Revue D'epidemiologie Et De Sante Publique[JOURNAL]
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200 papers
[Not Available].
Marleau J, Turgeon S, Turgeon J
Rev Epidemiol Sante Publique · 2022 Feb · PMID 35031185 · Publisher ↗
OBJECTIVES: The objective of Study 1 is to identify the psychometric assessment and reporting practices of authors who have analyzed data from the Kessler Abbreviated Psychological Distress Scale (K6), collected in Canad...
OBJECTIVES: The objective of Study 1 is to identify the psychometric assessment and reporting practices of authors who have analyzed data from the Kessler Abbreviated Psychological Distress Scale (K6), collected in Canadian population surveys. The goal of Study 2 is to compare the performance of six reliability coefficients estimated from K6 data. METHODS: In Study 1, 71 publications using the K6 were reviewed and synthesized using an analysis grid. In Study 2, analyses were performed to compare the performance of the alpha coefficient to five other reliability coefficients using data from the 2009-2010 and 2013-2014 Canadian Community Health Survey (CCHS). Specifically, we estimated all six coefficient values, as well as their confidence intervals, regarding all respondents and respondent subgroups. RESULTS: Out of the 71 publications identified in Study 1, only nine reported a reliability coefficient drawn from their own sample. Even though no condition essential to use of the alpha coefficient was mentioned, it was the only coefficient presented. In Study 2, the values of all the other coefficients were found to be higher than those of the alpha coefficient. Significant variations were found in some respondent subgroups. CONCLUSION: Existing recommendations for the use of reliability coefficients are poorly implemented. It behooves authors to provide more information in their manuscripts, thereby enabling assessment of the psychometric qualities of the K6. The presentation of reliability coefficients for relevant subgroups and confidence intervals must also become standard practice, so that results can be more precisely interpreted.
[Artificial intelligence for medical information departments : construction and evaluation of a decision-making tool to identify and prioritize stays of which the PMSI coding could be optimized, and to ensure the revenues generated by activity-based pricing].
Gutton J, Lin F, Billuart O … +4 more , Lajonchère JP, Crubilié C, Sauvage C, Buronfosse A
Rev Epidemiol Sante Publique · 2022 Feb · PMID 35027236 · Publisher ↗
BACKGROUND: Medical Information Departments help to optimize the hospital revenues generated by activity-based pricing. A review of medical files, selected after the targeting of coding summaries, is organized. The aim i...
BACKGROUND: Medical Information Departments help to optimize the hospital revenues generated by activity-based pricing. A review of medical files, selected after the targeting of coding summaries, is organized. The aim is to make any corrections to the diagnoses or coded procedures with a potential impact on the pricing of the stay. Targeting is of major importance as a means of concentrating resources on the files for which coding can be effectively improved. The tools available for targeting can be optimized. We have developed a decision-making support tool to make targeting more efficient. The objective of our study was to evaluate the performance of this tool. METHODS: The tool combines an artificial intelligence module with a rule-based expert module. A predictive score is assigned to each coding summary that reflects the probability of a revalued stay. Evaluation of the performance of this tool was based on a sample of 400 stays of at least 3 nights of patients hospitalized at the Paris Saint-Joseph Hospital from 1 November to 31 December 2019. Each stay was reviewed by a coding expert, without knowledge of the score assigned and without help from expert queries. Two main assessment criteria were used: area under the ROC curve and positive predictive value (PPV). RESULTS: The area under the ROC curve was 0.70 (CI 95% [0.64-0.76]). With a revalued coding rate of 32%, PPV was 41% for scores above 5, 65% for scores above 8, 88% for scores above 9. CONCLUSION: The study made it possible to validate the performance of the tool. The implementation of new variables could further increase its performance. This is an area of development to be considered, particularly with in view of generalizing individual invoicing in hospitals.
[Interest of a geostatistical approach to analyze the geographical disparities in human papillomavirus vaccine coverage in France].
Ribassin-Majed L, Pereira M, Magneron C … +4 more , Levy-Bachelot L, Fagherazzi G, Baldauf JJ, Raude J
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34728109 · Publisher ↗
BACKGROUND: The use of geostatistical methods remains rare in health studies. In order to assess the usefulness of the geostatistical approach in epidemiology, we chose to apply these methods to the vaccination coverage...
BACKGROUND: The use of geostatistical methods remains rare in health studies. In order to assess the usefulness of the geostatistical approach in epidemiology, we chose to apply these methods to the vaccination coverage rate (VCR) against human papillomavirus (HPV) in France. Indeed, HPV vaccine coverage remains low in France and geographical disparities are sizable. The objective of this study was to identify the socioecological factors that may explain these geographical variations. METHODS: Sociological, economic and behavioral data for 2016 have been gathered (demographics and public health database, web and social networks) and were correlated with the HPV VCR vaccine coverage over the French territory. Homogeneous geographical areas defined by strong correlations for groups of variables were selected. In each homogeneous area, principal component analysis was performed and a geostatistical approach provided an estimate predicting vaccine coverage at a given scale. RESULTS: HPV VCR spatial variations in France cannot be fully explained by a single model. In urban areas, a low rate of HPV VCR is preferentially associated with unfavorable socioeconomic factors (poverty, unemployment, immigration). In rural areas, HPV VCR is preferentially associated with sociocultural factors (socio-professional categories, education level, interest in alternative medicines the anti-vaccine movement). Two secondary geographical areas were defined: the Île-de-France region and 12 departments in northeastern France. In the Île-de-France region, the association with the economic factors one again appears as in urban areas in general. The northeasteran departments represent a particular case insofar as HPV VCR is relatively high, notwithstanding economic poverty indicators. CONCLUSION: Geostatistical modeling successfully identifies new potential explanations for HPV VCR geographical disparities in France. These results could help to adapt or develop future vaccination programs in specific areas by taking into account the sociological, economic and behavioral characteristics of their populations.
VIENT DE PARAÎTRE.
Rev Epidemiol Sante Publique · 2021 Nov · PMID 38620761 · Full text
Abstract loading — click title to view on PubMed.
[Investigating postvention best practices : The Delphi method].
Vachon M, Nicolas C, Notredame CE … +1 more , Séguin M
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34642047 · Publisher ↗
BACKGROUND: Postvention aims to implement services adapted to the needs of a population that may be vulnerable after suicide. While a plethora of postvention programs exist, they are generally based less on solid evidenc...
BACKGROUND: Postvention aims to implement services adapted to the needs of a population that may be vulnerable after suicide. While a plethora of postvention programs exist, they are generally based less on solid evidence than on the judgment of health professionals. Using the Delphi method, an Australian study obtained a consensus among experts as to which postvention actions are to be engineered in a postvention program. Since no similar study has been carried out for programs in French-speaking countries, it seemed important to reproduce the same type of study and to compare the respective results. The present study is aimed at establishing a French inventory of postvention actions and at achieving a consensus among experts as to the actions to be included in a postvention program. METHODS: A systematic review of the scientific literature (PRISMA method) and the gray literature (documentation on the WEB) made it possible to identify the different actions that have been included in various postvention programs. Using the DELPHI method, experts endeavored to assess their relevance. RESULTS: An inventory of 190 postvention actions was established and they were classified according to a sequential axis (pre-event, at the time of the event, and post-event), according to type of action (environment-centered or people-centered). The experts identified 128 actions to be included in a postvention program. CONCLUSION: Convergence was observed among the experts, as they identified the practices to be encouraged following a suicide. When comparing the results in French-speaking countries to the 548 actions selected in the Australian study, we observe similarities between the two studies regarding types of postvention actions. This study provides an update for health professionals on the most relevant practices to be included in a postvention program.
[Not Available].
Lustman M, Lapierre V, Darrouzes S
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34642046 · Publisher ↗
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Relationship between socioeconomic status and prostate cancer (incidence, aggressiveness, treatment with curative intent, and mortality): a spatial analysis using population-based cancer registry data.
Khadhra HB, Saint F, Trecherel E … +3 more , Lapôtre-Ledoux B, Zerkly S, Ganry O
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34629211 · Publisher ↗
BACKGROUND: Morbidity and mortality associated with prostate cancer in a given geographic area might be related to the level of socioeconomic deprivation. The Somme area (a region of northern France) is considered econom...
BACKGROUND: Morbidity and mortality associated with prostate cancer in a given geographic area might be related to the level of socioeconomic deprivation. The Somme area (a region of northern France) is considered economically disadvantaged, with major territorial disparities. The aim of this study was to assess the impact of the socioeconomic level on prostate cancer, using data from a population-based cancer registry. METHODS: The source of data on cases of prostate cancer between 2006 and 2010 was the Somme cancer registry (Amiens, France). Socioeconomic status was measured according to the European Deprivation Index (EDI), which was used to classify each geographical "IRIS" unit (the smallest sub-municipal geographical entity for which French census data are available) according to its level of social deprivation. For spatial analysis, we considered a hierarchical generalized linear model. RESULTS: In the spatial analysis, prostate cancer incidence was higher in the less disadvantaged areas and treatment frequency with curative intent was lower in the most disadvantaged areas. Cancer aggressiveness and mortality were higher in the most disadvantaged areas: relative risk (RR) = 1.36; 95% CI: [1.09; 1.73] and RR=3.09 [1.70; 5.59], respectively. CONCLUSION: Our results evidenced a significant association between socioeconomic deprivation and prostate cancer, with worse outcomes among men with the lowest socioeconomic status.
[Not Available].
Davin-Casalena B, Jardin M, Guerrera H … +8 more , Mabille J, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34454792 · Full text
BACKGROUND: The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healt...
BACKGROUND: The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS: Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS: Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION: The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.
[Not Available].
Valdés M, Alonso F, Pino P … +1 more , Nazzal C
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34393032 · Full text
POSITION DU PROBLèME: Le confinement mis en place au deuxième trimestre 2020 a entrainé une amélioration de la qualité de l'air de Santiago, capitale et plus grande ville du Chili, caractérisée par de fortes concentratio...
POSITION DU PROBLèME: Le confinement mis en place au deuxième trimestre 2020 a entrainé une amélioration de la qualité de l'air de Santiago, capitale et plus grande ville du Chili, caractérisée par de fortes concentrations en particules fines PM liées, en grande partie, au trafic routier. L'objectif était de mettre en évidence une potentielle réduction des visites aux urgences pour infarctus du myocarde aigu (IDM) et des décès dus à une cardiopathie ischémique (CPI) attribuable à l'émission de PM, en comparant les périodes équivalentes de 2019 et de 2020. MéTHODES: À Santiago, la surveillance de la qualité de l'air se fait grâce à neuf moniteurs situés dans neuf communes différentes : Cerro Navia, Cerrillos, El Bosque, Pudahuel, Independencia, La Florida, Quilicura, Santiago centre-ville et Las Condes (classées de la plus haute à la plus basse en matière de pauvreté multidimensionnelle). La concentration moyenne quotidienne de PM a été décrite avec des séries temporelles, et les visites aux urgences pour IDM et les décès dus à une CPI ont été analysés de façon trimestrielle pour chaque année. Pour estimer l'impact de l'excès de PM, les fractions de risque attribuables (FRA) pour les visites aux urgences pour IDM et les décès pour CPI ont été calculées. RéSULTATS: La moyenne quotidienne des PM a diminué dans huit des neuf communes de Santiago. Cependant, la réduction n'a été significative que dans trois communes. Les visites aux urgences pour IDM et les décès par CPI attribuables aux PM ont diminué légèrement mais significativement dans ces trois communes. Les FRA dans les autres communes sont restées similaires à 2019. CONCLUSIONS: Une réduction significative de la FRA des PM pour les décès par CPI et les visites aux urgences d'IDM n'a été observée que dans les communes avec une réduction significative de la concentration quotidienne moyenne de PM pendant la pandémie de COVID-19.
[Work, family, resources and unequal levels of psychological distress between working men and working women : vulnerability or gendered expression of stress?].
Bilodeau J, Marchand A, Demers A
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34393031 · Publisher ↗
INTRODUCTION: This study aims to compare the vulnerability hypothesis and the expression hypothesis to explain a greater level of psychological distress among working women than among working men. METHOD: The two hypothe...
INTRODUCTION: This study aims to compare the vulnerability hypothesis and the expression hypothesis to explain a greater level of psychological distress among working women than among working men. METHOD: The two hypotheses were contrasted by integrating work stressors, family stressors, work-family conflicts and psychosocial resources. The conceptual models were tested by using multilevel path analyses on 2026 employees in Quebec (Canada) based in 63 work establishments. RESULTS: Results partially supported both hypotheses. According to the vulnerability hypothesis, single parenting, child-related problems and self-esteem were indirectly involved in the variation of psychological distress among women through family-to-work, otherwise known as work-family conflict. According to the expression hypothesis, although family-to-work conflict was closely associated with more psychological distress among women, this stressor was also closely associated with higher at-risk alcohol consumption among men. Couple-related problems and a sense of control likewise played a role in the expression mechanism through family-to-work conflict. CONCLUSION: These results underline the importance of considering that gender contributes to mental health inequalities through multiple mechanisms. They also call for a distinction between the two directions of work-family conflict as gendered mediators.
[Survivorship care plan (SCP) : The viewpoints of women with breast cancer and their general practitioners].
Ladaique AF, Desandes E, Salleron J … +4 more , Di Patrizio P, Marchal F, Vogin G, Lesur A
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34344564 · Publisher ↗
BACKGROUND: The French National Cancer Institute recommends the use of survivorship care plans (SCP) for all cancer survivors. Developing useful SCP's requires understanding of what survivors and their providers need and...
BACKGROUND: The French National Cancer Institute recommends the use of survivorship care plans (SCP) for all cancer survivors. Developing useful SCP's requires understanding of what survivors and their providers need and how SCP's can be implemented in practice. We conducted a study to assess the delivery of SCP comprehensive binders for breast cancer women (BCW) and their general practitioners (GP) in a Cancer center from January 2019. METHODS: SCP binders, containing a full range of information on topics related to post-cancer care to survivor-specific information and referrals, were given to BCW during a post-treatment dedicated consultation. Then a letter, containing the treatment summary and 5-year follow-up schedule, was sent to their GPs. Comprehensive binder delivery assessment was carried out using item checkbox, and anonymous open-answered, self-reported questionnaires were sent by email to BCW and their GPs. RESULTS: The questionnaire response rates were 81.3% for BCW (n = 109/134) and 48.6% for their GPs (n = 52/107). Most BCW (85%) reported that SCP binders provided useful and comprehensive information. However, some of them (18%) felt abandoned and anonymous during the post-treatment follow-up. Most GPs found SCP letters from our anti-cancer center physicians to be useful for their patients, 38% of them had used this information to assure transition of care with other care providers. In addition, GPs were unanimous to express their feeling that this SCP could improve the long-term surveillance of BCW. There was a high concordance between BCW survivors' and PCP' answers, especially regarding SCPs as a communication bridge between GPs and BCW survivors. Response results concerning use of the binders: to talk about them: 59% for BCW vs. 51% for GPs, and to show them: 35% for BCW vs. 31% for GPs. CONCLUSION: The opinions of BCW survivors' and PCP' opinions about the use of SCP's by our Cancer Center seems to be favourable. It is essential to implement and develop SCP's as a key tool in long-term surveillance and support for cancer patient survivors and they are a useful instrument for care providers in communication and transition.
[Colorectal cancer screening program : Test completion rate and follow-up results after selective mailing of the test kit, based on likelihood of participation].
Koïvogui A, Vincelet C, Ait-Hadad H … +4 more , Pellissier H, Valibay S, Kaufmanis A, Benamouzig R
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34344563 · Publisher ↗
BACKGROUND: Even though theinterest of a Colorectal-Cancer Screening Program has been amply demonstrated, in French departments the participation rate (PR) seldom reaches 45%. In the absence of mass mailing, a strategy (...
BACKGROUND: Even though theinterest of a Colorectal-Cancer Screening Program has been amply demonstrated, in French departments the participation rate (PR) seldom reaches 45%. In the absence of mass mailing, a strategy (S-1) consisting in mailing a test kit to people having made a request was implemented in 2015. In 2017, another mailing strategy (S-2), which consisted in sending the test kit only to people likely to take the test, was programmed. This study assesses the respective impact of these two strategies as compared to the standard approach (S-0). METHODS: The study included 254,113 (S-0), 4,130 (S-1) and 10,887 (S-2) people aged 50-74, targeted during the 2016-2017 campaign in Seine-Saint-Denis (France). S-0 persons received a 2nd reminder without a test-kit, while S-1 persons received, at their request, a mailed test kit. Without having made a request, S-2 persons the mailed test kit according to probability of participation (Proba) which was estimated a priori by the ratio between the sum total of index values (frequency of previous participation, date of most recent participation, age) and a theoretical maximum. Completion rates (test/colonoscopy) were compared 18 months after the last S-2 kit was sent. RESULTS: PR was highest in S-1 (S-0: 5.8%, S-1: 74.9%, S-2: 31.3%; p < 0.0001). In S-2, PR rose as Proba increased (Proba: ]0-30%], ]30-50%], ]50-75%], ]75-100%]; PR: 21.1%, 23.3%, 36.2%, 52.8% respectively; p < 0.05). Compared to the ≥70 years age-group, the 50-54 years age-group presented a lower PR in S-1 (65.9% vs. 85.1%; p < 0.05) whereas it presented a higher PR in S-0 (4.3% vs. 7.1%; p < 0.05) and in S-2 (23.2% vs. 54.5%; p < 0.05). All in all, colonoscopy completion rates were highest in S-1 (S-0: 62.2%, S-1: 80.0%, S-2: 65.0%; p < 0.001). CONCLUSION: Test-kit mailing without spontaneous request does not lead to an optimal level of participation, thereby highlighting a need to give thought to new and improved mobilization methods. The relatively pronounced participation of younger persons, who are not favored by present-day testing specifications, underscores the interest of a specific approach addressed to active people, who are less inclined than elderly individuals to regularly consult their attending physicians.
[Quality of health worker-patient communication: What are the benefits of integrating mental health into front-line services in Guinea?].
Sow A, Smekens T, De Man J … +4 more , De Spigelaere M, Vanlerberghe V, Van Dormael M, Criel B
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34272084 · Publisher ↗
BACKGROUND: Patient-centred care presupposes communication based on empathy, active listening and dialogue. Our study examines the effects of integrating mental health in multi-purpose health centres on health workers' c...
BACKGROUND: Patient-centred care presupposes communication based on empathy, active listening and dialogue. Our study examines the effects of integrating mental health in multi-purpose health centres on health workers' communication with patients who consult for problems unrelated to mental health. The objective is to compare the quality of communication in health centres where staff have received specific training in the management of mental disorders (SM+) compared to those without such training (SM-). METHODS: The study was conducted among 18 health workers in charge of primary curative consultations in 12 non-governmental health centers in Guinea: 7 health workers in 4 SM+ health centers and 11 health workers in 8 SM- health centres. The study is based on mixed methods: observation, semi-structured and group interviews. The Global Consultation Rating Scale (GCRS) was applied to assess patient-centered communication. RESULTS: The SM+ GCRS scores obtained by SM+s during observations are generally higher than the SM- scores. The odds of having a "good quality" consultation are almost 3 times higher in SM+ than in SM- for some steps in the consultation process. The SM+ discourse is more patient-centered, and differs from the more biomedical discourse of SM-. SM- health workers do not consider all of the stages of a patient-centred consultation to be applicable and recommend "leapfrogging". On the contrary, SM+ health workers consider all stages to be important and are convinced that the integration of mental health has improved their communication through the training they have received and the practice of caring for persons with mental disorders. CONCLUSION: The integration of mental health into primary care provision represents an opportunity to improve the quality of care in its "patient-centred care" dimension. That said, optimal development of patient-centred care presupposes favorable structural conditions.
Interdisciplinary community-based participatory health research across the industrial region of the Étang de Berre : The EPSEAL Fos Crau study.
Jeanjean M, Lees J, Allen BL … +1 more , Cohen AK
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34256985 · Publisher ↗
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 lo...
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.
[Professional profiles and representations of staff members in Burundi health centers: Socio-professional groups with compartmentalizes knowledge].
Fromont A, Casini A, Haddad S … +2 more , Ryanguyenabi MC, Godin I
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34215480 · Publisher ↗
BACKGROUND: The professional identities, profiles and representations of Burundian health workers remain insufficiently explored. Our twofold objective is to identify the different socio-professional profiles of first-li...
BACKGROUND: The professional identities, profiles and representations of Burundian health workers remain insufficiently explored. Our twofold objective is to identify the different socio-professional profiles of first-line caregivers and to explore their respective representations of health workers and work. METHODS: The first study describes the overall population of the 1047 staff members employed in 2014-2015 in 62 health centers. The second is a cross-sectional survey conducted in April 2014. Using IRAMUTEQ© software, we conducted textology analysis of the structure and contents of 911 respondents' representations via 3 free associations with regard to 6 questions on the "good worker" and the "what renders one capable of doing good work". RESULTS: At the normative level, among all categories of staff, a relational role is a foundation of professional identity, while technical or administrative functions remain marginal. At the positional level, responses differed according to initial qualification level but not as a function of their role with patients or their professional experience. Three socio-professional categories emerged. The most qualified category (one-quarter of the population) consists primarily of male caregivers, with a high turnover rate (4 years) associated with prospects for further training and career development. These persons present the most professionalized representations of the worker and work. The second quarter has an average level of qualification and turnover (10 years), and is mainly composed of female caregivers with limited professional perspectives. This group's representations are less technical and more patient-centered. Finally, the remaining half consists of relatively low-skilled staff members in charge of technical and logistical support, who are likely to spend their entire career in the same center (>20 years). Largely disregarded by the health care system and its funders, they have few opportunities for training or advancement and despite their long experience, maintain profane representations of workers and work. CONCLUSION: Our results shed light on the predicament of unskilled staff members whose expectations are rarely taken into consideration, even though they represent a significant proportion of the workforce, perform tasks essential to quality of care, and serve as bearers of the memory of their hospital center. These results also highlight the compartmentalization of practices and knowledge between categories of workers and underscore the failure of continuous training strategies targeting the unskilled.
[Algorithms to identify chronic inflammatory rheumatism and psoriasis in medico-administrative databases: A review of the literature].
Castagné B, Viprey M, Caillet-Pascal P … +7 more , Belhassen M, Desjeux G, Bailly S, Estellat C, Soubrier M, Schott AM, groupe REDSIAM
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34215479 · Publisher ↗
BACKGROUND: We aimed to describe and discuss the algorithms used to identify chronic inflammatory rheumatisms and psoriasis in medico-administrative databases. METHODS: We performed a literature review on the Medline dat...
BACKGROUND: We aimed to describe and discuss the algorithms used to identify chronic inflammatory rheumatisms and psoriasis in medico-administrative databases. METHODS: We performed a literature review on the Medline database of articles published up to 31 January 2018. Our inclusion criteria were: original articles using medico-administrative databases in accordance with the International Classification of Diseases, version 10 (ICD-10) and concerning rheumatoid arthritis (RA) or ankylosing spondylitis (AS) or psoriatic arthritis (PsoA) or Psoriasis (Pso). Our exclusion criteria were: letters to the editor, commentaries on published articles, studies using codes other than those of the ICD or a previous version. RESULTS: Out of the 590 articles identified, 37 studies were included. Concerning RA (n=10), all studies used the M05 code, associated with the M06 code in six studies. The remaining four studies specifically targeted codes M06.0, M06.2, M06.3, M06.8, M06.9, and two of them also used code M12.3. For AS (n=8), 7 studies used the M45 code, while only one study used M45.9, M46.1 or M46.8. For Pso (n=17), all studies used the L40 code and/or at least two dispensations of vitamin D. Concerning PsoA (n=13), all studies used the same codes: M07.0, M07.1, M07.2, M07.3. CONCLUSION: We recommend using codes M05 and M06 rather than M06.1 and M06.4 for RA, M45 for AS, the algorithm L40 and/or two dispensations of topical vitamin D for psoriasis, and codes M070 to M073 to identify PsoA patients in medico-administrative databases.
Ischemic stroke in Morocco: Prehospital delay and associated factors.
Kharbach A, Obtel M, Achbani A … +4 more , Aasfara J, Hassouni K, Lahlou L, Razine R
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34148762 · Publisher ↗
OBJECTIVES: This study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco. PATIENTS AN...
OBJECTIVES: This study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco. PATIENTS AND METHODS: An observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department. RESULTS: A total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6hours (IQR, 4-16). Multiple regression analysis showed that illiteracy (OR 38.58; CI: 3.40-437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI: 1.57-80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI: 0.01-0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI: 0.00-0.36), and direct admission without reference (OR 0.005; CI: 0.00-0.07), were independently associated with late arrival (>4.5hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI: 4.37-138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI: 0.03-0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI: 0.00-0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI: 0.03-0.80), distance between 50 and 100km (OR 10.16; CI: 1.16-89.33), and direct admission without reference (OR 0.03; CI: 0.00-0.14), were independently associated with late arrival (>6hours) of patients with acute ischemic stroke. CONCLUSION: Patient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.
Household sampling through geocoded points and satellite view: A step-by-step approach to implement a spatial sampling method for demographic and health surveys in areas without population sampling frame and with limited resource settings.
Apetoh E, Roquet F, Palstra F … +2 more , Baxerres C, Le Hesran JY
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34148761 · Publisher ↗
INTRODUCTION: Spatial sampling is increasingly used in health surveys as it provides a simple way to randomly select target populations on sites where reliable and complete data on the general population are not availabl...
INTRODUCTION: Spatial sampling is increasingly used in health surveys as it provides a simple way to randomly select target populations on sites where reliable and complete data on the general population are not available. However, the previously implemented protocols have been poorly detailed, making replication difficult or even impossible. To our knowledge, ours is the first document describing step-by-step an efficient spatial sampling method for health surveys. Our objective is to facilitate the rapid acquisition of the technical skills and know-how necessary for its deployment. METHODS: The spatial sampling design is based on the random generation of geocoded points in the study area. Afterwards, these points were projected on the satellite view of Google Earth Pro™ software and the identified buildings were selected for field visits. A detailed formula of the number of points required, considering non-responses, is proposed. Density of buildings was determined by drawing circles around points and by using a replacement strategy when interviewing was unachievable. The method was implemented for a cross-sectional study during the April-May 2016 period in Cotonou (Bénin). The accuracy of the collected data was assessed by comparing them to those of the Cotonou national census. RESULT: This approach does not require prior displacement in the study area and only 1% of identified buildings with Google Earth Pro™ were no longer extant. Most of the measurements resulting from the general census were within the confidence intervals of those calculated with the sample data. Furthermore, the range of measurements resulting from the general census was similar to those calculated with the sample data. These include, for example, the proportion of the foreign population (unweighted 8.9%/weighted 9% versus 8.5% in census data), the proportion of adults over 17 years of age (56.7% versus 57% in census data), the proportion of households whose head is not educated (unweighted 21.9%/weighted 22.8% versus 21.1% in census data). CONCLUSION: This article illustrates how an epidemiological field survey based on spatial sampling can be successfully implemented at low cost, quickly and with little technical and theoretical knowledge. While statistically similar to simple random sampling, this survey method greatly simplifies its implementation.
[The contribution of teleconsultation and isolation of symptomatic cases in control of the COVID-19 outbreak a military base].
Allonneau A, Villeneuve JP, Sempere H … +8 more , Couderc A, Nicaise A, Soula M, Kerrien C, Minaberry S, Bertrand M, Mourougou M, Coste S
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34119362 · Full text
BACKGROUND: The first wave of COVID-19 swept over France during the first quarter of 2020, leading to saturation of the health care system. We wished to study, in a French military medical unit assisting one of the count...
BACKGROUND: The first wave of COVID-19 swept over France during the first quarter of 2020, leading to saturation of the health care system. We wished to study, in a French military medical unit assisting one of the country's largest armed forces populations, the impact of teleconsultation and the systematic isolation of all possible, probable and confirmed cases of COVID-19. METHODS: This is a retrospective study carried out from March 9 to May 31, 2020 on the basis of our activity register. The variables collected included type of medical consultation procedure, occupational status, classification of cases and date of onset of first symptoms. We have paralleled our activity with that of SOS Médecins and the emergency departments of the Île-de-France region. RESULTS/DISCUSSION: During this period, 1719 episodes of care (teleconsultations or physical consultations) were recorded, of which 91% (n=1561) were linked to COVID-19. We identified 598 "suspected" (possible and probable) and confirmed cases. "Isolated" teleconsultations (not followed by a face-to-face medical consultation, sample taking or necessitating the dispatch of prompt assistance) represented 86% of episodes of care (n=1482). Comparison of our activity and the number of new cases with the databases of SOS Médecins and the Île-de-France emergency services suggests that our isolation strategy was timely and effective. CONCLUSION: The contribution of teleconsultation was substantial and reassuring. Teleconsultation makes it possible to absorb a large volume of patients, is easy to implement, and entails no nosocomial risk. Isolation of infected patients should be a priority during an outbreak. Once it has become a priority to rapidly bring an epidemic under control, this attitude must be extended to all symptomatic patients.
[Not Available].
Rev Epidemiol Sante Publique · 2021 Jun · PMID 38620784 · Full text
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