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Humbert X, Dupouy J, Renard V, Pouchain D, Tudrej B, Partouche H, Rousselot N, Vincent YM, Ibanez G, Malmartel A, Jego M, Gilberg S, François M, Ferrat E, Saint-Lary O, Boussageon R. From guidelines to current practices: Suboptimal hypertension management in France. GPs' point of view. J Med Vasc 2024; 49:118-119. [PMID: 38697709 DOI: 10.1016/j.jdmv.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/06/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Xavier Humbert
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Julie Dupouy
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Vincent Renard
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Denis Pouchain
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Benoit Tudrej
- Collège national des généralistes enseignants, 75013 Paris, France.
| | - Henri Partouche
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | | | - Gladys Ibanez
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | - Maëva Jego
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Serge Gilberg
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | - Emilie Ferrat
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | - Rémy Boussageon
- Collège national des généralistes enseignants, 75013 Paris, France
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Camard L, Liard R, Duverne S, Ibanez G, Skendi M. Consensus on relevant point-of-care ultrasound skills in General Practice: a two-round French Delphi study. BMC Med Educ 2024; 24:341. [PMID: 38532436 DOI: 10.1186/s12909-024-05072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/18/2024] [Indexed: 03/28/2024]
Abstract
CONTEXT Point-of-Care Ultrasound (POCUS) has become an important tool in the clinical practice of many specialties, but its use and impact in General Practice in France remains to be explored. OBJECTIVE The objective of this study is to obtain a consensus among experienced French general practitioners on a list of relevant POCUS skills in General Practice in 4 anatomical regions. METHOD We used a two-round Delphi method to obtain a consensus. An initial list of skills was drawn by conducting a literature review. To rate each skill, we used a nine-point Likert scale. An interactive meeting between experts took place between Delphi rounds. POCUS experts in General Practice were defined as general practitioners with theoretical training in ultrasound who regularly perform ultrasound, who have performed ultrasound for more than five years and/or are involved in providing ultrasound training. RESULTS 11 French general practitioners screened 83 skills in 4 anatomical regions: abdominal, urogenital, vascular, gynecology and obstetrics. An agreement was obtained for 36 POCUS skills as to their appropriateness in General Practice. There were 17 skills with a strong appropriate agreement (100% of "7-9" ratings) and 19 skills with a relative agreement (100% of "5-9" ratings). CONCLUSION These skills could serve as a basis for guidelines on the use and curriculum of POCUS in General Practice in France as well as in other countries with similar healthcare systems.
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Affiliation(s)
- Louis Camard
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France.
| | - Roxane Liard
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France
| | - Sophie Duverne
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France
| | - Gladys Ibanez
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France
- Pierre-Louis Institute of Epidemiology and Public Health, Paris, France
| | - Mariela Skendi
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France.
- Department of Adult Radiology, Necker Hospital, Paris, France.
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Duguet T, Ibanez G, Schuers M, Lebeau JP, Roser K, Gomes CS, Cadwallader JS. General practice-related MeSH terms in main journals: a bibliometric analysis from 2011 to 2021. Br J Gen Pract 2024; 74:e120-e125. [PMID: 38253547 PMCID: PMC10824350 DOI: 10.3399/bjgp.2023.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/29/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND There are various Medical Subject Headings (MeSH) terms used to index general practice research, without consistency. AIM To understand how general practice-related research is indexed in the main general practice journals between 2011 and 2021, and to analyse the factors that influenced the choice of the general practice-related MeSH. DESIGN AND SETTING This was a quantitative bibliometric study conducted on MEDLINE. METHOD MeSH were selected according to the international definition of General Practice/Family Medicine: 'General Practice', 'Primary Health Care', 'Family Practice', 'General Practitioners', 'Physicians, Primary Care', and 'Physicians, Family'. Their use was studied from 2011 to 2021 on MEDLINE, reviewing the 20 general practice journals with the highest impact factors. A descriptive and analytical approach was used; the association of the country, journal, and year with the choice of general practice-related MeSH terms was analysed. RESULTS A total of 8514 of 150 286 articles (5.7%) were using one of the general practice-related MeSH terms. The most used were 'Primary Health Care' (4648/9984, 46.6%) and 'General Practice' (2841/9984, 28.5%). A total of 80.0% (6172/7723) of the articles were related to the UK or US and 71.0% (6055/8514) of the articles came from four journals (BJGP, BMJ, Journal of General Internal Medicine, and Annals of Family Medicine). Two main country clusters emerged from the use of general practice-related MeSH: a British cluster mainly using 'General Practice' and an American cluster using 'Primary Health Care'. The journals also mainly differed in their used of these two MeSH terms. CONCLUSION Important variations in the indexation of general practice research were found. Researchers should consider combining 'Primary Health Care' and 'General Practice' in their PubMed searches to access all the general practice research, regardless of their country of origin.
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Affiliation(s)
- Théo Duguet
- Department of General Practice, Sorbonne University, Paris
| | - Gladys Ibanez
- Department of General Practice, Sorbonne University, Paris, and INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris
| | - Matthieu Schuers
- Department of General Medicine, Rouen University Hospital, Rouen; Department of Biomedical Informatics, CHU Rouen, Rouen, and INSERM U 1142, LIMICS
| | | | - Kristell Roser
- Inter-University Health Library, Medicine-Odontology Center, Paris
| | - Cécilia Saldanha Gomes
- Department of General Practice, Sorbonne University, Paris, and INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris
| | - Jean-Sébastien Cadwallader
- Department of General Practice, Sorbonne University, Paris, and INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris
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Gieseken S, Ibanez G. Response to: Implementation Facilitators and Barriers for Primary Care Providers Prescribing Daily Oral PrEP to Adolescents in the United States (re: DOI: 10.1089/apc.2023.0090). AIDS Patient Care STDS 2024; 38:1-2. [PMID: 38133551 DOI: 10.1089/apc.2023.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Stephanie Gieseken
- Department of Nutrition and Dietetics, Florida International University, Miami, Florida, USA
| | - Gladys Ibanez
- Department of Epidemiology, Florida International University-Modesto A Maidique Campus, Miami, Florida, USA
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Manns A, Mahdjoub S, Ibanez G, Jarrier E, Daeipour A, Melchior M, El-Khoury F. Health professional's perception of a smoking cessation intervention among disadvantaged patients participating in a pragmatic randomized trial. BMC Health Serv Res 2023; 23:993. [PMID: 37710246 PMCID: PMC10503146 DOI: 10.1186/s12913-023-09950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Individuals who have a low socio-economic position (SEP) are more likely to smoke and face greater barriers to quitting tobacco. However, the effectiveness of tailored interventions has been limited probably due to specific challenges relative to this population. We conducted a mixed-method study to better understand health professionals' perceptions and barriers when implementing a preference-based smoking cessation (SC) intervention among disadvantaged smokers. METHODS A self-administered online questionnaire was sent to health professionals (doctors' and other health professionals specialized in SC) participating in "STOP" a pragmatic multicentre randomized controlled trial. Perceptions regarding patient eligibility, the doctor-patient relationship, general study organization, and satisfaction were measured. RESULTS Twenty-eight STOP study investigators responded. Health professionals prioritize smoking cessation for disadvantaged patients, but face challenges in approaching and following them. A research intervention providing cessation tools based on preference was deemed useful but generally undermined by time constraints. Health professionals' preconceptions regarding patients in low SEP having other "pressing problems" which might be exacerbated by quitting smoking were also identified. Further, participation in a research intervention was perceived as not satisfactory due to workload and lack of time. CONCLUSION Our results highlight general barriers inherent to implementing pragmatic trials. They also present specific challenges in smoking cessation trials among disadvantaged population, essential to advance equity in tobacco control.
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Affiliation(s)
- Aurélia Manns
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Sarah Mahdjoub
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Gladys Ibanez
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France
- Faculty of Medicine Pierre et Marie Curie, Department of Education and Research in General Medicine, Sorbonne Université, Paris, F75012, France
| | - Emilie Jarrier
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Ava Daeipour
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Maria Melchior
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Fabienne El-Khoury
- Department of social epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, 27 rue Chaligny, Paris, 75012, France.
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Bonello K, Figoni H, Blanchard E, Vignier N, Avenin G, Melchior M, Cadwallader JS, Chastang J, Ibanez G. Prevalence of smoking during pregnancy and associated social inequalities in developed countries over the 1995-2020 period: A systematic review. Paediatr Perinat Epidemiol 2023; 37:555-565. [PMID: 37427978 DOI: 10.1111/ppe.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Smoking during pregnancy (SDP) is an important source of preventable morbidity and mortality for both mother and child. OBJECTIVES The aim of this study was to describe changes in the prevalence of SDP over the last 25 years in developed countries (Human Development Index >0.8 in 2020) and associated social inequalities. DATA SOURCES A systematic review was conducted based on a search in PubMed, Embase and PsycInfo databases and government sources. STUDY SELECTION AND DATA EXTRACTION Published studies between January 1995 and March 2020, for which the primary outcome was to assess the national prevalence of SDP and the secondary outcome was to describe related socio-economic data were included in the analysis. The selected articles had to be written in English, Spanish, French or Italian. SYNTHESIS The articles were selected after successive reading of the titles, abstracts and full-length text. An independent double reading with intervention of a third reader in case of disagreement allowed including 35 articles from 14 countries in the analysis. RESULTS The prevalence of SDP differed across the countries studied despite comparable levels of development. After 2015, the prevalence of SDP ranged between 4.2% in Sweden and 16.6% in France. It was associated with socio-economic factors. The prevalence of SDP slowly decreased over time, but this overall trend masked inequalities within populations. In Canada, France and the United States, the prevalence decreased more rapidly in women of higher socio-economic status, and inequalities in maternal smoking were more marked in these countries. In the other countries, inequalities tended to decrease but remained significant. CONCLUSIONS During pregnancy, that is a period described as a window of opportunity, smoking and social vulnerability factors need to be detected to implement targeted prevention strategies aiming at reducing related social inequalities.
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Affiliation(s)
- Kim Bonello
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Hugo Figoni
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Estelle Blanchard
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Nicolas Vignier
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Guillaume Avenin
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Maria Melchior
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Jean-Sébastien Cadwallader
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Julie Chastang
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Gladys Ibanez
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
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Chastang J, Bruneau M, Mallick L, Gavet A, Hamidi Y, Roger E, Diaby A, Galvao E, Desportes V, Germanaud D, Desgrez V, Saldanha-Gomes C, Ibanez G. [Use of neurodevelopmental disorder screening tool in primary care : A multicenter observational study]. Rev Epidemiol Sante Publique 2023; 71:101595. [PMID: 37068363 DOI: 10.1016/j.respe.2023.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION Neurodevelopmental disorders (NDD) affect 5 to 15% of the population. Improved management largely depends on early detection in primary care. A screening tool was developed by an expert consensus and its use has been recommended since 2019. This tool has never been evaluated to date. The aim of this study was to investigate the prevalence and factors associated with the identification of neurodevelopmental disorders in primary care in children aged 6 months to 5 years. METHOD This work is a multicentric observational study carried out in general practice in two regions of France: Île-de-France and Auvergne-Rhône-Alpes. A multivariate analysis was performed to identify the factors associated with the presence of abnormal signs on the grid. RESULTS Five hundred and sixty-four (564) children aged 6 months to 4 years were included. The prevalence of children identified on the grid was 3.9%. The factors associated with the neurodevelopmental disorders identified in multivariate analysis were: low socio-professional status of the mother, male gender and parental concern about the child's neurodevelopment. Factors associated with identifying a developmental trajectory gap were male gender (OR = 2.10 (1.22-3.62)) and low socio-professional status of the mother (OR = 2.23 [1.05-4.70]). CONCLUSION This original work allowed us to carry out first-line testing of a tool for the identification of NDD in primary care and to evaluate the prevalence of identification of these disorders. A complementary cohort study will be necessary to evaluate the sensitivity and specificity of this identification tool.
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Affiliation(s)
- J Chastang
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France.
| | - M Bruneau
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - L Mallick
- Université Grenoble Alpes, Faculté de médecine de Grenoble, Département de médecine générale, 23, avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - A Gavet
- Université Grenoble Alpes, Faculté de médecine de Grenoble, Département de médecine générale, 23, avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Y Hamidi
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - E Roger
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - A Diaby
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - E Galvao
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - V Desportes
- Filière DéfiScience, Hôpital FME, Neurologie pédiatrique, CHU de Lyon HCL-GH Est, 59 boulevard Pinel, 69677 Bron Cedex, France
| | - D Germanaud
- UNIACT Neurospin, CEA_Inserm UMR1129, Université Paris Descartes, Paris, France
| | - V Desgrez
- Université Grenoble Alpes, Faculté de médecine de Grenoble, Département de médecine générale, 23, avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - C Saldanha-Gomes
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - G Ibanez
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
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Bonello K, Gomajee R, Ibanez G, Martins S, Keyes K, Nakamura A, Lepeule J, Strandberg-Larsen K, Fekom M, Melchior M. Maternal tobacco smoking during pregnancy and children's emotional and behavioural trajectories : The EDEN mother-child birth cohort study. Nicotine Tob Res 2023; 25:1174-1183. [PMID: 36786235 DOI: 10.1093/ntr/ntad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 01/01/2023] [Accepted: 02/13/2023] [Indexed: 02/15/2023]
Abstract
INTRODUCTION The nature of the relationship between maternal tobacco smoking during pregnancy and the occurrence of children's behavioural problems is still a matter of controversy. We tested this association using data collected among a sample of pregnant women and their offspring followed from birth to early adolescence (age 12 years), accounting for multiple parent, child, and family characteristics. METHODS Data come from 1424 mother-child pairs participating in the EDEN mother-child cohort in France. Using repeated measures (3, 5.5, 8 and 11.5 years) of the mother-reported Strengths and Difficulties Questionnaire, we estimated trajectories of children's emotional and behavioural difficulties. Two aspects of maternal smoking were studied: the timing (non-smoker, smoking during the periconceptional period or throughout pregnancy) and the level of use (cigarettes/day) during the first trimester of pregnancy. Robust Poisson regression models controlled for confounding factors including maternal mental health and socioeconomic characteristics using propensity scores with the overlap weighting technique. RESULTS Contrary to bivariate analyses, in propensity score-controlled regression models, maternal smoking throughout pregnancy was no longer significantly associated with offspring emotional or behavioural difficulties. Maternal heavy smoking (≥10cigarettes/day) remained significantly associated with intermediate levels of conduct problems (RR 1.25 95%CI 1.19-1.31). CONCLUSION The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties appears to be largely explained by women's other characteristics. However, maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics. IMPLICATIONS The relationship between maternal smoking during pregnancy (in 2 modalities: timing and level of smoking) and behavioural difficulties in children is still a matter of debate. While the relationship between any maternal tobacco use and offspring behavioural difficulties appears to be largely explained by confounding factors, heavy maternal smoking in the first trimester of pregnancy seems to be associated with offspring behavioural difficulties beyond the socioeconomic and mental health characteristics transmitted across generations.
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Affiliation(s)
- Kim Bonello
- Sorbonne University, School of Medicine, Department of general practice, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology (ERES), F-75012 Paris, France
| | - Ramchandar Gomajee
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology (ERES), F-75012 Paris, France
| | - Gladys Ibanez
- Sorbonne University, School of Medicine, Department of general practice, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology (ERES), F-75012 Paris, France
| | - Silvia Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York
| | - Katherine Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York
| | - Aurélie Nakamura
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Grenoble, France
| | - Johanna Lepeule
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Grenoble, France
| | | | - Mathilde Fekom
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology (ERES), F-75012 Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology (ERES), F-75012 Paris, France
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Azoyan L, Lombardi Y, Renaud MC, Duguet A, Georgin-Lavialle S, Cohen-Aubart F, Ibanez G, Steichen O. [Association between students' clinical performance and their success in the computerized national ranking tests: A single-center retrospective cohort study]. Rev Med Interne 2023; 44:5-11. [PMID: 35934597 DOI: 10.1016/j.revmed.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/04/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Before attending residency, 6th-year French medical students must validate a final examination including a practical clinical test in their faculty. However, the national ranking that determines their future specialty and region solely relies on a computerized knowledge test. Our goal was to investigate the association between the final faculty test and the national ranking test. METHODS In our faculty, the final examination includes a computerized theoretical test (similar to the national one) and a practical test: a standardized evaluation of semiology skills at the bedside and a standardized assessment of relational skills with role plays. The agreements between the national test and faculty computerized and practical tests were analyzed by intraclass correlation coefficients (ICC). RESULTS Data from 1806 students who underwent the three examinations from 2017 to 2021 were analyzed. There was a good agreement between the ranks in the faculty and national computerized tests: ICC 0.83 (95% CI 0.81-0.85). By contrast, the agreement between the ranks in the faculty practical test and the national computerized test was poor: ICC 0.13 (95% CI 0.08-0.17). Results were stable over the years. CONCLUSION The agreement between the ranking of the current national test and the clinical skills assessed by a specific faculty test is poor. This could relate to a true independence or to different levels of motivation to perform well. Indeed, the result of the national test is the most important one as it determines their career. Incorporating a clinical assessment into the national ranking test will motivate students to acquire clinical skills and value those who perform well this practical dimension.
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Affiliation(s)
- L Azoyan
- AP-HP, Hôpital Tenon, service de médecine interne, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France.
| | - Y Lombardi
- AP-HP, Hôpital Tenon, soins intensifs néphrologiques et rein aigu, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France
| | - M C Renaud
- Sorbonne Université, faculté de médecine, Paris, France
| | - A Duguet
- Sorbonne Université, faculté de médecine, Paris, France
| | - S Georgin-Lavialle
- AP-HP, Hôpital Tenon, service de médecine interne, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France
| | - F Cohen-Aubart
- Sorbonne Université, faculté de médecine, Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière service de médecine interne 2, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - G Ibanez
- Sorbonne Université, faculté de médecine, Paris, France; Sorbonne Université, département de médecine générale, Paris, France
| | - O Steichen
- AP-HP, Hôpital Tenon, service de médecine interne, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France; INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, équipe Sentinelles, 27 rue de Chaligny, 75012 Paris, France
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Moussaoui S, Chauvin P, Ibanez G, Soler M, Nael V, Morgand C, Robert S. Construction and Validation of an Individual Deprivation Index: a Study Based on a Representative Cohort of the Paris Metropolitan Area. J Urban Health 2022; 99:1170-1182. [PMID: 35653078 PMCID: PMC9161768 DOI: 10.1007/s11524-022-00648-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 12/31/2022]
Abstract
The association between health status and deprivation is well established. However, it is difficult to measure deprivation at an individual level and already-existing indices in France are not validated or do not meet the needs of health practitioners. The aim of this work was to establish a validated, easy-to-use, multidimensional, relevant index that was representative of the population in the Paris metropolitan area. From the SIRS 2010 cohort study, 14 socio-economic characteristics were selected: health insurance, educational background, socio-professional category, professional status, feelings of loneliness, emotional situation, household type, income, perceived financial situation, social support (support in daily life, financial and emotional), housing situation, and migration origin. In addition, a total of 12 health status, healthcare use, and nutrition-related variables were also selected. Content validity and internal validity of the index were explored. The 14 socio-economic indicators were associated to varying degrees with poorer health status, less use of healthcare, and poorer nutrition and were distributed across the 14 multiple-choice questions of the index. Each answer was rated from 0 to 2. The index value of 10 that isolates 20% of the most deprived individuals was used as threshold. "Being deprived," as defined with this value, was significantly associated with 9 of the 12 studied health variables. This index could be a relevant instrument in the assessment of deprivation and social inequalities of health.
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Affiliation(s)
- Sohela Moussaoui
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012, Paris, France.
- Sorbonne Université, Faculty of Medicine Pierre et Marie Curie, Department of Education and Research in General Medicine, F75012, Paris, France.
| | - Pierre Chauvin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012, Paris, France
| | - Gladys Ibanez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012, Paris, France
- Sorbonne Université, Faculty of Medicine Pierre et Marie Curie, Department of Education and Research in General Medicine, F75012, Paris, France
| | - Marion Soler
- University Hospital of Montpellier, 191 Av. du Doyen Gaston Giraud, 34295, Montpellier, France
| | - Virginie Nael
- Bordeaux University, 146 Rue Léo Saignat, 33076, Bordeaux, France
| | - Claire Morgand
- Inserm UMRS 1137, Paris, France
- Evaluation Department and Tools for Quality and Safety of Care, French National Authority for health, Saint Denis, France
| | - Sarah Robert
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012, Paris, France
- Sorbonne Université, Faculty of Medicine Pierre et Marie Curie, Department of Education and Research in General Medicine, F75012, Paris, France
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Fekom M, Bonello K, Gomajee R, Ibanez G, Martin S, Keyes K, Nakamura A, Lepeule J, Strandberg-Larsen K, Melchior M. Smoking during pregnancy and children’s emotional and behavioural trajectories. Eur J Public Health 2022. [PMCID: PMC9593937 DOI: 10.1093/eurpub/ckac129.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The nature of the relationship between maternal tobacco smoking during pregnancy and the occurrence of children's behavioural problems is still a matter of controversy. We tested this association using data collected among a sample of children followed from pregnancy to early adolescence (age 11.5 years), accounting for multiple parents’, children's and family characteristics. Methods Data come from 1424 mother-child pairs participating in the EDEN mother-child cohort set up in France. Using repeated measures (3, 5.5, 8 and 11.5 years) of the mother-reported Strengths and Difficulties Questionnaire, we estimated trajectories of children's emotional and behavioural difficulties. Two aspects of maternal smoking were studied: the timing and the level of use (cigarettes/day) during the first trimester of pregnancy. Multinomial regression models controlled for confounding factors including maternal mental health and socioeconomic characteristics using propensity scores with the overlap weighting technique. Results Contrary to bivariate analyses, in propensity score-controlled regression models, maternal smoking throughout pregnancy was no longer significantly associated with offspring emotional or behavioural difficulties. Maternal heavy smoking (≥10cigarettes/day) remained significantly associated with intermediate levels of overall emotional and behavioural difficulties (OR 1.64, 95%CI 1.04-2.58) and conduct problems (OR 3.05 95%CI 1.22-7.61), as well as with high levels of conduct problems symptoms (OR 2.82 95%CI 0.88-9.06) - although the latter did not reach statistical significance. Conclusions The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties appears to be largely explained by women's other characteristics. However, maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics. Key messages • The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties seem largely explained by the family's socio-demographic and behavioural characteristics. • Maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics.
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Affiliation(s)
- M Fekom
- Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre , Paris, France
| | - K Bonello
- General Practice, Sorbonne University, School of Medicine , Paris, France
- Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre , Paris, France
| | - R Gomajee
- Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre , Paris, France
| | - G Ibanez
- General Practice, Sorbonne University, School of Medicine , Paris, France
- Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre , Paris, France
| | - S Martin
- Epidemiology, Mailman School of Public Health, Columbia University , New York, USA
| | - K Keyes
- Epidemiology, Mailman School of Public Health, Columbia University , New York, USA
| | - A Nakamura
- Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS , Grenoble, France
| | - J Lepeule
- Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS , Grenoble, France
| | | | - M Melchior
- Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre , Paris, France
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Saffran D, Poon E, Ibanez G, Nakashima J, Naffar-Abu Amara S, Noe C, Hood T, Kumar P, DiMartino J, Dela Cruz F, Chesler L, Lin C. Regulation of oncogenic transcription and tumor growth in pediatric cancers by the CDK9 inhibitor KB-0742. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00999-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Haab E, Werschuren C, Parquet C, Sauvegrain P, Blanc J, Crenn-Hebert C, Fresson J, Gelly M, Gillard P, Gonnaud F, Vigoureux S, Ibanez G, Ngo C, Regnault N, Deneux-Tharaux C, Azria E. [Screening and healthcare for pregnant women with psycho-social vulnerability : A French national study]. Gynecol Obstet Fertil Senol 2022; 50:666-674. [PMID: 35820588 DOI: 10.1016/j.gofs.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/26/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Psycho-social vulnerabilities are a medical risk factor for both fetus and mother. Association between socioeconomic status and prenatal follow-up has been well established and inadequate follow-up is associated with higher morbidity and mortality in women in unfavorable situations. OBJECTIVE The objective is to identify screening strategies and to describe existing systems for pregnant women in psycho-social vulnerability in French maternity hospitals. MATERIAL AND METHODES This is a national survey conducted by questionnaire in all French maternities. RESULTS Screening by means of targeted questions is carried out by 96.7% of maternity units. Early prenatal interviews are offered systematically by 64% of maternity units and access to them is still difficult for women in vulnerable situations. In order to organize care pathways, 28.7% of maternities have a structured unit within their establishment and 81% state that they have mobilizable caregivers. Multidisciplinary meetings for the coordination of the various stakeholders are held by 85.8% of maternity units. Collaboration with networks and associations is emphasized. CONCLUSION A large proportion of maternities seek to identify women in situation of psycho-social vulnerabilities and to organize care paths. However, the resources implemented still appear insufficient for many maternity units. Each maternity hospital has resources and is developing initiatives to deal with the difficulties of care.
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Affiliation(s)
- E Haab
- Maternité Notre-Dame-de-Bon-Secours, Groupe Hospitalier Paris-Saint- Joseph, 185, rue Raymond-Losserand, 75876 Paris cedex 14, France.
| | - C Werschuren
- Maternité Notre-Dame-de-Bon-Secours, Groupe Hospitalier Paris-Saint- Joseph, 185, rue Raymond-Losserand, 75876 Paris cedex 14, France.
| | - C Parquet
- Maternité Notre-Dame-de-Bon-Secours, Groupe Hospitalier Paris-Saint- Joseph, 185, rue Raymond-Losserand, 75876 Paris cedex 14, France.
| | - P Sauvegrain
- Université de Paris, CRESS, Équipe de recherche en épidémiologie obstétricale périnatale et pédiatrique, EPOPé, INSERM U1153, INRA, Paris, France.
| | - J Blanc
- Service de gynécologie-obstétrique, Hôpital Nord, pôle Femmes-Parents-Enfants, hôpitaux universitaire de Marseille, AP-HM, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, faculté de médecine, campus La-Timone, EA 3279, CEReSS, centre d'études et de recherches sur les services de santé et qualité de vie, Marseille, France.
| | - C Crenn-Hebert
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, HUPNVS, Colombes, France.
| | - J Fresson
- Département d'information médicale, maternité du CHRU de Nancy, Nancy, France.
| | - M Gelly
- Centre de recherches sociologiques et politiques de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Seine-Saint-Denis, Paris, France.
| | - P Gillard
- Service de gynécologie obstétrique, Centre Hospitalier Universitaire d'Angers, Angers, France.
| | - F Gonnaud
- Service de pédopsychiatre, hospices civiles de Lyon, Lyon, France; Maternité et unité néonatale de la Croix-Rousse, Lyon, France.
| | - S Vigoureux
- Service de gynécologie, CHU de Nantes, 38, boulevard Jean-Monnet, 44000 Nantes, France.
| | - G Ibanez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Équipe de recherche en épidémiologie sociale (ERES), 75012 Paris, France.
| | - C Ngo
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, 75012 Paris, France; Hôpital privé des Peupliers, Ramsay santé, Paris, France.
| | - N Regnault
- Centre de recherche des Cordeliers, Sorbonne université, Inserm, université de Paris, équipe ETRES, 75006 Paris, France
| | - C Deneux-Tharaux
- Université de Paris, CRESS, Équipe de recherche en épidémiologie obstétricale périnatale et pédiatrique, EPOPé, INSERM U1153, INRA, Paris, France.
| | - E Azria
- Maternité Notre-Dame-de-Bon-Secours, Groupe Hospitalier Paris-Saint- Joseph, 185, rue Raymond-Losserand, 75876 Paris cedex 14, France; Université de Paris, CRESS, Équipe de recherche en épidémiologie obstétricale périnatale et pédiatrique, EPOPé, INSERM U1153, INRA, Paris, France.
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Moussaoui S, Combes S, Ibanez G, Gautier A, Relyea B, Vignier N. Are immigrants living in France more reluctant to receive vaccines than native-born French citizens? findings from the national health Barometer study. Vaccine 2022; 40:3869-3883. [DOI: 10.1016/j.vaccine.2022.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/12/2022] [Accepted: 05/14/2022] [Indexed: 01/04/2023]
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Skendi M, Liard R, Besacier C, Correas JM, Moussaoui S, Chastang J, Ibanez G. Intrauterine Pregnancy Detection and Gestational Age Assessment During Early Pregnancy by a Handheld Point-Of-Care Ultrasound Device Compared to a High-End Ultrasound System. An Accuracy and Reliability Study. POCUS J 2022; 7:225-231. [PMID: 36896381 PMCID: PMC9983726 DOI: 10.24908/pocus.v7i2.15458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: The main objective of this study is the evaluation of the accuracy and reliability of a handheld point of care ultrasound device (POCUS-hd) for intrauterine pregnancy (IUP) detection compared to comprehensive reference transabdominal ultrasound (TU). The secondary objectives were to evaluate POCUS-hd for intrauterine pregnancy (IUP) detection compared to transabdominal and transvaginal ultrasound (TUTV), evaluate the inter-device agreement and inter-rater reliability of gestational age during early pregnancy. Methods: It is an observational transverse study with consecutive patient recruitment. Two blinded operators systematically used POCUS-hd and reference transabdominal ultrasound for IUP diagnosis. The accuracy of POCUS-hd for IUP diagnosis was expressed as sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV). The gestational age (GA) was assessed based on the crown-rump length. The reliability and agreement of gestational age evaluation were assessed by Bland-Altman plots, kappa statistic, and intraclass correlation coefficients (ICC). Results: POCUS-hd compared to TU had a sensitivity of 95-100%, a specifcity of 90-100%, PPV of 95-100% and NPV of 90-100%. Inter-rater agreement for IUP detection using POCUS-hd was very good, kappa=1.0; CI95% [0.9-1.0]. The inter-device agreement limits (mean difference ± 2SD) for GA were: -3 to +2.3 days by Operator 1, -3.4 to +3.3 days by Operator 2 for POCUS-hd vs. TU and -3.1 to +2.3 days for POCUS-hd versus TUTV. Conclusion: This handheld POCUS device is an accurate and reliable diagnostic tool that can be used for IUP positive findings and GA assessment during early pregnancy by clinicians in family planning settings or general practice.
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Affiliation(s)
- Mariela Skendi
- Department of General Practice, Faculty of Medicine, Sorbonne University Paris France
| | - Roxane Liard
- Department of General Practice, Faculty of Medicine, Sorbonne University Paris France
| | - Charlotte Besacier
- Department of General Practice, Faculty of Medicine, Sorbonne University Paris France
| | | | - Sohela Moussaoui
- Department of General Practice, Faculty of Medicine, Sorbonne University Paris France
| | - Julie Chastang
- Department of General Practice, Faculty of Medicine, Sorbonne University Paris France
| | - Gladys Ibanez
- Department of General Practice, Faculty of Medicine, Sorbonne University Paris France
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16
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Luan L, Fraisse P, Cordel H, Charlois C, Méchaï F, Ibanez G, Hargreaves S, Mechain M, Vignier N. Screening for active and latent TB among migrants in France. Int J Tuberc Lung Dis 2021; 25:903-910. [PMID: 34686232 DOI: 10.5588/ijtld.21.0231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Migrants to Europe face a disproportionate burden of infections, including TB, yet little is known about the approach taken by primary and secondary care providers to screening and treatment. We therefore explored policy and practice relating to screening of active TB and latent TB infection (LTBI) in France.METHODS: We conducted an online national survey of French primary and secondary care physicians regarding their practices in relation to TB/LTBI screening among migrants.RESULTS: 367 physicians responded to the questionnaire among which 195 (53.1%) were primary care physicians, 126 (34.3%) were TB specialists in secondary care, and 46 (12.5%) other physicians; 303 (85.5%) were involved daily in the care of migrants. Most respondents recommended systematic TB screening with chest X-ray for migrants from medium and high-incidence countries (71.9%). Primary care physicians were less likely to offer screening than physicians in other settings (aOR 0.21, 95% CI 0.09-0.48). 220 (61.8%) offered LTBI screening for children (<15 years) and 34.0% for all migrants from high incidence countries.CONCLUSION: Improving awareness on TB screening is a critical next step to improve health outcomes in migrant groups and meet regional targets for tackling TB.
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Affiliation(s)
- L Luan
- Groupe hospitalier Sud Ile-de-France, Department of Public Health, Melun, Department of Social Epidemiology, Unité mixte de Recherche (UMR) 1136, Institut Pierre Louis d´Épidémiologie et de Santé Publique, Institut national de la Santé et de la Recherche médicale (INSERM), Sorbonne Université, Paris
| | - P Fraisse
- National network of TB control centres, Strasbourg Hospital, Strasbourg, France
| | - H Cordel
- Department of Tropical and Infectious Disease, Hôpital Avicenne, Assistance publique - Hôpitaux de Paris, Hôpitaux universitaires Paris Seine Saint-Denis, Université Sorbonne Paris Nord, Bobigny, France
| | - C Charlois
- Paris Tuberculosis Control Centre, Strasbourg, France
| | - F Méchaï
- Department of Tropical and Infectious Disease, Hôpital Avicenne, Assistance publique - Hôpitaux de Paris, Hôpitaux universitaires Paris Seine Saint-Denis, Université Sorbonne Paris Nord, Bobigny, France, Infection Antimicrobials Modelling Evolution, INSERM UMR 1137, Université Sorbonne Paris Nord, Paris, France
| | - G Ibanez
- Department of Social Epidemiology, Unité mixte de Recherche (UMR) 1136, Institut Pierre Louis d´Épidémiologie et de Santé Publique, Institut national de la Santé et de la Recherche médicale (INSERM), Sorbonne Université, Paris, Department of General Practice, Sorbonne Université, Paris, France
| | - S Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George´s University of London, London, UK
| | - M Mechain
- Bordeaux University Hospital, Bordeaux, France
| | - N Vignier
- Groupe hospitalier Sud Ile-de-France, Department of Public Health, Melun, Department of Social Epidemiology, Unité mixte de Recherche (UMR) 1136, Institut Pierre Louis d´Épidémiologie et de Santé Publique, Institut national de la Santé et de la Recherche médicale (INSERM), Sorbonne Université, Paris, Department of Tropical and Infectious Disease, Hôpital Avicenne, Assistance publique - Hôpitaux de Paris, Hôpitaux universitaires Paris Seine Saint-Denis, Université Sorbonne Paris Nord, Bobigny, France, Centre d´Investigation clinique (CIC) Antilles Guyane, CIC INSERM 1424, Département de Recherche Innovation et Santé Publique, Centre Hospitalier de Cayenne, Cayenne, French Guiana
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Dominjon L, Skendi M, Ibanez G, Chastang J. Adapter le parcours de soins prénatal par le repérage précoce d’un mal-être psychologique. Sante Publique 2021; 33:233-243. [PMID: 34553868 DOI: 10.3917/spub.212.0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The prevalence of poor mental health during pregnancy is estimated at 10% and it appears to be associated with increased maternal and child morbidity. This pilot study aims to assess the impact on pregnant women, their mental health, and health care trajectory of early identification of poor mental health during pregnancy. METHOD This interventional study was carried out in three districts of Paris and included two groups. The intervention group was composed of pregnant women whose screening for poor mental health consisted in systematically asking them, in the first trimester of pregnancy, a single question. The control group was composed of pregnant women monitored as usual. All of these women benefited from a telephone interview eight to twelve weeks after their recruitment in order to assess their mental health in the second trimester of pregnancy and describe their care pathway. RESULTS In the intervention group, women benefited from early prenatal interview more often and they felt that their medical care had improved their well-being during pregnancy more frequently (P < 0.05). Women in the control group found it harder to express their psychological difficulties, expressed them less frequently and had trouble with medical care follow-up when offered (P < 0.05). CONCLUSION The early screening for poor mental health by a single question during pregnancy seems to positively change the care pathway of pregnant women with poor mental health. In addition, it could improve the well-being of pregnant women in the second trimester of pregnancy.
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El-Khoury F, El Aarbaoui T, Héron M, Hejblum G, Métadieu B, Le Faou AL, Ibanez G, Melchior M. Smoking cessation using preference-based tools among socially disadvantaged smokers: study protocol for a pragmatic, multicentre randomised controlled trial. BMJ Open 2021; 11:e048859. [PMID: 34193499 PMCID: PMC8246378 DOI: 10.1136/bmjopen-2021-048859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Many smoking cessation aids such as nicotine replacement treatments and e-cigarettes have been proven effective in aiding smoking cessation attempts. Encouraging smokers with low socioeconomic position (SEP) to choose their smoking aid tool based on their preferences, and giving that tool free of charge, might increase the odds of smoking cessation. This trial examines the effectiveness of the 'STOP' (Sevrage Tabagique à l'aide d'Outils dédiés selon la Préférence: Smoking cessation using preference-based tools), a preference-based smoking cessation intervention for smokers with low SEP. METHODS AND ANALYSIS The STOP study is a randomised, multicentre, controlled trial (RCT). Smokers with low SEP and wishing to quit will be randomised to either the intervention or the control group (standard care). Participants in the intervention group will be asked to choose between different types of nicotine substitutes (patches, inhalers, gum, tablets, etc) and/or an electronic cigarette which will be delivered free of charge to aid their smoking cessation attempt.The primary outcome will be smoking abstinence at 6 months after inclusion, defined as self-reported 7-day point prevalence of tobacco abstinence. Secondary outcomes include the total number of days of abstinence at 6 months after inclusion, 7-day point prevalence tobacco abstinence at 1 and 3 months after inclusion and number of relapses.The study will also include an economic evaluation, and a process evaluation using a mixed methods approach. ETHICS AND DISSEMINATION The study was approved by the 'Île de France II' Institutional Review Board on 8 September 2020 (CPP Île de France II; Ref No: 20.01.31.65528 RIPH2 HPS), and results will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT04654585.
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Affiliation(s)
- Fabienne El-Khoury
- Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), department of Social epidemiology, Paris, France
- Eepidemiology department, University Hospital Group of Psychiatry and Neurosciences (GHU Paris), Paris, France
| | - Tarik El Aarbaoui
- Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), department of Social epidemiology, Paris, France
| | - Mégane Héron
- Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), department of Social epidemiology, Paris, France
| | - Gilles Hejblum
- Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), CLEPIVIR research team, Paris, France
| | | | - Anne-Laurence Le Faou
- Addiction Centre, Hôpital Européen Georges Pompidou, Pôle Psychiatrie-Addictologie, Hôpitaux Universitaires Paris-Ouest, Paris, France
- Network of research in substance use disorder, Fédération hospitalo-universitaire, Paris, France
| | - Gladys Ibanez
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Sorbonne University Faculty of Medicine, Paris, France
- SFTG Recherche (Société de Formation Thérapeutique du Généraliste Recherche), Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), department of Social epidemiology, Paris, France
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Héron M, Le Faou AL, Ibanez G, Métadieu B, Melchior M, El-Khoury Lesueur F. Smoking cessation using preference-based tools: a mixed method pilot study of a novel intervention among smokers with low socioeconomic position. Addict Sci Clin Pract 2021; 16:43. [PMID: 34193288 PMCID: PMC8243481 DOI: 10.1186/s13722-021-00254-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background Compared to smokers with favorable socio-economic position (SEP), those with low SEP are less likely to have a successful smoking cessation attempt. Tailored approaches are therefore needed, and general practitioners could help reaching and assisting usually hard-to-reach population. Method STOP (Sevrage Tabagique à l’aide d’Outils dédiés selon la Préférence) is a pilot study, examining the feasibility, acceptability and potentiality of a smoking cessation intervention centered on smoker’s preference. Smokers with low SEP, wishing to quit, were recruited in six healthcare centers in the Greater Paris area. They were asked to choose between different types of nicotine replacement therapy (NRT) products and/or e-cigarette with liquids delivered free of charge to aid their smoking cessation attempt. We describe the characteristics of recruited participants, their perception of smoking cessation aids, and the evolution of their smoking status 4 to 6 weeks after recruitment. Results We recruited 49 participants, of which 29% chose an e-cigarette, 29% chose NRT and 42% chose both an e-cigarette and NRT. The intervention was shown to be acceptable by participants and health professionals. Among the 24 participants followed for at least one month, 14 (28% of all participants) stopped smoking, and 9 (18%) considerably reduced their consumption. Conclusion The STOP intervention is feasible and acceptable, even if more efforts should be made to limit lost-to-follow-up. This preference-based intervention also shows interesting prospect in helping smokers with low SEP quit smoking. We will test the efficacy of this preference-based intervention in a randomized controlled trial.
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Affiliation(s)
- Mégane Héron
- Social Epidemiology Departement, Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Anne-Laurence Le Faou
- Centre Ambulatoire d'Addictologie, DMU Psychiatrie et Addictologie, Hôpital Européen Georges Pompidou, APHP.Centre, Paris, France.,Fédération Hospitalo-Universitaire Network of Research in Substance Use Disorder, Université de Paris, Paris, France
| | - Gladys Ibanez
- Social Epidemiology Departement, Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, 27 rue Chaligny, Paris, 75012, France.,Department of General Practice, Sorbonne Université, Paris, France
| | | | - Maria Melchior
- Social Epidemiology Departement, Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, 27 rue Chaligny, Paris, 75012, France
| | - Fabienne El-Khoury Lesueur
- Social Epidemiology Departement, Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, 27 rue Chaligny, Paris, 75012, France. .,Epidemiology Department, University Hospital Group of Psychiatry and Neurosciences (GHU-Paris), Paris, France.
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20
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Nouchi A, Chastang J, Miyara M, Lejeune J, Soares A, Ibanez G, Saadoun D, Morélot-Panzini C, Similowski T, Amoura Z, Boddaert J, Caumes E, Bleibtreu A, Lorenzo A, Tubach F, Pourcher V. Prevalence of hyposmia and hypogeusia in 390 COVID-19 hospitalized patients and outpatients: a cross-sectional study. Eur J Clin Microbiol Infect Dis 2021; 40:691-697. [PMID: 33033955 PMCID: PMC7543958 DOI: 10.1007/s10096-020-04056-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/30/2020] [Indexed: 12/22/2022]
Abstract
Anecdotal evidence rapidly accumulated during March 2020 from sites around the world that sudden hyposmia and hypogeusia are significant symptoms associated with the SARS-CoV-2 pandemic. Our objective was to describe the prevalence of hyposmia and hypogeusia and compare it in hospitalized and non-hospitalized COVID-19 patients to evaluate an association of these symptoms with disease severity. We performed a cross-sectional survey during 5 consecutive days in March 2020, within a tertiary referral center, associated outpatient clinic, and two primary care outpatient facilities in Paris. All SARS-CoV-2-positive patients hospitalized during the study period and able to be interviewed (n = 198), hospital outpatients seen during the previous month (n = 129), and all COVID-19-highly suspect patients in two primary health centers (n = 63) were included. Hospitalized patients were significantly more often male (64 vs 40%) and older (66 vs 43 years old in median) and had significantly more comorbidities than outpatients. Hyposmia and hypogeusia were reported by 33% of patients and occurred significantly less frequently in hospitalized patients (12% and 13%, respectively) than in the health centers' outpatients (33% and 43%, respectively) and in the hospital outpatients (65% and 60%, respectively). Hyposmia and hypogeusia appeared more frequently after other COVID-19 symptoms. Patients with hyposmia and/or hypogeusia were significantly younger and had significantly less respiratory severity criteria than patients without these symptoms. Olfactory and gustatory dysfunction occurs frequently in COVID-19, especially in young, non-severe patients. These symptoms might be a useful tool for initial diagnostic work-up in patients with suspected COVID-19.
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Affiliation(s)
- Agathe Nouchi
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France.
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.
| | - Julie Chastang
- Département de Médecine Générale, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Makoto Miyara
- INSERM UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Julie Lejeune
- INSERM UMR-S-1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - André Soares
- Département de Médecine Générale, Sorbonne Université, Paris, France
| | - Gladys Ibanez
- Département de Médecine Générale, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - David Saadoun
- INSERM, UMR-S-959, Immunology-Immunopathology- Immunotherapy (I3), Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Capucine Morélot-Panzini
- INSERM, UMR-S-1158, Service de Pneumologie et Réanimation Médicale (Département R3S), Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Thomas Similowski
- INSERM, UMR-S-1158, Service de Pneumologie et Réanimation Médicale (Département R3S), Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Zahir Amoura
- Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Service de Médecine Interne 2, Groupe Hospitalier Universitaire APHP, Sorbonne-Université, site Pitié-Salpêtrière, Paris, France
| | - Jacques Boddaert
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- INSERM UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Service de Gériatrie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Caumes
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Alexandre Bleibtreu
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alain Lorenzo
- Département de Médecine Générale, Sorbonne Université, Paris, France
| | - Florence Tubach
- INSERM UMR-S-1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Valérie Pourcher
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
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21
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Myers K, Li T, Baum M, Ibanez G, Fennie K. The individual, interactive, and syndemic effect of substance use, depression, education, and ethnicity on retention in HIV care. Int J STD AIDS 2020; 32:184-193. [PMID: 33323072 DOI: 10.1177/0956462419890727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, we sought to assess the individual, syndemic, and interactive associations between individual-level factors and retention in care. The sample was derived from the Miami Adult Studies on human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) cohort from 2009 to 2014. The variables were entered into a multiple logistic regression with retention as the outcome. Backward regression, adjusting for all main effects, was conducted to determine which two-way interactions were associated with retention. Multivariable logistic regression was used to test which number of factors were associated with retention. Non-Hispanic Black race/ethnicity was associated with improved retention (odds ratio [OR] = 2.44, 95% confidence interval [CI]: 1.06-5.75, p ≤ 0.05) when compared to Non-Hispanic White persons. Black-Hispanic and Other racial/ethnic identities were associated with increased retention (OR = 4.84, 95%CI: 1.16-25.79, p ≤ 0.05 and OR = 7.24, 95%CI: 1.54-54.05, p ≤ 0.05, respectively) when compared to Non-Hispanic White persons. The interaction between depressive symptoms and Alcohol Use Disorder Identification Test (AUDIT, a test that assesses alcohol use disorder) score was significantly and negatively associated with retention in HIV care (OR = 0.14, 95%CI: 0.01-1.11, p ≤ 0.10). The interaction between age and male gender was also negatively associated with retention (OR = 0.95, 95%CI: 0.88-1.01, p ≤ 0.10), and the interaction between male gender and depression was positively associated with retention (OR = 7.17, 95%CI: 0.84-98.49, p ≤ 0.10). In conclusion, multiple races/ethnicities, specifically Non-Hispanic Black, Black-Hispanic, and Other racial/ethnic identification, were associated with increased odds of retention. Multiple interactions, specifically depressive symptoms * alcohol use disorder and male gender * age, were negatively associated with retention. The male gender * depression interaction was positively associated with retention in HIV care.
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Affiliation(s)
- Kristopher Myers
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Tan Li
- Department of Epidemiology and Biostatistics, University of South Florida, Miami, FL, USA
| | - Marianna Baum
- Department of Dietetics and Nutrition, Florida International University, Miami, FL, USA
| | - Gladys Ibanez
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Kristopher Fennie
- Department of Epidemiology, Florida International University, Miami, FL, USA
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22
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Joseph V, Jones A, Canidate S, Mannes Z, Lu H, Ennis N, Ibanez G, Somboonwit C, Cook R. Factors associated with current and severe pain among people living with HIV: results from a statewide sample. BMC Public Health 2020; 20:1424. [PMID: 32948167 PMCID: PMC7501653 DOI: 10.1186/s12889-020-09474-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background People living with HIV (PLHIV) are more likely to suffer from pain compared to the general public. Pain often clusters with mental health symptoms and substance use. This study sought to evaluate mental health and substance use factors associated with any pain and severe pain intensities among PLHIV. Methods Data were derived from HIV+ adults (N = 733) recruited from community health centers across Florida who completed questionnaires regarding demographics, chronic pain, HIV clinical outcomes, mental health symptoms, and substance use information. Pain was assessed using the Brief Pain Inventory (BPI) short form. Multivariate logistic regression analysis was utilized to assess the relationship between selected covariates and pain. Results Approximately half (45.0%) of participants reported having any current pain while 16.1% reported severe pain. The odds of having any current pain were 2.49 (CI 95% 1.48, 4.18, p < 0.01) times greater among PLHIV reporting anxiety and 1.69 (CI 95% 1.11, 2.57, p = 0.01) times greater among PLHIV reporting PTSD compared to those without those factors. The odds of having severe pain were 2.03 (CI 95% 1.03, 4.01, p = 0.04) times greater among PLHIV reporting anxiety and 2.02 (CI 95% 1.26, 3.24, p < 0.01) times greater among female participants compared to PLHIV without those factors respectively. Factors including depression, alcohol consumption, and marijuana use were not statistically associated with any current pain nor with severe pain. Conclusion The relationship between pain and mental health is complex. Thus, future research is needed to determine if pain treatments may reduce mental health symptoms or if treatments can be targeted to address both issues simultaneously.
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Affiliation(s)
- Verlin Joseph
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Abenaa Jones
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Shantrel Canidate
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Zachary Mannes
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Huiyin Lu
- Fred Hutchinson Cancer Research Center, University of Washington, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Nichole Ennis
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Sciences, College of Medicine, Florida State University, 2010 Levy Ave, Bldg. B, suite 266, Tallahassee, FL, 32310, USA
| | - Gladys Ibanez
- Department of Epidemiology, Florida International University, 11200 S.W. 8th Street, Building AHC-5, Room 478, Miami, Florida, 33199, USA
| | - Charurut Somboonwit
- Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Robert Cook
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
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23
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Azria E, Sauvegrain P, Blanc J, Crenn-Hebert C, Fresson J, Gelly M, Gillard P, Gonnaud F, Vigoureux S, Ibanez G, Ngo C, Regnault N, Deneux-Tharaux C. [Systemic racism and health inequalities, a sanitary emergency revealed by the COVID-19 pandemic]. ACTA ACUST UNITED AC 2020; 48:847-849. [PMID: 32950731 PMCID: PMC7497546 DOI: 10.1016/j.gofs.2020.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- E Azria
- Maternité Notre-Dame-de-Bon-Secours, Groupe Hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75876 Paris cedex 14, France; Université de Paris, epidemiology and statistics research center/CRESS, INSERM, INRA, 75004 Paris, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France.
| | - P Sauvegrain
- Université de Paris, epidemiology and statistics research center/CRESS, INSERM, INRA, 75004 Paris, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - J Blanc
- Service de gynécologie-obstétrique, Hôpital Nord, pôle Femmes-Parents-Enfants, hôpitaux universitaire de Marseille, AP-HM, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, faculté de médecine, campus La-Timone, EA 3279, CEReSS, centre d'études et de recherches sur les services de santé et qualité de vie, Marseille, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - C Crenn-Hebert
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, HUPNVS, Colombes, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - J Fresson
- Département d'information médicale, maternité du CHRU de Nancy, Nancy, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - M Gelly
- Centre de recherches sociologiques et politiques de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Seine-Saint-Denis, Paris, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - P Gillard
- Service de gynécologie obstétrique, Centre Hospitalier Universitaire d'Angers, Angers, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - F Gonnaud
- Service de pédopsychiatre, hospices civiles de Lyon, Lyon, France; Maternité et unité néonatale de la Croix-Rousse, Lyon, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - S Vigoureux
- Service de gynécologie, CHU de Nantes, 38, boulevard Jean-Monnet, 44000 Nantes, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - G Ibanez
- Centre de recherche en epidémiologie et santé des populations (CESP), université Paris-Sud, université Paris-Saclay, Inserm, Villejuif, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - C Ngo
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, 75012 Paris, France; Hôpital privé des Peupliers, Ramsay santé, Paris, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - N Regnault
- Centre de recherche des Cordeliers, Sorbonne université, Inserm, université de Paris, équipe ETRES, 75006 Paris, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
| | - C Deneux-Tharaux
- Université de Paris, epidemiology and statistics research center/CRESS, INSERM, INRA, 75004 Paris, France; Unité santé périnatale, petite enfance et santé mentale, santé publique France, France
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24
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De Oliveira A, Chavannes B, Steinecker M, Denantes M, Chastang J, Ibanez G. How French general practitioners adapt their care to patients with social difficulties? Fam Med Community Health 2020; 7:e000044. [PMID: 32148723 PMCID: PMC6910763 DOI: 10.1136/fmch-2018-000044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 09/03/2019] [Accepted: 09/09/2019] [Indexed: 11/29/2022] Open
Abstract
Objective Several studies have shown the role of the primary care system in access to care and in reducing social inequalities in health. The objective of this study was to describe the practices of general practitioners (GPs) in taking into account the social environment of their patient, and the ways they adapted to social difficulties. Design Qualitative study comprising interviews and focus groups. Setting French primary care settings. Participants Twenty semistructured interviews and two focus groups were conducted with 33 GPs. Sessions were audio recorded, transcribed verbatim and analysed using thematic analysis. The reporting of findings was guided by consolidated criteria for reporting qualitative research. Result This study identified adaptations at three levels: in the individual management of patients (alert system, full involvement in prevention, better communication, prioritised additional examinations, financial facilities, help in administrative tasks), in the collective management of patients in an office (consultation without appointment, pay-for-performance indicators, medical staffs, multidisciplinary protocols, medical practice in group, medical student), and in the community management (patients description, cooperation with associations, public health sector and politics). Conclusion In France, GPs can take into account the social determinants of health in practice through simple or more complex actions.
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Affiliation(s)
- Annie De Oliveira
- Department of General Practice, Medicine Sorbonne University, Paris, France
| | - Barbara Chavannes
- Department of General Practice, Medicine Sorbonne University, Paris, France
| | - Magali Steinecker
- Department of General Practice, Medicine Sorbonne University, Paris, France
| | - Mady Denantes
- Department of General Practice, Medicine Sorbonne University, Paris, France
| | - Julie Chastang
- Department of General Practice, Medicine Sorbonne University, Paris, France
| | - Gladys Ibanez
- Department of General Practice, Medicine Sorbonne University, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, (IPLESP), F75012, Paris, France
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Robert S, Romanello L, Lesieur S, Kergoat V, Dutertre J, Ibanez G, Chauvin P. Effects of a systematically offered social and preventive medicine consultation on training and health attitudes of young people not in employment, education or training (NEETs): An interventional study in France. PLoS One 2019; 14:e0216226. [PMID: 31026298 PMCID: PMC6485762 DOI: 10.1371/journal.pone.0216226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/16/2019] [Indexed: 11/25/2022] Open
Abstract
Background NEETs (young people not in employment, education or training) are at higher risk for poorer mental and physical health. In France, the Missions locales (MLs) are the only social structures dedicated to this population. We sought to determine whether the systematic offer of a social and preventive medicine consultation at a ML might increase NEET participants’ access to training in the 12 months following the intervention. Methods This intervention research was a parallel randomised controlled interventional study conducted at five MLs in mainland France in 2011–2012. It included 976 NEETs aged 18 to 25 years who attended one of the five MLs. At inclusion, participants were randomly assigned (1:1:1) to three groups: those in the first group were invited to see a social worker (not studied in this paper), those in the second group were invited to see a doctor and a social worker (intervention group), and the third was a control group. The primary outcome was participation in at least one training session during the year following study inclusion. Results Among the 976 participants, 504 were randomly assigned to the intervention group and 472 to the control group; 704 (72.1%) were included in the analyses. A significantly higher proportion of the participants in the intervention group participated in a training session in the 12 months following the intervention than of those in the control group (63.3% vs 55.6%; p = 0.04). This difference was significantly greater for women, those less than 21 years of age, those unstably housed and those with a lower level of education. Conclusions Social and preventive medicine consultations that are fully integrated into the social services for NEETs have an impact on their access to training and contribute to changing some of their health-related behaviours. This may improve their access to the labour market.
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Affiliation(s)
- Sarah Robert
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
- Sorbonne Université, Pierre et Marie Curie Faculty of Medicine, Department of Education and Research in General Medicine, Paris, France
- * E-mail:
| | - Lucile Romanello
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
- INSERM, UVSQ, Université Paris-Saclay, Population-Based Epidemiological Cohorts Unit (UMS 11), Villejuif, France
| | - Sophie Lesieur
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
| | | | | | - Gladys Ibanez
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
- Sorbonne Université, Pierre et Marie Curie Faculty of Medicine, Department of Education and Research in General Medicine, Paris, France
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
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Ibanez G, Falcoff H, Denantes M, Magnier AM, Baunot N, Chauvin P, Dommergues M, Robert S. [The “Wellbeing” project: To more reliably identify and support pregnant women with psychological or social vulnerabilities]. Sante Publique 2019; 30:89-97. [PMID: 30547491 DOI: 10.3917/spub.184.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The perinatal period is one of the most critical periods in the life cycle. The health of the mother and child are strongly and permanently influenced by events occurring during pregnancy, delivery or early infancy. In psychological terms, nearly 10% of women reported poor self-rated mental health during pregnancy. Moreover, sociodemographic characteristics indicative of social disadvantage are associated with a higher risk of poor self-rated mental health. 81.3% of these women did not consult a healthcare professional for psychological problems. The well-being project is designed to optimise the care of pregnant women with psychological or socioeconomic vulnerabilities and to assess the value of an early prenatal interview.
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Chauvin P, Bouziane H, Ibanez G. Estimation des erreurs et/ou des biais écologiques liés à l’utilisation d’indices sociaux agrégés à l’IRIS, dont le FDep, dans le Grand Paris. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2018.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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28
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Hajjar F, Saint-Lary O, Cadwallader JS, Chauvin P, Boutet A, Steinecker M, Robert S, Ibanez G. Development of Primary Care Research in North America, Europe, and Australia From 1974 to 2017. Ann Fam Med 2019; 17:49-51. [PMID: 30670396 PMCID: PMC6342604 DOI: 10.1370/afm.2328] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/31/2018] [Accepted: 09/27/2018] [Indexed: 11/09/2022] Open
Abstract
Research is a necessity for high-quality medicine. We used the MEDLINE database to conduct a bibliometric analysis of research output with respect to primary care by 21 countries. For the period 1974 to 2017, the United States and the United Kingdom stood out in terms of publication volume, and the UK, Canada, and Australia had the greatest percentage of publications in primary care. As of 2017, publications in primary care represented a small proportion of total publications. The countries with the greatest publication productivity possess factors that should be considered with respect to strengthening research in primary care.
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Affiliation(s)
- Florence Hajjar
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
| | - Olivier Saint-Lary
- Department of Family Medicine, Faculty of Health Sciences Simone Veil, University Versailles Saint-Quentin en Yvelines (UVSQ), Montigny-le-Bretonneux, France.,CESP, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Jean-Sébastien Cadwallader
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France.,Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
| | - Pierre Chauvin
- Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
| | - Alexandre Boutet
- Inter-University Health Library, Medicine-Odontology Center, Paris, France
| | - Magali Steinecker
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
| | - Sarah Robert
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France.,Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
| | - Gladys Ibanez
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France .,Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
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Hajjar F, Saint-Lary O, Cadwallader JS, Chauvin P, Boutet A, Steinecker M, Robert S, Ibanez G. Development of Primary Care Research in North America, Europe, and Australia From 1974 to 2017. Ann Fam Med 2019; 17. [PMID: 30670396 PMCID: PMC6342604 DOI: 10.1370/afm.2328,] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Research is a necessity for high-quality medicine. We used the MEDLINE database to conduct a bibliometric analysis of research output with respect to primary care by 21 countries. For the period 1974 to 2017, the United States and the United Kingdom stood out in terms of publication volume, and the UK, Canada, and Australia had the greatest percentage of publications in primary care. As of 2017, publications in primary care represented a small proportion of total publications. The countries with the greatest publication productivity possess factors that should be considered with respect to strengthening research in primary care.
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Affiliation(s)
- Florence Hajjar
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
| | - Olivier Saint-Lary
- Department of Family Medicine, Faculty of Health Sciences Simone Veil, University Versailles Saint-Quentin en Yvelines (UVSQ), Montigny-le-Bretonneux, France
- CESP, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Jean-Sébastien Cadwallader
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
- Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
| | - Pierre Chauvin
- Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
| | - Alexandre Boutet
- Inter-University Health Library, Medicine-Odontology Center, Paris, France
| | - Magali Steinecker
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
| | - Sarah Robert
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
- Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
| | - Gladys Ibanez
- School of Medicine, Department of General Practice, Sorbonne University, Paris, France
- Sorbonne Universités, Institut Pierre Louis d'Épidémiologie et de Santé Publique Paris, France
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Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, Gaouaou N, Ibanez G. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth 2018; 18:455. [PMID: 30470200 PMCID: PMC6251086 DOI: 10.1186/s12884-018-2087-4] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/13/2018] [Indexed: 12/31/2022] Open
Abstract
Background Pregnancy is a period of transition with important physical and emotional changes. Even in uncomplicated pregnancies, these changes can affect the quality of life (QOL) of pregnant women, affecting both maternal and infant health. The objectives of this study were to describe the quality of life during uncomplicated pregnancy and to assess its associated socio-demographic, physical and psychological factors in developed countries. Methods A systematic review was performed according to the PRISMA guidelines. Searches were made in PubMed, EMBASE and BDSP (Public Health Database). Two independent reviewers extracted the data. Countries with a human development index over 0.7 were selected. The quality of the articles was evaluated on the basis of the STROBE criteria. Results In total, thirty-seven articles were included. While the physical component of QOL decreased throughout pregnancy, the mental component was stable and even showed an improvement during pregnancy. Main factors associated with better QOL were mean maternal age, primiparity, early gestational age, the absence of social and economic problems, having family and friends, doing physical exercise, feeling happiness at being pregnant and being optimistic. Main factors associated with poorer QOL were medically assisted reproduction, complications before or during pregnancy, obesity, nausea and vomiting, epigastralgia, back pain, smoking during the months prior to conception, a history of alcohol dependence, sleep difficulties, stress, anxiety, depression during pregnancy and sexual or domestic violence. Conclusions Health-related quality of life refers to the subjective assessment of patients regarding the physical, mental and social dimensions of well-being. Improving the quality of life of pregnant women requires better identification of their difficulties and guidance which offers assistance whenever possible.
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Affiliation(s)
- Nolwenn Lagadec
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Magali Steinecker
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Amar Kapassi
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Anne Marie Magnier
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Julie Chastang
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Sarah Robert
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Nadia Gaouaou
- Department of Education and Research in General Medicine, Faculty of Medicine Pierre et Marie Curie, 27, rue Chaligny - 75571, cedex 12, Paris, France
| | - Gladys Ibanez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
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Jacquet E, Robert S, Chauvin P, Menvielle G, Melchior M, Ibanez G. Social inequalities in health and mental health in France. The results of a 2010 population-based survey in Paris Metropolitan Area. PLoS One 2018; 13:e0203676. [PMID: 30216375 PMCID: PMC6138404 DOI: 10.1371/journal.pone.0203676] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/26/2018] [Indexed: 01/13/2023] Open
Abstract
The present study aimed to assess socioeconomic inequalities in general and mental health, depression and substance use disorders (daily tobacco use, hazardous alcohol use). Data from the 2010 SIRS (French acronym for Health, Inequalities, and Social Ruptures) study, which is deemed to be representative of the French-speaking adult population living in the Paris Metropolitan Area, were analysed. Different socioeconomic position indicators were selected: education, income and perceived financial status. Absolute measures (the slope index of inequality (SII)) and relative measures (the odds ratio (OR) and relative index of inequality (RII)) of health inequalities were used. The OR, RII and SII were adjusted for age, household type and migration characteristics and all analyses were performed separately for men and women. The study included 3,006 adults. The results showed significant relative and absolute socioeconomic inequalities in general, mental health and depression for all socioeconomic position indicators considered (education, income, and perceived financial status). The absolute inequalities were greater for women than for men. Strongest inequalities were observed by perceived financial status for men and women. Education seemed to play a stronger role in inequalities for women, whereas, for men, income seemed to play a stronger role. Only few socioeconomic inequalities were found in daily tobacco use, while a reversed gradient was observed for hazardous alcohol use. We hope that these results will be regularly re-evaluated and compared across time in order to monitor socioeconomic inequalities in health.
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Affiliation(s)
- Elsa Jacquet
- Epidemiology and Population Health Research Centre (CESP), Paris-Sud University, UMRS 1018, Le Kremlin-Bicêtre, France
- Department of General Practice, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - Sarah Robert
- Department of Social Epidemiology, Sorbonne University, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
- Department of General Practice, Sorbonne University, Paris, France
| | - Pierre Chauvin
- Department of Social Epidemiology, Sorbonne University, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Gwenn Menvielle
- Department of Social Epidemiology, Sorbonne University, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Maria Melchior
- Department of Social Epidemiology, Sorbonne University, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Gladys Ibanez
- Department of Social Epidemiology, Sorbonne University, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
- Department of General Practice, Sorbonne University, Paris, France
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Degarege A, Gebrezgi MT, Ibanez G, Wahlgren M, Madhivanan P. Effect of the ABO blood group on susceptibility to severe malaria: A systematic review and meta-analysis. Blood Rev 2018; 33:53-62. [PMID: 30029997 DOI: 10.1016/j.blre.2018.07.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 06/29/2018] [Accepted: 07/12/2018] [Indexed: 12/25/2022]
Abstract
Understanding how ABO blood group interacts with Plasmodium falciparum (P. falciparum) infection may facilitate development of antimalarial treatments and vaccines. This study systematically summarizes information on the relationship of ABO blood group with severe P. falciparum infection, level of parasitemia and haemoglobin. A total of 1923 articles were retrieved from five databases. After removal of duplicates, and two levels of screening, 21 articles were selected for inclusion in the meta-analysis. A meta-analysis of the studies showed an increased odds of severe P. falciparum infection among individuals with blood group A, B, AB or non-O compared with blood group O. However, the difference in the level of P. falciparum parasitemia was not significant among individuals with blood group A or non-O compared with blood group O. The difference in haemoglobin level among P. falciparum infected individuals was also not significant between those with blood group A, B or AB versus those with blood group O.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Merhawi T Gebrezgi
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
| | - Gladys Ibanez
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
| | - Mats Wahlgren
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institute, Stockholm, Sweden.
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA; Public Health Research Institute of India, Mysore, India.
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Griffin I, Algarin A, White S, Ibanez G. RE: "DIETARY INTAKE OF ANTIOXIDANT VITAMINS AND CAROTENOIDS AND RISK OF DEVELOPING ACTIVE TUBERCULOSIS IN A PROSPECTIVE POPULATION-BASED COHORT". Am J Epidemiol 2018; 187:1571-1572. [PMID: 29342225 DOI: 10.1093/aje/kwx382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/24/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabel Griffin
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida
| | - Angel Algarin
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida
| | - Stephen White
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida
| | - Gladys Ibanez
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida
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Vignier N, Dreneau C, Rauzet G, Bottero J, Leroy H, Deniaud F, Bouchaud O, Ibanez G, Janseen C, Mechain M. Quel bilan de santé les médecins proposent-t-ils aux personnes migrantes arrivant sur le territoire français ? Résultats d’une enquête de pratique. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhou C, Ibanez G, Miramont V, Steinecker M, Baiz N, Banerjee S, Just J, Annesi-Maesano I, Chastang J. Prenatal maternal depression related to allergic rhinoconjunctivitis in the first 5 years of life in children of the EDEN mother-child cohort study. Allergy Rhinol (Providence) 2017; 8:132-138. [PMID: 29070270 PMCID: PMC5662538 DOI: 10.2500/ar.2017.8.0213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Backgroud: Evidence about the relationship between prenatal maternal depression and the development of childhood asthma and allergies in early life is scarce. We aimed to examine this relationship by using data set of EDEN mother-child cohort study. A total of 1139 children were followed-up until the age of 5 years. METHODS Prenatal maternal depression was self-reported by using the Centre for Epidemiological Studies-Depression scale (CES-D) questionnaire and was classified into binary variable (maternal depression [CES-D score of ≥16] and no maternal depression [CES-D score of <16]). Asthma and allergies in the first 5 years were assessed by using the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC). Adjusted odds ratio (aOR) was estimated for the relationship between prenatal maternal depression and early life asthma and allergies by marginal models through the method of generalized estimating equation (GEE) when adjusting for the confounders. RESULTS In our study population, 13.67 % of the mothers had clinical significant depression (the total scores for CES-D ≥16) during pregnancy. For children ages 5 years, the prevalence of wheezing, physician-diagnosed asthma, physician-diagnosed eczema and allergic rhinoconjunctivitis were 46.78, 20.99, 29.17, and 22.54%, respectively. Prenatal maternal depression was associated with ever allergic rhinoconjunctivitis (aOR 1.87 [95% confidence interval {CI}, 1.33-2.62]). No significant relationships were found between prenatal maternal depression and wheezing, physician-diagnosed asthma and physician-diagnosed eczema (aOR 1.12 [95% CI, 0.91-1.39], aOR 1.23 [95% CI, 0.81-1.85] and aOR 1.17 [95% CI, 0.86-1.61], respecitvely). CONCLUSION Prenatal maternal depression was related to ever allergic rhinoconjunctivitis in the first 5 years of life in children of EDEN mother-child cohort study.
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Affiliation(s)
- Cailiang Zhou
- From the Division of Statistics, Measurement and Evaluation of sport, College of Sport Science, Bejing Sport University, Beijing, China
| | - Gladys Ibanez
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Vincent Miramont
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Magali Steinecker
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Nour Baiz
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Soutrik Banerjee
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Jocelyne Just
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Isabella Annesi-Maesano
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
| | - Julie Chastang
- Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Epidemiology of Allergic and Respiratory Disease Department, Paris, France
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Pinzón-Iregui MC, Ibanez G, Beck-Sagué C, Halpern M, Mendoza RM. "…like because you are a grownup, you do not need help": Experiences of Transition from Pediatric to Adult Care among Youth with Perinatal HIV Infection, Their Caregivers, and Health Care Providers in the Dominican Republic. J Int Assoc Provid AIDS Care 2017; 16:579-587. [PMID: 28895487 DOI: 10.1177/2325957417729749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
With the introduction of combination antiretroviral therapy (ART) worldwide, youth with perinatal HIV infection are increasingly surviving childhood and transitioning to adult care. Although a normal life span is anticipated posttransition, successful transition to adult HIV care has proven difficult, with worse outcomes posttransition than in pediatric and adult care. This study is a qualitative analysis of data from 4 focus groups of pre- and posttransition patients, caregivers, and healthcare providers in the Dominican Republic at an institution that provides comprehensive treatment including ART for HIV-infected persons of all ages. All groups discussed the problems and challenges that patients, caregivers, and providers experience while living the transition process and beyond. Five major themes emerged: the trauma of transition itself, ART adherence, experience and impact of stigma, social supports and barriers, and recommendations for improving outcomes. Participants' insights offered approaches for a versatile structured transition process.
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Affiliation(s)
- María C Pinzón-Iregui
- 1 Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Gladys Ibanez
- 1 Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Consuelo Beck-Sagué
- 1 Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mina Halpern
- 2 Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Rosa M Mendoza
- 3 University of Pennsylvania, Philadelphia, PA, USA.,4 Columbia University, New York, NY, USA
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Lucero RJ, Frimpong JA, Fehlberg EA, Bjarnadottir RI, Weaver MT, Cook C, Modave F, Rathore MH, Morano JP, Ibanez G, Cook RL. The Relationship Between Individual Characteristics and Interest in Using a Mobile Phone App for HIV Self-Management: Observational Cohort Study of People Living With HIV. JMIR Mhealth Uhealth 2017; 5:e100. [PMID: 28751298 PMCID: PMC5553004 DOI: 10.2196/mhealth.7853] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/07/2017] [Accepted: 06/10/2017] [Indexed: 12/19/2022] Open
Abstract
Background The human immunodeficiency virus (HIV) continues to be a major health issue in the United States, and an estimated 1.2 million people in the United States are living with HIV. As part of Healthy People 2020, the Office of Disease Prevention and Health Promotion has targeted the persistent demographic and geographic disparities in HIV prevalence and management. Preliminary evidence suggests that mobile health technology (smartphone apps) may be a promising way to support HIV self-management among vulnerable populations of people living with HIV (PLWH) who lack access to appropriate health care services. Objective This study examines the association between individual characteristics of PLWH and level of interest in using a free mobile phone app for HIV self-management. Methods This study was conducted using cross-sectional survey data collected in the Florida Cohort Study between 2014 and 2016 (N=766). Associations between individual characteristics of PLWH and level of interest in using a free mobile phone app for HIV self-management were examined using bivariate analysis and logistic regression. Results Overall, 85.5% (655/766) of respondents were interested in using a free mobile phone app that supports HIV self-management. Participants expressed the highest interest in app functions that facilitate communication with health care providers (568/740, 76.8%) or help to identify relevant health care services (556/745 74.6%). Age (OR 0.959, 95% CI 0.936-0.982), education (OR 1.281, 95% CI 1.027-1.598) and disability or inability to work (OR 0.296, 95% CI 0.145-0.606) were all significantly associated with being interested in using a free mobile phone app for HIV self-management. Conclusions This study indicates that a majority of PLWH are interested in using a free mobile phone app to self-manage their condition. The findings can inform the development of mobile phone apps that support effective HIV self-management.
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Affiliation(s)
- Robert James Lucero
- Department of Family, Community, and Health Systems Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - Jemima A Frimpong
- Carey Business School, John Hopkins University, Baltimore, MD, United States
| | - Elizabeth A Fehlberg
- Division of Research on Healthcare Value, Equity, and the Lifespan, RTI International, Research Triangle Park, NC, United States
| | - Ragnhildur I Bjarnadottir
- Department of Family, Community, and Health Systems Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - Michael T Weaver
- Department of Family, Community, and Health Systems Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - Christa Cook
- Department of Family, Community, and Health Systems Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - Francois Modave
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Mobeen H Rathore
- College of Medicine, University of Florida, Jacksonville, FL, United States
| | - Jamie P Morano
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Gladys Ibanez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Robert L Cook
- Department of Epidemiology, Colleges of Medicine and Public Health, University of Florida, Gainesville, FL, United States
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Chastang J, Baiz N, Parnet L, Cadwallader JS, De Blay F, Caillaud D, Charpin DA, Dwyer J, Lavaud F, Raherison C, Ibanez G, Annesi-Maesano I. Changes in body mass index during childhood and risk of various asthma phenotypes: a retrospective analysis. Pediatr Allergy Immunol 2017; 28:273-279. [PMID: 28140475 DOI: 10.1111/pai.12699] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND It is known that asthma is related to obesity but also to small birthweight. The objective of this study was to clarify this issue by assessing the putative relationship between the changes in corpulence between birth and childhood as assessed by body mass index (BMI) and asthma phenotypes. METHODS The following status in corpulence was assessed in 7781 schoolchildren using quartile of BMI at birth and at around 10 (9-11 years): underweight at birth and at around 10, underweight at birth and overweight at around 10, overweight at birth and underweight at around 10, overweight at birth and at around 10, and the reference group constituted by all the other children in whom corpulence changes were not extreme. Determination of asthma phenotypes (allergic, non-allergic, and exercise-induced asthma) was based on a clinical examination including skin prick tests, an exercise challenge test, and a questionnaire. RESULTS The risk of allergic asthma was higher in children with persistent underweight, children with persistent overweight, and children becoming markedly more corpulent. In boys, the risk of allergic asthma was significantly higher for the less corpulent children at birth, regardless of whether they remained so or become overweight. In girls, the risk of allergic asthma was significantly higher in those with persistent overweight. There were no significant associations between BMI changes and non-allergic and exercise-induced asthma. CONCLUSIONS We observed that some extreme changes in BMI, persistent underweight, and persistent overweight in childhood increased the risk of allergic asthma.
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Affiliation(s)
- Julie Chastang
- Faculté de médecine de l'hôpital Saint-Antoine, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136 Equipe Epidémiologie des maladies allergiques et respiratoires (EPAR), UPMC Univ Paris 06, Universités Paris Sorbonne, Paris, France.,Département de Médecine générale, Faculté de Médecine, Paris UPMC, Université Paris 6, Paris, France
| | - Nour Baiz
- Faculté de médecine de l'hôpital Saint-Antoine, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136 Equipe Epidémiologie des maladies allergiques et respiratoires (EPAR), UPMC Univ Paris 06, Universités Paris Sorbonne, Paris, France
| | - Laure Parnet
- Faculté de médecine de l'hôpital Saint-Antoine, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136 Equipe Epidémiologie des maladies allergiques et respiratoires (EPAR), UPMC Univ Paris 06, Universités Paris Sorbonne, Paris, France.,Département de Médecine générale, Faculté de Médecine, Paris UPMC, Université Paris 6, Paris, France
| | | | | | - Denis Caillaud
- Service de pneumologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - John Dwyer
- Faculté de médecine de l'hôpital Saint-Antoine, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136 Equipe Epidémiologie des maladies allergiques et respiratoires (EPAR), UPMC Univ Paris 06, Universités Paris Sorbonne, Paris, France
| | - François Lavaud
- Service de pneumologie et allergologie, CHU de Reims, Reims, France
| | - Chantal Raherison
- Service de pneumologie et affections respiratoires, CHU de Bordeaux, Bordeaux, France
| | - Gladys Ibanez
- Faculté de médecine de l'hôpital Saint-Antoine, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136 Equipe Epidémiologie des maladies allergiques et respiratoires (EPAR), UPMC Univ Paris 06, Universités Paris Sorbonne, Paris, France.,Département de Médecine générale, Faculté de Médecine, Paris UPMC, Université Paris 6, Paris, France
| | - Isabella Annesi-Maesano
- Faculté de médecine de l'hôpital Saint-Antoine, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136 Equipe Epidémiologie des maladies allergiques et respiratoires (EPAR), UPMC Univ Paris 06, Universités Paris Sorbonne, Paris, France
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Baïz N, Chastang J, Ibanez G, Annesi-Maesano I. Prenatal exposure to selenium may protect against wheezing in children by the age of 3. Immun Inflamm Dis 2016; 5:37-44. [PMID: 28250923 PMCID: PMC5322167 DOI: 10.1002/iid3.138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 12/16/2022]
Abstract
Introduction It has been suggested that human in utero exposure to heavy metals such as selenium can reduce the prevalence of childhood asthma and allergic diseases. However, data on this topic are scarce. The objective of the present study was to assess the putative associations between maternal selenium level during pregnancy and the risk of asthma, wheezing, allergic rhinitis, and atopic dermatitis in children from the EDEN birth cohort by the age of 1 and 3 years. Methods Plasma selenium concentrations were measured in maternal blood during mid‐pregnancy (24–28 weeks of gestation) in 861 mothers. Cohort children were followed up from birth to 3 years using health questionnaires filled out by the parents for asthma, wheezing, allergic rhinitis, and atopic dermatitis. Maternal plasma selenium was related to the childhood outcomes by the age of 1 and 3 years. Results Our results showed a significant negative association between a high maternal plasma selenium level during pregnancy and the risk of wheezing in the child by the age of 1 and 3 years. However, maternal plasma selenium during pregnancy was not associated with the prevalence of asthma, allergic rhinitis or atopic dermatitis. Conclusions The results of this study suggest that the level of fetal exposure to maternal selenium could have an influence on the risk of wheezing in infancy and potentially on the risk of developing asthma later in life.
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Affiliation(s)
- Nour Baïz
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR) Sorbonne Universités UPMC Univ Paris 06 INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) Medical School Saint-Antoine 75012 Paris France
| | - Julie Chastang
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR)Sorbonne UniversitésUPMC Univ Paris 06INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136)Medical School Saint-Antoine75012 ParisFrance; Department of General PracticeUPMC Université Paris 6Medical School Saint Antoine75012 ParisFrance
| | - Gladys Ibanez
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR)Sorbonne UniversitésUPMC Univ Paris 06INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136)Medical School Saint-Antoine75012 ParisFrance; Department of General PracticeUPMC Université Paris 6Medical School Saint Antoine75012 ParisFrance
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR) Sorbonne Universités UPMC Univ Paris 06 INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) Medical School Saint-Antoine 75012 Paris France
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Sheehan DM, Trepka MJ, Fennie KP, Prado G, Ibanez G, Maddox LM. Racial/ethnic disparities in delayed HIV diagnosis among men who have sex with men, Florida, 2000-2014. AIDS Care 2016; 29:311-318. [PMID: 27455856 DOI: 10.1080/09540121.2016.1211609] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Only about 85% of men who have sex with men (MSM) with human immunodeficiency virus (HIV) have been tested for and diagnosed with HIV. Racial/ethnic disparities in HIV risk and HIV care outcomes exist within MSM. We examined racial/ethnic disparities in delayed HIV diagnosis among MSM. Males aged ≥13 reported to the Florida Enhanced HIV/AIDS Reporting System 2000-2014 with a reported HIV transmission mode of MSM were analyzed. We defined delayed HIV diagnosis as an AIDS diagnosis within three months of the HIV diagnosis. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR). Of 39,301 MSM, 27% were diagnosed late. After controlling for individual factors, neighborhood socioeconomic status, and rural-urban residence, non-Latino Black MSM had higher odds of delayed diagnosis compared with non-Latino White MSM (aOR 1.15, 95% confidence interval [CI] 1.08-1.23). Foreign birth compared with US birth was a risk factor for Black MSM (aOR 1.27, 95% CI 1.12-1.44), but a protective factor for White MSM (aOR 0.77, 95% CI 0.68-0.87). Rural residence was a risk for Black MSM (aOR 1.79, 95% CI 1.36-2.35) and Latino MSM (aOR 1.87, 95% CI 1.24-2.84), but not for White MSM (aOR 1.26, 95% CI 0.99-1.60). HIV testing barriers particularly affect non-Latino Black MSM. Social and/or structural barriers to testing in rural communities may be significantly contributing to delayed HIV diagnosis among minority MSM.
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Affiliation(s)
- Diana M Sheehan
- a Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University , Miami , FL , USA.,b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , USA
| | - Mary Jo Trepka
- a Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University , Miami , FL , USA.,b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , USA
| | - Kristopher P Fennie
- b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , USA
| | - Guillermo Prado
- c Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Gladys Ibanez
- b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , USA
| | - Lorene M Maddox
- d Florida Department of Health , HIV/AIDS Section , Tallahassee , FL , USA
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Madhivanan P, Valderrama D, Krupp K, Ibanez G. Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA. Cult Health Sex 2015; 18:710-722. [PMID: 26671002 DOI: 10.1080/13691058.2015.1116125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cervical cancer disproportionately affects minorities, immigrants and low-income women in the USA, with disparities greatest among Latino immigrants. We examined barriers and facilitators to cervical cancer screening practices among a group of immigrant Latino women in Florida, USA. Between January and May 2013, six focus group discussions, involving 35 participants, were conducted among Hispanic women in Miami to explore their knowledge, beliefs about cervical cancer and facilitators and barriers to cervical cancer screening using a theoretical framework. The data showed that family support, especially from female relatives, was an important facilitator of screening and treatment. Women, however, reported prioritising family health over their own, and some expressed fatalistic beliefs about cancer. Major obstacles to receiving a Pap smear included fear that it might result in removal of the uterus, discomfort about being seen by a male doctor and concern that testing might stigmatise them as being sexually promiscuous or having a sexually transmitted disease. Targeted education on cancer and prevention is critically needed in this population. Efforts should focus on women of all ages since younger women often turn to older female relatives for advice.
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Affiliation(s)
- Purnima Madhivanan
- a Department of Epidemiology , Robert Stempel College of Public Health & Social Work, Florida International University , USA
| | - Diana Valderrama
- a Department of Epidemiology , Robert Stempel College of Public Health & Social Work, Florida International University , USA
| | - Karl Krupp
- b Department of Health Promotion and Disease Prevention , Robert Stempel College of Public Health & Social Work, Florida International University , USA
| | - Gladys Ibanez
- a Department of Epidemiology , Robert Stempel College of Public Health & Social Work, Florida International University , USA
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Otmani C, Ibanez G, Chastang J, Hommey N, Cadwallader JS, Magnier AM, Hadji S. [Role of the mother's family environment in the initiation of breastfeeding]. Sante Publique 2015; 27:785-795. [PMID: 26916851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION World Health Organization guidelines recommend exclusive breastfeeding for the first six months of life. The objective of this study was to determine the influence of the mother's personal circle and coworkers initiation of breastfeeding. METHODS A cross-sectional observational study was conducted in two maternity hospitals in Lyon and in the Paris area. The questionnaire described the characteristics of the couple and the newborn, and the mother's decision concerning the type of feeding. This study was approved by the ethics committees of the two maternity hospitals. Statistical analysis was performed with SAS 9.2 software. RESULTS The sample included 249 mothers recruited during the post-partum period. A majority of women (85%) decided on the type of feeding after discussion with a member of their personal circle or coworkers. Twelve percent of women did not know the health professionals' opinion concerning breastfeeding. Compared to women who chose breast or bottle feeding, women opting for mixed feeding made their decision later during pregnancy. The family environment, especially the husband, appeared to have the greatest influence on this decision. Encouragement from other family members or coworkers was also associated with higher breastfeeding initiation rates. CONCLUSION These results suggest the need for more intensive breastfeeding promotion by health care professionals while taking into account the mother's and the family's opinions.
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Ibanez G, Bernard JY, Rondet C, Peyre H, Forhan A, Kaminski M, Saurel-Cubizolles MJ. Effects of Antenatal Maternal Depression and Anxiety on Children's Early Cognitive Development: A Prospective Cohort Study. PLoS One 2015; 10:e0135849. [PMID: 26317609 PMCID: PMC4552796 DOI: 10.1371/journal.pone.0135849] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/27/2015] [Indexed: 12/03/2022] Open
Abstract
Introduction Studies have shown that depression or anxiety occur in 10–20% of pregnant women. These disorders are often undertreated and may affect mothers and children’s health. This study investigates the relation between antenatal maternal depression, anxiety and children’s early cognitive development among 1380 two-year-old children and 1227 three-year-old children. Methods In the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicative Development Inventory at 2 years of age and overall development with the Ages and Stages Questionnaire at 3 years of age. Multiple regressions and structural equation modeling were used to examine links between depression, anxiety during pregnancy and child cognitive development. Results We found strong significant associations between maternal antenatal anxiety and poorer children’s cognitive development at 2 and 3 years. Antenatal maternal depression was not associated with child development, except when antenatal maternal anxiety was also present. Both postnatal maternal depression and parental stimulation appeared to play mediating roles in the relation between antenatal maternal anxiety and children’s cognitive development. At 3 years, parental stimulation mediated 13.2% of the effect of antenatal maternal anxiety while postnatal maternal depression mediated 26.5%. Discussion The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed.
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Affiliation(s)
- Gladys Ibanez
- Paris-Descartes University, INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research team, Center for Epidemiology and Biostatistics (U1153), Paris, France
- School of Medicine, Department of General Practice, UPMC University Paris 06, Paris, France
- * E-mail:
| | - Jonathan Y. Bernard
- INSERM, Center for Research in Epidemiology and Population Health (CESP), U1018, Team "Epidemiology of diabetes, obesity and kidney disease: lifelong approach", F-94807 Villejuif, France
- Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France
| | - Claire Rondet
- School of Medicine, Department of General Practice, UPMC University Paris 06, Paris, France
| | - Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, Ecole Normale Supérieure, CNRS, EHESS, Paris, France
- Hôpital Robert Debré, Service de Psychopathologie de l'Enfant et de l'Adolescent, APHP, Paris, France
| | - Anne Forhan
- INSERM, Center for Research in Epidemiology and Population Health (CESP), U1018, Team "Epidemiology of diabetes, obesity and kidney disease: lifelong approach", F-94807 Villejuif, France
- Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France
| | - Monique Kaminski
- Paris-Descartes University, INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research team, Center for Epidemiology and Biostatistics (U1153), Paris, France
| | - Marie-Josèphe Saurel-Cubizolles
- Paris-Descartes University, INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research team, Center for Epidemiology and Biostatistics (U1153), Paris, France
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Abstract
Sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) have disproportionately affected the non-Hispanic black population in the United States. A person's community can affect his or her STI risk by the community's underlying prevalence of STIs, sexual networks, and social influences on individual behaviors. Racial residential segregation-the separation of racial groups in a residential context across physical environments-is a community factor that has been associated with negative health outcomes. The objective of this study was to examine if non-Hispanic blacks living in highly segregated areas were more likely to have risky sexual behavior. Demographic and sexual risk behavior data from non-Hispanic blacks aged 15-44 years participating in the National Survey of Family Growth were linked to Core-Based Statistical Area segregation data from the U.S. Census Bureau. Five dimensions measured racial residential segregation, each covering a different concept of spatial variation. Multilevel logistic regressions were performed to test the effect of each dimension on sexual risk behavior controlling for demographics and community poverty. Of the 3643 participants, 588 (14.5%) reported risky sexual behavior as defined as two or more partners in the last 12 months and no consistent condom use. Multilevel analysis results show that racial residential segregation was associated with risky sexual behavior with the association being stronger for the centralization [aOR (95% CI)][2.07 (2.05-2.08)] and concentration [2.05 (2.03-2.07)] dimensions. This suggests risky sexual behavior is more strongly associated with neighborhoods with high concentrations of non-Hispanic blacks and an accumulation of non-Hispanic blacks in an urban core. Findings suggest racial residential segregation is associated with risky sexual behavior in non-Hispanic blacks 15-44 years of age with magnitudes varying by dimension. Incorporating additional contextual factors may lead to the development of interventions that promote healthier behaviors and lower rates of HIV and other STIs.
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Affiliation(s)
- Khaleeq Lutfi
- Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.
| | - Mary Jo Trepka
- Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.
| | - Kristopher P Fennie
- Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.
| | - Gladys Ibanez
- Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.
| | - Hugh Gladwin
- Global & Sociocultural Studies, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.
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Ibanez G, Zabar J, Cadwallader JS, Rondet C, Lochard M, Magnier AM. Views of general practitioners on indoor environmental health risks in the perinatal period. Front Med (Lausanne) 2015; 2:32. [PMID: 26042219 PMCID: PMC4434900 DOI: 10.3389/fmed.2015.00032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 05/04/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Home is generally perceived as a safety place, whereas the concentration of pollutants, influenced not only by external pollution but also by human activities, the presence of domestic animals, construction and furniture materials, are sometimes greater than outside. OBJECTIVES The aim of this study is to determine the general practitioners' (GPs) views on indoor environmental health risks in the perinatal period. METHODS Four semi-structured focus group with 31 GPs were conducted in two French departments in November 2009, February, March, and April 2010. The focus group meetings were analyzed using a general thematic analysis. RESULTS Perinatal care is a special health issue and a time of privileged sensitization. The attitude of health risks are well known in the case of "traditionally" toxic substances. In the case of "emerging" environmental exposure, these attitudes depend on the knowledge, beliefs, and experience specific to each practitioner. GPs are acquiring a new role in the field of environmental health, while at the same time coming to grips with its own strengths and limitations. The implementation of prevention depends on factors, which are not only specific to the practitioner but also related to the parents and the organization of the medical practice. CONCLUSION The sensitization of GPs to environmental medicine, promotion of eco-citizen education, development of research, and the distribution of information are some of the means which need to be implemented to prevent harmful exposure of the infant.
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Affiliation(s)
- Gladys Ibanez
- Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06 , Paris , France ; SFTG Recherche, Société de Formation Thérapeutique du Généraliste Recherche , Paris , France
| | - Jehan Zabar
- Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06 , Paris , France
| | | | - Claire Rondet
- Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06 , Paris , France
| | | | - Anne Marie Magnier
- Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06 , Paris , France ; SFTG Recherche, Société de Formation Thérapeutique du Généraliste Recherche , Paris , France
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Ibanez G, Blondel B, Prunet C, Kaminski M, Saurel-Cubizolles MJ. Prevalence and characteristics of women reporting poor mental health during pregnancy: Findings from the 2010 French National Perinatal Survey. Rev Epidemiol Sante Publique 2015; 63:85-95. [DOI: 10.1016/j.respe.2015.02.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/01/2014] [Accepted: 02/06/2015] [Indexed: 10/23/2022] Open
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Beck-Sagué C, Pinzón-Iregui MC, Abreu-Pérez R, Lerebours-Nadal L, Navarro CM, Ibanez G, Soto S, Halpern M, Nicholas SW, Malow R, Dévieux JG. Disclosure of their status to youth with human immunodeficiency virus infection in the Dominican Republic: a mixed-methods study. AIDS Behav 2015; 19:302-10. [PMID: 25186784 DOI: 10.1007/s10461-014-0888-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A mixed-methods study was conducted to determine the proportion of HIV-infected children who knew their status, identify characteristics associated with children's knowledge of their status, and describe caregivers' and adolescents' experiences relevant to disclosure in the Dominican Republic (DR). Of 327 patients aged 6-18 years treated in the principal DR pediatric HIV facilities, 74 (22.6 %) knew their status. Patients aged 13 years or older and/or who had participated in non-clinical activities for HIV-infected children were more likely to know their status. Caregivers who had disclosed cited healthcare providers' advice, children's desire to know and concerns that children might initiate sexual activity before knowing or discover their status by accidental or malicious disclosure. Non-disclosing caregivers worried that children would be traumatized by disclosure and/or stigmatized if they revealed it to others. Adolescents supported disclosure by 10-12 years of age, considered withholding of children's HIV diagnosis ill-advised, and recommended a disclosure process focused initially on promoting non-stigmatizing attitudes about HIV.
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Affiliation(s)
- Consuelo Beck-Sagué
- Robert Stempel College of Public Health and Social Work, Florida International University (FIU), 11200 SW 8th Street, Miami, FL, 33199, USA,
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Otmani C, Ibanez G, Chastang J, Hommey N, Cadwallader JS, Magnier AM, Hadji S. Rôle de l’entourage maternel dans l’initiation de l’allaitement. Santé Publique 2015. [DOI: 10.3917/spub.156.0785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Chen Zee E, Cornet P, Lazimi G, Rondet C, Lochard M, Magnier AM, Ibanez G. [Impact of endocrine disrupting chemicals on birth outcomes]. ACTA ACUST UNITED AC 2013; 41:601-10. [PMID: 24120149 DOI: 10.1016/j.gyobfe.2013.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 08/26/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Endocrine disruptors are ubiquitous chemicals contaminants in the environment, wildlife, and humans. Their adverse effects on reproduction are well-documented. There is growing evidence that they can contribute to the current emergence of chronic diseases. OBJECTIVES Our aim is to assess the relationships between endocrine disruptors and the neonatal health outcomes. METHODS Two persons have independently reviewed Medline and Toxline databases about the following pollutants: bisphenol A, phthalates, parabens, brominated flame retardants and perfluorinated compounds. Only the human epidemiological studies, in general population with an abstract available, published between 2007 January the 1st and 2011 December the 31st, were analysed. The quality of each study was assessed with the Strobe score. RESULTS Twenty-five out of 680 studies were included in the analysis. All pollutants were widely detected in maternal and new borns samples. Most of the studies have shown associations between bisphenol A, brominated flame retardants and perfluorinated compounds and lower birth weight. The effects on gestational age were less documented and have shown no clear connection. Results for phthalates were more ambiguous. Only one non-instructive study was found on parabens. DISCUSSION Due to the inherent methological bias on endocrine disruptors research, further additional studies on environmental health must be investigated. It seems necessary to adopt preventive health measures first for vulnerable population.
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Affiliation(s)
- E Chen Zee
- Département de médecine générale, faculté de médecine Pierre et Marie Curie, 27, rue de Chaligny, 75012 Paris, France
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