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What are the determinants of functional decline in older adults with cancer? Results from the INCAPAC study
No full textInternational audienceINTRODUCTION: Older adults with cancer are exposed to greater difficulties in carrying out their daily activities due to cancer itself, its treatment, or both. The aim of this study was to describe functional decline after cancer diagnosis and to investigate the determinants of this decline among older individuals with cancer. MATERIALS AND METHODS: Using the Gironde cancer registries, older subjects (≥65 years) with a diagnosis of cancer between 2005 and 2018 were identified in three prospective cohorts on aging. Functional decline was defined as an increase of 1 point for Activities of Daily Living (ADL), 2 points for Instrumental Activities of Daily Living (IADL), and 3 points for the overall score (ADL + IADL) between cancer pre- and post-diagnosis visits. Logistic regression models were used to identify determinants of functional decline among older subjects who underwent a post-diagnostic assessment. Additionally, multinomial logistic regression models were performed to account for individuals who had died prior to the post-diagnostic cancer visit. RESULTS: A total of 306 individuals followed-up after the cancer diagnosis were included (median age at cancer diagnosis: 83; 44 % female). Older age at cancer, low educational level, impaired initial functional status, and poor five-year cancer-related prognosis were significantly associated with functional decline across all three scores. Multinomial logistic regression analyses (n = 489) yielded similar results, but only cancer-related factors, specifically unfavorable vital prognosis, were associated with higher risk of death. DISCUSSION: Functional decline in older individuals with cancer is both multifactorial and multidimensional. Further studies are needed to disentangle the effects of cancer and aging
Étude comparative des matériaux et des colorants dans les manufactures royales de tapisserie (Gobelins, Beauvais et Aubusson)
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Changes in the Ambulatory Use of Antibiotics in France Due to the COVID-19 Pandemic in 2020-2022: A Nationwide Time-Series Analysis
No full textInternational audienceWe estimated the changes in the ambulatory use of antibiotics in France due to the COVID-19 pandemic in 2020-2022 by conducting time-series analyses using nationwide data from French health insurance databases. We examined all systemic antibiotics dispensed from January 1, 2010 through March 31, 2022. Use of most antibiotics decreased during the 3-month period following the start of first lockdown (March 17, 2020), and these decreases persisted 12 months later. Some initial increases indicated potential stockpiling for antibiotics used for chronic indications. Azithromycin constituted a noticeable exception. In a context of reduced circulation of non-COVID-19 viruses, the observed decreases compared with forecasts could partly reflect habitual overuse of certain antibiotics
Attentes et croyances des aidants avant une intervention ESA en Lot-et-Garonne
No full textIntroduction: created by the 2008-2012 Alzheimer's plan, the ESA offers home rehabilitation sessions. It is aimed at patients suffering from Alzheimer's disease and related disorders, which cause symptoms that are difficult for caregiver to understand and cope with. Method: we carried out a qualitative study of caregiver in the Lot et Garonne region prior to ESA treatment, using semi-directed interviews, followed by analysis using grounded theory until the data were saturated. Recruitment was carried out by the three partner associations, shortly before their intervention. Results: eighteen interviews were conducted. Caregivers’ expectations varied according to their age, their relationship with the patient, their experience of being a caregiver and illness. Many caregivers hoped for stimulation leading to stabilisation or improvement in cognitive status, often in relation to the autonomy of the patient. They expect information and training on symptoms, as well as home ergonomics. The initiation of assistance, social expertise and overall support are also part of the expectations. Few beliefs emerged, including doubts about the expected effectiveness and apprehension about the reaction of the patient to the intervention. The difficulties associated with being a caregiver had a considerable impact on this work. Conclusion: the main expectations of caregivers prior to an ESA intervention are stimulation of the patient, information and training for themselves.Introduction : créée par le plan Alzheimer 2008-2012, l’ESA propose des séances de réhabilitation à domicile. Elle est à destination de patients atteints de la maladie d’Alzheimer et apparentées, qui sont à l’origine de symptômes difficiles à comprendre et à vivre par l’aidant. Méthode : nous avons mené une étude qualitative auprès des aidants de patients Lot et Garonnais avant une prise en charge ESA par entretiens semi-dirigés, puis une analyse selon la théorisation ancrée jusqu’à saturation des données. Le recrutement s’est fait par les trois associations partenaires, peu avant leur intervention. Résultats : dix-huit entretiens ont été menés. Les attentes des aidants varient selon l’âge, la relation avec l’aidé, le vécu du statut d’aidant et la maladie. De nombreux aidants espèrent une stimulation entraînant une stabilisation ou une amélioration de l’état cognitif souvent en lien avec l’autonomie de l’aidé. Il est attendu une information et une formation face aux symptômes, ainsi que l’ergonomie du domicile. L’initiation d’aides, l’expertise sociale et le soutien global font aussi partie des attentes. Peu de croyances ont émergé, dont le doute dans l’efficacité attendue et l’appréhension de la réaction de l’aidé à l’intervention. Les difficultés en rapport avec le statut d’aidant ont considérablement marqué ce travail. Conclusion : les aidants de patients avant une intervention ESA attendent principalement la stimulation de l’aidé, une information et une formation pour eux-mêmes
Des dimensions sensibles de l’activité essentielles en prévention : corps et désaccords des agriculteurs
No full textInternational audienceIn prevention processes associated with pesticide risk in agricultural settings, attention is overly focused on the expected benefits of technical prevention measures, to the detriment of a nuanced understanding of pesticide usage and their effects on the health of farmers who use them. Almost like putting the cart before the horse by trying to solve a problem before it has been properly understood and analyzed. A comprehensive approach rooted in ergonomics and anthropology aims to restore this balance and start from the analysis of work activity and the observation of working bodies in motion. In this article, we use these two approaches to understand and highlight the actual and sensitive work of farmers in the use of personal protective equipment (PPE). We show how PPE has become a focal point that may occult the broader issues of using approved toxic products and managing exposure risks in the context of a widely held collective belief that wearing PPE actually protects de facto. Through theseobjects, the formal and informal, material and immaterial dimensions of toxic risk regulation practices play out. These dimensions must be taken into account in the design of truly effective prevention measures. However, to bring prevention processes out of compensation and technique-based logics – which fail in practice – the invisible and sensitive dimensions that come into play in the development of self-preservation practices need to be documented and valued. The sensitive reading proposed here, by complementing the anthropotechnologicaland ergotoxicological approaches with an anthropology of the senses and drawing inspiration from an emerging philosophy of the body in dance, seeks to transcend the dualistic and cognitivist boundaries that prevent us from grasping the sensory depth of bodies engaged in activity analysis. In this sense, the use of a choreographic perspective seems relevant not only in the analysis of the technical practices of people in activity but also with a transformative aim, serving as an intermediary object of intervention and design.Dans les processus de prévention associés au risque pesticides en milieu agricole, l’attention se focalise trop sur les bénéfices escomptés de mesures de prévention d’ordre technique, au détriment d’une compréhension fine des usages et des effets de ces mesures sur la santé des agriculteurs. Dans cet article, nous mobilisons des approches compréhensives ancrées dans l’ergonomie et l’anthropologie pour appréhender et donner à voir le travail réel et sensible des agriculteurs dans les situations d’usage des équipements de protection individuelle (EPI). Nous montrons comment les EPI cristallisent plus largement les problématiques qui préoccupent les agriculteurs vis-à-vis de produits toxiques homologués dans le contexte d’une croyance collective répandue selon laquelle le fait de porter des EPI protégerait de fait. À travers ces objets se jouent les dimensions formelles et informelles, matérielles et immatérielles des pratiques de régulation des risques toxiques. Cette contribution invite à revisiter les paradigmes actuels de prévention et à investir le travail réel par l’observation des corps en gestes et l’appréhension des dimensions sensibles de l’activité au-delà des données de laboratoire relatives à l’efficacité de tel ou tel EPI
Semi-Supervised Learning for Lensed Quasar Detection
No full textInternational audienceLensed quasars are key to many areas of study in astronomy, offering a unique probe into the intermediate and far universe. However, finding lensed quasars has proved difficult despite significant efforts from large collaborations. These challenges have limited catalogues of confirmed lensed quasars to the hundreds, despite theoretical predictions that they should be many times more numerous. We train machine learning classifiers to discover lensed quasar candidates. By using semi-supervised learning techniques we leverage the large number of potential candidates as unlabelled training data alongside the small number of known objects, greatly improving model performance. We present our two most successful models: (1) a variational autoencoder trained on millions of quasars to reduce the dimensionality of images for input to a gradient boosting classifier that can make accurate predictions and (2) a convolutional neural network trained on a mix of labelled and unlabelled data via virtual adversarial training. These models are both capable of producing high-quality candidates, as evidenced by our discovery of GRALJ140833.73+042229.98. The success of our classifier, which uses only images, is particularly exciting as it can be combined with existing classifiers, which use other data than images, to improve the classifications of both models and discover more lensed quasars
Tropical Nature. Colonial and Post-Colonial Conservation in Africa and Asia
No full textInternational audienceAcross Africa and South-East Asia, the impulse to protect nature often dovetails with the domination of local people. From mass displacement to severe restrictions on land use and daily acts of violence, conservation work risks reproducing Eurocentric modes of colonialism and worsening the effects of the climate crisis. In this insightful and wide-ranging study of the colonial history of conservation, Tropical Nature seeks to provide a much-needed history of the Global South from its own perspective. Comparing case studies ranging from Ali Bongo’s Gabon, to the postcolonial African itinerary of the agronomist Arthur Bunting, this volume advances a “small-scale global history” that deciphers the relations binding human societies to the non-human world
Health-Related Quality of Life in Long-Term Survivors of Non-Hodgkin Lymphoma: A French Population-Based Study
No full textInternational audienceBackground/Objectives: Non-Hodgkin lymphoma (NHL) represents 63% of all hematological malignancies in France, with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) being the two most frequent forms. With the improvement of therapeutics, the issue of health-related quality of life (HRQoL) is becoming increasingly crucial for these patients. The aim was to compare HRQoL of NHL survivors with that of the general French population and to identify factors associated with HRQoL in NHL survivors. Methods: We conducted a population-based study among living patients from three registries of hematological malignancies, using standardized questionnaires, including the SF-12, in September 2023. The data collected were compared to those of a normative general French cohort. Results: In total, 493 patients completed the study questionnaires, yielding a response rate of 36%. The median time since diagnosis was 8 years (IQR 6-10) These NHL survivors reported lower HRQoL compared to the general French population, except in terms of bodily pain (p < 0.01). Each one-year increase in the time since diagnosis was associated with an increase in social functioning (p = 0.009). Men had better general health (p = 0.01) and less bodily pain (p = 0.007) than women. Higher income was associated with better HRQoL (p < 0.01). Underweight or obesity were associated with poorer physical functioning (p = 0.008). The presence of comorbidities, socioeconomic deprivation, anxiety, and depression were associated with poorer HRQoL (p < 0.01). Conclusions: This study provides valuable information of HRQoL values for comparison in further follow-up studies and proposes measures that could be implemented to improve the HRQoL of NHL survivors
Exploring heat risk in pregnant women: do environmental and social inequalities amplify heat exposure?
No full textInternational audienceHeat exposure in pregnancy has been associated with mother-child health. However, characterization of exposure to heat in pregnant women and its associated factors, such as air pollution, vegetation or social stressors, is lacking. We aimed to describe heat exposure according to air pollution and vegetation co-exposures, individual social position and socio-economic context of residence among French pregnant women. We studied 12,235 pregnant women from four mother-child cohorts. Exposure to heat (intensity, duration, severity), particulate matter, nitrogen dioxide (NO2), ozone (O3), and vegetation during summer were estimated at the women's residences. Socio-economic context of residence was assessed using the European Deprivation Index (EDI). Cumulative overexposure to heat, air pollution and vegetation were estimated according to reference values. Three profiles of heat exposure, multi-exposure and individual social position, were created using multivariate analysis and unsupervised clustering. Associations of the profiles of heat exposure and multi-exposure with air pollution, vegetation, individual social position and EDI were described using Wilcoxon tests and polytomous regressions. About one-third of pregnant women had a high heat exposure profile combining intense, severe and durable exposure. Depending on the location and year of pregnancy, 27-88% of women were overexposed to heat, air pollution and lack of vegetation. The relationships between profiles of heat and multi-exposure with air pollution, vegetation and individual social position and socioeconomic context of residence depended on the geographical and temporal context. No clear differential exposure pattern across social strata was found. Co-exposure to heat, air pollution and lack of vegetation is common among French pregnant women. Protective measures against summer heat would apply to all pregnant women, as heat exposure represents a universal risk, regardless of socioeconomic status. This research supports future epidemiological studies on combined effects of heat and co-exposures on pregnancy outcomes