BackgroundCramps are involuntary painful muscle contractions that mainly affect older people. Cramps may cause severe pain and sleep disturbance. Little information exists on the prevalence and the main features of cramps in primary care settings. The objective of this study was to estimate the prevalence and the main features of cramps among primary care patients aged 60 years and older.MethodsWe prospectively enrolled 516 patients aged 60 years and older in a cross-sectional study at 25 general practices in Alsace – France between October 2011 and March 2012. Questionnaires were used to obtain information about demographics, cramp presence and main features, medical history, and treatment.ResultsThe adjusted prevalence was 46 % (95 % CI: 38–53 %). Thirty-one per cent of the study sample reported being woken up by cramps, 15 % had cramps more than 3 times a month. Logistic regression revealed a slightly higher prevalence in the age group 65–69 years compared to 60–64 years. No significant association was observed between other age groups and prevalence, or between gender and prevalence. The main localization of cramps was in the calves (80 %). The duration since onset was 5 years or more for 58 %.ConclusionsCramps are common in primary care, and although only a minority of patients report suffering from cramps more than once a week, many patients report cramp-related sleep disturbance. Further studies are needed to assess risk factors and therapeutic options for patients suffering from cramps in primary care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0509-9) contains supplementary material, which is available to authorized users.

Legs cramps are a frequent disorder, which have a negative impact on quality of life, particularly among patients over 60 years old. Lifestyle factors such as alcohol consumption have been shown to be associated with nocturnal Leg cramps. this study aimed to explore the association between nocturnal leg cramps and a sedentary lifestyle among elderly patients. A case-control study was conducted with a Bayesian approach for sensitivity analysis. Patients over 60 years old consulting their family doctor were recruited in the Alsace region, france. cases were matched with controls free from cramps for age, sex, medical history and medications known to trigger cramps. the level of physical activity was assessed using the Dijon physical Activity Score (DpAS). We performed univariate and multivariate analyses adjusting for alcohol consumption. 272 participants were matched into 136 pairs. 11% of all were sedentary persons. Adjusting for alcohol consumption, we observed an association between nocturnal Leg cramps and a sedentary lifestyle oR = 9.84 (95% credibility interval [1.74; 101.9]; posterior probability 99.68%). Our findings represent an additional argument to promote physical activity to patients over 60 years old. They also highlight the need to develop and evaluate physical activity interventions in the treatment of nocturnal Legs cramps. Nocturnal Leg Cramps (NLC) are painful, involuntary contractions of muscles 1-3. NLC is a specific entity of idiopathic cramps occurring at rest in the lower limb during the night 4-7. NLC are associated with a reduced quality of sleep 6 and reduced physical component scores on the SF36 quality of life questionnaire 8. Among patients over 60 years old the cramp prevalence varies from 46% to 56% 4,9. Nonetheless, patients rarely report NLC to their general practitioners 4,10,11. One of the reasons may be the known lack of both effective and safe treatments 9,11-13. Specific medical conditions and drug treatments have been identified to be associated with muscle cramps 10,14. Recently, we also showed a strong association with the global consumption of alcoholic beverages 15. Still, most cramps are considered idiopathic 16 and their physiological mechanism remains unclear 10,14. Some authors suggest that neuromuscular structures located in muscle, tendons and nerve fibres seem to be involved in the trigger of muscle cramps 4-6. Congruently with this assumption, musculoskeletal conditions associated with sedentary lifestyle 17 as well as work postures 18-20 , prolonged standing 21 and western habit of sitting instead of squatting 22 have been suspected of causing cramps and specifically NLC. We hypothesize that there may be an association between sedentary lifestyle and NLC. To the best of our knowledge, no study confirmed such a link, our aim was therefore to assess the association between a sedentary lifestyle and Nocturnal Leg Cramps in elderly patients. Methods Study design. The study was conducted within 67 general practices of the Strasbourg General Medicine Department pract...

We identified an association between alcohol consumption and nocturnal leg cramps among patients aged 60 years and older attending general practices. These findings have implications for the prevention of cramps.

BackgroundThe death of a simulated patient is controversial. Some educators feel that having a manikin die is prejudicial to learning; others feel it is a way of better preparing students for these situations. Perceived self-efficacy (PSE) reflects a person’s perception of their ability to carry out a task. A high PSE is necessary to manage a task efficiently. In this study, we measured the impact of the death of a simulated patient on medical students’ perceived self-efficacy concerning their ability to cope with a situation of cardiac arrest.MethodsWe carried out a single-centre, observational, prospective study. In group 1 (n = 27), pre-graduate medical students were warned of the possible death of the manikin; group 2 students were not warned (n = 29). The students’ PSE was measured at the end of the simulated situation and after the debriefing.ResultsThe PSE of the two groups was similar before the debriefing (p = 0.41). It had significantly progressed at the end of the debriefing (p < 0,001). No significant difference was noted between the 2 groups (p = 0.382).ConclusionsThe simulated death of the manikin did not have a negative impact on the students’ PSE, whether or not they had been warned of the possible occurrence of such an event. Our study helps defend the position which supports the inclusion of unexpected death of the manikin in a simulation setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0944-x) contains supplementary material, which is available to authorized users.

Contexte : Pour assurer la professionnalisation des étudiants, le périmètre de la formation initiale doit déterminer de manière explicite les compétences professionnelles à développer, la culture professionnelle à privilégier et l’identité professionnelle (IP) à soutenir. Définie comme une représentation subjective de soi en tant que professionnel, cette dernière permet une meilleure compréhension des rôles et développe le bien-être tant professionnel que personnel. Or, l’IP demeure mal définie au sein du référentiel de la formation initiale en maïeutique. But : Explorer et analyser la construction de l’IP lors de la formation initiale en maïeutique, afin d’en améliorer l’accompagnement lors de la formation. Méthodes : Étude qualitative à l’aide d’entretiens individuels semi-dirigés d’étudiants en deuxième année de formation en sciences maïeutiques. Résultats : Neuf entretiens ont été réalisés. L’IP des étudiants en maïeutique (EM) se construit dans le rapport à soi, à la profession, à la formation et aux autres, selon des processus de socialisation biographique et relationnelle. La construction de l’IP est ponctuée de périodes de « dissonance identitaire » permettant de concilier aspirations personnelles et projections professionnelles. Le développement des compétences professionnelles permet à l’EM de participer aux rôles et d’incorporer son IP en émergence. La construction est perturbée par l’incompréhension des attendus de la formation par les différents acteurs. Conclusion : Des perspectives s’envisagent pour soutenir les EM dans leur construction identitaire : reconnaître les périodes de rupture, engager précocement les étudiants dans la réflexivité et impliquer tous les acteurs de la formation pour une conception partagée.