1
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Roche J, Vaillant-Ciszewicz AJ, Guerin O. [Better identifying and understanding post-traumatic stress disorder in the elderly]. Soins Gerontol 2024; 29:14-18. [PMID: 38677805 DOI: 10.1016/j.sger.2024.02.004] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Post-traumatic stress disorder (PTSD) is particularly common in the elderly, including those with cognitive impairments. We need to stress the importance of early detection to better understand the specific signs of this disorder in the elderly. Psychotherapies such as cognitive-behavioral therapy and Eye Movement Desensitization and Reprocessing are being explored for their effectiveness and adaptability with the elderly. Identifying post-traumatic stress disorder should be a shared responsibility, for the mental health of the elderly.
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Affiliation(s)
- Jean Roche
- CHU de Lille-Hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille, France.
| | | | - Olivier Guerin
- Centre hospitalier universitaire de Nice, Ircan-Université Côte d'Azur (UCA), Inserm U1081-CNRS UMR 7284, 4 avenue Reine Victoria, 06000 Nice, France
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2
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Porebski V, Bara L, Maillet D, Belin C, Carpentier A. [Better assessment, better care: Quetci, a questionnaire for assessing cognitive disorders in nursing practice]. Rev Infirm 2024; 73:37-39. [PMID: 38644001 DOI: 10.1016/j.revinf.2024.03.014] [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] [Indexed: 04/23/2024]
Abstract
Cognitive disorders can have significant repercussions on the quality of care and daily life for patients. We have developed a new tool specifically designed for nursing practice to identify these problems in patients with brain tumors. The Cognitive Impairment Assessment Questionnaire for nursing practice is an objective, quick and easy-to-administer tool that is readily accepted by patients.
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Affiliation(s)
- Virginie Porebski
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France.
| | - Liza Bara
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
| | - Didier Maillet
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
| | - Catherine Belin
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
| | - Antoine Carpentier
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
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3
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Ferchaud C, Lartaud A, Vettes A. [The multi-professional alliance in the diagnostic process]. Soins Gerontol 2024; 29:42-45. [PMID: 38418071 DOI: 10.1016/j.sger.2024.01.008] [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] [Indexed: 03/01/2024]
Abstract
Professional support for elderly people suffering from cognitive impairment needs to be comprehensive, and requires the active involvement of a wide range of professionals. Two clinical cases show how the combined support of a therapeutic day-care center and medical specialists can improve the quality of life of patients and their families, by helping to refine diagnoses or adjust treatment.
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Affiliation(s)
- Catherine Ferchaud
- Accueil de jour "Les Balkans", 1 allée Alquier-Debrousse, 75020 Paris, France
| | - Amélie Lartaud
- Accueil de jour "Les Balkans", 1 allée Alquier-Debrousse, 75020 Paris, France.
| | - Audrey Vettes
- Accueil de jour "Les Balkans", 1 allée Alquier-Debrousse, 75020 Paris, France
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4
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Menez C, Filleau C, Daumas L, Konig A, Lemaire J, Sacco G. [The contribution of physical activity to motivation in patients with minor to major cognitive impairment]. Soins Gerontol 2023; 28:18-23. [PMID: 37481287 DOI: 10.1016/j.sger.2023.06.005] [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] [Indexed: 07/24/2023]
Abstract
Alzheimer's disease (AD) brings with it the need to think about the loss of autonomy caused by cognitive impairment, and how to manage it. In this context, adapted physical activity has been shown to benefit the overall quality of life of people suffering from the disease. In our study of thirteen patients with AD or related neurodegenerative diseases, we assessed the impact of physical activity on self-esteem and motivation, with patients taking part in group exercise sessions lasting twelve weeks, one hour a week.
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Affiliation(s)
- Cindy Menez
- CMRR, Institut Claude-Pompidou, CHU de Nice, 10 rue Molière, 06100 Nice, France
| | - Christelle Filleau
- CMRR, Institut Claude-Pompidou, CHU de Nice, 10 rue Molière, 06100 Nice, France.
| | - Lyne Daumas
- CMRR, Institut Claude-Pompidou, CHU de Nice, 10 rue Molière, 06100 Nice, France
| | - Alexandra Konig
- CMRR, Institut Claude-Pompidou, CHU de Nice, 10 rue Molière, 06100 Nice, France
| | - Justine Lemaire
- CMRR, Institut Claude-Pompidou, CHU de Nice, 10 rue Molière, 06100 Nice, France
| | - Guillaume Sacco
- CMRR, Institut Claude-Pompidou, CHU de Nice, 10 rue Molière, 06100 Nice, France
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5
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Raynaud F, Viadere A. [Multidisciplinary and multimodal rehabilitation care for patients suffering from multiple sclerosis]. Soins 2023; 68:42-44. [PMID: 37037644 DOI: 10.1016/j.soin.2023.02.010] [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: 04/12/2023]
Abstract
The support provided at the Germaine-Revel medical center in the Rhône region involves assessing the patient as a whole, which is a key aspect of implementing personalized rehabilitation focused on one or more objectives. The team offers multidisciplinary and multimodal care, because the clinical symptoms of people with multiple sclerosis are very varied: they can include neuromotor, neurosensory, neurosensory and cognitive disorders, as well as bladder and bowel and genital disorders.
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Affiliation(s)
- Fabienne Raynaud
- Centre médical Germaine-Revel, 707 route de la Condamine, Saint-Maurice-sur-Dargoire, 69440 Chabanière, France
| | - Alexandra Viadere
- Centre médical Germaine-Revel, 707 route de la Condamine, Saint-Maurice-sur-Dargoire, 69440 Chabanière, France.
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6
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Couteau X. ['Anti-fugue' plant device, an innovative concept in gerontology]. Soins Gerontol 2021; 26:35-37. [PMID: 34462110 DOI: 10.1016/j.sger.2021.06.008] [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] [Indexed: 06/13/2023]
Abstract
Plant features represent a modality of outdoor architecture that can be integrated into a project to take into account the particularities of patients and residents, and in particular those with cognitive disorders and risks of running away. The concept of a "plant-based security system" is an innovative and transposable prevention approach that reconciles the constitutional right to freedom of movement and security. A living concept illustrated by the Seilleraye EHPAD in Carquefou.
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Affiliation(s)
- Xavier Couteau
- Établissement d'accueil de personnes âgées dépendantes La Seilleraye, centre hospitalier universitaire de Nantes, pôle de gérontologie clinique, impasse Seilleraye, 44470 Carquefou, France.
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7
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Sanlaville C, Loiseau Médecin Généraliste A, Colin C, Salmon PK, Letrilliart L. [General practitioners' views on cognitive disorders diagnosis: a qualitative study]. Soins Gerontol 2021; 26:35-42. [PMID: 34304810 DOI: 10.1016/j.sger.2021.05.009] [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: 10/21/2022]
Abstract
Diagnosis of cognitive disorders is at medical and ethical stake. The aim of an qualitative study based on interviews was to explore the views of general practitioners on this diagnosis. General practitioners are ambivalent about the relevance and temporality of the diagnosis of cognitive disorders, which could be resolved by a shared decision making at each stage of the diagnostic approach.
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Affiliation(s)
- Claire Sanlaville
- Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | | | - Cyrille Colin
- Université Claude-Bernard Lyon 1, 69622 Villeurbanne, France; Laboratoire Health services and performance research EA 7425, université Claude-Bernard Lyon 1, 69008 Lyon, France; Pôle Information médicale évaluation recherche, Hospices civils de Lyon, 3 quai des Célestins, 69002 Lyon, France
| | - Pierre-Krolak Salmon
- Centre mémoire, ressources, recherche de Lyon, Institut du vieillissement, Hospices civils de Lyon, Institut national de la santé et de la recherche médicale 1048, Centre national de la recherche scientifique 5292, 69008 Lyon, France; Action conjointe européenne "Act on dementia", université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69008 Lyon, France; Laboratoire Health services and performance research EA 7425, université Claude-Bernard Lyon 1, 69008 Lyon, France; Collège universitaire de médecine générale, Université Claude-Bernard Lyon 1, 8 avenue Rockefeller, 69373 Lyon cedex 08, France.
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8
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Guillaume C, Roche J. [Video calls to disoriented elderly persons during the COVID-19 health crisis]. Soins Gerontol 2021; 26:20-23. [PMID: 34083010 DOI: 10.1016/j.sger.2021.03.005] [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: 10/21/2022]
Abstract
Maintaining an exchange between the disoriented elderly patient and his family circle is essential to help reduce patient anxiety. When visits are not possible, the implementation of video calls with highly disoriented individuals shows a benefit of these virtual exchanges. The introduction of new technologies, if accompanied, does not disturb the patient and does not alter the quality of the relationship.
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Affiliation(s)
- Cécile Guillaume
- Service de psychogériatrie, hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille cedex, France.
| | - Jean Roche
- Service de psychogériatrie, hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille cedex, France
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9
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Noyé S, Bernardon A. [COVID-19, impact on residents and caregivers]. Soins Gerontol 2020; 25:34-37. [PMID: 33276904 DOI: 10.1016/j.sger.2020.09.011] [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] [Indexed: 11/18/2022]
Abstract
Following the COVID-19's entry into France, in order to protect the residents, the doors of the accommodation facilities for dependent elderly have been closed and a complete reorganization has been necessary. This confinement and restructuring behind closed doors has many consequences both for the residents and for the staff who accompany them on a daily basis. For the resident, the physical and/or psychological impact will be different depending on his degree of autonomy. The staff fear for their health, their families health, and the one of the elderly they accompany.
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Affiliation(s)
- Sébastien Noyé
- Établissement d'hébergement pour personnes âgées dépendantes Les Glycines, chemin de Fabréguette, 30460 Lasalle, France.
| | - Anne Bernardon
- Établissement d'hébergement pour personnes âgées dépendantes Les Glycines, chemin de Fabréguette, 30460 Lasalle, France
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10
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Vaillant-Ciszewicz AJ, Quaderi A, Palazzolo J, Robert P, Guérin O. [Techniques from EMDR Psychotherapy : a tool against disruptive psycho-behavioural disorders?]. Soins Gerontol 2019; 24:36-40. [PMID: 31806177 DOI: 10.1016/j.sger.2019.09.009] [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: 10/25/2022]
Abstract
Behavioural disorders in residential care facilities for dependent seniors are particularly common in residents with Alzheimer's and related diseases. Verbal agitation is one of the most disruptive behavioural disorders. The use of techniques from Eye Movement Desensitisation and Reprocessing therapy in gerontology, its applications and research perspectives may be illustrated.
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Affiliation(s)
| | - André Quaderi
- Laboratoire de recherche CoBteK, 10, rue Molière, 06100 Nice, France
| | - Jérôme Palazzolo
- Département santé, Université internationale Senghor, Al Mansheyah Al Kubra, Qism El-Mansheya, Alexandrie, Égypte
| | - Philippe Robert
- Laboratoire de recherche CoBteK, 10, rue Molière, 06100 Nice, France
| | - Olivier Guérin
- IRCAN, Université Nice-Sophia-Antipolis, Inserm, Centre hospitalier universitaire de Cimiez, 4, avenue Reine-Victoria, 06003 Nice cedex 1, France
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11
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Aubry R. [Ethical challenges surrounding the ageing of HIV-positive patients]. Soins 2019; 64:28-30. [PMID: 31023464 DOI: 10.1016/j.soin.2019.02.005] [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: 10/27/2022]
Abstract
More and more HIV-positive people now belong to the 50+ age group. This ageing is accompanied by specific medical and psychosocial problems. In 2018, the French National Consultative Ethics Committee published a paper on the ethical challenges of ageing. Ageing is not easy in a society from which people living with HIV and the elderly feel excluded.
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Affiliation(s)
- Régis Aubry
- CHRU de Besançon, Hôpital Jean-Minjoz, 25030 Besançon cedex, France.
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12
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Abstract
The disclosure of a cancer diagnosis in an elderly person is often difficult. It can be impacted by sensory or cognitive disorders, a depressive condition, or by the presence of family members. It is important to take account of a disease which is sometimes at an advanced stage, reduced life expectancy and obvious frailty. The disclosure should always be made whatever the clinical situation, but always with an adapted, honest and step-by-step process.
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Affiliation(s)
- Jean-Yves Niemier
- Service de médecine gériatrique aiguë, CHRU de Nancy, 29 avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
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13
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Thomas P, Chandès G, Hazif-Thomas C. [The reconstruction of meaning in dementia]. Soins Gerontol 2017; 22:41-44. [PMID: 28917336 DOI: 10.1016/j.sger.2017.06.012] [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] [Indexed: 06/07/2023]
Abstract
Dementia brings about progressive cognitive deterioration, combining memory problems, language difficulties and thought disorders. While there is currently no treatment for the organic disorders causing the dementia, help can be given to patients to slow down the regressive processes. Psychological mediations exist to support patients in their efforts to make sense of their environment.
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Affiliation(s)
- Philippe Thomas
- Centre de Recherches Sémiotiques (CeReS, EA 3648), Université de Limoges, 39 rue Camille Guérin, 87000 Limoges, France
| | - Gérard Chandès
- Centre de Recherches Sémiotiques (CeReS, EA 3648), Université de Limoges, 39 rue Camille Guérin, 87000 Limoges, France
| | - Cyril Hazif-Thomas
- Service de psychiatrie du sujet âgé, CHRU de Brest, route de Ploudalmezeau, 29820 Bohars, France.
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Auroprajna P, Naik BM, Sahoo JP, Keerthi GS, Pavanya M, Pal GK. Association of Sympathovagal Imbalance With Cognitive Impairment in Type 2 Diabetes in Adults. Can J Diabetes 2017; 42:44-50. [PMID: 28551162 DOI: 10.1016/j.jcjd.2017.01.008] [Citation(s) in RCA: 9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 12/18/2016] [Accepted: 01/26/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Sympathovagal imbalance (SVI) has been reported to be associated with metabolic derangements in type 2 diabetes. We investigated the association of SVI with cognitive impairment in patients with type 2 diabetes. METHODS Patients with a new diagnosis of type 2 diabetes (n=43) and age-matched healthy control subjects (n=43) were recruited for the study. Body mass index and blood pressure measurements were recorded. SVI was assessed by spectral analysis of heart rate variability (HRV), and cognitive function was assessed by recording the positive wave that appears in 300 milliseconds from application of stimulus in event-related potential tracing (P300). Insulin resistance was determined by the homeostatic model assessment of insulin resistance (HOMA-IR) formula using blood glucose and insulin data, and oxidative stress was assessed by estimation of malondialdehyde. Association of various factors with cognitive impairment was evaluated by Pearson correlation analysis, and independent contributions of these factors to cognitive impairment were assessed by multiple regression analysis. RESULTS P300 latency was significantly prolonged in the diabetes group compared with the control group. Ratio of low-frequency to high-frequency power (LF-HF ratio) of HRV, the marker of SVI was found to be significantly correlated and linked with P300. Malondialdehyde and HOMA-IR were correlated with LF-HF ratio. CONCLUSION Treatment-naïve patients with type 2 diabetes have SVI and considerable cognitive impairment. Insulin resistance and oxidative stress contribute to cognitive impairment, and SVI could be the physiologic link to cognitive impairment in treatment-naïve patients with type 2 diabetes.
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Affiliation(s)
- Pal Auroprajna
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Basanta Manjari Naik
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Jaya Prakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Gorantla Shravya Keerthi
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Manohar Pavanya
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Gopal Krushna Pal
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
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15
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Stefanuto M, Canovas S, Khaddar M, Sanchez S, Denormandie P. [Alzheimer's disease, the importance of the choice of words]. Soins Gerontol 2017; 22:12-16. [PMID: 28533040 DOI: 10.1016/j.sger.2017.03.003] [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] [Indexed: 06/07/2023]
Abstract
The terms 'dementia' and 'demented' are frequently used to refer to people with neurodegenerative diseases, such as Alzheimer's disease. Based on the cross-analysis of some observational data (historical, linguistic, legal and medical), it is possible to highlight the risks and the issues related to the terminological choices for patients and health professionals.
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Affiliation(s)
- Muriel Stefanuto
- Clinique SSR Korian Les Granges, 8 rue de Lorraine, 38130 Echirolles, France; Institut du Bien vieillir Korian, 32 rue Guersant, 75017 Paris, France.
| | | | - Marie Khaddar
- Ehpad la Saison dorée, 8 rue Antoine Péricaud, 69008 Lyon, France
| | - Stéphane Sanchez
- Pôle IMER, Hospices civils de Lyon, 6(e) étage, 162 avenue Lacassagne, 69003 Lyon, France
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16
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Vallat-Azouvi C. [Cognitive disorders of head trauma patients]. Rev Infirm 2017; 66:28-30. [PMID: 28284404 DOI: 10.1016/j.revinf.2016.12.028] [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] [Indexed: 06/06/2023]
Abstract
The repercussions of cognitive disorders resulting from a traumatic brain injury are considerable in patients' daily life. Their quality of life and that of their families is significantly reduced; their reintegration into working life difficult. This chronic cognitive disability requires adapted treatment.
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Affiliation(s)
- Claire Vallat-Azouvi
- UFR de psychologie, Laboratoire de psychopathologie et de neuropsychologie, EA 2027, Université Paris 8, 2 rue de la Liberté, 93526 Saint-Denis, France; Laboratoire HANDIReSP, EA 4047, UVSQ, 55 Avenue de Paris, 78000 Versailles, France; Antenne UEROS-UGECAMIDF, Hôpital Raymond-Poincaré, 104 boulevard Raymond-Poincaré, 92380 Garches, France.
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Abstract
Therapies based on cognitive remediation integrate psychiatric care. Cognitive remediation helps to ease cognitive disorders and enable patients to improve their day-to-day lives. It is essential to complete nurses' training in this field. This article presents the example of a patient with schizophrenia who followed the Cognitive Remediation Therapy programme, enabling him to access mainstream employment.
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Affiliation(s)
- Palmyre Schenin-King
- Unité de recherche clinique, EPS Ville-Évrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne Cedex, France.
| | - Fanny Thomas
- Unité de recherche clinique, EPS Ville-Évrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne Cedex, France
| | - Sonia Braha-Zeitoun
- Unité de recherche clinique, EPS Ville-Évrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne Cedex, France
| | - Noomane Bouaziz
- Unité de recherche clinique, EPS Ville-Évrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne Cedex, France
| | - Dominique Januel
- Unité de recherche clinique, EPS Ville-Évrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne Cedex, France
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