67 research outputs found
Impact environnemental de la diffusion de produits phytosanitaires par ruissellement
Lâagriculture moderne sâest appuyĂ©e sur lâutilisation croissante de produits phytosanitaires. Toutefois, la contamination des milieux comme les impacts sanitaires sont aujourdâhui avĂ©rĂ©s. Le transfert de ces produits vers les eaux de surface ou souterraines pourrait conduire Ă lâexposition de la population gĂ©nĂ©rale rĂ©sidant Ă proximitĂ© des zones agricoles. Notre objectif vise Ă dĂ©finir une mĂ©thodologie pour caractĂ©riser lâalĂ©a de pollution rĂ©sultant tant de lâĂ©pandage direct de produits phytosanitaires que de leur transfert par ruissellement au sein dâun bassin versant. Cette mĂ©thodologie est testĂ©e sur deux zones oĂč les prĂ©cipitations intenses provoquent dâimportants ruissellements, lâune en Languedoc-Roussillon et lâautre Ă lâextrĂȘme Nord du Cameroun. La premiĂšre phase consiste Ă quantifier la pression phytosanitaire au niveau des communes de la zone dâĂ©tude grĂące Ă lâIndicateur de FrĂ©quence des Traitements (IFT). Ensuite, une analyse hydrologique, qui sâappuie sur lâadaptation de la mĂ©thode cartographique IRIP (Indicateur de lâalĂ©a inondation par Ruissellement Intense Pluvial), permet de caractĂ©riser les zones propices Ă la production ou Ă lâaccumulation du ruissellement. Enfin, lâutilisation dâun SystĂšme dâInformation GĂ©ographique (SIG) permet, en recoupant lâIFT et ces zones ruisselantes, de dĂ©finir diffĂ©rents niveaux dâalĂ©a de pollution au sein du bassin versant. Cette Ă©tude devrait permettre dâaffiner la dĂ©finition de lâexposition humaine dans les analyses Ă©pidĂ©miologiques en population gĂ©nĂ©rale. Cependant, lâabsence de prise en compte de la propagation aĂ©rienne et souterraine de ces produits constitue une de ses principales limites. Enfin, elle pourrait ĂȘtre complĂ©tĂ©e par la prise en compte des transferts dâeau souterrains pour mieux Ă©valuer la pollution au sein de lâhydrosystĂšme.Modern agriculture is based on the increasing use of pesticides. Environmental contamination by pesticides as well as the health impacts are now proven. The transfer of these products into surface waters or groundwater could lead to exposure of the general population living near agricultural areas. The study aims to provide a useful methodology to characterize the pollution risk resulting from the direct application of plant protection products and their transfer by runoff within a watershed. This methodology is tested on two areas where intense rainfall are causing major runoff, one in Languedoc-Roussillon (France) and the other in the extreme north of Cameroon. The first step is to quantify the pest pressure within the municipalities in the studied areas with the Treatment Frequency Index (IFT). Then in a second time a hydrological analysis, based on the adaptation of the cartographic method IRIP (Indicator of the flood hazard by Intense Pluvial runoff), allows a characterization of areas suitable for the production or accumulation of runoff. Finally, the use of a Geographic Information System (GIS) allows, by matching the IFT and the streaming areas to define different levels of pollution hazard within the watershed. This study should refine the definition of human exposure in epidemiological analyzes in the general population. However, the lack of consideration of the air and underground propagation of these products is one of its major limitations. Finally, it could be supplemented by the inclusion of underground water transfers to better assess the pollution in the river system
Migrant health in French Guiana: Are undocumented immigrants more vulnerable?
<p>Abstract</p> <p>Background</p> <p>Few data exist on the health status of the immigrant population in French Guiana. The main objective of this article was to identify differences in its health status in relation to that of the native-born population.</p> <p>Methods</p> <p>A representative, population-based, cross-sectional survey was conducted in 2009 among 1027 adults living in Cayenne and St-Laurent du Maroni. Health status was assessed in terms of self-perceived health, chronic diseases and functional limitations. The migration variables were immigration status, the duration of residence in French Guiana and the country of birth. Logistic regression models were conducted.</p> <p>Results</p> <p>Immigrants account for 40.5% and 57.8% of the adult population of Cayenne and St-Laurent du Maroni, respectively. Most of them (60.7% and 77.5%, respectively) had been living in French Guiana for more than 10 years. A large proportion were still undocumented or had a precarious legal status. The undocumented immigrants reported the worst health status (OR = 3.18 [1.21-7.84] for self-perceived health, OR = 2.79 [1.22-6.34] for a chronic disease, and OR = 2.17 [1.00-4.70] for a functional limitation). These differences are partially explained by socioeconomic status and psychosocial factors. The country of birth and the duration of residence also had an impact on health indicators.</p> <p>Conclusion</p> <p>Data on immigrant health are scarce in France, and more generally, immigrant health problems have been largely ignored in public health policies. Immigrant health status is of crucial interest to health policy planners, and it is especially relevant in French Guiana, considering the size of the foreign-born population in that region.</p
Severe ACTA1-related nemaline myopathy: intranuclear rods, cytoplasmic bodies, and enlarged perinuclear space as characteristic pathological features on muscle biopsies.
peer reviewedNemaline myopathy (NM) is a muscle disorder with broad clinical and genetic heterogeneity. The clinical presentation of affected individuals ranges from severe perinatal muscle weakness to milder childhood-onset forms, and the disease course and prognosis depends on the gene and mutation type. To date, 14 causative genes have been identified, and ACTA1 accounts for more than half of the severe NM cases. ACTA1 encodes α-actin, one of the principal components of the contractile units in skeletal muscle. We established a homogenous cohort of ten unreported families with severe NM, and we provide clinical, genetic, histological, and ultrastructural data. The patients manifested antenatal or neonatal muscle weakness requiring permanent respiratory assistance, and most deceased within the first months of life. DNA sequencing identified known or novel ACTA1 mutations in all. Morphological analyses of the muscle biopsy specimens showed characteristic features of NM histopathology including cytoplasmic and intranuclear rods, cytoplasmic bodies, and major myofibrillar disorganization. We also detected structural anomalies of the perinuclear space, emphasizing a physiological contribution of skeletal muscle α-actin to nuclear shape. In-depth investigations of the nuclei confirmed an abnormal localization of lamin A/C, Nesprin-1, and Nesprin-2, forming the main constituents of the nuclear lamina and the LINC complex and ensuring nuclear envelope integrity. To validate the relevance of our findings, we examined muscle samples from three previously reported ACTA1 cases, and we identified the same set of structural aberrations. Moreover, we measured an increased expression of cardiac α-actin in the muscle samples from the patients with longer lifespan, indicating a potential compensatory effect. Overall, this study expands the genetic and morphological spectrum of severe ACTA1-related nemaline myopathy, improves molecular diagnosis, highlights the enlargement of the perinuclear space as an ultrastructural hallmark, and indicates a potential genotype/phenotype correlation
Offre de soins et expansion urbaine, consĂ©quences pour lâaccĂšs aux soins. Lâexemple de Ouagadougou (Burkina Faso)
Ouagadougou, capitale exemplaire dâun processus dâurbanisation dâun pays africain, donne lieu par sa croissance spatiale rapide et peu contrĂŽlĂ©e Ă un mode original de production de lâespace sâaccompagnant du dĂ©veloppement de vastes zones dâhabitat spontanĂ©. Dans ce contexte dâĂ©talement spatial, les autoritĂ©s sanitaires ont tentĂ© de rĂ©pondre Ă la demande de soins par la mise en place de politiques planificatrices ayant des impacts sur lâagencement du territoire.Notre objectif est de confronter la croissance spatiale et lâĂ©volution du nombre et du type de structures de soins modernes dans la ville. Cette Ă©tude repose, dans un premier temps, sur des recherches bibliographiques et dâarchives qui ont permis de retracer les diffĂ©rentes Ă©tapes de la croissance spatiale de la ville depuis le dĂ©but du vingtiĂšme siĂšcle. Dans un second temps, nous avons apprĂ©hendĂ© les diffĂ©rents Ă©lĂ©ments qui composent le systĂšme de soins (CSPS, hĂŽpitaux, cabinets privĂ©s de soins infirmiers, etc.) comme un semis de points. Un indicateur simple et synthĂ©tique de concentration a Ă©tĂ© utilisĂ© pour caractĂ©riser les formes des distributions spatiales des Ă©tablissements de soins dans la ville. Les infrastructures publiques sont rĂ©guliĂšrement rĂ©parties dans la ville ; leur distribution tĂ©moigne de la volontĂ© des pouvoirs publics dâassurer Ă lâensemble de la population une forme dâĂ©quitĂ© dans lâaccĂšs physique aux soins. La rĂ©partition spatiale des Ă©tablissements de soins privĂ©s, caractĂ©risĂ©e par des zones de concentration au centre de la ville et autour des plus grands axes de communication, souligne la logique marchande de leur implantation.Ces recompositions de lâespace sanitaire de la ville ne sont pas sans consĂ©quences sur lâaccĂšs aux soins et se traduisent par un accroissement des inĂ©galitĂ©s physiques dâaccĂšs aux soins, notamment pour les populations des quartiers pĂ©riphĂ©riques, plus particuliĂšrement des quartiers non lotis.Ouagadougou, exemplary capital city of an African country urbanization process, gives place by its fast and little controlled space growth to an original mode of space production being accompanied by the development of vast zones of spontaneous habitat. In this context of urban spreading out, the medical authorities tried to answer at the request of care by the installation of planning policies having impacts on the fitting of the territory. The aim of our study was to confront the space growth and the evolution of the number and the type of modern care structures in the city. This analysis rests, initially, on library searches and files which made it possible to recall the various stages of the space growth of the city since the beginning of the twentieth century. In the second time, we apprehended the various elements which make the system of care (CSPS, hospital, private cabinets of nursesâ care, etc.) like a sowing of points. A simple and synthetic concentration indicator was used to characterize the forms of spatial distributions of the health.care establishments in the city. The public infrastructures are regularly distributed in the city; their distribution testifies to the authorities' willpower to ensure the whole population a form of equity in the physical access to the care. The space distribution of the private health care establishments, characterized by zones of concentration in the city center and near the largest axes of communication, underlines the commercial logic of their implantation. These recombining of the sanitary city space have consequences on the access to care and result in an increase in the physical inequalities of care access, in particular for the populations of the peripheral districts, more particularly of the not parcelled out districts
Canicule et surmortalité à Paris en août 2003
The excess mortality related to the August 2003 heat-wave occurred with different intensity according to places: it was more important in Ăle-de-France and in the Centre region that in other areas of France. Its impact was more massive in urban environment than in the rural communes. In Paris, the expression of the excess mortality was clearly exacerbated with an increase of almost 190% of mortality between 1st and August 20th 2003 compared to the previous years. However, this extra-mortality did not occur in a homogeneous way in the city. The analysis of the space disparities of mortality in the city was led on the deaths domiciled according to two levels of aggregation, the districts (20) and the quarters (80). It rests, in other, on the cartography of simple indicators of mortality (standardized ratio of mortality) and of excess mortality. The determination of the factors of social risks (socio-demographic and socio-economic characteristics of the population) and contextual (temperature, pollution) is based on the construction of a Poisson regression model. In 2003 a space structure of mortality very different from that of the previous years review was highlighted: it is characterized by a pole of excess mortality in the south of the city. This shift of mortality is the result of a narrow intrication between socio-economic factors and other factors, such as the levels of pollution or the intra-urban variations of temperature. Beyond the dramatic dimension of this without precedent event, the study puts forward the social and economic precariousness of a part of the old population in the capital. This study thus stresses in a strong way the importance of the links between various dimensions (medical, social and contextual) of a health phenomenon
Offre de soins et expansion urbaine, consĂ©quences pour lâaccĂšs aux soins. Lâexemple de Ouagadougou (Burkina Faso)
Ouagadougou, exemplary capital city of an African country urbanization process, gives place by its fast and little controlled space growth to an original mode of space production being accompanied by the development of vast zones of spontaneous habitat. In this context of urban spreading out, the medical authorities tried to answer at the request of care by the installation of planning policies having impacts on the fitting of the territory. The aim of our study was to confront the space growth and the evolution of the number and the type of modern care structures in the city. This analysis rests, initially, on library searches and files which made it possible to recall the various stages of the space growth of the city since the beginning of the twentieth century. In the second time, we apprehended the various elements which make the system of care (CSPS, hospital, private cabinets of nursesâ care, etc.) like a sowing of points. A simple and synthetic concentration indicator was used to characterize the forms of spatial distributions of the health.care establishments in the city. The public infrastructures are regularly distributed in the city; their distribution testifies to the authorities' willpower to ensure the whole population a form of equity in the physical access to the care. The space distribution of the private health care establishments, characterized by zones of concentration in the city center and near the largest axes of communication, underlines the commercial logic of their implantation. These recombining of the sanitary city space have consequences on the access to care and result in an increase in the physical inequalities of care access, in particular for the populations of the peripheral districts, more particularly of the not parcelled out districts
Canicule et surmortalité à Paris en août 2003, le poids des facteurs socio-économiques
AccĂšs au texte intĂ©gral : http://eps.revues.org/index1383.htmlNational audienceLa surmortalitĂ© exceptionnelle observĂ©e parallĂšlement Ă l'Ă©pisode caniculaire d'aoĂ»t 2003 s'est produite avec une intensitĂ© diffĂ©rente selon les lieux : elle a Ă©tĂ© plus importante en Ăle-de-France et dans le Centre que dans d'autres rĂ©gions de France. Son impact a Ă©tĂ© plus massif en milieu urbain que dans les communes rurales. Ă Paris, l'expression de ce phĂ©nomĂšne a Ă©tĂ© particuliĂšrement exacerbĂ©e, avec une augmentation de prĂšs de 190% de la mortalitĂ© entre le 1er et le 20 aoĂ»t 2003 par rapport aux annĂ©es antĂ©rieures. Toutefois, cette surmortalitĂ© ne s'est pas produite de maniĂšre homogĂšne dans la ville. L'analyse des disparitĂ©s spatiales de mortalitĂ© dans la ville a Ă©tĂ© conduite sur les dĂ©cĂšs domiciliĂ©s selon deux niveaux d'agrĂ©gation, les arrondissements (au nombre de 20) et les quartiers (80). Elle repose sur la cartographie d'indicateurs simples de mortalitĂ© (ratio standardisĂ© de mortalitĂ©) et de surmortalitĂ© (ratio de mortalitĂ©). La dĂ©termination des facteurs de risques sociaux (caractĂ©ristiques socio-dĂ©mographiques et socio-Ă©conomiques de la population) et contextuels (tempĂ©rature, pollution, niveau socio-Ă©conomique du quartier) s'appuie sur la construction d'un modĂšle de rĂ©gression poissonnien. En 2003 une structure spatiale de mortalitĂ© diffĂ©rente de celle des annĂ©es de rĂ©fĂ©rence est mise en Ă©vidence qui se caractĂ©rise par un pĂŽle de surmortalitĂ© au sud de la ville. Ce dĂ©calage de la mortalitĂ© au cours de la canicule par rapport aux annĂ©es sans canicule pourrait s'expliquer par l'intrication Ă©troite entre des facteurs socio-Ă©conomiques et d'autres facteurs, tels que les niveaux de pollution ou les variations intra-urbaines de tempĂ©rature. Au-delĂ de la dimension dramatique de cet Ă©vĂ©nement sans prĂ©cĂ©dent, l'Ă©tude met en exergue la prĂ©caritĂ© sociale et Ă©conomique d'une partie de la population ĂągĂ©e de la capitale. Cette Ă©tude souligne donc de maniĂšre forte l'importance des liens rĂ©ciproques entre les diffĂ©rentes dimensions (sanitaires, sociales et contextuelles) d'un phĂ©nomĂšne de santĂ©
Canicule et surmortalité à Paris en août 2003, le poids des facteurs socio-économiques
AccĂšs au texte intĂ©gral : http://eps.revues.org/index1383.htmlNational audienceLa surmortalitĂ© exceptionnelle observĂ©e parallĂšlement Ă l'Ă©pisode caniculaire d'aoĂ»t 2003 s'est produite avec une intensitĂ© diffĂ©rente selon les lieux : elle a Ă©tĂ© plus importante en Ăle-de-France et dans le Centre que dans d'autres rĂ©gions de France. Son impact a Ă©tĂ© plus massif en milieu urbain que dans les communes rurales. Ă Paris, l'expression de ce phĂ©nomĂšne a Ă©tĂ© particuliĂšrement exacerbĂ©e, avec une augmentation de prĂšs de 190% de la mortalitĂ© entre le 1er et le 20 aoĂ»t 2003 par rapport aux annĂ©es antĂ©rieures. Toutefois, cette surmortalitĂ© ne s'est pas produite de maniĂšre homogĂšne dans la ville. L'analyse des disparitĂ©s spatiales de mortalitĂ© dans la ville a Ă©tĂ© conduite sur les dĂ©cĂšs domiciliĂ©s selon deux niveaux d'agrĂ©gation, les arrondissements (au nombre de 20) et les quartiers (80). Elle repose sur la cartographie d'indicateurs simples de mortalitĂ© (ratio standardisĂ© de mortalitĂ©) et de surmortalitĂ© (ratio de mortalitĂ©). La dĂ©termination des facteurs de risques sociaux (caractĂ©ristiques socio-dĂ©mographiques et socio-Ă©conomiques de la population) et contextuels (tempĂ©rature, pollution, niveau socio-Ă©conomique du quartier) s'appuie sur la construction d'un modĂšle de rĂ©gression poissonnien. En 2003 une structure spatiale de mortalitĂ© diffĂ©rente de celle des annĂ©es de rĂ©fĂ©rence est mise en Ă©vidence qui se caractĂ©rise par un pĂŽle de surmortalitĂ© au sud de la ville. Ce dĂ©calage de la mortalitĂ© au cours de la canicule par rapport aux annĂ©es sans canicule pourrait s'expliquer par l'intrication Ă©troite entre des facteurs socio-Ă©conomiques et d'autres facteurs, tels que les niveaux de pollution ou les variations intra-urbaines de tempĂ©rature. Au-delĂ de la dimension dramatique de cet Ă©vĂ©nement sans prĂ©cĂ©dent, l'Ă©tude met en exergue la prĂ©caritĂ© sociale et Ă©conomique d'une partie de la population ĂągĂ©e de la capitale. Cette Ă©tude souligne donc de maniĂšre forte l'importance des liens rĂ©ciproques entre les diffĂ©rentes dimensions (sanitaires, sociales et contextuelles) d'un phĂ©nomĂšne de santĂ©
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