RESUMEN
PURPOSE: Because of the increase of cannabis use, healthcare professionals are more and more confronted with pregnancies which have been exposed to this drug. There may be health consequences during the course of pregnancy and also for the babies throughout their development. We have made a study in order to evaluate practices of detection and care for pregnant women who use cannabis. METHODS: A questionnaire was sent to all gynaecologists (GYNs), obstetricians (OBs) and midwives (MWs) in the district of Loire-Atlantique and to a 20% randomized sample of general practitioners (GPs). RESULTS: The participation rate was 60.1%. Only 51.4% of healthcare professionals asked their patients about drugs use and 68.1% didn't feel informed enough about the risks of cannabis use during pregnancy. There was a significant difference between the healthcare professionals who deliver babies (OBs and MWs) and those who only do prenatal consultations (GYNs and GPs). The first group question their patients about the use of cannabis more often (69.1% versus 39.8%; p = 0.01), and also feel more informed about the risks of cannabis use during pregnancy (42.0% versus 24.4%; p = 0.025). CONCLUSIONS: Healthcare professionals who supervise childbirth have a more accurate perception of the risk related to the consumption of cannabis during pregnancy. But preventive action must be taken early on because the lack of early identification at the beginning of pregnancy represents a public health problem. After observing the results we feel there is a strong need for training for all practitioners.
Asunto(s)
Actitud del Personal de Salud , Abuso de Marihuana/prevención & control , Servicios de Salud Materna , Complicaciones del Embarazo/prevención & control , Femenino , Francia , Ginecología/normas , Ginecología/estadística & datos numéricos , Encuestas de Atención de la Salud , Humanos , Servicios de Salud Materna/normas , Servicios de Salud Materna/estadística & datos numéricos , Partería/normas , Partería/estadística & datos numéricos , Obstetricia/normas , Obstetricia/estadística & datos numéricos , Embarazo , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
The Celtic culture of Western Europe left magnificent gold objects, such as jewellery and weapons from nobility graves and hoarded coins, as well as field evidence of pre-Roman gold mining and metallurgical workshops that attest to the mining of local ores. This is the case of Central France where many precious metallic ores have been mined throughout the ages from the Prehistoric times onwards. One of the lingering problems in assessing the provenance of gold artefacts and coins is the lack of relevant data on the isotope geochemistry and mineralogy of ore sources. Forty gold ores samples were collected and studied from Limousin (French Massif Central), a very significant gold mining district from the Celtic times. Their Pb isotope compositions clearly show a local dichotomy i.e. two distinct groups of ores, one of Late Proterozoic to Early Paleozoic Pb model age and another associated to Variscan ages and consistent with field relationships, mineralogy and elemental analyses. The use of Cu and Ag isotopes, and their coupling with Pb isotopes, will refine the tracing of future metal provenance studies, but also highlight some metallurgical practices like deliberate metal additions to gold artefact or debasement of gold coins. The newly acquired Pb, Ag, and Cu isotopic data on gold ores improves our understanding of ore deposits geology and provide clarifications on the provenance of Celtic gold from this area and its economic importance.