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Worldwide trends in hyperuricaemia from 2000 to 2023: a systematic review and modelling analysis
No full textInternational audienceHyperuricaemia is not currently included in major global health surveillance frameworks, including the Global Burden of Diseases, Injuries, and Risk Factors Study, despite its well established clinical associations with non-communicable diseases. The absence of harmonised, comparable sex-specific prevalence estimates of hyperuricaemia across countries has limited its visibility in public health planning and prevention strategies. We aimed to provide the first standardised, sex-specific, global, regional, and national estimates of hyperuricaemia prevalence and cases from 2000 to 2023.MethodsFor this systematic review and modelling analysis, we searched PubMed, EMBASE, and Global Index Medicus for population-based studies reporting hyperuricaemia prevalence in adults between Jan 1, 2000, and April 8, 2025, without any language restrictions. Accounting for age, sex, hyperuricaemia diagnostic thresholds, urbanisation, and national income, prevalence estimates were generated with Bayesian hierarchical metaregression for 200 countries and territories from 2000 to 2023, with uncertainty expressed as 95% credible intervals (CrIs). No individuals with lived experience of hyperuricaemia were involved in the design or conduct of the study. The protocol was registered with PROSPERO (CRD420251145761).FindingsWe included 402 reports (420 studies) comprising 709 prevalence data points from 7 488 451 adults in 34 countries. Globally, the prevalence of hyperuricaemia increased from 6·7% (95% CrI 5·0–9·5) to 11·2% (8·2–15·2) in women and from 12·3% (9·8–17·0) to 18·6% (14·6–25·1) in men between 2000 and 2023. Prevalent cases of hyperuricaemia rose from 126 million (95% CrI 93–178) to 305 million (222–414) in women and from 226 million (180–312) to 500 million (392–676) in men, with population growth and ageing explaining roughly half the increase. Prevalence was consistently higher in high-income and urban settings, and increased with age in both men and women, with sex differences narrowing in older age groups. Prevalence rose in all regions, with the largest absolute increases in Polynesia and Micronesia among women (9·2 [95% CrI 2·9–10·9] percentage points) and in East Asia among men (10·8 [10·7–10·9] percentage points). In 2023, regional prevalence in women ranged from 4·0% (95% CrI 2·8–5·9) in North Africa and the Middle East to 42·6% (17·3–61·9) in Polynesia and Micronesia, and in men it ranged from 7·5% (4·9–11·2) in central Asia to 36·5% (12·0–66·8) in Polynesia and Micronesia. South Asia had the highest number of prevalent cases in 2023 (102 million [95% CrI 33–196] women and 120 million [37–266] men). At the country level, between 2000 and 2023, prevalence increased in 199 countries and territories among women and in 195 countries and territories among men. In 2023, country-level prevalence ranged from 1·4% (95% CrI 1·0–2·1) in Yemen to 55·8% (22·6–75·8) in the Cook Islands among women, and from 3·7% (2·3–5·9) to 46·5% (14·2–78·6) in the same countries among men.InterpretationThe global prevalence and prevalent cases of hyperuricaemia have risen markedly over the past two decades in both men and women, driven by population growth, ageing, and increasing age-specific rates. Although substantial heterogeneity exists across regions and countries, prevalence is consistently higher in high-income and urban settings and increases with age. These findings highlight the need to integrate hyperuricaemia into non-communicable disease surveillance systems and to implement targeted prevention and early management strategies to mitigate the associated metabolic and cardiovascular complications
Recherche et formations spécifiques visant à améliorer la santé du travaillant en santé
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Des méthodes mixtes pour comprendre et expliquer la mise en œuvre différenciée d’une politique publique. Retour sur une enquête collective sur les politiques d’emploi des personnes en situation de handicap dans la fonction publique
No full textInternational audienceUsing mixed methods to understand and explain the differentiated implementation of public policy. A review of a collective study on employment policies for people with disabilities in the civil service. Relying on a twelve-year collective mixed-methods research process, this article examines the implementation of disability policy in matters of employment within the Civil Service. More precisely, this research seeks to understand and explain the differentiated appropriation of that public policy by individual institutions, through the mobilisation of an actor who has emerged as central: the “disability officer” (référent handicap). The article retraces this collective research process and highlights the contribution of the various methods used to build a body of knowledge around this research object. In an initial exploratory phase, the different qualitative studies conducted on the various forms taken by employment policies for disabled people made it possible to characterise the new figure of the “disability officer”. The second phase made it possible to objectify the heterogeneity of disability officers’ profiles and working conditions (level of qualification, age, scope of action, proportion of time devoted to the function, etc.) thanks to a statistical survey. This phase also measured the breadth of their missions and better identified the difficulties encountered (lack of time, need for training, feeling of isolation, need for recognition, etc.). Finally, the third phase, conducted as a complementary qualitative interview survey, deepened the understanding of professionals’ trajectories and modes of engagement, by identifying specific positions within institutions and working configurations that favour disability-employment policies.Résumé S’appuyant sur un processus de recherche collective en méthodes mixtes de douze années, cet article examine la mise en œuvre de la politique handicap en matière d’emploi dans la Fonction publique. Cette recherche vise plus précisément à comprendre et expliquer l’appropriation différenciée de cette politique publique selon les établissements, à travers la mobilisation d’un acteur apparu comme central : le « référent handicap ». L’article retrace ce processus de recherche collective et met en lumière l’apport des différentes méthodes mobilisées pour construire un corpus de connaissances autour de cet objet de recherche. Dans une première phase exploratoire, les différents travaux qualitatifs menés sur les déclinaisons des politiques d'emploi des personnes handicapées ont permis de caractériser la figure nouvelle du « référent handicap ». La deuxième phase a permis d’objectiver l’hétérogénéité des profils et des conditions de travail des référents handicap (niveau de diplôme, âge, périmètre d’action, quotité de temps dédié à la fonction…) grâce à une enquête statistique. Cette phase a également permis de mesurer l’étendue de leurs missions et de mieux cerner les difficultés rencontrées (manque de temps, besoin de formation, sentiment de solitude, besoin de reconnaissance…). Enfin, la troisième phase, menée sous la forme d’une enquête qualitative complémentaire par entretiens, a approfondi la compréhension des trajectoires et des modalités d’engagement des professionnels, en identifiant des positionnements spécifiques dans les établissements et des configurations de travail favorables aux politiques d’emploi des personnes handicapées
Reimagining Urban River Bathing in Europe: A Multisectoral and Interdisciplinary Dive Into Lyon's Rivers (France)
No full textInternational audienceUrban river bathing is re‐emerging across Europe, driven by social demand and climate change impacts. The Urban Bathing Consortium, an interdisciplinary and intersectoral consortium initiated at the University of Lyon (France), is at the forefront of studying the challenges and opportunities of creating and managing healthy, safe, and accessible river bathing spaces. Through interdisciplinary collaboration among researchers and stakeholders, the consortium proposed an analytical framework, identifying seven critical dimensions for urban river bathing: the history and revival of city‐river relationships, legal and regulatory frameworks, bathing water quality, river drowning risks, river ecosystems, social perspectives, and urban planning. By examining these dimensions with state‐of‐the‐art approaches and drawing on Lyon's experiences, the study provides scientific insights and practical recommendations for future sustainable urban river bathing development. These include revitalizing historical city‐river connections, aligning local regulations with EU guidance, advancing holistic microbial water quality control, enhancing safety measures, incorporating ecological considerations, balancing competing river uses in urban planning, and addressing social needs for inclusive river governance
Translation, validity, and reliability of the Arabic-language version of the 11-item Neglect and Abuse Scale (NAS) in community older adults
No full textInternational audienceObjectives: To validate the 11-item Neglect and Abuse Scale (NAS) in Arabic and establish its psychometric robustness within a sample of community older adult.Method: A cross-sectional study was conducted involving 539 Arabic-speaking older adults from Egypt. The total sample was divided randomly into two subsamples (1/3 for the EFA and 2/3 for the CFA).Results: The initial analysis of the unidimensional structure indicated poor fit. Consequently, an EFA using oblimin rotation was conducted, which revealed a clear two-factor structure, explaining 54% of the variance. The first factor captured neglect-related experiences (e.g. being deceived, neglected, or denied rights), while the second factor reflected more overt forms of abuse (e.g. physical or verbal assault, betrayal, sexual harassment). A CFA, conducted on the solution obtained in the EFA, demonstrated acceptable fit. Reliability assessments indicated a commendable level of internal consistency. Sex invariance results showed no significant differences between male and female participants in the measurement characteristics. Concurrent validity analysis indicated a moderate negative correlation between the NAS scores and resilience and quality of life scores.Conclusion: This research provides a reliable and valid instrument for identifying and assessing elder neglect and abuse among Arabic-speaking communities, thereby supporting effective prevention and intervention strategies
Ce que l’Amérique est en train de faire à sa science
No full texthttps://theconversation.comLes décisions de l’administration Trump ont violemment frappé les universités et la science américaines. Pourtant, le recul relatif de l’influence scientifique des États-Unis s’inscrit dans une trajectoire plus ancienn
Autour du Covid. Les atteintes aux libertés au nom de la santé publique : panorama international
No full textInternational audienceFaut-il instaurer un couvre-feu, confiner, cibler certaines populations, et pour combien de temps ? Faut-il privilégier des mesures limitées ou imposer des restrictions sévères ? Autant de dilemmes auxquels les gouvernements du monde entier ont été confrontés lors de la crise du Covid-19.Confinements, pass sanitaires, traçage numérique… Si ces mesures exceptionnelles ont pu paraître nécessaires, elles ont aussi soulevé de profondes interrogations sur l’équilibre entre protection collective et droits individuels. Cinq ans plus tard, les réponses demeurent incertaines. Pourtant, il est indispensable d’en tirer des enseignements : de l’avis des spécialistes, une nouvelle crise sanitaire surviendra. Et nul ne comprendrait qu’aucune leçon n’ait été tirée de cet événement ayant causé près de sept millions de morts.À la croisée du droit, de la médecine, de la sociologie, de la philosophie et de l’éthique, cet ouvrage pluridisciplinaire éclaire les enjeux internationaux, analyse les choix opérés et propose des pistes pour mieux concilier, demain, protection de la santé publique et respect des libertés individuelles
L’accès aux soins. Un universalisme contrarié.
No full textInternational audienceFondé sur l’universalité de l’assurance maladie, le système de santé français peine pourtant à garantir un accès aux soins effectif pour tous. Obstacles financiers, administratifs, sociaux et territoriaux se cumulent et renforcent les inégalités. Cet ouvrage analyse les limites de l’universalisme et éclaire les enjeux du débat public sur l’accès aux soins
High-stress paint-only bike lanes in U.S. cities: prevalence in 2024 and patterns of geographical variation over 442 municipalities
No full textInternational audiencePaint-only bike lanes are ubiquitous in U.S. cities, yet these facilities may not provide an inviting environment for bicyclists of all ages and abilities. Awareness of the stressfulness of these facilities would inform monitoring and evaluation in response to revised policy guidance.We estimated the prevalence of high traffic stress on paint-only bike lanes across 442 U.S. cities and examined patterns of variation in this measure across cities and regions. Using street-segment–level bicycling stress data created by PeopleForBikes and derived from OpenStreetMap data and established stress criteria, we defined high-stress prevalence as the proportion of total paint-only lane-miles (conventional and buffered) classified as high stress. We conducted robustness checks to assess the potential impact of missing roadway attributes on these estimates.After adjustment, 61% of the length of paint-only bike lanes nationwide was classified as high stress. Prevalence was highest in the South (65%) and West (64%) and lowest in the Northeast (25%). Segment-level analyses showed that nearly all low-stress paint-only lanes were located on roads with speed limits of 25 mph and a single motor-vehicle lane in each direction, whereas most paint-only lanes overall were installed on faster, multi-lane roadways. At the city level, high-stress prevalence was more strongly associated with where paint-only lanes were placed within the roadway hierarchy than with the composition of the broader roadway network.By documenting the prevalence and placement patterns of high-stress paint-only bike lanes, this study provides baseline descriptive information to inform monitoring and evaluation following recent shifts in design guidance
Towards a Europe-wide reconstruction and analysis of hospital networks
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