Momar-Coumba Diop, Pauvreté, jeunes de la rue et sida : Les cas d’Abidjan et d’Accra

Ce livre propose les résultats d’une enquête menée auprès des jeunes de la rue par le Programme de gestion Urbaine et le Programme de lutte contre le sida de la GTZ. Les auteurs mettent en évidence les rapports qui existent entre la pauvreté urbaine et le sida dans les villes d’Abidjan et d’Accra. Leur objectif est de fournir des outils méthodologiques aux différents décideurs urbains pour qu’ils initient des projets et des lois visant à enrayer ce phénomène. Les thèmes de l’accès aux soins, ..

Proportion and number of upper-extremity musculoskeletal disorders attributable to the combined effect of biomechanical and psychosocial risk factors in a working population

The objective of this paper is to assess the combined effect of occupational biomechanical and psychosocial risk factors on the incidence of work-related upper-extremity musculoskeletal disorders (UEMSDs) and estimate the proportion and number of incident cases attributable to these risk factors in a working population. Using data from the French COSALI (COhorte des SAlariés LIgériens) cohort (enrolment phase: 2002-2005; follow-up phase: 2007-2010), a complete case analysis including 1246 workers (59% men, mean age: 38 years ± 8.6 at baseline) was performed. All participants underwent a standardized clinical examination at enrolment and 1611 workers were re-examined at follow-up. Population attributable fractions and the number of UEMSD cases attributable to occupational risk factors were calculated. During follow-up, 139 UEMSD cases were diagnosed, representing an estimated 129,320 projected incident UEMSD cases in the working population. After adjusting for personal factors, in model 1, 8664 cases (6.7%) were attributable to low social support, 19,010 (14.7%) to high physical exertion, and 20,443 (15.8%) to co-exposure to both factors. In model 2, 16,294 (12.6%) cases were attributable to low social support, 6983 (5.4%) to posture with arms above shoulder level, and 5043 (3.9%) to co-exposure to both factors. Our findings suggest that many cases of UEMSD could be potentially prevented by multidimensional interventions aimed at reducing exposure to high physical exertion and improving social support at work

Syndrome du canal carpien : impact de la co-exposition à des agents neurotoxiques et à des contraintes biomécaniques

Le syndrome du canal carpien est l’une des principales causes de maladie professionnelle. Dans un grand nombre de situations de travail, les travailleurs sont confrontés à des expositions multiples, mais peu de données sont disponibles sur les co-expositions des travailleurs à des agents chimiques neurotoxiques et à des contraintes biomécaniques

Evaluating beauty care provided by the hospital to women suffering from breast cancer: qualitative aspects

International audienceGOALS OF WORK: Cancer patients are offered more and more access to beauty care during their stay in the hospital. This kind of intervention has not been evaluated yet. Primary objective of our research was to determine what type of evaluation strategy to be implemented (as a supportive care with quality of life and/or medical benefits; as a service providing immediate comfort); intermediate objective was to investigate in scientific terms (psychological, sociological) the experience of beauty care by patients. PATIENTS AND METHODS: Sixty patients (all users of beauty care provided by hospital, 58 female, most of them treated for breast cancer, two male, mean age 53 years) and 11 nurses and physicians, from four French cancer centres were included. We used direct observation and semi-structured interviews, conducted by a sociologist and a psychologist; different types of beauty care were concerned. RESULTS: All the interviewed patients were satisfied. Patients appreciated acquiring savoir-faire on how to use make-up and on personal image enhancement. Psychological and social well-being benefits were mentioned. The beauty care was not alleged to be reducing the side effects of the treatments, but it had helped patients to accept or bear the burden of them. Providing care beyond that which is directly curative was appreciated by the patients as a sign that they were treated as a "whole" person. CONCLUSION: The survey brings valuable clues concerning beauty care experience by cancer patients; it suggests the relevance of quantitative evaluation of the immediate and long-term effects on the quality of life

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Occupational risk factors of shoulder disorders : interest in taking into account organizational factors

Les troubles musculo-squelettiques (TMS) sont une des questions les plus préoccupantes en santé au travail. Ils témoignent de l’intensification des conditions de travail qui affecte un nombre croissant de travailleurs. L’objectif de cette thèse était d’étudier les relations complexes entre les facteurs professionnels, notamment organisationnels, et les TMS de l’épaule.Trois populations salariées ont été étudiées : la cohorte Cosali et deux entreprises automobile et pharmaceutique. L’étude des caractéristiques organisationnelles des situations de travail par classifications ascendantes hiérarchiques des variables et des individus de la cohorte Cosali a identifié une classe d’organisation de type taylorien. Chez ces salariés, les douleurs et TMS de l’épaule étaient plus fréquents. Des modèles à équations structurelles ont montré que les facteurs organisationnels étaient des déterminants distaux des TMS en influençant l’exposition aux facteurs psychosociaux et physiques, alors que l’exposition aux facteurs physiques influençait à son tour les douleurs de l’épaule. L’application de la méthodologie aux deux populations des entreprises automobile et pharmaceutique a confirmé la pertinence du modèle issu de Cosali. En conclusion, les facteurs organisationnels sont des déterminants clés de la survenue des TMS de l’épaule en influençant en cascade les conditions d'exposition aux facteurs psychosociaux et physiques auxquels les travailleurs doivent faire face. Ces connaissances épidémiologiques originales améliorent la compréhension de la chaîne de déterminants des TMS et contribueront au ciblage des interventions de prévention sur les déterminants professionnels modifiables.Musculoskeletal disorders (MSDs) represent one of the most worrying issues in occupational health. They bear witness to the intensification of working conditions which affects an increasing number of workers. The aim of this thesis was to study the complex relationships between occupational factors and shoulder disorders, with attention paid to organizational factors. Three working populations were studied : the Cosali cohort, one automobile company and one pharmaceutical company. The study of the organizational characteristics of work situations by ascendant hierarchical clustering of variables and individuals of the Cosali cohort identified a Taylorist form of work organization. Among these employees, shoulder disorders were more frequent. Structural equation modeling has shown that organizational factors are distal determinants of MSDs by influencing exposure to psychosocial and physical factors, while exposure to physical factors in turn influences shoulder pain. The application of the methodology to the two populations of automotive and pharmaceutical companies confirmed the relevance of the Cosali model. In conclusion, organizational factors are key determinants of the onset of shoulder disorders by cascading the conditions of exposure to the psychosocial and physical factors that workers face. This original epidemiological knowledge improves understanding of the chain of determinants of MSDs and will contribute to the targeting of prevention interventions on modifiable occupational determinants