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1. The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study

Author

Jean-Baptiste Tostain, Marina Mathieu, Agnès Oude Engberink, Bernard Clary, Michel Amouyal, Béatrice Lognos, Pascal Demoly, Isabella Annesi-Maesano, Grégory Ninot, Nicolas Molinari, Arnaud Richard, Maha Badreddine, Claire Duflos, and Francois Carbonnel

Subjects
Medicine
Abstract

BackgroundEnvironmental and behavioral factors are responsible for 12.6 million deaths annually and contribute to 25% of deaths and chronic diseases worldwide. Through the One Health initiative, the World Health Organization and other international health organizations plan to improve these indicators to create healthier environments by 2030. To meet this challenge, training primary care professionals should be the priority of national policies. General practitioners (GPs) are ready to become involved but need in-depth training to gain and apply environmental health (EH) knowledge to their practice. In response, we designed the Primary Care Environment and Health (PCEH) online course in partnership with the Occitanie Regional Health Agency in France. This course was used to train GP residents from the Montpelier-Nimes Faculty of Medicine in EH knowledge. The course was organized in 2 successive parts: (1) an asynchronous e-learning modular course focusing on EH knowledge and tools and (2) 1 day of face-to-face sessions. ObjectiveThis study assessed the impact of the e-learning component of the PCEH course on participants’ satisfaction, knowledge, and behavior changes toward EH. MethodsThis was a pilot before-and-after study. Four modules were available in the 6-hour e-learning course: introduction to EH, population-based approach (mapping tools and resources), clinical cases, and communication tools. From August to September 2021, we recruited first-year GP residents from the University of Montpellier (N=130). Participants’ satisfaction, knowledge improvements for 19 EH risks, procedure to report EH risks to health authorities online, and behavior change (to consider the possible effects of the environment on their own and their patients’ health) were assessed using self-reported questionnaires on a Likert scale (1-5). Paired Student t tests and the McNemar χ2 test were used to compare quantitative and qualitative variables, respectively, before and after the course. ResultsA total of 74 GP residents completed the e-learning and answered the pre- and posttest questionnaires. The mean satisfaction score was 4.0 (SD 0.9) out of 5. Knowledge scores of EH risks increased significantly after the e-learning course, with a mean difference of 30% (P

Published
2024
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3. Meeting the needs of pregnant women in socially vulnerable situations: A phenomenological qualitative study

Author

Béatrice Lognos, Agnès Oude Engberink, Lorène Gonzalez, Julia Leandri, Carla Charlot Pisoni, Nadia Rachedi, Bernard Clary, Gérard Bourrel, Sabine Bayen, and Elodie Million

Subjects
Women's health, Health disparities, Pregnancy, Social vulnerability, Needs assessment, Phenomenology, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Objective: Vulnerability relates to fragile physical, psychological, and socio-environmental circumstances. Pregnant women's social vulnerability can lead to disruptions in their medical follow-ups, prematurity, and increased infant mortality rates, such that their special needs must be considered. Yet, despite different governments' ‘perinatality’ plans, international literature suggests their care can be improved. Although quantitative studies regularly evaluate these plans, few studies have assessed vulnerable pregnant women's views. This study explores the needs and expectations of vulnerable women regarding their follow-ups during pregnancy and identified strategies to improve their circumstances. Methods: The study was a phenomenological qualitative study involving semi-structured interviews with women who gave birth in the past six months (December 2017 to June 2018) and who fulfilled at least one vulnerability criterion. The women were recruited by French midwives and general practitioners (GPs). Findings: Concerning these vulnerable pregnant women, three phenomenological categories emerged: 1) they need to be monitored by a single trusted contact; 2) they seek medical and social support adapted to their situations that addresses their needs; and 3) they expect kind and person-centred communication skills from professionals who provide them appropriate information. Conclusion: We identified various international recommendations to screen and care for vulnerable pregnant women, but still these women often experience numerous challenges. Finally, the implementation of recommendations for healthcare professionals based on women's real-life experiences could help optimise the identification of vulnerable pregnant women as well as their follow-up care.

Published
2024
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4. Integrating general practitioners into crisis management would accelerate the transition from victim to effective professional: Qualitative analyses of a terrorist attack and catastrophic flooding

Author

Bernard Clary, Bélinda Baert, Gérard Bourrel, Michel Amouyal, Béatrice Lognos, Agnès Oude-Engberink, and Elodie Million

Subjects
Qualitative designs and methods, general practice/family medicine, general, disasters, terrorist attacks, flooding, Medicine (General), R5-920
Abstract

Background In 2018, Trèbes, 6,000 inhabitants with nine general practitioners (GPs) in southern France, experienced two tragedies; a terrorist attack in March, in which four people were killed, and a catastrophic flood in October, in which six people died and thousands more were affected.Objectives We aimed to obtain a substantive theory for improving crisis management by understanding the personal and professional effects of the two successive disasters on GPs in the same village.Methods This qualitative study conducted complete interviews with eight GPs individually, with subsequent analyses involving the conceptualisation of categories based on grounded theory.Results The analysis revealed that GPs underwent a double status transition. First, doctors who experienced the same emotional shock as the population became victims; their usual professional relationship changed from empathy to sympathy. The helplessness they felt was amplified by the lack of demand from the state to participate in the first emergency measures; consequently, they lost their professional status. In a second phase, GPs regained their values and skills and acquired new ones, thus regaining their status as competent professionals. In this context, the participants proposed integrating a coordinated crisis management system and the systematic development of peer support.Conclusion We obtained valuable information on the stages of trauma experienced by GPs, allowing a better understanding of the effects on personal/professional status. Thus, the inclusion of GPs in adaptive crisis management plans would limit the effects of traumatic dissociation while increasing their professional effectiveness.

Published
2022
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5. The central role of peers facilitators in the empowerment of breast cancer patients: a qualitative study

Author

Béatrice Lognos, Isabelle Boulze-launay, Million Élodie, Gérard Bourrel, Michel Amouyal, Xavier Gocko, Clary Bernard, Grégory Ninot, and Agnès Oude Engberink

Subjects
Empowerment, Peers, Patient association, Breast cancer, Phenomenological study, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from 18.1 million in 2018 and 14.1 million in 2012. Since the 2000s, cancer treatments have significantly improved, allowing either a cure or control of the disease. Patients share their experience of the disease and use supportive care solutions through involvement in patient associations and online forums. All the associations were built on the principle of “peer support,” which is based on mutual aid between people who suffer or have suffered from the same somatic or psychological illness or had the same life experience. This experiential knowledge can be explored to understand the role of peers and associations in the appropriation of their cancer. Methods A qualitative phenomenological study was undertaken through semi-structured interviews with 12 participants. Interviews were audio-recorded, transcribed verbatim, then analyzed by means of triangulation up to the point of theoretical saturation by a semio-pragmatic method. Results Four categories emerged: (1) “Transforms a painful experience into a positive one. It mobilizes the human values of sharing, love, and humility, which facilitates resilience”; (2) “The characteristics of the association, a non-medical place between people sharing a common destiny, resonates with patients’ needs and improves their well-being”; (3) “The association transforms the patients’ experiences by facilitating engagement that leads to a patient-expert (empowerment)”; and (4) “Understanding what is happening to them is soothing, reassuring, because patients’ concerns need to be heard and their care understood”. Conclusions This study highlights patient associations can serve as the mediator of NPI and facilate the empowerment of breast cancer patients. Practice implications Educating health professionals in initial and continuing education about non-pharmacological interventions will be a major issue. Teaching the patient-centred approach to health professionals is one of the priorities in initial and continuing medical education.

Published
2022
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6. The chronic disease Self‐Management Programme: A phenomenological study for empowering vulnerable patients with chronic diseases included in the EFFICHRONIC project

Author

Dallal Fracso, Gérard Bourrel, Christian Jorgensen, Hélène Fanton, Hein Raat, Alberto Pilotto, Graham Baker, Marta M. Pisano, Rosanna Ferreira, Verushka Valsecchi, Yves‐Marie Pers, and Agnes Oude Engberink

Subjects
chronic diseases, Chronic Disease Self‐Management Programme, empowerment, health education, phenomenology, vulnerable populations, Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Abstract Introduction The Chronic Disease Self‐Management Programme (CDSMP) has resulted in improved health outcomes for patients. However, research has focused mainly on those with chronic conditions and has not extensively explored prevention programmes targeting individuals with specific vulnerability profiles. Aim This study aimed to understand the effects of the CDSMP on the lived experience of vulnerable patients included in the EFFICHRONIC project in France, based on their needs and expectations before and after participation. Methods We conducted a qualitative phenomenological semio‐pragmatic study based on 37 in‐depth interviews with 20 patients (20 before/17 after CDSMP). Results By transforming existential dimensions (identity, relationship with others and bodily experience), chronic illness generates new needs in the vulnerable person. By resonating with the expectations and needs of participants, the CDSMP induces motivation and a sense of belonging to a community of peers. It has enabled the participants to become actors of their own health until empowerment. Although some limitations are reported, the programme has awakened a desire in the participants to take better care of their health and to develop personal skills with, for some, a desire to become involved in health education. Conclusion Our phenomenological approach highlighted the resonance between the programme (its design and implementation) and the lived experience of patients, as an effective element of empowerment. This necessitates training the facilitators to elicit the lived experience of patients. Furthermore, as a patient‐centred approach is required, the facilitators need to learn how to adapt the design of the programme to the singularity of the patient. Patient or Public Contribution Patients provided the data that were collected through in‐depth interviews, and their experiences before and after the programme were analysed.

Published
2022
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8. The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study

Author

Tostain, Jean-Baptiste, primary, Mathieu, Marina, additional, Oude Engberink, Agnès, additional, Clary, Bernard, additional, Amouyal, Michel, additional, Lognos, Béatrice, additional, Demoly, Pascal, additional, Annesi-Maesano, Isabella, additional, Ninot, Grégory, additional, Molinari, Nicolas, additional, Richard, Arnaud, additional, Badreddine, Maha, additional, Duflos, Claire, additional, and Carbonnel, Francois, additional

Published
2024
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9. General practitioners must acquire skills to communicate with child with Autism Spectrum Disorder to regain their values and role in the follow-up – phenomenological study

Author

Bernard Clary, Eva Marengo-Sorli, Agnès Oude-Engberink, Elodie Million, Sylvain Pavageau, Michel Amouyal, Philippe Serayet, François Carbonnel, Gérard Bourrel, and Béatrice Lognos

Subjects
autism spectrum disorder (asd), mental disorders, family practice, general practitioner, qualitative research, children, Public aspects of medicine, RA1-1270
Abstract

Objective To understand the perceptions and attitudes of general practitioners (GPs) regarding children with an Autism Spectrum Disorder (ASD). Design Phenomenological qualitative study. Setting Three focus groups, clinical settings. Subjects French GPs. Main outcome measures 22 GPs took part in the study divided among three focus groups. They were volunteers to participate. Data were transcribed verbatim and analysed using a grounded theory data analysis, completed with a semiopragmatic analysis. Results Representing autism as a strange disorder in the doctor–patient relationship, GPs perceive a loss of sensory contact with the child with ASD that prevents the usual professional relationship between doctor and patient. They disengage themselves from monitoring the subject, concentrating on supporting the family. According to them, their role was to refer the patient to a specialist in the case of clinical intuition, but they have several reasons to give themselves time, all the more so because once the diagnosis is made, they lose sight of the patient and their place in the care pathway. GPs expressed the need to acquire skills and strategies to communicate with the autistic child to recover their role and values. Conclusion GPs are disconcerted by the idea of communicating with children with ASD, as it takes them out of their usual professional benchmarks. They need communication tools that enable them to regain their role and relational value of the patient-centred approach. Beyond this, the question of the ‘ethics of care’ of the patient with a joint attention disorder is raised.KEY POINTS GPs are disconcerted with the idea of communicating with children with ASD. GPs need communication tools that enable them to regain their role and relational value of the patient-centred approach. The question of the ‘ethics of care’ of the patient with a joint attention disorder is raised.

Published
2021
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10. Pre-exposure prophylaxis makes it possible to better live one’s sexuality and guide men who have sex with men towards a responsible approach to their health: a phenomenological qualitative study about primary motivations for PrEP

Author

Marie Bistoquet, Alain Makinson, Vincent Tribout, Cyril Perrollaz, Gérard Bourrel, Jacques Reynes, and Agnès Oude Engberink

Subjects
Pre-exposure prophylaxis, HIV prevention, Quality of life, Qualitative research, Phenomenology, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Pre-exposure prophylaxis (PrEP) for HIV is instrumental in the prevention of HIV for HIV-uninfected persons, by drastically reducing the risk of acquisition in the case of high-risk exposures. Despite its demonstrated efficacy, it remained under-prescribed in France until 2018. The principal aim of this study was to understand the motivations of Men who have Sex with Men (MSM) who started using PrEP in Montpellier, France. Methods A phenomenological study was undertaken, using semi-structured interviews with twelve participants attending the University Hospital of Montpellier for PrEP. Interviews were analysed by means of triangulation up to the point of theoretical saturation, using a semio-pragmatic method. Results Fear of HIV infection, personalised regular follow-up, and the wish to take care of one’s health were the primary motivational factors. PrEP allows for a better sexual life restoring a sense of freedom despite the risks of STI, deemed manageable by PrEPers. PrEP does not modify long-term risk-taking behaviours but helps them better live their own sexuality and guides them towards a responsible approach to sexuality. Unclear information on PrEP, delivered by their family doctor, public campaigns or the media, leads to misrepresentations or negative social representation, including within the MSM community, which may delay its implementation. Conclusions Fear of HIV infection and the benefits of regular medical follow-up to take care of one’s health were motivational factors of importance for the use of PrEP by MSM in this study. PrEP transforms all existential dimensions of their lived experience, improving sexual identity and happiness. There is a need to improve professional awareness of the effectiveness of PrEP and to develop a patient centered approach, to disseminate information more widely to the general public and among MSM to reduce stigmatisation.

Published
2021
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11. Impact of a transition education program on health-related quality of life in pediatric patients with congenital heart disease: study design for a randomised controlled trial

Author

Oscar Werner, Charlene Bredy, Kathleen Lavastre, Sophie Guillaumont, Gregoire De La Villeon, Marie Vincenti, Cristelle Gerl, Yves Dulac, Nathalie Souletie, Philippe Acar, Laurence Pages, Marie-Christine Picot, Gerard Bourrel, Agnes Oude Engberink, Elodie Million, Hamouda Abassi, and Pascal Amedro

Subjects
Transition, Therapeutic education, Congenital heart disease, Quality of life, Adolescent, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background Recent advances in the field of congenital heart disease (CHD) led to an improved prognosis of the patients and in consequence the growth of a new population: the grown up with congenital heart disease. Until recently, more than 50% of these patients were lost to follow up because of the lack of specialized structures. The critical moment is the transition between paediatric and adult unit. Therapeutic education is crucial to solve this issue by helping patients to become independent and responsible. The TRANSITION-CHD randomized trial aims to assess the impact of a transition education program on health-related quality of life (HRQoL) of adolescents and young adults with CHD. Methods Multicentre, randomised, controlled, parallel arm study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (education program vs. no intervention). The primary outcome is the change in self-reported HRQoL between baseline and 12-month follow-up. A total of 100 patients in each group is required to observe a significant increase of the overall HRQoL score of 7 ± 13.5 points (on 100) with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (peak VO2, VAT, VE/VCO2 slope), level of knowledge of the disease using the Leuven knowledge questionnaire for CHD, physical and psychological status. Discussion As the current research is opening on patient related outcomes, and as the level of proof in therapeutic education is still low, we sought to assess the efficacy of a therapeutic education program on HRQoL of CHD patients with a randomized trial. Trial registration This study was approved by the National Ethics Committee (South-Mediterranean IV 2016-A01681-50) and was registered on Clinicaltrials.gov (NCT03005626).

Published
2021
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12. The first pelvic examination: A rite of passage for the women. A qualitative study about French women

Author

Elodie Million, Amandine Yvon, Agnès Oude-Engberink, Pierre Mares, Philippe Serayet, Sylvain Pavageau, Bernard Clary, and Béatrice Lognos

Subjects
pelvic examination, woman, prevention, qualitative research, patient-centred care, Medicine (General), R5-920
Abstract

Background French general practitioners (GP) and gynaecologists can make use of recommendations when performing a patient’s first pelvic examination. The indications and techniques for this examination are clear. The relational aspects and experience of the patients have been dealt with little. Objectives To analyse and understand the experience of French women during their first pelvic examination to propose practice recommendations based on their experiences. Methods Qualitative semi-structured interviews was conducted with 13 French women aged 18–30 years recruited from the surgery of a general practitioner using the snowball method. The data were analysed using an inductive method. Results The first pelvic examination was considered an indispensable rite of passage into adulthood and the life of a woman. They wanted a preparation for a consultation devoted to the first pelvic examination, with a time that is adapted to each woman. A patient-centred practitioner was more important than the pelvic examination itself. Conclusion Women requested for a general practitioner or a gynaecologist with a deeper understanding of a woman’s experience to perform their first pelvic examination. We propose practical recommendations: the following 3 phases for the consultation: before the pelvic examination where the women and the practitioners may get to know one another; during the examination, which would involve the technical aspects and the associated procedures; and after the examination, where the patients and the practitioners review the experience and discuss prevention.

Published
2020
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13. A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France

Author

Agnès Oude Engberink, Maryse Mailly, Valerie Marco, Daniele Bourrie, Jean-Pierre Benezech, Josyane Chevallier, Sandrine Vanderhoeven, Remy Crosnier, Gérard Bourrel, and Béatrice Lognos

Subjects
Patient-centered palliative approach, Mobile palliative care team, Phenomenology, Physician nurse balance, Recognition at work, Special situations and conditions, RC952-1245
Abstract

Abstract Background Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Methods Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Results Nurses recognize their role as being witnesses to the patient’s experience through their constant presence. This is in line with their professional values and gives them an “alert role” that can anticipate a patient-centered palliative approach. The physician’s positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, “rethinking care within a team environment” allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses “balance” while providing personal and professional support. Conclusions The Physician’s positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. “Recognition at work”, specifically “recognition of the individual role of nurse” is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a “facilitating intermediary” within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.

Published
2020
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15. Impact of a transition education program on health-related quality of life in pediatric patients with congenital heart disease: study design for a randomised controlled trial

Author

Werner, Oscar, Bredy, Charlene, Lavastre, Kathleen, Guillaumont, Sophie, De La Villeon, Gregoire, Vincenti, Marie, Gerl, Cristelle, Dulac, Yves, Souletie, Nathalie, Acar, Philippe, Pages, Laurence, Picot, Marie-Christine, Bourrel, Gerard, Oude Engberink, Agnes, Million, Elodie, Abassi, Hamouda, and Amedro, Pascal

Published
2021
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16. Obstacles et perspectives pratiques de la consultation en médecine générale du migrant porteur de troubles psychologiques. Étude qualitative auprès de médecins généralistes français.

Author

Lerigoleur, Marie, Urena-Dores, Aurélie, Gérard, Bourrel, Jaume, Cyril, Minet, Mathilde, Million, Élodie, Clary, Bernard, Oude Engberink, Agnès, and Lognos Folco, Béatrice

Abstract

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2024
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18. Qualitative approach to better understand the trajectory of patients with early and moderate stage CKD

Author

Agnes Oude Engberink, Gerard Bourrel, Olivier Moranne, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Oude engberink, Agnes

Subjects
[SDV] Life Sciences [q-bio], Transplantation, Nephrology, [SDV]Life Sciences [q-bio], [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2022
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19. Connected Health Devices for Health Care in French General Medicine Practice: Cross-Sectional Study

Author

El Amrani, Leila, Oude Engberink, Agnes, Ninot, Gregory, Hayot, Maurice, and Carbonnel, François

Subjects
Information technology, T58.5-58.64, Public aspects of medicine, RA1-1270
Abstract

BackgroundThe integration of Connected Health Devices (CHDs) is growing within mobile health (mHealth) and telemedicine, encouraged by institutions and industries. The idea is to improve lifestyle habits and health behaviors as a preventive goal in an aging population with fewer physicians available. However, their ill-defined place in health care does not promote their use in current medical practice. ObjectiveThe primary objective of this study was to quantify CHDs’ use rate by general practitioners (GPs). A secondary objective was to evaluate their benefits and limitations in usual care. MethodsA cross-sectional study through an Internet-based survey was addressed to French GPs via regional medical unions and continuous education agencies, supplemented with an informative website, from March 2015 to July 2015. Surveys where either the form was insufficiently filled or the main question was left unanswered were excluded from the study. ResultsA total of 1084 answers were analyzed, of which 19.46% (211/1084, 95% CI 17.1-21.8) GPs used CHDs, and 10.15% (110/1084, 95% CI 8.5-12.1) prescribed a CHD. CHD users statistically prescribed more CHDs (7.38% [80/1084] in the user group vs 2.86% [31/1084] in nonusers; P

Published
2017
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21. The central role of peers facilitators in the empowerment of breast cancer patients: a qualitative study

Author

Béatrice Lognos, Isabelle Boulze-launay, Million Élodie, Gérard Bourrel, Michel Amouyal, Xavier Gocko, Clary Bernard, Grégory Ninot, and Agnès Oude Engberink

Subjects
Counseling, Reproductive Medicine, Health Personnel, Obstetrics and Gynecology, Humans, Breast Neoplasms, Female, General Medicine, Peer Group, Qualitative Research
Abstract

Background In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from 18.1 million in 2018 and 14.1 million in 2012. Since the 2000s, cancer treatments have significantly improved, allowing either a cure or control of the disease. Patients share their experience of the disease and use supportive care solutions through involvement in patient associations and online forums. All the associations were built on the principle of “peer support,” which is based on mutual aid between people who suffer or have suffered from the same somatic or psychological illness or had the same life experience. This experiential knowledge can be explored to understand the role of peers and associations in the appropriation of their cancer. Methods A qualitative phenomenological study was undertaken through semi-structured interviews with 12 participants. Interviews were audio-recorded, transcribed verbatim, then analyzed by means of triangulation up to the point of theoretical saturation by a semio-pragmatic method. Results Four categories emerged: (1) “Transforms a painful experience into a positive one. It mobilizes the human values of sharing, love, and humility, which facilitates resilience”; (2) “The characteristics of the association, a non-medical place between people sharing a common destiny, resonates with patients’ needs and improves their well-being”; (3) “The association transforms the patients’ experiences by facilitating engagement that leads to a patient-expert (empowerment)”; and (4) “Understanding what is happening to them is soothing, reassuring, because patients’ concerns need to be heard and their care understood”. Conclusions This study highlights patient associations can serve as the mediator of NPI and facilate the empowerment of breast cancer patients. Practice implications Educating health professionals in initial and continuing education about non-pharmacological interventions will be a major issue. Teaching the patient-centred approach to health professionals is one of the priorities in initial and continuing medical education.

Published
2021

22. Impact of a Transition Education Program on the Quality of Life in Pediatric Patients with Congenital Heart Disease: Study Design for a Randomised Controlled Trial

Author

Oscar werner, Charlene Bredy, Kathleen LAVASTRE, Sophie Guillaumont, Gregoire De LA VILLEON, Marie Vincenti, Cristelle gerl, Yves DULAC, Nathalie Souletie, Philippe ACAR, Laurence Pages, Marie christine a PICOT, Gerard Bourrel, Agnes OUDE ENGBERINK, Elodie Millon, ABASSI Hamouda, Pascal Amedro, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, CHU Toulouse [Toulouse], Université de Montpellier (UM), MORNET, Dominique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service Cardiologie pédiatrique [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], 3. Good health
Abstract

Background: Recent advances in the field of congenital heart disease (CHD) led to an improved prognosis of the patients and in consequence the growth of a new population: the grown up with congenital heart disease. Until recently, more than 50% of these patients were lost to follow up because of the lack of specialized structures. The critical moment is the transition between paediatric and adult unit. Therapeutic education is crucial to solve this issue by helping patient to become independent and responsible. The TRANSITION randomized trial aims to assess the impact of a transition education program on the quality of life (QoL) of adolescents and young adults with CHD. Methods: multicentre, randomised, controlled, parallel arm study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (Education program vs. no intervention). The primary outcome is the change in self-reported QoL between baseline and 12-month follow-up. A total of 100 patients in each group is required to observe a significant increase of the overall QoL score of 7±13.5 points (on 100) with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (VO2max,VE/VCO2 slope), level of knowledge, physical and psychological status.Discussion: As the current research is opening on patient related outcomes, and as the level of proof in therapeutic education still low, we sought to assess the efficacy of a therapeutic education program on the QoL of CHD patients with a randomized trial.Trial registration: This study was approved by the National Ethics Committee (South-Mediterranean IV 2016-A01681-50) and was registered on Clinicaltrials.gov (NCT03005626) on 29th December 2016

Published
2021

23. Impact of a transition education program on health-related quality of life in pediatric patients with congenital heart disease: study design for a randomised controlled trial

Author

Agnès Oude Engberink, Elodie Million, Sophie Guillaumont, Cristelle Gerl, Oscar Werner, Gregoire De La Villeon, Laurence Pages, Gérard Bourrel, Pascal Amedro, Marie Vincenti, Philippe Acar, Charlene Bredy, Yves Dulac, Hamouda Abassi, Nathalie Souletie, Kathleen Lavastre, and Marie-Christine Picot

Subjects
Adult, Heart Defects, Congenital, Transition to Adult Care, medicine.medical_specialty, Adolescent, Heart disease, Disease, 030204 cardiovascular system & hematology, Therapeutic education, lcsh:Computer applications to medicine. Medical informatics, law.invention, Study Protocol, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Patient Education as Topic, Quality of life, Randomized controlled trial, law, Intervention (counseling), Humans, Medicine, 030212 general & internal medicine, Young adult, Lost to follow-up, Congenital heart disease, Randomized Controlled Trials as Topic, business.industry, Public Health, Environmental and Occupational Health, General Medicine, medicine.disease, Research Design, Transition, Quality of Life, Physical therapy, lcsh:R858-859.7, business
Abstract

BackgroundRecent advances in the field of congenital heart disease (CHD) led to an improved prognosis of the patients and in consequence the growth of a new population: the grown up with congenital heart disease. Until recently, more than 50% of these patients were lost to follow up because of the lack of specialized structures. The critical moment is the transition between paediatric and adult unit. Therapeutic education is crucial to solve this issue by helping patients to become independent and responsible. The TRANSITION-CHD randomized trial aims to assess the impact of a transition education program on health-related quality of life (HRQoL) of adolescents and young adults with CHD.MethodsMulticentre, randomised, controlled, parallel arm study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (education program vs. no intervention). The primary outcome is the change in self-reported HRQoL between baseline and 12-month follow-up. A total of 100 patients in each group is required to observe a significant increase of the overall HRQoL score of 7 ± 13.5 points (on 100) with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (peak VO2, VAT, VE/VCO2 slope), level of knowledge of the disease using the Leuven knowledge questionnaire for CHD, physical and psychological status.DiscussionAs the current research is opening on patient related outcomes, and as the level of proof in therapeutic education is still low, we sought to assess the efficacy of a therapeutic education program on HRQoL of CHD patients with a randomized trial.Trial registrationThis study was approved by the National Ethics Committee (South-Mediterranean IV 2016-A01681-50) and was registered on Clinicaltrials.gov (NCT03005626).

Published
2021
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24. La prophylaxie pré-exposition permet de mieux vivre sa sexualité et de guider les hommes ayant des rapports sexuels avec des hommes vers une approche responsable de leur santé : une étude qualitative phénoménologique sur les motivations principales de la PrEP

Author

Gérard Bourrel, Alain Makinson, Marie Bistoquet, Vincent Tribout, Jacques Reynes, Cyril Perrollaz, Agnès Oude Engberink, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Infectious and Tropical Diseases Department [Montpellier], Institut de Recherche pour le Développement (IRD)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Desbrest de santé publique (IDESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Male, lcsh:Immunologic diseases. Allergy, Quality of life, Anti-HIV Agents, media_common.quotation_subject, HIV prevention, Human sexuality, HIV Infections, Men who have sex with men, 03 medical and health sciences, Pre-exposure prophylaxis, Sexual and Gender Minorities, 0302 clinical medicine, Quality of life (healthcare), Nursing, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Social representation, Qualitative research, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Homosexuality, Male, media_common, Sexual identity, Motivation, 030505 public health, business.industry, Research, 3. Good health, Happiness, Molecular Medicine, Phenomenology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, lcsh:RC581-607
Abstract

BackgroundPre-exposure prophylaxis (PrEP) for HIV is instrumental in the prevention of HIV for HIV-uninfected persons, by drastically reducing the risk of acquisition in the case of high-risk exposures. Despite its demonstrated efficacy, it remained under-prescribed in France until 2018. The principal aim of this study was to understand the motivations of Men who have Sex with Men (MSM) who started using PrEP in Montpellier, France.MethodsA phenomenological study was undertaken, using semi-structured interviews with twelve participants attending the University Hospital of Montpellier for PrEP. Interviews were analysed by means of triangulation up to the point of theoretical saturation, using a semio-pragmatic method.ResultsFear of HIV infection, personalised regular follow-up, and the wish to take care of one’s health were the primary motivational factors. PrEP allows for a better sexual life restoring a sense of freedom despite the risks of STI, deemed manageable by PrEPers. PrEP does not modify long-term risk-taking behaviours but helps them better live their own sexuality and guides them towards a responsible approach to sexuality. Unclear information on PrEP, delivered by their family doctor, public campaigns or the media, leads to misrepresentations or negative social representation, including within the MSM community, which may delay its implementation.ConclusionsFear of HIV infection and the benefits of regular medical follow-up to take care of one’s health were motivational factors of importance for the use of PrEP by MSM in this study. PrEP transforms all existential dimensions of their lived experience, improving sexual identity and happiness. There is a need to improve professional awareness of the effectiveness of PrEP and to develop a patient centered approach, to disseminate information more widely to the general public and among MSM to reduce stigmatisation.

Published
2021
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25. Recommendations for risk management and better living with epilepsy. Phenomenological study of the experience of patients, relatives, and bereaved families

Author

François Carbonnel, Agnès Oude Engberink, Audrey Jaussent, Gérard Bourrel, Laurence Negre-Pages, Marie Faucanie, Arielle Crespel, Marie-Christine Picot, Myriam Boulais, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, and Gibier, François

Subjects
SUDEP, media_common.quotation_subject, Social Stigma, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Stigma (botany), law.invention, Phenomenology (philosophy), 03 medical and health sciences, Behavioral Neuroscience, Epilepsy, 0302 clinical medicine, Nursing, Seizures, law, Perception, medicine, Humans, 030212 general & internal medicine, Empowerment, Risk management, epilepsy-related risk, media_common, Risk Management, Stereotyping, business.industry, medicine.disease, 3. Good health, Neurology, Feeling, empowerment, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, CLARITY, epilepsy, phenomenology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, Psychology, 030217 neurology & neurosurgery
Abstract

International audience; Objective: To understand the lived experience of people with epilepsy (PWE) and their relatives, the risks associated with epilepsy, the information received from healthcare professionals, and the reaction to this information.Methods: Qualitative phenomenological study conducted between 2016 and 2018. Individual semi-directive in-depth interviews were performed based on a triangulation of sources in three study groups: PWE, relatives of PWE, and bereaved families. Interviews were analyzed continuously, using a semiopragmatic method until data saturation.Results: Interviews with PWE (N = 16), relatives of PWE (N = 8), and bereaved families (N = 10) led to several observations: (i) The stigmatizing representations of epilepsy and its constraints lead to a feeling of abnormality which determines the behavior of patients and their relatives; (ii) The global uncertainty surrounding epilepsy is an obstacle to the delivery of clear and personalized information by professionals, and, consequently, to empowerment; (iii) The communication skills of the physician have an impact on the lived experiences of patients and relatives; (iv) Better knowledge on direct mortal epilepsy-related risk could influence the perception of danger to oneself, and help find a balance between overprotection and trivialization. The experience of the patients and relatives led them to formulate concrete recommendations: (i) for the general public: to run information campaigns in order to limit stigmatization; (ii) for caregivers: to provide personalized and detailed information without minimizing the risks, in order to enable patients to “live by setting these risks”; (iii) for patients: to have a trusted person who is informed and trained in seizure management, to join patient associations.Conclusion: Our study points out that stigma, uncertainty, and lack of clarity of information are all barriers to patient empowerment. In order to provide prompt and personalized information on how to live with epilepsy while managing the risks, physicians need to develop person-centered communication skills. Future research is also required for the development of tools to facilitate this communication.

Published
2021
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26. General practitioners must acquire skills to communicate with child with Autism Spectrum Disorder to regain their values and role in the follow-up – phenomenological study

Author

Clary, Bernard, primary, Marengo-Sorli, Eva, additional, Oude-Engberink, Agnès, additional, Million, Elodie, additional, Pavageau, Sylvain, additional, Amouyal, Michel, additional, Serayet, Philippe, additional, Carbonnel, François, additional, Bourrel, Gérard, additional, and Lognos, Béatrice, additional

Published
2021
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27. The first pelvic examination: A rite of passage for the women. A qualitative study about French women

Author

Amandine Yvon, Béatrice Lognos, Elodie Million, Bernard Clary, Agnès Oude-Engberink, Philippe Serayet, Sylvain Pavageau, Pierre Mares, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Montpellier (UM), Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Paul-Valéry - Montpellier 3 (UPVM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Maison de Santé Pluriprofessionnelle Universitaire Avicenne (MSP-U), Centre d’Evaluation des programmes de Prévention Sante [Montpellier] (Plateforme CEPS), and lognos, béatrice

Subjects
Adult, medicine.medical_specialty, Rite of passage, [SDV]Life Sciences [q-bio], MESH: Attitude to Health, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, patient centred care, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pelvic examination, prevention, MESH: Grounded Theory, medicine, Humans, 030212 general & internal medicine, Physician-Patient Relations, lcsh:R5-920, medicine.diagnostic_test, business.industry, 030503 health policy & services, MESH: Gynecological Examination / psychology, [SDV] Life Sciences [q-bio], MESH: France, Snowball sampling, patient-centred care, MESH: Young Adult, Family medicine, Grounded Theory, woman, MESH: Physician-Patient Relations, Original Article, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Gynecological Examination, lcsh:Medicine (General), 0305 other medical science, Family Practice, business, Attitude to Health, qualitative research, Qualitative research
Abstract

International audience; Background: French general practitioners (GP) and gynaecologists can make use of recommendations when performing a patient's first pelvic examination. The indications and techniques for this examination are clear. The relational aspects and experience of the patients have been dealt with little.Objectives: To analyse and understand the experience of French women during their first pelvic examination to propose practice recommendations based on their experiences.Methods: Qualitative semi-structured interviews was conducted with 13 French women aged 18-30 years recruited from the surgery of a general practitioner using the snowball method. The data were analysed using an inductive method.Results: The first pelvic examination was considered an indispensable rite of passage into adulthood and the life of a woman. They wanted a preparation for a consultation devoted to the first pelvic examination, with a time that is adapted to each woman. A patient-centred practitioner was more important than the pelvic examination itself.Conclusion: Women requested for a general practitioner or a gynaecologist with a deeper understanding of a woman's experience to perform their first pelvic examination. We propose practical recommendations: the following 3 phases for the consultation: before the pelvic examination where the women and the practitioners may get to know one another; during the examination, which would involve the technical aspects and the associated procedures; and after the examination, where the patients and the practitioners review the experience and discuss prevention.

Published
2020
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28. Approche centrée patient et interventions non médicamenteuses (INM) en médecine générale

Author

Agnès Oude Engberink, Lucie Clotet, Béatrice Lognos, François Carbonnel, Sylvain Pavageau, and Gérard Bourrel

Abstract

L’essor des interventions non medicamenteuses (INM) a du sens et interpelle sur les besoins et les attentes des medecins et des usagers. Ces solutions de sante, nees de bouleversements societaux et economiques, doivent etre « repensees » pour etre integrees dans des parcours de soins coordonnes. L’approche centree patient est au cœur de cette demarche. La communaute medicale territoriale, en particulier les acteurs des soins primaires, doit se mobiliser pour elaborer des modalites d’enseignement et d’evaluation de ces INM par une recherche appropriee.

Published
2018
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29. Magnetic Resonance Imaging of Monocytes Labeled with Ultrasmall Superparamagnetic Particles of Iron Oxide Using Magnetoelectroporation in an Animal Model of Multiple Sclerosis

Author

Raoul D. Oude Engberink, Susanne M.A. van der Pol, Pjotr Walczak, Annette van der Toorn, Max A. Viergever, Christine D. Dijkstra, Jeff W.M. Bulte, Helga E. de Vries, and Erwin L.A. Blezer

Subjects
Biology (General), QH301-705.5, Medical technology, R855-855.5
Abstract

Infiltrated monocytes play a crucial role in the demyelination process during multiple sclerosis (MS), an inflammatory disease of the central nervous system (CNS). Still, methods to monitor their infiltration pattern over time are lacking. In this study, magnetoelectroporation (MEP) was used to label rat monocytes with the superparamagnetic iron oxide particles Sinerem, Endorem, and Supravist. Supravist-labeled monocytes were injected in rats that we induced with experimental autoimmune encephalomyelitis, a model for MS. Imaging at 4.7 and 9.4 T revealed multiple foci of decreased signal intensity predominantly located in the cerebellum. Immunohistochemical evaluation confirmed the presence of intracellular iron in infiltrated cells, indicating the suitability of MEP to specifically follow labeled monocytes in vivo in this disease model. This technique may be further optimized and potentially used in MS patients to assess monocyte migration into the brain and to monitor the efficacy of therapeutic agents aimed at blocking cellular migration into the CNS.

Published
2010
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31. La Plateforme CEPS : une structure universitaire de réflexion sur l’évaluation des interventions non médicamenteuses (INM)

Author

Grégory Ninot, Sylvain Agier, Simon Bacon, Claudine Berr, Isabelle Boulze, Gérard Bourrel, François Carbonnel, Valérie Clément, Michel David, Aurélie Gerazime, Adeline Gomez, Estelle Guerdoux-Ninot, Anne Laurent, Kim Lavoie, Thérèse Libourel, Béatrice Lognos, Francis Maffre, Jérôme Maitre, Sophie Martin, Grégory Mercier, Bertrand Nalpas, The Loc Nguyen, Agnes Oude Engberink, Jean-Louis Pujol, Xavier Quantin, Sylvie Rapior, Pierre Senesse, Anne Stoebner-Delbarre, and Raphaël Trouillet

Subjects
0303 health sciences, 03 medical and health sciences, 0302 clinical medicine, 030217 neurology & neurosurgery, 030304 developmental biology
Abstract

Les Interventions Non Medicamenteuses (INM) sont devenues des solutions incontournables pour ameliorer la qualite de vie et la sante. Elles presentent dans certains cas un impact positif sur la duree de vie et des benefices sociaux et economiques. Leur usage augmente sans cesse. Une plateforme universitaire collaborative basee a Montpellier, la Plateforme CEPS, reflechit aux manieres de les evaluer. Cet article presente plus en detail ses activites.

Published
2017
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33. A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France

Author

Agnès Oude Engberink, Jean-Pierre Bénézech, Sandrine Vanderhoeven, Daniele Bourrie, Valerie Marco, Maryse Mailly, Gérard Bourrel, Josyane Chevallier, Béatrice Lognos, Remy Crosnier, Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Fondation de France

Subjects
Adult, Male, Palliative care, Attitude of Health Personnel, Pain medicine, lcsh:Special situations and conditions, education, Nurses, Patient-centered palliative approach, Phenomenology (philosophy), 03 medical and health sciences, Mobile palliative care team, 0302 clinical medicine, Nursing, Health care, Patients' Rooms, Humans, 030212 general & internal medicine, Qualitative Research, Interpretative phenomenological analysis, business.industry, lcsh:RC952-1245, Palliative Care, General Medicine, Middle Aged, Focus group, Physician nurse balance, 3. Good health, Distress, Recognition at work, 030220 oncology & carcinogenesis, Female, Phenomenology, France, Psychology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Mobile Health Units, Qualitative research, Research Article
Abstract

Background Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Methods Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Results Nurses recognize their role as being witnesses to the patient’s experience through their constant presence. This is in line with their professional values and gives them an “alert role” that can anticipate a patient-centered palliative approach. The physician’s positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, “rethinking care within a team environment” allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses “balance” while providing personal and professional support. Conclusions The Physician’s positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. “Recognition at work”, specifically “recognition of the individual role of nurse” is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a “facilitating intermediary” within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.

Published
2019
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34. Management of Current Psychiatric Disorders

Author

François Carbonnel, Joanna Norton, Jean-Philippe Boulenger, Gérard Bourrel, Delphine Capdevielle, Agnès Oude Engberink, and Michel David

Subjects
03 medical and health sciences, Psychiatry and Mental health, medicine.medical_specialty, 0302 clinical medicine, business.industry, Family medicine, Medicine, 030212 general & internal medicine, business, Psychiatry, Original Research, 030227 psychiatry, Qualitative research
Abstract

Objective: Describe and analyse the experience of family physicians in managing current psychiatric disorders to obtain a better understanding of the underlying reasons of under-detection and inadequate prescribing identified in studies. Methods: A qualitative study using in-depth interviews. Sample of 15 practicing family physicians, recruited by telephone from a precedent cohort (Sesame1) with a maximum variation: sex, age, single or group practice, urban or rural. Qualitative method is inspired by the completed grounded theory of a verbatim semiopragmatic analysis from 2 experts in this approach. Results: Family physicians found that current psychiatric disorders were related to psychological symptoms in reaction to life events. Their role was to make patients aware of a psychiatric symptom rather than establish a diagnosis. Their management responsibility was considered in contrasting ways: it was claimed or endured. They defined their position as facilitating compliance to psychiatrist consultations, while assuring a complementary psychotherapeutic approach. Prescribing medication was not a priority for them. Conclusions: The identified under-detection is essentially due to inherent frontline conditions and complexity of clinical forms. The family physician role, facilitating compliance to psychiatrist consultations while assuring a support psychotherapy is the main result of this study. More studies should be conducted to define more accurately the clinical reality, management and course of current psychiatric disorders in primary care.

Published
2016
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35. De la définition des interventions non médicamenteuses à leur ontologie

Author

Gregoire Mercier, Gérard Bourrel, Aurélie Gerazime, Raphaël Trouillet, François Carbonnel, Isabelle Boulze-Launay, Estelle Guerdoux-Ninot, Pierre Senesse, Grégory Ninot, Sylvie Rapior, Thérèse Libourel, Béatrice Lognos, Agnès Oude Engberink, Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université de Montpellier (UM)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université Montpellier 1 (UM1), Centre d’Evaluation des programmes de Prévention Sante [Montpellier] (Plateforme CEPS), Université de Montpellier (UM), UMR 228 Espace-Dev, Espace pour le développement, Université de Guyane (UG)-Université des Antilles (UA)-Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM), Centre d’Ecologie Fonctionnelle et Evolutive (CEFE), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Institut National de la Recherche Agronomique (INRA)-Université Paul-Valéry - Montpellier 3 (UPVM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut de Recherche pour le Développement (IRD [France-Sud]), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Institut National de la Recherche Agronomique (INRA)-Université Paul-Valéry - Montpellier 3 (UPVM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)-Institut de Recherche pour le Développement (IRD [France-Sud]), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UM3)-Université de Montpellier (UM), Université des Antilles (UA)-Université de Guyane (UG)-Université de Montpellier (UM)-Université de La Réunion (UR)-Avignon Université (AU)-Université de Perpignan Via Domitia (UPVD)-Institut de Recherche pour le Développement (IRD), Université Paul-Valéry - Montpellier 3 (UM3)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-École pratique des hautes études (EPHE)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM)-Université de Guyane (UG)-Université des Antilles (UA), Université Paul-Valéry - Montpellier 3 (UPVM)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)

Subjects
03 medical and health sciences, 0302 clinical medicine, Non pharmacological interventions, 020205 medical informatics, 030220 oncology & carcinogenesis, Philosophy, 0202 electrical engineering, electronic engineering, information engineering, [SHS.PSY]Humanities and Social Sciences/Psychology, 02 engineering and technology, Good practice, Humanities
Abstract

Article disponible en ligne à l'adresse : http://hdl.handle.net/2042/65114; International audience; La multiplication des interventions non médicamenteuses (INM) et des doutes résiduels de leur efficacité imposent aujourd’hui de ne plus se cantonner à leur appellation générale et disciplinaire (psychothérapie, thérapie manuelle, complément alimentaire, activité physique adaptée, solution e-santé…) mais d’accéder à leur véritable contenu. Décrite de manière précise, chaque INM pourra être mieux évaluée par la science, surveillée par les professionnels et expliquée au patient. Pour ce faire, il est nécessaire de construire une modélisation de l’ensemble des connaissances scientifiques et d’usage sous la forme d’une ontologie informatique. Cette ontologie des INM facilitera les recherches bibliographiques, les statistiques d’usage et l’amélioration des bonnes pratiques. Une première version de cette classification internationale évolutive est disponible sur le site Internet de la Plateforme universitaire CEPS en accès libre.

Published
2018
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36. Inter-test reproducibility of the lung clearance index measured by multiple breath washout

Author

Sanja Stanojevic, Felix Ratjen, Esther Oude Engberink, Stephanie D. Davis, Reshma Amin, and George Z. Retsch-Bogart

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Pathology, Correlation coefficient, Cystic Fibrosis, Coefficient of variation, Lung Clearance Index, Cystic fibrosis, 03 medical and health sciences, 0302 clinical medicine, Lung Function, Internal medicine, medicine, Humans, 030212 general & internal medicine, skin and connective tissue diseases, MULTIPLE BREATH WASHOUT, Reproducibility, business.industry, Disease progression, Patient Acuity, Reproducibility of Results, Repeatability, Original Articles, medicine.disease, Prognosis, 3. Good health, 030228 respiratory system, Breath Tests, Mucociliary Clearance, Child, Preschool, Cardiology, Disease Progression, Female, sense organs, business
Abstract

The lung clearance index (LCI) has strong intra-test repeatability; however, the inter-test reproducibility of the LCI is poorly defined. The aim of the present study was to define a physiologically meaningful change in LCI in preschool children, which discriminates changes associated with disease progression from biological variability. Repeated LCI measurements from a longitudinal cohort study of children with cystic fibrosis and age-matched controls were collected to define the inter-visit reproducibility of the LCI. Absolute change, the coefficient of variation, Bland–Altman limits of agreement, the coefficient of repeatability, intra-class correlation coefficient, and percentage changes were calculated. LCI measurements (n=505) from 71 healthy and 77 cystic fibrosis participants (aged 2.6–6 years) were analysed. LCI variability was proportional to its magnitude, such that reproducibility defined by absolute changes is biased. A physiologically relevant change for quarterly LCI measurements in health was defined as exceeding ±15%. In clinically stable cystic fibrosis participants, the threshold was higher (±25%); however, for measurements made 24 h apart, the threshold was similar to that observed in health (±17%). A percentage change in LCI greater than ±15% in preschool children can be considered physiologically relevant and greater than the biological variability of the test., Biological variability of lung clearance index is dependent on magnitude; % change is better for tracking patients http://ow.ly/tgbX30dBbCX

Published
2017

37. Health Service Utilisation, Detection Rates by Family Practitioners, and Management of Patients with Common Mental Disorders in French Family Practice

Author

Anthony Mann, Agnès Oude Engberink, Michel David, Karen Ritchie, Delphine Capdevielle, Joanna Norton, C. Gandubert, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM), Département de psychiatrie adulte, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, Dynamique des capacités humaines et des conduites de santé (EPSYLON), and Université de Montpellier (UM)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université Montpellier 1 (UM1)

Subjects
Adult, Male, medicine.medical_specialty, education, detection, [SHS.PSY]Humanities and Social Sciences/Psychology, Service use, 03 medical and health sciences, Health services, 0302 clinical medicine, Nursing, General Practitioners, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, service use, common mental disorders, Aged, Original Research, business.industry, Mental Disorders, Health Services, Middle Aged, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Family medicine, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Female, France, Detection rate, business, Family Practice
Abstract

Objective: Provide up-to-date detection rates for common mental disorders (CMD) and examine patient service-use since the Preferred Doctor scheme was introduced to France in 2005, with patients encouraged to register with and consult a family practitioner (FP) of their choice. Methods: Study of 1133 consecutive patients consulting 38 FPs in the Montpellier region, replicating a study performed before the scheme. Patients in the waiting room completed the self-report Patient Health Questionnaire (PHQ) and Client Service-Receipt Inventory with questions on registration with a Preferred Doctor and doctor-shopping. CMD was defined as reaching PHQ criteria for depression, somatoform, panic or anxiety disorder. For each patient, FPs completed a questionnaire capturing psychiatric caseness. Results: 81.2% of patients were seeing their Preferred Doctor on the survey-day. Of those with a CMD, 52.6% were detected by the FP. This increased with CMD severity and comorbidity. Detected cases were more likely to be consulting their Preferred Doctor (84.7% versus 79.4% for non-detected cases, p = 0.05) rather than another FP. They declared more visits to psychiatrists (17.2% versus 6.7%, p = 0.002). There was no association with consultation frequency or doctor-shopping, which both declined between the two studies. Conclusion: The CMD detection rate is relatively high, with no increase compared to our previous study, despite a decline in doctor-shopping. An explanation is the same high proportion of patients visiting their usual FP on the survey-day at both periods, suggesting a limited impact of the scheme on care continuity. FP action taken highlights the importance of improving detection for providing care to patients with CMDs.

Published
2017
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38. Clinimetric Properties of the Lung Clearance Index in Adults and Children With Cystic Fibrosis

Author

Felix Ratjen, Esther Oude Engberink, and Sanja Stanojevic

Subjects
Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Cystic Fibrosis, business.industry, Lung Clearance Index, Critical Care and Intensive Care Medicine, medicine.disease, Cystic fibrosis, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Spirometry, Internal medicine, Forced Expiratory Volume, medicine, Humans, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, Child
Published
2016

39. Étude qualitative du sentiment « d’être prêt à exercer » la médecine générale chez des internes et de jeunes médecins généralistes

Author

Michel David, Gérard Bourrel, Michel Amouyal, and Agnès Oude Engberink

Abstract

Contexte : Durant le diplome d’etudes specialisees de medecine generale, six mois de stage ambulatoire sont obligatoires. Constatant un retard d’installation des jeunes generalistes, nous nous sommes demande si le sentiment « d’etre pret a exercer » jouait un role et s’il variait avec le temps d’apprentissage ambulatoire en cabinet de medecine generale. Objectif : Comprendre ce sentiment « d’etre pret a exercer » la medecine generale et son emergence. Methodes : Le materiel a ete recueilli a partir d’un guide d’entretien explorant a differents moments de leur apprentissage les experiences vecues d’internes en medecine generale et de jeunes medecins generalistes, lors de trois focus group filmes. Une analyse phenomenologique et pragmatique des differents verbatim a permis de faire emerger les categories et les elements invariants, constitutifs de ce sentiment, permettant de comprendre le phenomene « sentiment d’etre pret a exercer ». Resultat : Le sentiment « d’etre pret a exercer » est un phenomene evolutif, qui se deploie en trois moments phenomenologiques, allant du contact angoissant du metier avec ses valeurs ideales vers la maitrise des processus professionnels, en passant par l’acquisition en situation d’une competence realiste. Ces trois etapes prefigurent une progression pedagogique souhaitable lors du cursus de troisieme cycle. L’emergence de l’identite professionnelle, l’experience en contexte authentique fondant l’acquisition de savoirs, accompagnee du ressenti d’une legitimite, constituent les determinants du sentiment « d’etre pret a exercer ». Conclusion : L’approche comprehensive phenomenologique completee par une analyse qualitative semio-pragmatique est pertinente pour comprendre le sens du phenomene « se sentir pret a exercer ».

Published
2011
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40. MRI of monocyte infiltration in an animal model of neuroinflammation using SPIO-labeled monocytes or free USPIO

Author

Susanne M. A. van der Pol, Helga E. de Vries, Raoul D. Oude Engberink, Rick M. Dijkhuizen, Erik I. Hoff, Annette van der Toorn, Erwin L. A. Blezer, Molecular cell biology and Immunology, and Neuroscience Campus Amsterdam 2008

Subjects
Brain Infarction, Male, Pathology, medicine.medical_specialty, Contrast Media, Ferric Compounds, Monocytes, Lesion, In vivo, Cell Movement, Image Processing, Computer-Assisted, Medicine, Animals, Particle Size, Neuroinflammation, Inflammation, medicine.diagnostic_test, Staining and Labeling, business.industry, Monocyte, Magnetic resonance imaging, medicine.disease, Image Enhancement, Immunohistochemistry, Magnetic Resonance Imaging, Pathophysiology, In vitro, Rats, Disease Models, Animal, medicine.anatomical_structure, Neurology, Neurology (clinical), medicine.symptom, Intracranial Thrombosis, Cardiology and Cardiovascular Medicine, business, Infiltration (medical)
Abstract

Magnetic resonance imaging (MRI) has been applied to visualize monocyte infiltration with the use of intravenously injected ultrasmall superparamagnetic iron oxide (USPIO). However, USPIO uptake in vivo remains elusive, and the heterogeneous enhancement patterns observed by MRI point to multiple pathophysiological events. This study focused on specific imaging of monocyte infiltration into the brain by transfusion of superparamagnetic iron oxide (SPIO)-labeled monocytes in a rat model of neuroinflammation, experimentally induced photothrombosis (PT). At day 5 after lesion induction, animals were transfused with SPIO-labeled monocytes (5 × 106 cells) or free USPIO (17 mg Fe/kg). MRI was performed 24, 72 and, 120 h later. To investigate temporal changes directly after intravenous USPIO administration, MRI was performed repeatedly up to 8 h. Relaxation measurements showed that rat monocytes were efficiently labeled in vitro using SPIO ( R2=12±0.9 s−1). After transfusion of SPIO-labeled monocytes, a significant increase in contrast enhanced area (340%±106%) in the PT lesion was observed not before 72 h. Contrast enhancement after USPIO injection increased up to 407%±39% at a much earlier point of time (24 h) and diminished thereafter. Repetitive MRI directly after USPIO injection showed significant contrast enhancement in the lesion within 2 h. Our study shows that MRI enables in vivo tracking of SPIO-labeled monocytes longitudinally. Moreover, our data suggest that contrast enhancement after injection of free USPIO does not primarily represent signals from peripherally labeled monocytes that migrated toward the inflammatory lesion. The use of SPIO-labeled monocytes provides a better tool to specifically assess the time window of monocyte infiltration.

Published
2008
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43. Comprendre la décision vaccinale des parents pour mieux accompagner leurs choix : étude qualitative phénoménologique auprès des parents français

Author

Béatrice Lognos, Agnès Oude Engberink, Elodie Million, Suzanne Gagnon, François Carbonnel, Gérard Bourrel, Marion Vallart, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Montpellier (UM), Centre d’Evaluation des programmes de Prévention Sante [Montpellier] (Plateforme CEPS), Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM), Université Laval [Québec] (ULaval), Institut National de Santé Publique du Québec [Canada] (INSPQ), and MILLION, Elodie

Subjects
Adult, Male, Parents, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], Inequality, Adolescent, media_common.quotation_subject, Decision Making, analyse sémiopragmatique, Trust, Grounded theory, décision vaccinale, Young Adult, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Perception, medicine, Humans, Meaning (existential), Child, Qualitative Research, media_common, Physician-Patient Relations, Consumer Health Information, Public health, Vaccination, Public Health, Environmental and Occupational Health, Infant, General Medicine, Middle Aged, 3. Good health, médecine générale, santé publique, approche phénoménologique, Child, Preschool, Needs assessment, Grounded Theory, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Personal experience, France, Psychology, Recherche Qualitative, étude qualitative, Social psychology, Needs Assessment, Qualitative research
Abstract

International audience; OBJECTIFS : Comprendre les représentations des parents à partir de leur expérience vécue et leur influence sur la décision vaccinale de leurs enfants.MÉTHODES : Étude qualitative phénoménologique par entretiens semi-directifs en profondeur auprès de 14 parents volontaires ayant des enfants en âged’être vaccinés. Les participants ont été recrutés auprès de médecins de famille de la région de Montpellier (France).La méthodologie est inspirée de la grounded theory. Les données recueillies par enregistrement audio ont été analysées par une méthode sémiopragmatiquefaisant émerger des catégories conceptuelles donnant du sens au phénomène étudié.RÉSULTATS : Les parents méconnaissent les maladies contre lesquelles on vaccine et déclarent un besoin d’information. La perception de l’inégalité del’individu devant la maladie et le vaccin influence largement la décision vaccinale des parents. Elle induit chez eux un « tri » raisonné des vaccins, et les conduità faire une balance bénéfice/risque. Ils font confiance en leur médecin, dans les expériences personnelles plutôt que dans l’information médiatisée.CONCLUSION : La méconnaissance des maladies mêmes contre lesquelles on vaccine par les parents suggère que soit améliorée information aux parents surce sujet. Leur perception de l’inégalité de l’individu (leur enfant) devant la maladie et le vaccin est le déterminant principal de la décision vaccinale. Lesparents intègrent la vaccination dans une démarche éducative réfléchie, dépendant du style de vie, des expériences personnelles et de la confiance en leurmédecin. Ces résultats les rendent très « critiques » par rapport aux recommandations vaccinales de base.

Published
2015
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44. Le site de référence du Partenariat européen d’innovation pour un vieillissement actif et en bonne santé MACVIA-LR (contre les maladies chroniques pour un vieillissement en bonne santé en Languedoc-Roussillon)

Author

Miren David, Ariane Sultan, Guillaume Pandraud, Benoît G. Bardy, Jacques Morel, Giacomo Cavalli, Sylvain Jacquemin, Christine Rolland, Cyril Breuker, Philippe Boulet, Gregoire Mercier, Stéphane Bouly, Valérie Bruguière, Gwen Mathieu, Marc Meissonnier, Hervé Tassery, Vincent Marmelat, Michel Dauzat, Hubert Blain, Gérard Dray, Cyril Laurent, Christine Viarouge-Reunier, Marie Virginie Calmels, François Rivier, Gérard Dupeyron, Gérard Bourrel, Jacquie Berthe, Philippe Domy, Béatrice Lognos, Martine Aoustin, Davide Caimmi, Michel Kaczorek, Mélanie Badin, Pierre Nicolas, Alain Le Quellec, Sylvie Boichot, Vincent Le Moing, C. Boegner, Jérôme Fernandes, Michel Amouyal, Matthieu Desplan, Jean Paul Cristol, T. Camuzat, Karima Bakhti, Jean Michel Verdier, Paule Adnet, Christophe Jorgensen, Denis Sablot, Jean Ribstein, Henriette Dhivert-Donnadieu, Céline Vergne-Richard, Emilie Porte, Christine Azevedo, Isabelle Quéré, Dominique Jakovenko, Marion Gellerat-Rogier, Michel Tanfin, Karen Ritchie, Flavia Oana Coroian, Bernard Guillot, Fabrice Nouvel, J. Pelissier, Anna Bedbrook, Daniel Laune, Jean-Luc Bourrain, Yves Marie Pers, Jean Luc Savy, Chantal Marion, Cherif Heroum, Marianna Danko, Grégoire Vergotte, Françoise Radier-Pontal, Jean Luc Pasquié, Olivier Bénézet, Bernard Combe, Sylvain Richard, Liliane Landreau, Valérie Cros, Isabelle Rédini-Martinez, Emilie Viollet, David Guiraud, François Roubille, Jérôme Froger, Bertrand Coulet, Laurent Journot, Marie Suzanne Léglise, Sylvie Arnavieilhe, Isabel Tavares, Samir Jaber, Olivier Jonquet, David Morquin, Philippe Van de Perre, Roland Sicard, Raphaël Chiron, Vincent Tribout, Pierre Senesse, Xavier Quantin, Jacques Touchon, Kevin Mandrick, Alain Uziel, Vincent Bouix, Marie Christine Picot, Philippe Augé, Martine Lapierre, Antoine Avignon, Eric Pastor, Pascal Demoly, Kjerstin Torre, Jacques Mercier, Jean-Marie Robine, Dominique Larrey, D. J. Costa, Grégory Ninot, Laurent Schifano, Baya Soua, Anne Wojtusciszyn, Jean-Christophe Gris, Didier Delignières, Florence Gressard, Marie Pierre Pasdelou, Fabienne Portejoie, Michel Mondain, Philippe Nérin, Olivier Hantkié, Xavier Bobia, Delphine Paccard, Pierre Géraud Claret, Maxime Villiet, Jacques Burille, Christian Hérisson, Guillaume Tallon, V. Attalin, Jean Emmanuel de la Coussaye, William Camu, Didier Hoa, Chokri Boubakri, Jacques Reynes, Michel Enjalbert, Pascal Kouyoumdjian, Anthony Gellis, Jean Marc Lussert, Jean Philippe Pin, Christian Bourquin, Jean-Marc Lemaitre, Rodolphe Bourret, Isabelle Laffont, Claudine Berr, Marie Christine Courrouy-Michel, Nicolas Giraudeau, Trias Asteriou, Catherine Leblond, Cyril Meunier, Sylvain Lehmann, M. Nogues, Denise Strubel, Raul Punta-Morales, Alain Makinson, Jacques Bringer, Stéphane Perrey, Nathalie Pinto, Yannick Stephan, Charles Fattal, Jean Marc Davy, Arnaud Bourdin, Emilie Royère, Arnaud Dupeyron, Claire Daien, François Vialla, Frédéric Viart, Joël Bockaert, Arnaud Yves Goucham, Pierre Aubas, Huei Yune Bonnin, Fares Gouzi, Véronique Carre, Nicolas Best, Jean Pierre Riso, Jérome Cottalorda, Max Villain, Philippe Dauenhauer, Patrick Messner, Amélie Matheron, Claude Jeandel, Roxana Taddei-Ologeanu, Bernard Alomène, Sylvie Albert, Stéphane Cade, Gérard Canovas, Pauline Coignard, Karine Patte, Sofiane Ramdani, Frédéric Abecassis, Maurice Hayot, Marc Ychou, Anne Laure Coupet, Nathalie Raffort, D. Heve, Philippe Gabrion, Pierre Mares, Pierre Labauge, Marie Pierre Battesti, Denis Mottet, Philippe Fraisse, Jean Bousquet, Jean Louis Pujol, Emilie Galano, Pierre Fesler, Vincent Dufour, Gregory Baptista, Pierre Louis Bernard, Mireille Fouletier, Pierre Dujol, Xavier Vasquez, Jean Paul Ortiz, Pierre Martin-Gousset, Philippe Courtet, Oude Engberink, Valérie Handweiler, S. Granier, Laurence Vian, Françoise Leclercq, Frédéric Cuisinier, Pierre Costa, Guillaume Cayla, 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 Régional Universitaire de Nîmes (CHRU 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), Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Department of Geriatrics - Efficiency and Deficiency Laboratory, Hadassah Hebrew University Medical Center [Jerusalem], IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT), Département de Biostatistiques, Agence Régionale de Santé Languedoc Roussillon (ARS), Institut de Recherche en Infectiologie de Montpellier (IRIM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Roche Pharma Research and Early Development [Basel] (pRED), F. Hoffmann-La Roche [Basel], Service de gynécologie-obstétrique, Mécanismes adaptatifs : des organismes aux communautés (MAOAC), Centre National de la Recherche Scientifique (CNRS)-Collège de France (CdF)-Muséum national d'Histoire naturelle (MNHN), Laboratoire de Géochimie Isotopique Environnementale (GIS) / Université de Nîmes (GIS), Université de Nîmes (UNIMES)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Genre (LARHRA GENRE), LAboratoire de Recherche Historique Rhône-Alpes - UMR5190 (LARHRA), Centre National de la Recherche Scientifique (CNRS)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Grenoble Alpes (UGA), Département de Médecine générale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-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), Département de médecine générale, Université de Montpellier (UM), Euromov (EuroMov), Centre Européen de Réalité Virtuelle (CERV), École Nationale d'Ingénieurs de Brest (ENIB), Laboratoire de Mathématiques Blaise Pascal (LMBP), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Pathologies du système nerveux : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), CERFRANCE Nord Est - Ile de France, Réseau de Vigilance en Dermato-Allergologie - Groupe d'Etudes et de Recherches en DERmato-Allergologie (Revidal-Gerda), Réseau de Vigilance en Dermato-Allergologie (Revidal), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] (CMRRF), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, Laboratoire de Bioingénierie et NanoSciences (LBN), Institut de Génétique Moléculaire de Montpellier (IGMM), Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UM3)-Université de Montpellier (UM), Laboratory of Cardio-Vascular Physiology (LCVP), Université Montpellier 1 (UM1), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Rééducation et Réadaptation Neuro Orthopédique [Nîmes] (Pôle NACRRE), Hôpital Universitaire Carémeau [Nîmes], Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Oc Santé Montpellier, Artificial movement and gait restoration (DEMAR), Unité de Rééducation Neurologique, Centre Hélio-Marin CHU Nîmes, Department de Dermatologie, Médecine physique et de réadaptation, Hôpital Lapeyronie [Montpellier] (CHU), Institut de Génomique Fonctionnelle - Montpellier GenomiX (IGF MGX), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Orthopédique, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Centre Bouffard-Vercelli, Laboratoire de Mécanique et Technologie (LMT), École normale supérieure - Cachan (ENS Cachan)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Plateforme de Protéomique Clinique, CHU Saint-Eloi, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Département Conception et conduite des véhicules Aéronautiques et Spatiaux (DCAS), Institut Supérieur de l'Aéronautique et de l'Espace (ISAE-SUPAERO), Lab-STICC_TB_CID_TOMS, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de recherche souterrain de Meuse/Haute-Marne, Agence Nationale de gestion des Déchets Radioactifs, Aix-Marseille Université - Faculté des Sciences du Sport (AMU FSS), Aix Marseille Université (AMU), HORIBA Medical (HORIBA ABX SAS), HORIBA Scientific [France], Unité Mathématique, Informatique et Génome (MIG), Institut National de la Recherche Agronomique (INRA), Interactions, Corpus, Apprentissages, Représentations (ICAR), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines-Centre National de la Recherche Scientifique (CNRS), Unité clinique d'Immuno-Rhumatologie & Thérapeutique des maladies ostéo-articulaires, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Chimie des Substances Naturelles (ICSN), Centre National de la Recherche Scientifique (CNRS), UNICANCER - Institut régional du Cancer [Montpellier] (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Biocommunication en Cardio-Métabolique (BC2M), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département d'oncologie médicale et digestive, Centre de cancérologie Val d'Aurelle, Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université d'Orléans (UO)-Université Paris-Sud - Paris 11 (UP11), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et thérapie des déficits sensoriels et moteurs, Université Montpellier 2 - Sciences et Techniques (UM2)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche et de Diagnostic sur le Sida (CeDreS), CHU Treichville, Interaction entre Systèmes Protéiques et Différenciation dans la Cellule Tumorale (ISPDCT), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Dynamiques du droit (DD), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Centre National de la Recherche Scientifique (CNRS), Centre de pharmacologie et innovation dans le diabète (CPID), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre National de la Recherche Scientifique (CNRS), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Gui de Chauliac, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), IMT - Mines Alès Ecole Mines - Télécom ( IMT - MINES ALES ), Agence Régionale de Santé Languedoc Roussillon ( ARS ), Institut de Recherche en Infectiologie de Montpellier ( IRIM ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ), Roche Pharma Research and Early Development [Basel] ( pRED ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Mécanismes adaptatifs : des organismes aux communautés ( MAOAC ), Muséum National d'Histoire Naturelle ( MNHN ) -Collège de France ( CdF ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Géochimie Isotopique Environnementale (GIS) / Université de Nîmes ( GIS ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Nîmes ( UNIMES ), Institut de recherche en cancérologie de Montpellier ( IRCM ), Université Montpellier 1 ( UM1 ) -CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon ( MACVIA-LR ), Université Montpellier 1 ( UM1 ) -World Health Organization ( WHO/OMS ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -European Innovation Partnership on Active and Healthy Ageing Reference Site, Agence Nationale de Sécurité Sanitaire, de l'Alimentation, de l'environnement et du Travail ( ANSES ), ANSES, Genre ( LARHRA GENRE ), LAboratoire de Recherche Historique Rhône-Alpes - UMR5190 ( LARHRA ), Centre National de la Recherche Scientifique ( CNRS ) -Université Jean Moulin - Lyon III-Université Lumière - Lyon 2 ( UL2 ) -École normale supérieure - Lyon ( ENS Lyon ) -Université Pierre Mendès France - Grenoble 2 ( UPMF ) -Université Grenoble Alpes ( UGA ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Jean Moulin - Lyon III-Université Lumière - Lyon 2 ( UL2 ) -École normale supérieure - Lyon ( ENS Lyon ) -Université Pierre Mendès France - Grenoble 2 ( UPMF ) -Université Grenoble Alpes ( UGA ), Université Montpellier 1 ( UM1 ), Artificial movement and gait restoration ( DEMAR ), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier ( LIRMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -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 ), Université de Montpellier ( UM ), Euromov ( EuroMov ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Centre Européen de Réalité Virtuelle ( CERV ), École Nationale d'Ingénieurs de Brest ( ENIB ), Laboratoire de Mathématiques Blaise Pascal ( LMBP ), Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Centre National de la Recherche Scientifique ( CNRS ), Université Montpellier 1 ( UM1 ) -IFR76-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Réseau de Vigilance en Dermato-Allergologie - Groupe d'Etudes et de Recherches en DERmato-Allergologie ( Revidal-Gerda ), Réseau de Vigilance en Dermato-Allergologie ( Revidal ), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] ( CMRRF ), Laboratoire de Bioingénierie et NanoScience-UM, Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Dynamique des capacités humaines et des conduites de santé ( EPSYLON ), Université Paul-Valéry - Montpellier 3 ( UM3 ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Laboratory of Cardio-Vascular Physiology ( LCVP ), Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département de Rééducation et Réadaptation Neuro Orthopédique [Nîmes] ( Pôle NACRRE ), Centre Mutualiste de Réeducation Neurologique Propara ( PROPARA ), Hôpital Lapeyronie [Montpellier] ( CHU ), Institut de Génomique Fonctionnelle - Montpellier GenomiX ( IGF MGX ), Laboratoire de Mécanique et Technologie ( LMT ), École normale supérieure - Cachan ( ENS Cachan ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Saint-Eloi-Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université Montpellier 1 ( UM1 ) -Université Cheikh Anta Diop ( UCAD ) -Universtié Yaoundé 1 (Cameroun)-Université de Montpellier ( UM ), Département Conception et conduite des véhicules Aéronautiques et Spatiaux ( DCAS ), Institut Supérieur de l'Aéronautique et de l'Espace ( ISAE-SUPAERO ), Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance ( Lab-STICC ), École Nationale d'Ingénieurs de Brest ( ENIB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université européenne de Bretagne ( UEB ) -ENSTA Bretagne-Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ) -École Nationale d'Ingénieurs de Brest ( ENIB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université européenne de Bretagne ( UEB ) -ENSTA Bretagne-Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Aix-Marseille Université - Faculté des Sciences du Sport ( AMU FSS ), Aix Marseille Université ( AMU ), HORIBA Medical ( HORIBA ABX SAS ), Unité Mathématique, Informatique et Génome ( MIG ), Institut National de la Recherche Agronomique ( INRA ), Interactions, Corpus, Apprentissages, Représentations ( ICAR ), École normale supérieure - Lyon ( ENS Lyon ) -Université Lumière - Lyon 2 ( UL2 ) -INRP-Ecole Normale Supérieure Lettres et Sciences Humaines-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Institut de Chimie des Substances Naturelles ( ICSN ), Centre National de la Recherche Scientifique ( CNRS ), UNICANCER - Institut régional du Cancer [Montpellier] ( ICM ), Efficience Déficience Motrice [Montpellier] ( EDM ), Centre de pharmacologie et innovation dans le diabète ( CPID ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Centre National de la Recherche Scientifique ( CNRS ), Complexité, Innovation, Activités Motrices et Sportives ( CIAMS ), Université Paris-Sud - Paris 11 ( UP11 ) -Université d'Orléans ( UO ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Montpellier 2 - Sciences et Techniques ( UM2 ) -IFR76-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de recherche et de Diagnostic sur le Sida ( CeDreS ), Interaction entre Systèmes Protéiques et Différenciation dans la Cellule Tumorale ( ISPDCT ), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique ( CNRS ), Dynamiques du droit ( DD ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-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)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-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 Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Agence Régionale de la Santé (ARS), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Pierre Mendès France - Grenoble 2 (UPMF)-École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Oc Santé [Montpellier], Interactive Digital Humans (IDH), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Service de Rhumatologie [CHRU Montpellier], École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines (ENS LSH)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Institut du Cancer de Montpellier (ICM), Université Paris-Sud - Paris 11 (UP11)-Université d'Orléans (UO), Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université Montpellier 1 (UM1), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1), Muséum national d'Histoire naturelle (MNHN)-Collège de France (CdF)-Centre National de la Recherche Scientifique (CNRS), and CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Aging, [ SDV ] Life Sciences [q-bio], business.industry, [SDV]Life Sciences [q-bio], General Medicine, MESH: Accidental Falls, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Medicine, 030211 gastroenterology & hepatology, Accidental Falls, MESH: Aging, 030212 general & internal medicine, business, Humanities, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Le site de référence du Partenariat européen d'innovation pour un vieillissement actif et en bonne santé MACVIA-LR (contre les maladies chroniques pour un vieillissement en bonne santé en Languedoc-Roussillon)

Published
2015
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45. Management of Current Psychiatric Disorders

Author

Oude Engberink, Agnés, primary, Carbonnel, François, additional, David, Michel, additional, Norton, Joanna, additional, Bourrel, Gérard, additional, Boulenger, Jean-Philippe, additional, and Capdevielle, Delphine, additional

Published
2016
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46. Magnetic Resonance Imaging of Monocytes Labeled with Ultrasmall Superparamagnetic Particles of Iron Oxide Using Magnetoelectroporation in an Animal Model of Multiple Sclerosis

Author

Jeff W.M. Bulte, Max A. Viergever, Helga E. de Vries, Raoul D. Oude Engberink, Susanne M. A. van der Pol, Erwin L. A. Blezer, Pjotr Walczak, Annette van der Toorn, Christine D. Dijkstra, Molecular cell biology and Immunology, and NCA - Multiple Sclerosis and Other Neuroinflammatory Diseases

Subjects
Pathology, medicine.medical_specialty, lcsh:Medical technology, medicine.diagnostic_test, Chemistry, Monocyte, Multiple sclerosis, Central nervous system, Experimental autoimmune encephalomyelitis, Biomedical Engineering, Magnetic resonance imaging, Cell migration, Condensed Matter Physics, medicine.disease, medicine.anatomical_structure, lcsh:Biology (General), lcsh:R855-855.5, In vivo, medicine, Molecular Medicine, Radiology, Nuclear Medicine and imaging, Infiltration (medical), lcsh:QH301-705.5, Biotechnology
Abstract

Infiltrated monocytes play a crucial role in the demyelination process during multiple sclerosis (MS), an inflammatory disease of the central nervous system (CNS). Still, methods to monitor their infiltration pattern over time are lacking. In this study, magnetoelectroporation (MEP) was used to label rat monocytes with the superparamagnetic iron oxide particles Sinerem, Endorem, and Supravist. Supravist-labeled monocytes were injected in rats that we induced with experimental autoimmune encephalomyelitis, a model for MS. Imaging at 4.7 and 9.4 T revealed multiple foci of decreased signal intensity predominantly located in the cerebellum. Immunohistochemical evaluation confirmed the presence of intracellular iron in infiltrated cells, indicating the suitability of MEP to specifically follow labeled monocytes in vivo in this disease model. This technique may be further optimized and potentially used in MS patients to assess monocyte migration into the brain and to monitor the efficacy of therapeutic agents aimed at blocking cellular migration into the CNS.

Published
2010
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47. Magnetic resonance imaging of monocyte infiltration in an animal model of multiple sclerosis

Author

Oude Engberink, R.D., Viergever, Max A., Dijkstra, C.D., Blezer, ELA, and de Vries, H.E.

Abstract

The aim of this research was to study neuroinflammatory processes and more specifically the infiltration of monocytes in the central nervous system (CNS) in an animal model of multiple sclerosis (MS) using magnetic resonance imaging (MRI). Monocytes play a key role in MS pathology, and the study of their infiltration kinetics in vivo would benefit from a non-invasive imaging strategy. Initially, to visualize monocytes with MRI, we investigated different labeling strategies in human monocytes using super paramagnetic particles of iron oxide (SPIO, diameter > 50nm) and ultra small SPIO (USPIO, diameter 20 – 50nm). Histological analysis and MR validation showed that monocytes are labeled more efficiently using the larger SPIO compared to USPIO. Importantly, our optimal labeling condition allowed detection of monocytes by MRI without compromising important physiological cell functions like cell viability, migratory capacity and cytokine production. Subsequently, we used SPIO to label freshly isolated rat monocytes. Cell tracking experiments were performed in a rat model of neuroinflammation and we directly compared two main approaches of in vivo monocyte imaging: (1) Intravenous injection of monocytes that were labeled ex vivo with SPIO versus (2) the administration of free USPIO. In theory, free USPIO are taken up in the blood stream by circulating monocytes. Using method 1, we demonstrated longitudinal MR detection of SPIO-labeled monocytes that migrate towards an inflammatory site in the brain. Interestingly, method 2 resulted in an early decrease of signal intensity in the lesion (2 hours) and pointed to the detection of blood-brain barrier (BBB) leakage instead of monocyte migration. To monitor monocyte migration in the experimental model of MS in rats (experimental autoimmune encephalomyelitis; EAE), we had to introduce a novel labeling strategy: Magneto-Electroporation (MEP). Our results showed that an intravenous injection of monocytes labeled using MEP resulted in multiple foci of signal loss, predominantly in the white matter of the cerebellum in EAE rats. Therefore, MEP is essential to visualize the dynamic process of monocyte infiltration in pathologies with multiple small lesions in the CNS, as in case of MS. Complementary to our previous studies, we also focused on the administration of free USPIO in EAE rats. We found that USPIO enter the brain parenchyma of EAE rats within 1 hour whereas at 72 hours after injection, MR abnormalities were no longer present in the CNS. Subsequent imaging of the cervical lymph nodes revealed USPIO accumulation. Our data strongly suggest that the process of leakage over the BBB has to be considered next to cellular infiltration when interpreting post-USPIO MR images. Moreover, in this study we identified the potential use of USPIO-enhanced MRI to study non-invasively drainage in the inflammatory brain. In a clinical trial, we administered a novel USPIO to MS patients and compared enhancement patterns in the brain with enhancement obtained after conventional Gd-DTPA injections. We showed that USPIO enhancements were more frequently observed and several types of enhancement patterns could be distinguished and correlated to certain stages of lesion development. In conclusion, cellular MRI using iron oxide particles is a valuable tool to study the multiple aspects of inflammation in MS and may lead to effective treatment protocols for drugs that limit monocyte entry during neuroinflammation.

Published
2008

50. Book Reviews

Author

A.A. Trouwborst, Jack Goody, A. Kater, Ian Cunnison, Fredrik Barth, Alastair Lamb, H.J. de Graaf, W.K. Fraser-Tytler, Raymond Firth, R. Franke, Alfred Métraux, G. Oude Engberink, Peter I. Rose, H. Hoetink, S.M. Lipset, G. Gauthier-Larouche, A.J. Bernet Kempers, H. van den Berg, C.J. Lammers, Arnold van Gennep, E.M. Uhlenbeck, C. Staniland Wake, H. Th. Fischer, Jan de Vries, Th. P. van Baaren, A.N.J. den Hollander, C. Baks, J. van Baal, J. Prins, Andreas Lommel, D.G. Jongmans, John Beattie, P. van Emst, H.W. te Winkel, Luc de Heusch, J.R. Crawford, A.E. Bayer, Hugh Ashton, J.J. Romkes, J.H. Scherer, J.F. Holleman, Edwin S. Munger, C. Nooteboom, and A.H.J. Prins

Subjects
lcsh:History of Oceania (South Seas), lcsh:DU1-950, lcsh:PL1-8844, lcsh:Languages and literature of Eastern Asia, Africa, Oceania
Abstract

H.W. te Winkel, P. van Emst, Panorama der volken, deel III (Europa en Afrika). Roermond 1966. 491 blz., ills. - John Beattie, D.G. Jongmans, Anthropologists in the field. Van Gorcum & Comp. N.V., Assen 1967. 277 pp., P.C.W. Gutkind (eds.) - J. van Baal, Andreas Lommel, Primitieve Beschavingen. Uitgeverij W. Gaade, Den Haag 1966. 172 blz. - J. Prins, J. van Baal, Mensen in verandering. Ontstaan en groei van een nieuwe cultuur in ontwikkelingslanden. Voor het Koninklijk Instituut voor de Tropen uitgegeven door N.V. De Arbeiderspers, Amsterdam. 1967. (183 blz. plus 4 blz. verwijzingen). - C. Baks, A.N.J. den Hollander, De plurale samenleving; begrip zonder toekomst? J.A. Boom en Zn., Meppel 1966. 121 pp.,, O.D. van den Muijzenberg, J.D. Speckmann (eds.) - Th. P. van Baaren, Jan de Vries, The study of religion, a historical approach, translated with an introduction by Kees W. Bolle. Harcourt, Brace and World, Inc., New York 1967. XXIII + 231 pp. - H. Th. Fischer, C. Staniland Wake, The development of marriage and kinship. Classics in Anthropology. University of Chicago Press. Chicago, 1967 (Eerste Uitg. 1899). XLVI (Inleiding R. Needham). 510 pp., Index. - E.M. Uhlenbeck, Arnold van Gennep, The semi-scholars; translated from the French and edited with an introduction by Rodney Needham. Routledge & Kegan Paul, London 1967. XXIII + 71 pp. - C.J. Lammers, H. van den Berg, Structuren van hulpverlening. Van Gorcum, Assen 1968. 34 blz. (Openbare Les bij aanvaarding van het lectoraat in de sociologie van het maatschappelijk werk in de Faculteit der Sociale Wetenschappen aan de Vrije Universiteit te Amsterdam). - A.J. Bernet Kempers, G. Gauthier-Larouche, L’évolution de la maison rurale laurentienne. Les Presses de l’Université Laval. Quebec, 1967. 54 p., 12 pentekeningen. - H. Hoetink, S.M. Lipset, Elites in Latin America. Oxford Univ. Press, New York 1967, xii en 531 pp., A. Solari (eds.) - H. Hoetink, Peter I. Rose, The subject is race: Traditional ideologies and the teaching of race relations. Oxford University Press, New York, 1968. 181 p. - G. Oude Engberink, Alfred Métraux, Religions et Magies Indiennes d’Amérique du Sud. Éditions Gallimard, Bibliothèque des Sciences Humaines, Paris 1967. 290 pp. - R. Franke, Raymond Firth, The work of Gods in Tikopia. LSE Monographs on Social Anthropology, No. 1 and 2. Univ. of London, The Athlone Press, London, 1967. 490 pp., 8 plates, 15 figures. - Alastair Lamb, W.K. Fraser-Tytler, Afghanistan. A study of political developments in Central and Southern Asia. 3rd edition, revised by M.C. Gillett. Oxford University Press, London 1967, pp. xvi, 362, 4 maps, 7 plates, 4 appendices, index and bibliography. - H.J. de Graaf, Alastair Lamb, Asian frontiers. Studies in a continuing problem. Pall Mall Press. London (1968). - Fredrik Barth, Ian Cunnison, Baggara Arabs. Power and the lineage in a Sudanese nomad tribe. Clarendon Press: Oxford University Press, 1966. Pp. xiv, 233. 6 plates, 3 maps, text figures. - A. Kater, Jack Goody, The social organisation of the Lo Wiili. Second edition. Published for the International African Institute by Oxford University Press, London 1967. 123 pp. - A.A. Trouwborst, Luc de Heusch, Le Rwanda et la civilisation interlacustre. Études d’anthropologie historique et structurale. Université Libre de Bruxelles-Institut de Sociologie. Publié avec le concours du Centre National de l’industrialisation en Afrique noire. Brussel, 1966. 471 pp. - A.A. Trouwborst, J.R. Crawford, Witchcraft and sorcery in Rhodesia. Published for the International African Institute by the Oxford University Press. London, 1967, IX + 312 pp. - A.E. Bayer, Hugh Ashton, The Basuto. A social study of traditional and modern Lesotho. Published for the International African Institute by the Oxford University Press, London 1967. 359 pp. 16 plates. - J.J. Romkes, J.H. Scherer, Marriage and bride-wealth in the highlands of Buha (Tanganyika). V.R.B., Groningen 1965. 159 pp. - J.F. Holleman, Edwin S. Munger, Afrikaner and African nationalism - South African parallels and parameters. Published for the Institute of Race Relations by Oxford University Press, London 1967. xviii + 142 pp. - C. Nooteboom, A.H.J. Prins, Sailing from Lamu. Van Gorcum en comp. N.V., Assen 1965. 320 pp., 8 plates, maps, diags.

Published
1969

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