Front Public Health

BACKGROUND: Sheltered homeless families suffer from deleterious living conditions such as housing instability (i.e., moving from one shelter to another) that could be an additional barrier to healthcare utilization. Few studies have specifically examined perinatal health in homeless mothers and their utilization of prenatal healthcare. This study aimed to identify social determinants such as living conditions (i.e., housing instability) associated with inadequate prenatal care utilization (PCU) in sheltered homeless mothers in the Greater Paris area in France. METHODS: The homeless children and families cross-sectional survey [ENFAMS: (Enfants et familles sans logement)] was performed on a random representative sample of homeless families living in shelters in the greater Paris area in 2013. Following French guidelines, PCU was deemed inadequate if one or more of the following criteria was met: attending fewer than 50% of recommended prenatal visits, PCU initiation after the first trimester of pregnancy, and fewer than three ultrasounds during the entire pregnancy. Families were interviewed in 17 languages by trained peer interviewers in face-to-face interviews. Structural equation modeling was used to identify factors associated with inadequate PCU and to estimate correlations between them. RESULTS: This study analyzed data on 121 homeless sheltered mothers who had at least one child less than one year old. They were socially disadvantaged and most were born outside France. One in five (19.3%) had inadequate PCU. Associated factors were socio-demographic characteristics (young age, primiparous), health status (dissatisfaction with self-perceived general health), and living conditions (housing instability in the second and third trimesters). CONCLUSION: It is essential to reduce housing instability to help sheltered mothers to benefit from social, territorial and medical support and healthcare utilization. Housing stability for pregnant sheltered homeless mothers should be a priority to ensure better PCU and guarantee the newborn's health as much as possible

Front Public Health

OBJECTIVE: To examine the relationship between young adults' labor force participation and depression in the context of the COVID-19 pandemic. DESIGN SETTING PARTICIPANTS: Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews: 02/05/2020-12/06/2020; 26/10/2020-14/12/2020; 24/06/2021-09/08/2021) among 2,217 participants aged 18-30 years. Participants with prior mental health disorder (n = 50) were excluded from the statistical analyses. RESULTS: Using Generalized Estimating Equation (GEE) models controlled for participants' socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariable ORs, respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed that unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariable ORs, respectively, 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariable OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariable ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76; women: 1.19, 95% CI 0.85-1.67, multivariable ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45; women: 1.47, 95% CI 1.01-2.15). CONCLUSIONS AND RELEVANCE: Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the COVID-19 pandemic on the mental health of young adults.Connecting European Cohorts to Increase Common and Effective Response to SARS-CoV-2 Pandemic: ORCHESTR

Demographic, socioeconomic, and sociocultural factors associated with any breastfeeding in homeless mothers

In high‐income countries, breastfeeding has been shown to be positively associated with socioeconomic position. However, less is known about breastfeeding practices and their associated factors among extremely disadvantaged populations. We aimed to assess the associations of cultural origins and socioeconomic factors with any breastfeeding initiation and duration in homeless families. We analyzed data from 456 children aged 6 months to 5 years from the cross‐sectional ENFAMS survey, conducted in 2013 among a random sample of homeless families in shelters in the Greater Paris area. Data were collected by bilingual interviewers in 17 languages. Four nested multivariable robust Poisson regression models were run in a hierarchical framework to determine the factors associated with breastfeeding initiation and with any breastfeeding for 6 months or more. Most of the children (86.0%) had previously been or were currently being breastfed at the time of the survey; 58.9% were fed with breast milk ≥6 months. A higher maternal age and African origin were positively associated with breastfeeding ≥6 months, although the relation to the region of origin was moderated by education level. Migration to escape war, unrest or other violence and the child's birth in France were inversely associated with breastfeeding ≥6 months. Any breastfeeding by these homeless mothers seems influenced predominantly by their cultural origin and complicated by a difficult migration trajectory. The possible influence of poor material circumstances and cumulative hardship should encourage interventions targeted at homeless mothers that emphasize social/family support with a commitment to improving the family's living conditions

Psychiatry Res

In the literature, the association between medium and long-term PTSD (post-traumatic stress disorder) after terrorist attack has rarely been described. The objective of our study was to identify the factors associated with PTSD in the medium and longer term among people exposed to a terrorist attack in France. We used data from a longitudinal survey of 123 terror-exposed people interviewed 6-10 (medium term) and 18-22 (long term) months after. Mental health was assessed by the Mini Neuropsychiatric Interview. PTSD in the medium term was associated with history of traumatic events, low levels of social support and severe peri-traumatic reactions, which were in turn associated with high levels of terror exposure. PTSD in the medium term was linked in turn to the presence of anxiety and depressive disorders, which was also linked to PTSD in the longer term. The factors leading to PTSD are different in the medium and long term. In order to improve future support for people exposed to distressing events, it is important to follow up people with intense peri-traumatic reactions, high levels of anxiety and depression and to measure reactions

Caractérisation de la matière organique dissoute par chromatographie liquide d'exclusion stérique et LC-HRMS : étude d'empreintes typiques de sources naturelles et anthropiques dans les milieux aquatiques

National audienceLa matière organique dissoute (MOD), constituée d'un mélange complexe de composés chimiques variés, joue un rôle clé au coeur des processus biogéochimiques et dans le fonctionnement des écosystèmes aquatiques. Sa composition et ses propriétés physico-chimiques, combinées aux conditions environnementales du milieu, déterminent son devenir et sa réactivité dans les différents compartiments du milieu aquatique. La composition de la MOD est fortement liée à son origine (naturelle autochtone ou allochtone issue de différentes occupations de sols, MOD d'origine anthropique issue de rejet ponctuel ou diffus...). Dans ce contexte, l'objectif de nos travaux est d'explorer les empreintes physico-chimiques typiques des sources principales de MOD dans les bassins versants soumis à des pressions anthropiques diversifiées. Pour cela, nous avons besoin de développer une nouvelle stratégie de caractérisation intégrée de la MOD combinant les informations issues de plusieurs techniques d'analyses. Cette étude présente l'apport des techniques chromatographiques HPSEC-UV et LC-HRMS, pour caractériser plus finement la MOD en fonction des distributions de tailles des molécules. Ces techniques permettent clairement de différencier des types de sources de MOD (en particulier MOD d'origine naturelle vs. Anthropique) et d'observer les gradients de pressions anthropiques le long des cours d'eau

Caractérisation intégrée de la matière organique dissoute : étude d'empreintes typiques de sources naturelles et anthropiques dans les milieux aquatiques

National audienceLa matière organique dissoute (MOD), constituée d'un mélange complexe de composés chimiques variés, joue un rôle clé au coeur des processus biogéochimiques et dans le fonctionnement des écosystèmes aquatiques. Sa composition et ses propriétés physico-chimiques, combinées aux conditions environnementales du milieu, déterminent son devenir (dégradabilité biotique ou abiotique, distribution dans les différents compartiments du milieu aquatique...) et sa réactivité (consommation d'oxydants, complexation avec des micropolluants et influence sur leur biodisponibilité et donc leur toxicité...). La composition de la MOD dans les milieux aquatiques est fortement liée à son origine. Les sources de MOD dans un bassin versant sont nombreuses : MOD naturelle autochtone ou allochtone issue de différentes occupations de sols ; MOD d'origine anthropique issue de rejet ponctuel (rejet de station d'épuration, déversoirs d'orages...) ou diffus (eaux de ruissellement en zone rurale ou urbaine, débordements ou fuites de réseaux d'assainissement...). Dans ce contexte, l'objectif de nos travaux est d'explorer les empreintes typiques des sources principales de MOD dans les bassins versants soumis à des pressions anthropiques diversifiées. Pour cela, nous avons besoin de développer une nouvelle stratégie de caractérisation intégrée de la MOD (i.e. combinant les informations issues de plusieurs techniques d'analyses) qui soit généralisable à tous les types de MOD et facilement applicable à un grand nombre d'échantillons. Ainsi, depuis 2017, une base de données permet de recenser nos résultats issus d'analyses plus ou moins classiques (carbone organique dissous, demande biologique en oxygène à 5 et 28 jours, spectres UV-vis, fluorescence 3D, HPSEC-UV...) réalisées sur de nombreux échantillons (n=102 en juillet 2019) provenant de rejets et d'eaux de rivière plus ou moins impactées par les activités anthropiques. En parallèle, une approche de caractérisation moléculaire est menée sur ces échantillons par chromatographie liquide couplée à la spectrométrie de masse haute résolution (LC-HRMS). Les premiers résultats obtenus à partir de cette base de données permettent déjà : - de mettre en place un protocole de tri, correction et interprétation des nombreux signaux masse/charge (m/z) générés par LC-HRMS afin de fiabiliser l'étude moléculaires de la MOD ; - de tester de nouveaux descripteurs pour caractériser la MOD par HPSEC-UV (ratios d'aires de domaines de taille, identification de couples poids moléculaire et longueurs d'onde typiques) ou par fluorescence 3D (définition de pics spécifiques avec PARAFAC) ; - d'observer la variabilité de la MOD dans ces échantillons d'origines très variées ; - de mettre en évidence des indicateurs pertinents pour proposer une typologie de la MOD en fonction de ses sources. Cette approche intégrée multi-techniques devrait à terme permettre de caractériser plus finement la composition et les propriétés de la MOD. Elle sera développée plus en profondeur dans un travail de thèse qui commencera fin 2019