Améliorer la sécurité à vélo chez les enfants et les adolescents.

Le vélo demeure une activité populaire pour les enfants et les adolescents du monde entier; elle combine le plaisir de se déplacer rapidement et de nombreux avantages pour la santé et la société. Cependant, le vélo est également associé à un risque de blessures graves et de décès. Depuis dix ans, les recherches démontrent de plus en plus que l'amélioration de la sécurité des cyclistes dépend en grande partie de l'environnement dans lequel ils se déplacent et de mesures de sécurité individuelles comme le port du casque. Pour de nombreux enfants et adolescents, la pandémie a accru les possibilités de faire du vélo et, et elle ramené l'attention du public vers des infrastructures cyclables sécuritaires, telles que des voies cyclables réservées. Le présent document de principes passe en revue les données probantes en appui à des infrastructures cyclables plus sécuritaires pour les enfants et les adolescents, de même que les bienfaits du vélo pour la santé physique et mentale. Les avantages du transport actif chez les jeunes et l'influence de l'environnement bâti sur la sécurité et l'adoption du vélo sont exposés. Un aperçu des mesures que chacun peut prendre pour améliorer la sécurité à vélo est suivi de recommandations pour les cliniciens, la communauté des cyclistes, les parents et les décideurs.

[Can environmental impact be considered as a dimension of the proper use of medicines? From the 5th Forum of the Association for the Proper Use of Medicines]. / L'impact environnemental peut-il être considéré comme une dimension du bon usage des médicaments ? Retour sur le 5e Forum de l'Association Bon Usage du Médicament.

Through their footprint throughout their life cycle, from production to use, medicines have a significant impact on the environment. Reducing this impact is rarely considered from the perspective of the choices that healthcare professionals might have to make when prescribing or dispensing medicines. Should we consider environmental impact, alongside effectiveness and tolerance, one of the dimensions of the proper use of medicines? To address this question, the 5th Forum of the Association for the Proper Use of Medicines highlighted the main sources of pharmaceutical pollution: the carbon footprint linked to production, greenhouse gas emissions, the impact of residues on water and waste from packaging. While the eco-design of medicines should make it possible to limit their environmental impact upstream, there are still few initiatives aimed at their use. The Swedish "Hazard Score" assessment tool, which classifies compounds according to their potential to pollute the aquatic environment, was presented as a tool for guiding prescription choices. Through the exchanges between the various stakeholders (public authorities, doctors, pharmacists, manufacturers, patients) during this forum, recommendations were drawn up both on scientific and ethical grounds.

[The supportive environment in SRH: characteristics that promote self-determination]. / L'environnement soutenant en SSR : les caractéristiques qui favorisent l'autodétermination.

Hospitalization is an important stage in the life of the elderly. All too often, this experience is accompanied by both physical and psychological decline. Based on self-determination theory, the aim was to qualitatively characterize support for self-determination in follow-up care and rehabilitation services (behaviours and attitudes of healthcare professionals, and patients' perception of them).

[Psychiatric care teams: taking care and forgetting about it]. / Les équipes de soins en psychiatrie ou prendre soin à s'en oublier.

The psychiatric care team offers comprehensive, personalized support, raising public awareness, promoting mental equilibrium and combating stigmatization. Its role includes collaboration, communication, designing adapted treatment plans and creating a climate of trust to influence the quality of care. In this way, she contributes to a more inclusive and caring society. As such, her own state of well-being deserves special attention. However, they often work in a highly degraded ecosystem that can be likened to psychiatry in a war zone.

[Towards an ideal environment in neonatology]. / Vers un environnement idéal en néonatalogie.

The establishment of sensory systems occurs gradually along a transnatal continuum. During premature birth, hospitalization in neonatology, through its atypical sensory stimulations, can disrupt the development of the baby's still immature brain. To promote harmonious development in children, caregivers and parents must learn to take into account their sensory expectations in order to create the most suitable environment possible for their development.

[Children with atopic eczema and their environment]. / L'enfant atteint d'eczéma atopique et son environnement.

Taking an interest in the environment of a child suffering from eczema means understanding the word "environment" in the broadest possible sense: the child's lifestyle, family, social and cultural environment. By taking all these aspects into account, we can optimize the effectiveness of treatments, and avoid the multiple problems and comorbidities associated with moderate and severe eczema. It's up to caregivers to be vigilant about this, and to reposition the right gestures by spotting errors right from the start, even in the case of mild eczema. The best way to respond to this challenge, i.e. to help parents understand, is to draw on the principles of therapeutic patient education.

[Motivation for physical exercise: the benefits of active transport in the fight against sedentary lifestyles]. / Motivation à la pratique physique : intérêts des transports actifs pour lutter contre la sédentarité.

Our contemporary lifestyles offer little incentive to be physically active, and give us far fewer opportunities to be active than in the past, with many of our tasks being sedentary and most of our transport being motorized. While it's easy to acknowledge a lack of physical activity, putting it into practice is eminently more complex, and many researchers are trying to answer the thorny question: how can we enable people to be more physically active in their daily lives? With this in mind, the aim of this article is to show that active transport is an effective way of getting sedentary people to engage in regular physical activity.

[Angele experiment: innovative care paths for allergy sufferers]. / Expérimentation Angele : des parcours de soins innovants pour les patients allergiques.

The Angele project (for Allergies complexes: prise en charge globale, diététique et environnementale) is an article 51 experiment in shared care pathways in allergology. These care paths, dedicated to patients with allergies to house dust mites and/or food, involve collaboration between doctors and paramedics. The aim of this initiative is to optimize patient care by structuring their care pathways. This article presents these pathways and the preliminary results of the experiment.

[Antibiotic resistance, a cross-functional issue (One Health)]. / L'antibiorésistance, un enjeu transversal (One Health).

Antibiotic resistance is a public health issue that must be tackled within the One Health concept. This means continuing efforts to coordinate the action plans of the various ministries, on the one hand, and gaining a better understanding (from a scientific point of view) of the key points in the passage of antibiotic resistance between two sectors, on the other. This article shows how human medicine, veterinary medicine and the environment are affected by this issue.

[Using simulation for assessment: the example of OSCE in medical students]. / La simulation pour les évaluations : l'exemple des Ecos chez les étudiants en médecine.

Training of health sciences students is based on the acquisition of clinical skills. Tools assessing the application of theoretical knowledge through written examinations or the tools evaluating student's performance at patient bedsides are characterized by a low reliability. The Objective Structured Clinical Examination (OSCE) was developed to address the lack of reliability and standardization of traditional forms of the assessment of clinical performance.

Phenanthrene-degrading Sphingobium xenophagum are widely distributed in the western Pacific Ocean.

Six phenanthrene-degrading bacteria were isolated from surface seawater sampled from the western Pacific Ocean. They were identified as Sphingobium xenophagum (formerly Sphingomonas xenophaga) based on morphological, biochemical, and chemical characteristics, and 16S rRNA sequences. The salinity ranges for the growth of these isolates were broader than those of the seven reported Sphingomonas strains isolated from soil, and the optimum NaCl concentration in the growth medium was higher than that for soil sphingomonads. These isolates also exhibited higher phenanthrene-degrading activity under briny conditions than that of a phenanthrene-degrading Sphingomonas strain isolated from soil. A DNA fragment carrying nah genes, which are encoded on the naphthalene-catabolic plasmid NAH of Pseudomonas putida PpG7, hybridised less strongly with the total DNA of all isolates. Certain genes involved in phenanthrene degradation were also preliminarily characterised in all isolates. This is the first demonstration that S. xenophagum strains, which are able to degrade phenanthrene, are widely distributed in marine environments, and that the growth and phenanthrene-degrading activity of these strains are adapted to briny conditions. The results also suggest that genes for phenanthrene degradation, which are dissimilar to nah genes, were also ubiquitously distributed in marine strains.

Food Environment and Youth Intake May Influence Uptake of Gluten-Free Food Guide Recommendations in Celiac Disease.

A gluten-free (GF) food guide for children and youth (4-18 years) living with celiac disease (CD) has been developed and extensively evaluated by stakeholders, including registered dietitians. A case study analysis was conducted on data from 16 households of youth with CD to examine how factors related to parental food literacy, the home food environment, and food purchasing patterns may influence food guide uptake by Canadian youth with CD and their families. Households were of higher socioeconomic status, parents had good food literacy, and the home food availability of fruits, vegetables and GF grains was diverse. However, households also had a diverse supply of convenience foods and snack options. Youth reported consuming a larger proportion of these foods (>35% dietary intake) and had suboptimal diet quality. Dietary intake of fruits and vegetables were below GF plate model recommendations by over 30%. Despite limited economical barriers, good parental food literacy, and diverse food availability, meeting fruit and vegetable recommendations based on the pediatric GF food guide remains a major challenge. Findings inform that effective strategies and healthy public policies to support the uptake of GF food guide recommendations are needed to improve the health outcomes of youth with CD.

Sixty Percent of Foods Advertised in Grocery Store Flyers are Not In-line with Canada's Food Guide.

Purpose: To evaluate foods advertised in discount and premium grocery flyers for their alignment with Canada's 2007 Food Guide (CFG) and assess if alignment differed by food category, season, page location, and price.Methods: Weekly flyers (n = 192) were collected from discount and premium grocery chains from each of 4 seasons. Health Canada's Surveillance Tool was used to assess food items as in-line or not in-line with CFG.Results: Of 35 576 food items, 39.7% were in-line with CFG. There were no differences in proportions of foods not in-line in discount versus premium flyers (60.9% and 60.0%, respectively). Other Foods and Meat & Alternatives were advertised most (28.0% and 26.3%, respectively; P < 0.001). Milk & Alternatives were the least advertised food group (10.3%). Vegetables & Fruit (19.6%), Grains (21.6%), Milk & Alternatives (20.6%), and Meat & Alternatives (20.2%) were promoted least in Fall (P < 0.001). A higher proportion of foods advertised on middle pages were not in-line (61.0%) compared with front (56.6%) and back (58.8%) pages (P < 0.001). Not in-line foods were more expensive ($3.49, IQR = $2.82) than in-line foods ($3.28, IQR = $2.81; P < 0.001).Conclusions: While there was no difference in healthfulness of foods advertised in discount versus premium flyers, grocers advertised more foods not in-line with CFG. Government policies to improve the food environment should consider grocery flyers.

[French national overview of the inclusion of environmental criteria in the public purchasing of health products (drugs and sterile medical devices)]. / Prise en compte des critères environnementaux dans la commande publique des produits de santé.

OBJECTIVES: Healthcare products (HP) have a significant carbon footprint that must be included by regulation in the facility's purchasing policy. A national overview of the inclusion of environmental criteria (EC) in the public procurement (PP) of HP in hospitals has been carried out. METHODS: Thirty EC were identified in the literature. Two questionnaires were proposed: (i) for buyers that analyze the level of "importance" and "ease of application" for public tenders (PT), and (ii) for suppliers that declare their commitments and evidence. RESULTS: Six regional buyers and 28 suppliers participated. Buyers recognize the "importance" of sustainable development (SD) but are more reticent about the "applicability" of EC in PT. The environmental rating remains low: on average 4.38 (0.25-10.00) % of the total rating. Only 12 EC are integrated within some PT. Suppliers report a high and diversified commitment to SD: 18 suppliers sent 474 evidence. Buyers and suppliers converge on the optimization of primary packaging and the establishment of a minimum order or delivery group. CONCLUSIONS: Since the efficiency of PP is inevitable, EC that combines SD and savings should be prioritized. The integration of additional EC, simple and easily documented, allowing cost containment for both suppliers and buyers, is possible to promote sustainable purchasing.

[Depression in the elderly and the environment]. / Dépression chez la personne âgée et environnement.

Depression in the elderly is difficult to identify because it is often masked by other pathological features. It is therefore important for everyone involved to be vigilant and to be able to ask for help from a qualified professional. The individual interacts with his or her human and material environment. The environment can be depressogenic. The quality of life of the person intervenes in the course of the depression.

[The enriched garden concept: An innovation in geriatrics]. / Le concept de jardin enrichi, une innovation en gériatrie.

Societal expectations underline the importance of offering nursing home résidents an environment that is favorable to health and quality of life. Experimental studies conducted on the enriched environment have shown interesting perspectives without, however, transposing them to the living environment of the older persons. The enriched garden is an innovative concept in geriatrics, resulting from translational research that could provide encouraging answers to the question of improving the living environment in psycho-geriatric institutions.

[Child-nature interactions as the basis for a sense of kinship with the environment]. / Les interactions enfants-nature, assises du sentiment de parenté avec l'environnement.

With the advent of bipedalism, human beings have experienced a different relationship with the environment and have greatly transformed it. Today, 67 to 80% of French people live far from rural areas, in cities that are sometimes very large. However, relationships with nature are essential to our development and to our physical and emotional well-being. Supporting children through encounters with nature contributes to their development. In this way, it is possible to combine the care of young children with, in the longer term, the care of the environment.

Interdisciplinary community-based participatory health research across the industrial region of the Étang de Berre : The EPSEAL Fos Crau study.

BACKGROUND: We conducted a community-based participatory environmental health study in three towns: two in the heart of Marseille's industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône), and one on the periphery located about 30 km away (Saint-Martin-de-Crau). METHODS: We first conducted a cross-sectional survey of a random sample of residents in each of the three towns. We asked study participants to self-report a wide variety of health issues (Port-Saint-Louis: n = 272, Fos-sur-Mer: n = 543, Saint-Martin-de-Crau: n = 439). We then conducted focus groups with residents and other stakeholders to share preliminary data in order to propose areas of reflection and collaboratively produce contextually-situated knowledge of their health and environment. We directly standardized the prevalences (by age and gender) to the French metropolitan population to make our results more comparable. RESULTS: Study participants who lived closer to the core industrial zone (residents of Fos-sur-Mer and Port-Saint-Louis-du-Rhone) had higher prevalences of eye irritation, nose and throat problems, chronic skin problems and headaches than people who lived further away (residents of Saint-Martin-de-Crau). Residents also offered diverse qualitative insights about their environment and health experiences. DISCUSSION: We observed elevated prevalences of diseases that affected residents across the industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône) compared to those living outside (Saint-Martin-de-Crau), and qualitative evidence of how residents made sense of their health experiences strengthening an understanding of their own empirical observations which helps to produce knowledge about health in an industrial context. The results of the workshops show an important benefit from the co-production of local knowledge. CONCLUSION: We encourage future researchers to do in-depth, community-based research to comprehensively describe the health of residents in other heavily polluted zones, product local knowledge and to help identify policy solutions, engender trust among the local people, and identify opportunities for intervention.

Positive environmental impact of remote teleconsultation in urology during the COVID-19 pandemic in a highly populated area.

INTRODUCTION: Greenhouse gas (GHG) emissions are a serious environmental issue. The healthcare sector is an important emitter of GHGs. Our aim was to assess the environmental cost of teleconsultations in urology compared to face-to-face consultations. MATERIALS AND METHODS: Prospective study of all patients who had a remote teleconsultation over a 2-week period during COVID-19 pandemic. Main outcome was the reduction in CO2e emissions related to teleconsultation compared to face-to-face consultation and was calculated as: total teleconsultation CO2e emissions-total face-to-face consultation CO2e emissions. Secondary outcome measures were the reduction in travel distance and travel time related to teleconsultation. RESULTS: Eighty patients were included. Face-to-face consultations would have resulted in 6699km (4162 miles) of travel (83.7km (52 miles) per patient). Cars were the usual means of transport. CO2e avoided due to lack of travel was calculated at 1.1 tonnes. Teleconsultation was responsible for 1.1kg CO2e while face-to-face consultation emitted 0.5kg of CO2e. Overall, the total reduction in GHGs with teleconsultation was 1141kg CO2e, representing a 99% decrease in emissions. Total savings on transport were 974 € and savings on travel time were 112h (1.4h/patient). CONCLUSIONS: Teleconsultation reduces the environmental impact of face-to-face consultations. The use of teleconsultation in our urology departments resulted in the avoidance of more than 6000km of travel, equivalent to a reduction of 1.1 tonnes of CO2e. Teleconsultation should be considered for specific indications as the healthcare system attempts to become greener. LEVEL OF EVIDENCE: 3.

[Cognitive aging apart from dementia]. / Le vieillissement cognitif en dehors de la démence.

Cognitive aging apart dementia results from different genetic programming, different according to individuals. The aging of the various cognitive and very heterogeneous cognitive functions largely depends on the life course of each person. Social factors, in particular the environment in which a person lives, may or may not accelerate the processes of cognitive aging. The slower processing speeds of information from the environment, practical or strategic new acquisitions, and the difficult management of multiple tasks, reflect an age-related hypofrontality. Physical and mental health, social and relational well-being participate in good cognitive aging. Exploration of the different facets of cognitive aging shows its complexity.