48 research outputs found
Proximidad espacial y distancia social. Los grandes conjuntos de vivienda social y su población
Translated by Luis Campos M. and Malena Bastías S. Revised by Catherine PaquetteTraducción de Luis Campos M. y Malena Bastías S. Revisión de Catherine Paquett
Clinical research without consent in adults in the emergency setting: a review of patient and public views
<p>Abstract</p> <p>Background</p> <p>In emergency research, obtaining informed consent can be problematic. Research to develop and improve treatments for patients admitted to hospital with life-threatening and debilitating conditions is much needed yet the issue of research without consent (RWC) raises concerns about unethical practices and the loss of individual autonomy. Consistent with the policy and practice turn towards greater patient and public involvement in health care decisions, in the US, Canada and EU, guidelines and legislation implemented to protect patients and facilitate acute research with adults who are unable to give consent have been developed with little involvement of the lay public. This paper reviews research examining public opinion regarding RWC for research in emergency situations, and whether the rules and regulations permitting research of this kind are in accordance with the views of those who ultimately may be the most affected.</p> <p>Methods</p> <p>Seven electronic databases were searched: Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews, Philosopher's Index, Age Info, PsychInfo, Sociological Abstracts and Web of Science. Only those articles pertaining to the views of the public in the US, Canada and EU member states were included. Opinion pieces and those not published in English were excluded.</p> <p>Results</p> <p>Considering the wealth of literature on the perspectives of professionals, there was relatively little information about public attitudes. Twelve studies employing a range of research methods were identified. In five of the six questionnaire surveys around half the sample did <it>not </it>agree generally with RWC, though paradoxically, a higher percentage would <it>personally </it>take part in such a study. Unfortunately most of the studies were not designed to investigate individuals' views in any depth. There also appears to be a level of mistrust of medical research and some patients were more likely to accept an experimental treatment 'outside' of a research protocol.</p> <p>Conclusion</p> <p>There are too few data to evaluate whether the rules and regulations permitting RWC protects – or is acceptable to – the public. However, any attempts to engage the public should take place in the context of findings from further basic research to attend to the apparently paradoxical findings of some of the current surveys.</p
Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study
Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
Proximité spatiale et distance sociale. Les grands ensembles et leur peuplement
Jean-Claude Chamboredon, Madeleine Lemaire : Räumliche Nähe und soziale Distanz. Die Bevölkerung der städtischen Grossiedlungen ist eine vorgeformte Bevölkerung, die viele Eigentümlichkeiten ihrem Entstehungsvorgang schuldet. Dieser ist sehr verschieden von jenem, der dann stattfindet, wenn nur der Mechanismus des Immobilienmarktes in Gang gesetzt ist. — Dies führt zur Bildung einer heterogenen Bevölkerung, die diversifiert ist, einerseits durch die verschiedenen Kanale, die zur städtischen Grossiedlung führen und nebenbei durch die Veränderungen, die ein Niederlassen dort mit sich bringt. — So leben soziale Gruppen miteinander, die normalerweise räumlich getrennt sind und bei denen die Kontraste zwischen den verschiedenen Kategorien stark betont sind, starker als sie es normalerweise innerhalb der Bevolkerung der Gemeinde sind. — Das Verkennen der Bedingungen, die zur Bildung der Bevolkerung fuhren, erklärt zum Teil gewisse Tendenzen der Soziologie der neuen Wohneinheiten, die utopischen Neigungen und das ausschliessliche Betonen der Soziabilitat. Diese wird zum Nachteil des morphologischen Studium der Bevolkerung bevorzugt.Шамборедон, Жан-Клод и Лемер, Маделен : Пространственная близость и социальный дистанс.
Население больших ансамблев это население сформированное до этого, в котором проявлению многих его характеристик оно обязано процессу формирования резко отличающегося от такого, которое влияет только во время действия механизма рынка недвижимости. Это ведет к гетерогенному составу населения разнообразному благодаря различным формальным путям, ведущим к большому ансамблю и второстепенно, благодаря переменам наступающим при самом факте водворения в большом ансамбле. Итак, сосуществуют социальные группы, которые обыкновенно разделены пространством и в лоне которых контрасты между разными категориями сильно подчеркнуты и еще больше чем это обыкновенно встречается в среднем у населения общины.
Незнание условий формирования населения объясняет частично некоторые тенденции социологии новых единиц жилплоащди к утопическому настроению с исключительным нажимом на социабильность, привилегируя ее в ущерб морфологическому изучению населения.Jean-Claude Chamboredon and Madeleine Lemaire : Spatial proximity and social distance.
The population of big housing developments is preconstructed, it owes most of its characteristics to the manner in which the population was formed. Different factors operate when the mechanisms of the housing market alone, are considered. In the housing development, a heterogeneous population is formed and their diversity depends on the means of access to the development. In this way, social groups which are usually separated spatially, coexist; the contrasts are accentuated in these housing developments more than they normally are in the local population. Ignorance of the conditions of population formation explains in part, certain tendencies in the sociology of new housing developments, the Utopian vein and the exclusive insistence on sociability, at the expense of a morphological study of the population.Jean-Claude Chamboredon y Madeleine Lemaire : Proximidad espacial y distancia social.
La gente que vive en los grupos de edificios elevados es una población construida de antemano que debe muchas caracteristícas suyas al proceso de formación, muy diferente del que influye cuando sólo operan los mecanismos del mercado inmobiliaro. Eso lleva a la constitución de una población heterogénea que diversifican los diferentes trámites de acceso al edificio y secundariamente los cambrios que traen consigo la instalación en el edificio. Así pues, coexisten grupos sociales que, por lo común, están separados en el espacio y dentro de los cuales los contrastes entre categories diferentes resultan acentuados y más profundos que en la población del municipio. El desconocimiento de las condiciones de formación de la población explica en parte ciertas tendencies de la sociología de los nuevos grupos de habitacíon, la corriente utópica y la insistencia exclusiva sobre la sociabilidad, privilegiada a costa del estudio mor- fológico de la población.Chamboredon Jean-Claude, Lemaire Madeleine. Proximité spatiale et distance sociale. Les grands ensembles et leur peuplement. In: Revue française de sociologie, 1970, 11-1. pp. 3-33
Traductions et discriminations des compétences des jeunes dans un dispositif d'insertion : Voc'action: rapport final réalisé pour la Direction régionale ANPE-PACA
Cette étude s'inscrit dans le cadre d'une action expérimentale d'accompagnement de jeunes en situations précaires vers une intégration dans l'emploi : Voc'action. Cette action s'adressait à des jeunes de 16-25 ans issus de zones urbaines difficiles. Elle a concerné une centaine de jeunes répartis sur trois villes de la région PACA. Cette action a été menée en partenariat avec 3 acteurs institutionnels : l'ANPE, l'AFPA et l'Union Patronale régionale. Elle a associé tout au long de sa réalisation différents intervenants : centres de formation, centres de bilan, intervenants divers (animateurs, tuteurs d'entreprises)
Proximidad espacial y distancia social. Los grandes conjuntos de vivienda social y su población
Traducción de Luis Campos M. y Malena Bastías S. Revisión de Catherine Paquette
Durée du travail et déclin. De la norme du temps de travail : le sens de la mesure: rapport final pour la DARES
Résumé à venir.Des fiches d'entretiens situées en annexes du bilan présentent des extraits d'entretiens et leur contexte dans divers branches d'activités : "Industries agroalimentaires" ; "Fruit" : branche import-export ; "Viande" : industrie et commerce en gros de viande; Industrie sucrière; "Graine" : branche graines et semences, "bâtiment et travaux publics"; "Nettoyage et activité du déchet"; "Ordure" : entreprise de déchets et ordures ménagères; "Commerces et restauration"; "Transport" : routier, de fonds, sanitaires; Professions artistiques et culturelles; Secteur public et parapublic
Les techniciens dans un établissement d'une grosse société de l'aéronautique
Etude réalisée dans une grosse société nationale industrielle appartenant à la branche de la construction aéronautique dans le cadre d’un projet de recherche qui a donné lieu au rapport suivant : "L'insertion des femmes dans les professions de technicien supérieur de l'industrie liées aux nouvelles technologies : étude de cas dans la région PACA" / Anne-Marie Daune-Richard, Catherine Flament, Madeleine Lemaire, Catherine Marry. Rapport final financé par le CNRS dans le cadre du programme PIRTTEM-ANPE "Transformation de l'espace de qualification et insertion professionnelle". [Rapport de recherche] Laboratoire d'économie et de sociologie du travail (LEST). 1991, pp.25. ⟨halshs-03763685