Normes sociales et légitimité dans la Chine contemporaine

Isabelle Thireau, directeur d’études Enseignement suspendu durant l’année universitaire 2010-2011 Alain Cottereau, directeur d’étudesStéphane Baciocchi, ingénieur d’étudesCarole Gayet-Viaud, maître-assistant associée à l’ENSAPLV Pratiques d’enquête et sens de la réalité sociale : approches sociologique, anthropologique et historique Poursuivant l’analyse des enquêtes de terrain, le séminaire de cette année s’est consacré plus particulièrement à un aspect négligé des expériences d’investigatio..

Self-rated health: analysis of distances and transitions between response options

Purpose: We explored health differences between population groups who describe their health as excellent, very good, good, fair, or poor. Methods: We used data from a population-based survey which included self-rated health (SRH) and three global measures of health: the SF36 general health score (computed from the 4 items other than SRH), the EQ-5D health utility, and a visual analogue health thermometer. We compared health characteristics of respondents across the five health ratings. Results: Survey respondents (N=1.844, 49.2% response) rated their health as excellent (12.2%), very good (39.1%), good (41.9%), fair (6.0%), or poor (0.9%). The means of global health assessments were not equidistant across these five groups, for example, means of the health thermometer were 95.8 (SRH excellent), 88.8 (SRH very good), 76.6 (SRH good), 49.7 (SRH fair), and 33.5 (SRH poor, p<0.001). Recoding the SRH to reflect these mean values substantially improved the variance explained by the SRH, for example, the linear r 2 increased from 0.50 to 0.56 for the health thermometer if the SRH was coded as poor=1, fair=2, good=3.7, very good=4.5, and excellent=5. Furthermore, transitions between response options were not explained by the same health-related characteristics of the respondents. Conclusions: The adjectival SRH is not an evenly spaced interval scale. However, it can be turned into an interval variable if the ratings are recoded in proportion to the underlying construct of health. Possible improvements include the addition of a rating option between good and fair or the use of a numerical scale instead of the classic adjectival scal

Self-rated health: analysis of distances and transitions between response options

Purpose: We explored health differences between population groups who describe their health as excellent, very good, good, fair, or poor. Methods: We used data from a population-based survey which included self-rated health (SRH) and three global measures of health: the SF36 general health score (computed from the 4 items other than SRH), the EQ-5D health utility, and a visual analogue health thermometer. We compared health characteristics of respondents across the five health ratings. Results: Survey respondents (N=1.844, 49.2% response) rated their health as excellent (12.2%), very good (39.1%), good (41.9%), fair (6.0%), or poor (0.9%). The means of global health assessments were not equidistant across these five groups, for example, means of the health thermometer were 95.8 (SRH excellent), 88.8 (SRH very good), 76.6 (SRH good), 49.7 (SRH fair), and 33.5 (SRH poor, p<0.001). Recoding the SRH to reflect these mean values substantially improved the variance explained by the SRH, for example, the linear r 2 increased from 0.50 to 0.56 for the health thermometer if the SRH was coded as poor=1, fair=2, good=3.7, very good=4.5, and excellent=5. Furthermore, transitions between response options were not explained by the same health-related characteristics of the respondents. Conclusions: The adjectival SRH is not an evenly spaced interval scale. However, it can be turned into an interval variable if the ratings are recoded in proportion to the underlying construct of health. Possible improvements include the addition of a rating option between good and fair or the use of a numerical scale instead of the classic adjectival scal

Risk factors for noma disease: a 6-year, prospective, matched case-control study in Niger

Background Noma is a poorly studied disease that leads to severe facial tissue destruction in children in developing countries, but the cause remains unknown. We aimed to identify the epidemiological and microbiological risk factors associated with noma disease. Methods We did a prospective, matched, case-control study in Niger between Aug 1, 2001, and Oct 31, 2006, in children younger than 12 years to assess risk factors for acute noma. All acute noma cases were included and four controls for each case were matched by age and home village. Epidemiological and clinical data were obtained at study inclusion. We undertook matched-paired analyses with conditional logistic regression models. Findings We included 82 cases and 327 controls. Independent risk factors associated with noma were: severe stunting (odds ratio [OR] 4·87, 95% CI 2·35–10·09) or wasting (2·45, 1·25–4·83); a high number of previous pregnancies in the mother (1·16, 1·04–1·31); the presence of respiratory disease, diarrhoea, or fever in the past 3 months (2·70, 1·35–5·40); and the absence of chickens at home (1·90, 0·93–3·88). After inclusion of microbiological data, a reduced proportion of Fusobacterium (4·63, 1·61–13·35), Capnocytophaga (3·69, 1·48–9·17), Neisseria (3·24, 1·10–9·55), and Spirochaeta in the mouth (7·77, 2·12–28·42), and an increased proportion of Prevotella (2·53, 1·07–5·98), were associated with noma. We identifi ed no specifi c single bacterial or viral pathogen in cases. Interpretation Noma is associated with indicators of severe poverty and altered oral microbiota. The predominance of specifi c bacterial commensals is indicative of a modifi cation of the oral microbiota associated with reduced bacterial diversity.Funding Gertrude Hirzel Foundation

PREVENTION DU RISQUE INFECTIEUX EN MEDECINE GENERALE

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Les infections nosocomiales à pseudomonas aeruginosa (revue de la littérature)

STRASBOURG ILLKIRCH-Pharmacie (672182101) / SudocSudocFranceF

Perception par les patients de leur prise en charge médicale en soins primaires

INTRODUCTION: Peu de données existent dans la littérature sur l'évaluation par les patients de leur prise en charge médicale en soins primaire. L'objectif principal de cette étude est d'évaluer le pourcentage de patients estimant avoir subi un soin inadapté, une erreur de diagnostique (ED) ou thérapeutique (ET) en soins primaires, et l'impact du ressentiment perçu. Les objectifs secondaires: identifier les facteurs associés à la perceptions d'une erreur, connaître les motifs les plus fréquents de changement de médecin traitent (MT). MATERIELS ET METHODES: Il s'agit d'une étude étiologique transversale française réalisée de décembre 2012 à juin 2013 auprès de patients majeurs consultant dans 11 cabinets de médecins généralistes, répondant à un questionnaire anonyme. RESULTATS: 145 patients ont été inclus: 35,9% ont perçu un soin inadapté et/ou une erreur médicale, 24,1% ont peçu une ET (54,5% avec préjudice important voire plus). 17,9% ont alors changé de MT. La pathologie cardiaque chronique et les informations partielle délivrées en consultation sont les seuls facteurs indépendants associés de manière statistiquement significative à la perception d'une erreur (respectivement p=0,05, p=0,01). Le changement de MT à la suite d'une erreur médicale est le 3ème motif de changement après le déménagement du patient, le déménagement et/ou la retraite du MT. CONCLUSION: La perception d'erreur médicale en ambulatoire par les patients est fréquente. L'amélioration de la communication médecin-patient est un élément clé pour réduire les perceptions erronées des patientsAIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Signification des autoanticorps antiphosphatidyléthanolamine sériques au cours des thromboses (résultats préliminaires d'une étude européenne multicentrique)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Transcriptional regulation of the human MDR1 gene at the level of the inverted MED-1 promoter region.

International audienceThe typical multidrug resistance phenotype (MDR), the major cause of failure of cancer chemotherapy, is the result of the overexpression of the human MDR1 gene, the regulation of which is still incompletely understood. Using several EMSA experiments, we have identified a new regulatory sequence located from -103 to -98 bp relative to the +1 start site in the MDR1 promoter region. This sequence, which we called inverted MED-1, acts as a cis-activator for this gene. In transient transfection experiments of highly resistant human lymphoblastic CEM/VLB5 cells, its deletion from the promoter region is responsible for 60% inhibition of the MDR1 transcriptional activity. This sequence specifically binds a nuclear protein of about 150-160 kDa. We showed that its binding capacity is related to the chemoresistance level of the studied cell lines and may reflect the increased transcriptional activity of the MDR1 gene in multidrug-resistant cells