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Predicting recovery after stressors using step count data derived from activity monitors
No full textInternational audienceThis study examines the stressor-response process in physical activity among 226 participants across four countries. We analyzed their step count collected via activity monitors before and after a significant stressor: the COVID-19 lockdown. Results showed that a ‘local dynamic complexity’ metric significantly predicts the rate of recovery to pre-COVID levels of physical activity. These findings provide new opportunities for just-in-time interventions to support physical activity recovery after disruptive stressors
Une approche collective de la santé au cœur des territoires ruraux et insulaires de Bretagne : le savoir-faire communautaire des Semeurs de Santé
No full textLe projet « Les Semeurs de santé » est de mener des actions à la croisée de l’Education Thérapeutique, de l’éducation populaire et de la santé communautaire. Il est destiné aux personnes souffrant de maladies chroniques ou risquant d’en développer ainsi qu’à leurs aidants, dans des zones rurales et insulaires du territoire de démocratie en santé Lorient-Quimperlé.International audienceIntroduction: Thinking about health at the local level by involving local stakeholders makes it possible to move beyond the traditional sectoral boundaries to build meaningful interventions. This requires creating a supportive environment for collaboration . Les Semeurs de Santé seeks to address these challenges through a cooperative methodology that includes human support, training in cooperation, and a range of health-related actions . Methodology: Based on a case study approach combining different sources of qualitative data, this study (2018–2022) aims to document 1) the rollout of the intervention; 2) the contribution of each component to the creation of collaborative dynamics; and 3) the factors that influenced its implementation . Results: In each of the municipalities involved, groups of people got together to take action on the problems they themselves had identified. Each component of the intervention played a specific role in this mobilization. Two categories of factors were identified: 1) factors related to the implementation of the intervention itself and its ability to create a supportive environment for collective action; and 2) contextual factors related to the local context and the specific features of each municipality . Conclusion: Les Semeurs de Santé challenge the conditions of engagement and power relations within health systems. This experience shows that the collective dimension and citizen participation are intrinsically linked to encountering and recognizing others. It highlights the importance of learning processes as well as the need for continued investment .Introduction : L’approche territoriale de la santé permet de décloisonner et d’impliquer les acteurs locaux dans la construction d’une réponse singulière. Pour cela, les conditions nécessaires à la coopération doivent être réunies. L’intervention Les Semeurs de Santé entend répondre à ces enjeux en proposant une méthodologie coopérative constituée d’un accompagnement humain, d’une formation à la coopération et d’un panel d’actions en santé. Méthode : S’appuyant sur un dispositif par études de cas croisant différentes sources de données qualitatives, cette étude (2018-2022) vise à documenter 1) le déploiement de l’intervention ; 2) la contribution de chaque composante de l’intervention à la création de ces dynamiques ; et 3) les facteurs qui ont influencé ce déploiement. Résultats : Sur chaque commune d’intervention, des collectifs se sont mobilisés pour porter des actions à partir des problématiques qu’ils ont eux-mêmes identifiées. Chaque composante de l’intervention a joué un rôle spécifique dans cette mobilisation. Deux catégories de facteurs ont été identifiées : 1) les facteurs liés à la mise en œuvre en elle-même de l’intervention et à sa capacité à créer un environnement favorable à l’action collective ; 2) les facteurs contextuels se rapportant à l’inscription territoriale et à la prise en compte des spécificités de chaque commune. Conclusion : Les Semeurs de Santé questionnent les conditions d’engagement et les rapports de pouvoir dans les dispositifs de santé. Cette expérience nous montre que la dimension collective et la participation citoyenne sont intrinsèquement liées à la rencontre et la reconnaissance de l’autre, qu’elles résultent d’un apprentissage et nécessitent d’être cultivée
From epistolary exchanges between "paralyzed" people to epistolary and digital exchanges with able-bodied people. The Cordées System in France, 1932-2022
No full textInternational audienceThis article explains the history of the Cordées. This form of correspondence between people with disabilities was initiated and organized by the French association APF France Handicap as early as 1933 and continues to this day. The material that was analyzed includes letters and interviews with participants, as well as articles from Faire Face magazine and the Edelweiss newsletter. A four-stage presentation of the origins and evolution of the Epistolary Rope Teams is presented: 1) the passed-around notebooks, 2) the Cordées structuration, with an increase and then decrease in participants, 3) the Cordées' social composition transformation, with the inclusion of able-bodied people and family caregivers, and 4) today's Cordées, with the switch to digital technology, thematic diversification, and a significant decrease in participants.Cet article vise à expliquer l’histoire des Cordées – type d’échanges épistolaires entre personnes en grande dépendance pour les actes de la vie quotidienne – impulsées et structurées au sein de l’APF France Handicap à partir de 1932 et ayant encore cours aujourd’hui. Le matériau analysé est composé de lettres et d’interviews de cordistes, d’articles issus de la revue Faire Face et de la newsletter l’Edelweiss. Ces données ont permis de remonter aux origines des Cordées et de proposer une présentation en quatre étapes de leur évolution: le recours aux cahiers circulants, la structuration des cordées en parallèle d’une croissance puis d’une décroissance du nombre de cordistes, la transformation de la composition sociale des cordées avec l’ouverture aux personnes valides et proches aidants, et, enfin les cordées d’aujourd’hui avec le passage au numérique, une diversification thématique et une décroissance importante du nombre de cordistes
Associations of plasma persistent organic pollutants with brain atrophy, cognitive decline and risk of dementia in older adults
No full textInternational audiencePersistent Organic Pollutants (POP), including polychlorinated biphenyls (PCBs) and organochlorine pesticides, are established neurotoxicants in experimental models; yet it remains uncertain whether exposures in the general population increase the risk to develop brain aging pathologies. We assessed the prospective associations of plasma POP concentrations with three dementia-related outcomes in a population-based cohort of older adults.MethodsAnalyses included 515 participants from the Three-City Study, free of dementia at baseline at the time of blood measurements (1999–2000, mean age 72.5), who underwent up to 8 repeated assessments of cognitive function and dementia over 17 years and up to 3 neuroimaging examinations over 10 years. Plasma concentrations of 15 PCBs, 12 organochlorine pesticides and 1 brominated flame retardant were measured by gas chromatography coupled with tandem mass spectrometry (detection rate ≥5 %), and a POP score summarizing overall exposure was derived via factorial analysis. Associations with dementia risk, longitudinal changes in cognitive function (composite measure of four tests) and in brain volume (medial temporal lobe) were analyzed using Cox and linear mixed models, adjusted for baseline age, sex, education, apolipoprotein E (APOE) genotype, body mass index and total lipid concentrations.ResultsIn multivariable-adjusted models, neither individual POPs nor the total POP score were significantly and consistently associated with dementia-related outcomes. Significant interactions were observed between APOE genotype and highly-chlorinated PCBs (congeners 180, 194, and 196–203) across all outcomes (p for interaction ≤0.05), whereby adverse associations were seen in carriers of the APOE-ɛ4 allele, whereas opposing trends were observed in non-carriers.ConclusionOverall, this prospective study does not provide robust evidence to support an adverse association between exposure to POPs in the general population and the risk of all-cause dementia, cognitive decline, or brain atrophy in older adults
Validation clinique d’un algorithme d’identification de poussées de sclérose en plaques dans le système national de données de santé (SNDS)
No full textInternational audienceIntroduction : L’identification de poussées de sclérose en plaques (SEP) dans le Système National de Données de Santé (SNDS) nécessite le développement d’indicateurs précis et cliniques validés. Objectifs : Valider et améliorer un algorithme d’identification des poussées de SEP chez des patients initiant un premier traitement de fond de la SEP (patients naïfs). Méthodes : Un algorithme d’identification d’une poussée de SEP dans le SNDS a été développé à partir des délivrances de corticothérapie forte dose et des diagnostics d’hospitalisation. Cet algorithme a été validé et amélioré grâce au chaînage des données de l’Observatoire Français de la Sclérose en Plaques (OFSEP) et des données du SNDS, à partir d’une cohorte de patients avec premier traitement de fond entre juillet 2015 et décembre 2017, puis suivis jusqu’en décembre 2018. Résultats : Chez les patients naïfs (n=1640), la sensibilité de l’algorithme initial était de 64% (soit 64 poussées repérées dans le SNDS sur 100 poussées OFSEP) et 83% pour la spécificité (soit 83 patients sans poussée dans le SNDS sur 100 sans poussée dans OFSEP). Un algorithme optimisé a permis d’améliorer la sensibilité (75%) et faiblement la spécificité (85%). Dans la population non naïve (n=9966), les performances de l’algorithme restaient modérées (sensibilité 55%, spécificité 80%). Discussion : L’algorithme optimisé présente une sensibilité satisfaisante pour identifier une poussée de SEP chez les patients naïfs avec une bonne spécificité, à partir des données du SNDS ; certains écarts pouvant correspondre à des situations non enregistrées dans la base de l’OFSEP lorsque les patients ne sont pas pris en charge par leur clinicien habituel. Conclusion : Ce travail ouvre la voie à l’utilisation des données du SNDS pour les poussées de SEP avec un algorithme précis cliniquement validé chez les patients naïfs
Engagements et participation des jeunes aujourd'hui
No full textInternational audienceMasterDes définitions différentes de la démocratie?</div
Relative Effectiveness of High‐Dose vs. Standard‐Dose Influenza Vaccines in Preventing Hospitalizations: A National Retrospective Cohort Study in France, 2022/2023 Season
No full textInternational audienceBackground: A French cohort study (2021/2022 influenza season) found the high-dose influenza vaccine (HD) more effective than standard-dose vaccines (SDs) in preventing influenza-related hospitalizations in the elderly. The study continued to refine results and validate these findings.Methods: Data from community-dwelling 65+ adults who received HD or SD during the 2022/2023 vaccination campaign were extracted from the National Health database. Hospitalizations were recorded from 14 days postvaccination until June 30, 2023. HD and SD recipients were matched using a propensity score. Associations between vaccines and hospitalizations were assessed by estimating incidence rate ratios and converting them to HD vs. SD vaccine relative effectiveness (rVE).Results: A total of 675,412 HD recipients were matched to 2,701,648 SD recipients. The rVE for influenza-related hospitalizations was 27.4% [95% CI: 19.8; 34.3]. It ranged from 22.7% [9.8; 33.6] to 33.6% [21.2; 44.0] across age groups, indicating that HD consistently outperformed SDs in preventing influenza-related hospitalizations, with the highest effect observed in 85+.Conclusions: Our study is the first to publish rVE data comparing HD and SDs in a real-world setting in France for the 2022/2023 influenza season. Its findings reaffirm the benefit of HD vs. SDs. HD could help reduce the burden of severe respiratory infections in the elderly
Effect of physical exercise intervention on daily sleep quality in women with breast cancer and severe depressive or anxiety symptoms: a series of N-of-1 trials
No full textInternational audienceAim: The aim of this preliminary study was to examine the effects of a 12-week remote supervised physical activity intervention on daily self-reported sleep quality among women with breast cancer and severe depressive and anxiety symptoms.Method: A series of N-of-1 trials with an A-B-A’ design was carried out with ecological momentary assessments. Phase A and A’ (2-week) represented pre- and post-intervention measures and phase B represented the intervention phase. Participants received a daily prompt to report their sleep quality. Sixteen participants completed the treatment. Results: Sixteen out of eighteen participants completed the intervention. Participants’ age ranged from 29 to 61 years old, and 10 were included during their cancer treatment. A significant improvement of sleep quality was observed in 9 participants with moderate to large effects. However, the intervention had a moderate and significant negative effect on the sleep quality in 2 patients. Conclusion: This is the first study to show that physical activity is potentially effective in women with breast cancer and severe depressive and anxiety symptoms. The findings justify extension to a randomized controlled trial
Paracetamol (N-acetyl-para-aminophenol) disrupts early embryogenesis by cell cycle inhibition
No full textInternational audienceAbstract STUDY QUESTION Does paracetamol (N-acetyl-para-aminophenol (APAP) also known as acetaminophen) interfere with cell division and thereby disrupt pre-implantation embryonic development? SUMMARY ANSWER Our findings suggest that APAP exposure inhibits cell cycling during pre-implantation development (PID) through the reduction of DNA synthesis, potentially resulting in early embryonic loss. WHAT IS KNOWN ALREADY It is estimated that 10–40% of all human conceptions fail around the time of implantation. Genetic factors explain ∼50% of early embryonic loss, leaving a substantial portion of early losses without a known cause. Smoking and alcohol are established risk factors for spontaneous abortion, underscoring the importance of the chemical environment during embryonic development. STUDY DESIGN, SIZE, DURATION To address the challenges in determining the mechanism of action and the effects of APAP during PID, we utilized a range of approaches, including in vitro, ex vivo, and in vivo methods across various models ranging from yeasts to human embryos and women of fertile age. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 90 human embryos were exposed in vitro (22 cleavage stage and 68 blastocyst-stage embryos). Endometrial tissue and uterine fluid were collected from seven women as part of an endometrial scratching procedure. Follicular fluid was collected from 26 women during transvaginal ultrasound guided aspiration of the pre-ovulatory follicles. All human material was sampled in accordance with relevant guidelines and regulations with consent from the regional scientific ethical committee of the Capital Region of Denmark and signed informed patient consent given prior to donation. All mouse experiments were approved by the Danish Animal Experiments Inspectorate and under EU directive 2010/63/EU on the protection of animals used for scientific purposes. The cultivation of the human embryonic stem cell lines H1 and HUES4 was conducted in compliance with relevant guidelines and regulations, following approval from the regional scientific ethical committee of the Capital Region of Denmark. MAIN RESULTS AND THE ROLE OF CHANCE After exposure to APAP, we found an unequivocal repression of cell division across all used model systems. APAP exposure hindered cell cycle progression, likely by inhibiting ribonucleotide reductase, leading to reduced DNA synthesis and accumulation in the S-phase. At concentrations found in the reproductive system of women after standard dosing, APAP exposure decreased cell numbers in mouse and human cleavage-stage embryos or caused direct embryonic death. Similar exposure to mouse and human blastocyst-stage embryos resulted in a reduced inner cell mass and decreased DNA synthesis, respectively. LIMITATIONS, REASONS FOR CAUTION A limitation of the study is the low number of available human cleavage-stage embryos. However, the high number of human blastocysts and our translational approach, which demonstrated reproducibility across various model systems, partly addressed this limitation. Further studies are needed to confirm the potential association between APAP use and pregnancy loss in prospective cohorts. WIDER IMPLICATIONS OF THE FINDINGS Our findings indicate that the widely used mild analgesic APAP could contribute to early embryonic loss by impairing initial cell divisions. These results suggest that APAP should be used with caution by women attempting to conceive. Given that cell division is fundamental to all development, further investigation is now warranted to substantiate these findings and to elucidate possible implications for other developmental processes, such as gonadal and brain differentiation. STUDY FUNDING/COMPETING INTEREST(S) The research was funded by the Lundbeck Foundation (R324-2019-1881). Authors P.S. and H.K.M. were affiliated with the Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW; NNF21CC0073729). H.K.M. received a fellowship from the Novo Nordisk Foundation as part of the Copenhagen Bioscience PhD Program, supported by grant NNF19SA003544. M.H and A.D. are part of the National French Research Infrastructure France Exposome and have received funding from the European Regional Development Fund and Britanny region (Contrat Plan Etat Region, project Exposome, AIDEN 106201). TRIAL REGISTRATION NUMBER N/A
Les sciences sociales dans l'évaluation des politiques publiques : pour une approche conversationnelle
No full textCe working paper s’appuie sur les retours d’expérience croisés de deux équipes de chercheuses ayant participé à l’évaluation de trois expérimentations issues de l’article 51 de la Loi de financement pour la Sécurité sociale (LFSS) de 2018, dispositif permettant la mise en place d’expérimentations de financements dérogatoires au droit commun pour les acteurs du secteur de la santé. Nous défendons ici que la plus-value de l’évaluation des politiques publiques par des chercheurs se situe dans les conversations et les formes d’apprentissage qu’elles permettent entre les différents acteurs des politiques publiques. Cet apport se situe davantage dans la participation incrémentale et les échanges entre ces acteurs tout au long du processus d’évaluation, que dans le processus formel d’aide à la décision qui est souvent seul associé à l’activité d’évaluation. Nos retours d’expérience soulignent que, en dépit de l’intégration de plus en plus fréquente des sciences sociales et des méthodes qualitatives dans l’évaluation des politiques publiques, les conditions dans lesquelles ce type de plus-value peut émerger ne sont pas toujours réunies et méritent d’être elles-mêmes discutées, précisées, et valorisées