La reconstitution de l'offre dans les opérations de renouvellement urbain de 2000 à 2004

Contexte :Cette démarche fait suite à une première analyse conduite en 2002 - 2003, par le Certu et quatre cete, ayant abouti à l’élaboration d'un ouvrage intitulé : « Renouvellement urbain - Enseignements de 15 opérations de démolition/reconstruction " . Ce document, destiné aux acteurs du renouvellement urbain et en particulier aux DDE, a souligné la difficulté de reconstituer une offre sociale à l'échelle des agglomérations . Il a également pointé la nécessité d'une meilleure utilisation des PLH pour décliner des politiques de re-développement de l'offre plus équilibrées au sein des Communautés d'Agglomération. C'est pourquoi la DGUHC a souhaité qu'une nouvelle investigation soit réalisée autour de cette double question. Résumé : Au travers des analyses de sites concernant dix agglomérations, l'objectif poursuivi est :- d'analyser la définition, le contenu et la mise en œuvre des politiques de reconstitution de l'offre dans les opérations de renouvellement urbain, à l'échelle de l'agglomération. n - d'apprécier l'articulation entre la reconstitution de l'offre des opérations de renouvellement urbain et les politiques locales de l'habitat. - de favoriser la connaissance des pratiques au regard de la problématique formulée, en premier lieu dans le réseau de l'Équipement, mais aussi auprès des collectivités ou auprès d'autres acteurs du renouvellement urbain. L'étude a été conduite dans un contexte très évolutif en matière de réglementations, de financements et de stratégies institutionnelles avec, d'une part, la création de l'Agence Nationale de la Rénovation Urbaine et, d'autre part, la délégation de compétence aux collectivités locales en matière d'attribution d'aides à la pierre, ouverte par la loi du 13 août 2004 relative aux libertés et responsabilités locales . Elle n'a donc pas vocation à édicter des éléments de doctrine, elle rend compte d'intentions locales, dresse un certain nombre de constats, et tente d'en tirer de premiers enseignements dans le cadre de processus opérationnels, souvent à des stades très amon

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

La reconstitution de l'offre dans les opérations de renouvellement urbain de 2000 à 2004

Contexte :Cette démarche fait suite à une première analyse conduite en 2002 - 2003, par le Certu et quatre cete, ayant abouti à l’élaboration d'un ouvrage intitulé : « Renouvellement urbain - Enseignements de 15 opérations de démolition/reconstruction " . Ce document, destiné aux acteurs du renouvellement urbain et en particulier aux DDE, a souligné la difficulté de reconstituer une offre sociale à l'échelle des agglomérations . Il a également pointé la nécessité d'une meilleure utilisation des PLH pour décliner des politiques de re-développement de l'offre plus équilibrées au sein des Communautés d'Agglomération. C'est pourquoi la DGUHC a souhaité qu'une nouvelle investigation soit réalisée autour de cette double question. Résumé : Au travers des analyses de sites concernant dix agglomérations, l'objectif poursuivi est :- d'analyser la définition, le contenu et la mise en œuvre des politiques de reconstitution de l'offre dans les opérations de renouvellement urbain, à l'échelle de l'agglomération. n - d'apprécier l'articulation entre la reconstitution de l'offre des opérations de renouvellement urbain et les politiques locales de l'habitat. - de favoriser la connaissance des pratiques au regard de la problématique formulée, en premier lieu dans le réseau de l'Équipement, mais aussi auprès des collectivités ou auprès d'autres acteurs du renouvellement urbain. L'étude a été conduite dans un contexte très évolutif en matière de réglementations, de financements et de stratégies institutionnelles avec, d'une part, la création de l'Agence Nationale de la Rénovation Urbaine et, d'autre part, la délégation de compétence aux collectivités locales en matière d'attribution d'aides à la pierre, ouverte par la loi du 13 août 2004 relative aux libertés et responsabilités locales . Elle n'a donc pas vocation à édicter des éléments de doctrine, elle rend compte d'intentions locales, dresse un certain nombre de constats, et tente d'en tirer de premiers enseignements dans le cadre de processus opérationnels, souvent à des stades très amon

La reconstitution de l'offre dans les opérations de renouvellement urbain de 2000 à 2004

première analyse conduite en 2002 - 2003, par le Certu et quatre d'un ouvrage intitulé : « Renouvellement urbain - Enseignements Cette démarche fait suite à une Cete, ayant abouti à l'élaboration de 15 opérations de démolition/reconstruction D . Ce document, destiné aux acteurs du de reconstituer une offre d'une meilleure utilisation plus équilibrées au sein des soit réalisée autour de cette poursuivi est : renouvellement urbain et en particulier aux DDE, a souligné la difficulté sociale à l'échelle des agglomérations . Il a également pointé la nécessité des PLH pour décliner des politiques de re-développement de l'offre Communautés d'Agglomération. C'est pourquoi la DGUHC a souhaité qu'une nouvelle investigation double question. Résumé : Au travers des analyses de sites concernant dix agglomérations, l'objectif • d'analyser la définition, le contenu et la mise en oeuvre des politiques de reconstitution de l'offre dans les opérations de renouvellement urbain, à l'échelle de l'agglomération. n d'apprécier l'articulation entre la reconstitution de l'offre des opérations de renouvellement urbain et les politiques locales de l'habitat. • de favoriser la connaissance des pratiques au regard de la problématique formulée, en premier lieu dans le réseau de l'Équipement, mais aussi auprès des collectivités ou auprès d'autres acteurs du renouvellement urbain. L'étude a été conduite dans un contexte très évolutif en matière de réglementations, de financements et de stratégies institutionnelles avec, d'une part, la création de l'Agence Nationale de la Rénovation Urbaine et, d'autre part, la délégation de compétence aux collectivités locales en matière d'attribution d'aides à la pierre, ouverte par la loi du 13 août 2004 relative aux libertés et responsabilités locales . Elle n'a donc pas vocation à édicter des éléments de doctrine, elle rend compte d'intentions locales, dresse un certain nombre de constats, et tente d'en tirer de premiers enseignements dans le cadre de processus opérationnels, souvent à des stades très amont.66 pages, tableaux.Ministère de l'Equipement, Direction générale de l'Urbanisme, de l'Habitat et de la construction (DGUHC

Impact on disease mortality of clinical, biological, and virological characteristics at hospital admission and overtime in COVID‐19 patients

International audienc

Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life

International audienceBackground: Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients' quality of life.Methods: In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed.Results: Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54-4.90]; p < 0.001), pre-existing headaches before meningitis (OR: 2.38 [1.32-4.30]; p < 0.01), higher neutrophilic polynuclei percentage in the CSF of the initial lumbar puncture (OR: 1.02 [1.00-1.04]; p < 0.05), and brain abscess during the initial hospitalisation (OR: 8.32 [1.97-35.16]; p < 0.01) were associated with M12 persistent headaches. Neither the responsible microorganism, nor the corticoids use were associated with M12 persistent headaches. M12 neuro-functional disability (altered Glasgow Outcome Scale; p < 0.01), M12 physical handicap (altered modified Rankin score; p < 0.001), M12 depressive symptoms (p < 0.0001), and M12 altered physical (p < 0.05) and mental (p < 0.0001) qualities of life were associated with M12 headaches.Conclusion: Persistent headaches are frequent one year after meningitis and are associated with quality of life alteration

One-Year Sequelae and Quality of Life in Adults with Meningococcal Meningitis: Lessons from the COMBAT Multicentre Prospective Study

Trial registration: ClinicalTrial.Gov identification number NCT01730690.International audienceIntroduction: COMBAT is a prospective, multicentre cohort study that enrolled consecutive adults with community-acquired bacterial meningitis (CABM) in 69 participating centres in France between February 2013 and July 2015 and followed them for 1 year.Methods: Patients aged at least 18 years old, hospitalised with CABM were followed during their hospitalisation and then contacted by phone 12 months after enrolment. Here we present the prevalence of sequelae at 12 months in a subgroup of patients with meningococcal meningitis.Results: Five of the 111 patients with meningococcal meningitis died during initial hospitalisation and two died between discharge and 12 months, leaving 104 patients alive 1 year after enrolment, 71 of whom provided 12-month follow-up data. The median age was 30.0 years and 54.1% of the patients had no identified risk factor for meningitis. More than 30% reported persistent headache, more than 40% were not satisfied with their sleep and 10% had concentration difficulties. Hearing loss was present in about 15% of the patients and more than 30% had depressive symptoms. About 13% of the patients with a previous professional activity had not resumed work. On the SF-12 Health Survey, almost 50% and 30% had physical component or mental component scores lower than the 25th percentile of the score distribution in the French general population. There was a non-significant improvement in the patients' disability scores from hospital discharge to 12 months (p = 0.16), but about 10% of the patients had residual disability.Conclusions: Although most patients in our cohort survive meningococcal meningitis, the long-term burden is substantial and therefore it is important to ensure a prolonged follow-up of survivors and to promote preventive strategies, including vaccination

Relationship between serotypes, disease characteristics and 30-day mortality in adults with invasive pneumococcal disease

International audienc

Sex differences in post-acute neurological sequelae of SARS-CoV-2 and symptom resolution in adults after coronavirus disease 2019 hospitalization: an international multi-centre prospective observational study

: Although it is known that coronavirus disease 2019 can present with a range of neurological manifestations and in-hospital complications, sparse data exist on whether these initial neurological symptoms of coronavirus disease 2019 are closely associated with post-acute neurological sequelae of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2; PANSC) and whether female versus male sex impacts symptom resolution. In this international, multi-centre, prospective, observational study across 407 sites from 15 countries (30 January 2020 to 30 April 2022), we report the prevalence and risk factors of PANSC among hospitalized adults and investigate the differences between males and females on neurological symptom resolution over time. PANSC symptoms included altered consciousness/confusion, fatigue/malaise, anosmia, dysgeusia and muscle ache/joint pain, on which information was collected at index hospitalization and during follow-up assessments. The analysis considered a time to the resolution of individual and all neurological symptoms. The resulting times were modelled by Weibull regression, assuming mixed-case interval censoring, with sex and age included as covariates. The model results were summarized as cumulative probability functions and age-adjusted and sex-adjusted median times to resolution. We included 6862 hospitalized adults with coronavirus disease 2019, who had follow-up assessments. The median age of the participants was 57 years (39.2% females). Males and females had similar baseline characteristics, except that more males (versus females) were admitted to the intensive care unit (30.5 versus 20.3%) and received mechanical ventilation (17.2 versus 11.8%). Approximately 70% of patients had multiple neurological symptoms at the first follow-up (median = 102 days). Fatigue (49.9%) and myalgia/arthralgia (45.2%) were the most prevalent symptoms of PANSC at the initial follow-up. The reported prevalence in females was generally higher (versus males) for all symptoms. At 12 months, anosmia and dysgeusia were resolved in most patients, although fatigue, altered consciousness and myalgia remained unresolved in &gt;10% of the cohort. Females had a longer time to the resolution (5.2 versus 3.4 months) of neurological symptoms at follow-up for those with more than one neurological symptom. In the multivariable analysis, males were associated with a shorter time to the resolution of symptoms (hazard ratio = 1.53; 95% confidence interval = 1.39-1.69). Intensive care unit admission was associated with a longer time to the resolution of symptoms (hazard ratio = 0.68; 95% confidence interval = 0.60-0.77). Post-discharge stroke was uncommon (0.3% in females and 0.5% in males). Despite the methodological challenges involved in the collection of survey data, this international multi-centre prospective cohort study demonstrated that PANSC following index hospitalization was high. Symptom prevalence was higher and took longer to resolve in females than in males. This supported the fact that while males were sicker during acute illness, females were disproportionately affected by PANSC