The physical and psychological health of children entrusted to the care of the child protection and welfare service in Vendée.

BACKGROUND: The international literature has long established the importance of health issues presented by children entrusted to Child Protection and Welfare Service (Aide Sociale à l'Enfance -ASE, in France). This study examined the health of children entrusted to the ASE in Vendée (a French administrative region) in order to better understand and address their health needs. METHODS: A retrospective study of all children (623 out of 920) aged 0-18 years placed in foster care or an institution during 2019 was carried out. The data collection was based on the information in the medical form completed by the doctor during the annual health check. RESULTS: More than one quarter of the children had a written or spoken language disorder, 32% of children did not have a normal body mass index for their age, 10% of children suffered from enuresis, 4% from encopresis, and sleep disorders were observed in 29% of the study population. Furthermore, 51% of the children expressed psychological distress by internalizing or externalizing it, and 6% of children over 6 years of age had already run away or put themselves in danger. CONCLUSION: The results of our study are congruent with the international literature and confirm that children and adolescents in out-of-home care (foster care, residential care) have significantly higher healthcare needs than their peers. The findings also suggest several areas for improving the healthcare of children and adolescents entrusted to the care of the child protection and welfare services.

Cabazitaxel activity in men with metastatic castration-resistant prostate cancer with and without DNA damage repair defects.

BACKGROUND: Cabazitaxel was shown to improve overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) after abiraterone/enzalutamine and docetaxel failure, though benefit by the presence of DNA damage repair (DDR) defects is unknown. With the advent of poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPi) in partially overlapping indications with cabazitaxel, we aimed to determine cabazitaxel activity in men with mCRPC according to their DDR status. METHODS: This is a retrospective multicenter study that enrolled patients with mCRPC treated with cabazitaxel who had undergone DDR tumour tissue profiling. Patients with at least one deleterious germline or somatic alterations were considered DDR positive (DDR+). Each DDR + patient has been matched with a DDR negative (DDR-) from the same institution who underwent the same test. An exploratory cohort of patients found to be DDR + by liquid biopsy was also included. Prostate specific antigen (PSA) decline≥50% (PSA50), PSA progression-free survival (PFS, PSA-PFS), radiographic PFS (rPFS), clinical PFS or radiographic PFS (c/rPFS) and OS were evaluated. RESULTS: Among 190 men (95 DDR+, 95 DDR-) with tissue sequencing, PSA50 was achieved with cabazitaxel in 29/92 (32%) and 33/92 (36%) in patients with DDR+ and DDR- (P = 0.64). The median rPFS was 5.33 months [95%CI 4.34-7.04] versus 5.75 months [95%CI 4.67-7.27] (P = 0.55). The median OS was 15.4 months [95%CI 12.16-26.6] and 11.5 months [95%CI 9.76-14.4] (P = 0.036), respectively. No PSA50 responses on cabazitaxel were observed in BRCA1/2 patients previously treated with PARPi (n = 10). Similar outcomes with cabazitaxel were observed in the liquid biopsy cohort (n = 63 DDR+). CONCLUSIONS: Our study suggests that cabazitaxel is active in patients with mCRPC regardless of their DDR status, although its activity in men pretreated with a PARPi may be lower.

Scientific strategy and ad hoc response: the problem of typhoid in America and England, C. 1910-50.

In the early twentieth century, death rates from typhoid in European cities reached an all time low. By contrast, death rates in America were six times as high, and the American public health community began a crusade against the disease in 1912. In the 1920s, hopes for greater control of the disease focused not just on sewers and drinking water supplies, but on the newly established scientific means of immunization, the supervision of food-related pathways of infection, and the management of healthy carriers. The management of carriers, which lay at the core of any typhoid control program, proved an intractable problem, and typhoid remained a public health concern. America and England both struggled with control of the disease during the interwar period. Coming from different starting points, however, their approaches to the problem differed. This paper compares and contrasts these different public health strategies, considers the variable quality of support provided by bacteriological laboratories, and demonstrates that "accidental" typhoid outbreaks continued to happen up to the outbreak of World War II.

[Professional development of nurses in promoting health]. / Développement professionnel infirmier en promotion de la santé.

This research aims to help the nursing staff and it will help them to develop the skills to use among the school community. On top of her ordinary skills and beyond simple prescriptions, a nurse also has to teach and promote health. It is believed that there is a link between the professional and the personal development. This research deals with the different approaches of (N=30) nurses working within different schools in « Ille et Vilaine ¼. Nurses ?experiences have been questioned to identify how this professional development centered on three issues : awareness ; identity process and what group they belong to. This qualitive research lies on varied tools that use a compared analysis based on two different types : an oral interview and a pondering written part.

[Paul Ehrlich and commercial serum production: on the control of diphtheria antitoxin in the laboratory and in industry]. / Paul Ehrlich und die Serumproduzenten: Zur Kontrolle des Diphtherieserums in Labor und Fabrik.

The state control of the anti-diphtheria serum is a prime example for the efficient cooperation between state authorities, industrials and scientists. The article describes firstly the dynamics of this development and places it in the context of already existing approaches to drugs control. Of special interest are the motives which led the different actors to support the state control of sera. Secondly the reciprocal influences between Ehrlich and the serum producers are analyzed. It is shown that practical problems inspired Ehrlich's theoretical work, which in return led to an improvement of measurement techniques.

[Building confidence in biological products]. / Skabelse af tillid til biologiske produkter; Thorvald Madsen og international sundhed mellem de to verdenskrige.

During the last decades of the 19th century, discoveries in microbiology paved the way for health programmes as an integral part of social modernisation. Public opinion about the consequences for governmental involvement differed, but in Denmark the state's openness to modern medicine encouraged the establishment of Statens Serum Institut (SSI) in 1902, initially for the production of anti-diphtheritic serum. Under its director, Thorvald Madsen (1870-1957), the SSI soon acquired a reputation for the high quality of its products and its cutting edge research. After qualifying in medicine in 1893, Madsen worked both at the Pasteur Institute and with Paul Ehrlich in Frankfurt. During World War I, he served with the Red Cross, caring for German, Austrian and Russian prisoners of war. He had an extensive and expanding network of international contacts, and he was eminently qualified to assume the elected office of President of the League of Nations' Health Committee. The Committee served as the 'parliamentary body' of the League of Nations Health Organisation (LNHO), and Madsen's hand can be seen in much of the work undertaken by the LNHO. The drive to achieve uniform standards for biological products related directly to his own as well as the SSI's interests and expertise. Undoubtedly, standardization of biological products had an immense importance for their distribution, scientifically, commercially and therapeutically. Madsen was president of the LNHO's Commission on Biological Standardisation from 1924, and during the interwar years, the SSI was heavily involved in establishing standards for biological products such as tuberculin and tetanus antitoxin. Madsen's interests extended to application of prevention technologies, and he utilised the opportunities in Denmark to further their use, notably in the case of tuberculosis. The introduction of the BCG vaccine promised a solution to the TB problem, but the Lübeck disaster generated a widespread reaction against the vaccine. Sponsorship from the Rockefeller Foundation led to close investigation of TB incidence in Denmark, and eventually to the offer of vaccination of tuberculin-negative Danes. The programme provided a foundation for later UNICEF and WHO eradication policies. The paper throws light on how local cultures and experience, and personal dedication, shaped the policies developed by the interwar international movement.

The pioneering use of a questionnaire to investigate a food borne disease outbreak in early 20th century Britain.

This paper describes the investigation by a British local government board inspector in 1902, H Timbrell Bulstrode, into the cause of an outbreak of enteric fever after a mayoral banquet given at Winchester. This investigation helped to confirm the role of oysters as an agent of transmission of typhoid fever. The data are also reanalysed using a modern approach, which confirmed the role of oysters (odds ratio = 11.2, 95% CI 2.5 to 50.1). This episode is illustrative of the role of British public health inspectors at the turn of the 20th century as well as of the conditions in which the technique of investigating outbreaks of food borne diseases using a standardised menu was developed. Current methods of outbreak investigations that differ from Bulstrode's pioneering work are also discussed.

Animals, disease, and man: making connections.

The intricate causal relationships between disease in man and disease in animals first began to be elucidated in the mid-19th century. Although the connections between animal and human disease are now generally understood, individuals as well as societies remain slow to act on this knowledge. This paper examines the gradual recognition of these disease connections and explores the parallel theme of man's reluctance to appreciate the implications of these connections. It identifies factors that have inhibited the realization of the links between disease in man and animals, and discusses several milestones in the scientific elucidation of these links. Beginning with emerging concerns over the relationship between bovine and human tuberculosis in the 1860s, it follows the discovery of insect vectors, animal reservoirs, and the links between animals, influenza, and man. Despite warnings of the potential significance for human disease of patterns of changes in the relationship with animals and the natural world, scientists have continued to treat human and animal health as largely independent disciplines, while historians too have neglected this important aspect of human disease.

Professional advantage and public health: British veterinarians and State Veterinary Services, 1865-1939.

At the beginning of the twentieth century, municipal authorities in England and Wales, and in Scotland, began to develop systems of veterinary public health which encompassed both the welfare of animals and the safety of meat and milk intended for human consumption. This paper examines the motives behind veterinary attempts to extend the integration of human and animal health considerations within the public health framework in the inter-war period. In 1938 the Ministry of Agriculture implemented a national administrative structure for the management of animal diseases which absorbed the veterinary personnel of the municipal authorities, whose own veterinary public health activities largely fell into abeyance. As a result, the ideal of veterinary public health disappeared from British public health practice after 1939, and lost its force as a professional political cause. The mid-century disappearance of animal health from consideration in British public health programmes was one of a complex of historical strands which contributed to the late-twentieth-century emergence of public health crises over such animal-borne diseases as salmonellosis, Escherichia coli infection, and bovine spongiform encephalopathy.