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1. Changes over time in anxiety, depression, and stress symptoms among healthcare workers in French emergency departments during the first COVID-19 outbreak

Author

Douplat, Marion, Termoz, Anne, Subtil, Fabien, Haesebaert, Julie, Jacquin, Laurent, Durand, Guillaume, Potinet, Veronique, Hernu, Romain, Nohales, Ludivine, Mazza, Stéphanie, Berthiller, Julien, Tazarourte, Karim, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Hôpital Nord-Ouest de Villefranche-sur-Saône [Gleize] (HNOVS), Hôpital de la Croix-Rousse [CHU - HCL], and Dubois Frid, Caroline

Subjects
MESH: Humans, MESH: Anxiety, MESH: Depression, Depression, SARS-CoV-2, Emergency department, Health Personnel, COVID-19, Anxiety, Stress, MESH: Prospective Studies, Disease Outbreaks, [SHS]Humanities and Social Sciences, Psychiatry and Mental health, Clinical Psychology, MESH: Emergency Service, Hospital, Humans, Healthcare workers, MESH: COVID-19, MESH: Health Personnel, MESH: SARS-CoV-2, [SHS] Humanities and Social Sciences, Prospective Studies, MESH: Disease Outbreaks, Emergency Service, Hospital
Abstract

International audience; Study objective: Assess the changes in anxiety, depression, and stress levels over time and identify risk factors among healthcare workers in French emergency departments (EDs) during the first COVID-19 outbreak.Method: A prospective, multicenter study was conducted in 4 EDs and an emergency medical service (SAMU). During 3 months, participants completed fortnightly questionnaires to assess anxiety, depression, and stress using the Hospital Anxiety and Depression and the Chamoux-Simard scale. The changes in anxiety, depression, and stress levels over time were modelled by a linear mixed model including a period effect and a continuous time effect within periods.Results: A total of 211 respondents (43.5 %) completed the survey at inclusion. There was a decrease in mean anxiety (from 7.33 to 5.05, p < 0.001), mean depression (from 4.16 to 3.05, p = 0.009), mean stress at work (from 41.2 to 30.2, p = 0.008), and mean stress at home (from 33.0 to 26.0, p = 0.031) at the beginning of each period. The mean anxiety level was higher for administrative staff (+0.53) and lower for paramedics (-0.61, p = 0.047) compared to physicians. The anxiety level increased with the number of day and night shifts (0.13/day, p < 0.001, 0.12/night, p = 0.025) as did stress at work (1.6/day, p < 0.001, 1.1/night, p = 0.007). Reassigned healthcare workers were at higher risk of stress particularly compared to SAMU workers (stress at work: p = 0.015, at home: p = 0.021, in life in general: p = 0.018).Conclusion: Although anxiety, depression, and stress decreased over time, anxiety was higher among physicians and administrative staff. Reassignment and working hours were identified as potential risk factors for mental health distress in EDs.Trial registration: ClinicalTrials.gov NCT04383886.

Published
2022
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2. Fear of stigma from health professionals and family/neighbours and healthcare avoidance among PLHIV in Morocco: results from the Stigma Index survey Morocco

Author

Rosemary M, Delabre, Amal Ben, Moussa, Virginie, Villes, Mohammed, Elkhammas, Lahoucine, Ouarsas, Daniela, Castro Rojas Castro, Mehdi, Karkouri, Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Association de Lutte Contre le SIDA [Marrakech, Morocco], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut des sciences de la santé publique [Marseille] (ISSPAM)

Subjects
Male, Health Personnel, [SDV]Life Sciences [q-bio], Social Stigma, MESH: Delivery of Health Care, MESH: Fear, HIV Infections, Surveys and Questionnaires, Humans, MESH: Surveys and Questionnaires, Key Populations, MESH: Humans, Public Health, Environmental and Occupational Health, HIV, Fear, Healthcare access, MESH: HIV Infections, MESH: Male, Morocco, Stigma, MESH: Morocco, MESH: Health Personnel, Female, MESH: Social Stigma, Delivery of Health Care, MESH: Female
Abstract

Background Enacted or anticipated stigma among people living with HIV (PLHIV) can negatively impact healthcare engagement. We identified factors associated with having avoided HIV health services for fear of stigma among PLHIV in Morocco. Methods The Stigma Index survey was conducted in Morocco in March-June 2016. Factors associated with avoiding HIV testing and treatment services for fear of stigma by (A) health personnel or family/neighbours and (B) health personnel and family/neighbours compared to people who did not avoid health services for fear of stigma from either of the two sources were assessed using multinomial logistic regression models. Results Among 583 respondents, 280 (48.0%) were women and median number of years living with HIV was 5[IQR:2–7]. Half of the respondents reported avoiding health services for fear of stigma by health personnel and/or family/neighbours: (A) n = 228, 39.1% and (B) n = 68, 11.7%. After adjustment on perceived health status, not having had easy access to antiretroviral treatment ((A) aRR [95% CI] = 1.76[1.16; 2.68]; (B) 2.18[1.11; 4.27]), discrimination by PLHIV ((A) 1.87[1.12; 3.13]; (B) 3.35[1.63; 6.88]) and exclusion from social activities ((A) 1.70[1.10; 2.61]; (B) 2.63[1.39; 5.00]) were associated with having avoided health services for fear of stigma by health personnel or/and family/neighbours. Being female (2.85[1.48; 5.47]), not having been referred for an HIV test for suspected symptoms 3.47[1.67; 7.22], having discussed sexual/reproductive health with a health professional (4.56[2.38; 8.71]), and not having the feeling to influence decisions on local projects for PLHIV (3.47[1.37; 7.83], were associated with having avoided health services for fear of stigma by both sources. Conclusion Results suggest a cumulative effect of fear of stigma and discrimination among PLHIV in Morocco. PLHIV who have experienced discrimination may seek to avoid similar situations at the expense of their health. These results should inform multi-level interventions and broader advocacy efforts to reduce stigma and discrimination.

Published
2022
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3. Exercise in lung Cancer, the healthcare providers opinion (E.C.H.O.): Results of the EORTC lung cancer Group (LCG) survey

Author

Sara Pilotto, Alice Avancini, Jessica Menis, Isabella Sperduti, Matteo Giaj Levra, Thierry Berghmans, Paolo Bironzo, Mariana Brandão, Dirk De Ruysscher, John Edwards, Corinne Faivre-Finn, Nicolas Girard, Laurent Greillier, Lizza Hendriks, Sylvie Lantuejoul, Murielle Mauer, Silvia Novello, Mary O'Brien, Martin Reck, Noemi Reguart, Jordi Remon, Jan von der Thüsen, Anne-Marie C. Dingemans, Benjamin Besse, Michele Milella, Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Jules Bordet [Bruxelles], Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto = University of Porto, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Royal Holloway [University of London] (RHUL), University of Manchester [Manchester], Méthodes computationnelles pour la prise en charge thérapeutique en oncologie : Optimisation des stratégies par modélisation mécaniste et statistique (COMPO), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Multidisciplinary Oncology and Therapeutic Innovations Unit, Hôpital Nord [CHU - APHM], Département d'hématologie [Gustave Roussy], Institut Gustave Roussy (IGR), School for Oncology and Developmental Biology [Maastricht] (GROW), Maastricht University [Maastricht]-Maastricht University Medical Centre (MUMC), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Università degli studi di Torino = University of Turin (UNITO), German Center for Lung Research, August Pi i Sunyer Biomedical Research Institute - IDIBAPS [Barcelona, Spain], Centro Integral Oncologico Clara Campal, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Radiotherapie, Pulmonologie, Pathology, and Pulmonary Medicine

Subjects
Pulmonary and Respiratory Medicine, REHABILITATION, Cancer Research, Lung Neoplasms, Facilitators, Clinicians, Health Personnel, [SDV.CAN]Life Sciences [q-bio]/Cancer, AMERICAN-COLLEGE, GUIDELINES, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Referral and Consultation, SDG 3 - Good Health and Well-being, QUALITY-OF-LIFE, Surveys and Questionnaires, Humans, Barriers, Current practice, Exercise, Lung cancer, Oncologist, Physical activity, Recommendation, Referral and Consultation, MESH: Surveys and Questionnaires, MEDICINE ROUND-TABLE, MESH: Humans, RANDOMIZED CONTROLLED-TRIAL, CHEMOTHERAPY, MESH: Lung Neoplasms, PHYSICAL-ACTIVITY, Oncology, MESH: Exercise, MESH: Health Personnel, INTERVENTION
Abstract

Objectives: Exercise has been reported to alleviate disease as well as treatment impact in patients with lung cancer. Nevertheless, there is limited information available regarding the perception of lung cancer dedicated healthcare professionals’ and their advice on exercise. Materials and Methods: An online survey exploring healthcare professionals’ practice patterns, perceptions, barriers, and facilitators of exercise in patients with lung cancer was conducted within members of the EORTC Lung Cancer Group (LCG). Results: One hundred forty-one healthcare providers completed the survey, mainly medical and radiation oncologists. Overall, 63% of the study participants declared that they frequently assessed exercise level in their patients, and 43% of them reinforced the importance of exercise. However, only 10% referred patients to an exercise program or specialist. Although the majority of the respondents had a positive perception regarding the benefits and safety of exercise (even in patients with advanced disease and/or bone metastasis), two-thirds of clinicians reported not having adequate training about exercise counselling. Moreover, 53% reported to lack of knowledge of guidelines referring to exercise in patients with cancer. Several obstacles and facilitators to improve exercise promotion in lung cancer care were identified. Conclusion: Healthcare providers recognize the relevance and feasibility of exercise as part of cancer treatment intervention, but specific pathways to do the referral are frequently missing. Future structured and well-designed strategies and initiatives are needed to support an effective referral in order to implement exercise interventions routinely in clinical practice.

Published
2022
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4. Sex Differences in the Evolution of Neutralizing Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2

Author

Cyril Planchais, David Rey, Aurélie Velay, Ludivine Grzelak, Yoann Madec, Yves Hansmann, Isabelle Staropoli, Marie-Josée Wendling, Samira Fafi-Kremer, Arnaud Fontanet, Catherine Schmidt-Mutter, Timothée Bruel, Hugo Mouquet, Nathalie Reix, Ludovic Glady, Floriane Gallais, Olivier Schwartz, María González, Nicolas Meyer, Jérôme De Seze, Virus et Immunité - Virus and immunity, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Université Paris Cité (UPCité), Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Les Hôpitaux Universitaires de Strasbourg (HUS), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], CHU Strasbourg, Groupe Méthodes en Recherche Clinique [Strasbourg] (GMRC), Nouvel Hôpital Civil [Strasbourg], CHU Strasbourg-CHU Strasbourg, Immunologie humorale - Humoral Immunology, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Vaccine Research Institute (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), S. F. K.’s laboratory is funded by Strasbourg University Hospitals (Hôpitaux Universitaires de Strasbourg, PRI 7782), Agence Nationale de la Recherche (ANR-18-CE17-0028), Laboratoire d’Excellence TRANSPLANTEX (ANR-11-LABX-0070_TRANSPLANTEX), and Institut National de la Santé et de la Recherche Médicale (UMR_S 1109). O. S.’s laboratory is funded by Institut Pasteur, Urgence COVID-19 Fundraising Campaign of Institut Pasteur, Agence Nationale de recherches sur le sida, Sidaction, the Vaccine Research Institute (ANR-10-LABX-77), Labex IBEID (ANR-10-LABX-62-IBEID), 'TIMTAMDEN' Agence Nationale de la Recherche ANR-14-CE14-0029, 'CHIKV-Viro-Immuno' ANR-14-CE14-0015-01, the Gilead HIV cure program, and ANR/Fondation Pour la Recherche Médicale Flash COVID. L. Gr., is supported by the French Ministry of Higher Education, Research and Innovation., ANR-18-CE17-0028,HuMABK,Les anticorps monoclonaux humains : une Nouvelle approche thérapeutique contre l'infection par le virus BK et les maladies associées(2018), ANR-11-LABX-0070,TRANSPLANTEX,Nouveaux loci d'histocompatibilité/biomarqueurs en transplantation humaine: de la découverte à l'app(2011), ANR-10-LABX-0077,VRI,Initiative for the creation of a Vaccine Research Institute(2010), ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-14-CE14-0029,TIMTAMDEN,Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue(2014), ANR-14-CE14-0015,CHIKV-Viro-Immuno,Multiplication et Relation avec l'hôte du virus Chikungunya(2014), Virus et Immunité - Virus and immunity (CNRS-UMR3569), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Vaccine Research Institute [Créteil, France] (VRI), univOAK, Archive ouverte, APPEL À PROJETS GÉNÉRIQUE 2018 - Les anticorps monoclonaux humains : une Nouvelle approche thérapeutique contre l'infection par le virus BK et les maladies associées - - HuMABK2018 - ANR-18-CE17-0028 - AAPG2018 - VALID, Nouveaux loci d'histocompatibilité/biomarqueurs en transplantation humaine: de la découverte à l'app - - TRANSPLANTEX2011 - ANR-11-LABX-0070 - LABX - VALID, Laboratoires d'excellence - Initiative for the creation of a Vaccine Research Institute - - VRI2010 - ANR-10-LABX-0077 - LABX - VALID, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Appel à projets générique - Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue - - TIMTAMDEN2014 - ANR-14-CE14-0029 - Appel à projets générique - VALID, and Appel à projets générique - Multiplication et Relation avec l'hôte du virus Chikungunya - - CHIKV-Viro-Immuno2014 - ANR-14-CE14-0015 - Appel à projets générique - VALID

Subjects
0301 basic medicine, sex-related differences, MESH: Spike Glycoprotein, Coronavirus, medicine.disease_cause, Immunoglobulin G, MESH: Antibodies, Neutralizing, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, antibodies, MESH: COVID-19, Immunology and Allergy, Medicine, MESH: SARS-CoV-2, 030212 general & internal medicine, Polymerase chain reaction, Coronavirus, MESH: Immunoglobulin G, 2. Zero hunger, MESH: Humans, MESH: Middle Aged, biology, SARS-CoV-2, business.industry, COVID-19, MESH: Adult, MESH: Immunoglobulin M, MESH: Male, 3. Good health, 030104 developmental biology, Infectious Diseases, Real-time polymerase chain reaction, [INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV], Immunoglobulin M, MESH: HEK293 Cells, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Immunology, biology.protein, MESH: Health Personnel, Antibody, business, MESH: Female, Body mass index, MESH: Antibodies, Viral, MESH: Sex Characteristics, Sex characteristics
Abstract

We measured anti-spike (S), nucleoprotein (N), and neutralizing antibodies in sera from 308 healthcare workers with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 and with mild disease, collected at 2 timepoints up to 6 months after symptom onset. At month 1, anti-S and -N antibody levels were higher in male participants aged >50 years and participants with a body mass index (BMI) >25 kg/m2. At months 3–6, anti-S and anti-N antibodies were detected in 99% and 59% of individuals, respectively. Anti-S antibodies and neutralizing antibodies declined faster in men than in women, independent of age and BMI, suggesting an association of sex with evolution of the humoral response.

Published
2021
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5. COVID-19 pandemic

Author

W. J. Fokkens, Jürgen Schwarze, Cezmi A. Akdis, J Mullol, W. Czarlewski, Claudia Traidl-Hoffmann, Claus Bachert, D. Larenas-Linnemann, Tomas Chivato, M. Gotua, Mateo Bonini, Ludger Klimek, Vincenzo Patella, A. A. Cruz, Stephanie Dramburg, Kari C. Nadeau, H W Fritsch, K. Ohta, Thomas Eiwegger, Robert M. Naclerio, Antti Lauerma, A. Yorgancioglu, Aslı Gelincik, Piotr Kuna, Oliver Pfaar, Carmen Riggioni, Violeta Kvedariene, Markus Ollert, Sinthia Bosnic-Anticevich, V. Cardona, S. Del Giacco, Sanna Toppila-Salmi, Helen A. Brough, Heimo Breiteneder, Valérie Hox, B. Samolinski, Zuzana Diamant, G.W. Canonica, Lihong Zhang, María José Torres, Y. Okamoto, Liam O'Mahony, Radosław Gawlik, Jolanta Walusiak-Skorupa, Sharon Chinthrajah, Winfried Rief, T. Haatela, M. Morais-Almeida, Ioana Agache, Manfred Schedlowski, I Skypala, R. Brehler, D. Y. Wang, João Fonseca, I. J. Ansotegui, Robyn E O'Hehir, Oscar Palomares, Charlotte G. Mortz, J. C. Ivancevich, C. Suppli Ulrik, M. T. Ventura, P M Matricardi, S Untersmayr, Gabrielle L. Onorato, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Vanitha Sampath, Arũnas Valiulis, Marek Jutel, Luisa Brussino, Pedro Carreiro-Martins, Jean Bousquet, Nikolaos G. Papadopoulos, A. Bedbrook, Torsten Zuberbier, Karin Hoffmann-Sommergruber, Edward F. Knol, Ear, Nose and Throat, AII - Inflammatory diseases, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Philipps Universität Marburg = Philipps University of Marburg, Allergologie, Stimm und Sprachstörungen [Wiesbaden, Germany], Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], University of Wrocław [Poland] (UWr), ALL-MED, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Medizinische Universität Wien = Medical University of Vienna, Stanford University, Skane University Hospital [Malmo], Lund University [Lund], Charles University [Prague] (CU), University Medical Center Groningen [Groningen] (UMCG), Univ Toronto, Hosp Sick Children, Peter Gilgan Ctr Res & Learning, Mol Med, Toronto, ON M5G 0A4, Canada, The Hospital for sick children [Toronto] (SickKids), University of Toronto, Amsterdam UMC - Amsterdam University Medical Center, Alfred Health, Victoria University [Melbourne], University College Cork (UCC), Sean N. Parker Center for Allergy and Asthma Research [Stanford], Stanford Medicine, Stanford University-Stanford University, University Clinics of Essen, University of Essen, Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Helmholtz Zentrum München = German Research Center for Environmental Health, University Hospital Augsburg, National University of Singapore (NUS), Beijing Tongren Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Evelina London Children's Hospital, King‘s College London, CEU-San Pablo University and HM-Hospitals School of Medicine, University of Cagliari, Medical University of Silesia (SUM), Istanbul University, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Helsinki University Central Hospital, University of Helsinki, Odense University Hospital (OUH), Luxembourg Institute of Health (LIH), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Hospital Sant Joan de Déu [Barcelona], Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], University of Edinburgh, NHS Foundation Trust [London], The Royal Marsden, Nofer Institute of Occupational Medicine (NIOM), Hospital Quirónsalud Bizkaia [Bilbao], Ghent University Hospital, Sun Yat-Sen University [Guangzhou] (SYSU), Karolinska Institutet [Stockholm], Woolcock Institute of Medical Research [Sydney], The University of Sydney, University of Turin, Mauriziano Umberto I Hospital, Humanitas University [Milan] (Hunimed), Vall d'Hebron University Hospital [Barcelona], Hospital de Dona Estefania, NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Federal University of Bahia School of Medicine, Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Medical Consulting Czarlewski, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, MEDIDA, Lda, David Tvildiani Medical University (DTMU), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Barlicki University Hospital, Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], Pantai Hospital [Kuala Lumpur], Hospital CUF Descobertas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), CIBER de Epidemiología y Salud Pública (CIBERESP), Johns Hopkins University School of Medicine [Baltimore], Fukujuji Hospital, Tokyo National Hospital, Chiba Rosai Hospital, Chiba University Hospital, Royal Manchester Children's Hospital, University of Manchester [Manchester], General Children's Hospital of Athens P & A Kyriakou, 'Santa Maria della Speranza' Hospital, Centro Hospitalar e Universitário [Coimbra], Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), University of Coimbra [Portugal] (UC), Medical University of Warsaw - Poland, Hvidovre Hospital, University of Copenhagen = Københavns Universitet (UCPH), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Transilvania University of Brasov, Salvy-Córdoba, Nathalie, Department of Dermatology, Allergology and Venereology, and HUS Inflammation Center

Subjects
0301 basic medicine, viruses, Eaaci Position Paper, Medizin, Cochrane Library, GUIDELINES, FOOD ALLERGY, allergen immunotherapy, allergy clinic, anaphylaxis, asthma, clinical trials, COVID-19, Position Paper, psychological impact, SARS-CoV-2, Allergists, Health Personnel, Humans, Hypersensitivity, Information Technology, Patient Care Team, Triage, SARS‐CoV‐2, DESENSITIZATION, 0302 clinical medicine, MESH: Patient Care Team, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, HDE ALER, Pandemic, Health care, Immunology and Allergy, ATOPIC-DERMATITIS, MESH: COVID-19, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, allergen immunotherapy (AIT), virus diseases, DRUG HYPERSENSITIVITY REACTIONS, 3. Good health, INFECTIONS, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Triage, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Allergen immunotherapy, medicine.medical_specialty, MESH: Information Technology, MESH: Hypersensitivity, Immunology, education, MEDLINE, DIAGNOSIS, psychological COVID, 03 medical and health sciences, MESH: Allergists, COVID‐19, medicine, MESH: SARS-CoV-2, ddc:610, RHINOSINUSITIS, MESH: Humans, business.industry, Clinical trial, Coronavirus, EXACERBATIONS, 030104 developmental biology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Position paper, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

BackgroundThe Coronavirus disease 2019 (COVID‐19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.MethodThe scientific information on COVID‐19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet.ResultsBased on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic.

Published
2021
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6. Combined monitoring of IgG and IgA anti-Spike and anti-Receptor binding domain long term responses following BNT162b2 mRNA vaccination in Greek healthcare workers

Author

Ioannis Sarrigeorgiou, Dimitra Moschandreou, Alexios Dimitriadis, Gerasimina Tsinti, Evangelia Sotiropoulou, Eleni Ntoukaki, Petros Eliadis, Marija Backovic, Stavroula Labropoulou, Nicolas Escriou, Abraham Pouliakis, Georgia Giannopoulou, Eleni Gaitanarou, Konstantinos Lazaridis, Andreas Mentis, Avgi Mamalaki, Elisavet Grouzi, Peggy Lymberi, Institut Pasteur Hellénique, Réseau International des Instituts Pasteur (RIIP), Saint Savvas Hospital, Virologie Structurale - Structural Virology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d’innovation : vaccins – Innovation lab : vaccines, Institut Pasteur [Paris] (IP), Attikon University Hospital, We acknowledge support of this work by the HPI (Decision of the Administration Council, Reference Number: 14365 / 28.12.2020) and the project ‘INSPIRED’ (MIS 5002550), under the Action ‘Reinforcement of the Research and Innovation Infrastructure’, funded by the Operational Program ‘Competitiveness, Entrepreneurship and Innovation’ (NSRF 2014‐2020), and action co-funded by the Greek Government and the European Union—European Regional Development Fund.

Subjects
MESH: Immunoglobulin G, MESH: Humans, Multidisciplinary, Greece, SARS-CoV-2, Health Personnel, Vaccination, COVID-19, MESH: Vaccination, Immunoglobulin A, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Greece, Immunoglobulin G, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: COVID-19, MESH: Health Personnel, Humans, MESH: SARS-CoV-2, MESH: Immunoglobulin A, RNA, Messenger, MESH: BNT162 Vaccine, BNT162 Vaccine, MESH: RNA, Messenger
Abstract

International audience; Studies on the humoral response to homologous BNT162b2 mRNA-vaccination focus mainly on IgG antibody dynamics, while long-term IgA kinetics are understudied. Herein, kinetics of IgG and IgA levels against trimeric-Spike (S) and Receptor-Binding-Domain (RBD) were evaluated by in-house ELISAs in 146 two-dose vaccinated Greek healthcare workers (HCWs) in a 9-month period at six time points (up to 270 days after the first dose). The effect of a homologous booster third dose was also studied and evaluated. The peak of immune response was observed 21 days after the second dose; 100% seroconversion rate for anti-S and anti-RBD IgG, and 99.7% and 96.3% respectively for IgA. IgG antibody levels displayed higher increase compared to IgA. Declining but persistent anti-SARS-CoV-2 antibody levels were detected 9 months after vaccination; IgG and IgA anti-S levels approached those after the first dose, while a more rapid reduction rate for anti-RBD antibodies led to significantly lower levels for both classes, supporting the need for a booster dose. Indeed, a homologous booster third dose resulted in enhanced levels of anti-S of both classes, whereas anti-RBD didn’t exceed the peak levels after the second dose. Previous SARS-CoV-2 infection, flu vaccination, BMI

Published
2022
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7. Atypical clinical presentation of COVID-19 infection in residents of a long-term care facility

Author

Mylène Albrand, Stéphanie Miot, Jean Bousquet, Nadia Giacosa, Yves Rolland, Hubert Blain, Athanase Benetos, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Gérontopôle, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse], Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Gériatrie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Berlin Institute of Health (BIH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Humboldt-Universität zu Berlin, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Humboldt University Of Berlin, and Herrada, Anthony

Subjects
Male, Pediatrics, Delayed Diagnosis, rRT-PCR, Testing for SARS-CoV-2, Disease, Polymerase Chain Reaction, Hypoxemia, MESH: Long-Term Care, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: COVID-19, Medicine, Infection control, MESH: Skilled Nursing Facilities, 030212 general & internal medicine, MESH: Aged, Aged, 80 and over, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Brief Report, MESH: Accidental Falls, 3. Good health, MESH: Diarrhea, Diarrhea, COVID-19 Nucleic Acid Testing, Female, medicine.symptom, Presentation (obstetrics), Long-term-care facility, MESH: Pandemics, medicine.medical_specialty, Health Personnel, Asymptomatic, MESH: COVID-19 Nucleic Acid Testing, 03 medical and health sciences, Humans, MESH: SARS-CoV-2, Pandemics, Aged, Skilled Nursing Facilities, MESH: Humans, 030214 geriatrics, SARS-CoV-2, business.industry, COVID-19, MESH: Polymerase Chain Reaction, Long-Term Care, MESH: Male, MESH: Delayed Diagnosis, Long-term care, MESH: Health Personnel, Delirium, Accidental Falls, business, MESH: Female
Abstract

Key summary points Aim To assess the magnitude of the infection in residents from—and staff working in—a long-term-care facility (LTCF) 7 days after the identification of one resident with confirmed COVID-19 infection and the clinical presentation of the infected residents. Findings Two weeks after the first case, 50.9% of residents and 27.5% of the workers were tested positive for SARS-CoV-2. Diarrhea, fall, delirium, and hypothermia can be initial symptoms of COVID-19 in LTCF residents. Message The rapid dissemination of a COVID-19 infection in a LTCF may be due to a delay in the diagnosis of the first case, whose presentation could be atypical in residents., Purpose To assess the magnitude of the infection in residents from—and staff working in—a long-term-care facility (LTCF) 7 days after the identification of one resident with confirmed COVID-19 infection and to assess the clinical presentation of the infected residents. Methods All residents and staff members of a LTCF were tested for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction on nasopharyngeal swab. Residents were studied clinically 4 weeks after the first COVID diagnosis. Results Thirty-eight of the 79 residents (48.1%) tested positive for SARS-CoV-2. Respiratory symptoms were preceded by diarrhea (26.3%), a fall (18.4%), fluctuating temperature with hypothermia (34.2%) and delirium in one resident. Respiratory symptoms, including cough and oxygen desaturation, appeared after those initial symptoms or as the first sign in 36.8% and 52.2%, respectively. At any time of the disease, fever was observed in 65.8%. Twelve deaths occurred among the COVID-19 residents. Among the 41 residents negative for SARS-CoV-2, symptoms included cough (21.9%), diarrhea (7.3%), fever (21.9%), hypothermia (9.7%), and transient hypoxemia (9.8%). No deaths were observed in this group. 27.5% of the workers were also COVID-19 positive. Conclusion The rapid dissemination of the COVID-19 infection may be explained by the delay in the diagnosis of the first cases due to atypical presentation. Early recognition of symptoms compatible with COVID-19 may help to diagnose COVID-19 residents earlier and test for SARS-CoV-2 symptomatic and asymptomatic staff and residents earlier to implement appropriate infection control practices.

Published
2020
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8. Use of psychoactive substances by night-shift hospital healthcare workers during the first wave of the COVID-19 pandemic: a cross-sectional study based in Parisian public hospitals (ALADDIN)

Author

Lorraine Cousin, Vincent Di Beo, Fabienne Marcellin, Sarah Coscas, Véronique Mahé, Isabelle Chavignaud, Olivia Rousset Torrente, Olivier Chassany, Martin Duracinsky, Maria Patrizia Carrieri, Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Mission Fides - CME [Hôpital Paul-Brousse AP-HP] (MF), Hôpital Lariboisière-Fernand-Widal [APHP], Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], and AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)

Subjects
Male, MESH: Pandemics, Health Personnel, [SDV]Life Sciences [q-bio], occupational & industrial medicine, risk management, health & safety, MESH: Cross-Sectional Studies, MESH: Hospitals, Public, MESH: Alcoholism, Humans, MESH: COVID-19, MESH: SARS-CoV-2, Pandemics, MESH: Humans, Hospitals, Public, SARS-CoV-2, public health, COVID-19, MESH: Quality of Life, General Medicine, MESH: Male, Alcoholism, Cross-Sectional Studies, Quality of Life, MESH: Health Personnel, epidemiology
Abstract

ObjectivesThis study aimed to estimate the prevalence of psychoactive substance (PAS) use in night-shift healthcare workers (NSHW) during France’s first COVID-19 wave (March–May 2020).DesignObservational cross-sectional online survey.Setting39 public hospitals in the Assitance Publique des Hôpitaux de Paris (AP-HP) network in the Parisian area.ParticipantsA total of 1238 nurses, assistant nurses, X-ray technicians, managers, lab technicians, midwives and childcare assistants working at night or alternating between days and nights answered the questionnaire.InterventionOnline survey.Outcome measuresPAS use prevalence after weighting data for sex, age and profession using calibration on margins, in order to be representative of all AP-HP NSHW. We used the Fagerström scale and the Alcohol Use Disorders Identification Test Concise to assess PAS use.ResultsThe weighted estimated prevalences of daily smoking, alcohol drinking and tranquilliser use in participating NSHW were 21.4, 1.3 and 2.4%, respectively. Twelve per cent (11.7%) of our study sample used opioids. During the first COVID-19 wave, PAS use remained stable except for tobacco use, with 8.6% of participants reporting an increase. Previous 3-month prevalences of tranquilliser and opioid use were significantly higher than in the general population.ConclusionDaily smoking (especially in younger men) and tranquilliser and opioid use were highly prevalent in NSHW in the AP-HP network during France’s first COVID-19 wave. Specific interventions for quitting smoking and addressing determinants of tranquilliser and opioid use in NSHW need to be developed and evaluated to improve quality of life in these essential, underdiagnosed and undertreated health personnel.

Published
2022
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9. Antibodies Targeting KSHV gH/gL Reveal Distinct Neutralization Mechanisms

Author

Anna Katharina Großkopf, Armin Ensser, Thomas Fricke, Alexander Hahn, Marija Backovic, German Primate Center - Deutsches Primatenzentrum -- Leibniz Insitute for Primate Research -- [Göttingen, Allemagne] (GPC - DPZ), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Virologie Structurale - Structural Virology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), This work was supported by grants to A.S.H. from the Deutsche Forschungsgemeinschaft (https://www.dfg.de, grant no. HA 6013/4-1), the Wilhelm-Sander Foundation (https://www.wilhelm-sander-stiftung.de, and project no. 2019.027.1), and by an Exploration Grant from the Boehringer-Ingelheim Foundation to A.S.H, as well as by grants to A.E. from the Deutsche Forschungsgemeinschaft EN 423/5-1 and from the IZKF Erlangen, project A81.

Subjects
fusion, [SDV]Life Sciences [q-bio], KSHV, HHV-8, neutralizing antibodies, gH/gL, herpesvirus entry, Mice, Viral Envelope Proteins, Virology, MESH: COVID-19, Animals, MESH: SARS-CoV-2, MESH: Immunoglobulin A, ddc:610, MESH: BNT162 Vaccine, MESH: RNA, Messenger, MESH: Immunoglobulin G, MESH: Humans, KSHV HHV-8 neutralizing antibodies gH/gL herpesvirus entry fusion, MESH: Vaccination, Virus Internalization, Antibodies, Neutralizing, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, MESH: Greece, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Ferritins, Herpesvirus 8, Human, MESH: Health Personnel
Abstract

International audience; Kaposi’s sarcoma herpesvirus (KSHV) is associated with a significant disease burden, in particular in Sub-Sahara Africa. A KSHV vaccine would be highly desirable, but the mechanisms underlying neutralizing antibody responses against KSHV remain largely unexplored. The complex made of glycoproteins H and L (gH/gL) activates gB for the fusion of viral and cellular membranes in all herpesviruses. KSHV gH/gL also interacts with cellular Eph family receptors. To identify optimal antigens for vaccination and to elucidate neutralization mechanisms, we primed mice with recombinantly expressed, soluble gH/gL (gHecto/gL) that was either wildtype (WT), lacking defined glycosylation sites or bearing modified glycosylation, followed by boosts with WT gHecto/gL. We also immunized with a gL-gHecto fusion protein or a gHecto-ferritin/gL nanoparticle. Immune sera neutralized KSHV and inhibited EphA2 receptor binding. None of the regimens was superior to immunization with WT gHecto/gL with regard to neutralizing activity and EphA2 blocking activity, the gL-gHecto fusion protein was equally effective, and the ferritin construct was inferior. gH/gL-targeting sera inhibited gB-mediated membrane fusion and inhibited infection also independently from receptor binding and gL, as demonstrated by neutralization of a novel KSHV mutant that does not or only marginally incorporate gL into the gH/gL complex and infects through an Eph-independent route.

Published
2022
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10. Social and professional recognition are key determinants of quality of life at work among night-shift healthcare workers in Paris public hospitals (AP-HP ALADDIN COVID-19 survey)

Author

Duracinsky, Martin, Marcellin, Fabienne, Cousin, Lorraine, Di Beo, Vincent, Mahé, Véronique, Rousset-Torrente, Olivia, Carrieri, Patrizia, Chassany, Olivier, Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), and Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal

Subjects
MESH: Pandemics, MESH: Humans, Hospitals, Public, [SDV]Life Sciences [q-bio], Health Personnel, MESH: Delivery of Health Care, MESH: Quality of Life, COVID-19, MESH: Cross-Sectional Studies, MESH: Hospitals, Public, Cross-Sectional Studies, Quality of Life, MESH: COVID-19, MESH: Health Personnel, Humans, Delivery of Health Care, Pandemics
Abstract

Objective: Documenting the perceptions and experiences of frontline healthcare workers during a sanitary crisis is key to reinforce healthcare systems. We identify the determinants of quality of working life (QWL) among night-shift healthcare workers (NSHW) in Paris public hospitals shortly after the first-wave of the COVID-19 pandemic.Methods: The ALADDIN cross-sectional online survey (15 June to 15 September 2020) collected QWL, socio-economic, behavioral, and work-related information among 1,387 NSHW in the 39 hospitals of the Assistance Publique-Hôpitaux de Paris (AP-HP). Data were weighted (margin calibration) to be representative of the entire population of 12,000 AP-HP hospitals' NSHW regarding sex, age, and professional category. Linear regression was used to identify correlates of QWL (WRQoL scale).Results: New night position during the COVID pandemic, difficulties in getting screened for COVID, and considering protective measures inadequate were associated with poorer QWL, after adjustment for socio-economic characteristics, professional category, perceived health, physical activity, and history of harassment at work. Under-estimation of night-shift work by day-shift colleagues, reporting night work as a source of tension with friends, or feeling more irritable since working at night also impaired QWL. By contrast, satisfaction regarding COVID information received from the employer, and feeling valued by the general population during the pandemic improved QWL.Conclusions: Insufficient access to screening, information, and protective measures impaired QWL of NSHW after the first wave of COVID-19 in Paris public hospitals. Social and professional recognition of night-shift work were the key determinants of QWL in this population.

Published
2021
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11. Serologic responses to SARS-CoV-2 infection among hospital staff with mild disease in eastern France

Author

Yoann Madec, François Anna, Sandrine Fernandes-Pellerin, Marie Mielcarek, Olivier Schwartz, Rebecca Grant, Nicolas Collongues, Isabelle Staropoli, David Rey, Alexandre Bolle, Nathalie Jolly, Laura Tondeur, Charlotte Renaudat, Ludivine Grzelak, Nicolas Lefebvre, Marie-Noëlle Ungeheuer, Arnaud Fontanet, Bruno Hoen, Jérôme De Seze, Timothée Bruel, Catherine Schmidt-Mutter, Samira Fafi-Kremer, Aurélie Velay, Pierre Charneau, Philippe Souque, Nicolas Meyer, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Virus et Immunité - Virus and immunity, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), CHU Strasbourg, Virus et Immunité - Virus and immunity (CNRS-UMR3569), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Vaccine Research Institute (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Université Paris Cité (UPCité), Laboratoire commun Pasteur-TheraVectys, Institut Pasteur [Paris] (IP)-TheraVectys, Virologie Moléculaire et Vaccinologie / Molecular Virology and Vaccinology, Institut Pasteur [Paris] (IP), Centre de Recherche Translationnelle - Center for Translational Science (CRT), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], Groupe Méthodes en Recherche Clinique [Strasbourg] (GMRC), Nouvel Hôpital Civil [Strasbourg], CHU Strasbourg-CHU Strasbourg, École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Direction de la recherche médicale de l'Institut Pasteur, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), OS lab is funded by Institut Pasteur, ANRS, Sidaction, the Vaccine Research Institute (ANR- 10-LABX-77), Labex IBEID (ANR-10-LABX-62-IBEID), 'TIMTAMDEN' ANR-14-CE14-0029, 'CHIKV-Viro- Immuno' ANR-14-CE14-0015-01 and the Gilead HIV cure program. LG is supported by the French Ministry of Higher Education, Research and Innovation. SFK lab receives funding from Strasbourg University Hospitals (COVID-HUS, CE-2020-34)., ANR-10-LABX-0077,VRI,Initiative for the creation of a Vaccine Research Institute(2010), ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-14-CE14-0029,TIMTAMDEN,Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue(2014), ANR-14-CE14-0015,CHIKV-Viro-Immuno,Multiplication et Relation avec l'hôte du virus Chikungunya(2014), univOAK, Archive ouverte, Laboratoires d'excellence - Initiative for the creation of a Vaccine Research Institute - - VRI2010 - ANR-10-LABX-0077 - LABX - VALID, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Appel à projets générique - Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue - - TIMTAMDEN2014 - ANR-14-CE14-0029 - Appel à projets générique - VALID, Appel à projets générique - Multiplication et Relation avec l'hôte du virus Chikungunya - - CHIKV-Viro-Immuno2014 - ANR-14-CE14-0015 - Appel à projets générique - VALID, Vaccine Research Institute [Créteil, France] (VRI), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris]-TheraVectys, Institut Pasteur [Paris], and Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et nanosciences d'Alsace (FMNGE)

Subjects
Male, 0301 basic medicine, Future studies, MESH: Coronavirus Infections, [SDV]Life Sciences [q-bio], Antibodies, Viral, Severity of Illness Index, Neutralization, Serology, MESH: Antibodies, Neutralizing, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Reverse Transcriptase Polymerase Chain Reaction, MESH: COVID-19, 030212 general & internal medicine, Mild disease, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 0303 health sciences, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, biology, Reverse Transcriptase Polymerase Chain Reaction, General Medicine, Middle Aged, MESH: Hospitals, Hospitals, 3. Good health, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, [SDV.IMM.IA] Life Sciences [q-bio]/Immunology/Adaptive immunology, 030220 oncology & carcinogenesis, MESH: RNA, Viral, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, RNA, Viral, MESH: Betacoronavirus, Female, France, Sample collection, Antibody, Coronavirus Infections, Research Paper, Adult, medicine.medical_specialty, MESH: Pandemics, Coronavirus disease 2019 (COVID-19), Health Personnel, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Article, General Biochemistry, Genetics and Molecular Biology, Antibodies, Betacoronavirus, 03 medical and health sciences, Internal medicine, MESH: Severity of Illness Index, medicine, Humans, Serologic Tests, MESH: SARS-CoV-2, Symptom onset, Pandemics, 030304 developmental biology, MESH: Humans, business.industry, Mild covid-19, SARS-CoV-2, MESH: Serologic Tests, COVID-19, MESH: Adult, Antibodies, Neutralizing, MESH: Male, Personnel, Hospital, MESH: France, 030104 developmental biology, MESH: Pneumonia, Viral, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Antibody Formation, biology.protein, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, MESH: Antibodies, Viral
Abstract

PMCID: PMC7502660; International audience; BACKGROUND: The serologic response of individuals with mild forms of SARS-CoV-2 infection is poorly characterized.METHODS: Hospital staff who had recovered from mild forms of PCR-confirmed SARS-CoV-2 infection were tested for anti-SARS-CoV-2 antibodies using two assays: a rapid immunodiagnostic test (99.4% specificity) and the S-Flow assay (~99% specificity). The neutralizing activity of the sera was tested with a pseudovirus-based assay.FINDINGS: Of 162 hospital staff who participated in the investigation, 160 reported SARS-CoV-2 infection that had not required hospital admission and were included in these analyses. The median time from symptom onset to blood sample collection was 24 days (IQR: 21-28, range 13-39). The rapid immunodiagnostic test detected antibodies in 153 (95.6%) of the samples and the S-Flow assay in 159 (99.4%), failing to detect antibodies in one sample collected 18 days after symptom onset (the rapid test did not detect antibodies in that patient). Neutralizing antibodies (NAbs) were detected in 79%, 92% and 98% of samples collected 13-20, 21-27 and 28-41 days after symptom onset, respectively (P = 0.02). INTERPRETATION: Antibodies against SARS-CoV-2 were detected in virtually all hospital staff sampled from 13 days after the onset of COVID-19 symptoms. This finding supports the use of serologic testing for the diagnosis of individuals who have recovered from SARS-CoV-2 infection. The neutralizing activity of the antibodies increased overtime. Future studies will help assess the persistence of the humoral response and its associated neutralization capacity in recovered patients.FUNDINGS: The funders had no role in study design, data collection, interpretation, or the decision to submit the work for publication.

Published
2020
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12. Transparency of Health Informatics Processes as the Condition of Healthcare Professionals’ and Patients’ Trust and Adoption: the Rise of Ethical Requirements

Author

Brigitte Séroussi, Lina Fatima Soualmia, Kate Fultz Hollis, Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Oregon Health and Science University [Portland] (OHSU), Equipe Traitement de l'information en Biologie Santé (TIBS - LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), and Soualmia, Lina F

Subjects
[INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI], Artificial intelligence, 020205 medical informatics, Attitude of Health Personnel, Health Personnel, MESH: Attitude of Health Personnel, Internet privacy, MESH: Attitude to Health, 02 engineering and technology, Trust, Health informatics, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI], 03 medical and health sciences, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Humans, MESH: Artificial Intelligence, Bioethical Issues, 030212 general & internal medicine, Ethics, MESH: Humans, business.industry, Health Insurance Portability and Accountability Act, Health Information Technology, General Medicine, Transparency (behavior), 3. Good health, Data sharing, Information sensitivity, MESH: Medical Informatics, Editorial, General Data Protection Regulation, MESH: Trust, MESH: Bioethical Issues, MESH: Health Personnel, Informatics, medical, Yearbook, business, Attitude to Health, Medical Informatics, Medical ethics, IMIA Yearbook of Medical Informatics
Abstract

Objectives: To provide an introduction to the 2020 International Medical Informatics Association (IMIA) Yearbook by the editors. Methods: This editorial provides an introduction and overview to the 2020 IMIA Yearbook which special topic is: “Ethics in Health Informatics”. The keynote paper, the survey paper of the Special Topic section, and the paper about Donald Lindberg’s ethical scientific openness in the History of Medical Informatics chapter of the Yearbook are discussed. Changes in the Yearbook Editorial Committee are also described. Results: Inspired by medical ethics, ethics in health informatics progresses with the advances in biomedical informatics. With the wide use of EHRs, the enlargement of the care team perimeter, the need for data sharing for care continuity, the reuse of data for the sake of research, and the implementation of AI-powered decision support tools, new ethics requirements are necessary to address issues such as threats on privacy, confidentiality breaches, poor security practices, lack of patient information, tension on data sharing and reuse policies, need for more transparency on apps effectiveness, biased algorithms with discriminatory outcomes, guarantee on trustworthy AI, concerns on the re-identification of de-identified data. Conclusions: Despite privacy rules rooted in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in the USA and even more restrictive new regulations such as the EU General Data Protection Regulation published in May 2018, some people do not believe their data will be kept confidential and may not share sensitive information with a provider, which may also induce unethical situations. Transparency on healthcare data processes is a condition of healthcare professionals’ and patients’ trust and their adoption of digital tools.

Published
2020
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13. Intrafamily Transmission of Monkeypox Virus, Central African Republic, 2018

Author

Arnaud Fontanet, Ella Cyrielle Gonofio, Nicolas Berthet, Benjamin Selekon, Xavier Konamna, Antoine Gessain, Emmanuel Nakouné, Camille Besombes, Jean-Claude Manuguerra, Institut Pasteur [Paris] (IP), Institut Pasteur de Bangui, Réseau International des Instituts Pasteur (RIIP), Centre National de la Recherche Scientifique (CNRS), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), The authors thank Romain Duda for his assistance with identification of the animal species in Aka language. We also acknowledge Rebecca Grant for her relevant suggestion and her kind participation in the formatting of this research letter., Institut Pasteur [Paris], and Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)

Subjects
MESH: Monkeypox, Male, Epidemiology, animal diseases, viruses, lcsh:Medicine, MESH: Central African Republic / epidemiology, Zoonotic disease, West africa, Disease Outbreaks, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, MESH: Animals, 030212 general & internal medicine, Orthopoxvirus, MESH: Disease Outbreaks, Monkeypox virus, Child, Central Africa, biology, Transmission (medicine), virus diseases, respiratory system, MESH: Infant, 3. Good health, Central African Republic, Infectious Diseases, Geography, MESH: Young Adult, Child, Preschool, Female, MESH: Zoonoses, MESH: History, 21st Century, Disease transmission, Intrafamily Transmission of Monkeypox Virus, Central African Republic, 2018, Microbiology (medical), Adult, Adolescent, Health Personnel, 030231 tropical medicine, education, History, 21st Century, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Monkeypox, Young Adult, parasitic diseases, medicine, Research Letter, Animals, Humans, lcsh:RC109-216, Family, MESH: Family, MESH: Adolescent, MESH: Humans, lcsh:R, MESH: Child, Preschool, Outbreak, Infant, MESH: Adult, zoonosis, biology.organism_classification, medicine.disease, Virology, MESH: Male, outbreak investigation, zoonoses, MESH: Health Personnel, MESH: Female
Abstract

International audience; Monkeypox is a rare viral zoonotic disease; primary infections are reported from remote forest areas of Central and West Africa. We report an investigation of a monkeypox outbreak in Lobaye, southwest Central African Republic, in October 2018.

Published
2019
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14. Protection of Healthcare Workers Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection

Author

Jacques Izopet, Guillaume Martin-Blondel, Jean-Marc Soulat, Chloé Dimeglio, Marcel Miedougé, Fabrice Herin, Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Pistre, Karine

Subjects
Microbiology (medical), 2019-20 coronavirus outbreak, [SDV.IMM] Life Sciences [q-bio]/Immunology, Coronavirus disease 2019 (COVID-19), viruses, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), education, MEDLINE, MESH: Reinfection, Health personnel, Health care, MESH: COVID-19, Medicine, MESH: SARS-CoV-2, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Humans, business.industry, fungi, Virology, [SDV] Life Sciences [q-bio], Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Health Personnel, [SDV.IMM]Life Sciences [q-bio]/Immunology, business
Abstract

International audience; Recent reports of SARS-CoV-2 reinfection have raised questions as to whether and to what degree a first infection protects against reinfection. This is particularly important for healthcare workers (HCW) as they are always in the front line combatting both the present epidemic and any new waves of SARS-CoV-2 infection. These workers can also transmit the virus to co-workers and hospitalized susceptible patients. In their recent study, Lumley et al presented 6 months of data from a longitudinal seroprevalence study of UK HCW and showed that SARS-CoV-2 anti-nucleocapsid antibodies wane within months.

Published
2021
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15. Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017

Author

Sibylle Bernard-Stoecklin, Mamunur Rahman Malik, Abdullah M. Assiri, Birgit Nikolay, Maria D. Van Kerkhove, Hassan El Bushra, Moran Ki, Simon Cauchemez, Abdul Aziz Bin Saeed, Arnaud Fontanet, Peter Ben Embarek, Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale (CGH), Institut Pasteur [Paris]-Réseau International des Instituts Pasteur (RIIP), Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Ministry of Health [Riyadh], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), National Cancer Center Korea, Regional Office for the Eastern Mediterranean [Cairo] (EMRO), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), B.N. and S.C. acknowledge financial support from the Investissement d’Avenir program, the Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases program (Grant ANR-10-LABX-62-IBEID), the Models of Infectious Disease Agent Study of the National Institute of General Medical Sciences, the AXA Research Fund and the INCEPTION project (PIA/ANR-16-CONV-0005)., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), Institut Pasteur [Paris] (IP)-Réseau International des Instituts Pasteur (RIIP), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), WHO - Regional Office for the Eastern Mediterranean [Cairo, Egypt] (EMRO), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), and HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)

Subjects
0301 basic medicine, Male, Multivariate analysis, MESH: Coronavirus Infections, lcsh:Medicine, MESH: Infectious Disease Transmission, Professional-to-Patient, MESH: Comorbidity, Comorbidity, medicine.disease_cause, Disease Outbreaks, Infectious Disease Transmission, Professional-to-Patient, 0302 clinical medicine, Healthcare associated, MESH: Risk Factors, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Health care, Epidemiology, MESH: Disease Outbreaks, lcsh:Science, MESH: Aged, Cross Infection, Multidisciplinary, MESH: Middle Aged, Transmission (medicine), Age Factors, Middle Aged, MESH: Hospitals, Hospitals, 3. Good health, Middle East Respiratory Syndrome Coronavirus, Infectious diseases, Female, Coronavirus Infections, MESH: History, 21st Century, Adult, MESH: Republic of Korea, medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Middle East respiratory syndrome coronavirus, Health Personnel, Saudi Arabia, History, 21st Century, World health, Article, 03 medical and health sciences, Environmental health, MESH: Infectious Disease Transmission, Patient-to-Professional, Republic of Korea, medicine, Humans, Aged, MESH: Age Factors, MESH: Humans, business.industry, lcsh:R, MESH: Middle East Respiratory Syndrome Coronavirus, Outbreak, MESH: Cross Infection, MESH: Adult, MESH: Male, MESH: Saudi Arabia, 030104 developmental biology, Risk factors, MESH: Health Personnel, lcsh:Q, business, MESH: Female, 030217 neurology & neurosurgery
Abstract

Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6–8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3–5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01–0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.

Published
2019
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16. Seasonal gaps in measles vaccination coverage in Madagascar

Author

Mensah, K., Heraud, J.M., Takahashi, S., Winter, A.K., Metcalf, C.J.E., Wesolowski, A., Princeton University, Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Johns Hopkins Bloomberg School of Public Health [Baltimore], Johns Hopkins University (JHU), and CJEM, AKW and ST were supported by BMGF Grant # OPP1094793. CJEM, KM, APW were funded by Wellcome Trust Sustaining Health Grant (106866/Z/15/Z). APW is supported by a Career Award at the Scientific Interface from the Burroughs Wellcome Fund and by the National Library of Medicine of the National Institutes of Health under Award Number Dp2LM013102.

Subjects
Male, Vaccination Coverage, Health Personnel, Measles Vaccine, MESH: Measles Vaccine, MESH: Immunization Programs, Article, Disease Outbreaks, MESH: Madagascar, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Madagascar, Humans, MESH: Disease Outbreaks, MESH: Surveys and Questionnaires, Health Services Administration, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Humans, Immunization Programs, Vaccination, MESH: Child, Preschool, MESH: Infant, Newborn, Infant, Newborn, Infant, MESH: Vaccination Coverage, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Healthcare access, MESH: Health Services Administration, MESH: Infant, MESH: Male, Child, Preschool, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Measles, MESH: Health Personnel, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Seasons, MESH: Seasons, MESH: Female, Measles
Abstract

INTRODUCTION: Measles elimination depends on the successful deployment of measles containing vaccine. Vaccination programs often depend on a combination of routine and non-routine services, including supplementary immunization activities (SIAs) and vaccination weeks (VWs), that both aim to vaccinate all eligible children regardless of vaccination history or natural infection. Madagascar has used a combination of these activities to improve measles coverage. However, ongoing massive measles outbreak suggests that the country was in a “honeymoon” period and that coverage achieved needs to be re-evaluated. Although healthcare access is expected to vary seasonally in low resources settings, little evidence exists to quantify temporal fluctuations in routine vaccination, and interactions with other immunization activities. METHODS: We used three data sources: national administrative data on measles vaccine delivery from 2013 to 2016, digitized vaccination cards from 49 health centers in 6 health districts, and a survey of health workers. Data were analyzed using linear regressions, analysis of variance, and t-tests. FINDINGS: From 2013 to 2016, the footprint of SIAs and VWs is apparent, with more doses distributed during the relevant timeframes. Routine vaccination decreases in subsequent months, suggesting that additional activities may be interfering with routine services. The majority of missed vaccination opportunities occur during the rainy season. Health facility organization and shortage of vaccine contributed to vaccination gaps. Children born in June were the least likely to be vaccinated on time. DISCUSSION: Evidence that routine vaccination coverage varies over the year and is diminished by other activities suggests that maintaining routine vaccination during SIAs and VWs is a key direction for strengthening immunization programs, ensuring population immunity and avoiding future outbreaks. FUNDING: Wellcome Trust Fund, Burroughs Wellcome Fund, Gates Foundation, National Institutes of Health.

Published
2019
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17. Findings from the 2018 yearbook section on human factors and organizational issues

Author

Johanna Kaipio, Sylvia Pelayo, Organizational Issues, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Aalto University, CHU Lille, Université de Lille, and Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]

Subjects
020205 medical informatics, MESH: Health Information Interoperability, [SDV]Life Sciences [q-bio], Section (typography), MEDLINE, 02 engineering and technology, Editorial board, Section 2: Human Factors and Organizational Issues, Health informatics, 03 medical and health sciences, User-Computer Interface, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Electronic Health Records, Humans, MESH: Electronic Health Records/organization & administration, 030212 general & internal medicine, MESH: Medical Informatics/organization & administration, MESH: User-Computer Interface, Medical education, MESH: Humans, business.industry, Health Information Interoperability, Human factors and ergonomics, General Medicine, health information technology, usability, MESH: Alert Fatigue, ergonomics, Synopsis, MESH: Health Personnel, Yearbook, organizational issues, business, Psychology, Human factors, Alert Fatigue, Health Personnel, Medical Informatics
Abstract

Objective: To summarize significant research contributions published in 2017 on Human Factors and Organizational Issues (HFOI) in medical informatics. Methods: An extensive search using PubMed/Medline and Web of Science® was conducted to identify the scientific contributions published in 2017 that HFOI issues in medical informatics. The selection process comprised three steps: (i) 15 candidate best papers out of 695 references were first selected by the two section editors, (ii) external reviewers from internationally renowned research teams reviewed each candidate best paper, and (iii) the final selection of five best papers was conducted by the editorial board of the Yearbook. Results: The five best papers offer a glimpse of the quality and breadth of the work being conducted in the HFOI community. Conclusion: The selection of the HFOI section of the 2018 IMIA Yearbook highlights a growing number of high quality studies. There are especially more studies interested in testing Human Factors and Ergonomics methods and demonstrating the benefits.

Published
2018
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18. Use of a risk assessment method to improve the safety of negative pressure wound therapy

Author

Judith Pineau, Nicolas Martelli, Brigitte Bonan, Anne-Sophie Lelong, Patrice Prognon, Groupe de Recherche et d'Accueil en Droit et Economie de la Santé (GRADES), and Université Paris-Saclay

Subjects
Risk analysis, Safety Management, medicine.medical_specialty, Care process, MESH: Negative-Pressure Wound Therapy, Health Personnel, medicine.medical_treatment, Dermatology, [QFIN.RM]Quantitative Finance [q-fin]/Risk Management [q-fin.RM], MESH: Risk Assessment, Risk Assessment, MESH: Quality Improvement, Negative-pressure wound therapy, medicine, Humans, Medical prescription, Intensive care medicine, MESH: Humans, business.industry, Original Articles, Negative pressure wound therapy, Quality Improvement, 3. Good health, Surgery, MESH: Safety Management, Failure mode, effects, and criticality analysis, MESH: Patient Safety, MESH: Wounds and Injuries, Wounds and Injuries, MESH: Health Personnel, Clinical Competence, Patient Safety, MESH: Clinical Competence, Safety, Risk assessment, business, Negative-Pressure Wound Therapy
Abstract

International audience; To conduct a risk analysis of the negative pressure wound therapy (NPWT) care process and to improve the safety of NPWT, a working group of nurses, hospital pharmacists, physicians and hospital managers performed a risk analysis for the process of NPWT care. The failure modes, effects and criticality analysis (FMECA) method was used for this analysis. Failure modes and their consequences were defined and classified as a function of their criticality to identify priority actions for improvement. By contrast to classical FMECA, the criticality index (CI) of each consequence was calculated by multiplying occurrence, severity and detection scores. We identified 13 failure modes, leading to 20 different consequences. The CI of consequences was initially 712, falling to 357 after corrective measures were implemented. The major improvements proposed included the establishment of 6-monthly training cycles for nurses, physicians and surgeons and the introduction of computerised prescription for NPWT. The FMECA method also made it possible to prioritise actions as a function of the criticality ranking of consequences and was easily understood and used by the working group. This study is, to our knowledge, the first to use the FMECA method to improve the safety of NPWT.

Published
2012
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19. A statistical model to assess the risk of communicable diseases associated with multiple exposures in healthcare settings

Author

René Ecochard, Philippe Vanhems, Cécile Payet, Nicolas Voirin, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE)

Subjects
Risk, medicine.medical_specialty, Epidemiology, Health Personnel, [SDV]Life Sciences [q-bio], Disease transmission, MESH: Environmental Exposure, Health Informatics, MESH: Disease Transmission, Infectious, 01 natural sciences, Communicable Diseases, 010104 statistics & probability, 03 medical and health sciences, Health personnel, 0302 clinical medicine, Models, Environmental health, Influenza, Human, Credible interval, medicine, Disease Transmission, Infectious, Humans, 030212 general & internal medicine, 0101 mathematics, Models, Statistical, MESH: Humans, MESH: Risk, business.industry, MESH: Influenza, Human, Infectious, Health facilities, Environmental exposure, Environmental Exposure, Statistical, University hospital, Individual level, MESH: Health Facilities, Influenza, 3. Good health, Healthcare settings, MESH: Communicable Diseases, MESH: Health Personnel, business, MESH: Models, Statistical, Research Article, Human
Abstract

International audience; BACKGROUND: The occurrence of communicable diseases (CD) depends on exposure to contagious persons. The effects of exposure to CD are delayed in time and contagious persons remain contagious for several days during which their contagiousness varies. Moreover when multiple exposures occur, it is difficult to know which exposure is associated with the CD. METHODS: A statistical model at the individual level is presented to estimate the risk of CD to patients, in healthcare settings, with multiple observed exposures to other patients and healthcare workers and unobserved exposures to unobserved or unobservable sources. The model explores the delayed effect of observed exposure, of source contagiousness and of unobserved exposure. It was applied to data on influenza-like illness (ILI) among patients in a university hospital during 3 influenza seasons: from 2004 to 2007. Over a total of 138,411 patients-days of follow-up, 64 incident ILI cases were observed among 21,519 patients at risk of ILI. RESULTS: The ILI risk per 10,000 patients-days associated with observed exposure was about 129.1 (95% Credible Interval (CrI): 84.5, 182.9) and was associated at 72% with exposures to patients or healthcare workers 1 day earlier and at 41% with the 1st day of source contagiousness. The ILI risk associated with unobserved exposure was 0.8 (95% CrI: 0.3, 1.6) per 10,000 patients-days in non-epidemic situation in the community and 4.3 (95% CrI: 0.4, 11.0) in epidemic situation. CONCLUSIONS: The model could be an interesting epidemiological tool to further assess the relative contributions of observed and unobserved exposures to CD risk in healthcare settings.

Published
2013
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20. First human rabies case in French Guiana, 2008: epidemiological investigation and control

Author

Françoise Eltges, Hervé Bourhy, Jean-Baptiste Meynard, Claude Flamand, Philippe Dussart, Jean-Michel Fontanella, Franck Berger, Claire Grangier, Laurent Dacheux, J. Renner, Céline Dupuy, Maryvonne Goudal, Aba Mahamat, André Spiegel, Félix Djossou, Nicolas Krieger, Vanessa Ardillon, Frederic Queuche, Didier Hommel, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Departmental Veterinary Direction [Cayenne], Health Regional Agency [Cayenne], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence de la Rage-Dynamique des Lyssavirus et adaptation à l'hôte (CNR), Institut Pasteur [Paris] (IP), Dynamique des Lyssavirus et Adaptation à l'Hôte (DyLAH), The authors thank the Institut de Veille Sanitaire, Saint-Maurice, France (http://www.invs.sante.fr/) for their financial contribution to the National Reference Centre for Rabies that made this work possible., and Institut Pasteur [Paris]

Subjects
Male, medicine.medical_treatment, Saliva/virology, medicine.disease_cause, Health personnel, 0302 clinical medicine, Chiroptera, Epidemiology, MESH: Animals, Skin, 0303 health sciences, medicine.diagnostic_test, lcsh:Public aspects of medicine, Meningoencephalitis, MESH: Chiroptera, MESH: Rabies Vaccines, French Guiana/epidemiology, French Guiana, 3. Good health, MESH: Rabies virus, Rabies Vaccines/administration & dosage, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Medicine, Female, Post-Exposure Prophylaxis, Research Article, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Rabies, Health Personnel, 030231 tropical medicine, Rabies/*diagnosis/*epidemiology/prevention & control/virology, Rabies virus/*isolation & purification, 03 medical and health sciences, MESH: Rabies, MESH: Skin, Chiroptera/virology, parasitic diseases, MESH: French Guiana, medicine, Skin/virology, Animals, Humans, MESH: Saliva, Post-exposure prophylaxis, Saliva, MESH: Humans, 030306 microbiology, business.industry, Rabies virus, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Virology, MESH: Male, Rabies Vaccines, Skin biopsy, Post-Exposure Prophylaxis/methods, MESH: Health Personnel, business, MESH: Female, MESH: Post-Exposure Prophylaxis
Abstract

Background Until 2008, human rabies had never been reported in French Guiana. On 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis. Methodology/Principal Findings Molecular typing of the virus identified a Lyssavirus (Rabies virus species), closely related to those circulating in hematophagous bats (mainly Desmodus rotundus) in Latin America. A multidisciplinary Crisis Unit was activated. Its objectives were to implement an epidemiological investigation and a veterinary survey, to provide control measures and establish a communications program. The origin of the contamination was not formally established, but was probably linked to a bat bite based on the virus type isolated. After confirming exposure of 90 persons, they were vaccinated against rabies: 42 from the case's entourage and 48 healthcare workers. To handle that emergence and the local population's increased demand to be vaccinated, a specific communications program was established using several media: television, newspaper, radio. Conclusion/Significance This episode, occurring in the context of a Department far from continental France, strongly affected the local population, healthcare workers and authorities, and the management team faced intense pressure. This observation confirms that the risk of contracting rabies in French Guiana is real, with consequences for population educational program, control measures, medical diagnosis and post-exposure prophylaxis., Author Summary Until 2008, rabies had never been described within the French Guianan human population. Emergence of the first case in May 2008 in this French Overseas Department represented a public health event that markedly affected the local population, healthcare workers and public health authorities. The antirabies clinic of French Guiana, located at Institut Pasteur de la Guyane, had to reorganize its functioning to handle the dramatically increased demand for vaccination. A rigorous epidemiological investigation and a veterinary study were conducted to identify the contamination source, probably linked to a bat bite, and the exposed population. Communication was a key factor to controlling this episode and changing the local perception of this formerly neglected disease. Because similar clinical cases had previously been described, without having been diagnosed, medical practices must be adapted and the rabies virus should be sought more systematically in similarly presenting cases. Sharing this experience could be useful for other countries that might someday have to manage such an emergence.

Published
2012
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21. Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients

Author

Bruno Lina, Corinne Régis, Brigitte Coppéré, Silene Cronenberger, Olivier Robert, Brigitte Comte, Philippe Vanhems, Nicolas Voirin, Thomas Bénet, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Camille Jordan [Villeurbanne] ( ICJ ), École Centrale de Lyon ( ECL ), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Centre National de la Recherche Scientifique ( CNRS ), Virologie et pathologie humaine ( VirPath ), Université de Lyon-Université de Lyon, Service de médecine gériatrique, Hospices Civils de Lyon ( HCL ) -Hôpital Edouard Herriot [CHU - HCL], Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Institut Camille Jordan (ICJ), École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Virologie et pathologie humaine (VirPath), Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Camille Jordan [Villeurbanne] (ICJ), Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH : Orthomyxoviridae, [SDV]Life Sciences [q-bio], MESH : Aged, MESH : Prospective Studies, MESH: Influenza Vaccines, MESH: Aged, 80 and over, 0302 clinical medicine, Medical microbiology, Acute care, Health care, Medicine, MESH : Female, Prospective Studies, 030212 general & internal medicine, MESH : Influenza, Human, Prospective cohort study, MESH: Orthomyxoviridae, MESH: Aged, Aged, 80 and over, Cross Infection, 0303 health sciences, MESH: Middle Aged, biology, MESH: Influenza, Human, Vaccination, MESH: Nose, Healthcare worker, virus diseases, Middle Aged, MESH : Adult, MESH: Hospitals, Orthomyxoviridae, MESH: Case-Control Studies, Hospitals, 3. Good health, MESH : Hospitals, Infectious Diseases, MESH: Hemagglutination Inhibition Tests, Influenza Vaccines, Female, MESH : Nose, MESH : Cross Infection, Research Article, Adult, medicine.medical_specialty, MESH : Case-Control Studies, animal structures, Health Personnel, MESH : Male, education, Nose, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Influenza, Human, Humans, lcsh:RC109-216, MESH : Middle Aged, MESH : Aged, 80 and over, Aged, MESH: Humans, [ SDV ] Life Sciences [q-bio], 030306 microbiology, business.industry, MESH : Humans, Case-control study, MESH: Cross Infection, MESH: Adult, MESH: Vaccination, Hemagglutination Inhibition Tests, biology.organism_classification, MESH: Male, MESH: Prospective Studies, MESH : Hemagglutination Inhibition Tests, MESH : Influenza Vaccines, MESH : Vaccination, Case-Control Studies, Immunology, Emergency medicine, MESH: Health Personnel, MESH : Health Personnel, business, MESH: Female
Abstract

Background In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients. Methods A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring ≥ 72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients. Results In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (P = 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (P = 0.16). The proportion of ≥ 35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units. Conclusions Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.

Published
2012
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22. A report on the large measles outbreak in Lyon, France, 2010 to 2011

Author

Huoi, C., Casalegno, J. S., Bénet, T., Antoine Neuraz, Billaud, G., Eibach, D., Mekki, Y., Rudigoz, R., Massardier, J., Huissoud, C., Massoud, M., Gaucherand, P., Claris, O., Gillet, Y., Floret, D., Lina, B., Vanhems, P., Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Virologie et pathogenèse virale (VPV), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut de recherches sur la catalyse (IRC), Centre National de la Recherche Scientifique (CNRS), Institut cellule souche et cerveau (SBRI), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Division of Pediatric Intensive Care, Hôpital Femme Mère Enfant, Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institut cellule souche et cerveau (U846 Inserm - UCBL1), and Neuraz, Antoine

Subjects
Male, [SDV]Life Sciences [q-bio], Disease Outbreaks, Hospitals, University, MESH: Pregnancy, Pregnancy, MESH: Child, Prospective Studies, MESH: Incidence, Pregnancy Complications, Infectious, MESH: Disease Outbreaks, Child, MESH: Aged, MESH: Middle Aged, Incidence, Vaccination, MESH: Sex Distribution, Middle Aged, MESH: Infant, MESH: Young Adult, Child, Preschool, Population Surveillance, MESH: Measles, Female, France, Adult, Adolescent, Health Personnel, MESH: Population Surveillance, Young Adult, Age Distribution, Humans, MESH: Pregnancy Complications, Infectious, Sex Distribution, MESH: Age Distribution, Aged, MESH: Adolescent, MESH: Hospitals, University, MESH: Humans, MESH: Child, Preschool, Infant, MESH: Adult, MESH: Vaccination, Mandatory Reporting, MESH: Male, MESH: Prospective Studies, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Mandatory Reporting, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female, Measles
Abstract

International audience; In 2010 and 2011, the city of Lyon, located in the Rhône-Alpes region (France), has experienced one of the highest incidences of measles in Europe. We describe a measles outbreak in the Lyon area, where cases were diagnosed at Lyon University hospitals (LUH) between 2010 and mid-2011. Data were collected from the mandatory notification system of the regional public health agency, and from the virology department of the LUH. All patients and healthcare workers who had contracted measles were included. Overall, 407 cases were diagnosed, with children of less than one year of age accounting for the highest proportion (n=129, 32%), followed by individuals between 17 and 29 years-old (n=126, 31%). Of the total cases, 72 (18%) had complications. The proportions of patients and healthcare workers who were not immune to measles were higher among those aged up to 30 years. Consequently, women of childbearing age constituted a specific population at high risk to contract measles and during this outbreak, 13 cases of measles, seven under 30 years-old, were identified among pregnant women. This study highlights the importance of being vaccinated with two doses of measles vaccine, the only measure which could prevent and allow elimination of the disease.

Published
2012

23. Consensus document regarding cardiovascular safety at sports arenas: position stand from the European Association of Cardiovascular Prevention and Rehabilitation (EACPR), section of Sports Cardiology

Author

Borjesson, M, Serratosa, L, Carre, F, Corrado, Domenico, Drezner, J, Dugmore, Dl, Heidbuchel, Hh, Mellwig, Kp, Panhuyzen Goedkoop NM, Papadakis, M, Rasmusen, H, Sharma, S, Solberg, Ee, van Buuren, F, Pelliccia, A, writing group on behalf of the EACPR Section of Sports Cardiology, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine du sport et d'explorations fonctionnelles, CHU Pontchaillou [Rennes], University of Washington [Seattle], Department of Cardiology [K.U.Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-University Hospital Gasthuisberg [Leuven], EACPR section of sports cardiology, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-University Hospital Gasthuisberg

Subjects
Emergency Medical Services, medicine.medical_treatment, MESH: Cardiopulmonary Resuscitation, 030204 cardiovascular system & hematology, Medical Records, 0302 clinical medicine, Mass gathering, MESH: Health Planning, 030212 general & internal medicine, MESH: Quality of Health Care, Rehabilitation, Cardiovascular diseases [NCEBP 14], biology, Communication, MESH: Equipment and Supplies, Checklist, 3. Good health, Transportation of Patients, Equipment and Supplies, Action plan, Cardiology, MESH: Emergency Medical Services, MESH: Communication, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Medical emergency, medicine.symptom, Cardiology and Cardiovascular Medicine, Sports, MESH: Medical Records, medicine.medical_specialty, Health Personnel, Interprofessional Relations, MESH: Emergency Treatment, Sudden death, MESH: Checklist, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, MESH: Interprofessional Relations, medicine, Humans, Chain of survival, Emergency Treatment, Quality of Health Care, MESH: Humans, business.industry, Athletes, Sudden cardiac arrest, MESH: Death, Sudden, Cardiac, medicine.disease, biology.organism_classification, Cardiopulmonary Resuscitation, Health Planning, Death, Sudden, Cardiac, Life support, MESH: Transportation of Patients, MESH: Health Personnel, MESH: Defibrillators, MESH: Sports, business, human activities, Defibrillators
Abstract

Item does not contain fulltext Mass gathering events in sports arenas create challenges regarding the cardiovascular safety of both athletes and spectators. A comprehensive medical action plan, to ensure properly applied cardiopulmonary resuscitation, and wide availability and use of automated external defibrillators (AEDs), is essential to improving survival from sudden cardiac arrest at sporting events. This paper outlines minimum standards for cardiovascular care to assist in the planning of mass gathering sports events across Europe with the intention of local adaptation at individual sports arenas, to ensure the full implementation of the chain of survival.

Published
2011
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24. Expected and unexpected adverse effects H1N1 vaccination for health care workers in a university hospital

Author

Aurélien Dinh, Jérôme Salomon, Christine Lawrence, Alexis Descatha, Services des maladies infectieuses, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Equipe Hygiène, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Kaniewski, Nadine

Subjects
medicine.medical_specialty, Health Personnel, 030204 cardiovascular system & hematology, Hospitals, University, MESH: Influenza A Virus, H1N1 Subtype, MESH: Influenza Vaccines, 03 medical and health sciences, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Surveys and Questionnaires, Influenza, Human, Health care, medicine, Humans, 030212 general & internal medicine, Adverse effect, ComputingMilieux_MISCELLANEOUS, MESH: Hospitals, University, MESH: Humans, General Veterinary, General Immunology and Microbiology, business.industry, MESH: Influenza, Human, MESH: Questionnaires, Vaccination, Public Health, Environmental and Occupational Health, Influenza a, MESH: Vaccination, medicine.disease, University hospital, 3. Good health, Infectious Diseases, Immunization, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Influenza Vaccines, Emergency medicine, Molecular Medicine, MESH: Health Personnel, Disease prevention, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Medical emergency, business
Abstract

International audience; no abstract

Published
2010
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25. Temporal variability and social heterogeneity in disease transmission: the case of SARS in Hong Kong

Author

Alain-Jacques Valleron, Gabriel M. Leung, Anne Cori, Pierre-Yves Boëlle, Guy Thomas, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), School of Public Health, The University of Hong Kong (HKU), The authors thank the following for research funding: The Research Fund for the Control of Infectious Diseases of the Food and Health Bureau of the Hong Kong SAR Government (GML), The University of Hong Kong SARS Research Fund (GML), The EU Sixth Framework Programme for Research for Policy Support (contracts SP22-CT-2004-511066 and FP6-2003-SSP2-513715) (AC, P-YB, GT, GML, A-JV), and Autard, Delphine

Subjects
Time Factors, Public Health and Epidemiology/Infectious Diseases, MESH: Infectious Disease Transmission, Professional-to-Patient, Severe Acute Respiratory Syndrome, 01 natural sciences, Public Health and Epidemiology/Nosocomial and Healthcare-Associated Infections, Disease Outbreaks, Infectious Disease Transmission, Professional-to-Patient, law.invention, 010104 statistics & probability, 0302 clinical medicine, law, Community-Acquired Infections - epidemiology - transmission - virology, Epidemiology, Health care, 030212 general & internal medicine, MESH: Disease Outbreaks, lcsh:QH301-705.5, Cross Infection, education.field_of_study, Ecology, Risk of infection, Cross Infection - epidemiology - transmission - virology, Infectious Diseases/Nosocomial and Healthcare-Associated Infections, SARS Virus, Markov Chains, 3. Good health, Community-Acquired Infections, Transmission (mechanics), Geography, Severe acute respiratory syndrome-related coronavirus, Computational Theory and Mathematics, MESH: Community-Acquired Infections, Modeling and Simulation, MESH: Stochastic Processes, symbols, Hong Kong, Monte Carlo Method, Algorithms, MESH: Hong Kong, Research Article, Infectious Diseases/Epidemiology and Control of Infectious Diseases, medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Health Personnel, Population, MESH: SARS Virus, MESH: Algorithms, MESH: Monte Carlo Method, 03 medical and health sciences, Cellular and Molecular Neuroscience, symbols.namesake, MESH: Markov Chains, MESH: Severe Acute Respiratory Syndrome, MESH: Infectious Disease Transmission, Patient-to-Professional, Infectious Diseases/Viral Infections, Genetics, medicine, Severe Acute Respiratory Syndrome - epidemiology - transmission, Humans, 0101 mathematics, education, Molecular Biology, Ecology, Evolution, Behavior and Systematics, Simulation, Stochastic Processes, Models, Statistical, MESH: Humans, business.industry, Public health, MESH: Time Factors, Outbreak, MESH: Cross Infection, Markov chain Monte Carlo, lcsh:Biology (General), [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Mathematics/Statistics, Public Health and Epidemiology/Epidemiology, business, MESH: Models, Statistical, Demography
Abstract

The extent to which self-adopted or intervention-related changes in behaviors affect the course of epidemics remains a key issue for outbreak control. This study attempted to quantify the effect of such changes on the risk of infection in different settings, i.e., the community and hospitals. The 2002-2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong, where 27% of cases were healthcare workers, was used as an example. A stochastic compartmental SEIR (susceptible-exposed-infectious-removed) model was used: the population was split into healthcare workers, hospitalized people and general population. Super spreading events (SSEs) were taken into account in the model. The temporal evolutions of the daily effective contact rates in the community and hospitals were modeled with smooth functions. Data augmentation techniques and Markov chain Monte Carlo (MCMC) methods were applied to estimate SARS epidemiological parameters. In particular, estimates of daily reproduction numbers were provided for each subpopulation. The average duration of the SARS infectious period was estimated to be 9.3 days (±0.3 days). The model was able to disentangle the impact of the two SSEs from background transmission rates. The effective contact rates, which were estimated on a daily basis, decreased with time, reaching zero inside hospitals. This observation suggests that public health measures and possible changes in individual behaviors effectively reduced transmission, especially in hospitals. The temporal patterns of reproduction numbers were similar for healthcare workers and the general population, indicating that on average, an infectious healthcare worker did not infect more people than any other infectious person. We provide a general method to estimate time dependence of parameters in structured epidemic models, which enables investigation of the impact of control measures and behavioral changes in different settings. © 2009 Cori et al., published_or_final_version

Published
2009
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26. Prevalence and factors of intensive care unit conflicts: the conflicus study

Author

Azoulay, Elie, Timsit, Jean-François, Sprung, Charles, Soares, Marcio, Rusinová, Katerina, Lafabrie, Ariane, Abizanda, Ricardo, Svantesson, Mia, Rubulotta, Francesca, Ricou, Bara, Benoit, Dominique, Heyland, Daren, Joynt, Gavin, Français, Adrien, Azeivedo-Maia, Paulo, Owczuk, Radoslaw, Benbenishty, Julie, De Vita, Michael, Valentin, Andreas, Ksomos, Akos, Cohen, Simon, Kompan, Lidija, Ho, Kwok, Abroug, Fekri, Kaarlola, Anne, Gerlach, Herwig, Kyprianou, Theodoros, Michalsen, Andrej, Chevret, Sylvie, Schlemmer, Benoît, Intensive Care Medicine, For The Conflicus Study Investigators And For The Ethics Section Of The European Society Of, Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center [Jerusalem], Intensive Care Unit, Instituto Nacional de Câncer, Prague University Hospital, Servei de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, Centre for Health Care Sciences, Örebro University Hospital [Örebro, Sweden], Policlinico University Hospital Catania, Department of Intensive Care, Geneva University Hospitals and University of Geneva, Department of Intensive Care Medicine, Ghent University Hospital, Department of Medicine, Queen's University [Kingston, Canada], Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong [Hong Kong]-Prince of Wales Hospital, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Anesthesia and Intensive Care, Hospital de S. João, Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), General and Medical Intensive Care Unit, II, Medical Department, Surgical Intensive Care Unit, Semmelweis University [Budapest], University College of London [London] (UCL), Clinical Centre Ljubljana, University of Ljubljana, Royal Perth Hospital, CHU Fattouma Bourguiba [Monastir] (HFB), Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Department of Anesthesiology, Intensive Care Medicine, and Pain Management, Vivantes-Klinikum Neukoelln, Computer Science Department [Cyprus], University of Cyprus [Nicosia], HELIOS Spital, Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Vesin, Aurélien, and University of Cyprus [Nicosia] (UCY)

Subjects
Male, Questionnaires, Multivariate analysis, Intensive Care Units/*statistics & numerical data, Burnout, Hospitals, University/statistics & numerical data, Critical Care and Intensive Care Medicine, MESH: Perception, law.invention, Conflict, Psychological, Hospitals, University, 0302 clinical medicine, MESH: Hospitals, Public, law, MESH: Risk Factors, Risk Factors, Surveys and Questionnaires, Prevalence, Medicine, 030212 general & internal medicine, Workload/psychology, Burnout, Professional, MESH: Workload, Terminal Care, ddc:617, Communication, Workload, MESH: Stress, Psychological, Orvostudományok, MESH: Interpersonal Relations, MESH: Conflict (Psychology), Intensive care unit, Burnout, Professional/epidemiology/psychology, 3. Good health, Europe, Intensive Care Units, MESH: Terminal Care, MESH: Communication, Female, Stress, Psychological/epidemiology/psychology, Pulmonary and Respiratory Medicine, Adult, Hospitals, Public/statistics & numerical data, Conflict (Psychology), Attitude of Health Personnel, Health Personnel, MESH: Attitude of Health Personnel, MESH: Social Support, Klinikai orvostudományok, Occupational burnout, Europe/epidemiology, 03 medical and health sciences, MESH: Cross-Sectional Studies, Nursing, Intensive care, Intervention (counseling), MESH: Burnout, Professional, Humans, Interpersonal Relations, MESH: Prevalence, MESH: Hospitals, University, MESH: Humans, Job strain, business.industry, Hospitals, Public, MESH: Questionnaires, Social Support, 030208 emergency & critical care medicine, MESH: Adult, MESH: Male, Health Personnel/psychology/statistics & numerical data, Cross-Sectional Studies, Terminal Care/psychology/statistics & numerical data, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Health Personnel, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Perception, MESH: Europe, business, MESH: Female, Stress, Psychological
Abstract

International audience; RATIONALE: Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs. OBJECTIVES: To record the prevalence, characteristics, and risk factors for conflicts in ICUs. METHODS: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries). MEASUREMENTS AND MAIN RESULTS: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings. CONCLUSIONS: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.

Published
2009
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27. High level of burnout in intensivists: prevalence and associated factors

Author

Elie Azoulay, Nathalie Embriaco, Karine Barrau, Laurent Papazian, Nancy Kentish, Anderson Loundou, Frédéric Pochard, Medical Intensive Care Unit, Université de la Méditerranée - Aix-Marseille 2-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Département de Sociologie, Université Bordeaux Segalen - Bordeaux 2, Maison de Solenn [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Vesin, Aurélien

Subjects
Male, health care facilities, manpower, and services, Burnout, Critical Care and Intensive Care Medicine, MESH: Occupational Exposure, 0302 clinical medicine, MESH: Health Surveys, Risk Factors, MESH: Risk Factors, Prevalence, Medicine, 030212 general & internal medicine, Burnout, Professional, Response rate (survey), MESH: Middle Aged, Middle Aged, Occupational Diseases, Female, France, Pulmonary and Respiratory Medicine, Adult, MESH: Occupational Diseases, medicine.medical_specialty, Critical Care, Health Personnel, education, Intensivist, Occupational burnout, 03 medical and health sciences, Nursing, Intensive care, Occupational Exposure, Severity of illness, MESH: Burnout, Professional, Humans, MESH: Intensive Care, MESH: Prevalence, MESH: Humans, business.industry, Stressor, 030208 emergency & critical care medicine, MESH: Adult, Odds ratio, Health Surveys, MESH: Male, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

International audience; RATIONALE: Professional burnout is a psychological syndrome arising in response to chronic interpersonal stressors on the job. There is the perception that intensivists are particularly exposed to stress because lives are literally in their hands. OBJECTIVE: To evaluate the prevalence and associated factors (patients or organization) of burnout among physicians working in intensive care units (ICUs) (including interns, residents, fellows, and attending physicians). METHODS: A 1-day national survey was conducted in adult ICUs in French public hospitals. MEASUREMENTS: The level of burnout was evaluated on the basis of the Maslach Burnout Inventory (MBI). MAIN RESULTS: A total of 189 ICUs participated and 978 surveys were returned (82.3% response rate). A high level of burnout was identified in 46.5% of the respondents. Ordinal logistic regression showed that female sex (odds ratio, 1.58; 95% confidence interval, 1.09 to 2.30) was independently associated with a higher MBI score. Whereas no factor related to the severity of illness of patients was retained by the model, organizational factors were strongly associated with a higher MBI score. Workload (the number of night shifts per month, a long period of time from the last nonworking week, night shift the day before the survey) and impaired relationships (such as conflict with another colleague intensivist, and/or with a nurse) were the variables independently associated with a higher MBI score. In contrast, the quality of the relationships with chief nurses and nurses was associated with a lower MBI score. CONCLUSIONS: Approximately one-half of the intensivists presented a high level of burnout. Organizational factors, but not factors related to the patients, appeared to be associated with burnout.

Published
2007
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28. Perception and use of the results of patient satisfaction surveys by care providers in a French teaching hospital

Author

Georges Weil, José Labarère, Laurent Boyer, Elisabeth Doutre, Patrice Francois, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), TIMB, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble

Subjects
Male, Quality management, 0302 clinical medicine, Health care, MESH: Data Collection, 030212 general & internal medicine, MESH: Quality of Health Care, media_common, MESH: Aged, Total quality management, MESH: Middle Aged, Data Collection, 030503 health policy & services, Health Policy, Questionnaire, General Medicine, Middle Aged, 3. Good health, Patient Satisfaction, Female, Customer satisfaction, France, 0305 other medical science, Adult, medicine.medical_specialty, Adolescent, Attitude of Health Personnel, Health Personnel, media_common.quotation_subject, MESH: Attitude of Health Personnel, MEDLINE, 03 medical and health sciences, Patient satisfaction, medicine, Humans, Quality (business), Hospitals, Teaching, Aged, Quality of Health Care, MESH: Adolescent, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, MESH: Hospitals, Teaching, MESH: Male, MESH: Patient Satisfaction, MESH: France, Family medicine, MESH: Health Personnel, MESH: Total Quality Management, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Total Quality Management
Abstract

International audience; OBJECTIVE: . The aim of this study was to assess clinical staff's opinions on the results of in-patient satisfaction surveys and their use within the quality improvement process. SETTING: The institution is a 2200-bed teaching hospital of tertiary health care employing 8000 professionals. Patient satisfaction surveys are carried out each year using a validated questionnaire mailed to a random sample of patients. The specific results of each department are sent to the medical and paramedical managers. METHODS: We conducted a questionnaire survey on 500 care providers randomly selected in every medical and surgical department. RESULTS: A total of 261 questionnaires were returned and analysed. Overall, 94% of responders had a favourable opinion of the patient satisfaction surveys. They considered that the patient was able to judge hospital service quality, especially in its relational, organizational, and environmental dimensions. The specific results for the department were less well known than the overall hospital results (60 versus 76%). These results were formally discussed in the department according to 40% of responders; 40% declared that these data resulted in improvement actions and considered that they led to modifications in their behaviour with patients. CONCLUSIONS: Despite a declared interest in satisfaction surveys, the results remain underused by hospital staff and insufficiently discussed within teams.

Published
2006
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