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Collective Expert Reports
INSERM Collective Expertise Centre
nstitut National de la Santé et de la Recherche Médicale (INSERM)
2004
© 2000-2008
Institut National de la Santé et de la Recherche Médicale (INSERM)
Table of Contents
Gambling
:
Contexts and addictions (2008)
Group of experts and authors
Foreword
Summary
Recommendations
Appendix: Inserm collective expert review
Physical activity
:
Contexts and effects on health (2008)
Group of experts and authors
Foreword
Synthesis
Recommendations
Appendix: Inserm collective expert review
Alzheimer’s Disease
:
Scientific, medical and societal implications (2007)
Group of experts and authors
Preface
Foreword
Synthesis
Recommendations
Appendix 1: Inserm collective expert review
Appendix 2
Appendix 3: Care models prioritised in function of patients’ needs
Dyslexia Dysorthography Dyscalculia
:
Review of the scientific data (2007)
Group of experts and authors
Preface
Foreword
Synthesis
Principal findings
Recommendations
Meeting-debate held on January 16, 2007
Appendix: Inserm collective expert review
Growth and Puberty Secular Trends, Environmental and Genetic Factors (2007)
Group of experts and authors
Foreword
Summary
Recommendations
Appendix: Inserm collective expert review
Cancers: Long-term prognoses (2006)
Expert advisory group and authors
Foreword
Synthesis
Glycol ethers: New toxicological data (2006)
Foreword
Group of experts and authors
Synthesis
Hearing deficits: Emerging research and applications to children (2006)
Expert advisory group and authors
Foreword
Synthesis
Recommendations
The voice and its disorders in teachers (2006)
Foreword
Group of experts and authors
Hearings
Scientific and editorial coordination
Bibliographic assistance
Synthesis
Recommendations
Obesity: Assessment and the evaluation of obesity prevention and management programs (2006)
Expert advisory group and authors
Foreword
1 Epidemiological data
2 Biological and behavioral determinants
3 Economic determinants and prevention issues
4 Cost of the disease
5 International prevention programs and operations
6 Preventive programs and operations in France
7 International recommendations and guides
8 Management of children in France
9 Management of obese adolescents in France
10 Management of adults in France
11 International research
12 Research in France
Principal findings and principles for action
Developing national obesity prevention policies: an international perspective
Conduct: Disorder in children and adolescents (2005)
Foreword
Expert advisory group and authors
Summary
Recommendations
Cancer: A methodological approach for studying the link between cancer and the environment (2005)
Foreword
Expert advisory group and authors
Epidemiological data
Elements of methodology
Suicide: Psychological autopsy, a research tool for prevention (2005)
Expert advisory group and authors
Synthesis
Recommendations
Tuberculosis: Place of vaccination in control of the disease (2004)
Foreword
Expert advisory group and authors
Summary
Deficiencies and handicaps of perinatal origin: Screening and management (2004)
Foreword
Expert advisory group and authors
Summary
Recommendations
Psychotherapy: Three approaches evaluated (2004)
Foreword
Expert advisory group and authors
Summary
How do we see the methodological problems in evaluating psychotherapies?
What are the different types of studies taken from the literature to evaluate the psychotherapies?
What are the different forms of the psychodynamic and psychoanalytical approach?
What are the different forms of cognitive-behavioural psychotherapies?
What techniques are used in family or couple therapy?
What is the net result of the evaluation studies of psychodynamic (psychoanalytical) psychotherapies?
What results are obtained with cognitive-behavioural approach techniques?
What are the results obtained with family and couple therapy techniques?
What data are available on the comparative assessment of the different therapies?
What factors can be assessed to determine which therapy is suitable for which disorder?
Conclusion
Tobacco: Understand dependence in order to act (2004)
Foreword
Expert advisory group and authors
Summary
Recommendations
Alcohol: Social damages, abuse, and dependence (2003)
Foreword
Expert advisory group and authors
Summary
Global alcohol consumption has fallen from almost 18 litres of pure alcohol per year and per inhabitant in 1960 to almost 11 litres in 1999
From 20 years of age, more than one French person in two consumes alcohol at least once a week
In the working environment, men drink twice as much alcohol as women
In young people, repeated bouts of inebriation are often associated with regular alcohol or cannabis consumption
Alcohol plays a key role in the contemporary youth party scene
The advertising or health-related message is perceived and accepted much more readily when coming from a source that is appreciated by the recipient
Alcohol is involved three times more often in road-traffic accidents than in accidents in the workplace
Alcohol is responsible for approximately 1,900 deaths per year on the road
Behaviour under the influence of alcohol is governed by complex, determining factors
Alcohol could be responsible for 10% to 20% of accidents in the workplace
As regards alcohol intake, company practice is not always applied
According to victims of violence, approximately 30% of the perpetrators had consumed alcohol
Alcohol consumption affects social status: quality of study, type of employment, employee level
The cost of loss of income associated with illness or premature death costs four times more than health expenditure
Approximately 15% of alcohol consumers present with a symptom of dependency
Almost 40% of alcohol-dependent subjects present with another mental disorder
Some temperamental traits are indicative of excessive alcohol consumption
There is an interaction between environmental and genetic factors in the process of alcohol dependency
In animals, forced dependency modifies certain receptors and disrupts neurotransmitter balance
In animals, variations in emotional reactivity influence alcohol consumption
In humans, questionnaires and biological markers can be used to assess the problems associated with alcohol consumption
Combine an aetiological trait with a specific therapeutic strategy to boost efficacy
Recommendations
Mental disorders: Children and adolescents screening and prevention (2002)
Foreword
Expert advisory group and authors
Summary
Epidemiology in the area of mental disorders requires validated tools
In France, one child of eight has a mental disorder
Among the sociodemographic determinants, gender and age exert a particular influence on the prevalence of mental disorders
Events in the perinatal period could increase the risk of mental disorders
A genetic susceptibility has been involved in the majority of mental disorders
Parental psychiatric morbidity is also a risk factor, albeit nonspecific, for mental disorders in children
Neurodevelopment involves gene–environment interactions
Neurobiological disturbances are observed in certain mental disorders
The cognitive approach enables us to break down the mechanisms of normal or pathologic mental functioning
Learning difficulties may express a dysfunction of cognitive development
Cerebral morphologic and functional anomalies are associated with the cognitive dysfunctions seen in certain mental disorders
How do we attempt early detection of autism during the first two years of life?
How can ADHD be identified in the pre-school period?
How can the delay be reduced between the appearance of the first symptoms of obsessive–compulsive disorder and its diagnosis?
What would assist in the early detection of anxiety disorders?
What would assist the early detection of affective disorders?
How can we predict the course of an eating disorder toward a pathologic form?
How is it possible to identify, during childhood, the predictive signs of a risk of schizophrenia?
Comprehensive educational programmes may reduce the cognitive, communicative, social, and behavioural handicaps of autism
Prevention programmes are being developed that are adapted to the child's level of risk in relation to anxiety or affective disorders
Recommendations
Cannabis: Effects of consumption on health (2001)
Foreword
Expert advisory group and authors
Summary
In 2000, more than half of all 18-year-olds in France experimented with cannabis
During 2000 in France, about 15% of 18-year-old boys used cannabis more than 40 times
The prevalence of consumption in adolescents has risen during the last 10 years in France as well as in other western countries
The epidemiological data on abuse and dependency are still incomplete
Tobacco, alcohol, and cannabis share the same social determinants for initiation of use
Individual vulnerability factors are associated with cannabis abuse
Patients presenting with certain mental disorders are more likely to be excessive cannabis users
Do common factors explain the co-occurrence of schizophrenia and cannabis abuse?
The pharmacological effects of cannabis mainly originate from Δ9-THC
Δ9-THC and its metabolites can be analysed in the urine and blood
Is it dangerous to drive after using cannabis?
Cannabis consumption has immediate or short-term effects
Elevated cannabis consumption can cause psychosis
Repeated cannabis use may have longer-term effects
Chronic cannabis consumption could increase the risk of certain cancers
Research into the effects on the unborn baby of exposure in utero should be more rigorous
Δ
9
-THC induces well-characterised behavioural responses in animals
Δ
9
-THC induces tolerance and subjective effects in animals
Δ9-THC acts through the intermediary of the endogenous cannabinoid system
The behavioural effects of the cannabinoids correlate closely with the distribution of receptors in the central nervous system
Mechanisms of action for the cannabinoids can be proposed in the various target tissues
Recommendations
Alcohol: Health effects (2001)
Foreword
Expert advisory group and authors
Summary
Most of the alcohol ingested enters the blood circulation
Ethanol is mainly metabolised in the liver
The liver is one of the principal targets for the effects of alcohol
Oxidative stress is one of the essential mechanisms of ethanol-induced hepatotoxicity
Pro-inflammatory cytokines are involved in the pathogenesis of alcohol-induced liver lesions
Ethanol is neurotoxic regardless of whether consumption is acute or chronic
Cerebral imaging techniques reveal anatomical and functional abnormalities in chronic alcohol consumers
The fetal central nervous system is particularly sensitive to maternal alcohol consumption during pregnancy
Alcohol consumption during pregnancy affects the child's psychomotor development
The hypothesis regarding the protective role of moderate alcohol consumption on cognitive functions in the elderly has yet to be demonstrated
Moderate alcohol consumption is associated with a reduced cardiovascular risk in epidemiological studies
Alcohol consumption is associated with an established or probable increase in certain forms of cancer
The development of alcohol-related diseases is partly subject to individual genetic susceptibility
The effects of alcohol consumption interact with nutritional status
The effect of alcohol on global and cardiovascular mortality varies according to consumption levels
The overall mortality rate associated with chronic alcohol consumption is higher in France for populations over 35 years of age
Recommendations
Information and prevention
Research development
Health education for young people: Approaches and methods (2001)
Foreword
Expert advisory group and authors
Synthesis
From prevention to health education and promotion: a conceptual and methodological development
Youth and their health: perceptions and representations
Implementation of health education: the institutional framework of the educational system
Four examples of context: implementing health education in school settings
Institutional measures in France for establishing health education in schools
Peer approaches: students as players in health education and promotion
Principal characteristics of intervention programs
Evaluating the effectiveness of health education
Prevention of risks related to sexual behavior
Prevention of the risks associated with smoking
Prevention of risks associated with alcohol use
Prevention of the risks associated with "drug" use
The prevention of risks associated with psychoactive substance use in France
Recommendations
Dioxins in the environment: What are the health risks? (2000)
Foreword
Expert advisory group and authors
Synthesis
Nomenclature and physico-chemical properties of PCDDs and PCDFs
Structure–activity relationship
Assay methods
Expression of assay results
PCDD and PCDF formation
Principal dioxin reservoirs and emission sources
Contamination of environmental compartments
Transfer into the food chain
Human exposure assessment
Population burdens
Acute toxicity
Immunotoxicity in animals
Effects on animal reproduction and development
Carcinogenic effects in animals
Carcinogenic effects in humans
Other toxic effects in humans
Effects on reproduction and development in humans
Molecular cascade involving the Ah receptor
Consequences of the induction of cytochromes P450
Mechanisms of action involving the Ah receptor in endocrine diseases
Toxicokinetic models for risk assessment
Assessment of risk for low-dose chronic exposures
Risk assessment in the case of short-term overexposure
Recommendations
Childhood obesity: Screening and prevention (2000)
Foreword
Expert advisory group and authors
Synthesis
Toward an international definition of childhood obesity
Weight and height curves: an easy-to-use screening tool for childhood obesity
The prevalence of childhood obesity is above 10% in France
Changes in mean calorie intake cannot explain the increased prevalence of obesity in western populations
The prevalence of obesity increases with sedentary lifestyle
Genetic predisposition in common obesity is established, but the genes implicated remain to be identified
Obesity and socio-economic status: an uncertain relation in childhood
Obesity in childhood and adolescence is associated with increased cardiovascular morbidity in adulthood
Until now, preventive measures were not successful
Diagnosis of obesity is based on auxology and becomes more accurate by measuring fat mass distribution
Serum insulin, leptin, and free fatty acid levels are high in obese children
Nutritional factors affecting adipocyte formation, a phenomenon particularly important during early childhood and puberty
Obesity develops when energy intake exceeds energy expenditure
Maternal and postnatal diet influences the early development of systems regulating eating behavior in the animal
Brown adipose tissue in humans and its role in energy balance: a potential anti-obesity effect?
Regular physical activity induces reduced fat mass and improves metabolic anomalies in obese children
Recommendations
Copyright © 2000-2008
Institut National de la Santé et de la Recherche Médicale (INSERM)
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