1
|
Dib F, Chauvin P, Launay O. When an Immunization Stress-Related Response Interrupts a School-Based Vaccination Program: The Case of France. J Adolesc Health 2024; 74:854. [PMID: 38519252 DOI: 10.1016/j.jadohealth.2024.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Fadia Dib
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France; Université Paris Cité, INSERM, F-CRIN I REIVAC, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Pierre Chauvin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Odile Launay
- Université Paris Cité, INSERM, F-CRIN I REIVAC, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| |
Collapse
|
2
|
Luque-Paz D, Verdier MC, Lefèvre CR, Chauvin P, Goter T, Armange L, Bayeh B, Lalanne S, Tattevin P, Jouneau S. Pleural penetration of amoxicillin and metronidazole during pleural infection: An ambispective cohort study. Int J Antimicrob Agents 2023; 62:107004. [PMID: 37839716 DOI: 10.1016/j.ijantimicag.2023.107004] [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: 06/08/2023] [Revised: 09/06/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES The pharmacokinetics of antibiotics in pleural fluid during pleural infections has been poorly described. This study aimed to explore amoxicillin and metronidazole diffusion into the pleural space. METHODS This was an ambispective, single-centre study that included patients with complicated parapneumonic effusion or pleural empyema managed with repeated therapeutic thoracentesis as first-line treatment between 2014 and 2022. Pleural steady-state or trough concentrations of amoxicillin and metronidazole were measured, with a lower limit of quantification of 5 mg/L. RESULTS Seventy paired blood and pleural samples were analysed from 40 patients. The median (interquartile range) patient age was 55 years (45-67 years) and 88% were male. The median patient weight was 65.8 kg (57.3-82 kg) and median plasma albumin concentration was 29.7 g/L (23.7-33.9 g/L). Median creatinine clearance was 106 mL/min (95-117 mL/min). Median amoxicillin pleural concentrations in patients treated with oral, bolus and continuous intravenous administrations (6 g/day) were, respectively, 5.2 (<5-6.4), 9.4 (8-13.1) and 10.8 (7.1-13.1) mg/L. Pleural concentrations were <5 mg/L in 5/11 samples (45%) with oral treatment and 6/59 (10%) with intravenous treatment. Median metronidazole pleural concentrations were 18.4 (15.7-22.8) mg/L, with all patients being treated orally (1.5 g/day). CONCLUSIONS Oral metronidazole (1.5 g/day) and intravenous amoxicillin (6 g/day) achieved therapeutic targets in pleural fluid in most cases, but oral amoxicillin did not.
Collapse
Affiliation(s)
- David Luque-Paz
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR 1230, Rennes, France.
| | - Marie-Clémence Verdier
- Clinical Pharmacology Department, CHU Rennes, Rennes, France; University of Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Charles R Lefèvre
- Biochemistry Laboratory, Pontchaillou Hospital CHU Rennes, Rennes, France
| | - Pierre Chauvin
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Thomas Goter
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Lucas Armange
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | | | | | - Pierre Tattevin
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France; University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR 1230, Rennes, France
| | - Stéphane Jouneau
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France; University of Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| |
Collapse
|
3
|
Cottu A, Groh M, Desaintjean C, Marchand-Adam S, Guillevin L, Puechal X, Beaumesnil S, Lazaro E, Samson M, Taille C, Durel CA, Diot E, Nicolas S, Guilleminault L, Ebbo M, Cathebras P, Dupin C, Yildiz H, Belfeki N, Pugnet G, Chauvin P, Jouneau S, Lifermann F, Martellosio JP, Cottin V, Terrier B. Benralizumab for eosinophilic granulomatosis with polyangiitis. Ann Rheum Dis 2023; 82:1580-1586. [PMID: 37550002 DOI: 10.1136/ard-2023-224624] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Benralizumab is effective in the treatment of eosinophilic asthma and is being investigated for the treatment of other eosinophil-associated diseases. Reports on the use of benralizumab for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) are limited to case reports and small case series. METHODS We conducted a multicentre, retrospective study including EGPA patients treated with off-label benralizumab. The primary endpoint was the rate of complete response defined as no disease activity (Birmingham Vasculitis Activity Score=0) and a prednisone dose ≤4 mg/day. Partial response was defined as no disease activity and a prednisone dose ≥4 mg/day. RESULTS Sixty-eight patients were included, including 31 (46%) who had previously received mepolizumab. The use of benralizumab was warranted by uncontrolled asthma in 54 (81%), persistent ear, nose and throat (ENT) manifestations in 27 (40%) and persistent glucocorticoids (GCs) use in 48 (74%) patients. Median (IQR) follow-up after starting benralizumab was 23 (9-34) months. Thirty-three patients (49%) achieved a complete response, 24 (36%) achieved a partial response and 10 (15%) did not respond. Among the 57 patients who initially responded, 10 (18%) eventually required further line treatments. GCs were discontinued in 23 patients (38%). Prior mepolizumab use was associated with a higher rate of primary failure (26.7% vs 5.4%, p=0.034) and less frequent GCs discontinuation (14.8% vs 55.9%, p=0.001). Vasculitis flares occurred in 7 patients (11%) and were associated with histological evidence of vasculitis and/or antineutrophil cytoplasmic antibodies positivity at benralizumab initiation (p=0.004). CONCLUSIONS Benralizumab appears to be an effective treatment for refractory asthma or ENT manifestations in EGPA and allows GC-sparing. However, its efficacy was lower after prior failure of mepolizumab.
Collapse
Affiliation(s)
- Adrien Cottu
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
| | - Matthieu Groh
- National Referral Center for Hypereosinophilic Syndrome (CEREO), Department of Internal Medicine, Hopital Foch, Suresnes, France
| | - Charlene Desaintjean
- Department of Respiratory Diseases, Hospital for Cardiologie and Pneumology Louis Pradel, Lyon, France
| | - Sylvain Marchand-Adam
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHRU de Tours, Tours, France
| | - Loïc Guillevin
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
| | - Xavier Puechal
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
| | - Stacy Beaumesnil
- Department of Internal Medicine and Infectious Diseases, University Hospital Centre, Bordeaux, France
| | - Estibaliz Lazaro
- Department of Internal Medicine and Infectious Diseases, University Hospital Centre, Bordeaux, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, University Hospital Centre, Dijon, France
| | - Camille Taille
- Reference Center for Rare Pulmonary Diseases and University of Paris Cité, Inserm 1152, Hospital Bichat - Claude-Bernard, Paris, France
| | | | - Elizabeth Diot
- Department of Internal Medicine, CHRU de Tours, Tours, France
| | - Sarah Nicolas
- Department of Internal Medicine, CHRU de Tours, Tours, France
| | - Laurent Guilleminault
- Department of Respiratory Medicine, University Hospital Centre Toulouse, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Inserm U1291, CNRS U5282, Toulouse 2 University, Toulouse, France
| | - Mikael Ebbo
- Departement of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | | | - Clairelyne Dupin
- Reference Center for Rare Pulmonary Diseases and University of Paris Cité, Hospital Bichat - Claude-Bernard, Paris, France
| | - Halil Yildiz
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Nabil Belfeki
- Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Sud Ile-de-France, Melun, France
| | - Grégory Pugnet
- Department of Internal Medicine and Clinical Immunology, CHU Toulouse Rangueil, Toulouse, France
| | - Pierre Chauvin
- Department of Respiratory Diseases, University Hospital Centre Rennes, Rennes, France
| | - Stephane Jouneau
- Department of Respiratory Diseases, IRSET UMR 1085, Rennes 1 University, Pontchaillou Hospital, Rennes, France
| | | | | | - Vincent Cottin
- Department of Respiratory Diseases, Hospital for Cardiologie and Pneumology Louis Pradel, Lyon, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
- Université Paris Cité, Paris, France
| |
Collapse
|
4
|
Jouneau S, Rousseau C, Lederlin M, Lescoat A, Kerjouan M, Chauvin P, Luque-Paz D, Guillot S, Oger E, Vernhet L, Thibault R. Malnutrition And Decreased Food Intake At Diagnosis Are Associated With Hospitalization And Mortality Of Idiopathic Pulmonary Fibrosis Patients. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.102] [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: 03/28/2023]
|
5
|
Coirier V, Delamaire F, Chauvin P, Kerjouan M, Lederlin M, Maamar A, Jouneau S. A case report of Covid-19 in an autoimmune pulmonary alveolar proteinosis: An association in tune with the times! Respir Med Case Rep 2023; 42:101825. [PMID: 36874265 PMCID: PMC9969748 DOI: 10.1016/j.rmcr.2023.101825] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/20/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023] Open
Abstract
Autoimmune pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the alveoli accumulation of surfactants proteins and lipids, which diagnosis is confirmed by the presence of GM-CSF antibodies in serum. PAP can be evoked when its characteristic images on chest computed-tomography (CT) are present: bilateral and multifocal ground-glass opacities and crazy-paving appearance. Patients with PAP are at an increased risk of opportunistic infections caused by Nocardia, mycobacteria and fungal pathogens due to impaired processing of pulmonary surfactant. We here report a typical case of newly diagnosed autoimmune PAP, with initial indication to realize a whole-lung lavage. Despite this treatment the patient presented a marked clinical worsening, with increasing need for oxygen and finally the need for mechanical ventilation. The chest CT was controlled and found to be typical of PAP, while the search for opportunistic infections remained negative. Finally, SARS-CoV-2 PCR was performed on bronchoalveolar lavage fluid, and was positive, whereas it had previously been negative twice. Our case report highlights the difficulty of distinguishing SARS-CoV-2 infection in the context of PAP, as the chest CT features are similar. We believe that a SARS-CoV-2 RT-PCR should be systematically realized in case of respiratory deterioration in PAP patients.
Collapse
Affiliation(s)
- Valentin Coirier
- Department of Infectious Diseases and Intensive Care, Rennes University Hospital, Rennes, France
| | - Flora Delamaire
- Department of Infectious Diseases and Intensive Care, Rennes University Hospital, Rennes, France
| | - Pierre Chauvin
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Mallorie Kerjouan
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Mathieu Lederlin
- Department of Radiology, Rennes University Hospital, Rennes, France
| | - Adel Maamar
- Department of Infectious Diseases and Intensive Care, Rennes University Hospital, Rennes, France
| | - Stéphane Jouneau
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France.,IRSET UMR 1085, Rennes University, Rennes, France
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Dib F, Mayaud P, Renaudie C, Launay O, Chauvin P. Determinants of human papillomavirus (HPV) vaccine uptake among girls in France: A population-based telephone survey. Hum Vaccin Immunother 2022; 18:2083894. [PMID: 35766886 PMCID: PMC9621050 DOI: 10.1080/21645515.2022.2083894] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction The uptake of human papillomavirus (HPV) vaccination in France remains low. The aim of this study was to identify factors associated with the uptake of the HPV vaccine in girls aged 11–14 years in France. Methods We conducted a telephone survey among a quota sample of 1102 mothers of 11-14-year-old daughters residing in mainland France, using the French Survey Questionnaire for the Determinants of HPV Vaccine Hesitancy (FSQD-HPVH). The dependent variable was the uptake of at least one dose of the HPV vaccine in the daughter. The independent variables included the FSQD-HPVH item variables, the Global Vaccine Confidence Index item variables, the daughter’s age, and the mother’s socioeconomic status. Results Overall, 38.6% of the mothers indicated that their daughter received at least one dose of the HPV vaccine. The multivariate analysis revealed that agreeing with the statement that doctors/health care providers believe vaccinating girls against HPV was a good idea, and having asked questions to the attending doctor about HPV vaccines were associated with a higher HPV vaccine uptake (OR = 4.99 , 95% CI [2.09–11.89]; and OR = 3.44, 95% CI [2.40–4.92]). Mother’s belief that her daughter was too young to be vaccinated against HPV (OR = 0.16 , 95% CI [0. 09–0.29]) and lower daughter’s age (OR = 0.17 , 95% CI [0.10–0.28] for girls aged 11 compared to those aged 14) were found strongly inversely associated with HPV vaccination, followed by agreeing with the statement that the HPV vaccine was unsafe (OR = 0.42 , 95% CI [0.26–0.67]), identifying as true the statement that HPV was very rare (OR = 0.49 , 95% CI [0.31–0.77]), and the mother’s refusal of own vaccination (OR = 0.57 , 95% CI [0.40–0.80]). Conclusion We have identified important determinants associated with HPV vaccine uptake in France. Interventions designed to improve HPV vaccine uptake should be tailored to address these determinants.
Collapse
Affiliation(s)
- Fadia Dib
- REIVAC; Assistance Publique- Hôpitaux de Paris, Hôpital CochinINSERM CIC 1417, F-CRIN, I, Paris, France.,INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Odile Launay
- REIVAC; Assistance Publique- Hôpitaux de Paris, Hôpital CochinINSERM CIC 1417, F-CRIN, I, Paris, France.,Université de Paris, Faculté de médecine Paris Descartes, Paris, France
| | - Pierre Chauvin
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| |
Collapse
|
8
|
Jouneau S, Rousseau C, Lederlin M, Lescoat A, Kerjouan M, Chauvin P, Luque-Paz D, Guillot S, Oger E, Vernhet L, Thibault. R. Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients. Clin Nutr 2022; 41:1335-1342. [DOI: 10.1016/j.clnu.2022.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/06/2022] [Accepted: 05/02/2022] [Indexed: 11/03/2022]
|
9
|
Chauvin P, Morzadec C, de Latour B, Llamas-Gutierrez F, Luque-Paz D, Jouneau S, Vernhet L. Soluble CD163 is produced by monocyte-derived and alveolar macrophages, and is not associated with the severity of idiopathic pulmonary fibrosis. Innate Immun 2022; 28:138-151. [PMID: 35522300 PMCID: PMC9136464 DOI: 10.1177/17534259221097835] [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] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
The soluble form of the membrane hemoglobin scavenger receptor CD163 (sCD163), released by shedding, is a strong marker for macrophage activation. Serum sCD163 levels rise in several acute inflammatory states and some fibrosing diseases. Monocyte-derived macrophages (MoDM) differentiated by macrophage colony-stimulating factor (M-MoDM) contribute to the pathophysiology of idiopathic pulmonary fibrosis (IPF), an irreversible and rapidly fatal interstitial lung disease. Since M-MoDM express high membrane CD163 levels, we thus postulated that sCD163 could be a relevant biomarker for macrophage activation in IPF. We found that M-MoDM constitutively released higher amounts of sCD163 (49.5 ± 24.5 ng/ml) than monocytes (0.45 ± 0.32 ng/ml) or MoDM differentiated with granulocyte macrophage-stimulating factor (2.24 ± 0.98 ng/ml). The basal production of sCD163 by M-MoDM was increased following stimulation with lipopolysaccharide (123.4 ± 54.9 ng/ml) or ATP (168.9 ± 41.8 ng/ml). The sCD163 release was controlled by metalloproteases but not through ADAM17 activation. Moreover, CD163-positive macrophages and sCD163 were detected in pulmonary tissues and alveolar fluids of Caucasian patients with IPF, respectively. IPF alveolar macrophages constitutively secreted sCD163 amounts (67.6 ± 44.6 ng/µg RNA) which were significantly higher than those released by alveolar macrophages isolated from controls (19.2 ± 7.6 ng/µg RNA) or patients with other interstitial lung disease (31.5 ± 16.6 ng/µg RNA). However, the concentrations of sCD163 in blood serum collected from 155 patients with IPF did not correlate with the severity of their disease. In conclusion, our results show that M-MoDM constituted a pertinent model to study the regulation of sCD163 production. Yet, serum sCD163 values could not provide a prognostic biomarker for IPF in our cohort.
Collapse
Affiliation(s)
- Pierre Chauvin
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche
en santé, environnement et travail), Rennes, France
| | - Claudie Morzadec
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé,
environnement et travail), Rennes, France
| | - Bertrand de Latour
- Service de Chirurgie cardio-thoracique et vasculaire, Centre Hospitalier Universitaire,
Rennes, France
| | | | - David Luque-Paz
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche
en santé, environnement et travail), Rennes, France
| | - Stéphane Jouneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche
en santé, environnement et travail), Rennes, France
- Service de Pneumologie, Centre de compétences pour les maladies
pulmonaires rares de Bretagne, Centre Hospitalier Universitaire,
Rennes, France
| | - Laurent Vernhet
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé,
environnement et travail), Rennes, France
| |
Collapse
|
10
|
Motreff Y, Pirard P, Vuillermoz C, Rabet G, Petitclerc M, Stene LE, Baubet T, Chauvin P, Vandentorren S. Mental health care utilization by first responders after Paris attacks. Occup Med (Lond) 2021; 72:81-90. [PMID: 34729607 PMCID: PMC8863088 DOI: 10.1093/occmed/kqab150] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background First responders (FRs) are frequently exposed to potentially traumatic events, including terror attacks, and may consequently be at risk of developing mental health disorders. Prior research suggests that FRs with mental health disorders often do not receive appropriate treatment. More knowledge is needed about their use of mental health care (MHC). Aims This study aimed to identify factors associated with receiving immediate support, post-immediate support and engagement in MHC among FRs of the November 2015 terror attacks in Paris. Methods A web-based study was conducted 8–12 months after the attacks on 663 FRs who were mobilized during the night and/or the aftermath of the attacks. Logistic regression was performed to analyse factors associated with MHC. Results Overall, 44 FRs sought MHC. Among FRs with post-traumatic stress disorder (PTSD), partial PTSD or depression (n = 60), 38% sought MHC (n = 23). Post-immediate support was associated with immediate support, and both were associated with knowing someone who could help regarding the potential psychological risks following a traumatic event. MHC engagement was associated with a history of MHC, post-immediate support and the presence of PTSD, partial PTSD or depression. Conclusions Among FRs with PTSD, partial PTSD or depression, few sought MHC. Improved access to MHC for FRs after terror attacks is essential. Knowing someone who could help regarding potential psychological risks may facilitate immediate and/or post-immediate support. Furthermore, post-immediate support could encourage engagement in MHC. Efforts should be made before and after potentially traumatic events to ensure mental health education for FR.
Collapse
Affiliation(s)
- Y Motreff
- Santé publique France, Direction des maladies non transmissibles et traumatismes, Saint-Maurice, France.,INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
| | - P Pirard
- Santé publique France, Direction des maladies non transmissibles et traumatismes, Saint-Maurice, France.,MOODS, INSERM U 1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - C Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
| | - G Rabet
- Santé publique France, Direction appui, traitements et analyses des données, Saint-Maurice, France
| | - M Petitclerc
- Service médical d'urgence-bureau de santé et de prévention, Brigade de sapeurs-pompiers de Paris, 1, place Jules-Renard, Paris, France.,Université Sorbonne Paris Nord, Ecole doctorale Erasme, Laboratoire UTRPP, Villetaneuse, France
| | - L Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - T Baubet
- Université Sorbonne Paris Nord, Ecole doctorale Erasme, Laboratoire UTRPP, Villetaneuse, France.,APHP Hôpital Avicenne, Psychopathology Department for Children, Adolescents, General Psychiatry and Specialized Addiction, Bobigny, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - P Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
| | - S Vandentorren
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France.,Santé publique France, Direction des régions, Saint-Maurice, France
| |
Collapse
|
11
|
Luque Paz D, Bayeh B, Chauvin P, Poizeau F, Lederlin M, Kerjouan M, Lefevre C, de Latour B, Letheulle J, Tattevin P, Jouneau S. Intrapleural use of urokinase and DNase in pleural infections managed with repeated thoracentesis: A comparative cohort study. PLoS One 2021; 16:e0257339. [PMID: 34547022 PMCID: PMC8454966 DOI: 10.1371/journal.pone.0257339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/14/2021] [Accepted: 08/30/2021] [Indexed: 01/13/2023] Open
Abstract
Introduction Evacuation of infected fluid in pleural infections is essential. To date, the use of an intrapleural fibrinolytic agent such as urokinase and DNase has not yet been assessed in infections managed by repeated therapeutic thoracentesis (RTT). Methods We performed a retrospective comparative study of two successive cohorts of consecutive patients with pleural infections from 2001 to 2018. Between 2001 and 2010, patients had RTT with intrapleural urokinase (RTT-U). After 2011, patients received intrapleural urokinase and DNase with RTT (RTT-UD). Data were collected through a standardized questionnaire. Results One hundred and thirty-three patients were included: 93 were men and the mean age was 59 years (standard deviation 17.2). Eighty-one patients were treated with a combination of intrapleural urokinase and DNase, and 52 were treated with intrapleural urokinase only. In the RTT-UD, RTT failure occurred in 14 patients (17%) compared to 10 (19%) in the RTT-U group (P = 0.82). There was no difference between the two groups in intensive care unit admission, surgical referrals or in-hospital mortality. RTT-UD was associated with faster time to apyrexia (aOR = 0.51, 95%CI [0.37–0.72]), a reduced length of hospital stay (aOR = 0.61, 95%CI [0.52–0.73]) and a higher volume of total pleural fluid retrieved (aOR = 1.38, 95%CI [1.02–1.88]). Complications were rare with only one hemothorax in the RTT-UD group and no pneumothorax requiring drainage in either group. Conclusion Compared to urokinase only, intrapleural use of urokinase and DNase in RTT was associated with quicker defervescence, shorter hospital stay and increased volumes of pleural fluid drained. Randomized controlled trials evaluating urokinase and DNase with RTT technique would be required to confirm these results.
Collapse
Affiliation(s)
- David Luque Paz
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
- University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR 1230, Rennes, France
- * E-mail:
| | - Betsega Bayeh
- Department of Pneumology and Respiratory Functional Exploration, University Hospital of Tours, Tours, France
| | - Pierre Chauvin
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Florence Poizeau
- EA 7449 (Pharmacoepidemiology and Health Services Research) REPERES, Univ Rennes, CHU Rennes, Rennes, France
- PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France
- Department of Dermatology, CHU Rennes, Rennes, France
| | - Mathieu Lederlin
- Department of Radiology, Pontchaillou University Hospital, Rennes, France
| | - Mallorie Kerjouan
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
| | - Charles Lefevre
- Biochemistry Laboratory, Pontchaillou Hospital CHU Rennes, Rennes, France
| | - Bertrand de Latour
- Department of Thoracic and Cardiovascular Surgery, Rennes University Hospital, Rennes, France
| | - Julien Letheulle
- Department of Internal Medicine, Laval Center Hospital, Laval, France
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
- University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR 1230, Rennes, France
| | - Stéphane Jouneau
- Department of Respiratory Diseases, Rennes University Hospital, Rennes, France
- University of Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| |
Collapse
|
12
|
Dib F, Mayaud P, Longfier L, Chauvin P, Launay O. Effect of Internet use for searching information on vaccination on the uptake of human papillomavirus vaccine in France: A path-analysis approach. Prev Med 2021; 149:106615. [PMID: 33989671 DOI: 10.1016/j.ypmed.2021.106615] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/18/2021] [Accepted: 05/09/2021] [Indexed: 11/18/2022]
Abstract
Internet is a popular source of information regarding vaccination. This study aimed to determine whether there is a negative association between Internet use among French vaccine-hesitant mothers and HPV vaccine uptake by their daughters, and to gain insight into the pathways that would link Internet use to the lack of HPV vaccine uptake. We conducted a pooled cross-sectional analysis across the 2015, 2016, 2017 and 2018 Vaccinoscopie® Survey. Multivariate logistic regression and path models were used in the analysis. The study sample included a total of 2038 respondent mothers. Of those, 89 (4.4%) declared having never been in the situation of searching for information regarding a vaccination they had hesitated about, leaving 1949 mothers for the present analysis. Approximately 24% (466/1949) of the mothers declared using the Internet as a source of vaccine information. In multivariate logistic regression adjusted for physician recommendation of HPV vaccination, attitudes towards vaccines in general, perception of HPV vaccine usefulness, maternal level of education, region of residence, and the survey year, the use of Internet by the mothers was significantly associated with a lower HPV vaccination among their daughters (adjusted odds ratio (aOR), 0.66; 95% confidence interval (CI), 0.47-0.91). Path analysis further confirmed the negative effect of Internet use (β = -0.10, standard error (SE) = 0.02, P < 0.0001), highlighting how the Internet plays a detrimental role in HPV vaccine uptake through a lower perceived level of HPV vaccine usefulness, a lower perceived level of information on childhood vaccination, and unfavorable attitudes towards vaccination in general.
Collapse
Affiliation(s)
- Fadia Dib
- INSERM CIC 1417, F-CRIN, I REIVAC, Assistance Publique- Hôpitaux de Paris, Hôpital Cochin, Paris, France; INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France.
| | - Philippe Mayaud
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Odile Launay
- INSERM CIC 1417, F-CRIN, I REIVAC, Assistance Publique- Hôpitaux de Paris, Hôpital Cochin, Paris, France; Université de Paris, Faculté de médecine Paris Descartes, Paris, France
| |
Collapse
|
13
|
Chauvin P, Sohier L, Rochas Y, Kerjouan M, Salé A, Lederlin M, Jouneau S. [Ambulatory management of bilateral secondary spontaneous pneumothorax in palliative care]. Rev Mal Respir 2021; 38:773-779. [PMID: 34045087 DOI: 10.1016/j.rmr.2021.05.006] [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: 07/29/2020] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Secondary spontaneous pneumothoraces account for 35% of all pneumothoraces after the age of 50. Their management is still debated and can be challenging due to the underlying respiratory condition. In our observation, the use of small-bore chest tubes allowed prolonged ambulatory care in a palliative setting. CASE REPORT We report the case of a 54-year-old woman suffering from a leiomyosarcoma with multiple pulmonary metastases who had repeated episodes of pneumothorax, one of which was bilateral. Treatment involved the bilateral insertion of 8.5F pigtail catheters connected to Heimlich valves that allowed management as an outpatient. Recurrences were treated similarly, in association with oncological management, providing great additional benefits for patient comfort in this palliative context. CONCLUSION Altogether, this case report confirms the applicability of outpatient management for drained spontaneous secondary pneumothoraces, even bilateral, especially in a palliative-care setting.
Collapse
Affiliation(s)
- P Chauvin
- Service de pneumologie, Hôpital Pontchaillou, CHU Pontchaillou, 2, rue Henri le Guilloux, 35033 Rennes cedex 9, France.
| | - L Sohier
- Service de pneumologie, Groupe hospitalier de Bretagne Sud, 56322 Lorient, France
| | - Y Rochas
- Service de pneumologie, Groupe hospitalier de Bretagne Sud, 56322 Lorient, France
| | - M Kerjouan
- Service de pneumologie, Hôpital Pontchaillou, CHU Pontchaillou, 2, rue Henri le Guilloux, 35033 Rennes cedex 9, France
| | - A Salé
- Service de pneumologie, Hôpital Pontchaillou, CHU Pontchaillou, 2, rue Henri le Guilloux, 35033 Rennes cedex 9, France
| | - M Lederlin
- Service de radiologie et d'imagerie médicale, Hôpital Pontchaillou, CHU de Rennes, 35033 Rennes, France
| | - S Jouneau
- Service de pneumologie, Hôpital Pontchaillou, CHU Pontchaillou, 2, rue Henri le Guilloux, 35033 Rennes cedex 9, France; IRSET UMR 1085, université de Rennes 1, 35000 Rennes, France
| |
Collapse
|
14
|
Dib F, Mayaud P, Chauvin P, Launay O. Online mis/disinformation and vaccine hesitancy in the era of COVID-19: Why we need an eHealth literacy revolution. Hum Vaccin Immunother 2021; 18:1-3. [PMID: 33625960 PMCID: PMC8920122 DOI: 10.1080/21645515.2021.1874218] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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: 12/24/2022] Open
Abstract
The quality of online health information is cause for concern in general, and the spread of mis/disinformation on the benefits and risks of vaccines has certainly been fueling vaccine hesitancy. In the wake of the COVID-19 pandemic, we have entered an era of unprecedented “infodemic.” There has never been a more urgent time to address the long-standing question of how to overcome the deleterious influence of exposure to online mis/disinformation on vaccine uptake. eHealth literacy, a skill set including media literacy, is key to navigating the web in search for health information and processing the one encountered through social media. Studies assessing the impact of increasing eHealth literacy on behavioral attitudes and health outcomes in the general population are relatively scarce to date. Yet for many reasons, leveraging eHealth literacy skills, and more specifically, media literacy, could be of great value to help mitigate the detrimental effects of erroneous information on vaccination decision-making. In this paper, we make the case that eHealth and media literacies should be viewed as fundamental skills that have the potential to empower citizens to better recognize online mis/disinformation and make informed decisions about vaccination as any other health matters.
Collapse
Affiliation(s)
- Fadia Dib
- Inserm Cic 1417, F-crin, I Reivac; Assistance Publique- Hôpitaux de Paris, Hôpital Cochin, Paris, France
- INSERM, Sorbonne Université, Institut Pierre Louis d’épidémiologie et de Santé Publique, Paris, France
| | - Philippe Mayaud
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d’épidémiologie et de Santé Publique, Paris, France
| | - Odile Launay
- Inserm Cic 1417, F-crin, I Reivac; Assistance Publique- Hôpitaux de Paris, Hôpital Cochin, Paris, France
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France
| |
Collapse
|
15
|
Calin R, Massari V, Pialoux G, Reydellet N, Plenel E, Chauvin C, Jauffret-Roustide M, Day N, Kreplak G, Maresca AF, Derche N, Louis S, Pol S, Doré V, Rouzioux C, Chauvin P. Acceptability of on-site rapid HIV/HBV/HCV testing and HBV vaccination among three at-risk populations in distinct community-healthcare outreach centres: the ANRS-SHS 154 CUBE study. BMC Infect Dis 2020; 20:851. [PMID: 33198672 PMCID: PMC7670674 DOI: 10.1186/s12879-020-05601-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV, HBV and HCV infections continue to represent major health concerns, especially among key at-risk populations such as men who have sex with men (MSM), people who inject drugs (PWIDs), transgender women (TGW) and sex workers (SW). The objective of the ANRS-CUBE study was to evaluate the acceptability of a healthcare, community-based strategy offering a triple rapid HIV-HBV-HCV testing, and HBV vaccination, targeted at three priority groups (MSM, PWIDs and TGW/SWs), in three community centers, in the Paris area. METHODS This longitudinal multicentric non-randomized study included all adult volunteers attending one of the three specialized community centers in Paris, between July 2014 and December 2015. HIV, HBV and HCV status and acceptability of HBV vaccination were evaluated. RESULTS A total of 3662, MSM, 80 PWIDs and 72 TGW/SW were recruited in the three centers respectively. Acceptability of rapid tests was 98.5% in MSM and 14.9% in TGW/SWs, but could not be estimated in PWIDs since the number of users attending and the number of proposals were not recorded. User acceptability of HBV vaccination was weak, only 17.9% of the eligible MSM (neither vaccinated, nor infected) agreed to receive the first dose, 12.2% two doses, 5.9% had a complete vaccination. User acceptability of HBV vaccination was greater in PWIDs and TGW/SWs, but decreased for the last doses (66.7 and 53.3% respectively received a first dose, 24.4 and 26.7% a second dose and 6.7 and 0% a third dose). Fifty-three participants (49 MSM and 4 PWIDs) were discovered HIV positive, more than half with a recent infection. All but two HIV positive participants were linked to appropriate care in less than one month. CONCLUSIONS Rapid HIV-HCV-HBV screening showed a very high level of acceptability among MSM. Efforts need to be made to improve immediate acceptability for HBV vaccination, especially among MSM, and follow-up doses compliance. Our results show the important role of community centers in reaching targets, often fragile, populations, while also suggesting the need to reinforce on-site human support in terms of testing and vaccination, especially when addressing PWIDs.
Collapse
Affiliation(s)
- Ruxandra Calin
- Service de Maladies Infectieuses, Hôpital Tenon, Groupe Hospitalier Est, AP-HP, 4 rue de la Chine, 75970, Paris, Cedex 20, France.
- Inserm, IPLESP, ERES, Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne Université, 75012, Paris, France.
| | - Véronique Massari
- Inserm, IPLESP, ERES, Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne Université, 75012, Paris, France
| | - Gilles Pialoux
- Service de Maladies Infectieuses, Hôpital Tenon, Groupe Hospitalier Est, AP-HP, 4 rue de la Chine, 75970, Paris, Cedex 20, France
- Sorbonne Université, UPMC Université, Paris 06, France
| | | | - Eve Plenel
- Le Kiosque, Checkpoint-Paris, Groupe SOS, Paris, France
| | - Carole Chauvin
- Le Kiosque, Checkpoint-Paris, Groupe SOS, Paris, France
- Cermes3, Inserm U988, CNRS UMR8211, EHESS, Université de Paris, Paris, France
| | | | - Nesrine Day
- Laboratoires Centre Biologique Chemin Vert (CBCV), Paris, France
| | - Georges Kreplak
- Laboratoires Centre Biologique Chemin Vert (CBCV), Paris, France
| | - Anaenza Freire Maresca
- ARCAT, Pasaje Latino, Groupe SOS, Paris, France
- AP-HP, Hôpital Ambroise Pare, Service de Médecine Interne, Boulogne-Billancourt, France
| | | | - Sandra Louis
- CSAPA 110 Les Halles, ARCAT, Groupe SOS, Paris, France
| | - Stanislas Pol
- AP-HP, Hôpital Cochin, Service d'hépatologie, Paris, France
| | - Véronique Doré
- ANRS: Agence Nationale de Recherche sur le sida et les hépatites virales, Paris, France
| | - Christine Rouzioux
- Le Kiosque, Checkpoint-Paris, Groupe SOS, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Pierre Chauvin
- Inserm, IPLESP, ERES, Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne Université, 75012, Paris, France
| |
Collapse
|
16
|
Dauriac-Le Masson V, Mercuel A, Guedj MJ, Douay C, Chauvin P, Laporte A. Mental Healthcare Utilization among Homeless People in the Greater Paris Area. Int J Environ Res Public Health 2020; 17:ijerph17218144. [PMID: 33158155 PMCID: PMC7663026 DOI: 10.3390/ijerph17218144] [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] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 11/16/2022]
Abstract
The healthcare utilization of homeless people is generally considered insufficient, and studies often suffer from methodological bias (institutionalized vs. street samples). To adapt public health policies in France, epidemiological data on this population are scarce. The objective of this study was to analyze the use of psychiatric care by homeless people with mental health problems in the Greater Paris area and to define the factors influencing this use. The data were from the SAMENTA survey performed in 2009 with a representative random street sample of 859 homeless people from the Greater Paris area. The survey studied the use of psychiatric care (lifelong use, current follow-up, discontinuation of follow-up and treatment) and factors potentially associated with this use for people with a diagnosis of a psychotic, mood or anxiety disorder, with the diagnosis established with an original survey device. Because of our complex sampling design, we describe data for only a weighted estimated prevalence, weighted estimation of the number of people in the population (N) and unweighted total subgroup studied in the survey (n). Among 840 homeless people with useable data, 377 (N = 9762) had a psychiatric disorder. The use of whole-life care for these people may seem high, estimated at 68.7%, but few people were followed up for their disorders (18.2%); individuals with a psychotic disorder were more frequently followed up (36.5%) than others were (p < 0.05). Among those followed up (n = 86, N = 1760), 63.0% were taking medication. Access to care for these people seemed preserved, but the maintenance of care seemed problematic; indeed, among people with a lifelong whole use of care (n= 232, N = 6705), 72.3% could be considered to have discontinued care. The factors that improved lifetime health service utilization or follow-up were socio-demographic (age < 42 years, more educated), social (with social security coverage, not living in a hotel), and medical (psychotic disorder, personality disorder, suicide risk, somatic chronic illness, perception of mental suffering). Improving the care of homeless people with psychiatric disorders requires improving access to care for those isolated from the health system (in particular those living in hotels) and to guarantee continuity of care, by adapting the organization of the care system and promoting social rehabilitation.
Collapse
Affiliation(s)
- Valérie Dauriac-Le Masson
- Département d’Information Médicale, GHU Paris Psychiatrie & Neurosciences, 75014 Paris, France
- Correspondence: ; Tel.: +33-1-45-65-86-16
| | - Alain Mercuel
- SMES, GHU Paris Psychiatrie & Neurosciences, 75014 Paris, France;
| | | | - Caroline Douay
- Observatoire du Samusocial de Paris, 75012 Paris, France;
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, 75012 Paris, France;
| | - Anne Laporte
- Santé publique France, French National Public Health Agency, 94410 Saint-Maurice, France;
| |
Collapse
|
17
|
Traoré M, Vallée J, Chauvin P. Risk of late cervical cancer screening in the Paris region according to social deprivation and medical densities in daily visited neighborhoods. Int J Health Geogr 2020; 19:18. [PMID: 32466794 PMCID: PMC7254665 DOI: 10.1186/s12942-020-00212-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background Social and physical characteristics of the daily visited neighborhoods have gained an extensive interest in analyzing socio-territorial inequalities in health and healthcare. The objective of the present paper is to estimate and discuss the role of individual and contextual factors on participation in preventive health-care activities (smear screening) in the Greater Paris area focusing on the characteristics of daily visited neighborhoods in terms of medical densities and social deprivation. Methods The study included 1817 women involved in the SIRS survey carried out in 2010. Participants could report three neighborhoods they regularly visit (residence, work/study, and the next most regularly visited). Two “cumulative exposure scores” have been computed from household income and medical densities (general practitioners and gynecologists) in these neighborhoods. Multilevel logistic regression models were used to measure association between late cervical screening (> 3 years) and characteristics of daily visited neighborhoods (residential, work or study, visit). Results One-quarter of the women reported that they had not had a smear test in the previous 3 years. Late smear test was found to be more frequent among younger and older women, among women being single, foreigners and among women having a low-level of education and a limited activity space. After adjustment on individual characteristics, a significant association between the cumulative exposure scores and the risk of a delayed smear test was found: women who were exposed to low social deprivation and to low medical densities in the neighborhoods they daily visit had a significantly higher risk of late cervical cancer screening than their counterparts. Conclusions For a better understanding of social and territorial inequalities in healthcare, there is a need for considering multiple daily visited neighborhoods. Cumulative exposure scores may be an innovative approach for analyzing contextual effects of daily visited neighborhoods rather than focusing on the sole residential neighborhood.
Collapse
Affiliation(s)
- Médicoulé Traoré
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis D'ÉPIDÉMIOLOGIE et de Santé Publique, Paris, France.
| | | | - Pierre Chauvin
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis D'ÉPIDÉMIOLOGIE et de Santé Publique, Paris, France
| |
Collapse
|
18
|
Briot K, Grange L, Cortet B, Feron JM, Chauvin P, Coulomb A, Alliot-Launois F, Sellami R, Touboul C, Perrin L, Joubert JM, Launois R. Real-world care for individuals aged over fifty with fractures in France: Evidence for a wide care gap-The EPIFRACT Study. Joint Bone Spine 2020; 87:467-473. [PMID: 32387150 DOI: 10.1016/j.jbspin.2020.04.007] [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: 01/30/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To describe the care trajectories of adults aged ≥50 years with fragility fractures in France. METHODS A postal questionnaire was sent to 15,000 individuals aged ≥50 years extracted from a representative panel of the French population (METASKOPE) in April-May 2018. Respondents experiencing a single fragility fracture in the previous three years constituted the study population. Information was collected regarding diagnosis, hospitalisations, physician visits and treatment related to the fractures. RESULTS 13,914 participants returned a questionnaire (92.8%), of whom 436 reported a single fragility fracture. Their mean age was 68.7±10.3 years. 11.9% of this sample had undergone bone densitometry (DXA) prior to the fracture and 11.9% had received a diagnostic of osteoporosis. Following the fracture, a further 17.4% underwent DXA and 8.5% were diagnosed with osteoporosis. 74.3% of fractures were initially managed in an emergency department and 29.6% led to immediate hospitalisation. Prior to fracture, 3.4% received a specific anti-osteoporotic treatment, 10.1% vitamin D and 6.4% calcium supplementation. After the fracture, these figures rose to 10.8%, 26.8% and 19.0% respectively. 86.2% participants made at least one follow-up visit to a physician. CONCLUSIONS The rate of DXA screening following fragility fractures in subjects over fifty is very low. Most patients with fragility fractures did not receive a diagnosis of osteoporosis. The proportion of patients treated with a specific anti-osteoporotic treatment after a fracture is low even though around half consulted their general practitioner after the fracture. Practice guidelines are thus not being adhered to in everyday clinical practice in France.
Collapse
Affiliation(s)
- Karine Briot
- Service de rhumatologie, hôpital Cochin, Paris, France.
| | - Laurent Grange
- Service de rhumatologie, CHU Grenoble Alpes, Hôpital Sud, Echirolles, France; AFLAR - Association Française de Lutte Anti-Rhumatismale, Paris, France
| | - Bernard Cortet
- Service de rhumatologie, EA 4490, CHU Lille, Lille, France
| | - Jean-Marc Feron
- Service de chirurgie orthopédique, HUEP Saint Antoine, Sorbonne université, Paris, France
| | - Pierre Chauvin
- Department of social epidemiology, Inserm, Sorbonne université, institut Pierre Louis d'épidémiologie et de santé publique (UMRS 1136), Paris, France
| | | | | | | | | | | | | | - Robert Launois
- Réseau d'évaluation en économie de la santé, Paris, France
| |
Collapse
|
19
|
Franck JE, Ringa V, Rigal L, Sassenou J, Cœuret-Pellicer M, Chauvin P, Menvielle G. Patterns of gynaecological check-up and their association with body mass index within the CONSTANCES cohort. J Med Screen 2020; 28:10-17. [PMID: 32279590 DOI: 10.1177/0969141320914323] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To investigate the relationship between patterns of gynaecological check-up and body mass index while accounting for various determinants of health care use. METHODS Sequence analysis and clustering were used to highlight patterns of gynaecological check-up, which included the regularity of breast and cervical cancer screening and visits to the gynaecologist over four years, among 6182 women aged 54-65 included in the CONSTANCES cohort between 2013 and 2015 in France. Multinomial logistic regressions were used to study the association between these patterns and women's body mass index. RESULTS We identified four patterns of gynaecological check-up, from (A) no or inappropriate check-up (20%) to (D) almost one visit to the gynaecologist every year, overscreening for cervical cancer and frequent use of opportunistic breast cancer screening (12%). From patterns A to D, the proportion of obese women decreased and that of women with normal body mass index increased. Obese and overweight women underwent more breast than cervical cancer screening and were less often overscreened than normal weight women. These differences were only partly explained by the lower socioeconomic situation of overweight and obese women. Beyond the financial barrier, the screening modality and the type of exam may play a role. Among women who were screened for cervical cancer, obese and overweight women were less often screened by a gynaecologist. CONCLUSION Further efforts should be made to enhance the take-up of screening among obese women who are deterred by the healthcare system.
Collapse
Affiliation(s)
- Jeanna-Eve Franck
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Virginie Ringa
- CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France. Ined, Paris, France
| | - Laurent Rigal
- CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France. Ined, Paris, France
| | - Jeanne Sassenou
- CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France. Ined, Paris, France
| | - Mireille Cœuret-Pellicer
- Inserm-Versailles Saint Quentin en Yvelines University, "Epidemiological Population-Based Cohorts Unit", Villejuif, France
| | - Pierre Chauvin
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Gwenn Menvielle
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| |
Collapse
|
20
|
Traoré M, Vuillermoz C, Chauvin P, Deguen S. Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression. Int J Environ Res Public Health 2020; 17:E1958. [PMID: 32192057 PMCID: PMC7143570 DOI: 10.3390/ijerph17061958] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for "health, inequalities and social ruptures") cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07-3.35]) or middle-income (OR = 1.91; CI = [1.09-3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10-2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health.
Collapse
Affiliation(s)
- Médicoulé Traoré
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Cécile Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Séverine Deguen
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
- EHESP School of Public Health, F35043 Rennes, France
| |
Collapse
|
21
|
Vuillermoz C, Stene LE, Aubert L, Motreff Y, Pirard P, Baubet T, Lesieur S, Chauvin P, Vandentorren S. Non-participation and attrition in a longitudinal study of civilians exposed to the January 2015 terrorist attacks in Paris, France. BMC Med Res Methodol 2020; 20:63. [PMID: 32171236 PMCID: PMC7071581 DOI: 10.1186/s12874-020-00943-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/28/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Non-participation and attrition are rarely studied despite being important methodological issues when performing post-disaster studies. A longitudinal survey of civilians exposed to the January 2015 terrorist attacks in Paris, France, was conducted 6 (Wave 1) and 18 months (Wave 2) after the attacks. We described non-participation in Wave 1 and determined the factors associated with attrition in Wave 2. METHODS Multivariate logistic regression models were used to compare participants in both waves with those who participated in the first wave only. Analyses were performed taking the following factors into account: socio-demographic characteristics, exposure to terror, peri-traumatic reactions, psychological support, perceived social support, impact on work, social and family life, and mental health disorders. Characteristics of new participants in Wave 2 were compared with participants in both waves using a chi-square test. RESULTS Of the 390 persons who were eligible to participate in the survey, 190 participated in Wave 1 (participation rate: 49%). The most frequently reported reason for non-participation was to avoid being reminded of the painful event (32%, n = 34/105). In Wave 2, 67 were lost to follow-up, 141 people participated, of whom 123 participated in Wave 1 (re-participation rate: 65%) and 18 were new. Attrition in Wave 2 was associated with socio-demographic characteristics (age, French origin) and location during the attacks, but not with terror exposure or mental health disorders. Compared with those who participated in both waves, new participants declared less social and psychological support since the attacks. CONCLUSIONS Attrition at 6 months was not associated with exposure to terror or mental health disorders, which indicates that any bias in future analyses on IMPACTS on mental health outcomes will be limited. Our findings suggest the importance of adapting similar surveys for people of foreign origin and of improving strategies to avoid attrition of younger people, for example by using social media, peers, and the educational environment. The present study also revealed that a high level of exposure to terror and a lack of social and psychological support after a terrorist event could impede individuals' participation in similar surveys in the short term.
Collapse
Affiliation(s)
- Cécile Vuillermoz
- Centre National de la Recherche Scientifique (CNRS), Centre Maurice Halbwachs (CNRS-UMR8097, EHESS, ENS), F75014, Paris, France.
| | - Lise Eilin Stene
- Norwegian centre for violence and traumatic stress studies (NKVTS), Oslo, Norway
| | - Lydéric Aubert
- Santé publique France, Direction des régions, F94415, Saint-Maurice, France
| | - Yvon Motreff
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
- Santé publique France, Direction des maladies non transmissibles et traumatismes, F94415, Saint-Maurice, France
| | - Philippe Pirard
- Santé publique France, Direction des maladies non transmissibles et traumatismes, F94415, Saint-Maurice, France
| | - Thierry Baubet
- CESP Inserm 1178, Université Paris 13, Paris, France
- Psychopathology Department for Children, Adolescents, General Psychiatry and Specialized Addiction, APHP Hôpital Avicenne, F93009, Bobigny, France
- Centre national de Ressources et de Résilience (CNRR), Paris, France
| | - Sophie Lesieur
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| | - Pierre Chauvin
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| | - Stéphanie Vandentorren
- Santé publique France, Direction des régions, F94415, Saint-Maurice, France
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| |
Collapse
|
22
|
Cortet B, Chauvin P, Feron JM, Grange L, Coulomb A, Launois R, Alliot-Launois F, Sellami R, Touboul C, Vincent B, Joubert JM, Briot K. Fragility fractures in France: epidemiology, characteristics and quality of life (the EPIFRACT study). Arch Osteoporos 2020; 15:46. [PMID: 32170512 DOI: 10.1007/s11657-019-0674-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 07/19/2019] [Accepted: 11/21/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Between 1 and 2% of people aged 50 years and over living at home in France are likely to experience a fragility fracture each year. Three-quarters of these individuals are not diagnosed with osteoporosis and lose the opportunity for appropriate care. PURPOSE To estimate the incidence of fragility fractures in France and to describe the characteristics of individuals with such fractures and of their fractures. METHODS In April-May 2018, a postal survey was performed in France targeting a representative panel of 15,000 individuals aged ≥ 50 years, who were invited to complete a questionnaire. If they reported experiencing a fracture in the previous 3 years, they were asked to provide information on demographics, fracture type, risk factors for fractures and osteoporosis diagnosis. Only fragility fractures were considered, and these were classified as major (associated with increased mortality) or minor, based on the fracture site. RESULTS Around 13,914 panellists returned an exploitable questionnaire (92.8%). About 425 participants reported ≥ 1 fragility fracture (453 fractures), corresponding to a 12-month incidence rate of 1.4% [95%CI: 1.2, 1.6]. Incidence was higher in women (1.99% [1.87, 2.05]) than in men (0.69% [0.38, 0.86]) and increased with age. Around 157 fractures (34.6%) were classified as major. Participants reporting major fractures were older than those reporting minor fractures (mean age: 72.6 ± 11.3 vs 67.1 ± 10.6) and more likely to report previous corticosteroid use (odds ratio: 1.90 [95%CI: 1.13, 3.18]). No other patient characteristic was associated with fracture severity. About 117 participants with fractures (27.5%) had undergone bone densitometry, and 97 (22.8%) declared having received a diagnosis of osteoporosis. CONCLUSIONS Around 340,000 people aged ≥ 50 years living at home in France are estimated to experience osteoporotic fractures each year. However, > 75% of panellists reporting fractures were never diagnosed with osteoporosis and thus did not have the opportunity to receive appropriate care.
Collapse
Affiliation(s)
- Bernard Cortet
- Centre Hospitalier Régional Universitaire de Lille, Département Universitaire de Rhumatologie, Hôpital Roger Salengro, CHU Lille, Avenue du Professeur Emile Laine, 59037, Lille Cedex, France.
| | - Pierre Chauvin
- Department of Social Epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), INSERM, Sorbonne Université, Paris, France
| | - Jean-Marc Feron
- Service de Chirurgie Orthopédique, HUEP Saint Antoine, Sorbonne Université, Paris, France
| | - Laurent Grange
- Service de Rhumatologie, CHU Grenoble Alpes, Hôpital Sud, Échirolles, France
- AFLAR - Association Française de Lutte Anti-Rhumatismale, Paris, France
| | | | | | | | | | | | | | | | - Karine Briot
- Service de Rhumatologie, Hôpital Cochin, Paris, France
| |
Collapse
|
23
|
Diridollou T, Sohier L, Rousseau C, Angibaud A, Chauvin P, Gaignon T, Tas M, Lemerre J, Kerjouan M, Salé A, Lederlin M, Jouneau S. Idiopathic pulmonary fibrosis: Significance of the usual interstitial pneumonia (UIP) CT-scan patterns defined in new international guidelines. Respir Med Res 2020; 77:72-78. [PMID: 32416587 DOI: 10.1016/j.resmer.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/03/2019] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The new 2018 international guidelines for diagnosing usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) by CT scan split the old pattern possible UIP (2011 IPF guidelines) into two new patterns: probable UIP and indeterminate for UIP. However, the proportions and prognoses of these new CT-scan patterns are not clear. METHODS We used a monocentric retrospective cohort of 322 patients suspected of having IPF (University Hospital of Rennes; Competence Center for Rare Lung Diseases; 1 January 2012-31 December 2017). All patients initially diagnosed by CT scan as possible UIP were included. The chest CT-scans were then reclassified according to the new 2018 international guidelines by 3 observers. These data were then subjected to survival analysis with multivariate Cox regression using a composite endpoint of death, lung transplantation, a decline of≥10% in forced vital capacity (FVC), or hospitalization. RESULTS Of the 89 possible UIP patients included, 74 (83%) were reclassified as probable UIP and 15 (17%) as indeterminate for UIP. Probable UIP patients were more likely to meet the composite endpoint (56/74 [75.7%] vs. 5/15 [33%] patients; HR [IC 95%] =3.12 [1.24; 7.83], P=0.015). Multivariate analysis indicated that the probable UIP pattern was associated with significantly increased risk of reaching the composite endpoint (HR [95% CI]=2.85[1.00; 8.10], P=0.049). CONCLUSION The majority of possible UIP diagnoses corresponded to probable UIP, which was associated with a significantly worse prognosis than indeterminate for UIP. This distinction between these two CT patterns emphasizes the relevance of the new international guidelines for the diagnosis of IPF.
Collapse
Affiliation(s)
- T Diridollou
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France.
| | - L Sohier
- Service de pneumologie, centre hospitalier Lorient, Lorient, France
| | - C Rousseau
- Centre d'investigation clinique, Inserm 1414, Rennes, France
| | - A Angibaud
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France
| | - P Chauvin
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France
| | - T Gaignon
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France
| | - M Tas
- Service de radiologie, CHU de Rennes, France, université de Rennes 1, Rennes, France
| | - J Lemerre
- Service de radiologie, CHU de Rennes, France, université de Rennes 1, Rennes, France
| | - M Kerjouan
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France
| | - A Salé
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France
| | - M Lederlin
- Service de radiologie, CHU de Rennes, France, université de Rennes 1, Rennes, France
| | - S Jouneau
- Service de pneumologie, centre de compétences pour les maladies rares pulmonaires, CHU de Rennes, France, Université de Rennes 1, Rennes, France; Service de pneumologie, centre hospitalier Lorient, Lorient, France; Centre d'investigation clinique, Inserm 1414, Rennes, France; Service de radiologie, CHU de Rennes, France, université de Rennes 1, Rennes, France; UMR1085, IRSET, université de Rennes 1, Rennes, France.
| |
Collapse
|
24
|
Motreff Y, Baubet T, Pirard P, Rabet G, Petitclerc M, Stene LE, Vuillermoz C, Chauvin P, Vandentorren S. Factors associated with PTSD and partial PTSD among first responders following the Paris terror attacks in November 2015. J Psychiatr Res 2020; 121:143-150. [PMID: 31821960 DOI: 10.1016/j.jpsychires.2019.11.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 09/11/2019] [Revised: 11/10/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022]
Abstract
During the evening of 13 November 2015, the deadliest terror attacks in France in recent times occurred in the Paris area. Overall, 130 people were killed, 643 were physically injured and several thousands were psychologically impacted. Thousands of first responders, including health professionals, firefighters, affiliated volunteers and police officers were mobilized that night and during the subsequent weeks. The aims of our study were to measure the psychological impact on first responders in terms of post-traumatic stress disorder (PTSD) and partial PTSD as well as associated factors 12 months after the 13 November 2015 terrorist attacks. First responders who had intervened during the night and/or the aftermath of the terror attacks had the possibility of answering a web-based study 8-12 months after the attacks. They satisfied criterion A of the DSM 5 definition of PTSD. PTSD and partial PTSD were measured using the PCL-5. Gender, age, educational level, exposure, first responder category, mental health and traumatic event history, training and social support were all analysed as potential factors associated with PTSD and partial PTSD, using multinomial logistic regression. Overall, 663 participants were included in this analysis. Prevalence of PTSD in our sample went from 3.4% among firefighters to 9.5% among police officers and prevalence of partial PTSD from 10.4% among health professionals to 23.2% among police officers. Low educational level and social isolation were associated with PTSD and partial PTSD. Intervention on unsecured crime scenes and lack of training were associated with PTSD. Special attention should be given to first responders living in social isolation, those with low educational levels and those who intervene in unsecured crime scenes. Education and training about the potential mental health consequences of mass trauma intervention should be developed.
Collapse
Affiliation(s)
- Yvon Motreff
- Santé publique France, Direction des maladies non transmissibles et traumatismes, F-94415 Saint-Maurice, France; Sorbonne Université, Inserm, Institut Pierre Louis D'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012, Paris, France.
| | - Thierry Baubet
- CESP Inserm 1178, Université Paris 13, Paris, France; Psychopathology Department for Children, Adolescents, General Psychiatry and Specialized Addiction, APHP Hôpital Avicenne, F93009, Bobigny, France; Centre National de Ressources et de Résilience (CNRR), Paris, France
| | - Philippe Pirard
- Santé publique France, Direction des maladies non transmissibles et traumatismes, F-94415 Saint-Maurice, France; CESP Inserm 1178, Université Paris 13, Paris, France
| | - Gabrielle Rabet
- Santé publique France, Direction appui traitements et analyses des données, F-94415 Saint-Maurice, France
| | - Matthieu Petitclerc
- Service Médical D'urgence - Bureau de Santé et de Prévention, Brigade de Sapeurs-pompiers de Paris, 1, Place Jules-Renard, 75017, Paris, France; Université Paris 13, Ecole Doctorale Erasme, Laboratoire UTRPP, F93430, Villetaneuse, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Cécile Vuillermoz
- Centre National de La Recherche Scientifique (CNRS), Équipe de Recherche sur Les Inégalités Sociales - Centre Maurice Halbwachs (CNRS-UMR8097, EHESS, ENS), Paris, France
| | - Pierre Chauvin
- Sorbonne Université, Inserm, Institut Pierre Louis D'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012, Paris, France
| | - Stéphanie Vandentorren
- Sorbonne Université, Inserm, Institut Pierre Louis D'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012, Paris, France; Santé publique France, Direction des régions, F-94415 Saint-Maurice, France
| |
Collapse
|
25
|
Combes SJB, Simonnot N, Azzedine F, Aznague A, Chauvin P. Self-Perceived Health among Migrants Seen in Médecins du Monde Free Clinics in Europe: Impact of Length of Stay and Wealth of Country of Origin on Migrants' Health. Int J Environ Res Public Health 2019; 16:ijerph16244878. [PMID: 31817068 PMCID: PMC6950051 DOI: 10.3390/ijerph16244878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/29/2019] [Accepted: 11/30/2019] [Indexed: 11/16/2022]
Abstract
Health of migrants is a widely studied topic. It has been argued that migrant health may deteriorate over time. Though migrants are a “hard to reach” population in survey data, this paper builds on a unique dataset provided by Médecins du Monde from five countries. We study self-perceived health (SPH) in connection with socio-economic and demographic factors and length of stay. Results differ for men and women. Compared to other documented migrants, asylum seekers have a 50–70% greater chance of having worse health. Migrants with better living conditions have a 57–78% chance of being in better health. Male migrants with a job have between a 82–116% chance of being in good health. The probability for women from poorer countries to have a better physical SPH after three months of residing in the host country is six-fold that of women from richer countries. This paper contributes widely to the knowledge of health of migrants. Contrary to other evidence, health of women migrants from poorer countries tends to improve with length of stay.
Collapse
Affiliation(s)
- Simon Jean-Baptiste Combes
- Univ Rennes, EHESP, CNRS, ARENES–UMR 6051, 35000 Rennes, France; (F.A.); (A.A.)
- French Collaborative Institute on Migration, 93322 Aubervilliers, France
- Correspondence:
| | - Nathalie Simonnot
- Médecins du Monde–Doctors of the World, International Network, 75018 Paris, France;
| | - Fabienne Azzedine
- Univ Rennes, EHESP, CNRS, ARENES–UMR 6051, 35000 Rennes, France; (F.A.); (A.A.)
- French Collaborative Institute on Migration, 93322 Aubervilliers, France
| | - Abdessamad Aznague
- Univ Rennes, EHESP, CNRS, ARENES–UMR 6051, 35000 Rennes, France; (F.A.); (A.A.)
| | - Pierre Chauvin
- Department of Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), 75012 Paris, France;
| |
Collapse
|
26
|
Vuillermoz C, Montreff Y, Pirard P, Lesieur S, Chauvin P, Baubet T, Vandentorren S. Psychological follow-up and its perception in civilians involved in the January 2015 terrorist attack in Paris, France. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.801] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A terrorist attack occurred in Paris in January 2015 against the staffs of the Charlie Hebdo magazine and a kosher grocery. This study examined the psychological follow-up and the non-satisfaction of the people civilians involved in the terrorist attacks.
Methods
The IMPACTS survey, an open cohort study of civilians involved in the terrorist attacks was conducted 6-10 (wave 1) and 18-22 months (wave 2) after the attacks. Psychologists interviewed in face-to-face 190 civilians in wave 1 and 123 of them participate to the wave 2. A questionnaire was used to collect data on socio-demographic characteristics, exposure level, social support, psychological support and perception, impact on work and social functioning, and mental health disorders.
Results
In wave 1 (N = 190), 24% of participants had initiated a regular follow-up with a psychologist or a psychiatrist. Reasons of non-follow-up were: they had refused because they did not feel the need or they did not want to talk about it (60%), it was not suggested to them (30%), or they have already had a follow-up before (12%). In wave 2 (N = 123), 25% had a regular follow-up with a psychologist/psychiatrist since the events, 22.0% had had a follow-up but not anymore in wave 2, 15% did not have a follow-up in wave 1 but they had in wave 2 and 38.2% never had. Psychological aid from professionals for resilience has not been appropriate for 32% of the participants at 6 months and for 39% at 18 months. In both waves, non-satisfaction of follow-up was more frequent among witnesses than with those who were directly exposed.
Conclusions
Six months after the January 2015 terrorist attacks in Paris, among the participants without psychological follow-up, it was not offered to nearly a third of participants. In order to enhance resilience, psychological aid should also be provided to those who have not been directly exposed.
Main message
Psychological follow-up should be provided to all civilians in short and long-term.
Collapse
Affiliation(s)
- C Vuillermoz
- Centre National de la Recherche Scientifique, Centre Maurice Halbwachs, Paris, France
| | - Y Montreff
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - P Pirard
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - S Lesieur
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
| | - P Chauvin
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
| | - T Baubet
- CESP Inserm, Université Paris, Paris, France
| | - S Vandentorren
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
- Santé Publique France, Cellule d’intervention en région Nouvelle-Aquitaine, Saint-Maurice, France
| |
Collapse
|
27
|
Vandentorren S, Vuillermoz C, Motreff Y, Pirard P, Lesieur S, Baubet T, Chauvin P. Psychological support in short term after the January 2015 terrorist attack in Paris, France. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.802] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A terrorist attack occurred in Paris in January 2015 against the staffs of the Charlie Hebdo magazine and a kosher grocery. This study examined psychological support given to the people directly exposed, witnesses and close relatives of those who were injured, hostages or died.
Methods
The IMPACTS survey was an open cohort lead in 2 waves (6 and 18 months after the events). Psychologists interviewed in face-to-face 190 civilians in wave 1. A questionnaire was used to collect data on socio-demographic characteristics, exposure level, psychological and social support, impact on work and social functioning, and mental health disorders.
Results
Among the 190 participants in wave 1, 24.3% did not receive psychological support neither in 48 hours, between 2 and 7 days, and after 1 week. Among those who had received support, they had a contact in average with 3 institutions or associations. Within the 48 hours, psychological support was mainly provided by Medico-psychological emergency unit (CUMP) (45.2%). Between 2 and 7 days, CUMP (42.6%) and a Parisian hospital in specialized care unit for trauma (44.6%) had mainly offered psychological support. One week after events, psychological support was mainly provided by consultation in specialized care unit for trauma (41.4%) or in ambulatory (27.6%). Lack of psychological support was more frequent among men, unemployed, and witnesses (versus those who were directly exposed).
Conclusions
This study suggests offering psychological support to the whole population that have been potentially impacted, and also for those who had not been directly threatened. Long-term psychological follow-up of the most affected ones remains an objective to consolidate initial care.
Main message: Psychological follow-up should be provided not only to threatened people but also to the most vulnerable people (unemployed).
Collapse
Affiliation(s)
- S Vandentorren
- Centre National de la Recherche Scientifique, French National Public Health Agency, Saint-Maurice, France
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
| | - C Vuillermoz
- Centre National de la Recherche Scientifique, Centre Maurice Halbwachs, Paris, France
| | - Y Motreff
- Centre National de la Recherche Scientifique, French National Public Health Agency, Saint-Maurice, France
- Santé Publique France, Cellule d’intervention en région Nouvelle-Aquitaine, Saint-Maurice, France
| | - P Pirard
- Centre National de la Recherche Scientifique, French National Public Health Agency, Saint-Maurice, France
| | - S Lesieur
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
| | - T Baubet
- CESP Inserm, Université Paris, Paris, France
| | - P Chauvin
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Department of Social Epidemiology, Sorbonne Université, Paris, France
| |
Collapse
|
28
|
Maj C, Poncet L, Panjo H, Gautier A, Chauvin P, Menvielle G, Cadot E, Ringa V, Rigal L. General practitioners who never perform Pap smear: the medical offer and the socio-economic context around their office could limit their involvement in cervical cancer screening. BMC Fam Pract 2019; 20:114. [PMID: 31416425 PMCID: PMC6694570 DOI: 10.1186/s12875-019-1004-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/31/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND In France, with the growing scarcity of gynecologists and a globally low and socially differentiated coverage of cervical cancer screening (CCS), general practitioners (GPs) are valuable resources to improve screening services for women. Still all GPs do not perform Pap smears. In order to promote this screening among GPs, the characteristics of physicians who never perform CCS should be more precisely specified. Besides already-known individual characteristics, the contextual aspects of the physicians' office, such as gynecologist density in the area, could shape GPs gynecological activities. METHODS To analyze county (département) characteristics of GPs' office associated with no performance of CCS, we used a representative sample of 1063 French GPs conducted in 2009 and we constructed mixed models with two levels, GP and county. RESULTS Almost 35% (n = 369) of the GPs declared never performing CCS. GPs working in counties with a poor GP-density per inhabitants were more likely to perform CCS (odds ratio (OR) = 0.52 for each increase of density by 1 GP per 10,000 inhabitants, 95% confidence interval (CI) = 0.37-0.74). On the contrary, GPs working in counties with an easier access to a gynecologist were more likely not to perform CCS (OR = 1.06 for each increase of density by 1 gynecologist per 100,000 women, 95%CI = 1.03-1.10 and OR = 2.02 if the first gynecologist is reachable in less than 15 min, 95%CI = 1.20-3.41) as well as GPs working in areas with a poverty rate above the national average (OR = 1.66, 95%CI = 1.09-2.54). These contextual characteristics explain most of the differences between counties concerning rates of not performing CCS. CONCLUSIONS Specific programs should be developed for GPs working in contexts unfavorable to their involvement in CCS.
Collapse
Affiliation(s)
- Chiara Maj
- General Practice Department, Univ Paris-Sud, Le Kremlin Bicêtre, France
| | - Lorraine Poncet
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Ined, Paris, France
| | - Henri Panjo
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Ined, Paris, France
| | | | - Pierre Chauvin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, F75012, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, F75012, France
| | - Emmanuelle Cadot
- IRD - Hydrosciences UMR 5569, Montpellier University, Montpellier, F-34090, France
| | - Virginie Ringa
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Ined, Paris, France
| | - Laurent Rigal
- General Practice Department, Univ Paris-Sud, Le Kremlin Bicêtre, France.
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France.
- Ined, Paris, France.
| |
Collapse
|
29
|
Jackson Y, Courvoisier DS, Duvoisin A, Ferro-Luzzi G, Bodenmann P, Chauvin P, Guessous I, Wolff H, Cullati S, Burton-Jeangros C. Impact of legal status change on undocumented migrants' health and well-being (Parchemins): protocol of a 4-year, prospective, mixed-methods study. BMJ Open 2019; 9:e028336. [PMID: 31154311 PMCID: PMC6549650 DOI: 10.1136/bmjopen-2018-028336] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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] [Received: 12/03/2018] [Revised: 04/08/2019] [Accepted: 05/02/2019] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Migrants without residency permit, known as undocumented, tend to live in precarious conditions and be exposed to an accumulation of adverse determinants of health. Only scarce evidence exists on the social, economic and living conditions-related factors influencing their health status and well-being. No study has assessed the impact of legal status regularisation. The Parchemins study is the first prospective, mixed-methods study aiming at measuring the impact on health and well-being of a regularisation policy on undocumented migrants in Europe. METHODS AND ANALYSIS The Parchemins study will compare self-rated health and satisfaction with life in a group of adult undocumented migrants who qualify for applying for a residency permit (intervention group) with a group of undocumented migrants who lack one or more eligibility criteria for regularisation (control group) in Geneva Canton, Switzerland. Asylum seekers are not included in this study. The total sample will include 400 participants. Data collection will consist of standardised questionnaires complemented by semidirected interviews in a subsample (n=38) of migrants qualifying for regularisation. The baseline data will be collected just before or during the regularisation, and participants will subsequently be followed up yearly for 3 years. The quantitative part will explore variables about health (ie, health status, occupational health, health-seeking behaviours, access to care, healthcare utilisation), well-being (measured by satisfaction with different dimensions of life), living conditions (ie, employment, accommodation, social support) and economic situation (income, expenditures). Several confounders including sociodemographic characteristics and migration history will be collected. The qualitative part will explore longitudinally the experience of change in legal status at individual and family levels. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee of Geneva, Switzerland. All participants provided informed consent. Results will be shared with undocumented migrants and disseminated in scientific journals and conferences. Fully anonymised data will be available to researchers.
Collapse
Affiliation(s)
- Yves Jackson
- Division of Primary Care Medicine, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Department of General Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Aline Duvoisin
- Institute of sociological research, University of Geneva, Geneva, Switzerland
| | - Giovanni Ferro-Luzzi
- Haute Ecole de Gestion, University of applied sciences of Western Switzerland, Carouge, Switzerland
- Geneva School of Economics and Management, Universite de Geneve, Geneva, Switzerland
| | - Patrick Bodenmann
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - Pierre Chauvin
- Department of Social Epidemiology, Inserm, UMRS 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- UMRS 1136, Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Idris Guessous
- Division of Primary Care Medicine, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Hans Wolff
- Division of Prison Health, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- Institute of sociological research, University of Geneva, Geneva, Switzerland
- Swiss NCCR LIVES, Universite de Geneve, Geneva, Switzerland
| | - Claudine Burton-Jeangros
- Institute of sociological research, University of Geneva, Geneva, Switzerland
- Swiss NCCR LIVES, Universite de Geneve, Geneva, Switzerland
| |
Collapse
|
30
|
Vignier N, Dray Spira R, Pannetier J, Ravalihasy A, Gosselin A, Lert F, Lydie N, Bouchaud O, Desgrees Du Lou A, Chauvin P. Refusal to provide healthcare to sub-Saharan migrants in France: a comparison according to their HIV and HBV status. Eur J Public Health 2019; 28:904-910. [PMID: 29982518 DOI: 10.1093/eurpub/cky118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background In this study, we aim to measure and compare the frequency of reported denial of care in sub-Saharan African migrants living in the Paris area, according to their HIV and HBV status and social and migration characteristics. Methods The ANRS-PARCOURS study is a life-event survey conducted in 2012-13 in healthcare facilities in the Paris area, among three groups of sub-Saharan migrants recruited in primary care centres (N = 760; reference group), in dedicated centres for HIV care (N = 922; HIV group) and in centres for chronic hepatitis B care (N = 777; CHB group). Characteristics associated with refusal of care since arrival in France were identified using a logistic regression model. Results Compared to the reference group (6%, P < 0.001), the reported refusal of care was twice as high in the HIV group (12%) and the CHB group (10%). In the multivariate analysis, men and women living with HIV were at greater risk of being denied care (aOR = 2.20[1.14-4.25] and 2.24[1.25-4.01]). Women covered by the specific health insurance (HI) for precarious or undocumented migrants were also at higher risk (aOR = 2.07[1.10-3.89] and 2.69[1.18-6.10], respectively). The risk was also increased in men who remained for at least one year without permit of residence or without HI and among those who were threatened in their country. Conclusion Refusals to provide healthcare are frequent and deleterious situations especially for migrants living with HIV. Health decision makers, public insurance bodies and health professional councils must address this issue to improve equity in the healthcare system.
Collapse
Affiliation(s)
- Nicolas Vignier
- Department of Social Epidemiology, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, Paris, France.,Department of Infectious and Tropical Diseases, Groupe hospitalier Sud Ile-de-France, Sorbonne Université, Melun, France
| | - Rosemary Dray Spira
- Department of Social Epidemiology, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, Paris, France
| | - Julie Pannetier
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - Andrainolo Ravalihasy
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - Anne Gosselin
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - France Lert
- Center for Research in Epidemiology and Population Health (CESP-U 1018), INSERM, Université Paris Sud, Villejuif, France
| | - Nathalie Lydie
- Direction de la prévention et de la promotion de la santé-Unité Santé sexuelle, Santé Publique France, French National Agency of Public Health, Saint-Maurice, France
| | - Olivier Bouchaud
- Department of Infectious and Tropical diseases, and Laboratoire Educations et Pratiques de Santé (LEPS EA 3412), Paris 13 University, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Annabel Desgrees Du Lou
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - Pierre Chauvin
- Department of Social Epidemiology, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, Paris, France
| | | |
Collapse
|
31
|
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.
Collapse
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
| |
Collapse
|
32
|
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.
Collapse
|
33
|
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
|
34
|
Traoré M, Vallée J, Chauvin P. Prise en compte des multiples quartiers d’activité dans l’étude des inégalités socio-territoriales de santé dans le Grand Paris : l’exemple du recours au frottis cervico-utérin. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2018.12.023] [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: 11/29/2022] Open
|
35
|
Vignier N, Desgrees Du Lou A, Pannetier J, Ravalihasy A, Gosselin A, Lert F, Lydie N, Bouchaud O, Dray Spira R, Chauvin P. Social and structural factors and engagement in HIV care of sub-Saharan African migrants diagnosed with HIV in the Paris region. AIDS Care 2019; 31:897-907. [PMID: 30709323 DOI: 10.1080/09540121.2019.1576842] [Citation(s) in RCA: 4] [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: 10/27/2022]
Abstract
Migrants from sub-Saharan Africa (SSA) are often diagnosed at an advanced stage of HIV, and many of them have harsh living conditions. We aimed to evaluate the entry into care after HIV diagnosis and examine the related social determinants. The ANRS PARCOURS study is a life-event survey conducted in 2012-2013 in the Paris region among. Time between HIV diagnosis of SSA migrants living diagnosed HIV positive in France and HIV care and the determinants was assessed yearly by using mixed-effects logistic regression models. Among a total of 792 participants, 94.2% engaged in HIV care within the year of HIV diagnosis, 4.3% in the following year and 2.5% beyond the second year after diagnosis. The participants were more likely to engage in HIV care during years when they were effectively covered by health insurance and if the HIV test was carried out at the initiative of the doctor. Immigration for economic reasons or owing to threats in his/her country of origin was associated with delayed engagement in HIV care. Additionally, 4.3% of treated participants discontinued HIV care at least once at the time of the survey and more often if diagnosed at an advanced HIV disease stage and financially dependent.
Collapse
Affiliation(s)
- Nicolas Vignier
- a Department of Social Epidemiology , INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Paris , France.,b Department of Infectious and Tropical Diseases , Groupe hospitalier Sud Ile-de-France , Melun , France
| | | | - Julie Pannetier
- c IRD, INSERM , Université Paris Descartes, CEPED, SAGESUD team , Paris , France
| | | | - Anne Gosselin
- c IRD, INSERM , Université Paris Descartes, CEPED, SAGESUD team , Paris , France
| | - France Lert
- d INSERM , Center for Research in Epidemiology and Population Health (CESP-U 1018) , Villejuif , France
| | - Nathalie Lydie
- e Santé Publique France , French National Agency of Public Health , Saint-Maurice , France
| | - Olivier Bouchaud
- f Department of Infectious and Tropical diseases, and Laboratoire Educations et Pratiques de Santé (LEPS EA 3412) , Paris 13 University, Assistance Publique-Hôpitaux de Paris (AP-HP), Avicenne Hospital , Bobigny , France
| | - Rosemary Dray Spira
- a Department of Social Epidemiology , INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Paris , France
| | - Pierre Chauvin
- a Department of Social Epidemiology , INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Paris , France
| | | |
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
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.
Collapse
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
| |
Collapse
|
38
|
Vanhaesebrouck A, Vuillermoz C, Robert S, Parizot I, Chauvin P. Who self-medicates? Results from structural equation modeling in the Greater Paris area, France. PLoS One 2018; 13:e0208632. [PMID: 30557334 PMCID: PMC6296538 DOI: 10.1371/journal.pone.0208632] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 07/03/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Our study aimed to describe the prevalence of self-medication among the Paris adult population and to identify the factors associated with self-medication. MATERIALS AND METHODS This cross-sectional study was based on data collected from the SIRS cohort (a French acronym for "Health, inequalities and social ruptures") in 2005 in the Paris metropolitan area using a face-to-face administration questionnaire among a representative sample of 3,023 French-speaking adults. Structural equation models were used to investigate the factors associated with self-medication in the overall population and according to income. RESULTS The prevalence of self-medication in the past four weeks was 53.5% in the Paris metropolitan area. Seven factors were directly associated with self-medication in the structural equation model. Self-medication was found more common among women, young people, in active employment or student, with a high income, but also among people with a health information seeking behavior, with a high daily mobility, and/or with a history of unmet healthcare needs due to economic reasons. When looking at these coefficients according to income, the association between self-medication and daily mobility appeared stronger in the bottom quartile of income whereas it was no longer significant in the rest of the survey population. CONCLUSION Self-medication is a frequent practice in the Paris metropolitan area. This study confirms the role of some factors found to be associated with self-medication in the literature such as age or gender and draws attention to other factors rarely explored such as daily mobility, especially among people with a low income, or health information seeking behavior.
Collapse
Affiliation(s)
- A. Vanhaesebrouck
- Department of Social Epidemiology, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), INSERM, Sorbonne Université, Paris, France
| | - C. Vuillermoz
- Department of Social Epidemiology, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), INSERM, Sorbonne Université, Paris, France
- Research team on social inequalities, Centre Maurice Halbwachs (UMR 8097), CNRS, EHESS, ENS, Paris, France
| | - S. Robert
- Department of Social Epidemiology, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), INSERM, Sorbonne Université, Paris, France
- Department of General Practice, Sorbonne Université, Paris, France
| | - I. Parizot
- Research team on social inequalities, Centre Maurice Halbwachs (UMR 8097), CNRS, EHESS, ENS, Paris, France
| | - P. Chauvin
- Department of Social Epidemiology, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), INSERM, Sorbonne Université, Paris, France
| |
Collapse
|
39
|
Crampe-Casnabet C, Franck JE, Ringa V, Coeuret-Pellicer M, Chauvin P, Menvielle G. Role of obesity in differences in cervical cancer screening rates by migration history. The CONSTANCES survey. Cancer Epidemiol 2018; 58:98-103. [PMID: 30530110 DOI: 10.1016/j.canep.2018.11.009] [Citation(s) in RCA: 5] [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] [Received: 06/15/2018] [Revised: 11/02/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immigrant women often have lower cervical cancer screening (CCS) rates, tend to have a higher body mass index (BMI) and may be more vulnerable to BMI-related stigmatization. Our aim was to assess the role of BMI in differences in CCS rates by migration history. METHODS Analyses were based on the 2012-2015 inclusion data (n = 27,226) for the population-based CONSTANCES cohort, including detailed, self-reported information on demographics and socioeconomic characteristics, migration history, health behaviours, health, and health care use. Measured BMI (underweight (<18.5), normal-weight (18.5-25), overweight (25-30), obese (>30)) was collected. Poisson regression models with robust variance were conducted to assess the contribution of BMI to differences in CCS rates by migration history, and analyses stratified by BMI were done. Multiple imputations were performed. RESULTS The CCS rates ranged from 87% among French-born women with two French parents to 86% among French-born women with at least one parent of foreign origin, 82% among naturalized immigrants and 74% among non-naturalized immigrants. After adjusting for covariates, non-naturalized immigrants showed an 11% (95% CI: 8%-14%) lower CCS rate than French-born women with two French parents. Adjusting for BMI did not change the estimates. When stratifying by BMI category, non-naturalized immigrants showed an 11% (7%-14%) lower CCS rate then French-born with two French parents when normal weight, a 9% (2%-16%) lower CCS rate when overweight, and an 18% (5%-30%) lower CCS rate when obese. CONCLUSION Migration history and BMI jointly impact CCS rates. They were lower among all non-naturalized immigrants, particularly those who were obese.
Collapse
Affiliation(s)
- Cyrielle Crampe-Casnabet
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| | - Jeanna-Eve Franck
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| | - Virginie Ringa
- CESP, INSERM U1018, Univ Paris-Saclay, Univ Paris-Sud, UVSQ, Villejuif, France.
| | - Mireille Coeuret-Pellicer
- Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France; University of Versailles St-Quentin, UMRS 1018, Villejuif, France.
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| | - Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| |
Collapse
|
40
|
Motreff Y, Pirard P, Baubet T, Chauvin P, Vandentorren S. Mental health impact on first responders of the November 2015 Paris terror attacks. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Motreff
- Santé publique France, Saint-Maurice, France
| | - P Pirard
- Santé publique France, Saint-Maurice, France
| | - T Baubet
- CESP, Inserm 1178, Université Paris 13, Bobigny, France
| | - P Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | | |
Collapse
|
41
|
Vuillermoz C, Baubet T, Lesieur S, Sanna A, Motreff Y, Pirard P, Chauvin P, Vandentorren S. Health, work and social life impacts of January 2015 terrorist attacks in Paris on victim’s relatives; 6 and 18 months after events. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Vuillermoz
- CNRS, Centre Maurice Halbwachs, Department of Social Inequalities, Paris, France
| | - T Baubet
- INSERM, Université Paris 13, Paris, France
- Hôpital Avicenne, Bobigny, France
| | - S Lesieur
- INSERM, Sorbonne Universités UPMC, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - A Sanna
- Santé publique France, Saint-Maurice, France
| | - Y Motreff
- Santé publique France, Saint-Maurice, France
| | - P Pirard
- Santé publique France, Saint-Maurice, France
| | - P Chauvin
- INSERM, Sorbonne Universités UPMC, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | | |
Collapse
|
42
|
Vandentorren S, Roze M, Chauvin P, Rezzoug D, Baubet T, Melchior M. Post-Traumatic Stress Disorders in homeless migrant women in the Paris region. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Vandentorren
- Santé Publique France, French National Public Health Agency, Regional unit (Cire) Ile-de-France, Paris, France
| | | | | | | | | | | |
Collapse
|
43
|
Scherpereel A, Durand-Zaleski I, Cotté FE, Fernandes J, Debieuvre D, Blein C, Gaudin AF, Tournier C, Vainchtock A, Chauvin P, Souquet PJ, Westeel V, Chouaïd C. Access to innovative drugs for metastatic lung cancer treatment in a French nationwide cohort: the TERRITOIRE study. BMC Cancer 2018; 18:1013. [PMID: 30348130 PMCID: PMC6196460 DOI: 10.1186/s12885-018-4958-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/22/2018] [Accepted: 10/16/2018] [Indexed: 12/20/2022] Open
Abstract
Background Territorial differences in the access to innovative anticancer drugs have been reported from many countries. The objectives of this study were to evaluate access to innovative treatments for metastatic lung cancer in France, and to assess whether socioeconomic indicators were predictors of access at the level of the municipality of residence. Methods All incident cases of metastatic lung cancer hospitalised for a chemotherapy in public hospitals in 2011 were identified from the French National Hospital discharge database. Information on prescription of innovative drugs from an associated database (FICHCOMP) was crossed with the population density of the municipality and a social deprivation index based on national census data. Results Overall, 21,974 incident cases of metastatic lung cancer were identified, all of whom were followed for 2 years. Of the 11,486 analysable patients receiving chemotherapy in the public sector, 6959 were treated with a FICHCOMP drug at least once, principally pemetrexed. In multivariate analysis, prescription of FICHCOMP drugs was less frequent in patients ≥66 years compared to those ≤55 years (odds ratio: 0.49 [0.44–0.55]), in men compared to women (0.86 [0.79–0.94]) and in patients with renal insufficiency (0.55 [0.41–0.73]) and other comorbidities. Prescription rates were also associated with social deprivation, being lowest in the most deprived municipalities compared to the most privileged municipalities (odds ratio: 0.82 [0.72–0.92]). No association was observed between the population density of the municipality and access to innovative drugs. Conclusion Although access to innovative medication in France seems to be relatively equitable, social deprivation is associated with poorer access. The reasons for this need to be investigated and addressed.
Collapse
Affiliation(s)
- Arnaud Scherpereel
- Pulmonary and Thoracic Oncology Department, CHU de Lille, Lille University, Lille, France
| | - Isabelle Durand-Zaleski
- URCEco Île-de-France, Hôtel-Dieu Hospital, Paris, France.,Department of Public Health, Henri-Mondor Hospital, Créteil, France
| | - François-Emery Cotté
- Health Economics and Outcomes Research, Laboratoire Bristol-Myers Squibb, Rueil-Malmaison, France.
| | | | - Didier Debieuvre
- Department of Chest Medicine, GHRMSA, Emile Muller Hospital, Mulhouse, France
| | | | - Anne-Françoise Gaudin
- Health Economics and Outcomes Research, Laboratoire Bristol-Myers Squibb, Rueil-Malmaison, France
| | | | | | - Pierre Chauvin
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, Sorbonne Universités, UPMC Université Paris 06, INSERM, Paris, France
| | - Pierre-Jean Souquet
- Department of Chest Medicine, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - Virginie Westeel
- Department of Chest Medicine, Jean Minjoz University Hospital, Besançon, France
| | - Christos Chouaïd
- Department of Chest Medicine, Créteil University Hospital, Créteil, France
| |
Collapse
|
44
|
Gossec L, Berenbaum F, Chauvin P, Hudry C, Cukierman G, de Chalus T, Dreuillet C, Saulot V, Tong S, Russo-Marie F, Joubert JM, Saraux A. Correction to: Development and application of a questionnaire to assess patient beliefs in rheumatoid arthritis and axial spondyloarthritis. Clin Rheumatol 2018; 37:2659. [PMID: 30143962 PMCID: PMC6154104 DOI: 10.1007/s10067-018-4241-9] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The original version of this article was revised due to a retrospective Open Access order.
Collapse
Affiliation(s)
- Laure Gossec
- Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (INSERM UMRS 1136), GRC-UPMC 08 (EEMOIS), Paris, France.
- Service de rhumatologie, Hôpital Pitié Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Francis Berenbaum
- Sorbonne Université, INSERM, Paris, France
- Department of Rheumatology, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Pierre Chauvin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), Department of Social Epidemiology, Sorbonne Universités, Paris, France
| | - Christophe Hudry
- Department of Rheumatology, Hôpital Cochin, AP-HP, Paris, France
| | | | | | | | | | | | | | | | - Alain Saraux
- Department of Rheumatology, CHU de la Cavale-Blanche, Brest, France
- INSERM, LabEx IGO, UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Brest, France
| |
Collapse
|
45
|
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.
Collapse
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
| |
Collapse
|
46
|
Vandentorren S, Chauvin P. Health and Health Care for Homeless People in Various Contexts. Int J Environ Res Public Health 2018; 15:ijerph15050948. [PMID: 29747459 PMCID: PMC5981987 DOI: 10.3390/ijerph15050948] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Stéphanie Vandentorren
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, 75012 Paris, France.
- Santé Publique France, French National Public Health Agency, 94410 Saint-Maurice, France.
- Observatoire du Samusocial de Paris, 75012 Paris, France.
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, 75012 Paris, France.
| |
Collapse
|
47
|
Vandentorren S, Pirard P, Sanna A, Aubert L, Motreff Y, Dantchev N, Lesieur S, Chauvin P, Baubet T. Impacts psychotraumatiques et prise en charge thérapeutique des personnes impliquées dans les attentats de janvier 2015 en Île-de-France. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.329] [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: 10/17/2022] Open
|
48
|
Guiguet M, Dionou S, Volant J, Samba MC, Benammar N, Chauvin P, Simon A. Men from Sub-Saharan Africa Living in Worker Hostels in France: A Hidden Population with Poor Access to HIV Testing. J Immigr Minor Health 2018; 19:991-994. [PMID: 26979169 DOI: 10.1007/s10903-016-0385-3] [Citation(s) in RCA: 5] [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: 12/27/2022]
Abstract
Delayed presentation to care among HIV-infected individuals continued to be frequent in France. Migrants are at high risk for late presentation. This cross-sectional study investigated barriers to HIV testing in the specific population of men from sub-Saharan Africa living in four migrant worker hostels in Paris, France. Factors associated with never having been tested for HIV were examined using logistic regression. In all, 550 men participated, coming mainly from Mali and Senegal, with 31 % having lived in France for less than 5 years, and 25 % without any health insurance. Only 37 % have ever been tested for HIV. Not having health insurance was the main risk factor for never-testing [adjusted odds ratio (aOR) 2.4; 95 % confidence interval (CI) 1.4-4.0]. Despite free and anonymous HIV testing available at dedicated public screening centers, 63 % of men living in migrant worker hostels had never been tested for HIV.
Collapse
Affiliation(s)
- M Guiguet
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Pierre Louis Institute of Epidemiology and Public Health, (IPLESP UMRS 1136), 75013, Paris, France.
| | - S Dionou
- CDAG-Department of Internal Medicine and Clinical Immunology, AP-HP, Hôpital Pitié Salpêtrière, 75013, Paris, France.,COREVIH Ile-de-France Centre, 75013, Paris, France
| | - J Volant
- Fédération SOS Hépatite, 75020, Paris, France
| | - M C Samba
- CDAG-Department of Internal Medicine and Clinical Immunology, AP-HP, Hôpital Pitié Salpêtrière, 75013, Paris, France
| | - N Benammar
- CDAG-Department of Internal Medicine and Clinical Immunology, AP-HP, Hôpital Pitié Salpêtrière, 75013, Paris, France
| | - P Chauvin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Pierre Louis Institute of Epidemiology and Public Health, (IPLESP UMRS 1136), 75013, Paris, France
| | - A Simon
- CDAG-Department of Internal Medicine and Clinical Immunology, AP-HP, Hôpital Pitié Salpêtrière, 75013, Paris, France
| |
Collapse
|
49
|
Vandentorren S, Pirard P, Sanna A, Aubert L, Motreff Y, Dantchev N, Lesieur S, Chauvin P, Baubet T. Healthcare provision and the psychological, somatic and social impact on people involved in the terror attacks in January 2015 in Paris: cohort study. Br J Psychiatry 2018; 212:207-214. [PMID: 29557760 DOI: 10.1192/bjp.2017.63] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Terrorist attacks occurred in Paris in January 2015. Aims To assess the mental health impact and the access to psychomedical care of people exposed to the attacks. METHOD We implemented an open-cohort design 6 and 18 months after the attacks. Exposed civilians and rescue workers were included according to the exposure criteria A for post-traumatic stress disorder (PTSD) in DSM-5. A face-to-face questionnaire conducted by trained psychologists was used to collect sociodemographic characteristics, exposure level, scores on psychometric scales, an international neuropsychiatric interview and access to care. RESULTS Six months after the attacks, 18% of civilians reported symptoms of PTSD, 31% had anxiety disorders and 11% depression. Among rescue workers, 3% reported symptoms of PTSD and 14% anxiety disorders. During the 48 h following the attacks, 53.2% of civilian had access to psychomedical care v. 35% of rescue and police staff. CONCLUSIONS We found severe psychological consequences, even in people who were less exposed. Declaration of interest None.
Collapse
Affiliation(s)
- Stephanie Vandentorren
- Direction of Regional Office,Santé publique France,The French Public Health Agency,Saint Maurice,France and INSERM,Sorbonne Université,Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP,Department of social epidemiology,Paris,France
| | - Philippe Pirard
- Direction of chronic diseases and injuries,Santé publique France,The French Public Health Agency,Saint Maurice cedex,France
| | - Alice Sanna
- Direction of Regional Office,Santé publique France,The French Public Health Agency,Saint Maurice cedex,France
| | - Lyderic Aubert
- Direction of Regional Office,Santé publique France,The French Public Health Agency,Saint Maurice cedex,France
| | - Yvon Motreff
- Direction of chronic diseases and injuries,Santé publique France,The French Public Health Agency,Saint Maurice cedex,France
| | | | - Sophie Lesieur
- INSERM,Sorbonne Université,Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP,Department of social epidemiology,France
| | - Pierre Chauvin
- INSERM,Sorbonne Université,Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP,Department of social epidemiology,France
| | - Thierry Baubet
- PHD,CESP Inserm 1178,Université Paris 13,Paris,France and Hopital Avicenne,Bobigny,France
| |
Collapse
|
50
|
Darbeda S, Falissard B, Orri M, Barry C, Melchior M, Chauvin P, Vandentorren S. Adaptive Behavior of Sheltered Homeless Children in the French ENFAMS Survey. Am J Public Health 2018; 108:503-510. [PMID: 29470117 DOI: 10.2105/ajph.2017.304255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To describe the adaptive behaviors in a large sample of homeless children and identify factors associated with developmental delay. METHODS Data were from a cross-sectional survey of 557 children younger than 6 years randomly sampled among homeless sheltered families in the Paris region, France (January-May 2013). An interviewer and a psychologist conducted face-to-face interviews to collect information on sociodemographic and health characteristics. We assessed adaptive behaviors using the Vineland Adaptive Behavior Scales, second edition (VABS-II). RESULTS The mean VABS-II composite score (SD) was 75.4 (12.0), and most participating children (80.9%) were considered developmentally delayed. Characteristics negatively associated with children's developmental score were age, birth in a country other than France, low birth weight, and past-year hospitalization. CONCLUSIONS There is a high prevalence of developmental delays among children growing up homeless. Public Health Implications. Long-term integrated programs improving parenting and children's opportunities for stimulation and socialization should be developed in daycare centers, schools, shelters, and medical practices to minimize negative effects of early living conditions on children's development.
Collapse
Affiliation(s)
- Stéphane Darbeda
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Bruno Falissard
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Massimiliano Orri
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Caroline Barry
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Maria Melchior
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Pierre Chauvin
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Stéphanie Vandentorren
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| |
Collapse
|