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Author Response: Cancer Risk Among Patients With Multiple Sclerosis: A 10-Year Nationwide Retrospective Cohort Study
No full textLetters to the Editor: Editors' ChoiceInternational audienc
Reporting ESG des groupes de la grande distribution alimentaire : focus sur l’emploi des personnes en situation de handicap
No full textInternational audienceOur research examines the reporting on the employment of people with disabilities made by French food retail groups. Our findings, based on a thematic content analysis, show that this reporting includes varied information related to the organizational structure of these groups and their actions. We also show how this reporting can reinforce their pragmatic, normative, and cognitive legitimacy in the eyes of their stakeholders, and we propose a typology of these groups based on their reporting practices. Our study helps clarify the link between disability reporting and legitimization strategies, and enriches understanding of corporate social responsibility (CSR) and environmental, social, and governance (ESG) reporting issues in food retail chains. Our research can thus guide organizations, particularly retail chains, wishing to promote the employment of people with disabilities and transparently communicate their commitments.Notre recherche étudie le reporting sur l’emploi de personnes en situation de handicap par les groupes de la grande distribution alimentaire française. Nos résultats, fondés sur une analyse thématique de contenu, montrent que ce reporting intègre des informations variées en lien avec la structuration des groupes et leurs actions. Nous montrons, par ailleurs, en quoi ce reporting peut renforcer leur légitimité pragmatique, normative et cognitive, auprès de leurs parties prenantes et proposons une typologie des groupes en fonction de leur reporting. Notre étude contribue à clarifier le lien entre reporting sur le handicap et stratégie de légitimation, ainsi qu’à enrichir la compréhension des enjeux de la RSE et du reporting ESG dans les réseaux de la grande distribution alimentaire. Notre recherche peut ainsi guider les organisations, notamment les réseaux de points de vente, souhaitant promouvoir l’emploi de personnes en situation de handicap et rendre compte de leurs engagements
Validation of REFRESH: a dietary screener for Rapid Evaluation FoR Environmentally Sustainable and Healthy diets
No full textDate d'acceptation du manuscrit : 2025-05International audienceBackgroundThe urgency of promoting sustainable diets, coupled with limited knowledge of dietary sustainability among health professionals, highlights the need for simple tools to assist in advocating for such diets in clinical settings.ObjectiveNotre objectif était de concevoir un outil de dépistage diététique pour évaluer la santé alimentaire et la durabilité environnementale, et de le valider.MethodsREFRESH (Rapid Evaluation FoR Environmentally Sustainable and Healthy diets) is a dichotomous tool targeting 10 key food groups for healthy diets with low environmental impacts. Each food group is scored as either 0 or 1 point, resulting in a total score ranging from 0 to 10—where 0 indicates the lowest and 10 the highest adherence to an environmentally sustainable and healthy diet. Internal consistency was assessed using the Kuder Richardson-20 (KR-20) coefficient. REFRESH’s relative validity was compared against food diaries, evaluating item agreement, and using Bland-Altman analysis for the total REFRESH score. Cross-classification was tested in low, medium, and high adherence to sustainable healthy diets, along with weighted kappa index. Construct validity was evaluated through Pearson correlation between REFRESH-derived scores and health-promoting and detrimental food groups and nutrients, and environmental impact indicators, as derived from food diaries.ResultsREFRESH had a KR-20 coefficient of 0.70, indicating good internal consistency. It showed high agreement with food diaries (60-88% item agreement), and Bland-Altman analysis indicated REFRESH scores were 1.1 points higher on average than food diaries. Cross-classification showed 59% agreement between methods, with only 1% of participants misclassified in the opposite category. REFRESH-derived scores positively correlated with health-promoting food groups and nutrients, and negatively with detrimental ones. Higher scores were linked to reduced environmental impacts.ConclusionsREFRESH has demonstrated good validity for assessing dietary healthiness and environmental sustainability, helping identify individuals with suboptimal diets
Des échanges épistolaires entre “Paralysés” aux échanges épistolaires et numériques avec des valides : le système des Cordées en 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 1932 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 1933 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
Carpal tunnel syndrome and occupational co-exposure to biomechanical factors and neurotoxic chemicals using job-exposure matrices and self-reported exposure: Findings from the Constances cohort
No full textInternational audienceObjective To study the association between occupational co-exposure to biomechanical risk factors, potentially neurotoxic chemicals and carpal tunnel syndrome (CTS) in a large cohort of French workers, using two methods to estimate chemical exposure: job-exposure matrices (JEM) and self-reported exposure. Methods A randomly selected sample of adults were included between 2012 and 2018 in the French cohort CONSTANCES. Self-reported CTS was assessed using the first self-administered follow-up questionnaire, sent out approximately one year after baseline. Occupational exposure to biomechanical risk factors was assessed using self-administered questionnaire completed at inclusion. Lifetime occupational exposure to chemicals was assessed using two different methods: with JEMs and with a self-administered questionnaire completed at inclusion. Multivariate logistic regression models were used to evaluate the association between co-exposure to biomechanical risk factors and chemicals and CTS, adjusted for personal and medical factors and stratified by gender. Results For the analysis using JEM assessment, 35,941 workers (16,920 men and 19,021 women) were included: 261 men (1.5%) and 469 women (2.5%) declared having CTS at follow-up. There was an association between CTS and the co-exposure group: OR=2.37 [1.60–3.44] in men and OR=2.09 [1.55–2.77] in women, compared to the non-exposed group. For the self-reported chemicals analysis, 42,168 workers (20,877 men and 21,291 women) were included: 338 men (1.6%) and 532 women (2.5%) declared having CTS at follow-up. There was an association between CTS and the co-exposure group: OR=3.07 [2.28–4.08] in men and OR=2.68 [1.91–3.66] in women, compared to the non-exposed group. Conclusions The study showed an association between self- reported CTS and co-exposure to biomechanical risk factors and chemicals. This finding should be confirmed using more objective case definition of CTS, e.g. carpal tunnel release surgery
Universités américaines : l’internationalisation devient-elle une ligne de défense ?
No full texthttps://theconversation.comOuvrir des campus à l’étranger peut-il devenir une stratégie pour les universités américaines désireuses d’échapper aux pressions politiques du locataire de la Maison Blanche ? Pas si sûr… Coûts cachés, standards académiques difficiles à maintenir, instabilité des pays hôtes : ces implantations sont bien plus fragiles qu’elles n’en ont l’air – et parfois tout simplement intenables
Savoirs expérientiels personnels « hors du sens commun » liés à la maladie chronique
No full textInternational audienceThe aim of this article is to relate, from a personal point of view, some 'uncommon' knowledge relating to the experience and management of my chronic health problems. The construction of this experiential expertise is based both on my experience of the illness and my understanding of it, as well as on the way in which I perceive my environment. In the first part, I discuss my medical career and how I have built up knowledge about illness and its management. Some ‘uncommon’ experiential knowledge has been slow to emerge and has been perfected, while others have not. In the second part, I present some 'uncommon' experiential knowledge, divided into several categories: (1) those based on adapting medical or alternative treatments, or judging their efficacy; (2) those based primarily on the type of postures to adopt, and (3) those based on selecting and adapting the equipment to be used.Cet article vise à exposer, d’un point de vue personnel, certains savoirs « hors du sens commun » relatifs au vécu et à la gestion de mes problèmes de santé chroniques. La construction de cette expertise expérientielle repose à la fois sur le vécu de la maladie, sa compréhension, mais aussi sur la manière dont j’appréhende mon environnement. Dans une première partie, j’évoque ma trajectoire médicale, et la manière dont j’ai construit des savoirs sur la maladie et sa gestion. Certains savoirs expérientiels « hors du sens commun » ont été lents à émerger et sont perfectionnés, d’autres non. Dans une seconde partie, je présente ces savoirs expérientiels « hors du sens commun », classés en plusieurs catégories : (1) ceux qui se fondent sur l’adaptation des traitements médicaux ou alternatifs ou sur le jugement sur leur efficacité ; (2) ceux qui reposent principalement sur le type de postures à adopter, et (3) ceux qui reposent sur la sélection et l’adaptation du matériel à utiliser
The effect of extreme temperatures on healthcare utilization during pregnancy: Findings from a nationally representative survey in India
No full textInternational audienceBackground: Extreme temperatures are increasing in frequency and severity, posing growing risks to maternal and child health through adverse pregnancy and birth outcomes. This challenge is especially pronounced in countries like India, that lack adequate protections against climate-related health risks. While socio-economic and accessibility barriers already limit healthcare utilization during pregnancy, climatic factors such as extreme temperatures can create additional obstacles to accessing these essential services, thereby influencing pregnancy and birth outcomes both directly and indirectly.Methods: We conducted a cross-sectional analysis using data from the National Family Health Survey (NFHS-5), a nationally representative survey for India. We examined recent healthcare utilization reported by women in their fifth month of pregnancy or later (N = 10,606). Temperature exposure was measured using daily Wet Bulb Globe Temperature (WBGT), Heat Index, and Dry Bulb Temperature (DBT) matched to respondents' geo-coded residential clusters. We calculated the number of days during the study period when temperature values exceeded or fell below extreme temperature thresholds. Generalized mixed-effects models with Inverse Propensity of Treatment Weighting (IPTW) examined associations between extreme temperature and no healthcare contact, with effect modification tested across socioeconomic variables.Findings: Extreme heat exposure significantly increased the likelihood of healthcare non-utilization among pregnant women, with the strongest associations observed for WBGT and Heat Index measures. Each additional day above the 90th percentile WBGT threshold increased odds of no healthcare contact by 11%, with similar patterns across the 85th and 95th percentiles. Heat Index showed consistent positive associations across all thresholds (8-11% increases), while DBT trends were positive but not statistically significant. For extreme cold exposure, temperature indicators showed some association with healthcare non-utilization, though results were not consistent across exposure definitions. We did not find evidence of effect modification across socioeconomic groups, with only a few isolated exposure definitions showing significant difference between subgroups
First implementation of a collaborative care model for common mental disorders in primary care in France: Fidelity of care manager intervention matters
No full textAbstract Background Care for common mental disorders relies on primary care, where they often remain undiagnosed and untreated. The collaborative care model (CoCM) is a team-based approach involving care managers (CMs) who work alongside general practitioners and remote psychiatrists to provide evidence-based mental healthcare. Between 2021 and 2023, a pilot study implemented the CoCM for the first time in France in four primary care practices with nurses with previous professional experience in psychiatry acting as the CMs. As part of the implementation research of this pilot, we analyzed the fidelity of the CM intervention with the original CoCM, considering the CM process of care metrics and whether it followed a stepped-care approach, and its link with patients’ outcomes, which have rarely been addressed in previous international research on the CoCM. Methods Using electronic medical records, we calculated fidelity measures, including CM early intervention (time to first intervention), intensive care (number of visits and intervention duration), evidence-based care (type of care delivered), and variations according to initial symptom severity, in line with a stepped-care approach. Patient outcomes, particularly depression response and remission, were described according to initial symptom severity and fidelity measures. Results A total of 235 patients were included in the study. The care provided by CMs tended to match the original CoCM, in terms of early intervention, intensive care, and type of care delivered. It was adapted to the initial symptom severity, in particular for early intervention, in line with a stepped-care approach. Higher fidelity of the CM intervention to the CoCM, especially with respect to the time to treatment initiation and number of visits, was associated with better patient outcomes. Conclusions The CoCM shows promise for improving the treatment of common mental disorders in a stepped-care approach in French primary care. Its extension requires ensuring the fidelity of the CM intervention to the model in real-world settings, which appears crucial to achieving optimal patient outcomes and provides useful lessons for other countries implementing the CoCM. Trial registration number : not applicabl
