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Daytime and nighttime heatwave intensity and acute care utilization for mental and neurological disorders in California
No full textInternational audienceHeatwave exposures have been linked to a variety of mental and neurological disorders. Little is known, however, about the potentially differential associations of daytime versus nighttime heatwave intensity with subtypes of mental and neurological disorders. In this time-stratified case-crossover study, we estimated and compared the associations of typically dry daytime and typically humid nighttime heatwave intensities, characterized by heatwave indices (HWIs), with acute care utilizations for various subtypes of mental and neurological disorders in 1412 ZIP Code Tabulation Areas in California from 2006 to 2019. A total of 4309 294 acute care utilizations for mental disorders and 2097 563 for neurological disorders were included in this study. Higher associations with nighttime HWI were found for most disease subtypes, including anxiety disorder, depressive disorder, schizophrenia, bipolar disorder, post-traumatic stress disorder, Alzheimer’s disease and related dementias, and Parkinson’s disease; while daytime HWI showed a higher impact on conduct disorders (P < .001). On average, during the warm season in California, nighttime heatwaves accounted for about 70.6% and 34.0% of acute care utilizations for mental and neurological disorders that were attributable to heatwaves, respectively. Our findings highlight the detrimental impacts of humid nighttime heatwaves on mental and neurological health and call for innovative heat preparedness actions and increased awareness among public health practitioners as more nighttime heatwaves are anticipated under climate change
Preferences and Covid-19 vaccination intentions
No full textInternational audienceWe set up an original vaccination demand model inspired from prospect theory to explain Covid-19 vaccination intentions among French adults. Our extension accounts for patience and valuation of the vaccination as a common good in individual preferences. This framework can explain why over 40% of the French population intended to reject the Covid-19 vaccination at the end of 2020. The model explains differences in vaccination intentions across population subgroups and, most notably, accounts for heterogeneity in vaccination behaviors among younger and older individuals that neither expected utility nor rank-dependent utility can offer. We calibrate the model based on an original survey carried out on a representative sample of the adult French population in November 2020 and allowing to identify curvatures of the value function, the discount rates and the willingness to cooperate. Out-of-sample analysis shows that this model can also predict the evolution of the vaccination intentions between November 2020 and March 2021. Finally, the model suggests that the international differences in the vaccination intentions are closely related to the vaccine-related valuation of the collective immunity
Anxiolytic Medication Use in Low‐ Middle‐ and High‐Income Countries: A World Mental Health Surveys Report
No full textInternational audienceABSTRACT Background Anxiolytic medications, particularly benzodiazepines, are widely prescribed, giving impetus to long‐standing debates about how often these agents should be employed in clinical practice. There are, however, few cross‐country studies of the pharmacoepidemiology of these agents. We report on the frequency of anxiolytic medication use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries. Methods Face‐to‐face interviews with community samples totaling n = 49,919 respondents in the World Health Organization World Mental Health (WMH) Surveys asked about anxiolytic medication use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses to all respondents. Results A weighted 5.6% ( n = 4079) of respondents reported anxiolytic medication use within the past 12 months; the vast majority comprised benzodiazepine use, and use was highest amongst respondents with a subthreshold major depressive episode (MDE) (25.2%) and a 12‐month MDE (19.8%). Rates were significantly higher in high‐income countries (HICs) than low‐ and middle‐income countries (LMICs) (8.5% vs. 2.2%, χ 2 1 = 559.6, p < 0.001). Short‐acting benzodiazepines and z‐drugs were most commonly used for sleep (66.5% and 85.5%), while intermediate‐acting benzodiazepines and long‐acting benzodiazepines were most commonly used either for sleep (37.9% and 30.1%) or anxiety (33.3% and 32.0%). Across all conditions, anxiolytic medications were reported as very effective by 55.7% of users and somewhat effective by an additional 32.2% of users, with similar proportions in HICs and LMICs. Negative predictors of high perceived effectiveness were a 12‐month MDE and taking anxiolytic medication for comorbid anxiety and depression. Conclusion These data do not definitely answer the question of how often benzodiazepines should be prescribed in clinical practice, but they usefully inform discussions of how to optimize their use. It is noteworthy that anxiolytic medications, particularly benzodiazepines, are largely prescribed for anxiety and sleep, and that they are widely perceived to be either very or somewhat effective by users. However, more targeted prescription of these agents may be necessary; in particular antidepressant intervention should be prioritized in the pharmacotherapy of major depressive disorder
Fieldwork as inquiry in management research: dancing with the field
No full textInternational audienceMost approaches to qualitative research methods in management and organization studies (MOS) implicitly enact spatial perspectives, crystallized in the idea of “accessing the field”. Field sites are thus performed as objective spaces in which research takes place. In this paper, we set out to challenge this spatial perspective by developing a processual approach that conceptualizes fieldwork as ‘inquiry’ as defined by John Dewey. To this end, we draw on an inter-case analysis of four independent research projects to demonstrate the processual, fluid, continuous, and shared constitution of a field of inquiry. We call this alternative approach ‘dancing with the field’. It allows us to move beyond the highly spatialized notion of access to the field and to materialize orprioritize different forms of relationality. We understand ‘accessing the field’ and ‘dancing with the field’ as two intertwined and complementary modes of both attachment to and detachment from the field
Démocratie en santé : parole, langage et contre-pouvoirs.: Le rôle des patients et de leurs représentants dans la transformation des pratiques de soin.
No full textInternational audienceSpeech is never neutral in the field of health: it shapes relationships, reveals power dynamics, and determines the ability of stakeholders to influence the decisions that affect them. By examining speech as a political act, Alexandre Berkesse questions the conditions under which patients, loved ones, and professionals can have their experiences and legitimacy recognized. He thus explores the close ties between language, agency, and democracy in healthcare, demonstrating how spaces for expression—or their absence—concretely influence care and support practices.La parole n’est jamais neutre dans le champ de la santé : elle structure les relations, révèle les rapports de pouvoir et conditionne la capacité des acteurs à peser sur les décisions qui les concernent. En s’intéressant à la parole comme acte politique, Alexandre Berkesse interroge les conditions dans lesquelles patients, proches et professionnels peuvent faire reconnaître leur expérience et leur légitimité. Il explore ainsi les liens étroits entre langage, pouvoir d’agir et démocratie en santé, en montrant comment les espaces d’expression — ou leur absence — influencent concrètement les pratiques de soin et d’accompagnement
Health impacts of a short-lived, small-scale wildfire in South Korea
No full textInternational audienceBackground: A wildfire occurred in the Gyeongpo district of Gangneung city, South Korea, on 11 April 2023, lasting for 8 h and burning 300 acres. While previous studies have examined the health effects of major wildfires, research on short-lasting, small-scale wildfires remains scarce. By capitalizing on the timing of the wildfire as a natural experiment, we investigated the health effects of the Gangneung wildfire on residents living near the wildfire site.Methods: The wildfire-exposed and control districts were determined based on satellite images of land damage. The weekly number of district-level cause-specific hospital visits was extracted from the National Health Insurance Database. The number of hospital visits for residents living in the exposed district was compared with that in 20 control districts by using the Generalized Synthetic Control Method. The excess number of visits attributable to the wildfire was estimated for periods of 0-3 and 0-7 weeks following the wildfire.Results: Over 8 weeks following the wildfire, excess respiratory disease hospital visits {308.7 cases [95% confidence interval (CI): 119.7, 603.6]} were observed in residents of the exposed district, including cases of upper respiratory infections, influenza and pneumonia, and chronic lower respiratory diseases. Cardiovascular disease visits [83.3 cases (95% CI: 32.4, 136.0)] of the exposed district, notably for hypertensive disorders and ischemic heart diseases, increased for ≤4 weeks post-wildfire.Conclusion: Excess respiratory and cardiovascular disease-related hospital visits were observed among residents living near the wildfire site. Even a small-scale wildfire may have health impacts on residents for >2 months
Investigation of sociodemographic, temporal, and meteorological heterogeneity in the short-term blood pressure response to air pollutants
No full textInternational audienceNo abstract availabl
Exploring factors affecting malaria vaccination intention and COVID-19 vaccine uptake: evidence from a joint analysis in rural Senegal
No full textInternational audienceBackground: Current malaria vaccination efforts target infants from 5 months of age; however, adult malaria mortality remains a significant and under-reported issue in high-transmission settings. Concerns are emerging that COVID-19-related vaccine hesitancy may extend to upcoming vaccines, including hypothetical ones such as a malaria vaccine for adults. This study investigates both shared and vaccine-specific determinants of malaria vaccination intention, comparing them with those influencing COVID-19 vaccine uptake.Methods: A cross-sectional telephone survey was conducted in 2023 among 795 adults residing in the rural area of Niakhar, Senegal. The Health Belief Model served as the analytical framework to identify determinants of vaccination behaviours and intentions. A multivariable bivariate probit model was used to jointly assess factors associated with favourable intentions to receive a hypothetical adult malaria vaccine and actual uptake of the COVID-19 vaccine.Results: Among surveyed participants, 35.6% had received at least one dose of a COVID-19 vaccine, and 58.6% expressed favourable intentions to receive a malaria vaccine, assuming it were available and free of charge. COVID-19vaccinated individuals were 60% (p < 0.001) more likely to report favourable intentions to receive a malaria vaccine.In the multivariable probit model, perceived disease severity was more strongly associated with COVID-19 vaccine uptake, whereas perceived disease susceptibility more strongly predicted favourable intentions to receive a malaria vaccine. Women were more likely to support malaria vaccination (p = 0.005), while adults aged 59 years and older had higher rates of COVID-19 vaccination (p < 0.001).Conclusions: These findings suggest that although some determinants are vaccine-specific, most are shared across vaccines. The results offer actionable insights to guide future malaria vaccination strategies. Further research in urban settings and across diverse countries is warranted to enhance understanding of cross-vaccine perceptions and to inform targeted communication efforts.</p