Revue D'epidemiologie Et De Sante Publique[JOURNAL]
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200 papers
[Spatio-temporal dynamics of bacillary dysentery outbreaks in Democratic Republic of the Congo, 1999-2013].
Mbuyi W M G, Makasa Mandja B, Kebela Ilunga B
Rev Epidemiol Sante Publique · 2021 Feb · PMID 33518368 · Publisher ↗
PROBLEM STATEMENT: From 1999 to 2013 in the Democratic RC, monitoring of bacillary dysentery in bloody diarrhea revealed an average rate of attack in 620 out of 100,000 inhabitants. Within the study period, biological co...
PROBLEM STATEMENT: From 1999 to 2013 in the Democratic RC, monitoring of bacillary dysentery in bloody diarrhea revealed an average rate of attack in 620 out of 100,000 inhabitants. Within the study period, biological confirmation was available in less than 1% of cases. A dozen dysentery outbreaks were confirmed in laboratories as shigellosis. In this study, our objective is to improve dysentery surveillance. METHODS: A descriptive method based on epidemiological and biological data was applied, and a literature review was included. RESULTS: According to historical research, the first dysentery epidemics occurred in the Mayombe Region in the early 1920s. Spatial dynamics show that the eastern part of the country experienced the highest number of attacks. Time series of bloody diarrhea in the country have revealed a decrease since 2005. No seasonality was found. CONCLUSION: Shigellosis outbreaks have become rare and of low magnitude. Our results suggest a need for further exploration of the causes and determinants of high incidences of bloody diarrhea. Present-day diminution of shigellosis outbreaks calls for research into explanatory factors.
[Patterns of antidepressant dispensing among children and adolescents between 2015 and 2017 in the French region of Midi-Pyrenees].
Nguyen-Soenen J, Driot D, Verges Y … +2 more , Dupouy J, Birebent J
Rev Epidemiol Sante Publique · 2021 Feb · PMID 33309402 · Publisher ↗
BACKGROUND: In France, consumption of antidepressant drugs by children and teenagers has been on the rise, even though recommendations for use are limited due to their association with serious adverse reactions. The obje...
BACKGROUND: In France, consumption of antidepressant drugs by children and teenagers has been on the rise, even though recommendations for use are limited due to their association with serious adverse reactions. The objective of this study was to describe the patterns of antidepressant drug dispensing among children and adolescents in the French region of Midi-Pyrenees. METHOD: The data regarding the Midi-Pyrenees region were extracted from the French Health Insurance Database (SNDS) using their ATC codes. The reimbursements for antidepressants, benzodiazepines and neuroleptics dispensed to patients from 6 to 17 years old between January 2015 and June 2017 were analyzed, after which data on the antidepressants themselves were selected. The population was divided into sub-groups according to age (children : 6 to 11 years old, teenagers: 12 to 17 years old). RESULTS: During the 30 months analyzed, 12,783 antidepressants were dispensed to 3506 patients. The antidepressants were primarily issued (90%) to teenagers. In terms of prevalence, 24.7% of the teenagers had amitriptyline delivered at least once, while 31.2% of them received sertraline at least once. Regarding total amount of antidepressant issuances, sertraline was first in both the child (26.9%) and the teenage (40.7%) populations. Benzodiazepine with an antidepressant was issued to 35.1% of the children and teenagers. CONCLUSIONS: Amitriptyline was the most widely dispensed antidepressant among children, and sertraline among teenagers. However, fluoxetine is recommended as the first-line treatment for depression affecting this population. A psychotropic drug prescription assistance website such as psychotropes.fr addressed to general practitioners might improve the implementation of recommendations and guidelines.
[How health care professionals perceive chronic disease: Changes in therapeutic patient education (TPE) assessment from 2011 to 2017 in a French university hospital].
Cherillat MS, Berland P, Odoul J … +2 more , Borie C, Gerbaud L
Rev Epidemiol Sante Publique · 2021 Feb · PMID 33280942 · Publisher ↗
BACKGROUND: Since 2010, in France, Therapeutic Patient Education (TPE) programs have applied to the Regional Health Agency (RHA) for authorization. Every four years, these programs are mandatorily re-evaluated, and the a...
BACKGROUND: Since 2010, in France, Therapeutic Patient Education (TPE) programs have applied to the Regional Health Agency (RHA) for authorization. Every four years, these programs are mandatorily re-evaluated, and the assessment allows for change in the program management criteria. In our hospital, we studied the evolution of the Therapeutic Patient Education (TPE) appraisal benchmarks, otherwise known as "indicators", in the 17 programs having been authorized and renewed at least once by the RHA. METHOD: The TPE program appraisal benchmarks are classified in terms of structure, process and outcomes; program activity itself as well as pedagogic, psychosocial and bioclinical indicators are taken into consideration. We wished to determine the extent to which these indicators were addressed, applied and renewed or created during renewal of the TPE programs. Statistical tests were carried out in order to compare changes in the number of benchmarks in each category before and after the renewal process. RESULTS: During the first authorization, there existed 533 appraisal benchmarks, while they numbered 550 for the second. As for "before-and-after" changes, they consisted in a reduced number of outcome indicators (43.7% to 35.1%), whereas process indicators increased (36.8% to 43.1%) (P=0.0141). In comparison to the category pertaining to pedagogic, psychosocial and bioclinical indicators, the most widely registered indicator category (55.5%) and the most frequently collected indicator category involved the program activity itself (54.7%) (P<0.0001), which increased pronouncedly during renewal periods (67.6%) (P=0.0002). Conversely, the pedagogic and psychosocial indicators were little if at all collected. As regards the latter, there was nevertheless a considerable increase in indicators related to skills and changes favoring health-promoting behaviours. Strictly bioclinical indicators have been largely supplanted by those having to do with the disease evolution, its impact and risk management. CONCLUSION: The major role assigned to process and structure indicators reflects the fact that they are predominantly structured by RHA requests. Even if this initial study necessitates further research, it highlights a change in the design of educational and psychosocial assessments among caregivers, a change likely to reflect their interest in how patients go about managing their illnesses, (more or less healthy) lifestyles and daily lives.
How do patients and health professionals perceive the role of family members in the decision-making process regarding the choice of a dialysis method? A qualitative study.
Senghor AS
Rev Epidemiol Sante Publique · 2021 Feb · PMID 33261955 · Publisher ↗
BACKGROUND: Therapeutic decisions often seem to be the product of interaction between health professionals and patients alone. However, some realities make it essential to consider family members when examining care of p...
BACKGROUND: Therapeutic decisions often seem to be the product of interaction between health professionals and patients alone. However, some realities make it essential to consider family members when examining care of patients, especially in the construction of therapeutic choices. Implementation of measures such as therapeutic patient education to make the patient an actor in his own healthcare, and the impact of disease on the patient's social and professional activities mean there is an important place for family members in a patient's care pathway. This study aims to examine the role of family members and the family environment in decision-making on treatment for patients with chronic kidney disease. It also analyzes how they contribute to the construction of patients' choices on dialysis methods through their involvement in a therapeutic patient education program. METHODS: This study involved thirty-six semi-structured interviews: sixteen with patients and twenty with health professionals. Therapeutic patient education sessions, interactions and information exchanges between patients and health professionals, as well as participant behaviours, were also observed. Analysis was thematic. RESULTS: Results indicate that the factors influencing the patient's choice of dialysis methods include the family environment as the place where the disease is experienced, the need to maintain family ties, the advice provided by family members and their active participation in therapeutic patient education sessions and partnership between family members and health professionals in the decision-making process. CONCLUSION: This study highlights the reality of decision-making processes that can start from a non-hospital setting. Furthermore, it argues for greater consideration of the needs, values, and preferences of family members in mechanisms designed to promote patient participation in therapeutic decisions.
[The French "pill scare": Did women go to a gynecologist more often to have an easier access to the IUD?].
Le Guen M, Agius R, Panjo H … +2 more , Moreau C, groupe Baromètre Santé 2016
Rev Epidemiol Sante Publique · 2020 Nov · PMID 33162269 · Publisher ↗
BACKGROUND: In December 2012, a media controversy about negative side-effects of oral contraceptives on women's health, also called "pill scare", broke out in France. While several analyses highlighted a change in women'...
BACKGROUND: In December 2012, a media controversy about negative side-effects of oral contraceptives on women's health, also called "pill scare", broke out in France. While several analyses highlighted a change in women's contraceptive practices following this media controversy, no analysis has been conducted to determine the possible changes in their choices of health professionals and its repercussions on their contraceptive use. METHODS: Our study is based on data from three population-based cross-sectional surveys conducted in 2010, 2013 and 2016 (Fecond 2010, Fecond 2013 and Baromètre Santé 2016) that collected information on women's contraceptive practices and the specialties of the health professionals having prescribed the methods they were using. RESULTS: Between 2010 and 2016, women went to a gynecologist or a midwife more often than to a general practitioner for prescription of a reversible contraceptive method. However, their changes in visiting prescribers did not explain the changes in their contraceptive practices observed over the period. In 2016, access to health professional remained largely dependent on women's socio-demographic characteristics: older ones and those from a more privileged social background or living in urban areas were more likely to consult a gynecologist for prescription of their contraceptive method. On the other hand, consultations of midwives for contraceptive prescription were more frequent among women with children and among those who relied on public health insurance alone. CONCLUSION: Following the "pill scare" that occurred in France in December 2012, the decision by some women to use the IUD instead of the pill led them to change health professionals, and also led practitioners to change their prescribing practices.
[Health care safety: The discrepancies between experience and degree of satisfaction of hospitalized patients observed in interviews performed by user representatives].
Gross O, Agostini B, Belleval P … +6 more , Cavé I, Citrini M, Fernandes S, Ghadi M, Graeve N, Gagnayre R
Rev Epidemiol Sante Publique · 2020 Nov · PMID 33162268 · Publisher ↗
INTRODUCTION: The purpose of this article is to present the results of a qualitative survey conducted by user representatives (URs) focusing on the health care safety experience of hospitalized patients. The authors wish...
INTRODUCTION: The purpose of this article is to present the results of a qualitative survey conducted by user representatives (URs) focusing on the health care safety experience of hospitalized patients. The authors wished to identify factors associated with safety of care and, more specifically, with the possibly ominous medical events reported by patients. METHODS: After being trained with these objectives in mind, eight URs conducted semi-directive interviews with fourteen patients hospitalized in eleven separate hospital units in nine different hospitals. RESULTS: Eight types of factors consisting in 30 contributing factors liable to be reported by patients were identified: 1) factors related to patients' basic needs; 2) personalization of care; 3) professional factors; 4) organizational factors; 5) communication factors; 6) caregiver responsiveness; 7) infectious risks; 8) continuity of care. Patients' overall feelings about their hospitalization remained excellent notwithstanding more tempered, even negative experiences. CONCLUSION: This paradoxical result shows that the patients' actual experience is far more instructive than their degree of satisfaction. In light of this study, the acceptability of this type of research (i.e. research conducted by URs) is excellent and it also appears highly feasible, whatever the limitations imposed by organizational considerations.
[Dialogue between general practitioner and patient regarding tobacco and alcohol consumption, from the patient's standpoint].
Cogordan C, Quatremère G, Andler R … +3 more , Guignard R, Richard JB, Nguyen-Thanh V
Rev Epidemiol Sante Publique · 2020 Nov · PMID 33162267 · Publisher ↗
BACKGROUND: General practitioners (GP) are key players in screening and counselling for smokers and alcohol drinkers exceeding French guidelines for low-risk consumption thresholds. Tackling the subject from the patients...
BACKGROUND: General practitioners (GP) are key players in screening and counselling for smokers and alcohol drinkers exceeding French guidelines for low-risk consumption thresholds. Tackling the subject from the patients' perspective, the authors aim at estimating the proportion of the population having discussed their smoking and alcohol consumption with their GPs, and to pinpoint the factors associated with their having done so. METHODS: The data (n=6346) are derived from nationwide representative phone survey in mainland France conducted by the French public health monitoring center Baromètre de Santé publique France. RESULTS: Among the persons aged 18-75 having consulted a GP over the last 12 months (82.5%), 36.7% stated that smoking had been discussed in consultation while 16.8% had talked about alcohol use. For both substances, being a man, a smoker, an excessive alcohol user and having a chronic illness were not only independently associated with being questioned by one's doctor, but also with more frequent patient initiative. About 87% considered it normal to be asked by their GP about their alcohol intake, this proportion being higher among men and people with high incomes. CONCLUSION: Even though a large portion of the population would deem it normal to discuss smoking and alcohol intake in consultation with a GP, the subjects are rarely broached. Our results underline the need to bolster efforts at systematic screening for substance use by GPs.
Disparate exposure to physically demanding working conditions in France.
Havet N, Fournier J, Stefanelli J … +2 more , Plantier M, Penot A
Rev Epidemiol Sante Publique · 2020 Nov · PMID 33139128 · Publisher ↗
BACKGROUND: Our study was aimed at examining disparate exposure to physically demanding working conditions in France, a key objective being to identify the types of employees/jobs requiring high-priority preventive actio...
BACKGROUND: Our study was aimed at examining disparate exposure to physically demanding working conditions in France, a key objective being to identify the types of employees/jobs requiring high-priority preventive actions. METHODS: We analyzed the data from the 2017 French nationwide cross-sectional survey (SUMER) on occupational hazards to which French employees in various sectors were subjected. The prevalence of several types of physically demanding working conditions (lifting of heavy loads, awkward body postures, vibrations, noise, and extreme temperatures) was explored. Potential associations of individual and job characteristics with these factors of hardship at work were studied by multivariate logistic regression. RESULTS: In total, 48% of employees were exposed to at least one physically demanding working condition and 24.8% were exposed to multiple constraints. While managers and intellectual professionals were exposed relatively infrequently to physical constraints, blue-collar workers experienced the highest frequency of exposure. On the one hand, the role of company size depended on the factor of hardship at work considered; on the other hand, employees in large-scale companies were generally less exposed. As expected, employees in the construction industry were the most exposed to physical constraints; that said, our results also show that some activities in the services sector (e.g., personal care, administrative and support services) were quite significantly affected by a wide array of physically demanding working conditions. CONCLUSION: Notwithstanding the establishment in France of Plans de Santé au travail (preventive workplace health and safety plans), occupational risks were found to be high, and above all, they were unevenly distributed among the various socio-professional categories, and strongly contributed to social inequalities in health. Our results identify the types of publics to be designated as high-priority targets for preventive measures aimed at reducing the adverse impacts of physically demanding working conditions and the incidence of associated musculoskeletal disorders.
[Factors related to the one-month retention of 8507 employees declared medically unfit in Hauts-de-France companies between 2014 and 2018].
Boulanger B, Surquin M, Fantoni-Quinton S … +1 more , Leroyer A
Rev Epidemiol Sante Publique · 2020 Nov · PMID 33139127 · Publisher ↗
BACKGROUND: Given the low rate of retention in a company after an employee has been found unfit for the job, our aim was to determine the factors related to employees being kept by their company one month after being dec...
BACKGROUND: Given the low rate of retention in a company after an employee has been found unfit for the job, our aim was to determine the factors related to employees being kept by their company one month after being declared unfit for the job due to either a musculoskeletal disease (MSD) or a mental health disorder (MHD). METHODS: This study was based on all employees declared unfit for the job by the occupational physicians in the "Unfitness" survey in the French "Hauts-de-France" region between 2014 and 2018. For each of the two groups of workers, factors related to the employees being kept by their company one month after being declared unfit for the job were studied by logistic regression. RESULTS: Only 6.9% of the 5352 workers declared unfit for the job due to MSD were kept in their company whereas 3.6% of the 3155 workers declared unfit for the job due to MHD were kept in theirs. For the two groups of workers, the proportion of employees kept by their company decreased with female gender (OR=0.63 95%CI [0.47-0.84] for MSD and OR=0.50 [0.32-0.78] for MHD for female vs. male), long sick-leave (OR=0.26 [0.18-0.40] for MSD and OR=0.22 [0.11-0.45] for MHD for sick-leave>6 months vs. no sick leave), small size of the company (<50 employees) and working in the construction field or services sector (vs. industry or administration). Concerning the employees declared unfit due to MSD alone, the proportion of employees kept by their company decreased for seniors (>50 years old) and for those with low seniority (<5 years). CONCLUSION: "Retention in a company" as a tool for "maintenance of employment" is a little-discussed subject, lending further credence to the current recommendations for reduction of inequalities in working conditions and vocational training of employees according to age and socio-occupational category, and also for reduction of inequalities in occupational pathways according to gender.
[Risk of incarceration of persons undergoing psychiatric care. A retrospective longitudinal study on the French department of Oise using information from a psychiatric hospital discharge database].
Plancke L, Gonfroy J, Lancelevée C … +5 more , Danel T, Delaplace C, Fovet T, Thomas P, Amariei A
Rev Epidemiol Sante Publique · 2020 Nov · PMID 33131979 · Publisher ↗
INTRODUCTION: Compared to the general population, persons with mental disorders are overrepresented in prison. In a study carried out in Picardy (northern France) in 2017, a quarter of those entering prison had had conta...
INTRODUCTION: Compared to the general population, persons with mental disorders are overrepresented in prison. In a study carried out in Picardy (northern France) in 2017, a quarter of those entering prison had had contact with a psychiatric service prior to their incarceration. Since to our knowledge no work on this subject has been published in France, we conducted a retrospective study, the main objective of which was to propose an estimate measure of incarceration likelihood in people with mental disorders. METHODS: Using data from a psychiatric hospital discharge database (Recueil d'informations médicalisé en psychiatrie, RimP), we searched for patients aged 18 and older who had received psychiatric care (except for those who were incarcerated at baseline) at the Oise psychiatric hospital in 2015-2016 and identified those who had also been registered by the psychiatric care tool (DSP) in liaison with the same hospital. As a marker of incarceration, registration was the event to be investigated. Survival analyses (Kaplan-Meier), first simple and then stratified by age, gender, past history, main diagnosis and intensity of care outside of prison were carried out to calculate likelihood of incarceration. A multivariate Cox model was used in order to identify the factors associated with incarceration. RESULTS: Among the 25,029 patients monitored in the Oise psychiatric hospital in 2015-2016, 126 had experienced incarceration during the 12 months following their inclusion in the study, i.e. an incarceration probability of 0.45% (95 % confidence interval: 0.37-0.55%). The incarcerated patients were younger (36.6 years in average versus 44.7-Pt-test<0.0001), more often male (96.8% versus 43.7% - P<0.0001), and had a more frequent history of detention (11.1% versus 0.6% - P <0.0001) and psychiatric care (20.6% versus 10.1% - P<0.0001) than the general population. The probability of incarceration at 12 months for the population followed in the psychiatry unit was 3.2 times higher than the detention rate of the general population in Oise over the same period. CONCLUSION: Our study confirms the pronouncedly high incarceration rate of people with mental disorders. Scheduled to begin in 2020, coding in the RimP of a single nationwide patient identifier for all the procedures and stays described will allow the generalized measurement by means of the proposed indicator throughout France.
[Not Available].
Rev Epidemiol Sante Publique · 2020 Nov · PMID 38620727 · Full text
Abstract loading — click title to view on PubMed.
[Not Available].
Faure S, Guédon G, Drubay PA
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32988578 · Publisher ↗
Abstract loading — click title to view on PubMed.
[A joint study of the multidimensional factors associated with the overall quality of adult diets in Canada].
Godonou GGDM, Bocoum I, Koraï B
Rev Epidemiol Sante Publique · 2020 Nov · PMID 32981771 · Publisher ↗
BACKGROUND: With 26% of Canadians suffering from obesity, significant steps are needed to reduce the social and economic costs entailed by their condition. Given its major contribution to this phenomenon, the quality of...
BACKGROUND: With 26% of Canadians suffering from obesity, significant steps are needed to reduce the social and economic costs entailed by their condition. Given its major contribution to this phenomenon, the quality of diet has been at the heart of numerous previous studies. The objective of the study is to analyze, based on recent data, the association between the quality of the diet of Canadian adults (18 years old and over), and their individual characteristics as well as those of their living environment, including several new elements (prices of fruits and vegetables, food security status). METHODS: Using data from the 2015 CCHS-Nutrition Survey and information from the 2007 Canadian Food Guide, a diet quality score (also called healthy eating index) was first calculated and then associated with different factors (identified in a literature review) through multiple linear regressions. RESULTS: In addition to confirming its association with age, gender, overall well-being and other socio-economic factors, this study reveals that quality of adult diets is negatively correlated with the evolution of people's food insecurity status and the increase of vegetable prices in the Canadian provinces since 2002. The positive link between diabetes and the quality of diet could reflect healthier eating behaviors due to the constraints generated by this disease. While city dwellers generally have access to a more diversified food supply, they nevertheless do not have a better diet than the rural population. Finally, non-North American immigrants appear to have a better diet than non-autochthonous Canadians. CONCLUSION: Paying more attention to food insecurity and to the affordability of vegetables are avenues to explore in view of improving the quality of nourishment in Canada. In any event, longitudinal studies shall be required to confirm the role and to measure the actual influence of these variables on the quality of individual adult diets.
[Not Available].
Giraudeau B, Blanc-Lapierre A, Seegers V … +1 more , Caille A
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32951634 · Full text
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[Epidemiological profile of female victims of psychological violence during the pre and postpartum periods in the Sédhiou region, Senegal].
Leye MMM, Gueye M, Seck I
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32948362 · Publisher ↗
BACKGROUND: In Senegal, psychological violence remains a taboo subject insofar as it often arises in the closed circle of family life. It has a highly negative impact on the health of pregnant women. The objective of thi...
BACKGROUND: In Senegal, psychological violence remains a taboo subject insofar as it often arises in the closed circle of family life. It has a highly negative impact on the health of pregnant women. The objective of this work was to study the epidemiological profile of female victims of psychological violence before and after birth in the Sédhiou region. METHOD: An observational, cross-sectional and analytical study was carried out from December 4, 2018 to April 4, 2019. The study population consisted of all the women received for postnatal consultation in one of the referral health structures in the Sédhiou region. Data were collected using a survey form and a questionnaire administered to the women having met the inclusion criteria. The data were entered using CS Pro software and subsequently analyzed using R 3.4.4 software. RESULTS: The mean age of the women was 25.4±7.8 (14-43 years). A total of 222 women (55.5 %) had suffered psychological violence during the prepartum period. Isolated psychological violence represented 44.3 % of the surveyed population, while psychological violence associated with sexual or physical violence represented 8.0 % and 5.4 % of the respondent population, respectively. The factors associated with psychological violence during the prepartum period were pursuit of a professional activity [ORaj=4.7 (1.3-17.0)], high educational status [ORaj=7.0 (4.2-11.5)] and performance of fewer than 3 antenatal consultations (ANC) [ORaj=2.2 (1.2-4.0)]. Maternal, fetal and neonatal complications were more frequent among victims of psychological violence (P<0.05). During the postpartum period, 26.5 % of the women who had been victims of violence during the prepartum period mentioned the fact that the aggression had ceased. The other women continued to endure violence, which was even more intense among 2.5 %. CONCLUSION: Psychological violence among pregnant women has a negative impact on the health of the mother and the newborn. This state of affairs should induce health care providers to increase popular awareness of its detrimental effects. Communication efforts aimed at behavioral change will need to be combined during prenatal consultations with strengthened screening for violence, the objective being to achieve improved care.
[The troubled epistemology of the first wave of research on Covid-19].
Coste J, Bizouarn P, Leplège A
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32948361 · Full text
Abstract loading — click title to view on PubMed.
[To what extent Africa can limit the impact of the COVID-19 pandemic?].
Hoummadi L, Hafid J, Machraoui S … +1 more , Admou B
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32948360 · Full text
Following the onset of the global COVID-19 pandemic and the alerts issued by the World Health Organization, for several months attention has been focused on Africa as a potentially severely endangered continent. A sizabl...
Following the onset of the global COVID-19 pandemic and the alerts issued by the World Health Organization, for several months attention has been focused on Africa as a potentially severely endangered continent. A sizable number of African countries, mainly low and middle income, suffer from limited available resources, especially in critical care, and COVID-19 is liable to overwhelm their already fragile health systems. To effectively manage what is shaping up as a multidimensional crisis, the challenge unquestionably goes beyond the necessary upgrading of public health infrastructures. It is also a matter of anticipating and taking timely action with regard to factors that may mitigate the propagation of SARS-CoV2 and thereby cushion the shock of the pandemic on the African continent. While some of these factors are largely unmanageable (climate, geography…), several others (socio-cultural, religious, audio-visual, and potentially political…) could be more or less effectively dealt with by African governments and populations.
[Health care delivery and psychiatric hospitalizations in the prisons of the North of France: An observational study].
Eck M, Plancke L, Horn M … +3 more , Amad A, Thomas P, Fovet T
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32900559 · Publisher ↗
BACKGROUND: In French prisons, psychiatric care for inmates is organized into three levels: ambulatory care within each jail in "unités sanitaires en milieu pénitentiaire" (USMP: sanitary units in correctional settings),...
BACKGROUND: In French prisons, psychiatric care for inmates is organized into three levels: ambulatory care within each jail in "unités sanitaires en milieu pénitentiaire" (USMP: sanitary units in correctional settings), day hospitalizations in the 28 services médico-psychologiques régionaux (SMPR, "regional medical-psychological services") and full-time hospitalizations in one of the nine "unités d'hospitalisation spécialement aménagées" (UHSA: specially equipped hospital units). Despite high prevalence of mental disorders among French prisoners, the efficiency of these specialized psychiatric care units has been insufficiently studied. The main goal of this study is to describe full-time psychiatric hospitalizations for inmates in the twenty prisons located in the North of France. METHODS: We conducted a descriptive study based on medical and administrative data and survey results. The following data were collected for each prison regarding 2016: 1) number and occupancy rates for mental health professionals and 2) psychiatric hospitalization rates (in the UHSA of Lille-Seclin and the general psychiatric hospitals). RESULTS: Provision of care is incomplete: the vacancy rate in the health units studied reaches 40 %. Moreover, access to UHSA is unequal: it varies pronouncedly according to the location of the prison; only inmates in prisons close to the UHSA benefit from satisfactory access. CONCLUSION: Access to psychiatric care for inmates remains problematic in France, particularly due to a lack of mental health professionals in USMPs, the overload of patients in UHSAs and the distance of theses facilities from certain prisons and jails.
Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students.
Nouayti H, Bouanani NH, Hammoudi J … +4 more , Mekhfi H, Legssyer A, Bnouham M, Ziyyat A
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32896444 · Publisher ↗
BACKGROUND: Overweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overw...
BACKGROUND: Overweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco. METHODS: A cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity. RESULTS: The prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P<0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR=1.76; [1.18-2.63]; P<0.01), father's income≥5000MAD (OR=1.32; [1.02-1.70]; P<0.05), father's overweight (including obesity) (OR=1.87; [1.38-2.54]; P<0.001) and female sex (OR=1.31; [1.02-1.68]; P<0.05). CONCLUSION: The prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.
[Impact of models of care integrating direct access to physiotherapy in primary care and emergency care contexts in patients with musculoskeletal disorders: A narrative review].
Demont A, Quentin J, Bourmaud A
Rev Epidemiol Sante Publique · 2020 Sep · PMID 32893028 · Publisher ↗
BACKGROUND: Musculoskeletal disorders are increasing in prevalence, principally due to sedentary behaviors. Strong evidence supports an early need for first-line treatment including physiotherapy. New and innovative mode...
BACKGROUND: Musculoskeletal disorders are increasing in prevalence, principally due to sedentary behaviors. Strong evidence supports an early need for first-line treatment including physiotherapy. New and innovative models in primary and emergency care have been drawn up and put the physiotherapist's skills to work in early and first-line management of patients with musculoskeletal disorders. The objectives of this review were to identify and describe studies assessing models of care integrating direct access to physiotherapy in primary care and in emergency care for patients with musculoskeletal disorders and to provide perspectives on the application of these two models in France. METHODS: A literature review was carried out including studies extracted from four scientific databases: PubMed, CINAHL, Embase, and PEDro. The selected articles had to address the clinical effectiveness or efficiency of these models for the provision of care in primary or in emergency care. A narrative literature review method was used. The synthesis deals with the qualitative analysis of the included studies. RESULTS: Thirty-nine studies were included in this review: 19 on assessment of the direct access to physiotherapy model in primary care and 20 on the direct access to physiotherapy model in emergency departments as concerns patients with musculoskeletal disorders. The studies showed that the different models incorporating direct access to physiotherapy in primary or in emergency care provided better outcomes in terms of quality and access to care while maintaning a similar degree of safety. However, the methodology of the studies included was estimated as being of heterogeneous quality. CONCLUSION: The studies dealing with the new models for provision of care integrating direct access to physiotherapy in primary care or emergency care impart two lessons: (1) they are not designed to replace the physician; (2) collaboration between different health professionals aimed at improving patients' access to efficient care is to be encouraged. It would be worthwhile to focus upon dissemination factors that would enhance the efficiency of these innovative models in other countries, as in France.
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