Impact of COVID-19 pandemic on characteristics, extent and trends in child maltreatment in 34 Euro-CAN COST Action countries: a scoping review protocol.

Introduction While the factors commonly associated with an increased risk of child maltreatment (CM) were found to be increased during COVID-19, reports of actual maltreatment showed varying trends. Similarly, evidence regarding the impact of COVID-19 on CM within the European Cooperation on Science and Technology and Network Collaborative (COST) Action countries remains inconsistent. This scoping review aims to explore the extent and nature of evidence pertaining to CM within the countries affiliated with the Child Abuse and Neglect in Europe Action Network (Euro-CAN), funded by the COST. Methods and analysis Key electronic databases were searched to identify eligible papers, reports and other material published between January 2020 and April 2023: PubMed, EMBASE, PsycINFO, Social Policy and Practice, Scopus and Web of Science. To cover the breadth of evidence, a systematic and broad search strategy was applied using a combination of keywords and controlled vocabulary for four concepts: children, maltreatment, COVID-19 and Euro-CAN countries, without restrictions on study design or language. Grey literature was searched in OpenGrey and Google Scholar. Two reviewers will independently screen full-text publications for eligibility and undertake data extraction, using a customised grid. The screening criteria and data charting will be piloted by the research team.The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews will be followed to present the results. Results will be summarised in a tabular form and narratively. Ethics and dissemination This review will identify and summarise publicly available data, without requiring ethical approval. The findings will be disseminated to the Euro-CAN Network and reported to the COST Association. They will also be published in a peer-reviewed journal. This protocol is registered on Open Science Framework

Impact of COVID-19 pandemic on characteristics, extent and trends in child maltreatment in 34 Euro-CAN COST Action countries: a scoping review protocol

Introduction While the factors commonly associated with an increased risk of child maltreatment (CM) were found to be increased during COVID-19, reports of actual maltreatment showed varying trends. Similarly, evidence regarding the impact of COVID-19 on CM within the European Cooperation on Science and Technology and Network Collaborative (COST) Action countries remains inconsistent. This scoping review aims to explore the extent and nature of evidence pertaining to CM within the countries affiliated with the Child Abuse and Neglect in Europe Action Network (Euro-CAN), funded by the COST. Methods and analysis Key electronic databases were searched to identify eligible papers, reports and other material published between January 2020 and April 2023: PubMed, EMBASE, PsycINFO, Social Policy and Practice, Scopus and Web of Science. To cover the breadth of evidence, a systematic and broad search strategy was applied using a combination of keywords and controlled vocabulary for four concepts: children, maltreatment, COVID-19 and Euro-CAN countries, without restrictions on study design or language. Grey literature was searched in OpenGrey and Google Scholar. Two reviewers will independently screen full-text publications for eligibility and undertake data extraction, using a customised grid. The screening criteria and data charting will be piloted by the research team. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews will be followed to present the results. Results will be summarised in a tabular form and narratively. Ethics and dissemination This review will identify and summarise publicly available data, without requiring ethical approval. The findings will be disseminated to the Euro-CAN Network and reported to the COST Association. They will also be published in a peer-reviewed journal. This protocol is registered on Open Science Framework

Toll-like receptor 4 selective inhibition in medullar microenvironment alters multiple myeloma cell growth.

peer reviewedBone marrow (BM) mesenchymal stromal cells (MSCs) are abnormal in multiple myeloma (MM) and play a critical role by promoting growth, survival, and drug resistance of MM cells. We observed higher Toll-like receptor 4 (TLR4) gene expression in MM MSCs than in MSCs from healthy donors. At the clinical level, we highlighted that TLR4 expression in MM MSCs evolves in parallel with the disease stage. Thus, we reasoned that the TLR4 axis is pivotal in MM by increasing the protumor activity of MSCs. Challenging primary MSCs with TLR4 agonists increased the expression of CD54 and interleukin-6 (IL-6), 2 factors directly implicated in MM MSC-MM cell crosstalk. Then, we evaluated the therapeutic efficacy of a TLR4 antagonist combined or not with conventional treatment in vitro with MSC-MM cell coculture and in vivo with the Vk*MYC mouse model. Selective inhibition of TLR4 specifically reduced the MM MSC ability to support the growth of MM cells in an IL-6-dependent manner and delayed the development of MM in the Vk*MYC mouse model by altering the early disease phase in vivo. For the first time, we demonstrate that specific targeting of the pathological BM microenvironment via TLR4 signaling could be an innovative approach to alter MM pathology development

À propos de la responsabilité : entretiens avec des psychiatres participant à l’activité d’une Cellule d’Urgence Médico-Psychologique en France métropolitaine

Introduction : Les Cellules d’Urgence Médico-Psychologiques sont spécifiquement françaises. De création récente, 1995, suite à l’attentat survenu dans le RER station Saint-Michel à PARIS, elles ont été rapidement, dès 1997, encadrées par des textes légaux. Ces textes énoncent les objectifs de prise en charge et les missions des volontaires. A la lecture de ces documents, nous avons le sentiment qu’il s’agit d’une entité où il se pratique un exercice atypique de la psychiatrie. Notre attention a notamment été retenue par le fait que les volontaires psychologues, psychiatres ou infirmiers participant à l’activité d’une CUMP semblent interchangeables. Problématique : Comment en tant que psychiatre envisager sa responsabilité dans la pratique atypique des CUMP où les professionnels semblent interchangeables ? Objectif : Notre objectif principal était de recueillir la vision des psychiatres sur leur responsabilité de médecin lors de leur activité au sein d’une Cellule d’Urgence Médico-Psychologique. Matériel et méthodes : Nous avons réalisé une étude qualitative auprès de psychiatres participant à l’activité d’une CUMP en France métropolitaine. Une proposition de participation au travail a été faite par email aux psychiatres figurant dans l’annuaire des CUMP version 2016. Etaient inclus les psychiatres ayant répondu favorablement à notre email et avec lesquels un entretien téléphonique avait pu être réalisé. Les entretiens étaient semi-dirigés à l’aide d’une grille d’entretien puis analysés à l’aide d’une grille spécifique construite à partir de la littérature. Nous nous sommes également intéressés au champ lexical utilisé par les psychiatres pour mentionner ceux qui sont pris en charge par les Cellules d’Urgence Médico-Psychologiques. Résultats : Dix-sept entretiens téléphoniques ont été réalisés entre février et avril 2018. La responsabilité était envisagée au plan civil et pénal par quelques psychiatres avec la mention du devoir d’être assuré et de respect absolu du secret médical. La responsabilité était surtout envisagée au plan professionnel et articulée autour de quatre grands thèmes par les médecins interrogés. D’abord évaluer les demandes et décider si la situation relevait ou non d’une intervention de la CUMP. Ensuite, porter une attention particulière à l’animation du réseau et à la formation des volontaires. Puis organiser le réseau, la mission pour enfin, intervenir sur le terrain notamment, pour la prise en charge des personnes, et si besoin, de prescrire et rédiger des certificats médicaux. La majorité des psychiatres interrogés (53%) ne mentionnaient pas ceux qui étaient pris en charge par la CUMP.Discussion et conclusion : Notre étude nous a permis de mettre en évidence, un flou pour les médecins quand à la définition de leur pratique, et ce bien qu’elle soit définie par des textes légaux. Une telle définition du travail des psychiatres semble insuffisante et notre étude met selon nous en évidence un certain malaise des médecins pour se positionner dans la pratique atypique de la psychiatrie au sein des CUMP, témoignant de leurs difficultés à définir leur identité professionnelle

Maltraitance envers les enfants et Covid-19

En France, au début de l’année 2020, environ 690 000 vies ont pu être épargnées grâce au confinement général de la population et aux mesures restrictives de lutte contre la Covid-19. Conséquence inattendue, ces mesures ont eu un impact sur une autre frange vulnérable de la population : celle des jeunes enfants, pour lesquels il a été démontré une augmentation des maltraitances subies à cette période. À partir de données de la littérature et de l’apport de nos travaux de recherche dans le domaine, nous proposons une documentation de cette crise des violences intra-familiales, intriquée dans la crise sanitaire de la Covid-19

Hospitalization for physical child abuse: Associated medical factors and medical history since birth

International audienceBackground: Physical abuse often begins at a very young age and sometimes results in serious or fatal injuries. It is crucial to diagnose physical abuse as early as possible to protect this vulnerable population. Objective: To study the factors associated with the first hospitalization for physical abuse from birth to the infant's first birthday in France. Participants and setting: We included all singleton children born in a hospital setting in France between 2009 and 2013, who were identified from the French national information system database (SNDS). Methods: To study factors associated with the first hospitalization for physical abuse during the first year after birth, we used the Fine and Gray regression model. Factors included in the multivariate model were the infant's sex, prematurity, neonatal conditions, the number of hospitalizations (at least two), medical consultations and complementary universal health insurance (proxy for family precariousness and socio-economic vulnerability). Results: Over the 2009–2013 period, among 3,432,921 newborn singletons, 903 (0.026 %) were hospitalized for physical abuse in the year following birth. Among the factors associated with physical abuse, such as prematurity (aHR = 2.2[1.8–2.7]), male sex (aHR = 1.3[1.2–1.5]), or having had at least two hospitalizations (aHR = 1.7[1.4–2.1]), we found that complementary universal health insurance coverage was the factor most associated (aHR = 4.1[3.5–4.7]) with being hospitalized for physical abuse. Conclusion: These findings could help introduce preventative measures for infant protection in certain groups, such as parents of infants born prematurely, especially if they are in a precarious situation. This study also suggests that particular attention should be paid to infants who have been hospitalized at least two times in the first year of life, whatever the reason

Mental Health Support for Hospital Staff during the COVID-19 Pandemic: Characteristics of the Services and Feedback from the Providers

French authorities created mental health support services to accompany HCWs during the pandemic. We aimed to obtain feedback from staff providing these mental health support services within French hospitals to identify positive and negative features and avenues for improvement. A mixed-methods study was performed between 1 April and 30 June 2020. We contacted 77 centres to identify those providing mental health support services. We developed a questionnaire containing questions about the staff providing the service (quantitative part), with open questions to enable feedback from service providers (qualitative part). Of the 77 centres, 36 had mental health support services; 77.8% were created specifically for the epidemic. Services were staffed principally by psychologists, mainly used a telephone platform, and had a median opening time of 8 h/day. Thirty-seven professionals provided feedback, most aged 35–49 years. For 86.5%, it was their first time providing such support. Median self-reported comfort level was 8 (interquartiles 3–10), and 95% would do it again. Respondents reported (i) difficulties with work organisation, clinical situations, and lack of recognition and (ii) a desire for training. This study suggests that mental health support needs to be adapted to the needs of HCWs, both in terms of the content of the service and the timing of delivery

Resource availability drives bacterial succession during leaf-litter decomposition in a bromeliad ecosystem

International audienceDespite the growing number of investigations on microbial succession during the last decade, most of our knowledge on primary succession of bacteria in natural environments comes from conceptual models and/or studies of chronosequences. Successional patterns of litter-degrading bacteria remain poorly documented, especially in undisturbed environments. Here we conducted an experiment with tank bromeliads as natural freshwater microcosms to assess major trends in bacterial succession on two leaf-litter species incubated with or without animal exclusion. We used amplicon sequencing and a co-occurrence network to assess changes in bacterial community structure according to treatments. Alpha-diversity and community complexity displayed the same trends regardless of the treatments, highlighting that primary succession of detrital-bacteria is subject to resource limitation and biological interactions, much like macro-organisms. Shifts in bacterial assemblages along the succession were characterized by an increase in uncharacterized taxa and potential N-fixing bacteria, the latter being involved in positive co-occurrence between taxa. These findings support the hypothesis of interdependence between taxa as a significant niche-based process shaping bacterial communities during the advanced stage of succession

Physical abuse of young children during the COVID-19 pandemic: Alarming increase in the relative frequency of hospitalizations during the lockdown period

International audienceBackground: In France, the COVID-19 pandemic led to a general lockdown from mid-March to mid-May 2020, forcing families to remain confined. We hypothesized that children may have been victims of more physical abuse during the lockdown, involving an increase in the relative frequency of hospitalization. Methods: Using the national administrative database on all admissions to public and private hospitals (PMSI), we selected all children aged 0–5 years hospitalized and identified physically abused children based on ICD-10 codes. We included 844,227 children hospitalized in March–April 2017–2020, of whom 476 (0.056%) were admitted for physical abuse. Relative frequency of hospitalization for physical abuse observed in March to April 2020 were compared with those from the same months in the three previous years (2017–2019). Findings: Even if absolute number of children exposed to physical abuse did not fluctuate significantly, we found a significant increase in the relative frequency of young children hospitalized for physical abuse from 2017 (0.053%) to 2020 (0.073%). Compared with the 2017–2019 period, and considering the observed decrease in the number of overall hospital admissions during the first lockdown, the number of children exposed to physical violence was 40% superior to what would be expected. Interpretation: The sharp increase in the relative frequency of hospitalizations for physical abuse in children aged 0–5 years in France is alarming. As only the most severe cases were brought to the hospital for treatment during the lockdown, our figures probably only represent the tip of the iceberg of a general increase of violence against young children

Risk and protective factors for the possible development of post-traumatic stress disorder among intensive care professionals in France during the first peak of the COVID-19 epidemic

International audienceBackgroundIntensive care units (ICU) are among the healthcare services most affected by the COVID-19 crisis. Stressors related to insecurity, unpredictability, patient death and family distress are significant, and put healthcare workers (HCWs) at high risk of post-traumatic stress disorder (PTSD). The aims of this study were to measure the prevalence of post-traumatic stress disorder in HCWs and to identify risk factors and protective factors during the epidemic in France.MethodsDuring the first peak of the epidemic (from 22 April to 13 May 2020), we assessed sources of stress (PS-ICU scale), mental health (GHQ-12) and coping strategies (Brief-COPE). Three months later (03 June to 6 July 2020), PTSD was assessed using the IES-R scale, with additional questions about sources of support. Data were collected using self-report questionnaires administered online.ResultsAmong 2153 professionals who participated in the study, 20.6% suffered from potential PTSD, mostly intrusion symptoms. Risk factors for the development of PTSD were having experienced additional difficult events during the crisis, having a high level of psychological distress, a high level of perceived stress related to the workload and human resources issues, the emotional burden related to the patient and family, and stressors specific to COVID-19 during the first peak of the crisis. The use of positive thinking coping strategies decreased the relationship between perceived stress and the presence of PTSD, while social support seeking strategies increased the relationship. Finally, the HCWs preferred to use support from colleagues, relatives and/or a psychologist, and very few used the telephone hotlines.ConclusionThe epidemic has had a strong traumatic impact on intensive care HCWs. Given the risk of PTSD, we need to consider implementing easily-accessible support services that focus on positive thinking coping strategies, during and after the crisis