Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 93.778
Filtrar
2.
Artigo em Inglês | MEDLINE | ID: mdl-33007976

RESUMO

BACKGROUND: Understanding SARS-CoV-2 dynamics and transmission is a serious issue. Its propagation needs to be modeled and controlled. The Alsace region in the East of France has been among the first French COVID-19 clusters in 2020. METHODS: We confront evidence from three independent and retrospective sources: a population-based survey through internet, an analysis of the medical records from hospital emergency care services, and a review of medical biology laboratory data. We also check the role played in virus propagation by a large religious meeting that gathered over 2000 participants from all over France mid-February in Mulhouse. RESULTS: Our results suggest that SARS-CoV-2 was circulating several weeks before the first officially recognized case in Alsace on 26 February 2020 and the sanitary alert on 3 March 2020. The religious gathering seems to have played a role for secondary dissemination of the epidemic in France, but not in creating the local outbreak. CONCLUSIONS: Our results illustrate how the integration of data coming from multiple sources could help trigger an early alarm in the context of an emerging disease. Good information data systems, able to produce earlier alerts, could have avoided a general lockdown in France.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Betacoronavirus , Monitoramento Epidemiológico , França/epidemiologia , Humanos , Comportamento de Massa , Pandemias , Estudos Retrospectivos
3.
J Environ Qual ; 49(4): 921-932, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33016496

RESUMO

Colloids (1-1,000 nm) are important phosphorus (P) carriers in agricultural soils. However, most studies are based on colloids from soil waters extracted in the laboratory, thus limiting the understanding of the natural transfer of colloidal P along the soil-to-stream continuum. Here, we conducted a field study on the colloidal P in both natural soil waters and their adjacent stream waters in an agricultural catchment (Kervidy-Naizin, western France). Soil waters (10-15 cm, Albeluvisol) of two riparian wetlands and the adjacent stream waters were sampled monthly during wet seasons of the 2015-2016 hydrological year (seven dates in total). Ultrafiltration at three pore sizes (5 kDa, 30 kDa, and 0.45 µm) was combined with inductively coupled plasma mass spectrometry (ICP-MS) to investigate variability in colloidal P concentration and its concomitant elemental composition. Results showed that colloidal P represented, on average, 45 and 30% of the total P (<0.45 µm) in the soil waters and stream waters, respectively. We found that colloidal P was preferentially associated with (a) organic carbon in the fine nanoparticle fraction (5-30 kDa) and (b) iron-oxyhydroxides and organic carbon in the coarse colloidal fraction (30 kDa-0.45 µm). The results confirmed that colloidal P is an important component of total P in both soil waters and stream waters under field conditions, suggesting that riparian wetlands are hotspot zones for the production of colloidal P at the catchment scale, which has the potential to be transported to adjacent streams.


Assuntos
Rios , Solo , Coloides , França , Fósforo/análise
4.
Cancer Radiother ; 24(6-7): 762-767, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32873486

RESUMO

Health data financed by the French national solidarity system constitute a common heritage. Such data should be exploited to optimize care while complying with ethics and fundamental rights of citizens. The creation of the Health Data Hub (HDH) was allowed by the 24 July 2019 Law on the organization and transformation of the French health system. Its objective is to enable authorized innovative project leaders to access non-nominative data via a state-of-the-art secure technological platform. It appears to be one of the strong points of the French Artificial Intelligence strategy. This structure is a public interest group which associates 56 stakeholders, mostly from the public authorities. It implements, in partnership with the National Health Insurance Fund, the major strategic orientations relating to the National Health Data System set by the French State and the Ministry of Solidarity and Health. The Health Data Hub allows cross-reference of consolidated databases with SNDS data. Several use cases are under construction. The creation of relational databases in radiation oncology is also possible through specific strategies to get pseudonymized data from the various radiotherapy software programs upstream of the Health Data Hub.


Assuntos
Bases de Dados Factuais , Oncologia , Neoplasias/radioterapia , Radioterapia (Especialidade) , França , Humanos
5.
Epidemiol Infect ; 148: e221, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32958091

RESUMO

The main objective of this paper is to address the following question: are the containment measures imposed by most of the world governments effective and sufficient to stop the epidemic of COVID-19 beyond the lock-down period? In this paper, we propose a mathematical model which allows us to investigate and analyse this problem. We show by means of the reproductive number, ${\cal R}_0$ that the containment measures appear to have slowed the growth of the outbreak. Nevertheless, these measures remain only effective as long as a very large fraction of population, p, greater than the critical value $1-1/{\cal R}_0$ remains confined. Using French current data, we give some simulation experiments with five scenarios including: (i) the validation of model with p estimated to 93%, (ii) the study of the effectiveness of containment measures, (iii) the study of the effectiveness of the large-scale testing, (iv) the study of the social distancing and wearing masks measures and (v) the study taking into account the combination of the large-scale test of detection of infected individuals and the social distancing with linear progressive easing of restrictions. The latter scenario was shown to be effective at overcoming the outbreak if the transmission rate decreases to 75% and the number of tests of detection is multiplied by three. We also noticed that if the measures studied in our five scenarios are taken separately then the second wave might occur at least as far as the parameter values remain unchanged.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Simulação por Computador , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , França/epidemiologia , Humanos , Modelos Teóricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Reprodutibilidade dos Testes
6.
PLoS One ; 15(9): e0239573, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970772

RESUMO

INTRODUCTION: Severe acute respiratory syndrome coronavirus2 has caused a global pandemic of coronavirus disease 2019 (COVID-19). High-density lipoproteins (HDLs), particles chiefly known for their reverse cholesterol transport function, also display pleiotropic properties, including anti-inflammatory or antioxidant functions. HDLs and low-density lipoproteins (LDLs) can neutralize lipopolysaccharides and increase bacterial clearance. HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) decrease during bacterial sepsis, and an association has been reported between low lipoprotein levels and poor patient outcomes. The goal of this study was to characterize the lipoprotein profiles of severe ICU patients hospitalized for COVID-19 pneumonia and to assess their changes during bacterial ventilator-associated pneumonia (VAP) superinfection. METHODS: A prospective study was conducted in a university hospital ICU. All consecutive patients admitted for COVID-19 pneumonia were included. Lipoprotein levels were assessed at admission and daily thereafter. The assessed outcomes were survival at 28 days and the incidence of VAP. RESULTS: A total of 48 patients were included. Upon admission, lipoprotein concentrations were low, typically under the reference values ([HDL-C] = 0.7[0.5-0.9] mmol/L; [LDL-C] = 1.8[1.3-2.3] mmol/L). A statistically significant increase in HDL-C and LDL-C over time during the ICU stay was found. There was no relationship between HDL-C and LDL-C concentrations and mortality on day 28 (log-rank p = 0.554 and p = 0.083, respectively). A comparison of alive and dead patients on day 28 did not reveal any differences in HDL-C and LDL-C concentrations over time. Bacterial VAP was frequent (64%). An association was observed between HDL-C and LDL-C concentrations on the day of the first VAP diagnosis and mortality ([HDL-C] = 0.6[0.5-0.9] mmol/L in survivors vs. [HDL-C] = 0.5[0.3-0.6] mmol/L in nonsurvivors, p = 0.036; [LDL-C] = 2.2[1.9-3.0] mmol/L in survivors vs. [LDL-C] = 1.3[0.9-2.0] mmol/L in nonsurvivors, p = 0.006). CONCLUSION: HDL-C and LDL-C concentrations upon ICU admission are low in severe COVID-19 pneumonia patients but are not associated with poor outcomes. However, low lipoprotein concentrations in the case of bacterial superinfection during ICU hospitalization are associated with mortality, which reinforces the potential role of these particles during bacterial sepsis.


Assuntos
HDL-Colesterol/sangue , LDL-Colesterol/sangue , Infecções por Coronavirus/sangue , Pneumonia Bacteriana/sangue , Pneumonia Associada à Ventilação Mecânica/sangue , Pneumonia Viral/sangue , Superinfecção/sangue , Idoso , Betacoronavirus , Infecções por Coronavirus/mortalidade , Feminino , França , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Bacteriana/mortalidade , Pneumonia Associada à Ventilação Mecânica/mortalidade , Pneumonia Viral/mortalidade , Estudos Prospectivos
7.
Rev Infirm ; 69(263): 37-39, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32993905

RESUMO

Covid-19: psychological support programmes. The spread of Covid-19 in France, the confinement of the population and the changes to our way of life as a result of the health crisis have caused psychological distress to many people of all ages and conditions. In response to these problems, numerous remote psychological support programmes have been set up through teleconsultations. PsyCovid-19, created at Cadillac psychiatric hospital, is one such example.


Assuntos
Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Sistemas de Apoio Psicossocial , Telemedicina , Betacoronavirus , França/epidemiologia , Humanos , Pandemias
8.
Bull Cancer ; 107(9): 867-880, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32919610

RESUMO

INTRODUCTION: Few studies have explored the long-term occupational situation after cancer. The aim of our study were to study the employment status among long-term cancer survivors and to compare it to cancer-free controls from the general population at 5, 10 or 15 years after cancer diagnosis. METHODS: From data of a registry-based study, long-term survivors from breast,cervical and colorectal cancer, randomly selected from three tumor registries in France, were compared to cancer-free controls randomly selected from electoral lists. We selected active cancer survivors and cancer-free controls aged less than 60 at the time of the survey. We have studied the employment status of cases vs. controls and the factors associated with employment status. RESULTS: At 5, 10 or 15 years after diagnosis, we did not observe any significant difference in employment status between cases and controls. Among cases, 17% had lost their jobs. Older age, lower incomes, lower education, a short-term employment contract, the presence of co-morbidities, fatigue and a worse quality of life were associated with job loss. DISCUSSION: Although the employment status of the cases was comparable to that of the controls, efforts should be intensified to make it easier for patients diagnosed with cancer to return to work.


Assuntos
Sobreviventes de Câncer , Emprego/estatística & dados numéricos , Adulto , Neoplasias da Mama/terapia , Neoplasias Colorretais/terapia , Estudos Transversais , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Tempo , Neoplasias do Colo do Útero/terapia , Adulto Jovem
9.
BMC Infect Dis ; 20(1): 682, 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32942989

RESUMO

BACKGROUND: Enterobacter cloacae species is responsible for nosocomial outbreaks in vulnerable patients in neonatal intensive care units (NICU). The environment can constitute the reservoir and source of infection in NICUs. Herein we report the impact of preventive measures implemented after an Enterobacter cloacae outbreak inside a NICU. METHODS: This retrospective study was conducted in one level 3 NICU in Lyon, France, over a 6 year-period (2012-2018). After an outbreak of Enterobacter cloacae infections in hospitalized neonates in 2013, several measures were implemented including intensive biocleaning and education of medical staff. Clinical and microbiological characteristics of infected patients and evolution of colonization/infection with Enterobacter spp. in this NICU were retrieved. Moreover, whole genome sequencing was performed on 6 outbreak strains. RESULTS: Enterobacter spp. was isolated in 469 patients and 30 patients developed an infection including 2 meningitis and 12 fatal cases. Preventive measures and education of medical staff were not associated with a significant decrease in patient colonisation but led to a persistent decreased use of cephalosporin in the NICU. Infection strains were genetically diverse, supporting the hypothesis of multiple hygiene defects rather than the diffusion of a single clone. CONCLUSIONS: Grouped cases of infections inside one setting are not necessarily related to a single-clone outbreak and could reveal other environmental and organisational problematics. The fight against implementation and transmission of Enterobacter spp. in NICUs remains a major challenge.


Assuntos
Enterobacter cloacae/patogenicidade , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/prevenção & controle , Controle de Infecções/métodos , Surtos de Doenças/prevenção & controle , Enterobacter cloacae/genética , Enterobacter cloacae/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , Fezes/microbiologia , Feminino , França , Humanos , Higiene , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Sepse Neonatal/epidemiologia , Sepse Neonatal/microbiologia , Estudos Retrospectivos , Sequenciamento Completo do Genoma
10.
Sante Publique ; 32(2): 247-251, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32985841

RESUMO

The COVID-19 Coronavirus epidemic started in December 2019 in China, and progressed very quickly in France. Its consequences were the implementation of national measures such as the containment of the population, but also a disorganization of the healthcare system, in particular concerning oral care. Indeed, dental procedures produce aerosols which can be loaded with viral particles, and as such, constitute a major contamination route by the virus. At the request of the Conference of Deans of the Faculties of Odontology, the National College of University Dentists in Public Health (CNCDUSP) set up a working group in order to issue recommendations for oral care in the context of the COVID-19 epidemic, given the specific risks faced by practitioners. Considering the lack of awareness of the specifics of dentistry in the medical world and among decision-makers, and given the speed with which national measures to fight the epidemic were implemented, the recommendations of the CNCDUSP had to be drawn up rigorously and quickly before being released to the profession. They take into account epidemiological data related to the virus, the specificities of oral care, and thus propose protective measures for dental surgery professionals.The necessary adaptation of the healthcare system during an epidemic will certainly make it possible to learn lessons from this health crisis.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência Odontológica/organização & administração , Epidemias , Pneumonia Viral/epidemiologia , França/epidemiologia , Humanos , Pandemias
12.
Lancet Public Health ; 5(10): e536-e542, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32950075

RESUMO

BACKGROUND: The COVID-19 pandemic has had a profound effect on general health care. We aimed to evaluate the effect of a nationwide lockdown in France on admissions to hospital for acute myocardial infarction, by patient characteristics and regional prevalence of the pandemic. METHODS: In this registry study, we collected data from 21 centres participating in the ongoing French Cohort of Myocardial Infarction Evaluation (FRENCHIE) registry, which collects data from all patients admitted for ST segment elevation myocardial infarction (STEMI) or non-ST segment elevation myocardial infarction (NSTEMI) within 48 h of symptom onset. We analysed weekly hospital admissions over 8 weeks: the 4 weeks preceding the institution of the lockdown and the 4 weeks following lockdown. The primary outcome was the change in the number of hospital admissions for all types of acute myocardial infarction, NSTEMI, and STEMI between the 4 weeks before lockdown and the 4 weeks after lockdown. Comparisons between categorical variables were made using χ2 tests or Fisher's exact tests. Comparisons of continuous variables were made using Student's t tests or Mann-Whitney tests. Poisson regression was used to determine the significance of change in hospital admissions over the two periods, after verifying the absence of overdispersion. Age category, region, and type of acute myocardial infarction (STEMI or NSTEMI) were used as covariables. The FRENCHIE cohort is registered with ClinicalTrials.gov, NCT04050956. FINDINGS: Between Feb 17 and April 12, 2020, 1167 patients were consecutively admitted within 48 h of acute myocardial infarction (583 with STEMI, 584 with NSTEMI) and were included in the study. Admissions for acute myocardial infarction decreased between the periods before and after lockdown was instituted, from 686 before to 481 after lockdown (30% decrease; incidence rate ratio 0·69 [95% CI 0·51-0·70]). Admissions for STEMI decreased from 331 to 252 (24%; 0·72 [0·62-0·85]), and admissions for NSTEMI decreased from 355 to 229 (35%; 0·64 [0·55-0·76]) following institution of the lockdown, with similar trends according to sex, risk factors, and regional prevalence of hospital admissions for COVID-19. INTERPRETATION: A marked decrease in hospital admissions was observed following the lockdown, irrespective of patient characteristics and regional prevalence of COVID-19. Health authorities should be aware of these findings, in order to adapt their message if the COVID-19 pandemic persists or recurs, or in case of future major epidemics. FUNDING: Recherche Hospitalo-Universitaire en Santé iVasc.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infarto do Miocárdio/terapia , Pandemias/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Sistema de Registros , Fatores de Risco
13.
Ann Ist Super Sanita ; 56(3): 373-377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32959804

RESUMO

We aimed to compare COVID-19-specific and all-cause mortality rates among natives and migrants in Italy and to investigate the clinical characteristics of individuals dying with COVID-19 by native/migrant status. The mortality rates and detailed clinical characteristics of natives and migrants dying with COVID-19 were explored by considering the medical charts of a representative sample of patients deceased in Italian hospitals (n = 2,687) between February 21st and April 29th, 2020. The migrant or native status was assigned based on the individual's country of birth. The expected all-cause mortality among natives and migrants living in Italy was derived by the last available (2018) dataset provided by the Italian National Institute of Statistics. Overall, 68 individuals with a migration background were identified. The proportions of natives and migrants among the COVID-19-related deaths (97.5% and 2.5%, respectively) were similar to the relative all-cause mortality rates estimated in Italy in 2018 (97.4% and 2.6%, respectively). The clinical phenotype of migrants dying with COVID-19 was similar to that of natives except for the younger age at death. International migrants living in Italy do not have a mortality advantage for COVID-19 and are exposed to the risk of poor outcomes as their native counterparts.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Migrantes/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Albânia/etnologia , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , França/etnologia , Efeito do Trabalhador Sadio , Registros Hospitalares , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade/etnologia , Neoplasias/epidemiologia , Obesidade/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Insuficiência Renal Crônica/epidemiologia
14.
Rev Infirm ; 69(263): 43-45, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32993907

RESUMO

Student nurses at the heart of the Covid-19 crisis. Many student nurses were involved in dealing with the Covid-19 health crisis. As a consequence, the block release training programme was completely overturned in order to meet the urgent requirements of health and medical-social institutions. Two student nurses from Île-de-France, in their third year of training, share anonymously their experience on the ground during the health crisis. Their experiences, which required polyvalence, adaptability, stress management and autonomy on their part, have considerably enriched their portfolio of competencies.


Assuntos
Infecções por Coronavirus/enfermagem , Educação em Enfermagem/organização & administração , Pandemias , Pneumonia Viral/enfermagem , Estudantes de Enfermagem/psicologia , Infecções por Coronavirus/epidemiologia , França/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
15.
AIDS ; 34(12): 1765-1770, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32889852

RESUMO

OBJECTIVE: A new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) emerged in China during late 2019 and resulted in the coronavirus disease 2019 (COVID-19) pandemic which peaked in France in March-April 2020. Immunodeficiency, precariousness and promiscuity could increase the risk of COVID-19 in HIV-infected patients and in preexposure prophylaxis (PrEP) users. No epidemiological data are available in these two populations. We report COVID-19 attack rate in HIV-infected patients and in PrEP users in the Rhône department, France, and compared it with the general population. DESIGN: Retrospective analysis of a laboratory database. METHODS: COVID-19 testing strategy in France was centered on symptomatic infections, hospitalized patients and symptomatic healthcare workers while most asymptomatic cases were not confirmed. SARS-CoV-2 positivity rate on PCR assays and COVID-19 attack rate were determined in HIV-infected patients and in PrEP users. COVID-19 attack rate in the general population was estimated from health authorities' database and demographic data. A corrected attack rate taking into account the laboratory representativeness was calculated. RESULTS: From March to April 2020, 24 860 samples from 19 113 patients (HIV-infected 77, PrEP users 27, others 19 009) were assessed for SARS-CoV-2 PCR assay. The positivity rate appeared similar in HIV-infected patients (15.6%), in PrEP users (14.8%) and in other patients (19.1%). The crude/corrected COVID-19 attack rate appeared similar in HIV-infected patients (0.31/0.38%) and in PrEP users (0.38/0.42%), and of the same order as the estimated attack rate in the general population (0.24%). CONCLUSION: The risk of symptomatic COVID-19 in France appeared similar in HIV-infected patients and in PrEP users compared with the general population.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por HIV/complicações , Pneumonia Viral/epidemiologia , Profilaxia Pré-Exposição , Adulto , Idoso , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Bases de Dados Factuais , Feminino , França/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pandemias , Estudos Retrospectivos , Fatores de Risco
16.
BMC Public Health ; 20(1): 1393, 2020 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-32919467

RESUMO

BACKGROUND: Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. METHODS: The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants was selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. RESULTS: Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tools to preserve anonymity. CONCLUSIONS: Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


Assuntos
Emigração e Imigração , Infecções por HIV/prevenção & controle , Promoção da Saúde , Hepatite B/prevenção & controle , Hepatite C/prevenção & controle , Assunção de Riscos , Migrantes , Adulto , Cultura , Grupos Étnicos , França , Conhecimentos, Atitudes e Prática em Saúde , Hepacivirus , Hepatite B Crônica/prevenção & controle , Hepatite C Crônica/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Pesquisa Qualitativa , Fatores de Risco , Comportamento Sexual , População Suburbana , Adulto Jovem
19.
JMIR Mhealth Uhealth ; 8(9): e23153, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32924946

RESUMO

BACKGROUND: Critical care teams are on the front line of managing the COVID-19 pandemic, which is stressful for members of these teams. OBJECTIVE: Our objective was to assess whether the use of social networks is associated with increased anxiety related to the COVID-19 pandemic among members of critical care teams. METHODS: We distributed a web-based survey to physicians, residents, registered and auxiliary nurses, and nurse anesthetists providing critical care (anesthesiology, intensive care, or emergency medicine) in several French hospitals. The survey evaluated the respondents' use of social networks, their sources of information on COVID-19, and their levels of anxiety and information regarding COVID-19 on analog scales from 0 to 10. RESULTS: We included 641 respondents in the final analysis; 553 (86.3%) used social networks, spending a median time of 60 minutes (IQR 30-90) per day on these networks. COVID-19-related anxiety was higher in social network users than in health care workers who did not use these networks (median 6, IQR 5-8 vs median 5, IQR 3-7) in univariate (P=.02) and multivariate (P<.001) analyses, with an average anxiety increase of 10% in social network users. Anxiety was higher among health care workers using social networks to obtain information on COVID-19 than among those using other sources (median 6, IQR 5-8 vs median 6, IQR 4-7; P=.04). Social network users considered that they were less informed about COVID-19 than those who did not use social networks (median 8, IQR 7-9 vs median 7, IQR 6-8; P<.01). CONCLUSIONS: Our results suggest that social networks contribute to increased anxiety in critical care teams. To protect their mental health, critical care professionals should consider limiting their use of these networks during the COVID-19 pandemic.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral/psicologia , Rede Social , Adulto , Anestesiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Cuidados Críticos , Estudos Transversais , Medicina de Emergência , Feminino , França/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Prospectivos , Inquéritos e Questionários
20.
Sante Publique ; 32(2): 247-251, 2020 09 15.
Artigo em Francês | MEDLINE | ID: mdl-32989954

RESUMO

The COVID-19 Coronavirus epidemic started in December 2019 in China, and progressed very quickly in France. Its consequences were the implementation of national measures such as the containment of the population, but also a disorganization of the healthcare system, in particular concerning oral care. Indeed, dental procedures produce aerosols which can be loaded with viral particles, and as such, constitute a major contamination route by the virus. At the request of the Conference of Deans of the Faculties of Odontology, the National College of University Dentists in Public Health (CNCDUSP) set up a working group in order to issue recommendations for oral care in the context of the COVID-19 epidemic, given the specific risks faced by practitioners. Considering the lack of awareness of the specifics of dentistry in the medical world and among decision-makers, and given the speed with which national measures to fight the epidemic were implemented, the recommendations of the CNCDUSP had to be drawn up rigorously and quickly before being released to the profession. They take into account epidemiological data related to the virus, the specificities of oral care, and thus propose protective measures for dental surgery professionals.The necessary adaptation of the healthcare system during an epidemic will certainly make it possible to learn lessons from this health crisis.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência Odontológica/organização & administração , Epidemias , Pneumonia Viral/epidemiologia , França/epidemiologia , Humanos , Pandemias
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA