The individual deprivation EPICES score is reliable. Deprivation was related to excess death rate, which clearly indicates that deprivation is a determinant factor that should be considered systematically by health policy makers and health-care providers.

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BackgroundFlexible optical bronchoscopes are essential for management of airways in ICU, but the conventional reusable flexible scopes have three major drawbacks: high cost of repairs, need for decontamination, and possible transmission of infectious agents. The main objective of this study was to measure the cost of bronchoalveolar lavage (BAL) and percutaneous tracheostomy (PT) using reusable bronchoscopes and single-use bronchoscopes in an ICU of an university hospital. The secondary objective was to compare the satisfaction of healthcare professionals with reusable and single-use bronchoscopes.MethodsThe study was performed between August 2009 and July 2014 in a 16-bed ICU. All BAL and PT procedures were performed by experienced healthcare professionals. Cost analysis was performed considering ICU and hospital organization. Healthcare professional satisfaction with single-use and reusable scopes was determined based on eight factors. Sensitivity analysis was performed by applying discount rates (0, 3, and 5%) and by simulation of six situations based on different assumptions.ResultsAt a discount rate of 3%, the costs per BAL for the two reusable scopes were 188.86€ (scope 1) and 185.94€ (scope 2), and the costs per PT for the reusable scope 1 and scope 2 and single-use scopes were 1613.84€, 410.24€, and 204.49€, respectively. The cost per procedure for the reusable scopes depended on the number of procedures performed, maintenance costs, and decontamination costs. Healthcare professionals were more satisfied with the third-generation single-use Ambu® aScope™.ConclusionsThe cost per procedure for the single-use scope was not superior to that for reusable scopes. The choice of single-use or reusable bronchoscopes in an ICU should consider the frequency of procedures and the number of bronchoscopes needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0228-3) contains supplementary material, which is available to authorized users.

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Deprivation is associated with a higher prevalence of the metabolic syndrome. The most relevant threshold for waist circumference could be 94 cm for men and 88 cm for women.

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BackgroundEmployment conditions are associated with health inequities. In 2013, French young people had the highest unemployment rate and among those who worked as salaried workers most of them had temporary job. The purpose of the study was to assess mental health state of French young people through the prism of their occupational status and to measure whether occupational status is a determinant of health inequities.MethodsA cross-sectional multicentre observational survey was performed in June and July 2010 in 115 French Local Social Centres and 74 Health Examination Centres, who were available to participate. The survey was based on an anonymous self-administrated questionnaire delivered by social workers or healthcare professionals to young people age from 16 to 25 years old. The questionnaire was composed of 54 items. Several health outcomes were measured: self-perceived health, mental health, addictions and to be victim of violence. The association of occupational status and mental health was assessed by adjusting results on age and gender and by introducing other explanatory variables such as social deprivation.ResultsA total of 4282 young people completed the questionnaire, a response rate of 83%, 1866 men and 2378 women, sex-ratio 0.79. French young people having a non-working occupational status or a non-permanent working status were more exposed to poor self-perceived health, poor mental health, addictions and violence. To be at school particularly secondary school was a protective factor for addiction.ConclusionsOccupational status of French young people was a determinant of mental health inequities. Young people not at work and not studying reported greater vulnerability and should be targeted therefore by appropriate and specific social and medical services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-017-0634-7) contains supplementary material, which is available to authorized users.