Scientific publications portal of EHESP researchers
Not a member yet
5609 research outputs found
Sort by
From educating mothers to neuroparenting: Ideas and controversies in parenting issues
No full textInternational audienceSince the early 1990s, a specific sector of public action called “parenting support” emerged in many developed countries. This policy should not distract from the fact that the primary socialization carried out by parents, in particular mothers, has been an explicit focus of policy for over a century. In this chapter, Claude Martin proposes to understand the developments and turns involved in this globalized issue of parenting. The first section looks back at the development of these debates since the end of the 19th century, initially marked by public health issues and the fight against infant mortality, then by the post-war development of a market in counselling for mothers, inspired by different theoretical traditions in psychology, and culminating in the 1990s in a specific parenting public policy. The second looks at the parallel development of neuroscience since the 1990s and its impact on this sector through the politicization of a certain number of ideas by decision makers and professionals in the field. This lay use of neuroscience has generated two avenues of development, one concerning children's cognitive development, the other on their emotional development. The third section proposes to grasp the meaning and depth of these changes to determine whether we are facing a simple revival of old methods or a paradigm shift
Effects of fine particulate matter from wildfire and non-wildfire sources on emergency-department visits in people who were housed and unhoused in San Diego County (CA, USA) during 2012–20: a time-stratified case–crossover study
No full textInternational audienceBackground: Being unhoused can increase vulnerability to adverse health effects due to air pollution. We aimed to quantify changes in emergency-department visits during and after exposure to wildfire-specific and non-wildfire particulate matter 2·5 μm or less in diameter (PM2·5) in San Diego County (CA, USA) in people who were both unhoused and housed.Methods: For this time-stratified case-crossover study, we used data on exposure to wildfire-specific PM2·5 in California and individual-level data for people admitted to the emergency departments of two hospitals (UC San Diego Health emergency departments at La Jolla and Hillcrest, San Diego) in San Diego County between July 1, 2012, and Dec 31, 2020. People with a postcode outside of San Diego County were excluded. Demographic information was age group, race or ethnicity, and transport to the emergency department. Wildfire-specific PM2·5 concentration at the postcode level was previously estimated using an ensemble model that combined multiple machine-learning algorithms and explanatory variables obtained via data on 24-h mean PM2·5 concentrations from the US Environmental Protection Agency Air Quality System. Conditional logistic regression models were applied, adjusting for specific humidity, wind velocity, and maximum temperature extracted from the US Gridded Surface Meteorological Dataset. Housing status was established by registration staff or triage nurses on arrival at the emergency department. For people who were unhoused, exposure was defined based on the weighted mean PM2·5 concentration at the city level proportional to the number of people who were unhoused in each specific city across urban centres in San Diego County. For people who were housed, we used residence postcode to measure exposure. We assessed the association between PM2·5 from wildfire and non-wildfire sources and emergency-department visits in people who were housed and unhoused.Findings: There were 587 562 emergency-department visits at the two hospitals, 76 407 (13·0%) of which were by people who were unhoused. People who were housed had a higher exposure to overall PM2·5 (24-h mean over the study period of 9·904 mg/m3, SD 3·445) and non-wildfire PM2·5 (9·663, 2·977) than people who were unhoused (9·863, 3·221; 9·557, 2·599). However, people who were unhoused had a higher exposure to wildfire-specific PM2·5 (0·305, 1·797) than people who were housed (0·240, 1·690). Overall PM2·5 exposure was associated with increased odds of emergency-department visits for both people who were housed (odds ratio 1·003, 95% CI 1·001-1·004 per 1 μg/m3 PM2·5 for 0-3 days after exposure) and people who were unhoused (1·004, 1·000-1·008 for 0-3 days after exposure). We found that non-wildfire PM2·5 was associated with emergency-department visits among people who were housed (1·003, 1·002-1·005 for 0-3 days after exposure) and wildfire-specific PM2·5 was associated with emergency-department visits in people who were unhoused (1·006, 1·001-1·011 for 0-3 days after exposure).Interpretation: People who were unhoused in San Diego County were more likely to visit emergency departments after exposure to increased wildfire-specific PM2·5. As the intensity and frequency of wildfires increase, understanding risk factors for vulnerable populations, such as people who are unhoused, is crucial to develop effective adaptation strategies
Changes in psychiatric disorder incidence patterns during the COVID-19 pandemic in Korea: a study using the nationwide universal health insurance data
No full textInternational audienceBackground:Few studies have evaluated the incidence of various psychiatric disorders during the coronavirus disease (COVID-19) pandemic using hospital visit data for the entire population of a nation. We used Korea’s universal compulsory health insurance data to conduct a descriptive analysis to evaluate changes in psychiatric disorder incidence during the COVID-19 pandemic. Methods: Hospital visit data related to psychiatric disorders were retrieved from the National Health Insurance Database. First-ever diagnosis for specific psychiatric disorders for each Korean was identified (from January 2015 to February 2023) and monthly age-standardized incidence rates were calculated. An interrupted time-series analysis was used to estimate counterfactual disease incidence rates and observed and counterfactual rates were compared using difference-in-difference framework. Results: Compared to pre-pandemic period, there was a decrease in the incidence [percentage changes in monthly rate (95% confidence intervals)] of organic mental disorders [-14.6% (-18.4, -10.9)] and psychoactive substance related disorders [-12.9% (-17.5, -8.3)] during the pandemic. However, anxiety disorders [8.8% (3.1, 14.6)], behavioral syndromes associated with physiological disturbances [8.1% (4.2, 11.9)], mental retardation [8.6% (3.0, 14.2)], psychological developmental disorders [19.6% (11.5, 27.7)], childhood- and adolescent-onset behavioral and emotional disorders [45.1% (28.4, 61.8)], and unspecified mental diseases [51.8% (39.8, 63.8)] increased. Conclusions: Psychological disease incidence patterns changed substantially during the pandemic in South Korea. Various pandemic-related stressors, such as disrupted lifestyles and hospital accessibility, may have influenced these changes. The causes and public health consequences of these changes require further evaluation
Disability history in France: past, present and future
No full textInternational audienceWhat is disability? How might a focus on disability as a category of human experience change the way we think and write about the French past? In this roundtable seven historians discuss the emergence of disability studies in France, assessing the continued relevance of classics in the field as well as new directions in research. Scholarly attention to disability, the contributors argue, has the potential to transform modern French historiography, not only by challenging our understanding of major ‘turning points’ such as the French Revolution or the world wars, but offering fresh insights into race, class and gender identities, as well as citizenship, inclusion and belonging in French society
A convergent mixed methods to study registration on kidney transplantation waiting list refusal by women and men on dialysis in France
No full textInternational audienceNot all patients on dialysis want to be registered on the kidney transplantation (KT) waiting list and undergo transplantation. The aim of this convergent mixed methods study was to determine the features of patients refusing to be registered on the KT waiting list and the reasons. Quantitative data on all 2017-2019 incident 18-85-year-old dialysis patients, eligible for KT, were extracted from the REIN registry in France. Qualitative data were collected through semi-structured interviews with patients on dialysis and nephrologists from the Bretagne, Île-de-France and Normandie French regions. The binary logistic regression method was used to identify factors/reasons associated with registration refusal and an inductive thematic analysis was performed on qualitative data. The quantitative analysis included data of 10,512 patients (mean age = 57.5 years). Among them, 860 (8.18%) refused to be registered on the KT waiting list. The multivariate analysis showed that women were 83% more likely to refuse registration compared with men. The qualitative analysis included 21 patients and 11 nephrologists. The integration of the results from the quantitative and qualitative analyses allowed identifying some factors associated with the registration refusal. Most of these factors converged across analyses. These included age, sex/gender, autonomy on dialysis and comorbidities. The integration of the results highlighted some divergence concerning sex/gender and autonomy and an area of expansion related to comorbidities. In conclusion, the patient age, sex/gender and comorbidities appear to play an important role in the refusal to be registered on the waiting list. Interventions focused on these factors might help to improve KT accessibility in France
Alcool : Santé, prévention, marketing et lobbying
No full textInternational audienceDepuis les années 1960, la consommation de boissons alcoolisées a considérablement diminué en France. Cependant, son niveau reste l’un des plus élevés au monde.Une prise de conscience se fait progressivement parmi les citoyens de plus en plus intéressés par ce problème de santé. Des études scientifiques récentes éclairent sur les risques liés à l’alcool, et les stratégies agressives de marketing des industriels de l’alcool envers les plus jeunes sont dévoilées par les associations. Si les acteurs de la santé tentent de déployer des politiques publiques et de prévention efficaces pour réduire la consommation d’alcool des Français, le secteur économique de l’alcool freine et bloque leur mise en place grâce à des stratégies de lobbying redoutables pour influencer les décideurs et les élus.En 10 questions, dans un format clair et concis, cet ouvrage fait le point sur l’ensemble des aspects du sujet complexe et passionnant qu’est la consommation d’alcool et des mesures efficaces pour la réduire
Chapitre 5. Sociologie des professions du champ sanitaire et social
No full textInternational audienceLes professions jouent un rôle central dans le domaine sanitaire et social. Que ce soit à l’hôpital où existent deux lignes d’autorité, une administrative et l’autre médicale, en médecine de ville où les relations entre les professions et l’Assurance maladie sont centrales, ou encore dans le secteur social et médico-social qui s’est construit en mettant en rapport des populations catégorisées et des professions spécialisées. Ces professions ont en commun d’être garanties par des institutions mais aussi défendues par des groupes qui savent se mobiliser. L’intérêt porté aujourd’hui au développement des « compétences » introduit une nouvelle conception du « professionnel » centrée sur l’expertise individuelle et l’évaluation. Pour aider à comprendre les dimensions sociologiques des professions, ce chapitre aborde d’abord la notion selon quatre axes : la démographie, le rôle joué dans la société, la division du travail et le rapport à l’État (5.1.). Dans un second temps seront analysés les enjeux actuels de la professionnalisation (5.2.)
How can the environmental sustainability of healthcare products be taken into account throughout their life cycle?
No full textNational audienceHealthcare product procurement accounts for around 50% of the French healthcare system’s greenhouse gas emissions. This lesson learned from the publication of the Shift Project’s work in November 2021 has been a catalyst within the healthcare system, accelerating the consideration and implementation of actions aimed at reducing the environmental impact of the healthcare system, before, during and after care. In addition to their carbon footprint, healthcare products have a wide range of environmental impacts, including on water, air and soil, throughout their entire life cycle. We have chosen to divide this life cycle into four main stages: from research and development to production, distribution and market access, use and finally end-of-life management. Analysis of the regulatory framework at each stage and of existing initiatives described in the literature or by those in the field have structured and fuelled our thinking. We found that existing regulations focus exclusively on the health risk, with little or no consideration of the environmental risk, which is in itself a health risk. Furthermore, the implementation of certain structuring actions during the first 3 stages of the life cycle would make it possible to simplify or even eliminate the major problem of waste management associated with the end-of-life of healthcare products. With this in mind, we have produced 9 recommendations to ensure that the environmental impact of healthcare products is better taken into account throughout their life cycle
From educating mothers to neuroparenting: Ideas and controversies in parenting issues
No full textpublished in Nicolas Marquis (ed), Education, parenting and mental health care in Europe: The contradictions of building autonomous individuals, Routledge, 2024.Since the early 1990s, a specific sector of public action called "parenting support" emerged in many developed countries. This policy should not distract from the fact that the primary socialization carried out by parents, in particular mothers, has been an explicit focus of policy for over a century. In this chapter, Claude Martin proposes to understand the developments and turns involved in this globalized issue of parenting. The first section looks back at the development of these debates since the end of the 19 th century, initially marked by public health issues and the fight against infant mortality, then by the postwar development of a market in counselling for mothers, inspired by different theoretical traditions in psychology, and culminating in the 1990s in a specific parenting public policy. The second looks at the parallel development of neuroscience since the 1990s and its impact on this sector through the politicization of a certain number of ideas by decision makers and professionals in the field. This lay use of neuroscience has generated two avenues of development, one concerning children's cognitive development, the other on their emotional development. The third section proposes to grasp the meaning and depth of these changes to determine whether we are facing a simple revival of old methods or a paradigm shift
Decript - deciphering the human prenatal chemical exposome using high-resolution mass spectrometry
No full textInternational audienceBackground: During pregnancy, women are exposed to mixtures of chemical compounds, including pharmaceuticals, food additives, pesticides, flame-retardants or plasticizers. Certain substances in these mixtures have been associated with potential long-term health concerns for offspring. Combining several advantageous aspects (e.g. pivotal landmark in fetal/maternal linkage, easily accessible, large amount of tissue), the placenta is now recognized as a relevant matrix to study prenatal chemical exposures. However, some questions remain to be answered before using the organ at cohort-scale. Notably, tissue heterogeneity implies variability on several biological dimensions (cell composition, genes expression, protein/metabolite activity). Similarly, the sequestration and distribution of exogenous compounds in placenta is unknown.Methods: Using a standardized pattern, eighteen samples were taken from 25 placentas, at 3 distances from the cord insertion site, and at 3 depths (chorion, villous part and basal plate), providing 450 samples. The samples were analyzed via LC-HRMS (X500R QTOF, Sciex) after a minimal sample preparation. Data processing was done using several chemo-informatics tools (XCMS and W4M implemented in GALAXY) after workflow optimization and QA/QC validation. The annotation of features was achieved using fragmentation spectra comparison (DDA-MS2) with in-house and public databases, combined with MS1 and predicted RT-based matching to generate a small molecules placenta atlas.Results: 113 features were annotated with confidence level 1 (7%) and 2 (93%) in negative mode ionization. 15% of these annotations are exogenous compounds (pharmaceuticals, parabens, phthalates, phenols). Multivariate statistics highlight differences between chorion and the two other types of tissues. Several features (annotated and not) were detected with significantly different intensities between tissue types or between different placentas.Conclusion: After the set-up of a standardized pattern for collection, different zonas from placentas have been analyzed by LC-HRMS with a non-targeted approach. Several features were annotated and their relative intensities were compared on different variables, intra and inter-placentas