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Prevalence, risk and protective factors of postpartum depression and anxiety symptoms in the Allada district, Benin
No full textInternational audiencePurpose: Postpartum depression symptoms (PPDS) and postpartum anxiety symptoms (PPAS) are a major global public health issue, especially in low-resource settings. This study aimed to determine the prevalence of PPDS and PPAS in Benin, Sub-Saharan Africa, at one year postpartum and to identify associated risk and protective factors.Methods: Pregnant women were recruited for a longitudinal mother-child cohort in the Allada District of Benin, and a cross-sectional analysis was performed on data collected at one-year postpartum. Maternal depression and anxiety symptoms were assessed one year postpartum using the Edinburgh Postnatal Depression Scale (EPDS)-validated in Benin and translated into Fon-and its anxiety subscale (EPDS-3 A). Cut-off scores for high depressive and anxiety symptoms were ≥ 13 and ≥ 6, respectively. Potential risk and protective factors including maternal, child characteristics, socioeconomic status, and social support were analyzed using multivariable-adjusted logistic regression models.Results: At one year postpartum, 13% of 742 mothers had PPDS, and 21% PPAS. Risk factors for PPDS included recent alcohol consumption (previous three months) (aOR = 1.88; 95%CI: 1.17-3.02) and food insecurity (aOR = 4.47; 95%CI: 1.29-17.4), while partner cohabitation reduced PPDS odds (aOR = 0.45; 95%CI: 0.26-0.80). PPAS risk factors included recent alcohol consumption (aOR = 2.17; 95%CI: 1.44-3.28) and regular child care support from 3 + childcare providers (aOR = 2.91; 95%CI: 1.50-5.68). Protective factors for PPAS included the minority Aizo ethnicity (aOR = 0.58; 95%CI: 0.36-0.93) and living in an individual house (aOR = 0.45; 95%CI: 0.24-0.85).Conclusion: This study sheds light on the prevalence of PPDS and PPAS at one year postpartum in the Beninese context, as well as associated factors. Findings underscore the importance of establishing postpartum psychological follow-up and targeted strategies to support maternal mental health in low-resource settings, addressing both socioeconomic vulnerabilities and social support structures
À la recherche d'un logement sain : la discrète vulnérabilité résidentielle des familles d’enfants atteints de maladies respiratoires chroniques. Le cas de la mucoviscidose.
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Burden of mycetoma in Burkina Faso: case series and systematic review
No full textInternational audienceMycetoma is a chronic inflammatory disease characterized by progressive and devastating granulomatous subcutaneous tissue involvement. It primarily occurs in regions classified within the ‘mycetoma belt’, encompassing various countries. Notably, West African nations, including Burkina Faso (BF), are situated within this belt, yet there is a significant lack of data regarding mycetoma in these regions. With this background, this study set out to determine the mycetoma prevalence in BF. A comprehensive review was conducted to document the presence of mycetoma in BF. Searches were performed in PubMed, ScienceDirect, African Journals Online (AJOL) and Google Scholar databases. Data were reported following the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) guidelines. Additionally, the study encompassed a case series involving three patients. From 1960 to 2024, 25 mycetoma cases have been documented in BF. Overall, the clinical cases share similar sociodemographic, clinical, diagnostic, therapeutic and outcome characteristics. Specifically, these cases illustrate that mycetoma predominantly affects vulnerable groups in BF. The majority of mycetoma cases (96%) were reported in the Sahelian zone of BF. Predominantly, these cases (80%) had foot mycetoma. This study highlights the challenges of mycetoma management in BF, indicating significant obstacles in early diagnosis and effective treatment
Approche structurale de la représentation sociale du goût sucré : étude quantitative exploratoire en population générale française
No full textInternational audienceThe aim of the present study was to explore the social representation of sweetness, especially its central nucleus. We designed an online survey (n = 1500) to collect data onqualitative (‘‘healthy’’, ‘‘traditional’’, ‘‘natural’’, ‘‘sweet’’, ‘‘appetizing’’, ‘‘nauseating’’)and functional (‘‘energizing’’, ‘‘comforting’’, ‘‘nourishing’’) cognitive elements and expected sweetness intensity of nine visually presented foods. Exploratory and confirmatory factoranalyses established associations between sweetness and cognitive elements for each food. Afactor score estimating adherence to each cognitive structure was used to perform a typology ofindividuals. We established the social representations of sweetness for banana (healthy, nourishing, energizing, sweet), chocolate cake (sweet, appetizing, comforting), honey (natural,energizing, healthy) and sugar (sweet, energizing, comforting), to which participants adhered diversely, according to their sociodemographic characteristics. Our findings suggest theexistence of diverse sweet tastes, intertwined with social representations specific of their food.L’objectif de la présente étude était d’explorer la structure de la représentation sociale du goût sucré, et notamment son noyau central. Une enquête en ligne a permis à 1500 participants d’estimer (sur une échelle de 0 à 100) les aspects qualitatifs (« sain », « traditionnel », « naturel », « doux », « appétissant », « écœurant »), fonctionnels (« énergisant », « réconfortant », « nourrissant ») ainsi que l’intensité attendue du goût sucré de neuf aliments présentés visuellement. Les associations entre le goût sucré et ces éléments cognitifs ont été déterminés par analyses factorielles exploratoires, puis confirmatoires. Un score factoriel estimant l’adhésion à chaque structure cognitive a ensuite été utilisé pour effectuer une typologie d’individus. Nous avons établi les représentations sociales du goût sucré de la banane (sain, nourrissant, énergisant, doux), du gâteau au chocolat (doux, appétissant, réconfortant), du miel (naturel, énergisant, sain) et du sucre (doux, énergisant, réconfortant) auxquels les participants adhéraient de manière variable en fonction de leurs caractéristiques sociodémographiques. Il existe donc divers goûts sucrés indissociables des représentations sociales propres à leurs aliments
Protéger la santé des riverains de carrières « au-delà des poussières sédimentables »
No full textInternational audienceThere are a number of health risks for people living near quarries, mainly respiratory and cardiovascular. These primarily result from airborne exposure to dust and other pollutants generated by the extraction of materials and processing activities. Protecting the health of residents is a public health issue and should be based on an integrated approach combining regulations, dust monitoring, community commitments, prevention programmes, and research. This approach should provide a framework for action by stakeholders, enabling them to meet the challenges they face in terms of preventing and controlling health risks for these populations. To this end, it is necessary to consider the mineralogical and chemical composition of these dusts, the associated health risks, and the various avenues for action. Based on the state of knowledge of these various topics, the French regulatory framework for dust monitoring should be reviewed from both a technical and an implementation standpoint. Recommendations are made to better protect the health of people living near quarries.Les risques sanitaires encourus par les personnes vivant à proximité des carrières sont multiples, principalement respiratoires et cardiovasculaires, qui découlent avant tout de l’exposition par voie aérienne aux poussières et autres polluants générés par les activités d’extraction et de traitement des matériaux. La protection de la santé des riverains relève de la sécurité sanitaire et devrait reposer sur une approche intégrée combinant réglementation, surveillance des poussières, engagement communautaire, programme de prévention et recherche, constituant ainsi un cadre d’action pour les parties prenantes pour relever les enjeux en termes de prévention et de contrôle des risques sanitaires pour ces populations. Pour cela, il est nécessaire de prendre en compte la composition minéralogique et chimique de ces poussières, les risques sanitaires qui leur sont associés et les différents leviers en termes d’action. Au regard des connaissances relatives à ces différents aspects, il apparaît que le dispositif réglementaire français de surveillance des poussières mérite d’être repensé tant du point de vue technique que dans ses modalités de mise en œuvre. Des recommandations sont formulées en ce sens pour mieux protéger la santé des riverains de carrière
Planetary Health: why not empower the Sports and Exercise Medicine community to play the game of life well?
No full textInternational audienceHuman activities affect the planet by altering natural cycles. They contribute to climate change and pollution, posing challenges to ecosystems, biodiversity, human wellbeing and health. There is a need to consider Planetary Health, which is described as a solutions-oriented, transdisciplinary field and social movement focused on analysing and addressing the impacts of human disruptions to the Earth's natural systems on human health and all life on Earth. This viewpoint discusses the responsibilities, choices, potential roles and practical initiatives concerning Planetary Health for the Sports and Exercise Medicine (SEM) community. Practices in both medicine and sport impact the environment. We can shift our human and SEM activities and adopt a Planetary Health approach. Our role as the SEM community is to protect and promote the health of athletes and populations. This also involves caring for the environment, given the close link between environmental and human health. Therefore, as an SEM community, we are concerned about the health of our ecosystems and the importance of respecting planetary boundaries. Our scientific expertise, inspirational leadership and ethics should encourage us to raise awareness and become exemplary torchbearers. We must embrace the challenge of addressing humanity's planetary crises to rise to the occasion, uphold our values and strengthen our connection with nature: 'faster, higher, stronger-all together'.</div
Moderately elevated ambient temperature is associated with mortality in dialysis patients, but not in transplant patients
No full textInternational audienceBackground:In many parts of the world, heat waves have been associated with excess morbidity and mortality in the general population. Studies on the effects of high-temperature exposure in kidney transplantation are lacking and are scare in dialysis patients. The aim of this study was to investigate the association between high temperatures and mortality for CKD stage 5 patients treated with dialysis or with a kidney graft in France using various definition of elevated temperature. Methods:In this retrospective cohort study, the association between temperature indicators and mortality was analysed with Poisson models taking into account the trend over time and seasonality and possible confounding factors. Models were compared by their AIC. All patients treated with RRT between 2012 and 2022 in France were extracted from the national REIN registry. Various definitions of elevated temperatures were explored based on all temperature measured at one station per district per hour and per day, from June to September during the years 2012–2022 in Metropolitan France.Results:Between June and September, over the years 2012–2022, temperatures varied from 6.7 to 45.4°C. During this period, 20 174 deaths were recorded among 116 808 dialysis patients and 3 340 among 64 531 transplanted patients. A maximum temperature over 32.5°C was associated with mortality, IR 1.09 (1.04–1.15) in the dialyzed population. No association was found among transplanted patients.Conclusions:Further analyses are needed to confirm these results and better understand the biological and clinical impact of heat-intensity and the cumulative effect with other environmental factors such as air pollution. More detailed studies on reasons for hospitalizations and causes of death are also planned
Resetting public adherence: iterative strategies to counteract pandemic fatigue
No full textInternational audienceNon-pharmaceutical interventions (NPIs) are essential for controlling infectious diseases during pre-vaccine periods, yet their success hinges on sustained public adherence. This study investigates adherence dynamics to tiered restriction systems implemented during COVID-19 in six geographical regions across Europe, North America, Africa, and South America. Using daily mobility data and linear-mixed models, we assessed three types of fatigue: overall fatigue (linked to cumulative time under restrictions), tier fatigue (linked to time spent under a specific tier), and iteration fatigue (linked to repeated implementation of the same tier). Tier fatigue caused the most rapid adherence loss, producing effects within days that overall fatigue required months of restrictions to achieve. Iterative application of shorter NPIs, interspersed with temporary relaxation, helped reset adherence, mitigating fatigue and sometimes even improving compliance. Psychological relief and a sense of regained autonomy during relaxation periods may renew public willingness to comply when restrictions are reintroduced. These findings emphasize the dual benefits of short, strategic NPIs for epidemic control and public resilience, offering actionable insights for designing more sustainable pandemic interventions
Time to care: How a homecare model harnesses nurses’ professional ethic and cultivates caring
No full textInternational audienceBackground A persistent devaluation of care-work, difficult working conditions, and low salaries have led to challenges with staff recruitment and retention in the homecare sector in France. A new homecare organization adopting an innovative organizational model recently experimented an hourly payment method yielding positive outcomes. Objectives Using Tronto’s caring framework, this paper analyzes the strategies used by the founders as they developed their innovative model and the nursing activities performed during home visits. Design A longitudinal qualitative study was conducted between 2017 and 2023. Homecare nursing teams were shadowed for 1–2 days per year yielding detailed field notes on caregiving activities, both before and after the new payment method. Secondary data included reports, videos, articles, and unpublished documents found online. Ethical considerations While there is no requirement in France to obtain ethical approval in non-interventional research, verbal consent was obtained by all participants prior to their involvement in the study; confidentiality and anonymity were strictly maintained; and pseudonyms were assigned to protect identities. Findings 63 interviews and 185 h of shadowing and observations were conducted. Results revealed a virtuous cycle of caring facilitated and encouraged by new incentives that resonated with nurses’ professional ethics. The favorable working environment and the hourly payment method enabled nurses to provide caregiving in accordance with their values. Conclusions As the new hourly payment experiment is scaled-up nationally, it is imperative that it is not isolated from the organizational model. Without the underpinning values and principles, the hourly payment method alone is unlikely to shift the value attributed to caring