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Pradier C, Balinska MA, Bailly L. Enhancing multi-sectoral collaboration in health: the open arena for public health as a model for bridging the knowledge-translation gap. FRONTIERS IN HEALTH SERVICES 2023; 3:1216234. [PMID: 37790087 PMCID: PMC10544995 DOI: 10.3389/frhs.2023.1216234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/06/2023] [Indexed: 10/05/2023]
Abstract
Effective public health interventions at local level must involve communities and stakeholders beyond the health services spectrum. A dedicated venue for structured discussion will ensure ongoing multi-sectoral collaboration more effectively than convening ad hoc meetings. Such a venue can be created using existing resources, at minimal extra cost. The University Hospital in Nice (France) has established an Open Arena for Public Health which can serve as a model for promoting collaborative partnerships at local level. The Arena has been successful in implementing sustainable interventions thanks to a set of principles, including: non-hierarchical governance and operating, fair representation of stakeholders, consensus as to best available evidence internationally and locally, policy dialogues: open, free-flowing discussions without preconceived solutions, and an experimental approach to interventions.
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Affiliation(s)
- Christian Pradier
- Department of Public Health, Nice University Hospital, University of Côte D'Azur, Nice, France
- Clinical Research Unit (UR2CA), Nice University Hospital, University of Côte D'Azur, Nice, France
| | - Marta A. Balinska
- Clinical Research Unit (UR2CA), Nice University Hospital, University of Côte D'Azur, Nice, France
| | - Laurent Bailly
- Department of Public Health, Nice University Hospital, University of Côte D'Azur, Nice, France
- Clinical Research Unit (UR2CA), Nice University Hospital, University of Côte D'Azur, Nice, France
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Ferré N, Racine AN, Fuente D, Pjevac D, Fuch A, Garbarino JM, Pradier C. [Feedback on the implementation of a departmental physical activity project for the elderly]. SANTE PUBLIQUE 2019; Vol. 31:53-60. [PMID: 31210517 DOI: 10.3917/spub.191.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Regular physical activity is nowadays recognized as one of the keys for ageing well. A number of interventions are therefore developed for this target group. The goal of this study was to examine the establishment and impact of a structured physical activity program for subjects aged 60 or more on a departmental scale and according to the point of view of different actors engaged. METHODS The PAS Project (Prévention Active Senior), coordinated by a resource and expertise center, consisted of conceiving and implementing a structured physical activity program for subjects aged 60 or more. In every municipality, the program was conducted by a local sports instructor in partnership with a municipal representative. It consisted of 3 weekly sessions of physical activity (2 supervised and 1 individual) over a period of 3 months. The data was collected thanks to the tools developed for the evaluation. RESULTS The program was conducted in 27 municipalities. A total of 586 participants enrolled in the program and 439 completed the final evaluation. This project allowed for the improvement of three main physical capacities (endurance, muscular strength, and balance) for most of the participants. At the end of the program, more than 50% of municipalities created or supported a long term physical activity offer for elderly. DISCUSSION This study highlights the need of adapting this kind of intervention to the local context. It confirmed the interest of a combined individual and more general approach, as well as a cross-sectorial work in order to create the conditions for sustainable daily physical activity for the target group.
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Bailly L, d'Arripe-Longueville F, Fabre R, Emile M, Valbousquet J, Ferré N, Colson S, Pradier C. Impact of improved urban environment and coaching on physical condition and quality of life in elderly women: a controlled study. Eur J Public Health 2018; 29:5098720. [PMID: 30239667 DOI: 10.1093/eurpub/cky192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Physical activity can slow the ageing process and preserve autonomy in the elderly. The aim of this study was to assess the combined impact of an organized urban walking circuit and individual coaching on women senior citizens' physical well-being and quality of life. METHODS Insufficiently physically active women >65 years were included in a quasi-experimental trial. Active arm: District with improved urban environment (IUE). Control arm: District without improved urban environment (WIUE). In each district, subjects were randomly allocated to receive coaching (C+ vs. C-). The main outcome measures were endurance, physical activity score, flexibility, quality of life, physical self-esteem, ageing exercise stereotypes, functional health and perceived health at baseline, three (M3) and six (M6) months. RESULTS Fifty-two insufficiently physically active women were included, 23 in IUE and 29 in WIUE. Groups were comparable at baseline. At M3, endurance and physical activity score significantly improved compared with baseline in the IUE group and in the C+ group while no statistically significant change was observed for the WIUE group and the C- group. Moreover, endurance score was higher in the IUE group, whether coupled with coaching or not. After the coaching was removed, the IUE group regresses to baseline overall and the WIUE shows a decrement in endurance. CONCLUSION Our study highlights the positive impact of an improved environment and of individual coaching on the level of physical activity and quality of life of insufficiently physically active elderly women.
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Affiliation(s)
- L Bailly
- Université Côte d'Azur, LAMHESS, Nice, France
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | | | - R Fabre
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - M Emile
- Université Côte d'Azur, LAMHESS, Nice, France
| | - J Valbousquet
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - N Ferré
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - S Colson
- Université Côte d'Azur, LAMHESS, Nice, France
| | - C Pradier
- Université Côte d'Azur, LAMHESS, Nice, France
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
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Al-Bayan M, Islam N, Edwards S, Duncan DT. Neighborhood perceptions and hypertension among low-income black women: a qualitative study. BMC Public Health 2016; 16:1075. [PMID: 27733142 PMCID: PMC5062878 DOI: 10.1186/s12889-016-3741-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 10/04/2016] [Indexed: 11/30/2022] Open
Abstract
Background The majority of studies examining the role of neighborhoods and hypertension-related outcomes have been quantitative in nature and very few studies have examined specific disadvantaged populations, including low-income housing residents. The objective of this study was to use qualitative interviews to explore low-income Black women’s perceptions of their neighborhoods and to understand how those perceptions may affect their health, especially as it relates to blood pressure. Methods Seventeen Black female participants, living in public housing communities in New York City, completed one semi-structured, audiotaped interview in July of 2014. All interviews were transcribed, coded, and analyzed for emerging themes using N’Vivo 10 software. Results Three major themes emerged: (1) social connectedness, (2) stress factors, and (3) availability of food options. For example, factors that caused stress varied throughout the study population. Sources of stress included family members, employment, and uncleanliness within the neighborhood. Many participants attributed their stress to personal issues, such as lack of employment and relationships. In addition, the general consensus among many participants was that there should be a greater density of healthy food options in their neighborhoods. Some believed that the pricing of fresh foods in the neighborhoods should better reflect the financial status of the residents in the community. Conclusions Various neighborhood influences, including neighborhood disorder and lack of healthy food options, are factors that appear to increase Black women’s risk of developing high blood pressure. Implications of this research include the need to develop interventions that promote good neighborhood infrastructure (e.g. healthy food stores to encourage good nutrition habits and well-lit walking paths to encourage daily exercise), in addition to interventions that increase hypertension awareness in low-income neighborhoods.
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Affiliation(s)
| | - Nadia Islam
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, Room 621, New York, NY, 10016, USA
| | | | - Dustin T Duncan
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, Room 621, New York, NY, 10016, USA.
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Levasseur M, Généreux M, Bruneau JF, Vanasse A, Chabot É, Beaulac C, Bédard MM. Importance of proximity to resources, social support, transportation and neighborhood security for mobility and social participation in older adults: results from a scoping study. BMC Public Health 2015; 15:503. [PMID: 26002342 PMCID: PMC4460861 DOI: 10.1186/s12889-015-1824-0] [Citation(s) in RCA: 177] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/06/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Since mobility and social participation are key determinants of health and quality of life, it is important to identify factors associated with them. Although several investigations have been conducted on the neighborhood environment, mobility and social participation, there is no clear integration of the results. This study aimed to provide a comprehensive understanding regarding how the neighborhood environment is associated with mobility and social participation in older adults. METHODS A rigorous methodological scoping study framework was used to search nine databases from different fields with fifty-one keywords. Data were exhaustively analyzed, organized and synthesized according to the International Classification of Functioning, Disability and Health (ICF) by two research assistants following PRISMA guidelines, and results were validated with knowledge users. RESULTS The majority of the 50 selected articles report results of cross-sectional studies (29; 58%), mainly conducted in the US (24; 48%) or Canada (15; 30%). Studies mostly focused on neighborhood environment associations with mobility (39; 78%), social participation (19; 38%), and occasionally both (11; 22%). Neighborhood attributes considered were mainly 'Pro ducts and technology' (43; 86) and 'Services, systems and policies' (37; 74%), but also 'Natural and human-made changes' (27; 54%) and 'Support and relationships' (21; 42%). Mobility and social participation were both positively associated with Proximity to resources and recreational facilities, Social support, Having a car or driver's license, Public transportation and Neighborhood security, and negatively associated with Poor user-friendliness of the walking environment and Neighborhood insecurity. Attributes of the neighborhood environment not covered by previous research on mobility and social participation mainly concerned 'Attitudes', and 'Services, systems and policies'. CONCLUSION Results from this comprehensive synthesis of empirical studies on associations of the neighborhood environment with mobility and social participation will ultimately support best practices, decisions and the development of innovative inclusive public health interventions including clear guidelines for the creation of age-supportive environments. To foster mobility and social participation, these interventions must consider Proximity to resources and to recreational facilities, Social support, Transportation, Neighborhood security and User-friendliness of the walking environment. Future studies should include both mobility and social participation, and investigate how they are associated with 'Attitudes', and 'Services, systems and policies' in older adults, including disadvantaged older adults.
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Affiliation(s)
- Mélanie Levasseur
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke, 1036 Belvedere South, J1H 4C4, Sherbrooke, QC, Canada.
| | - Mélissa Généreux
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke, 1036 Belvedere South, J1H 4C4, Sherbrooke, QC, Canada.
- Public Health Department, Health and Social Services Agency, 300 King East, Suite 300, J1J 1B1, Sherbrooke, QC, Canada.
| | - Jean-François Bruneau
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Montreal Polytechnique, Downtown Station, P.O. Box 6079, H3C 3A7, Montreal, QC, Canada.
| | - Alain Vanasse
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Research Centre, CHUS, 3001 12th Avenue North, J1H 5N4, Sherbrooke, QC, Canada.
| | - Éric Chabot
- Ordre des urbanistes du Québec, H2Y 3V4, Montreal, QC, Canada.
| | - Claude Beaulac
- Ordre des urbanistes du Québec, H2Y 3V4, Montreal, QC, Canada.
| | - Marie-Michèle Bédard
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
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El Houssaini K, Ivanov AI, Bernard C, Jirsa VK. Seizures, refractory status epilepticus, and depolarization block as endogenous brain activities. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2015; 91:010701. [PMID: 25679555 DOI: 10.1103/physreve.91.010701] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Indexed: 06/04/2023]
Abstract
Epilepsy, refractory status epilepticus, and depolarization block are pathological brain activities whose mechanisms are poorly understood. Using a generic mathematical model of seizure activity, we show that these activities coexist under certain conditions spanning the range of possible brain activities. We perform a detailed bifurcation analysis and predict strategies to escape from some of the pathological states. Experimental results using rodent data provide support of the model, highlighting the concept that these pathological activities belong to the endogenous repertoire of brain activities.
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Affiliation(s)
- Kenza El Houssaini
- Aix Marseille Université, Inserm, INS UMR_S 1106, 13005, Marseille, France
| | - Anton I Ivanov
- Aix Marseille Université, Inserm, INS UMR_S 1106, 13005, Marseille, France
| | - Christophe Bernard
- Aix Marseille Université, Inserm, INS UMR_S 1106, 13005, Marseille, France
| | - Viktor K Jirsa
- Aix Marseille Université, Inserm, INS UMR_S 1106, 13005, Marseille, France
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