total sample (N = 4,621) was randomly divided into calibration and validation samples. An exploratory factor analysis was conducted in the calibration sample. Eighty items, with loadings equal or higher than 0.30 on their own factor and lower on the remaining factors, were retained. A confirmatory factor analysis was performed over the survival items in the validation sample in order to select the best 10 items for each scale. This short version (named ZKPQ-50-CC) presents psychometric properties strongly similar to the original version in the four countries. Moreover, the factor structure are near equivalent across the four countries since the congruence indices were all higher than 0.90. It is concluded that the ZKPQ-50-CC presented a high cross-language replicability, and it could be an useful questionnaire that may be used for personality research.

Do socioeconomic factors shape weight and obesity trajectories over the transition from midlife to old age? Results from the French GAZEL cohort study

BACKGROUND: Obesity is a contemporary epidemic that does not affect all age groups and sections of society equally. OBJECTIVE: The objective was to examine socioeconomic differences in trajectories of body mass index (BMI; in kg/m(2)) and obesity between the ages of 45 and 65 y. DESIGN: A total of 13,297 men and 4532 women from the French GAZEL (Gaz de France Electricité de France) cohort study reported their height in 1990 and their weight annually over the subsequent 18 y. Changes in BMI and obesity between ages 45 and 49 y, 50 and 54 y, 55 and 59 y, and 60 and 65 y as a function of education and occupational position (at age 35 y) were modeled by using linear mixed models and generalized estimating equations. RESULTS: BMI and obesity rates increased between the ages of 45 and 65 y. In men, BMI was higher in unskilled workers than in managers at age 45 y; this difference in BMI increased from 0.82 (95% CI: 0.66, 0.99) at 45 y to 1.06 (95% CI: 0.85, 1.27) at 65 y. Men with a primary school education compared with those with a high school degree at age 45 y had a 0.75 (95% CI: 0.51, 1.00) higher BMI, and this difference increased to 1.32 (95% CI: 1.03,1.62) at age 65 y. Obesity rates were 3.35% and 7.68% at age 45 y and 9.52% and 18.10% at age 65 y in managers and unskilled workers, respectively; the difference in obesity increased by 4.25% (95% CI: 1.87, 6.52). A similar trend was observed in women. Conclusions: Weight continues to increase in the transition between midlife and old age; this increase is greater in lower socioeconomic groups.

Personality disorders and the Five-Factor Model among French speakers in Africa and Europe

Objective: Several authors have suggested that Personality Disorders (PDs) might be more accurately described using a dimensional model instead of a categorical one. The aim of this study was to describe the relationship between PDs and the Five-Factor Model (FFM)-a dimensional model describing normal personality traits known for its invariance across cultures-in two different cultural settings. Method: Subjects from nine French-speaking African countries (n = 2,014) and from Switzerland (n = 697) completed both the French-version of the IPDE screening questionnaire, assessing the ten DSM-IV PDs, and the French-version of the NEO-PI-R, assessing the five domains and thirty facets of the FFM. Results: Correlations between PDs and the five domains of the FFM were similar in both samples. For example, Neuroticism was highly correlated with Borderline, Avoidant, and Dependent PDs in both Africa and Switzerland. The total rank-order correlation (rho) between the two correlation matrices was very high (rho = 0.93) and significant (P < 0.001), as were the rhos for all domains of the FFM and all PDs, except Paranoid and Dependent PDs. However, the rhos for PDs across facet-scales were all highly significant (P < 0.001). Moreover, 80% of Widiger and colleagues' predictions and 70 % of Lynam and Widiger's prototypes, concerning the relationship between PDs and the FFM, were confirmed in both samples. Conclusions: The relationship between PDs and the FFM was stable in two samples separated by a great cultural distance. These results suggest that a dimensional approach and in particular the FFM might be useful for describing PDs in a variety of cultural settings.

Heterogeneous metabolic adaptation of C57BL/6J mice to high-fat diet.

C57BL/6J mice were fed a high-fat, carbohydrate-free diet (HFD) for 9 mo. Approximately 50% of the mice became obese and diabetic (ObD), approximately 10% lean and diabetic (LD), approximately 10% lean and nondiabetic (LnD), and approximately 30% displayed intermediate phenotype. All of the HFD mice were insulin resistant. In the fasted state, whole body glucose clearance was reduced in ObD mice, unchanged in the LD mice, and increased in the LnD mice compared with the normal-chow mice. Because fasted ObD mice were hyperinsulinemic and the lean mice slightly insulinopenic, there was no correlation between insulin levels and increased glucose utilization. In vivo, tissue glucose uptake assessed by 2-[(14)C]deoxyglucose accumulation was reduced in most muscles in the ObD mice but increased in the LnD mice compared with the values of the control mice. In the LD mice, the glucose uptake rates were reduced in extensor digitorum longus (EDL) and total hindlimb but increased in soleus, diaphragm, and heart. When assessed in vitro, glucose utilization rates in the absence and presence of insulin were similar in diaphragm, soleus, and EDL muscles isolated from all groups of mice. Thus, in genetically homogenous mice, HFD feeding lead to different metabolic adaptations. Whereas all of the mice became insulin resistant, this was associated, in obese mice, with decreased glucose clearance and hyperinsulinemia and, in lean mice, with increased glucose clearance in the presence of mild insulinopenia. Therefore, increased glucose clearance in lean mice could not be explained by increased insulin level, indicating that other in vivo mechanisms are triggered to control muscle glucose utilization. These adaptive mechanisms could participate in the protection against development of obesity.

Inconspicuous assessment of diet-induced thermogenesis using whole-body indirect calorimetry.

We report a novel technique for computing diet-induced thermogenesis using data from 24-h respiration chamber measurements of 76 subjects. Physical activity (PA) was determined using a radar system to assess its duration and an accelerometer to evaluate its intensity. The regression line relating PA and energy expenditure facilitated calculation of the integrated thermogenic response to the total energy ingested (11.4% ± 3.8%), which is consistent with the values classically reported in the literature (10%) at the group level.

Ad libitum intake of a high-carbohydrate or high-fat diet in young men: effects on nutrient balances.

The effect of diet composition [high-carbohydrate, low-fat (HC) and high-fat, low-carbohydrate (HF) diets] on macronutrient intakes and nutrient balances was investigated in young men of normal body weight. Eleven subjects were studied on two occasions for 48 h in a whole-body indirect calorimeter in a crossover design. Subjects selected their meals from a list containing a large variety of common food, which had a food quotient > 0.85 for the HC diet and < 0.85 for the HF diet. The average ad libitum intake was 14.41 +/- 0.85 MJ/d (67%, 18%, and 15% of energy as carbohydrate, fat, and protein, respectively) with the HC diet and 18.25 +/- 0.90 MJ/d (26%, 61%, and 13% of energy as carbohydrate, fat, and protein, respectively) with the HF diet. Total energy expenditure was not significantly influenced by diet composition: 10.46 +/- 0.27 and 10.97 +/- 0.22 MJ/d for the HC and HF diets, respectively. During the 2 test days, cumulative carbohydrate storage was 418 +/- 72 and 205 +/- 47 g, and fat balance was 29 +/- 17 and 291 +/- 29 g with the HC and HF diets, respectively. Only the HF diet induced a significantly positive fat balance. These results emphasize the important role of the dietary fat content in body fat storage.