Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life

International audienc

Attempts, Successes, and Failures of Distance Learning in the Time of COVID-19

Over 1.7 billion students around the world have had their education disrupted by the spread of the Coronavirus disease worldwide. Schools and universities have not faced this level of disruption since World War II. The COVID-19 pandemic presented a colossal challenge for teachers to urgently and massively adapt all their classes to distance learning in order to maintain educational continuity with the same quality. Even if some teachers and certain classes were ready to face the situation, a large majority had to adapt their teaching and learning in a very short time without training, with insufficient bandwidth, and with little preparation. This unexpected and rapid transition to online learning has led to a multiplication of teachers’ strategies for distance learning in lectures, tutorials, project groups, lab works, and assessments. The purpose of this paper is to present the feedback from students and teachers who participated in the lockdown semester of two different groups of a 5-year program in Chemistry, Environment and Chemical Engineering (100 students) at INSA Toulouse (France). The analysis has highlighted some great successes and some failures in the solutions proposed. Consequently, some guidelines can be given to help us all to learn the lessons of such a singular experience in order to face the unexpected future with more knowledge and more successful distance learning. Teachers have shown very strong resilience during this crisis, at the cost of significant personal commitment. They admit that they have learned more about distance education in two months than in the last 10 years

Psychometric properties of the measure of achieved capabilities in homeless services

Background Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.info:eu-repo/semantics/publishedVersio

L'économie de la prévention: Enjeux et problématiques

National audienceL'Organisation mondiale de la santé (OMS) désigne la prévention comme « tout acte destiné à éviter des phénomènes attendus ». Les économistes ont tendance, depuis l'article fondateur d'Ehrlich et Becker [1972], à distinguer deux familles de prévention : l'autoprotection et l'auto-assurance. Dans ce cadre, la prévention peut être définie comme l’ensemble des actions menées dans le but de préparer ou d’empêcher la survenue de certains risques mais aussi de minimiser les conséquences négatives induites par leur survenue. La prévention peut donc avoir pour objectifs soit de réduire l’occurrence ou la survenue d’un risque, soit d’adapter le comportement en présence du risque réalisé (Kenkel [2000]). L’approche de santé publique distingue, quant à elle, trois catégories d’actions préventives. La prévention primaire représente l’ensemble des actions qui réduisent l’occurrence ou l’incidence d’une maladie. Vacciner les personnes âgées contre la grippe ou vacciner les enfants contre le ror (Rougeole, Oreillons, Rubéole) répond à cet objectif. La prévention secondaire représente les actions qui visent à réduire la morbidité ou les conséquences d’une maladie une fois celle-ci apparue. Les campagnes de dépistage du cancer du sein auprès des femmes de plus de 50 ans, de même que la campagne actuelle d’incitation au dépistage de l’hépatite C auprès de la population française ont pour objectif de repérer dans la population ciblée les personnes nécessitant une prise en charge la plus précoce possible pour éviter l’évolution de la maladie vers des complications et, si possible, l’éradiquer chez la personne par une prise en charge adaptée. Enfin, la prévention tertiaire représente les actions qui ont pour objectif de réduire l’invalidité associée à des maladies chroniques. Ainsi conseiller, sur le plan diététique, les personnes souffrant de diabète permet de réduire les risques d’invalidité

Évaluation économique du dépistage et du traitement de l’hépatite C

L’intérêt des approches économiques dans le domaine de la santé réside dans la possibilité de hiérarchiser, sur la base de deux critères (efficacité médicale et coûts), les programmes médicaux susceptibles d’être menés, et d’aider à fixer des objectifs de santé publique, à moyen ou à long terme, compatibles avec les ressources disponibles. Cet article présente une revue de la littérature spécifique des principaux travaux d’évaluation économique qui se sont efforcés de contribuer à la définition de politiques optimales en matière de dépistage et de traitement de l’hépatite C. Les résultats de ces évaluations économiques montrent d’une part, que, malgré un coût économique immédiat important, le dépistage de certaines populations à risque est source à long terme d’économies par rapport à l’absence de dépistage, et suggèrent, d’autre part, que les traitements, y compris les plus coûteux et performants, aboutissent à sauver des années de vie pour des rapports qui ne sont jamais supérieurs à ceux généralement admis comme limite pour les interventions dans le domaine de la santé

“Locked down outside”: Perception of hazard and health resources in COVID-19 epidemic context among homeless people

International audienceWhile social inequality is widely recognised as being a risk factor for COVID-19 infection or serious forms of the disease, many questions still remain concerning the perception of hazard and protective measures by the most vulnerable populations. This mixed-methods study aimed (1) to describe the self-perceived health and protective measures linked to COVID-19 of homeless people in one of the largest and poorest cities in France, and (2) to assess which skills and resources they used to address the COVID-19 pandemic. The quantitative survey addressed these questions among a sample of 995 homeless people living either on the streets, in homeless shelters or in squats/slums, whereas the qualitative survey was constructed from 14 homeless interviewees. Both data collections were carried out between June and July 2020. Results showed that COVID-19 infection was clearly perceived by homeless people as a risk, but the experience of being homeless placed this risk among several others. Different practices of protection were observed according to the type of living place. Lockdown of the general population severely impacted the survival systems of the populations furthest from housing, with alarming rates of people without access to water or food. 77% of homeless participants reported that they encountered significant financial difficulties. All interviewees were particularly attentive to their health, with awareness and even a familiarity with the risks of infectious diseases long before the pandemic. Using a capability framework, our study showed a predominant lack of external health-related resources for homeless people, while internal health-related resources were more developed than expected. None of the places and lifestyles studied was favourable to health: collective shelters due to a greater restriction of people's choices, slums and street life due to a greater lack of basic resources

Is diverting loop ileostomy necessary for completion proctectomy with ileal pouch- anal anastomosis? A multicenter randomized trial of the GETAID Chirurgie group (IDEAL trial): rationale and design (NCT03872271)

International audienceBackground: There is no quality evidence of the benefit of defunctioning ileostomy (DI) in ileal pouch-anal anastomoses (IPAAs) performed for inflammatory bowel disease (IBD), but most surgical teams currently resort to DI. In the case of a staged procedure with subtotal colectomy first, completion proctectomy with IPAA is performed for healthy patients, namely, after nutritional support, inflammation reduction and immunosuppressive agent weaning. Therefore, the aim of this trial is to assess the need for systematic DI after completion proctectomy and IPAA for IBD

Genotypic and Phenotypic Analysis of Dairy Lactococcus lactis Biodiversity in Milk: Volatile Organic Compounds as Discriminating Markers

The diversity of nine dairy strains of Lactococcus lactis subsp. lactis in fermented milk was investigated by both genotypic and phenotypic analyses. Pulsed-field gel electrophoresis and multilocus sequence typing were used to establish an integrated genotypic classification. This classification was coherent with discrimination of the L. lactis subsp. lactis bv. diacetylactis lineage and reflected clonal complex phylogeny and the uniqueness of the genomes of these strains. To assess phenotypic diversity, 82 variables were selected as important dairy features; they included physiological descriptors and the production of metabolites and volatile organic compounds (VOCs). Principal-component analysis (PCA) demonstrated the phenotypic uniqueness of each of these genetically closely related strains, allowing strain discrimination. A method of variable selection was developed to reduce the time-consuming experimentation. We therefore identified 20 variables, all associated with VOCs, as phenotypic markers allowing discrimination between strain groups. These markers are representative of the three metabolic pathways involved in flavor: lipolysis, proteolysis, and glycolysis. Despite great phenotypic diversity, the strains could be divided into four robust phenotypic clusters based on their metabolic orientations. Inclusion of genotypic diversity in addition to phenotypic characters in the classification led to five clusters rather than four being defined. However, genotypic characters make a smaller contribution than phenotypic variables (no genetic distances selected among the most contributory variables). This work proposes an original method for the phenotypic differentiation of closely related strains in milk and may be the first step toward a predictive classification for the manufacture of starters