Emilien Jeannot

Effectiveness of Iyengar Yoga in Treating Spinal (Back and Neck) Pain: A Systematic Review

Considerable amount of money spent in health care is used for treatments of lifestyle related, chronic health conditions, which come from behaviors that contribute to morbidity and mortality of the population. Back and neck pain are two of the most common musculoskeletal problems in modern society that have significant cost in health care. Yoga, as a branch of complementary alternative medicine, has emerged and is showing to be an effective treatment against nonspecific spinal pain. Recent studies have shown positive outcome of yoga in general on reducing pain and functional disability of the spine. The objective of this study is to conduct a systematic review of the existing research within Iyengar yoga method and its effectiveness on relieving back and neck pain (defined as spinal pain). Database research form the following sources (Cochrane library, NCBI PubMed, the Clinical Trial Registry of the Indian Council of Medical Research, Google Scholar, EMBASE, CINAHL, and PsychINFO) demonstrated inclusion and exclusion criteria that selected only Iyengar yoga interventions, which in turn, identified six randomized control trials dedicated to compare the effectiveness of yoga for back and neck pain versus other care. The difference between the groups on the postintervention pain or functional disability intensity assessment was, in all six studies, favoring the yoga group, which projected a decrease in back and neck pain. Overall six studies with 570 patients showed, that Iyengar yoga is an effective means for both back and neck pain in comparison to control groups. This systematic review found strong evidence for short-term effectiveness, but little evidence for long-term effectiveness of yoga for chronic spine pain in the patient-centered outcomes.

A comparison of the spatial dependence of body mass index among adults and children in a Swiss general population

Background:Body mass index (BMI) may cluster in space among adults and be spatially dependent. Whether BMI clusters among children and how age-specific BMI clusters are related remains unknown. We aimed to identify and compare the spatial dependence of BMI in adults and children in a Swiss general population, taking into account the area’s income level.Methods:Geo-referenced data from the Bus Santé study (adults, n=6663) and Geneva School Health Service (children, n=3601) were used. We implemented global (Moran’s I) and local (local indicators of spatial association (LISA)) indices of spatial autocorrelation to investigate the spatial dependence of BMI in adults (35–74 years) and children (6–7 years). Weight and height were measured using standardized procedures. Five spatial autocorrelation classes (LISA clusters) were defined including the high–high BMI class (high BMI participant’s BMI value correlated with high BMI-neighbors’ mean BMI values). The spatial distributions of clusters were compared between adults and children with and without adjustment for area’s income level.Results:In both adults and children, BMI was clearly not distributed at random across the State of Geneva. Both adults’ and children’s BMIs were associated with the mean BMI of their neighborhood. We found that the clusters of higher BMI in adults and children are located in close, yet different, areas of the state. Significant clusters of high versus low BMIs were clearly identified in both adults and children. Area’s income level was associated with children’s BMI clusters.Conclusions:BMI clusters show a specific spatial dependence in adults and children from the general population. Using a fine-scale spatial analytic approach, we identified life course-specific clusters that could guide tailored interventions.

Evolution of overweight and obesity among elementary school children in Geneva

QUESTIONS UNDER STUDY In view of the alarming trend in childhood obesity (O) and overweight (OW) observed in certain countries, the aim of the study is to measure the prevalence of O and OW in successive cohorts of elementary school children in Geneva. METHODS All 5-6-year-old children attending public schools in the Canton of Geneva were measured and weighed during a systematic health check at school from 2003 to 2008. BMI was calculated and plotted on standardised BMI for age tables, using Coles and Kromeyers references. RESULTS Using Coles references, the overall trend was a small non-significant decrease for OW 0.7 points (p = 0.33) and O 0.5 points (p = 0.23) over the 5-year period. For girls, OW decreased by 1.1 point (p = 0.47) and O decreased by 0.5 points (p = 0.61), whilst for boys OW decreased by 0.3 points (p = 0.54) and O decreased by 0.6 points (p = 0.23). A non-significant decrease or stabilisation in the prevalence of overweight and obesity was observed over the 5-year period in both boys and girls. CONCLUSION These observations corroborate observations from Sweden and France, showing a levelling off in obesity and overweight in young children.

Alumni evaluation of a community-oriented master of public health program.

Health workforce development is a public health priority for the World Health Organization. Public Health training programs need to be relevant in a public health perspective and efficient in and educational perspective. This implies evaluating the programs: in this regard student’s perception might be interesting, or the opinion of external experts, or the experience of alumni. To study the perception of alumni of a master’s program in public health in order to reevaluate the goals and objectives of the program, a cross-sectional survey through a self-administered questionnaire among former students that graduated from the Geneva University Master in Public Health program was done. This self-administered questionnaire included closed questions on a Likert five-point scale for regarding the use at work of tools acquired during the course, as well as open questions. Overall the alumni gave a positive evaluation of the course. As strong points were mentioned: networking opportunities, student-centered approach and multi-professional background of the student body. More critically judged were: tutorship, time constraints and costs. As most useful tools in their professional settings alumni mentioned: communication skills, project evaluation competencies and literature search strategies and again networking which in this case seemed to be quite active. Evaluation surveys among alumni allow reevaluation of the program’s goals and objectives in the light of their professional needs.

Prevalence and clinical characteristics of the DSM IV major depression among general internal medicine patients

OBJECTIVE The aim of this study was to investigate the prevalence and clinical characteristics of the DSM IV major depressive disorder (MDD) among patients admitted to the General Internal Medicine Service of the Geneva University Hospital. METHOD 557 patients admitted to the IM of the Geneva University Hospital aged 18 to 70 were investigated. Each subject was assessed by a clinical psychologist using the SCID (Structured Clinical Interview Depression for DSM-IV) questionnaire. RESULTS 69 patients (12.4%) met diagnostic criteria for MDD (men: 8.8%, women: 16.9%, p=.004). Among subjects with major depression, depressed mood (97%), fatigue (91%), and diminished interest and pleasure (81%) were the most prevalent symptoms. Recurrent thoughts of death were present in 48% of depressed patients. CONCLUSIONS This study raises further evidence that an elevated proportion of patients admitted to an acute care general internal medicine facility meet DSM IV criteria for MDD with nearly half of depressed patients suffering from recurrent thoughts of death. It emphasizes the necessity of a targeted, continuous, and active support given by the psychiatry liaison service in the internal medicine setting.

Self-sampling to improve cervical cancer screening coverage in Switzerland: a randomised controlled trial

Background:The aim of this study is to evaluate whether self-sampling can increase screening attendance of women who do not attend regular screening in Switzerland.Methods:Participants were proactively recruited in Geneva between September 2011 and November 2015. Women (25–69 years) who had not undergone CC screening in the last 3 years were considered eligible. Through a 1 : 1 ratio randomisation, enrolled participants were invited to either undergo liquid-based cytology, which was performed by a health-care provider (control group, CG) or to take a self-sample for HPV-testing, which was mailed to their home (intervention group, IG).Results:A total of 331 and 336 women were randomised in the CG and in the IG, respectively. Overall, 7.3% (95% CI: 4.9–10.6) women in the CG and 5.7% (95% CI: 3.6–8.7) women in the IG did not undergo the initial screening (P=0.400). There were 1.95% (95% CI: 0.8–4.3) women in the CG and 5.05% (95% CI: 3.1–8.1) women in the IG with a positive screen who did not attend triage and colposcopy (P=0.036).Conclusions:The participation in CC screening in women offered self-sampling was not higher than among those offered specimen collection by a clinician. Compliance with further follow-up for women with a positive HPV test on the self-sample requires further attention.

Sociodemographic and Economic Determinants of Overweight and Obesity for Public-school Children in Geneva State, Switzerland: A Cross-sectional Study

Background: Obesity among children and adolescents is a growing public health problem. The purpose of this study is to assess the prevalence, socioeconomic and demographic determinants of overweight and obesity in schoolchildren from Geneva. Methods: A cross-sectional study was undertaken at the Public School of Geneva canton in Switzerland. A total of 8544 public school children were collected and analyzed: 2577 were in second grade, 2641 in fifth grade and 3326 in eighth grade. To identify overweight and obesity we used the definition issued by the International Obesity Task Force. Child characteristics included gender, age, socioeconomic status (SES) of father and mother, and school grade. The multivariate logistic regression model was used to examine potential predictors of overweight/obesity. Results: The prevalence of overweight or obese children was 14.4% in second grade, 17.3% in fifth grade and 18.6% in eighth grade. Multivariate logistic regression analyses reveal that children that have a low economic status or certain citizenships are more likely to be overweight or obese. Children of Kosovar origin, have a higher risk of OBO in second grade (adjusted odds ratio [OR] = 2.19; 95% confidence interval [CI]: 1.20–4.00), fifth grade (adjusted OR = 2.36 95% CI: 1.27–4.39) and in eighth grade (adjusted OR = 2.15 95% CI: 1.27–4.39). Association between SES and overweight was high with regards to the fathers SES in fifth grade (adjusted OR = 4.21 95% CI: 2.83–6.25). Conclusions: Overweight and obesity is associated to socioeconomic and sociodemographic factors. The analyzes reveals that children with a low economic status and/or from certain countries are more likely to be overweight or obese than Swiss children. There is an urgent need for action to prevent further increase in overweight or obesity among children.

Most children who took part in a comprehensive malnutrition programme in Madagascar reached and maintained the recovery threshold

The benefits of including nutritional education in programmes that tackle moderate and severe acute malnutrition remain poorly documented. This study in Madagascar evaluated the nutritional status of children who took part in an innovative programme that included maternal education, on completion and after a year.

Successful implementation and results of an HPV vaccination program in Geneva Canton, Switzerland

We describe a human papillomavirus (HPV) vaccination program implemented since 2007 in Geneva Canton, Switzerland, that used school services, a public hospital, and private physicians as vaccination providers. We assessed program performance with the evolution of immunization coverage during the first four years of program implementation. We measured vaccination coverage of the target population using individual records of vaccination status collected by service providers and transmitted to the Geneva Canton Medical Office. The target population was 20,541 adolescent girls aged 11–19 years as of September 1, 2008, who resided in the canton when the program began. As of June 30, 2012, HPV vaccination coverage was 72.6% and 74.8% in targeted cohorts for three and two doses, respectively. The global coverage for three doses increased by 27 percentage points from December 2009 to June 2012. Coverage for girls aged 16–18 years at the beginning of the program reached 80% or more four years into the program. High coverage by this HPV vaccination program in Geneva was likely related to free vaccination and easy access to the vaccine using a combination of delivery services, including school health services, a public hospital, and private physicians, covering most eligible adolescent girls.

Évolution de la couverture vaccinale de l'année scolaire 2003–2004 à 2007–2008 pour les enfants de cinq à six ans à Genève

OBJECTIVE The authors had for aim to study the evolution of vaccination coverage for diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella (MMR) and Haemophilus influenzae b (Hib) in 5 to 6-year-old children in Geneva, from school year 2003-2004 to 2006-2007. DESIGN The data was collected from vaccination cards of 17,184 children attending public schools in the Geneva canton. RESULTS The average vaccination coverage over the study period was 93.4% for diphtheria, 93.5% for tetanus, 92.5% for pertussis, and 92.4% for poliomyelitis. For MMR and Hib, the coverage was 80.6, 78.4, 79.1 and 81.2% respectively. Between 2003 and 2007, an increase of coverage was observed for all vaccines. It was especially observed for MMR and Hib vaccines, even though the coverage remained below 90%. CONCLUSION In the Geneva canton, epidemiological surveillance of vaccination coverage of 5 to 6-year-old children can be achieved through systematic data analysis of childrens vaccination cards. All commonly used vaccines reached the recommended coverage rates, except for MMR and Hib, even though their coverage had significantly increased.