L’imparfait dans la quête

Ce témoignage relate l’histoire d’une collecte menée dans l’île de Noirmoutier au début des années quatre-vingts par une enfant du pays à la recherche de ses racines et confrontée à l’état parcellaire et mouvant des littératures orales. Entre sentiment d’appartenance insulaire, et perception intime, la recherche révèle l’importance et la place du fragment au sein de l’analyse.The author relates her fieldwork on the island of Noirmoutier at the beginning of the 1980s. As a “child of the land” in search of her roots, she allied an intimate perception of things with an analytical stance. Confronted with a fragmentary and ever-changing body of oral literature, her analysis reveals the importance of the fragment

Rire pour mieux résister. Les conteurs-menteurs de Noirmoutier

Les textes qui vont suivre appartiennent au répertoire des conteurs-menteurs de l’île de Noirmoutier en Vendée. Collectés en 1980, ils appuient une pratique orale vivante et facétieuse qui perdure sous différentes formes, encore aujourd’hui.   COMMUNE LIBRE DE GABION LISTE DE REDRESSEMENT, D’UNION, DE TORSION ET DE DÉRISION MONSALEFernandPropriétaire inondéMAFIRaimondMarin en permissionLACOLOElle est au nordJournalistePATOUPierreGratteurMANICHEAiméExpert-comptableDIGOURDITTEHenriCrieurBRONNEQ..

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Pratiques d’enquêtes

Les années 1960 ont marqué un tournant pour les recherches en littérature orale, tant du point de vue théorique que méthodologique. À partir de recherches, d'époques et de terrains différents, ce double numéro montre ce qu'apportent les avancées technologiques (de l'enregistreur cassette au numérique) dans les manières de concevoir la production orale (avec la question de la performance) et dans celles de sa restitution (notamment avec le numérique). Ces avancées ne peuvent toutefois être abordées sans une réflexion d'ordre éthique ; réflexion qui ne laissent nullement indifférents les collaborateurs de ce double numéro

The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19)

International audienceAbstract Background It is not clear whether pre-existing macrovascular complications (ischemic heart disease, stroke or peripheral artery disease) are associated with health outcomes in people with diabetes mellitus hospitalized for COVID-19. Methods We conducted cohort studies of adults with pre-existing diabetes hospitalized for COVID-19 infection in the UK, France, and Spain during the early phase of the pandemic (between March 2020—October 2020). Logistic regression models adjusted for demographic factors and other comorbidities were used to determine associations between previous macrovascular disease and relevant clinical outcomes: mortality, intensive care unit (ICU) admission and use of invasive mechanical ventilation (IMV) during the hospitalization. Output from individual logistic regression models for each cohort was combined in a meta-analysis. Results Complete data were available for 4,106 (60.4%) individuals. Of these, 1,652 (40.2%) had any prior macrovascular disease of whom 28.5% of patients died. Mortality was higher for people with compared to those without previous macrovascular disease (37.7% vs 22.4%). The combined crude odds ratio (OR) for previous macrovascular disease and mortality for all four cohorts was 2.12 (95% CI 1.83–2.45 with an I 2 of 60%, reduced after adjustments for age, sex, type of diabetes, hypertension, microvascular disease, ethnicity, and BMI to adjusted OR 1.53 [95% CI 1.29–1.81]) for the three cohorts. Further analysis revealed that ischemic heart disease and cerebrovascular disease were the main contributors of adverse outcomes. However, proportions of people admitted to ICU (adjOR 0.48 [95% CI 0.31–0.75], I 2 60%) and the use of IMV during hospitalization (adjOR 0.52 [95% CI 0.40–0.68], I 2 37%) were significantly lower for people with previous macrovascular disease. Conclusions This large multinational study of people with diabetes mellitus hospitalized for COVID-19 demonstrates that previous macrovascular disease is associated with higher mortality and lower proportions admitted to ICU and treated with IMV during hospitalization suggesting selective admission criteria. Our findings highlight the importance correctly assess the prognosis and intensive monitoring in this high-risk group of patients and emphasize the need to design specific public health programs aimed to prevent SARS-CoV-2 infection in this subgroup

Type 1 Diabetes in People Hospitalized for COVID-19: New Insights From the CORONADO Study

International audienc