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42 results on '"MESH: Health Personnel"'

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

Author: Douplat, Marion, Termoz, Anne, Subtil, Fabien, Haesebaert, Julie, Jacquin, Laurent, Durand, Guillaume, Potinet, Veronique, Hernu, Romain, Nohales, Ludivine, Mazza, Stéphanie, Berthiller, Julien, Tazarourte, Karim, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Hôpital Nord-Ouest de Villefranche-sur-Saône [Gleize] (HNOVS), Hôpital de la Croix-Rousse [CHU - HCL], and Dubois Frid, Caroline
Subjects: MESH: Humans, MESH: Anxiety, MESH: Depression, Depression, SARS-CoV-2, Emergency department, Health Personnel, COVID-19, Anxiety, Stress, MESH: Prospective Studies, Disease Outbreaks, [SHS]Humanities and Social Sciences, Psychiatry and Mental health, Clinical Psychology, MESH: Emergency Service, Hospital, Humans, Healthcare workers, MESH: COVID-19, MESH: Health Personnel, MESH: SARS-CoV-2, [SHS] Humanities and Social Sciences, Prospective Studies, MESH: Disease Outbreaks, Emergency Service, Hospital
Abstract: International audience; Study objective: Assess the changes in anxiety, depression, and stress levels over time and identify risk factors among healthcare workers in French emergency departments (EDs) during the first COVID-19 outbreak.Method: A prospective, multicenter study was conducted in 4 EDs and an emergency medical service (SAMU). During 3 months, participants completed fortnightly questionnaires to assess anxiety, depression, and stress using the Hospital Anxiety and Depression and the Chamoux-Simard scale. The changes in anxiety, depression, and stress levels over time were modelled by a linear mixed model including a period effect and a continuous time effect within periods.Results: A total of 211 respondents (43.5 %) completed the survey at inclusion. There was a decrease in mean anxiety (from 7.33 to 5.05, p < 0.001), mean depression (from 4.16 to 3.05, p = 0.009), mean stress at work (from 41.2 to 30.2, p = 0.008), and mean stress at home (from 33.0 to 26.0, p = 0.031) at the beginning of each period. The mean anxiety level was higher for administrative staff (+0.53) and lower for paramedics (-0.61, p = 0.047) compared to physicians. The anxiety level increased with the number of day and night shifts (0.13/day, p < 0.001, 0.12/night, p = 0.025) as did stress at work (1.6/day, p < 0.001, 1.1/night, p = 0.007). Reassigned healthcare workers were at higher risk of stress particularly compared to SAMU workers (stress at work: p = 0.015, at home: p = 0.021, in life in general: p = 0.018).Conclusion: Although anxiety, depression, and stress decreased over time, anxiety was higher among physicians and administrative staff. Reassignment and working hours were identified as potential risk factors for mental health distress in EDs.Trial registration: ClinicalTrials.gov NCT04383886.
Published: 2022
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2. Short communication: Do clinical guidelines for bipolar disorders adequately address sleep, circadian rhythm, activity and lifestyle problems?

Author: Tibby Flint, Vincent Hennion, Bruno Etain, Jan Scott, University of Bristol [Bristol], Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département Médico-Universitaire Neurosciences [Sorbonne Université] (DMU Neurosciences), CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Fondation FondaMental [Créteil], Newcastle University [Newcastle], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Etain, Bruno
Subjects: Bipolar Disorder, Energy, MESH: Humans, MESH: Sleep, Health Personnel, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Circadian, MESH: Life Style, Lifestyle, Quality, Practice guidelines, Circadian Rhythm, Psychiatry and Mental health, Clinical Psychology, MESH: Bipolar Disorder, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Bipolar disorders, Humans, MESH: Health Personnel, MESH: Circadian Rhythm, Sleep, Life Style
Abstract: International audience; Objectives Clinical practice guidelines (CPGs) for the treatment of bipolar disorder (BD) provide guidance to health care professionals and patients about the management of core aspects of BD. This study evaluated the overall quality of CPGs and examined the quantity, specificity, clarity and utility of recommendations about four key contemporary themes: sleep, circadian rhythms, activity and energy, and healthy lifestyles. Methods English language editions of CPGs for the treatment of BD were identified by a systematic search of the literature from 2007 onwards (i.e. 15 years). Blind independent ratings were combined to give consensus scores for the quality of each CPGs (using the 14-item International Center for Allied Health Evidence guideline checklist). Composite ratings of the quantity, specificity, clarity and utility of recommendations about the key themes were undertaken using a 0-3 scale. Results Twenty-five CPGs were eligible for review. Overall quality was high (median checklist score=10), but only 11 (44%) CPGs included even basic information about circadian rhythm disturbances. Combined scores for composite ratings about sleep and circadian rhythms were significantly correlated with overall quality of the CPG (sleep, r = 0.43; circadian rhythms, r = 0.42) but not with year of publication. Limitations No reliable scale exists for generating composite ratings of the four themes we examined. Conclusions Circadian rhythms and chronobiology represent neglected domains in CPGs. Incorporating this important theme into future editions of CPGs would aid health care professionals to identify, prevent, or intervene with these problems and improve outcomes for a significant proportion of individuals with BD.
Published: 2022
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3. Fear of stigma from health professionals and family/neighbours and healthcare avoidance among PLHIV in Morocco: results from the Stigma Index survey Morocco

Author: Rosemary M, Delabre, Amal Ben, Moussa, Virginie, Villes, Mohammed, Elkhammas, Lahoucine, Ouarsas, Daniela, Castro Rojas Castro, Mehdi, Karkouri, Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Association de Lutte Contre le SIDA [Marrakech, Morocco], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut des sciences de la santé publique [Marseille] (ISSPAM)
Subjects: Male, Health Personnel, [SDV]Life Sciences [q-bio], Social Stigma, MESH: Delivery of Health Care, MESH: Fear, HIV Infections, Surveys and Questionnaires, Humans, MESH: Surveys and Questionnaires, Key Populations, MESH: Humans, Public Health, Environmental and Occupational Health, HIV, Fear, Healthcare access, MESH: HIV Infections, MESH: Male, Morocco, Stigma, MESH: Morocco, MESH: Health Personnel, Female, MESH: Social Stigma, Delivery of Health Care, MESH: Female
Abstract: Background Enacted or anticipated stigma among people living with HIV (PLHIV) can negatively impact healthcare engagement. We identified factors associated with having avoided HIV health services for fear of stigma among PLHIV in Morocco. Methods The Stigma Index survey was conducted in Morocco in March-June 2016. Factors associated with avoiding HIV testing and treatment services for fear of stigma by (A) health personnel or family/neighbours and (B) health personnel and family/neighbours compared to people who did not avoid health services for fear of stigma from either of the two sources were assessed using multinomial logistic regression models. Results Among 583 respondents, 280 (48.0%) were women and median number of years living with HIV was 5[IQR:2–7]. Half of the respondents reported avoiding health services for fear of stigma by health personnel and/or family/neighbours: (A) n = 228, 39.1% and (B) n = 68, 11.7%. After adjustment on perceived health status, not having had easy access to antiretroviral treatment ((A) aRR [95% CI] = 1.76[1.16; 2.68]; (B) 2.18[1.11; 4.27]), discrimination by PLHIV ((A) 1.87[1.12; 3.13]; (B) 3.35[1.63; 6.88]) and exclusion from social activities ((A) 1.70[1.10; 2.61]; (B) 2.63[1.39; 5.00]) were associated with having avoided health services for fear of stigma by health personnel or/and family/neighbours. Being female (2.85[1.48; 5.47]), not having been referred for an HIV test for suspected symptoms 3.47[1.67; 7.22], having discussed sexual/reproductive health with a health professional (4.56[2.38; 8.71]), and not having the feeling to influence decisions on local projects for PLHIV (3.47[1.37; 7.83], were associated with having avoided health services for fear of stigma by both sources. Conclusion Results suggest a cumulative effect of fear of stigma and discrimination among PLHIV in Morocco. PLHIV who have experienced discrimination may seek to avoid similar situations at the expense of their health. These results should inform multi-level interventions and broader advocacy efforts to reduce stigma and discrimination.
Published: 2022
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4. Cancer de la vessie localement avancé ou métastatique : identification des freins et leviers du parcours des patients en France

Author: Nadine, Houédé, Cécile, Flahault, Marine, Gross-Goupil, Solenn, Le Clanche, Yann, Le Goff, Frédérick, Merlier, Géraldine, Pignot, Bertrand, Pourroy, Constance, Thibault, Evanguelos, Xylinas, Marie-Noelle, Solbes, Gwenael, Dénéchère, Morgan, Roupret, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Cancérologie du GARD ICG - CHU Nîmes (Instit Cancéro - GARD), Laboratoire de Psychopathologie et Processus de Santé (LPPS (URP_4057)), Université Paris Cité (UPCité), CHU Bordeaux [Bordeaux], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Service Pharmacie [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pfizer Oncology, CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Initiatives, MESH: Humans, Prise en charge, Health Personnel, Accompagnement psychologique, Cancer de la vessie localement avancé, Family caregivers, MESH: Quality of Life, Locally advanced bladder cancer, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Caregivers, Cancer de la vessie métastatique, Metastatic bladder cancer, MESH: Urinary Bladder Neoplasms, MESH: France, Caregivers, Urinary Bladder Neoplasms, Quality of Life, Parcours de soins, Humans, MESH: Health Personnel, France, Aidants, Psychological support, Healthcare pathway
Abstract: International audience; Introduction: Bladder cancer is currently ranked as the 8th most common cancer in France. However, the patient care pathway for this cancer is still not well known.Methods: A telephone survey was conducted with fifteen healthcare professionals, ten patients, and five family caregivers between November 2020 and March 2021. The objectives of this survey were to identify the major steps in the care pathway according to the medical, emotional and societal dimensions, for patients with locally advanced or metastatic bladder cancer, the associated barriers, and the initiatives to be implemented to improve it.Results: Several barriers were identified at different stages of the overall care pathway, including lack of knowledge of risk factors and warning signs of the disease by the general population and some healthcare professionals, difficulties linked to the announcement consultation, lack of psychological support for patients and their caregivers, and lack of information given about the disease and supportive care.Discussion: These results allowed us to identify three major initiatives which could improve the overall care pathway and the quality of life of patients and their caregivers: 1/implementation of a public awareness campaign on bladder cancer; 2/creation of booklets for patients and their caregivers to provide them with a source of reliable information; and 3/the creation of communication tools between healthcare professionals and patients to facilitate exchanges during consultations.; Introduction > Le cancer de la vessie est aujourd'hui classé en huitième position des cancers lesplus fréquents en France. Le parcours de soins de ce cancer est, cependant, mal connu.Méthodes > Une enquête téléphonique a été menée en France auprès de quinze professionnels desanté, dix patients et cinq aidants entre novembre 2020 et mars 2021. Les objectifs de cetteenquête étaient d'identifier les grandes étapes du parcours de soins des patients atteints d'uncancer de la vessie localement avancé ou métastatique, selon l'angle médical, émotionnel etsociétal, les freins y étant associés et les initiatives à mettre en place pour l'améliorer. IntroductionLe cancer d'origine vésicale est dans 90 % des cas un carcinomeurothélial, dont l'incidence est de 13 000 nouveaux cas diag-nostiqués chaque année en France [1], le plaçant en huitièmeposition des cancers les plus fréquents. Il arrive au quatrièmerang des cancers masculins et au quatorzième rang des cancersféminins et est responsable d'environ 5000 décès par an enFrance (3778 décès chez les hommes et 1235 décès chez lesfemmes, observés en 2017). Il est ainsi le septième cancer leplus mortel en France [1].Les principaux facteurs de risque du cancer de la vessie sontl'âge, avec une moyenne d'âge au diagnostic de 73 ans chezl'homme et 78 ans chez la femme [2], et le tabagisme [3]. Unfumeur a, en effet, environ 5,5 fois plus de risque de développerla maladie par rapport à un non-fumeur. En France, le tabagismeserait responsable de 53 % des cas de tumeurs de la vessie chezles hommes et de 39 % chez les femmes [4]. Les autres facteursde risque sont l'exposition professionnelle à des substances,comme les amines aromatiques, à des agents infectieux (ex :schistosome), ou à certains médicaments (ex : traitement anté-rieur à base de cyclophosphamide). Les facteurs de risqueassociés au carcinome urothélial en font historiquement uncancer principalement masculin [5].Le diagnostic de ce cancer peut être retardé, à cause de symp-tômes cliniques non spécifiques pouvant laisser penser, notam-ment, à une infection urinaire, tels qu'une augmentation de lafréquence urinaire, de l'urgence mictionnelle et une dysurie, quiRésultats > Plusieurs freins ont été identifiés à différentes étapes du parcours, notamment lemanque de connaissance des facteurs de risque et signes d'alerte de la maladie par le grand publicet certains professionnels de santé, les difficultés liées à la consultation d'annonce, le manqued'accompagnement psychologique pour les patients et aidants, le manque d'informations don-nées sur la maladie et les soins de support.Discussion > Ces résultats ont permis d'identifier ainsi trois grandes initiatives qui permettraientd'améliorer le parcours de soins dans sa globalité et la qualité de vie des patients et de leursaidants : 1/mise en place d'une campagne de sensibilisation du grand public sur le cancer de lavessie ; 2/création de livrets à destination des patients et de leurs aidants pour leur fournir unesource d'informations fiables ; et 3/la création d'outils de communication entre soignants etpatients pour faciliter les échanges lors des consultations.
Published: 2022
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5. Exercise in lung Cancer, the healthcare providers opinion (E.C.H.O.): Results of the EORTC lung cancer Group (LCG) survey

Author: Sara Pilotto, Alice Avancini, Jessica Menis, Isabella Sperduti, Matteo Giaj Levra, Thierry Berghmans, Paolo Bironzo, Mariana Brandão, Dirk De Ruysscher, John Edwards, Corinne Faivre-Finn, Nicolas Girard, Laurent Greillier, Lizza Hendriks, Sylvie Lantuejoul, Murielle Mauer, Silvia Novello, Mary O'Brien, Martin Reck, Noemi Reguart, Jordi Remon, Jan von der Thüsen, Anne-Marie C. Dingemans, Benjamin Besse, Michele Milella, Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Jules Bordet [Bruxelles], Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto = University of Porto, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Royal Holloway [University of London] (RHUL), University of Manchester [Manchester], Méthodes computationnelles pour la prise en charge thérapeutique en oncologie : Optimisation des stratégies par modélisation mécaniste et statistique (COMPO), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Multidisciplinary Oncology and Therapeutic Innovations Unit, Hôpital Nord [CHU - APHM], Département d'hématologie [Gustave Roussy], Institut Gustave Roussy (IGR), School for Oncology and Developmental Biology [Maastricht] (GROW), Maastricht University [Maastricht]-Maastricht University Medical Centre (MUMC), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Università degli studi di Torino = University of Turin (UNITO), German Center for Lung Research, August Pi i Sunyer Biomedical Research Institute - IDIBAPS [Barcelona, Spain], Centro Integral Oncologico Clara Campal, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Radiotherapie, Pulmonologie, Pathology, and Pulmonary Medicine
Subjects: Pulmonary and Respiratory Medicine, REHABILITATION, Cancer Research, Lung Neoplasms, Facilitators, Clinicians, Health Personnel, [SDV.CAN]Life Sciences [q-bio]/Cancer, AMERICAN-COLLEGE, GUIDELINES, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Referral and Consultation, SDG 3 - Good Health and Well-being, QUALITY-OF-LIFE, Surveys and Questionnaires, Humans, Barriers, Current practice, Exercise, Lung cancer, Oncologist, Physical activity, Recommendation, Referral and Consultation, MESH: Surveys and Questionnaires, MEDICINE ROUND-TABLE, MESH: Humans, RANDOMIZED CONTROLLED-TRIAL, CHEMOTHERAPY, MESH: Lung Neoplasms, PHYSICAL-ACTIVITY, Oncology, MESH: Exercise, MESH: Health Personnel, INTERVENTION
Abstract: Objectives: Exercise has been reported to alleviate disease as well as treatment impact in patients with lung cancer. Nevertheless, there is limited information available regarding the perception of lung cancer dedicated healthcare professionals’ and their advice on exercise. Materials and Methods: An online survey exploring healthcare professionals’ practice patterns, perceptions, barriers, and facilitators of exercise in patients with lung cancer was conducted within members of the EORTC Lung Cancer Group (LCG). Results: One hundred forty-one healthcare providers completed the survey, mainly medical and radiation oncologists. Overall, 63% of the study participants declared that they frequently assessed exercise level in their patients, and 43% of them reinforced the importance of exercise. However, only 10% referred patients to an exercise program or specialist. Although the majority of the respondents had a positive perception regarding the benefits and safety of exercise (even in patients with advanced disease and/or bone metastasis), two-thirds of clinicians reported not having adequate training about exercise counselling. Moreover, 53% reported to lack of knowledge of guidelines referring to exercise in patients with cancer. Several obstacles and facilitators to improve exercise promotion in lung cancer care were identified. Conclusion: Healthcare providers recognize the relevance and feasibility of exercise as part of cancer treatment intervention, but specific pathways to do the referral are frequently missing. Future structured and well-designed strategies and initiatives are needed to support an effective referral in order to implement exercise interventions routinely in clinical practice.
Published: 2022
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6. Sex Differences in the Evolution of Neutralizing Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2

Author: Cyril Planchais, David Rey, Aurélie Velay, Ludivine Grzelak, Yoann Madec, Yves Hansmann, Isabelle Staropoli, Marie-Josée Wendling, Samira Fafi-Kremer, Arnaud Fontanet, Catherine Schmidt-Mutter, Timothée Bruel, Hugo Mouquet, Nathalie Reix, Ludovic Glady, Floriane Gallais, Olivier Schwartz, María González, Nicolas Meyer, Jérôme De Seze, Virus et Immunité - Virus and immunity, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Université Paris Cité (UPCité), Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Les Hôpitaux Universitaires de Strasbourg (HUS), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], CHU Strasbourg, Groupe Méthodes en Recherche Clinique [Strasbourg] (GMRC), Nouvel Hôpital Civil [Strasbourg], CHU Strasbourg-CHU Strasbourg, Immunologie humorale - Humoral Immunology, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Vaccine Research Institute (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), S. F. K.’s laboratory is funded by Strasbourg University Hospitals (Hôpitaux Universitaires de Strasbourg, PRI 7782), Agence Nationale de la Recherche (ANR-18-CE17-0028), Laboratoire d’Excellence TRANSPLANTEX (ANR-11-LABX-0070_TRANSPLANTEX), and Institut National de la Santé et de la Recherche Médicale (UMR_S 1109). O. S.’s laboratory is funded by Institut Pasteur, Urgence COVID-19 Fundraising Campaign of Institut Pasteur, Agence Nationale de recherches sur le sida, Sidaction, the Vaccine Research Institute (ANR-10-LABX-77), Labex IBEID (ANR-10-LABX-62-IBEID), 'TIMTAMDEN' Agence Nationale de la Recherche ANR-14-CE14-0029, 'CHIKV-Viro-Immuno' ANR-14-CE14-0015-01, the Gilead HIV cure program, and ANR/Fondation Pour la Recherche Médicale Flash COVID. L. Gr., is supported by the French Ministry of Higher Education, Research and Innovation., ANR-18-CE17-0028,HuMABK,Les anticorps monoclonaux humains : une Nouvelle approche thérapeutique contre l'infection par le virus BK et les maladies associées(2018), ANR-11-LABX-0070,TRANSPLANTEX,Nouveaux loci d'histocompatibilité/biomarqueurs en transplantation humaine: de la découverte à l'app(2011), ANR-10-LABX-0077,VRI,Initiative for the creation of a Vaccine Research Institute(2010), ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-14-CE14-0029,TIMTAMDEN,Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue(2014), ANR-14-CE14-0015,CHIKV-Viro-Immuno,Multiplication et Relation avec l'hôte du virus Chikungunya(2014), Virus et Immunité - Virus and immunity (CNRS-UMR3569), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Vaccine Research Institute [Créteil, France] (VRI), univOAK, Archive ouverte, APPEL À PROJETS GÉNÉRIQUE 2018 - Les anticorps monoclonaux humains : une Nouvelle approche thérapeutique contre l'infection par le virus BK et les maladies associées - - HuMABK2018 - ANR-18-CE17-0028 - AAPG2018 - VALID, Nouveaux loci d'histocompatibilité/biomarqueurs en transplantation humaine: de la découverte à l'app - - TRANSPLANTEX2011 - ANR-11-LABX-0070 - LABX - VALID, Laboratoires d'excellence - Initiative for the creation of a Vaccine Research Institute - - VRI2010 - ANR-10-LABX-0077 - LABX - VALID, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Appel à projets générique - Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue - - TIMTAMDEN2014 - ANR-14-CE14-0029 - Appel à projets générique - VALID, and Appel à projets générique - Multiplication et Relation avec l'hôte du virus Chikungunya - - CHIKV-Viro-Immuno2014 - ANR-14-CE14-0015 - Appel à projets générique - VALID
Subjects: 0301 basic medicine, sex-related differences, MESH: Spike Glycoprotein, Coronavirus, medicine.disease_cause, Immunoglobulin G, MESH: Antibodies, Neutralizing, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, antibodies, MESH: COVID-19, Immunology and Allergy, Medicine, MESH: SARS-CoV-2, 030212 general & internal medicine, Polymerase chain reaction, Coronavirus, MESH: Immunoglobulin G, 2. Zero hunger, MESH: Humans, MESH: Middle Aged, biology, SARS-CoV-2, business.industry, COVID-19, MESH: Adult, MESH: Immunoglobulin M, MESH: Male, 3. Good health, 030104 developmental biology, Infectious Diseases, Real-time polymerase chain reaction, [INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV], Immunoglobulin M, MESH: HEK293 Cells, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Immunology, biology.protein, MESH: Health Personnel, Antibody, business, MESH: Female, Body mass index, MESH: Antibodies, Viral, MESH: Sex Characteristics, Sex characteristics
Abstract: We measured anti-spike (S), nucleoprotein (N), and neutralizing antibodies in sera from 308 healthcare workers with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 and with mild disease, collected at 2 timepoints up to 6 months after symptom onset. At month 1, anti-S and -N antibody levels were higher in male participants aged >50 years and participants with a body mass index (BMI) >25 kg/m2. At months 3–6, anti-S and anti-N antibodies were detected in 99% and 59% of individuals, respectively. Anti-S antibodies and neutralizing antibodies declined faster in men than in women, independent of age and BMI, suggesting an association of sex with evolution of the humoral response.
Published: 2021
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7. COVID-19 pandemic

Author: W. J. Fokkens, Jürgen Schwarze, Cezmi A. Akdis, J Mullol, W. Czarlewski, Claudia Traidl-Hoffmann, Claus Bachert, D. Larenas-Linnemann, Tomas Chivato, M. Gotua, Mateo Bonini, Ludger Klimek, Vincenzo Patella, A. A. Cruz, Stephanie Dramburg, Kari C. Nadeau, H W Fritsch, K. Ohta, Thomas Eiwegger, Robert M. Naclerio, Antti Lauerma, A. Yorgancioglu, Aslı Gelincik, Piotr Kuna, Oliver Pfaar, Carmen Riggioni, Violeta Kvedariene, Markus Ollert, Sinthia Bosnic-Anticevich, V. Cardona, S. Del Giacco, Sanna Toppila-Salmi, Helen A. Brough, Heimo Breiteneder, Valérie Hox, B. Samolinski, Zuzana Diamant, G.W. Canonica, Lihong Zhang, María José Torres, Y. Okamoto, Liam O'Mahony, Radosław Gawlik, Jolanta Walusiak-Skorupa, Sharon Chinthrajah, Winfried Rief, T. Haatela, M. Morais-Almeida, Ioana Agache, Manfred Schedlowski, I Skypala, R. Brehler, D. Y. Wang, João Fonseca, I. J. Ansotegui, Robyn E O'Hehir, Oscar Palomares, Charlotte G. Mortz, J. C. Ivancevich, C. Suppli Ulrik, M. T. Ventura, P M Matricardi, S Untersmayr, Gabrielle L. Onorato, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Vanitha Sampath, Arũnas Valiulis, Marek Jutel, Luisa Brussino, Pedro Carreiro-Martins, Jean Bousquet, Nikolaos G. Papadopoulos, A. Bedbrook, Torsten Zuberbier, Karin Hoffmann-Sommergruber, Edward F. Knol, Ear, Nose and Throat, AII - Inflammatory diseases, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Philipps Universität Marburg = Philipps University of Marburg, Allergologie, Stimm und Sprachstörungen [Wiesbaden, Germany], Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], University of Wrocław [Poland] (UWr), ALL-MED, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Medizinische Universität Wien = Medical University of Vienna, Stanford University, Skane University Hospital [Malmo], Lund University [Lund], Charles University [Prague] (CU), University Medical Center Groningen [Groningen] (UMCG), Univ Toronto, Hosp Sick Children, Peter Gilgan Ctr Res & Learning, Mol Med, Toronto, ON M5G 0A4, Canada, The Hospital for sick children [Toronto] (SickKids), University of Toronto, Amsterdam UMC - Amsterdam University Medical Center, Alfred Health, Victoria University [Melbourne], University College Cork (UCC), Sean N. Parker Center for Allergy and Asthma Research [Stanford], Stanford Medicine, Stanford University-Stanford University, University Clinics of Essen, University of Essen, Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Helmholtz Zentrum München = German Research Center for Environmental Health, University Hospital Augsburg, National University of Singapore (NUS), Beijing Tongren Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Evelina London Children's Hospital, King‘s College London, CEU-San Pablo University and HM-Hospitals School of Medicine, University of Cagliari, Medical University of Silesia (SUM), Istanbul University, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Helsinki University Central Hospital, University of Helsinki, Odense University Hospital (OUH), Luxembourg Institute of Health (LIH), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Hospital Sant Joan de Déu [Barcelona], Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], University of Edinburgh, NHS Foundation Trust [London], The Royal Marsden, Nofer Institute of Occupational Medicine (NIOM), Hospital Quirónsalud Bizkaia [Bilbao], Ghent University Hospital, Sun Yat-Sen University [Guangzhou] (SYSU), Karolinska Institutet [Stockholm], Woolcock Institute of Medical Research [Sydney], The University of Sydney, University of Turin, Mauriziano Umberto I Hospital, Humanitas University [Milan] (Hunimed), Vall d'Hebron University Hospital [Barcelona], Hospital de Dona Estefania, NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Federal University of Bahia School of Medicine, Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Medical Consulting Czarlewski, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, MEDIDA, Lda, David Tvildiani Medical University (DTMU), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Barlicki University Hospital, Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], Pantai Hospital [Kuala Lumpur], Hospital CUF Descobertas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), CIBER de Epidemiología y Salud Pública (CIBERESP), Johns Hopkins University School of Medicine [Baltimore], Fukujuji Hospital, Tokyo National Hospital, Chiba Rosai Hospital, Chiba University Hospital, Royal Manchester Children's Hospital, University of Manchester [Manchester], General Children's Hospital of Athens P & A Kyriakou, 'Santa Maria della Speranza' Hospital, Centro Hospitalar e Universitário [Coimbra], Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), University of Coimbra [Portugal] (UC), Medical University of Warsaw - Poland, Hvidovre Hospital, University of Copenhagen = Københavns Universitet (UCPH), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Transilvania University of Brasov, Salvy-Córdoba, Nathalie, Department of Dermatology, Allergology and Venereology, and HUS Inflammation Center
Subjects: 0301 basic medicine, viruses, Eaaci Position Paper, Medizin, Cochrane Library, GUIDELINES, FOOD ALLERGY, allergen immunotherapy, allergy clinic, anaphylaxis, asthma, clinical trials, COVID-19, Position Paper, psychological impact, SARS-CoV-2, Allergists, Health Personnel, Humans, Hypersensitivity, Information Technology, Patient Care Team, Triage, SARS‐CoV‐2, DESENSITIZATION, 0302 clinical medicine, MESH: Patient Care Team, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, HDE ALER, Pandemic, Health care, Immunology and Allergy, ATOPIC-DERMATITIS, MESH: COVID-19, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, allergen immunotherapy (AIT), virus diseases, DRUG HYPERSENSITIVITY REACTIONS, 3. Good health, INFECTIONS, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Triage, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Allergen immunotherapy, medicine.medical_specialty, MESH: Information Technology, MESH: Hypersensitivity, Immunology, education, MEDLINE, DIAGNOSIS, psychological COVID, 03 medical and health sciences, MESH: Allergists, COVID‐19, medicine, MESH: SARS-CoV-2, ddc:610, RHINOSINUSITIS, MESH: Humans, business.industry, Clinical trial, Coronavirus, EXACERBATIONS, 030104 developmental biology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Position paper, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: BackgroundThe Coronavirus disease 2019 (COVID‐19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.MethodThe scientific information on COVID‐19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet.ResultsBased on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic.
Published: 2021
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8. Combined monitoring of IgG and IgA anti-Spike and anti-Receptor binding domain long term responses following BNT162b2 mRNA vaccination in Greek healthcare workers

Author: Ioannis Sarrigeorgiou, Dimitra Moschandreou, Alexios Dimitriadis, Gerasimina Tsinti, Evangelia Sotiropoulou, Eleni Ntoukaki, Petros Eliadis, Marija Backovic, Stavroula Labropoulou, Nicolas Escriou, Abraham Pouliakis, Georgia Giannopoulou, Eleni Gaitanarou, Konstantinos Lazaridis, Andreas Mentis, Avgi Mamalaki, Elisavet Grouzi, Peggy Lymberi, Institut Pasteur Hellénique, Réseau International des Instituts Pasteur (RIIP), Saint Savvas Hospital, Virologie Structurale - Structural Virology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d’innovation : vaccins – Innovation lab : vaccines, Institut Pasteur [Paris] (IP), Attikon University Hospital, We acknowledge support of this work by the HPI (Decision of the Administration Council, Reference Number: 14365 / 28.12.2020) and the project ‘INSPIRED’ (MIS 5002550), under the Action ‘Reinforcement of the Research and Innovation Infrastructure’, funded by the Operational Program ‘Competitiveness, Entrepreneurship and Innovation’ (NSRF 2014‐2020), and action co-funded by the Greek Government and the European Union—European Regional Development Fund.
Subjects: MESH: Immunoglobulin G, MESH: Humans, Multidisciplinary, Greece, SARS-CoV-2, Health Personnel, Vaccination, COVID-19, MESH: Vaccination, Immunoglobulin A, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Greece, Immunoglobulin G, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: COVID-19, MESH: Health Personnel, Humans, MESH: SARS-CoV-2, MESH: Immunoglobulin A, RNA, Messenger, MESH: BNT162 Vaccine, BNT162 Vaccine, MESH: RNA, Messenger
Abstract: International audience; Studies on the humoral response to homologous BNT162b2 mRNA-vaccination focus mainly on IgG antibody dynamics, while long-term IgA kinetics are understudied. Herein, kinetics of IgG and IgA levels against trimeric-Spike (S) and Receptor-Binding-Domain (RBD) were evaluated by in-house ELISAs in 146 two-dose vaccinated Greek healthcare workers (HCWs) in a 9-month period at six time points (up to 270 days after the first dose). The effect of a homologous booster third dose was also studied and evaluated. The peak of immune response was observed 21 days after the second dose; 100% seroconversion rate for anti-S and anti-RBD IgG, and 99.7% and 96.3% respectively for IgA. IgG antibody levels displayed higher increase compared to IgA. Declining but persistent anti-SARS-CoV-2 antibody levels were detected 9 months after vaccination; IgG and IgA anti-S levels approached those after the first dose, while a more rapid reduction rate for anti-RBD antibodies led to significantly lower levels for both classes, supporting the need for a booster dose. Indeed, a homologous booster third dose resulted in enhanced levels of anti-S of both classes, whereas anti-RBD didn’t exceed the peak levels after the second dose. Previous SARS-CoV-2 infection, flu vaccination, BMI
Published: 2022
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9. Impact of the COVID-19 crisis on healthcare workers: The need to address quality of working life issues

Author: Fabienne Marcellin, Lorraine Cousin, Vincent Di Beo, Véronique Mahé, Olivia Rousset‐Torrente, Patrizia Carrieri, Olivier Chassany, Martin Duracinsky, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], and AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
Subjects: Pulmonary and Respiratory Medicine, MESH: Humans, [SDV]Life Sciences [q-bio], MESH: COVID-19, MESH: Health Personnel, MESH: SARS-CoV-2
Abstract: International audience; See related Reply
Published: 2022
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10. Atypical clinical presentation of COVID-19 infection in residents of a long-term care facility

Author: Mylène Albrand, Stéphanie Miot, Jean Bousquet, Nadia Giacosa, Yves Rolland, Hubert Blain, Athanase Benetos, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Gérontopôle, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse], Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Gériatrie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Berlin Institute of Health (BIH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Humboldt-Universität zu Berlin, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Humboldt University Of Berlin, and Herrada, Anthony
Subjects: Male, Pediatrics, Delayed Diagnosis, rRT-PCR, Testing for SARS-CoV-2, Disease, Polymerase Chain Reaction, Hypoxemia, MESH: Long-Term Care, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: COVID-19, Medicine, Infection control, MESH: Skilled Nursing Facilities, 030212 general & internal medicine, MESH: Aged, Aged, 80 and over, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Brief Report, MESH: Accidental Falls, 3. Good health, MESH: Diarrhea, Diarrhea, COVID-19 Nucleic Acid Testing, Female, medicine.symptom, Presentation (obstetrics), Long-term-care facility, MESH: Pandemics, medicine.medical_specialty, Health Personnel, Asymptomatic, MESH: COVID-19 Nucleic Acid Testing, 03 medical and health sciences, Humans, MESH: SARS-CoV-2, Pandemics, Aged, Skilled Nursing Facilities, MESH: Humans, 030214 geriatrics, SARS-CoV-2, business.industry, COVID-19, MESH: Polymerase Chain Reaction, Long-Term Care, MESH: Male, MESH: Delayed Diagnosis, Long-term care, MESH: Health Personnel, Delirium, Accidental Falls, business, MESH: Female
Abstract: Key summary points Aim To assess the magnitude of the infection in residents from—and staff working in—a long-term-care facility (LTCF) 7 days after the identification of one resident with confirmed COVID-19 infection and the clinical presentation of the infected residents. Findings Two weeks after the first case, 50.9% of residents and 27.5% of the workers were tested positive for SARS-CoV-2. Diarrhea, fall, delirium, and hypothermia can be initial symptoms of COVID-19 in LTCF residents. Message The rapid dissemination of a COVID-19 infection in a LTCF may be due to a delay in the diagnosis of the first case, whose presentation could be atypical in residents., Purpose To assess the magnitude of the infection in residents from—and staff working in—a long-term-care facility (LTCF) 7 days after the identification of one resident with confirmed COVID-19 infection and to assess the clinical presentation of the infected residents. Methods All residents and staff members of a LTCF were tested for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction on nasopharyngeal swab. Residents were studied clinically 4 weeks after the first COVID diagnosis. Results Thirty-eight of the 79 residents (48.1%) tested positive for SARS-CoV-2. Respiratory symptoms were preceded by diarrhea (26.3%), a fall (18.4%), fluctuating temperature with hypothermia (34.2%) and delirium in one resident. Respiratory symptoms, including cough and oxygen desaturation, appeared after those initial symptoms or as the first sign in 36.8% and 52.2%, respectively. At any time of the disease, fever was observed in 65.8%. Twelve deaths occurred among the COVID-19 residents. Among the 41 residents negative for SARS-CoV-2, symptoms included cough (21.9%), diarrhea (7.3%), fever (21.9%), hypothermia (9.7%), and transient hypoxemia (9.8%). No deaths were observed in this group. 27.5% of the workers were also COVID-19 positive. Conclusion The rapid dissemination of the COVID-19 infection may be explained by the delay in the diagnosis of the first cases due to atypical presentation. Early recognition of symptoms compatible with COVID-19 may help to diagnose COVID-19 residents earlier and test for SARS-CoV-2 symptomatic and asymptomatic staff and residents earlier to implement appropriate infection control practices.
Published: 2020
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11. Use of psychoactive substances by night-shift hospital healthcare workers during the first wave of the COVID-19 pandemic: a cross-sectional study based in Parisian public hospitals (ALADDIN)

Author: Lorraine Cousin, Vincent Di Beo, Fabienne Marcellin, Sarah Coscas, Véronique Mahé, Isabelle Chavignaud, Olivia Rousset Torrente, Olivier Chassany, Martin Duracinsky, Maria Patrizia Carrieri, Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Mission Fides - CME [Hôpital Paul-Brousse AP-HP] (MF), Hôpital Lariboisière-Fernand-Widal [APHP], Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], and AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
Subjects: Male, MESH: Pandemics, Health Personnel, [SDV]Life Sciences [q-bio], occupational & industrial medicine, risk management, health & safety, MESH: Cross-Sectional Studies, MESH: Hospitals, Public, MESH: Alcoholism, Humans, MESH: COVID-19, MESH: SARS-CoV-2, Pandemics, MESH: Humans, Hospitals, Public, SARS-CoV-2, public health, COVID-19, MESH: Quality of Life, General Medicine, MESH: Male, Alcoholism, Cross-Sectional Studies, Quality of Life, MESH: Health Personnel, epidemiology
Abstract: ObjectivesThis study aimed to estimate the prevalence of psychoactive substance (PAS) use in night-shift healthcare workers (NSHW) during France’s first COVID-19 wave (March–May 2020).DesignObservational cross-sectional online survey.Setting39 public hospitals in the Assitance Publique des Hôpitaux de Paris (AP-HP) network in the Parisian area.ParticipantsA total of 1238 nurses, assistant nurses, X-ray technicians, managers, lab technicians, midwives and childcare assistants working at night or alternating between days and nights answered the questionnaire.InterventionOnline survey.Outcome measuresPAS use prevalence after weighting data for sex, age and profession using calibration on margins, in order to be representative of all AP-HP NSHW. We used the Fagerström scale and the Alcohol Use Disorders Identification Test Concise to assess PAS use.ResultsThe weighted estimated prevalences of daily smoking, alcohol drinking and tranquilliser use in participating NSHW were 21.4, 1.3 and 2.4%, respectively. Twelve per cent (11.7%) of our study sample used opioids. During the first COVID-19 wave, PAS use remained stable except for tobacco use, with 8.6% of participants reporting an increase. Previous 3-month prevalences of tranquilliser and opioid use were significantly higher than in the general population.ConclusionDaily smoking (especially in younger men) and tranquilliser and opioid use were highly prevalent in NSHW in the AP-HP network during France’s first COVID-19 wave. Specific interventions for quitting smoking and addressing determinants of tranquilliser and opioid use in NSHW need to be developed and evaluated to improve quality of life in these essential, underdiagnosed and undertreated health personnel.
Published: 2022
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12. Antibodies Targeting KSHV gH/gL Reveal Distinct Neutralization Mechanisms

Author: Anna Katharina Großkopf, Armin Ensser, Thomas Fricke, Alexander Hahn, Marija Backovic, German Primate Center - Deutsches Primatenzentrum -- Leibniz Insitute for Primate Research -- [Göttingen, Allemagne] (GPC - DPZ), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Virologie Structurale - Structural Virology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), This work was supported by grants to A.S.H. from the Deutsche Forschungsgemeinschaft (https://www.dfg.de, grant no. HA 6013/4-1), the Wilhelm-Sander Foundation (https://www.wilhelm-sander-stiftung.de, and project no. 2019.027.1), and by an Exploration Grant from the Boehringer-Ingelheim Foundation to A.S.H, as well as by grants to A.E. from the Deutsche Forschungsgemeinschaft EN 423/5-1 and from the IZKF Erlangen, project A81.
Subjects: fusion, [SDV]Life Sciences [q-bio], KSHV, HHV-8, neutralizing antibodies, gH/gL, herpesvirus entry, Mice, Viral Envelope Proteins, Virology, MESH: COVID-19, Animals, MESH: SARS-CoV-2, MESH: Immunoglobulin A, ddc:610, MESH: BNT162 Vaccine, MESH: RNA, Messenger, MESH: Immunoglobulin G, MESH: Humans, KSHV HHV-8 neutralizing antibodies gH/gL herpesvirus entry fusion, MESH: Vaccination, Virus Internalization, Antibodies, Neutralizing, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, MESH: Greece, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Ferritins, Herpesvirus 8, Human, MESH: Health Personnel
Abstract: International audience; Kaposi’s sarcoma herpesvirus (KSHV) is associated with a significant disease burden, in particular in Sub-Sahara Africa. A KSHV vaccine would be highly desirable, but the mechanisms underlying neutralizing antibody responses against KSHV remain largely unexplored. The complex made of glycoproteins H and L (gH/gL) activates gB for the fusion of viral and cellular membranes in all herpesviruses. KSHV gH/gL also interacts with cellular Eph family receptors. To identify optimal antigens for vaccination and to elucidate neutralization mechanisms, we primed mice with recombinantly expressed, soluble gH/gL (gHecto/gL) that was either wildtype (WT), lacking defined glycosylation sites or bearing modified glycosylation, followed by boosts with WT gHecto/gL. We also immunized with a gL-gHecto fusion protein or a gHecto-ferritin/gL nanoparticle. Immune sera neutralized KSHV and inhibited EphA2 receptor binding. None of the regimens was superior to immunization with WT gHecto/gL with regard to neutralizing activity and EphA2 blocking activity, the gL-gHecto fusion protein was equally effective, and the ferritin construct was inferior. gH/gL-targeting sera inhibited gB-mediated membrane fusion and inhibited infection also independently from receptor binding and gL, as demonstrated by neutralization of a novel KSHV mutant that does not or only marginally incorporate gL into the gH/gL complex and infects through an Eph-independent route.
Published: 2022
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13. Social and professional recognition are key determinants of quality of life at work among night-shift healthcare workers in Paris public hospitals (AP-HP ALADDIN COVID-19 survey)

Author: Duracinsky, Martin, Marcellin, Fabienne, Cousin, Lorraine, Di Beo, Vincent, Mahé, Véronique, Rousset-Torrente, Olivia, Carrieri, Patrizia, Chassany, Olivier, Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), and Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal
Subjects: MESH: Pandemics, MESH: Humans, Hospitals, Public, [SDV]Life Sciences [q-bio], Health Personnel, MESH: Delivery of Health Care, MESH: Quality of Life, COVID-19, MESH: Cross-Sectional Studies, MESH: Hospitals, Public, Cross-Sectional Studies, Quality of Life, MESH: COVID-19, MESH: Health Personnel, Humans, Delivery of Health Care, Pandemics
Abstract: Objective: Documenting the perceptions and experiences of frontline healthcare workers during a sanitary crisis is key to reinforce healthcare systems. We identify the determinants of quality of working life (QWL) among night-shift healthcare workers (NSHW) in Paris public hospitals shortly after the first-wave of the COVID-19 pandemic.Methods: The ALADDIN cross-sectional online survey (15 June to 15 September 2020) collected QWL, socio-economic, behavioral, and work-related information among 1,387 NSHW in the 39 hospitals of the Assistance Publique-Hôpitaux de Paris (AP-HP). Data were weighted (margin calibration) to be representative of the entire population of 12,000 AP-HP hospitals' NSHW regarding sex, age, and professional category. Linear regression was used to identify correlates of QWL (WRQoL scale).Results: New night position during the COVID pandemic, difficulties in getting screened for COVID, and considering protective measures inadequate were associated with poorer QWL, after adjustment for socio-economic characteristics, professional category, perceived health, physical activity, and history of harassment at work. Under-estimation of night-shift work by day-shift colleagues, reporting night work as a source of tension with friends, or feeling more irritable since working at night also impaired QWL. By contrast, satisfaction regarding COVID information received from the employer, and feeling valued by the general population during the pandemic improved QWL.Conclusions: Insufficient access to screening, information, and protective measures impaired QWL of NSHW after the first wave of COVID-19 in Paris public hospitals. Social and professional recognition of night-shift work were the key determinants of QWL in this population.
Published: 2021
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14. One year later

Author: Dimeglio, Chloé, Herin, Fabrice, Miedougé, Marcel, Da-Silva, Isabelle, Porcheron, Marion, Martin-Blondel, Guillaume, Soulat, Jean-Marc, Izopet, Jacques, Pistre, Karine, Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: MESH: Humans, SARS-CoV-2, [SDV]Life Sciences [q-bio], fungi, education, Vaccination, virus diseases, COVID-19, MESH: Vaccination, Neutralizing antibodies, [SDV] Life Sciences [q-bio], [SDV.IMM.VAC] Life Sciences [q-bio]/Immunology/Vaccinology, Healthcare workers, MESH: COVID-19, MESH: Health Personnel, MESH: SARS-CoV-2, sense organs, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, skin and connective tissue diseases, MESH: Immunity
Abstract: International audience; A recent study in this journal reported that prior SARS-CoV-2 infection is protective even in the absence of a detectable humoral immune response.1 Our prospective longitudinal study was designed to measure the changes in the binding and neutralizing antibody titers in seropositive healthcare workers (HCWs) over a year and the changes in individuals who had and had not been vaccinated. We also assessed the incidence of positive SARS-CoV-2 RNA tests among HCWs who were seropositive for SARS-CoV-2 antibodies and in those who were seronegative.
Published: 2021
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15. Serologic responses to SARS-CoV-2 infection among hospital staff with mild disease in eastern France

Author: Yoann Madec, François Anna, Sandrine Fernandes-Pellerin, Marie Mielcarek, Olivier Schwartz, Rebecca Grant, Nicolas Collongues, Isabelle Staropoli, David Rey, Alexandre Bolle, Nathalie Jolly, Laura Tondeur, Charlotte Renaudat, Ludivine Grzelak, Nicolas Lefebvre, Marie-Noëlle Ungeheuer, Arnaud Fontanet, Bruno Hoen, Jérôme De Seze, Timothée Bruel, Catherine Schmidt-Mutter, Samira Fafi-Kremer, Aurélie Velay, Pierre Charneau, Philippe Souque, Nicolas Meyer, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Virus et Immunité - Virus and immunity, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), CHU Strasbourg, Virus et Immunité - Virus and immunity (CNRS-UMR3569), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Vaccine Research Institute (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Université Paris Cité (UPCité), Laboratoire commun Pasteur-TheraVectys, Institut Pasteur [Paris] (IP)-TheraVectys, Virologie Moléculaire et Vaccinologie / Molecular Virology and Vaccinology, Institut Pasteur [Paris] (IP), Centre de Recherche Translationnelle - Center for Translational Science (CRT), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], Groupe Méthodes en Recherche Clinique [Strasbourg] (GMRC), Nouvel Hôpital Civil [Strasbourg], CHU Strasbourg-CHU Strasbourg, École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Direction de la recherche médicale de l'Institut Pasteur, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), OS lab is funded by Institut Pasteur, ANRS, Sidaction, the Vaccine Research Institute (ANR- 10-LABX-77), Labex IBEID (ANR-10-LABX-62-IBEID), 'TIMTAMDEN' ANR-14-CE14-0029, 'CHIKV-Viro- Immuno' ANR-14-CE14-0015-01 and the Gilead HIV cure program. LG is supported by the French Ministry of Higher Education, Research and Innovation. SFK lab receives funding from Strasbourg University Hospitals (COVID-HUS, CE-2020-34)., ANR-10-LABX-0077,VRI,Initiative for the creation of a Vaccine Research Institute(2010), ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-14-CE14-0029,TIMTAMDEN,Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue(2014), ANR-14-CE14-0015,CHIKV-Viro-Immuno,Multiplication et Relation avec l'hôte du virus Chikungunya(2014), univOAK, Archive ouverte, Laboratoires d'excellence - Initiative for the creation of a Vaccine Research Institute - - VRI2010 - ANR-10-LABX-0077 - LABX - VALID, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Appel à projets générique - Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue - - TIMTAMDEN2014 - ANR-14-CE14-0029 - Appel à projets générique - VALID, Appel à projets générique - Multiplication et Relation avec l'hôte du virus Chikungunya - - CHIKV-Viro-Immuno2014 - ANR-14-CE14-0015 - Appel à projets générique - VALID, Vaccine Research Institute [Créteil, France] (VRI), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris]-TheraVectys, Institut Pasteur [Paris], and Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et nanosciences d'Alsace (FMNGE)
Subjects: Male, 0301 basic medicine, Future studies, MESH: Coronavirus Infections, [SDV]Life Sciences [q-bio], Antibodies, Viral, Severity of Illness Index, Neutralization, Serology, MESH: Antibodies, Neutralizing, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Reverse Transcriptase Polymerase Chain Reaction, MESH: COVID-19, 030212 general & internal medicine, Mild disease, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 0303 health sciences, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, biology, Reverse Transcriptase Polymerase Chain Reaction, General Medicine, Middle Aged, MESH: Hospitals, Hospitals, 3. Good health, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, [SDV.IMM.IA] Life Sciences [q-bio]/Immunology/Adaptive immunology, 030220 oncology & carcinogenesis, MESH: RNA, Viral, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, RNA, Viral, MESH: Betacoronavirus, Female, France, Sample collection, Antibody, Coronavirus Infections, Research Paper, Adult, medicine.medical_specialty, MESH: Pandemics, Coronavirus disease 2019 (COVID-19), Health Personnel, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Article, General Biochemistry, Genetics and Molecular Biology, Antibodies, Betacoronavirus, 03 medical and health sciences, Internal medicine, MESH: Severity of Illness Index, medicine, Humans, Serologic Tests, MESH: SARS-CoV-2, Symptom onset, Pandemics, 030304 developmental biology, MESH: Humans, business.industry, Mild covid-19, SARS-CoV-2, MESH: Serologic Tests, COVID-19, MESH: Adult, Antibodies, Neutralizing, MESH: Male, Personnel, Hospital, MESH: France, 030104 developmental biology, MESH: Pneumonia, Viral, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Antibody Formation, biology.protein, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, MESH: Antibodies, Viral
Abstract: PMCID: PMC7502660; International audience; BACKGROUND: The serologic response of individuals with mild forms of SARS-CoV-2 infection is poorly characterized.METHODS: Hospital staff who had recovered from mild forms of PCR-confirmed SARS-CoV-2 infection were tested for anti-SARS-CoV-2 antibodies using two assays: a rapid immunodiagnostic test (99.4% specificity) and the S-Flow assay (~99% specificity). The neutralizing activity of the sera was tested with a pseudovirus-based assay.FINDINGS: Of 162 hospital staff who participated in the investigation, 160 reported SARS-CoV-2 infection that had not required hospital admission and were included in these analyses. The median time from symptom onset to blood sample collection was 24 days (IQR: 21-28, range 13-39). The rapid immunodiagnostic test detected antibodies in 153 (95.6%) of the samples and the S-Flow assay in 159 (99.4%), failing to detect antibodies in one sample collected 18 days after symptom onset (the rapid test did not detect antibodies in that patient). Neutralizing antibodies (NAbs) were detected in 79%, 92% and 98% of samples collected 13-20, 21-27 and 28-41 days after symptom onset, respectively (P = 0.02). INTERPRETATION: Antibodies against SARS-CoV-2 were detected in virtually all hospital staff sampled from 13 days after the onset of COVID-19 symptoms. This finding supports the use of serologic testing for the diagnosis of individuals who have recovered from SARS-CoV-2 infection. The neutralizing activity of the antibodies increased overtime. Future studies will help assess the persistence of the humoral response and its associated neutralization capacity in recovered patients.FUNDINGS: The funders had no role in study design, data collection, interpretation, or the decision to submit the work for publication.
Published: 2020
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16. Transparency of Health Informatics Processes as the Condition of Healthcare Professionals’ and Patients’ Trust and Adoption: the Rise of Ethical Requirements

Author: Brigitte Séroussi, Lina Fatima Soualmia, Kate Fultz Hollis, Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Oregon Health and Science University [Portland] (OHSU), Equipe Traitement de l'information en Biologie Santé (TIBS - LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), and Soualmia, Lina F
Subjects: [INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI], Artificial intelligence, 020205 medical informatics, Attitude of Health Personnel, Health Personnel, MESH: Attitude of Health Personnel, Internet privacy, MESH: Attitude to Health, 02 engineering and technology, Trust, Health informatics, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI], 03 medical and health sciences, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Humans, MESH: Artificial Intelligence, Bioethical Issues, 030212 general & internal medicine, Ethics, MESH: Humans, business.industry, Health Insurance Portability and Accountability Act, Health Information Technology, General Medicine, Transparency (behavior), 3. Good health, Data sharing, Information sensitivity, MESH: Medical Informatics, Editorial, General Data Protection Regulation, MESH: Trust, MESH: Bioethical Issues, MESH: Health Personnel, Informatics, medical, Yearbook, business, Attitude to Health, Medical Informatics, Medical ethics, IMIA Yearbook of Medical Informatics
Abstract: Objectives: To provide an introduction to the 2020 International Medical Informatics Association (IMIA) Yearbook by the editors. Methods: This editorial provides an introduction and overview to the 2020 IMIA Yearbook which special topic is: “Ethics in Health Informatics”. The keynote paper, the survey paper of the Special Topic section, and the paper about Donald Lindberg’s ethical scientific openness in the History of Medical Informatics chapter of the Yearbook are discussed. Changes in the Yearbook Editorial Committee are also described. Results: Inspired by medical ethics, ethics in health informatics progresses with the advances in biomedical informatics. With the wide use of EHRs, the enlargement of the care team perimeter, the need for data sharing for care continuity, the reuse of data for the sake of research, and the implementation of AI-powered decision support tools, new ethics requirements are necessary to address issues such as threats on privacy, confidentiality breaches, poor security practices, lack of patient information, tension on data sharing and reuse policies, need for more transparency on apps effectiveness, biased algorithms with discriminatory outcomes, guarantee on trustworthy AI, concerns on the re-identification of de-identified data. Conclusions: Despite privacy rules rooted in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in the USA and even more restrictive new regulations such as the EU General Data Protection Regulation published in May 2018, some people do not believe their data will be kept confidential and may not share sensitive information with a provider, which may also induce unethical situations. Transparency on healthcare data processes is a condition of healthcare professionals’ and patients’ trust and their adoption of digital tools.
Published: 2020
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17. Intrafamily Transmission of Monkeypox Virus, Central African Republic, 2018

Author: Arnaud Fontanet, Ella Cyrielle Gonofio, Nicolas Berthet, Benjamin Selekon, Xavier Konamna, Antoine Gessain, Emmanuel Nakouné, Camille Besombes, Jean-Claude Manuguerra, Institut Pasteur [Paris] (IP), Institut Pasteur de Bangui, Réseau International des Instituts Pasteur (RIIP), Centre National de la Recherche Scientifique (CNRS), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), The authors thank Romain Duda for his assistance with identification of the animal species in Aka language. We also acknowledge Rebecca Grant for her relevant suggestion and her kind participation in the formatting of this research letter., Institut Pasteur [Paris], and Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)
Subjects: MESH: Monkeypox, Male, Epidemiology, animal diseases, viruses, lcsh:Medicine, MESH: Central African Republic / epidemiology, Zoonotic disease, West africa, Disease Outbreaks, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, MESH: Animals, 030212 general & internal medicine, Orthopoxvirus, MESH: Disease Outbreaks, Monkeypox virus, Child, Central Africa, biology, Transmission (medicine), virus diseases, respiratory system, MESH: Infant, 3. Good health, Central African Republic, Infectious Diseases, Geography, MESH: Young Adult, Child, Preschool, Female, MESH: Zoonoses, MESH: History, 21st Century, Disease transmission, Intrafamily Transmission of Monkeypox Virus, Central African Republic, 2018, Microbiology (medical), Adult, Adolescent, Health Personnel, 030231 tropical medicine, education, History, 21st Century, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Monkeypox, Young Adult, parasitic diseases, medicine, Research Letter, Animals, Humans, lcsh:RC109-216, Family, MESH: Family, MESH: Adolescent, MESH: Humans, lcsh:R, MESH: Child, Preschool, Outbreak, Infant, MESH: Adult, zoonosis, biology.organism_classification, medicine.disease, Virology, MESH: Male, outbreak investigation, zoonoses, MESH: Health Personnel, MESH: Female
Abstract: International audience; Monkeypox is a rare viral zoonotic disease; primary infections are reported from remote forest areas of Central and West Africa. We report an investigation of a monkeypox outbreak in Lobaye, southwest Central African Republic, in October 2018.
Published: 2019
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18. Protection of Healthcare Workers Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection

Author: Jacques Izopet, Guillaume Martin-Blondel, Jean-Marc Soulat, Chloé Dimeglio, Marcel Miedougé, Fabrice Herin, Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Pistre, Karine
Subjects: Microbiology (medical), 2019-20 coronavirus outbreak, [SDV.IMM] Life Sciences [q-bio]/Immunology, Coronavirus disease 2019 (COVID-19), viruses, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), education, MEDLINE, MESH: Reinfection, Health personnel, Health care, MESH: COVID-19, Medicine, MESH: SARS-CoV-2, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Humans, business.industry, fungi, Virology, [SDV] Life Sciences [q-bio], Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Health Personnel, [SDV.IMM]Life Sciences [q-bio]/Immunology, business
Abstract: International audience; Recent reports of SARS-CoV-2 reinfection have raised questions as to whether and to what degree a first infection protects against reinfection. This is particularly important for healthcare workers (HCW) as they are always in the front line combatting both the present epidemic and any new waves of SARS-CoV-2 infection. These workers can also transmit the virus to co-workers and hospitalized susceptible patients. In their recent study, Lumley et al presented 6 months of data from a longitudinal seroprevalence study of UK HCW and showed that SARS-CoV-2 anti-nucleocapsid antibodies wane within months.
Published: 2021
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19. Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017

Author: Sibylle Bernard-Stoecklin, Mamunur Rahman Malik, Abdullah M. Assiri, Birgit Nikolay, Maria D. Van Kerkhove, Hassan El Bushra, Moran Ki, Simon Cauchemez, Abdul Aziz Bin Saeed, Arnaud Fontanet, Peter Ben Embarek, Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale (CGH), Institut Pasteur [Paris]-Réseau International des Instituts Pasteur (RIIP), Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Ministry of Health [Riyadh], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), National Cancer Center Korea, Regional Office for the Eastern Mediterranean [Cairo] (EMRO), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), B.N. and S.C. acknowledge financial support from the Investissement d’Avenir program, the Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases program (Grant ANR-10-LABX-62-IBEID), the Models of Infectious Disease Agent Study of the National Institute of General Medical Sciences, the AXA Research Fund and the INCEPTION project (PIA/ANR-16-CONV-0005)., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), Institut Pasteur [Paris] (IP)-Réseau International des Instituts Pasteur (RIIP), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), WHO - Regional Office for the Eastern Mediterranean [Cairo, Egypt] (EMRO), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), and HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)
Subjects: 0301 basic medicine, Male, Multivariate analysis, MESH: Coronavirus Infections, lcsh:Medicine, MESH: Infectious Disease Transmission, Professional-to-Patient, MESH: Comorbidity, Comorbidity, medicine.disease_cause, Disease Outbreaks, Infectious Disease Transmission, Professional-to-Patient, 0302 clinical medicine, Healthcare associated, MESH: Risk Factors, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Health care, Epidemiology, MESH: Disease Outbreaks, lcsh:Science, MESH: Aged, Cross Infection, Multidisciplinary, MESH: Middle Aged, Transmission (medicine), Age Factors, Middle Aged, MESH: Hospitals, Hospitals, 3. Good health, Middle East Respiratory Syndrome Coronavirus, Infectious diseases, Female, Coronavirus Infections, MESH: History, 21st Century, Adult, MESH: Republic of Korea, medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Middle East respiratory syndrome coronavirus, Health Personnel, Saudi Arabia, History, 21st Century, World health, Article, 03 medical and health sciences, Environmental health, MESH: Infectious Disease Transmission, Patient-to-Professional, Republic of Korea, medicine, Humans, Aged, MESH: Age Factors, MESH: Humans, business.industry, lcsh:R, MESH: Middle East Respiratory Syndrome Coronavirus, Outbreak, MESH: Cross Infection, MESH: Adult, MESH: Male, MESH: Saudi Arabia, 030104 developmental biology, Risk factors, MESH: Health Personnel, lcsh:Q, business, MESH: Female, 030217 neurology & neurosurgery
Abstract: Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6–8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3–5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01–0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.
Published: 2019
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20. Seasonal gaps in measles vaccination coverage in Madagascar

Author: Mensah, K., Heraud, J.M., Takahashi, S., Winter, A.K., Metcalf, C.J.E., Wesolowski, A., Princeton University, Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Johns Hopkins Bloomberg School of Public Health [Baltimore], Johns Hopkins University (JHU), and CJEM, AKW and ST were supported by BMGF Grant # OPP1094793. CJEM, KM, APW were funded by Wellcome Trust Sustaining Health Grant (106866/Z/15/Z). APW is supported by a Career Award at the Scientific Interface from the Burroughs Wellcome Fund and by the National Library of Medicine of the National Institutes of Health under Award Number Dp2LM013102.
Subjects: Male, Vaccination Coverage, Health Personnel, Measles Vaccine, MESH: Measles Vaccine, MESH: Immunization Programs, Article, Disease Outbreaks, MESH: Madagascar, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Madagascar, Humans, MESH: Disease Outbreaks, MESH: Surveys and Questionnaires, Health Services Administration, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Humans, Immunization Programs, Vaccination, MESH: Child, Preschool, MESH: Infant, Newborn, Infant, Newborn, Infant, MESH: Vaccination Coverage, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Healthcare access, MESH: Health Services Administration, MESH: Infant, MESH: Male, Child, Preschool, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Measles, MESH: Health Personnel, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Seasons, MESH: Seasons, MESH: Female, Measles
Abstract: INTRODUCTION: Measles elimination depends on the successful deployment of measles containing vaccine. Vaccination programs often depend on a combination of routine and non-routine services, including supplementary immunization activities (SIAs) and vaccination weeks (VWs), that both aim to vaccinate all eligible children regardless of vaccination history or natural infection. Madagascar has used a combination of these activities to improve measles coverage. However, ongoing massive measles outbreak suggests that the country was in a “honeymoon” period and that coverage achieved needs to be re-evaluated. Although healthcare access is expected to vary seasonally in low resources settings, little evidence exists to quantify temporal fluctuations in routine vaccination, and interactions with other immunization activities. METHODS: We used three data sources: national administrative data on measles vaccine delivery from 2013 to 2016, digitized vaccination cards from 49 health centers in 6 health districts, and a survey of health workers. Data were analyzed using linear regressions, analysis of variance, and t-tests. FINDINGS: From 2013 to 2016, the footprint of SIAs and VWs is apparent, with more doses distributed during the relevant timeframes. Routine vaccination decreases in subsequent months, suggesting that additional activities may be interfering with routine services. The majority of missed vaccination opportunities occur during the rainy season. Health facility organization and shortage of vaccine contributed to vaccination gaps. Children born in June were the least likely to be vaccinated on time. DISCUSSION: Evidence that routine vaccination coverage varies over the year and is diminished by other activities suggests that maintaining routine vaccination during SIAs and VWs is a key direction for strengthening immunization programs, ensuring population immunity and avoiding future outbreaks. FUNDING: Wellcome Trust Fund, Burroughs Wellcome Fund, Gates Foundation, National Institutes of Health.
Published: 2019
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21. Opinions et perceptions de professionnels de santé après une formation en E-learning à l’entretien motivationnel

Author: Candau-Tilh, Paul, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Isabelle Dupie
Subjects: MESH: Motivational Interviewing, MESH: Education, Distance, Entretien motivationnel, Professionnels de santé en soins primaires, MESH: Education, Continuing, MESH: Health Personnel, Formation E-learning, MESH: Primary Health Care, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background: in 2014, chronic diseases were responsible for 87% of deaths in France. An important way to reduce chronic diseases is to focus on reducing the risk factors associated with them and improving therapeutic adherence. Motivational interviewing (MI) is an effective key to take up this challenge and its spread in France is essential. The goal of this study is to gather the feedback of 17 non-trained health professionals after their participation in a e-learning training on MI. Method: translation of the MI e-learning training tool created by EQuiP, including the script and the production of videos. Recruitment of primary healthcare professionals in order to carry out a qualitative survey through semi-structured interviews. The interviews were transcribed word by word, then coded and finally analyzed. Results: 5 general practitioners, 4 physiotherapists, 5 pharmacists and 3 nurses were interviewed between June and November 2018. The discovery of the MI through a synthetic and flexible tool gave rise to questions and aroused reflections on the participants’ behaviour during their consultations while transmitting them the basis of the MI. MI is seen as an innovative approach, opposed to a directive approach, promoting patient empowerment. However, interaction is missing, and a deep involvement of the participant is key compared to a face-to-face training. Conclusion: easy to spread out, this training can allow a healthcare team to change its behaviour to improve the management of chronic diseases. Nevertheless, it should be completed by additional trainings with more supervision so that the professional could become "motivational".; Contexte : en 2014, les pathologies chroniques étaient responsables de 87% des décès en France. Un moyen important de faire reculer les maladies chroniques est de s’attacher à réduire les facteurs de risque qui leur sont associés et d’améliorer l’adhésion thérapeutique. La diffusion de l’entretien motivationnel (EM) en France pourrait être une clef efficace pour relever ce défi. Objectif : évaluer les perceptions et opinions de 17 professionnels de santé non formés après une formation en E-learning à l’EM. Méthode : traduction de la formation en E-learning à l’entretien motivationnel proposé par EQuiP, comportant : traduction du script, réalisation des séquences vidéo. Recrutement de professionnels de santé de soins primaires, réalisation d’une étude qualitative par entretiens semi-dirigés. Les entretiens sont retranscrits, codés à partir des verbatim et enfin analysés. Résultats : 5 médecins généralistes, 4 kinésithérapeutes, 5 Pharmaciens et 3 Infirmiers ont été interrogés entre Juin et Novembre 2018. La découverte de l’EM à travers cet outil synthétique et flexible à susciter une remise en question et la transmission des bases de l’EM. L’EM est perçu comme une approche innovante favorisant l’autonomisation des patients. Toutefois, l’outil manque d’interaction et demande une attention plus importante que la formation présentielle. Conclusion : facile à diffuser, cette formation peut permettre à une équipe soignante un changement de posture pour améliorer la prise en charge des maladies chroniques. Elle devra néanmoins être complétée par une formation comportant plus de supervision pour que chacun devienne « motivationnel ».
Published: 2019

22. Findings from the 2018 yearbook section on human factors and organizational issues

Author: Johanna Kaipio, Sylvia Pelayo, Organizational Issues, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Aalto University, CHU Lille, Université de Lille, and Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Subjects: 020205 medical informatics, MESH: Health Information Interoperability, [SDV]Life Sciences [q-bio], Section (typography), MEDLINE, 02 engineering and technology, Editorial board, Section 2: Human Factors and Organizational Issues, Health informatics, 03 medical and health sciences, User-Computer Interface, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Electronic Health Records, Humans, MESH: Electronic Health Records/organization & administration, 030212 general & internal medicine, MESH: Medical Informatics/organization & administration, MESH: User-Computer Interface, Medical education, MESH: Humans, business.industry, Health Information Interoperability, Human factors and ergonomics, General Medicine, health information technology, usability, MESH: Alert Fatigue, ergonomics, Synopsis, MESH: Health Personnel, Yearbook, organizational issues, business, Psychology, Human factors, Alert Fatigue, Health Personnel, Medical Informatics
Abstract: Objective: To summarize significant research contributions published in 2017 on Human Factors and Organizational Issues (HFOI) in medical informatics. Methods: An extensive search using PubMed/Medline and Web of Science® was conducted to identify the scientific contributions published in 2017 that HFOI issues in medical informatics. The selection process comprised three steps: (i) 15 candidate best papers out of 695 references were first selected by the two section editors, (ii) external reviewers from internationally renowned research teams reviewed each candidate best paper, and (iii) the final selection of five best papers was conducted by the editorial board of the Yearbook. Results: The five best papers offer a glimpse of the quality and breadth of the work being conducted in the HFOI community. Conclusion: The selection of the HFOI section of the 2018 IMIA Yearbook highlights a growing number of high quality studies. There are especially more studies interested in testing Human Factors and Ergonomics methods and demonstrating the benefits.
Published: 2018
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23. Évaluation de la satisfaction lors de la première consultation en gynécologie, chez les jeunes femmes de 18 à 25 ans en France

Author: Vignaud, Camille, Université Paris Descartes - École de sages-femmes Baudelocque (UPD ESF Baudelocque), Université Paris Descartes - Paris 5 (UPD5), and Marine Promonet
Subjects: Professionnels de santé, Première consultation, FIrst consultation, Young woman, Satisfaction, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH: Women, Gynécologie, MESH: Office Visits, BERCER method, MESH: Personal Satisfaction, Health professionals, MESH: Health Personnel, MESH: Gynecology, Méthode BERCER, Jeune femme
Abstract: Objective: evaluation of the first gynecology consultation among young women in France. Patients and methods: retrospective, observational, descriptive study using a questionnaire on line (GoogleForms®), posted on the social network Facebook from of 23 August 2017 to 6 September 2017 and accumulating 1545 responses in two weeks including 1398 exploitable responses. Results: we were able to determine that several determinants influenced women's overall satisfaction. In our study, 78.6% of young women were satisfied, 16% were dissatisfied and 5.4% were enchanted with their first consultation in reproductive health (p
Published: 2018

24. La bientraitance en secteur psychiatrique. Points de vue des soignants, difficultés rencontrées et propositions de sensibilisation et de promotion de la bientraitance

Author: aderet, Lee, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Renaud Espaze
Subjects: [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Psychiatry, MESH: Mental Health, Politicy, Contre-transfert, MESH: Stereotyping, Bientraitance, MESH: Countertransference, MESH: Ethics, Professionnels de santé, Politique de santé mentale, MESH: Health Personnel, Stigmatisation, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Secteur psychiatrique, Éthique
Abstract: While the well-care of the vulnerable finds growing public awareness and illustrates the significant improvement in ethical concern over the last decades, particularly regarding the children and the elderly, the psychiatric sector seems slower to integrate this new approach into its professional practice. After defining the idea of well-care and related concepts – mistreatment as well as some ethical principles –, this study questions the limits of the concept of well-care. Well-care inherently suffers from blurred contours and also from a certain lack of clarity of the promotion and awareness messages on the subject issued by the health authorities who act in this case as judge and jury by also fulfilling the mission of evaluating and controlling the quality of care services. To better understand the place of ethical questioning and well-care in psychiatry, this study traces the history of the psychiatric sector, presents the principles of institutional therapy and outlines the current state of the French psychiatric sector highlighting the challenges it faces. The close links between politics, law and psychiatry make relevant the analysis of the use of the word well-care in the French “Psychiatry and Mental health” plans, in the laws governing psychiatric care and in the recommendations for good professional practice. By means of a field survey combining two distinct methods, one quantitative and the other qualitative, in three inpatient units of a psychiatric adult sector, this study accounts for the perception of well-care by professionals and their difficulties to seize and integrate the ethical values associated with well-care in everyday practice. Finally, this study offers orientations to help develop concrete measures in order to improve awareness and well-care actions grounded in field reality of professionals working in a psychiatric sector. These measures to promote well-care in psychiatric sectors can inspire and help elaborate medical projects in psychiatric wards or establishments but to have true ethical value they must proceed from brainstorming to include all the participants intervening in the care process: staff both medical and non -medical, patients...; Alors que la bientraitance des personnes vulnérables trouve un écho grandissant auprès de l’opinion publique et illustre les avancées éthiques importantes des dernières décennies, notamment concernant les enfants et les personnes âgées, le secteur psychiatrique semble plus long à intégrer la question de la bientraitance aux pratiques professionnelles. Après avoir défini le concept de bientraitance et les notions qui s’y rattachent – la maltraitance ainsi que certaines notions d’éthique –, cette étude questionne les limites du concept de bientraitance. La bientraitance souffre intrinsèquement de contours flous mais également d’un certain manque de lisibilité des messages de sensibilisation et de promotion sur ce sujet diffusés par des autorités sanitaires qui sont ici juge et partie puisqu’elles assurent également la mission d’évaluation et de contrôle de la qualité des soins. Afin de mieux comprendre la place du questionnement éthique et de la bientraitance en psychiatrie, cette étude retrace l’histoire du secteur psychiatrique, présente les principes de la thérapie institutionnelle puis dessine le visage du secteur actuel en soulignant les défis auxquels il doit faire face. Les liens étroits entre politique, droit et psychiatrie rendent pertinente l’analyse de la façon dont la bientraitance est inscrite dans les plans « Psychiatrie et Santé mentale », les lois encadrant les soins en psychiatrie ainsi que dans les recommandations de bonnes pratiques professionnelles. Au travers d’une enquête de terrain en deux parties, l’une quantitative et l’autre qualitative, au sein de trois unités d’hospitalisation d’un secteur de psychiatrie adulte, cette étude rend compte de la perception de la bientraitance par les professionnels ainsi que leurs difficultés à se saisir, s’approprier et mettre en pratique au quotidien les valeurs éthiques associées la bientraitance. Enfin, cette étude propose des pistes de réflexion pour élaborer des mesures concrètes de sensibilisation et de promotion de la bientraitance adaptées au vécu des professionnels. Ces mesures de développement de la bientraitance en secteur psychiatrique peuvent inspirer des projets de service ou d’établissement mais, pour avoir une réelle valeur éthique, nécessitent d’être le fruit d’une réflexion de tous les acteurs du soin : personnel médical et non-médical, usagers…
Published: 2016

25. Use of a risk assessment method to improve the safety of negative pressure wound therapy

Author: Judith Pineau, Nicolas Martelli, Brigitte Bonan, Anne-Sophie Lelong, Patrice Prognon, Groupe de Recherche et d'Accueil en Droit et Economie de la Santé (GRADES), and Université Paris-Saclay
Subjects: Risk analysis, Safety Management, medicine.medical_specialty, Care process, MESH: Negative-Pressure Wound Therapy, Health Personnel, medicine.medical_treatment, Dermatology, [QFIN.RM]Quantitative Finance [q-fin]/Risk Management [q-fin.RM], MESH: Risk Assessment, Risk Assessment, MESH: Quality Improvement, Negative-pressure wound therapy, medicine, Humans, Medical prescription, Intensive care medicine, MESH: Humans, business.industry, Original Articles, Negative pressure wound therapy, Quality Improvement, 3. Good health, Surgery, MESH: Safety Management, Failure mode, effects, and criticality analysis, MESH: Patient Safety, MESH: Wounds and Injuries, Wounds and Injuries, MESH: Health Personnel, Clinical Competence, Patient Safety, MESH: Clinical Competence, Safety, Risk assessment, business, Negative-Pressure Wound Therapy
Abstract: International audience; To conduct a risk analysis of the negative pressure wound therapy (NPWT) care process and to improve the safety of NPWT, a working group of nurses, hospital pharmacists, physicians and hospital managers performed a risk analysis for the process of NPWT care. The failure modes, effects and criticality analysis (FMECA) method was used for this analysis. Failure modes and their consequences were defined and classified as a function of their criticality to identify priority actions for improvement. By contrast to classical FMECA, the criticality index (CI) of each consequence was calculated by multiplying occurrence, severity and detection scores. We identified 13 failure modes, leading to 20 different consequences. The CI of consequences was initially 712, falling to 357 after corrective measures were implemented. The major improvements proposed included the establishment of 6-monthly training cycles for nurses, physicians and surgeons and the introduction of computerised prescription for NPWT. The FMECA method also made it possible to prioritise actions as a function of the criticality ranking of consequences and was easily understood and used by the working group. This study is, to our knowledge, the first to use the FMECA method to improve the safety of NPWT.
Published: 2012
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26. A statistical model to assess the risk of communicable diseases associated with multiple exposures in healthcare settings

Author: René Ecochard, Philippe Vanhems, Cécile Payet, Nicolas Voirin, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE)
Subjects: Risk, medicine.medical_specialty, Epidemiology, Health Personnel, [SDV]Life Sciences [q-bio], Disease transmission, MESH: Environmental Exposure, Health Informatics, MESH: Disease Transmission, Infectious, 01 natural sciences, Communicable Diseases, 010104 statistics & probability, 03 medical and health sciences, Health personnel, 0302 clinical medicine, Models, Environmental health, Influenza, Human, Credible interval, medicine, Disease Transmission, Infectious, Humans, 030212 general & internal medicine, 0101 mathematics, Models, Statistical, MESH: Humans, MESH: Risk, business.industry, MESH: Influenza, Human, Infectious, Health facilities, Environmental exposure, Environmental Exposure, Statistical, University hospital, Individual level, MESH: Health Facilities, Influenza, 3. Good health, Healthcare settings, MESH: Communicable Diseases, MESH: Health Personnel, business, MESH: Models, Statistical, Research Article, Human
Abstract: International audience; BACKGROUND: The occurrence of communicable diseases (CD) depends on exposure to contagious persons. The effects of exposure to CD are delayed in time and contagious persons remain contagious for several days during which their contagiousness varies. Moreover when multiple exposures occur, it is difficult to know which exposure is associated with the CD. METHODS: A statistical model at the individual level is presented to estimate the risk of CD to patients, in healthcare settings, with multiple observed exposures to other patients and healthcare workers and unobserved exposures to unobserved or unobservable sources. The model explores the delayed effect of observed exposure, of source contagiousness and of unobserved exposure. It was applied to data on influenza-like illness (ILI) among patients in a university hospital during 3 influenza seasons: from 2004 to 2007. Over a total of 138,411 patients-days of follow-up, 64 incident ILI cases were observed among 21,519 patients at risk of ILI. RESULTS: The ILI risk per 10,000 patients-days associated with observed exposure was about 129.1 (95% Credible Interval (CrI): 84.5, 182.9) and was associated at 72% with exposures to patients or healthcare workers 1 day earlier and at 41% with the 1st day of source contagiousness. The ILI risk associated with unobserved exposure was 0.8 (95% CrI: 0.3, 1.6) per 10,000 patients-days in non-epidemic situation in the community and 4.3 (95% CrI: 0.4, 11.0) in epidemic situation. CONCLUSIONS: The model could be an interesting epidemiological tool to further assess the relative contributions of observed and unobserved exposures to CD risk in healthcare settings.
Published: 2013
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27. Risk of rabies transmission and adverse effects of postexposure prophylaxis in health care workers exposed to a fatal case of human rabies

Author: Hervé Bourhy, Claude Flamand, Didier Hommel, Magalie Demar, Aba Mahamat, Philippe Dussart, Jean-Michel Fontanella, André Spiegel, Félix Djossou, Jean-Baptiste Meynard, Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Centre Collaborateur de l'OMS pour la Rage - Dynamique des lyssavirus et adaptation à l'hôte (CC-OMS), Institut Pasteur [Paris] (IP), Centre National de Référence de la Rage-Dynamique des Lyssavirus et adaptation à l'hôte (CNR), and Institut Pasteur [Paris]
Subjects: Adult, Male, medicine.medical_specialty, Epidemiology, Rabies, Health Personnel, [SDV]Life Sciences [q-bio], MESH: Risk Assessment, Risk Assessment, MESH: Occupational Exposure, 03 medical and health sciences, 0302 clinical medicine, MESH: Rabies, Occupational Exposure, Health care, Hospital-acquired infection, MESH: French Guiana, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Rabies transmission, Adverse effect, Risk management, 0303 health sciences, MESH: Humans, 030306 microbiology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, MESH: Rabies Vaccines, MESH: Adult, medicine.disease, MESH: Male, 3. Good health, French Guiana, Vaccination, Infectious Diseases, Rabies Vaccines, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Health Personnel, business, Risk assessment, Post-Exposure Prophylaxis, MESH: Post-Exposure Prophylaxis
Abstract: Presented in part as an oral communication at the 10th Journées Nationales d’Infectiologie, Marseille, France, June 10-12, 2009.; International audience; On May 27, 2008, a patient died from rabies at the Cayenne Hospital in French Guiana. Postexposure prophylaxis vaccination was implemented for all health care workers exposed to this patient. Examining the management of such a rare risk reveals important factors in the education of personnel who may have contact with a patient with rabies, to permit appropriate risk assessment and reduce unnecessary postexposure prophylaxis, taking into account the risks and costs of adverse events.
Published: 2012
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28. First human rabies case in French Guiana, 2008: epidemiological investigation and control

Author: Françoise Eltges, Hervé Bourhy, Jean-Baptiste Meynard, Claude Flamand, Philippe Dussart, Jean-Michel Fontanella, Franck Berger, Claire Grangier, Laurent Dacheux, J. Renner, Céline Dupuy, Maryvonne Goudal, Aba Mahamat, André Spiegel, Félix Djossou, Nicolas Krieger, Vanessa Ardillon, Frederic Queuche, Didier Hommel, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Departmental Veterinary Direction [Cayenne], Health Regional Agency [Cayenne], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence de la Rage-Dynamique des Lyssavirus et adaptation à l'hôte (CNR), Institut Pasteur [Paris] (IP), Dynamique des Lyssavirus et Adaptation à l'Hôte (DyLAH), The authors thank the Institut de Veille Sanitaire, Saint-Maurice, France (http://www.invs.sante.fr/) for their financial contribution to the National Reference Centre for Rabies that made this work possible., and Institut Pasteur [Paris]
Subjects: Male, medicine.medical_treatment, Saliva/virology, medicine.disease_cause, Health personnel, 0302 clinical medicine, Chiroptera, Epidemiology, MESH: Animals, Skin, 0303 health sciences, medicine.diagnostic_test, lcsh:Public aspects of medicine, Meningoencephalitis, MESH: Chiroptera, MESH: Rabies Vaccines, French Guiana/epidemiology, French Guiana, 3. Good health, MESH: Rabies virus, Rabies Vaccines/administration & dosage, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Medicine, Female, Post-Exposure Prophylaxis, Research Article, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Rabies, Health Personnel, 030231 tropical medicine, Rabies/*diagnosis/*epidemiology/prevention & control/virology, Rabies virus/*isolation & purification, 03 medical and health sciences, MESH: Rabies, MESH: Skin, Chiroptera/virology, parasitic diseases, MESH: French Guiana, medicine, Skin/virology, Animals, Humans, MESH: Saliva, Post-exposure prophylaxis, Saliva, MESH: Humans, 030306 microbiology, business.industry, Rabies virus, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Virology, MESH: Male, Rabies Vaccines, Skin biopsy, Post-Exposure Prophylaxis/methods, MESH: Health Personnel, business, MESH: Female, MESH: Post-Exposure Prophylaxis
Abstract: Background Until 2008, human rabies had never been reported in French Guiana. On 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis. Methodology/Principal Findings Molecular typing of the virus identified a Lyssavirus (Rabies virus species), closely related to those circulating in hematophagous bats (mainly Desmodus rotundus) in Latin America. A multidisciplinary Crisis Unit was activated. Its objectives were to implement an epidemiological investigation and a veterinary survey, to provide control measures and establish a communications program. The origin of the contamination was not formally established, but was probably linked to a bat bite based on the virus type isolated. After confirming exposure of 90 persons, they were vaccinated against rabies: 42 from the case's entourage and 48 healthcare workers. To handle that emergence and the local population's increased demand to be vaccinated, a specific communications program was established using several media: television, newspaper, radio. Conclusion/Significance This episode, occurring in the context of a Department far from continental France, strongly affected the local population, healthcare workers and authorities, and the management team faced intense pressure. This observation confirms that the risk of contracting rabies in French Guiana is real, with consequences for population educational program, control measures, medical diagnosis and post-exposure prophylaxis., Author Summary Until 2008, rabies had never been described within the French Guianan human population. Emergence of the first case in May 2008 in this French Overseas Department represented a public health event that markedly affected the local population, healthcare workers and public health authorities. The antirabies clinic of French Guiana, located at Institut Pasteur de la Guyane, had to reorganize its functioning to handle the dramatically increased demand for vaccination. A rigorous epidemiological investigation and a veterinary study were conducted to identify the contamination source, probably linked to a bat bite, and the exposed population. Communication was a key factor to controlling this episode and changing the local perception of this formerly neglected disease. Because similar clinical cases had previously been described, without having been diagnosed, medical practices must be adapted and the rabies virus should be sought more systematically in similarly presenting cases. Sharing this experience could be useful for other countries that might someday have to manage such an emergence.
Published: 2012
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29. Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients

Author: Bruno Lina, Corinne Régis, Brigitte Coppéré, Silene Cronenberger, Olivier Robert, Brigitte Comte, Philippe Vanhems, Nicolas Voirin, Thomas Bénet, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Camille Jordan [Villeurbanne] ( ICJ ), École Centrale de Lyon ( ECL ), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Centre National de la Recherche Scientifique ( CNRS ), Virologie et pathologie humaine ( VirPath ), Université de Lyon-Université de Lyon, Service de médecine gériatrique, Hospices Civils de Lyon ( HCL ) -Hôpital Edouard Herriot [CHU - HCL], Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Institut Camille Jordan (ICJ), École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Virologie et pathologie humaine (VirPath), Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Camille Jordan [Villeurbanne] (ICJ), Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, MESH : Orthomyxoviridae, [SDV]Life Sciences [q-bio], MESH : Aged, MESH : Prospective Studies, MESH: Influenza Vaccines, MESH: Aged, 80 and over, 0302 clinical medicine, Medical microbiology, Acute care, Health care, Medicine, MESH : Female, Prospective Studies, 030212 general & internal medicine, MESH : Influenza, Human, Prospective cohort study, MESH: Orthomyxoviridae, MESH: Aged, Aged, 80 and over, Cross Infection, 0303 health sciences, MESH: Middle Aged, biology, MESH: Influenza, Human, Vaccination, MESH: Nose, Healthcare worker, virus diseases, Middle Aged, MESH : Adult, MESH: Hospitals, Orthomyxoviridae, MESH: Case-Control Studies, Hospitals, 3. Good health, MESH : Hospitals, Infectious Diseases, MESH: Hemagglutination Inhibition Tests, Influenza Vaccines, Female, MESH : Nose, MESH : Cross Infection, Research Article, Adult, medicine.medical_specialty, MESH : Case-Control Studies, animal structures, Health Personnel, MESH : Male, education, Nose, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Influenza, Human, Humans, lcsh:RC109-216, MESH : Middle Aged, MESH : Aged, 80 and over, Aged, MESH: Humans, [ SDV ] Life Sciences [q-bio], 030306 microbiology, business.industry, MESH : Humans, Case-control study, MESH: Cross Infection, MESH: Adult, MESH: Vaccination, Hemagglutination Inhibition Tests, biology.organism_classification, MESH: Male, MESH: Prospective Studies, MESH : Hemagglutination Inhibition Tests, MESH : Influenza Vaccines, MESH : Vaccination, Case-Control Studies, Immunology, Emergency medicine, MESH: Health Personnel, MESH : Health Personnel, business, MESH: Female
Abstract: Background In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients. Methods A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring ≥ 72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients. Results In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (P = 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (P = 0.16). The proportion of ≥ 35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units. Conclusions Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.
Published: 2012
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30. Influenza vaccination coverage among patients and healthcare workers in a university hospital during the 2006-2007 influenza season

Author: Philippe Vanhems, Mitra Saadatian-Elahi, Nicolas Voirin, Caroline Landelle, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), ThEMAS, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Unité de qualitique et d'évaluation médicale - pole Santé Publique, CHU Grenoble-CHU Grenoble, Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), and Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Unité de qualitique et d'évaluation médicale - pole Santé Publique
Subjects: Male, Health Personnel/statistics & numerical data, [SDV]Life Sciences [q-bio], health care facilities, manpower, and services, Hospitals, University/statistics & numerical data, Influenza Vaccines/therapeutic use, Hospitals, University, MESH: Influenza Vaccines, 0302 clinical medicine, Health care, Medicine, Infection control, 030212 general & internal medicine, Prospective Studies, MESH: Aged, 0303 health sciences, MESH: Middle Aged, MESH: Influenza, Human, virus diseases, Middle Aged, University hospital, 3. Good health, Vaccination, Infectious Diseases, Influenza Vaccines, Vaccination coverage, Molecular Medicine, Female, Medical emergency, medicine.medical_specialty, Health Personnel, education, Influenza season, 03 medical and health sciences, MESH: Cross-Sectional Studies, Influenza, Human, Humans, Aged, MESH: Hospitals, University, MESH: Humans, General Veterinary, General Immunology and Microbiology, 030306 microbiology, business.industry, Public health, Influenza, Human/immunology/prevention & control, Public Health, Environmental and Occupational Health, medicine.disease, MESH: Male, MESH: Prospective Studies, Cross-Sectional Studies, Immunization, Emergency medicine, MESH: Health Personnel, business, MESH: Female
Abstract: International audience; Despite years of public health effort to increase vaccine uptake among populations recommended for influenza vaccination, immunization rates remain low among patients and healthcare workers (HCWs). The objective of this study was to report on influenza vaccination coverage of patients and HCWs for the same time period in 4 wards of a university hospital. A prospective cross-sectional study was conducted among patients and HCWs between December 11, 2006 and April 15, 2007 and individual factors associated with being vaccinated against influenza were assessed. Results indicated that older patients were significantly more vaccinated than younger patients. Physicians and residents were more likely to be vaccinated that the rest of staff, with possible differences between wards. Immunization of HCWs is a major issue in infection control in hospitals and long-term care facilities. However, the impact of influenza vaccination among HCWs in reducing hospital-acquired influenza and patient morbidity needs to be explored further.
Published: 2012
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31. A report on the large measles outbreak in Lyon, France, 2010 to 2011

Author: Huoi, C., Casalegno, J. S., Bénet, T., Antoine Neuraz, Billaud, G., Eibach, D., Mekki, Y., Rudigoz, R., Massardier, J., Huissoud, C., Massoud, M., Gaucherand, P., Claris, O., Gillet, Y., Floret, D., Lina, B., Vanhems, P., Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Virologie et pathogenèse virale (VPV), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut de recherches sur la catalyse (IRC), Centre National de la Recherche Scientifique (CNRS), Institut cellule souche et cerveau (SBRI), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Division of Pediatric Intensive Care, Hôpital Femme Mère Enfant, Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institut cellule souche et cerveau (U846 Inserm - UCBL1), and Neuraz, Antoine
Subjects: Male, [SDV]Life Sciences [q-bio], Disease Outbreaks, Hospitals, University, MESH: Pregnancy, Pregnancy, MESH: Child, Prospective Studies, MESH: Incidence, Pregnancy Complications, Infectious, MESH: Disease Outbreaks, Child, MESH: Aged, MESH: Middle Aged, Incidence, Vaccination, MESH: Sex Distribution, Middle Aged, MESH: Infant, MESH: Young Adult, Child, Preschool, Population Surveillance, MESH: Measles, Female, France, Adult, Adolescent, Health Personnel, MESH: Population Surveillance, Young Adult, Age Distribution, Humans, MESH: Pregnancy Complications, Infectious, Sex Distribution, MESH: Age Distribution, Aged, MESH: Adolescent, MESH: Hospitals, University, MESH: Humans, MESH: Child, Preschool, Infant, MESH: Adult, MESH: Vaccination, Mandatory Reporting, MESH: Male, MESH: Prospective Studies, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Mandatory Reporting, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female, Measles
Abstract: International audience; In 2010 and 2011, the city of Lyon, located in the Rhône-Alpes region (France), has experienced one of the highest incidences of measles in Europe. We describe a measles outbreak in the Lyon area, where cases were diagnosed at Lyon University hospitals (LUH) between 2010 and mid-2011. Data were collected from the mandatory notification system of the regional public health agency, and from the virology department of the LUH. All patients and healthcare workers who had contracted measles were included. Overall, 407 cases were diagnosed, with children of less than one year of age accounting for the highest proportion (n=129, 32%), followed by individuals between 17 and 29 years-old (n=126, 31%). Of the total cases, 72 (18%) had complications. The proportions of patients and healthcare workers who were not immune to measles were higher among those aged up to 30 years. Consequently, women of childbearing age constituted a specific population at high risk to contract measles and during this outbreak, 13 cases of measles, seven under 30 years-old, were identified among pregnant women. This study highlights the importance of being vaccinated with two doses of measles vaccine, the only measure which could prevent and allow elimination of the disease.
Published: 2012

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

Author: Borjesson, M, Serratosa, L, Carre, F, Corrado, Domenico, Drezner, J, Dugmore, Dl, Heidbuchel, Hh, Mellwig, Kp, Panhuyzen Goedkoop NM, Papadakis, M, Rasmusen, H, Sharma, S, Solberg, Ee, van Buuren, F, Pelliccia, A, writing group on behalf of the EACPR Section of Sports Cardiology, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine du sport et d'explorations fonctionnelles, CHU Pontchaillou [Rennes], University of Washington [Seattle], Department of Cardiology [K.U.Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-University Hospital Gasthuisberg [Leuven], EACPR section of sports cardiology, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-University Hospital Gasthuisberg
Subjects: Emergency Medical Services, medicine.medical_treatment, MESH: Cardiopulmonary Resuscitation, 030204 cardiovascular system & hematology, Medical Records, 0302 clinical medicine, Mass gathering, MESH: Health Planning, 030212 general & internal medicine, MESH: Quality of Health Care, Rehabilitation, Cardiovascular diseases [NCEBP 14], biology, Communication, MESH: Equipment and Supplies, Checklist, 3. Good health, Transportation of Patients, Equipment and Supplies, Action plan, Cardiology, MESH: Emergency Medical Services, MESH: Communication, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Medical emergency, medicine.symptom, Cardiology and Cardiovascular Medicine, Sports, MESH: Medical Records, medicine.medical_specialty, Health Personnel, Interprofessional Relations, MESH: Emergency Treatment, Sudden death, MESH: Checklist, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, MESH: Interprofessional Relations, medicine, Humans, Chain of survival, Emergency Treatment, Quality of Health Care, MESH: Humans, business.industry, Athletes, Sudden cardiac arrest, MESH: Death, Sudden, Cardiac, medicine.disease, biology.organism_classification, Cardiopulmonary Resuscitation, Health Planning, Death, Sudden, Cardiac, Life support, MESH: Transportation of Patients, MESH: Health Personnel, MESH: Defibrillators, MESH: Sports, business, human activities, Defibrillators
Abstract: Item does not contain fulltext Mass gathering events in sports arenas create challenges regarding the cardiovascular safety of both athletes and spectators. A comprehensive medical action plan, to ensure properly applied cardiopulmonary resuscitation, and wide availability and use of automated external defibrillators (AEDs), is essential to improving survival from sudden cardiac arrest at sporting events. This paper outlines minimum standards for cardiovascular care to assist in the planning of mass gathering sports events across Europe with the intention of local adaptation at individual sports arenas, to ensure the full implementation of the chain of survival.
Published: 2011
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33. Improvement of Inter-Services Communication through a CDSS Dedicated to Myocardial Perfusion Scintigraphy

Author: Nies, Julie, Georg, Gersende, Faraggi, Marc, Colombet, Isabelle, Durieux, Pierre, MEDASYS, Haute Autorité de Santé [Saint-Denis La Plaine] ( HAS ), Médecine nucléaire [CHU Pompidou], Hôpital Européen Georges Pompidou [APHP] ( HEGP ), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Université Paris Descartes - Faculté de Médecine ( UPD5 Médecine ), Université Paris Descartes - Paris 5 ( UPD5 ), Département de Santé Publique et Informatique Médicale, Haute Autorité de Santé [Saint-Denis La Plaine] (HAS), Médecine nucléaire [CHU HEGP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: [SDV]Life Sciences [q-bio], MESH : Computer Graphics, MESH : Access to Information, Task Performance and Analysis, MESH : Task Performance and Analysis, MESH : Myocardial Perfusion Imaging/instrumentation, MESH: Computer Communication Networks, MESH : Decision Making, Computer-Assisted, MESH: Myocardial Perfusion Imaging/instrumentation, MESH: Decision Making, Computer-Assisted, Communication, MESH: Clinical Decision-Making, Myocardial Perfusion Imaging, MESH : Health personnel, MESH : Computer Communication Networks, MESH : Medical Informatics/methods, organization, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hospitals, MESH: Cardiology, Perfusion, MESH : Cardiology, MESH : Perfusion, MESH : Medical Record Linkage, MESH: Communication, Medical Record Linkage, MESH : Software, MESH: Computer Graphics, MESH : Communication, MESH : Decision Support Techniques, MESH: Medical Record Linkage, MESH: Perfusion, education, medical ward – technical service communication, Access to Information, Computer Communication Networks, MESH: Software, MESH : Myocardial Perfusion Imaging/methods, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, MESH: Health personnel, Computer Graphics, Humans, MESH: Decision Support Systems, Clinical/organization & administration, [ SDV ] Life Sciences [q-bio], Computers, MESH: Decision Support Techniques, MESH: Task Performance and Analysis, MESH: Myocardial Perfusion Imaging/methods, Decision Support Systems, Clinical, MESH : Decision Support Systems, Clinical/organization & administration, MESH : Clinical Decision-Making, MESH: Access to Information, CDSS, CPOE, Medical Informatics, Software, MESH: Medical Informatics/methods, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; This study addresses the question of communication between medical wards and the nuclear medicine department for the realization of myocardial perfusion scintigraphy. It analyses the effects of a reminder for completing the content of an order form. It shows that the CDSS impacted ordering practices. It could be seen as a system enabling to structure the information and improve the quality of orders.
Published: 2011
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34. Exposure to bacteria of healthcare workers' forearms during care in geriatric units

Author: D. Gunther, Philippe Gaspard, C. Roth, Xavier Bertrand, Daniel Talon, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratory of Inorganic Chemistry, Eidgenössische Technische Hochschule [Zürich] ( ETH Zürich ), Institute of Space and Atmospheric Studies [Saskatoon] ( ISAS ), University of Saskatchewan [Saskatoon] ( U of S ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich] (ETH Zürich), Institute of Space and Atmospheric Studies [Saskatoon] (ISAS), Department of Physics and Engineering Physics [Saskatoon], and University of Saskatchewan [Saskatoon] (U of S)-University of Saskatchewan [Saskatoon] (U of S)
Subjects: MESH : Hospital Units, Colony Count, Microbial, MESH: Geriatrics, 030501 epidemiology, MESH: Long-Term Care, Health personnel, 0302 clinical medicine, MESH: Aged, 80 and over, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Epidemiology, Health care, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Skin, Geriatrics, Aged, 80 and over, General Medicine, 3. Good health, Forearm, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Hospital Units, France, MESH : Long-Term Care, 0305 other medical science, Hospital Units, Microbiology (medical), medicine.medical_specialty, MESH : Colony Count, Microbial, Health Personnel, 03 medical and health sciences, Nursing, MESH: Skin, medicine, MESH : Skin, Humans, MESH : Bacteria, MESH : Aged, 80 and over, MESH : Forearm, MESH : France, MESH : Geriatrics, MESH: Colony Count, Microbial, MESH: Humans, Bacteria, business.industry, Public health, MESH : Humans, Long-Term Care, MESH: France, Long-term care, MESH: Bacteria, Family medicine, MESH: Forearm, MESH: Health Personnel, MESH : Health Personnel, business
Abstract: International audience
Published: 2010
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35. Expected and unexpected adverse effects H1N1 vaccination for health care workers in a university hospital

Author: Aurélien Dinh, Jérôme Salomon, Christine Lawrence, Alexis Descatha, Services des maladies infectieuses, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Equipe Hygiène, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Kaniewski, Nadine
Subjects: medicine.medical_specialty, Health Personnel, 030204 cardiovascular system & hematology, Hospitals, University, MESH: Influenza A Virus, H1N1 Subtype, MESH: Influenza Vaccines, 03 medical and health sciences, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Surveys and Questionnaires, Influenza, Human, Health care, medicine, Humans, 030212 general & internal medicine, Adverse effect, ComputingMilieux_MISCELLANEOUS, MESH: Hospitals, University, MESH: Humans, General Veterinary, General Immunology and Microbiology, business.industry, MESH: Influenza, Human, MESH: Questionnaires, Vaccination, Public Health, Environmental and Occupational Health, Influenza a, MESH: Vaccination, medicine.disease, University hospital, 3. Good health, Infectious Diseases, Immunization, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Influenza Vaccines, Emergency medicine, Molecular Medicine, MESH: Health Personnel, Disease prevention, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Medical emergency, business
Abstract: International audience; no abstract
Published: 2010
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36. Temporal variability and social heterogeneity in disease transmission: the case of SARS in Hong Kong

Author: Alain-Jacques Valleron, Gabriel M. Leung, Anne Cori, Pierre-Yves Boëlle, Guy Thomas, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), School of Public Health, The University of Hong Kong (HKU), The authors thank the following for research funding: The Research Fund for the Control of Infectious Diseases of the Food and Health Bureau of the Hong Kong SAR Government (GML), The University of Hong Kong SARS Research Fund (GML), The EU Sixth Framework Programme for Research for Policy Support (contracts SP22-CT-2004-511066 and FP6-2003-SSP2-513715) (AC, P-YB, GT, GML, A-JV), and Autard, Delphine
Subjects: Time Factors, Public Health and Epidemiology/Infectious Diseases, MESH: Infectious Disease Transmission, Professional-to-Patient, Severe Acute Respiratory Syndrome, 01 natural sciences, Public Health and Epidemiology/Nosocomial and Healthcare-Associated Infections, Disease Outbreaks, Infectious Disease Transmission, Professional-to-Patient, law.invention, 010104 statistics & probability, 0302 clinical medicine, law, Community-Acquired Infections - epidemiology - transmission - virology, Epidemiology, Health care, 030212 general & internal medicine, MESH: Disease Outbreaks, lcsh:QH301-705.5, Cross Infection, education.field_of_study, Ecology, Risk of infection, Cross Infection - epidemiology - transmission - virology, Infectious Diseases/Nosocomial and Healthcare-Associated Infections, SARS Virus, Markov Chains, 3. Good health, Community-Acquired Infections, Transmission (mechanics), Geography, Severe acute respiratory syndrome-related coronavirus, Computational Theory and Mathematics, MESH: Community-Acquired Infections, Modeling and Simulation, MESH: Stochastic Processes, symbols, Hong Kong, Monte Carlo Method, Algorithms, MESH: Hong Kong, Research Article, Infectious Diseases/Epidemiology and Control of Infectious Diseases, medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Health Personnel, Population, MESH: SARS Virus, MESH: Algorithms, MESH: Monte Carlo Method, 03 medical and health sciences, Cellular and Molecular Neuroscience, symbols.namesake, MESH: Markov Chains, MESH: Severe Acute Respiratory Syndrome, MESH: Infectious Disease Transmission, Patient-to-Professional, Infectious Diseases/Viral Infections, Genetics, medicine, Severe Acute Respiratory Syndrome - epidemiology - transmission, Humans, 0101 mathematics, education, Molecular Biology, Ecology, Evolution, Behavior and Systematics, Simulation, Stochastic Processes, Models, Statistical, MESH: Humans, business.industry, Public health, MESH: Time Factors, Outbreak, MESH: Cross Infection, Markov chain Monte Carlo, lcsh:Biology (General), [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Mathematics/Statistics, Public Health and Epidemiology/Epidemiology, business, MESH: Models, Statistical, Demography
Abstract: The extent to which self-adopted or intervention-related changes in behaviors affect the course of epidemics remains a key issue for outbreak control. This study attempted to quantify the effect of such changes on the risk of infection in different settings, i.e., the community and hospitals. The 2002-2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong, where 27% of cases were healthcare workers, was used as an example. A stochastic compartmental SEIR (susceptible-exposed-infectious-removed) model was used: the population was split into healthcare workers, hospitalized people and general population. Super spreading events (SSEs) were taken into account in the model. The temporal evolutions of the daily effective contact rates in the community and hospitals were modeled with smooth functions. Data augmentation techniques and Markov chain Monte Carlo (MCMC) methods were applied to estimate SARS epidemiological parameters. In particular, estimates of daily reproduction numbers were provided for each subpopulation. The average duration of the SARS infectious period was estimated to be 9.3 days (±0.3 days). The model was able to disentangle the impact of the two SSEs from background transmission rates. The effective contact rates, which were estimated on a daily basis, decreased with time, reaching zero inside hospitals. This observation suggests that public health measures and possible changes in individual behaviors effectively reduced transmission, especially in hospitals. The temporal patterns of reproduction numbers were similar for healthcare workers and the general population, indicating that on average, an infectious healthcare worker did not infect more people than any other infectious person. We provide a general method to estimate time dependence of parameters in structured epidemic models, which enables investigation of the impact of control measures and behavioral changes in different settings. © 2009 Cori et al., published_or_final_version
Published: 2009
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37. Clinical assessment of stereoscopic optic disc photographs for glaucoma: the European Optic Disc Assessment Trial

Author: Gábor Holló, Christoph Faschinger, Hans G Lemij, P. Juhani Airaksinen, Andrea Mistlberger, Jost B. Jonas, Michele Iester, Alfonso Antón, Thierry Zeyen, Alain M. Bron, David F. Garway-Heath, Nicolaas J. Reus, Fotis Topouzis, The Rotterdam Eye Hospital, Moorfields Eye Hospital, Service d'Ophtalmologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), University of Genoa (UNIGE), Department of Ophthalmology, School of Medicine [Thessaloniki, Grèce], Aristotle University of Thessaloniki, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Centre des Sciences du Goût et de l'Alimentation [Dijon] ( CSGA ), Institut National de la Recherche Agronomique ( INRA ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), University of Genoa ( UNIGE ), and A' Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki
Subjects: Male, Intraocular pressure, MESH: Ophthalmology, genetic structures, Optic disk, MESH : Aged, Ocular hypertension, Glaucoma, Scanning laser polarimetry, MESH: Observer Variation, MESH: Aged, 80 and over, Photography, MESH : Female, Tomography, MESH : Glaucoma, MESH : Intraocular Pressure, MESH: Aged, Aged, 80 and over, Observer Variation, MESH: Middle Aged, medicine.diagnostic_test, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, MESH: Tomography, MESH : Adult, Middle Aged, MESH: Reproducibility of Results, Europe, medicine.anatomical_structure, Scanning Laser Polarimetry, [ SDV.MHEP.OS ] Life Sciences [q-bio]/Human health and pathology/Sensory Organs, MESH : Ophthalmoscopy, MESH: Optic Disk, Female, MESH : Sensitivity and Specificity, MESH : Tomography, MESH: Glaucoma, Optic disc, Adult, medicine.medical_specialty, MESH : Male, Health Personnel, MESH : Europe, Optic Disk, [ SDV.MHEP.GEG ] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Sensitivity and Specificity, Ophthalmoscopy, MESH: Intraocular Pressure, Ophthalmology, MESH : Optic Disk, medicine, MESH : Ocular Hypertension, Humans, MESH : Middle Aged, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, MESH : Aged, 80 and over, Intraocular Pressure, MESH : Scanning Laser Polarimetry, Aged, MESH: Humans, business.industry, MESH: Scanning Laser Polarimetry, MESH : Reproducibility of Results, MESH : Humans, Reproducibility of Results, MESH: Adult, MESH : Observer Variation, medicine.disease, MESH: Photography, eye diseases, MESH: Sensitivity and Specificity, MESH: Male, MESH: Ocular Hypertension, MESH: Ophthalmoscopy, MESH : Ophthalmology, Optometry, MESH: Health Personnel, Ocular Hypertension, MESH : Health Personnel, sense organs, MESH: Europe, business, MESH : Photography, MESH: Female, Kappa
Abstract: International audience; PURPOSE: To determine the diagnostic accuracy of judging optic disc photographs for glaucoma by ophthalmologists. DESIGN: Evaluation of diagnostic test and technology. PARTICIPANTS: A total of 243 of 875 invited ophthalmologists in 11 European countries. METHODS: We determined how well each participant classified 40 healthy eyes and 48 glaucomatous eyes with varying severity of the disease on stereoscopic slides. Duplicate slides were provided for determining intraobserver agreement. All eyes were also imaged with the GDx with variable corneal compensation (GDx-VCC) (Carl Zeiss Meditec AG, Jena, Germany) and the Heidelberg Retina Tomograph (HRT) I (Heidelberg Engineering GmbH, Heidelberg, Germany). Diagnostic accuracies of clinicians were compared with those of the best machine classifiers. MAIN OUTCOME MEASURES: Accuracy of classification, expressed as sensitivity, specificity, and overall accuracy. Intraobserver agreement (kappa). RESULTS: The overall diagnostic accuracy of ophthalmologists was 80.5% (standard deviation [SD], 6.8; range, 61.4%-94.3%). The machine classifiers outperformed most observers in diagnostic accuracy; the GDx-VCC nerve fiber indicator and the HRT's best classifier correctly classified 93.2% and 89.8% of eyes, respectively. The intraobserver agreement (kappa) varied between -0.13 and 1.0 and was on average good (0.7). CONCLUSIONS: In general, ophthalmologists classify optic disc photographs moderately well for detecting glaucoma. There is, however, large variability in diagnostic accuracy among and agreement within clinicians. Common imaging devices outperform most clinicians in classifying optic discs. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
Published: 2009
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38. An assessment of interactions between global health initiatives and country health systems

Author: Mark Dybul, Jean-Paul Moatti, Tim Evans, Rifat Atun, Justine Hsu, Ruairi Brugha, Badara Samb, Carissa F. Etienne, Asia Russell, Jim Yong Kim, Francesca Celletti, Anna Wright, Sania Nishtar, Chauvin, Pierre, World Health Organisation (WHO), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), O'Neill Institute, Georgetown University [Washington] (GU), Imperial College London, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Heartfile, Harvard School of Public Health, Royal College of Surgeons, Health GAP, World Health Organization Maximizing Positive Synergies, Georgetown University, and Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)
Subjects: Budgets, Economic growth, MESH: Delivery of Health Care, Global Health, Health Services Accessibility, 0302 clinical medicine, Global health, Medicine, MESH: Health Planning, 030212 general & internal medicine, Health Workforce, MESH: Quality of Health Care, MESH: Healthcare Disparities, MESH: Developing Countries, MESH: Health Services Accessibility, MESH: Program Evaluation, 030503 health policy & services, Health Policy, Environmental resource management, Financing, Organized, 1. No poverty, MESH: Equipment and Supplies, General Medicine, Millennium Development Goals, 3. Good health, MESH: Health Priorities, Equipment and Supplies, MESH: Health Manpower, MESH: Information Systems, MESH: Health Policy, 0305 other medical science, Goals, Information Systems, MESH: Health Services Needs and Demand, medicine.medical_specialty, MESH: Health Expenditures, Health Personnel, Developing country, MESH: International Agencies, MESH: Financing, Organized, 03 medical and health sciences, Humans, Healthcare Disparities, Developing Countries, Health policy, Quality of Health Care, Health Services Needs and Demand, Equity (economics), MESH: Humans, MESH: Budgets, business.industry, Health Priorities, Public health, International health, International Agencies, Health Planning, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Goals, Global Health Initiatives, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Health Expenditures, business, Delivery of Health Care, MESH: World Health, Program Evaluation
Abstract: International audience; Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.
Published: 2009
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39. Prevalence and factors of intensive care unit conflicts: the conflicus study

Author: Azoulay, Elie, Timsit, Jean-François, Sprung, Charles, Soares, Marcio, Rusinová, Katerina, Lafabrie, Ariane, Abizanda, Ricardo, Svantesson, Mia, Rubulotta, Francesca, Ricou, Bara, Benoit, Dominique, Heyland, Daren, Joynt, Gavin, Français, Adrien, Azeivedo-Maia, Paulo, Owczuk, Radoslaw, Benbenishty, Julie, De Vita, Michael, Valentin, Andreas, Ksomos, Akos, Cohen, Simon, Kompan, Lidija, Ho, Kwok, Abroug, Fekri, Kaarlola, Anne, Gerlach, Herwig, Kyprianou, Theodoros, Michalsen, Andrej, Chevret, Sylvie, Schlemmer, Benoît, Intensive Care Medicine, For The Conflicus Study Investigators And For The Ethics Section Of The European Society Of, Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center [Jerusalem], Intensive Care Unit, Instituto Nacional de Câncer, Prague University Hospital, Servei de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, Centre for Health Care Sciences, Örebro University Hospital [Örebro, Sweden], Policlinico University Hospital Catania, Department of Intensive Care, Geneva University Hospitals and University of Geneva, Department of Intensive Care Medicine, Ghent University Hospital, Department of Medicine, Queen's University [Kingston, Canada], Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong [Hong Kong]-Prince of Wales Hospital, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Anesthesia and Intensive Care, Hospital de S. João, Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), General and Medical Intensive Care Unit, II, Medical Department, Surgical Intensive Care Unit, Semmelweis University [Budapest], University College of London [London] (UCL), Clinical Centre Ljubljana, University of Ljubljana, Royal Perth Hospital, CHU Fattouma Bourguiba [Monastir] (HFB), Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Department of Anesthesiology, Intensive Care Medicine, and Pain Management, Vivantes-Klinikum Neukoelln, Computer Science Department [Cyprus], University of Cyprus [Nicosia], HELIOS Spital, Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Vesin, Aurélien, and University of Cyprus [Nicosia] (UCY)
Subjects: Male, Questionnaires, Multivariate analysis, Intensive Care Units/*statistics & numerical data, Burnout, Hospitals, University/statistics & numerical data, Critical Care and Intensive Care Medicine, MESH: Perception, law.invention, Conflict, Psychological, Hospitals, University, 0302 clinical medicine, MESH: Hospitals, Public, law, MESH: Risk Factors, Risk Factors, Surveys and Questionnaires, Prevalence, Medicine, 030212 general & internal medicine, Workload/psychology, Burnout, Professional, MESH: Workload, Terminal Care, ddc:617, Communication, Workload, MESH: Stress, Psychological, Orvostudományok, MESH: Interpersonal Relations, MESH: Conflict (Psychology), Intensive care unit, Burnout, Professional/epidemiology/psychology, 3. Good health, Europe, Intensive Care Units, MESH: Terminal Care, MESH: Communication, Female, Stress, Psychological/epidemiology/psychology, Pulmonary and Respiratory Medicine, Adult, Hospitals, Public/statistics & numerical data, Conflict (Psychology), Attitude of Health Personnel, Health Personnel, MESH: Attitude of Health Personnel, MESH: Social Support, Klinikai orvostudományok, Occupational burnout, Europe/epidemiology, 03 medical and health sciences, MESH: Cross-Sectional Studies, Nursing, Intensive care, Intervention (counseling), MESH: Burnout, Professional, Humans, Interpersonal Relations, MESH: Prevalence, MESH: Hospitals, University, MESH: Humans, Job strain, business.industry, Hospitals, Public, MESH: Questionnaires, Social Support, 030208 emergency & critical care medicine, MESH: Adult, MESH: Male, Health Personnel/psychology/statistics & numerical data, Cross-Sectional Studies, Terminal Care/psychology/statistics & numerical data, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Health Personnel, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Perception, MESH: Europe, business, MESH: Female, Stress, Psychological
Abstract: International audience; RATIONALE: Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs. OBJECTIVES: To record the prevalence, characteristics, and risk factors for conflicts in ICUs. METHODS: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries). MEASUREMENTS AND MAIN RESULTS: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings. CONCLUSIONS: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
Published: 2009
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40. High level of burnout in intensivists: prevalence and associated factors

Author: Elie Azoulay, Nathalie Embriaco, Karine Barrau, Laurent Papazian, Nancy Kentish, Anderson Loundou, Frédéric Pochard, Medical Intensive Care Unit, Université de la Méditerranée - Aix-Marseille 2-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Département de Sociologie, Université Bordeaux Segalen - Bordeaux 2, Maison de Solenn [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Vesin, Aurélien
Subjects: Male, health care facilities, manpower, and services, Burnout, Critical Care and Intensive Care Medicine, MESH: Occupational Exposure, 0302 clinical medicine, MESH: Health Surveys, Risk Factors, MESH: Risk Factors, Prevalence, Medicine, 030212 general & internal medicine, Burnout, Professional, Response rate (survey), MESH: Middle Aged, Middle Aged, Occupational Diseases, Female, France, Pulmonary and Respiratory Medicine, Adult, MESH: Occupational Diseases, medicine.medical_specialty, Critical Care, Health Personnel, education, Intensivist, Occupational burnout, 03 medical and health sciences, Nursing, Intensive care, Occupational Exposure, Severity of illness, MESH: Burnout, Professional, Humans, MESH: Intensive Care, MESH: Prevalence, MESH: Humans, business.industry, Stressor, 030208 emergency & critical care medicine, MESH: Adult, Odds ratio, Health Surveys, MESH: Male, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; RATIONALE: Professional burnout is a psychological syndrome arising in response to chronic interpersonal stressors on the job. There is the perception that intensivists are particularly exposed to stress because lives are literally in their hands. OBJECTIVE: To evaluate the prevalence and associated factors (patients or organization) of burnout among physicians working in intensive care units (ICUs) (including interns, residents, fellows, and attending physicians). METHODS: A 1-day national survey was conducted in adult ICUs in French public hospitals. MEASUREMENTS: The level of burnout was evaluated on the basis of the Maslach Burnout Inventory (MBI). MAIN RESULTS: A total of 189 ICUs participated and 978 surveys were returned (82.3% response rate). A high level of burnout was identified in 46.5% of the respondents. Ordinal logistic regression showed that female sex (odds ratio, 1.58; 95% confidence interval, 1.09 to 2.30) was independently associated with a higher MBI score. Whereas no factor related to the severity of illness of patients was retained by the model, organizational factors were strongly associated with a higher MBI score. Workload (the number of night shifts per month, a long period of time from the last nonworking week, night shift the day before the survey) and impaired relationships (such as conflict with another colleague intensivist, and/or with a nurse) were the variables independently associated with a higher MBI score. In contrast, the quality of the relationships with chief nurses and nurses was associated with a lower MBI score. CONCLUSIONS: Approximately one-half of the intensivists presented a high level of burnout. Organizational factors, but not factors related to the patients, appeared to be associated with burnout.
Published: 2007
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41. Perception and use of the results of patient satisfaction surveys by care providers in a French teaching hospital

Author: Georges Weil, José Labarère, Laurent Boyer, Elisabeth Doutre, Patrice Francois, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), TIMB, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble
Subjects: Male, Quality management, 0302 clinical medicine, Health care, MESH: Data Collection, 030212 general & internal medicine, MESH: Quality of Health Care, media_common, MESH: Aged, Total quality management, MESH: Middle Aged, Data Collection, 030503 health policy & services, Health Policy, Questionnaire, General Medicine, Middle Aged, 3. Good health, Patient Satisfaction, Female, Customer satisfaction, France, 0305 other medical science, Adult, medicine.medical_specialty, Adolescent, Attitude of Health Personnel, Health Personnel, media_common.quotation_subject, MESH: Attitude of Health Personnel, MEDLINE, 03 medical and health sciences, Patient satisfaction, medicine, Humans, Quality (business), Hospitals, Teaching, Aged, Quality of Health Care, MESH: Adolescent, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, MESH: Hospitals, Teaching, MESH: Male, MESH: Patient Satisfaction, MESH: France, Family medicine, MESH: Health Personnel, MESH: Total Quality Management, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Total Quality Management
Abstract: International audience; OBJECTIVE: . The aim of this study was to assess clinical staff's opinions on the results of in-patient satisfaction surveys and their use within the quality improvement process. SETTING: The institution is a 2200-bed teaching hospital of tertiary health care employing 8000 professionals. Patient satisfaction surveys are carried out each year using a validated questionnaire mailed to a random sample of patients. The specific results of each department are sent to the medical and paramedical managers. METHODS: We conducted a questionnaire survey on 500 care providers randomly selected in every medical and surgical department. RESULTS: A total of 261 questionnaires were returned and analysed. Overall, 94% of responders had a favourable opinion of the patient satisfaction surveys. They considered that the patient was able to judge hospital service quality, especially in its relational, organizational, and environmental dimensions. The specific results for the department were less well known than the overall hospital results (60 versus 76%). These results were formally discussed in the department according to 40% of responders; 40% declared that these data resulted in improvement actions and considered that they led to modifications in their behaviour with patients. CONCLUSIONS: Despite a declared interest in satisfaction surveys, the results remain underused by hospital staff and insufficiently discussed within teams.
Published: 2006
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42. Natural rubber latex allergy among health care workers: a systematic review of the evidence

Author: Jacques Ameille, C Pecquet, Karine Chevrie, Jean Bousquet, Antoine Flahault, Olivier Vandenplas, Jean-Jacques Duron, Isabella Annesi-Maesano, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de la Santé au Travail [Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Bousquet J, Flahault A, O Vandenplas, Ameille J, JJ Duron, C Pecquet, K Chevrie, and Annesi-Maesano je
Subjects: Allergy, Health Personnel, medicine.disease_cause, MESH: Occupational Exposure, 030207 dermatology & venereal diseases, 0302 clinical medicine, Allergen, Immunopathology, Prevalence, Immunology and Allergy, Prospective Studies, MESH: Incidence, Sensitization, MESH: Gloves, Protective, education.field_of_study, Incidence, 3. Good health, Occupational Diseases, medicine.anatomical_structure, Latex allergy, MESH: Occupational Diseases, medicine.medical_specialty, Occupational Diseases/*epidemiology/prevention & control, Immunology, Population, education, 03 medical and health sciences, MESH: Cross-Sectional Studies, Latex Hypersensitivity, MESH: Latex Hypersensitivity, Occupational Exposure, Internal medicine, medicine, Humans, MESH: Prevalence, Asthma, MESH: Humans, business.industry, Occupational Exposure/adverse effects, Odds ratio, medicine.disease, MESH: Prospective Studies, Cross-Sectional Studies, 030228 respiratory system, Latex Hypersensitivity/*epidemiology/prevention & control, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Gloves, Protective
Abstract: International audience; BACKGROUND: Natural rubber latex is a recognized allergen, but a recent meta-analysis failed to find any association between latex exposure and allergy in health care workers (HCWs). OBJECTIVES: A meta-analysis was carried out under the auspices of the French National Regulatory Authority to assess the allergic risk induced by latex gloves in HCWs. METHODS: The risk of work-related exposure to latex for the development of latex allergy was assessed. Prevalence and incidence rates of latex sensitization or allergy were compared in HCWs and in the general population. Exposure-response relationships were assessed in HCWs. RESULTS: Latex allergy was found in 4.32% (range, 4.01% to 4.63%) of HCWs and in 1.37% (range, 0.43% to 2.31%) of the general population. Latex-positive skin prick test responses ranged from 2.1% to 3.7% in the general population and from 6.9% to 7.8% for the HCWs. HCWs exposed to latex showed an increased risk of hand dermatitis (odds ratio [OR], 2.46; 95% CI, 2.11-2.86), asthma or wheezing (OR, 1.55; 95% CI, 1.15-2.08), rhinoconjunctivitis (OR, 2.73; 95% CI, 1.97-3.81), and at least one generic symptom (OR, 1.27; 95% CI, 1.09-1.47). Sensitization to latex was significantly associated with asthma and rhinoconjunctivitis. By contrast, exposure to latex was not associated with a significantly increased risk of positive skin prick test responses to latex (OR, 1.47; 95% CI, 0.94-2.30). CONCLUSION: HCWs have an increased risk of sensitization and allergic symptoms to latex. CLINICAL IMPLICATIONS: Prevention of latex allergy in HCWs is needed.
Published: 2006
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