Risk of asthmatic episodes in children exposed to sulfur dioxide stack emissions from a refinery point source in Montreal, Canada.

BACKGROUND: Little is known about the respiratory effects of short-term exposures to petroleum refinery emissions in young children. This study is an extension of an ecologic study that found an increased rate of hospitalizations for respiratory conditions among children living near petroleum refineries in Montreal (Canada). METHODS: We used a time-stratified case-crossover design to assess the risk of asthma episodes in relation to short-term variations in sulfur dioxide levels among children 2-4 years of age living within 0.5-7.5 km of the refinery stacks. Health data used to measure asthma episodes included emergency department (ED) visits and hospital admissions from 1996 to 2004. We estimated daily levels of SO2 at the residence of children using a) two fixed-site SO2 monitors located near the refineries and b) the AERMOD (American Meteorological Society/Environmental Protection Agency Regulatory Model) atmospheric dispersion model. We used conditional logistic regression to estimate odds ratios associated with an increase in the interquartile range of daily SO2 mean and peak exposures (31.2 ppb for AERMOD peaks). We adjusted for temperature, relative humidity, and regional/urban background air pollutant levels. RESULTS: The risks of asthma ED visits and hospitalizations were more pronounced for same-day (lag 0) SO2 peak levels than for mean levels on the same day, or for other lags: the adjusted odds ratios estimated for same-day SO2 peak levels from AERMOD were 1.10 [95% confidence interval (CI), 1.00-1.22] and 1.42 (95% CI, 1.10-1.82), over the interquartile range, for ED visits and hospital admissions, respectively. CONCLUSIONS: Short-term episodes of increased SO2 exposures from refinery stack emissions were associated with a higher number of asthma episodes in nearby children

Le maintien en emploi de personnes souffrant d’une maladie mentale

L’insertion au travail de personnes souffrant d’une maladie mentale s’avère complexe et difficile. Pour celles qui travaillent, le maintien en emploi est de courte durée. Cet article vise à identifier des déterminants personnels du maintien en emploi de personnes souffrant d’une maladie mentale et inscrites dans un programme de réinsertion au travail. Des 105 personnes qui travaillent durant le suivi de 9 mois après leur inscription à un programme, près de 50 % maintiennent leur première activité de travail. Les résultats d’analyses de survie révèlent que selon l’indicateur de maintien en emploi observé (premier ou dernier emploi obtenu), les variables qui apparaissent comme significatives peuvent être reliées aux aspects sociodémographiques (aide financière reçue), travail (la durée d’absence du marché du travail, le type d’emploi obtenu), cognitif (fonctions exécutives) et clinique (symptômes paranoïdes). En conclusion, les auteurs suggèrent non seulement de considérer les variables inhérentes à la personne souffrant d’une maladie mentale pour prédire le maintien en emploi, mais aussi d’évaluer de façon plus systématique son milieu de travail.Work integration for people with mental illness is complex and difficult. For those who obtain employment, job tenure is typically brief. The purpose of this article is to identify the personal determinants of job tenure of people with severe mental illness registered in prevocational programs. Out of 105 people with mental illness who are employed during the nine month follow-up after their registration in a prevocational program, close to 50 % kept their first job. According to the job tenure indicators (first or last job obtained), the results from survival analyses show that the significant variables are related to background characteristics (financial aid), work-related characteristics (length of absence from the workplace, type of job), cognitive (executive functions), and clinical aspects (paranoid symptoms). In conclusion, the authors propose not only to assess personal variables to better understand the work integration process for people with mental illness, but also to conduct a systematic evaluation of the job site.La inserción al trabajo de personas que sufren de una enfermedad mental resulta compleja y difícil. Para aquellas que trabajan, mantenerse en un empleo dura poco tiempo. Este artículo busca identificar las variables personales de las personas que sufren de una enfermedad mental y que están inscritas a un programa de reinserción al trabajo para mantenerse en un empleo. De las 105 personas que trabajan durante el seguimiento de 9 meses después de su inscripción a un programa, cerca del 50% conservan su primera actividad de trabajo. Los resultados de los análisis de sobrevivencia revelan que según el índice de mantenimiento en empleo observado (primer o último empleo obtenido), las variables que aparecen como significativas pueden estar relacionadas con aspectos sociodemográficos (ayuda financiera recibida), trabajo (la duración de la ausencia en el mercado de trabajo, el tipo de empleo obtenido), cognitivos (funciones ejecutivas) y clínicos (síntomas paranoides). En conclusión, los autores no solamente sugieren considerar las variables inherentes a la persona que sufre de una enfermedad mental para predecir el mantenimiento del empleo, sino también evaluar de manera más sistemática su medio de trabajo.A inserção no trabalho, para pessoas que sofrem de uma doença mental, mostra-se complexa e difícil. Para as que trabalham, a continuação no emprego é de curta duração. Este artigo visa identificar determinantes pessoais da continuação no trabalho para pessoas que sofrem de uma doença mental e inscritas em um programa de reinserção no trabalho. Das 105 pessoas que trabalham, durante o acompanhamento de nove meses após a inscrição em um programa, cerca de 50% mantêm sua primeira atividade de trabalho. Os resultados de análises de sobrevivência revelam que, segundo o indicador de continuação no emprego observado (primeiro ou último emprego obtido), as variáveis que aparecem como significativas podem estar ligadas aos aspectos sócio-demográficos (auxílio financeiro recebido), ao trabalho (duração da ausência no mercado de trabalho, tipo de emprego obtido), aos aspectos cognitivos (funções executivas) e clínicos (sintomas paranóides). Concluindo, os autores sugerem, não apenas considerar as variáveis inerentes à pessoa que sofre de uma doença mental para predizer a continuação no emprego, mas também avaliar, de maneira mais sistemática, seu meio de trabalho

Étude d'une bactérie dénitrifiante du Biodôme de Montréal

Le nitrate est une molécule soluble qui diffuse rapidement dans les eaux de surfaces et les eaux souterraines, contaminant ainsi l’eau potable. Le nitrate contribue à l’eutrophisation des lacs et des rivières et devient toxique pour les animaux à partir de certaines concentrations. Methylophaga nitratireducticrescens JAM1 est une bactérie méthylotrophe isolée à partir d'un système de dénitrification d'eau de mer supplémenté en méthanol au Biodôme de Montréal. Cette bactérie compose à elle seule plus de 50% du biofilm dénitrifiant retrouvé dans le système de dénitrification. Contrairement aux autres espèces de Methylophaga, la souche JAM1 possède la particularité de croitre dans des conditions dénitrifiantes en présence de nitrate et de méthanol. La croissance de JAM1 dans les conditions dénitrifiantes, réduisant le nitrate en nitrite, est corrélée avec la présence de deux gènes codant pour des nitrate reductase narG. Le génome de JAM1 a été séquencé et consiste en un chromosome de 3,137,192 bp. Le séquençage du génome de JAM1 a confirmé la présence de deux opérons nar mais aussi de deux opérons nor (nitric oxide reductase) et d'un opéron nos (nitrous oxide reductase). De plus, une sequence nirK codant pour une nitrite reductase tronquée de 82 acides aminés a été trouvée, ce qui pourrait expliquer que la souche JAM1 est seulement capable de réduire le nitrate en nitrite. Notre travail consiste à étudier les gènes de dénitrification de la souche JAM1. Les deux gènes narG sont exprimés aussi bien en conditions aérobies que dénitrifiantes. Par ailleurs, les autres gènes liés à la dénitrification sont également exprimés, incluant le nirK tronqué. Des mesures d'expression ont montré que les gènes narG étaient exprimés différemment en fonction des conditions de cultures. Un mutant knockout de narG1 a montré de grosses différences de croissance et de taux de réduction du nitrate par rapport à la souche sauvage. Des différences d'expression du gène narG2 entre le mutant narG1 et la souche sauvage ont également été démontrées. La construction du mutant knockout narG2 est en cours et permettra de révéler l'importance de ce gène pour la croissance de la bactérie et la réduction du nitrate

BMC Geriatr

Background In 2015 in France, 585,560 people were nursing home residents. A large body of studies has identified predictors of poor quality of life and poor adaptation in institution, mostly for residents without dementia. With 42 to 72% of these residents diagnosed with dementia, it is crucial to identify what factors prior to admission might have an impact on quality of life once the admission is finalized, in order to target specific domains of intervention, while the person still lives at home and after his/her admission. Methods QOL-EHPAD is a prospective, multi-centred, observational cohort study. At baseline, we will collect retrospective data on the life of 150 persons with dementia and their caregivers. These data will refer to the conditions of admission to a nursing home (emergency admission, involvement in the decision, admission from home or from the hospital) and to the 6 months prior to the admission of the person with dementia: sociodemographic and medical data, psychological tests, information on quality of life, satisfaction, behaviour, and nutrition. Similar data about life in the nursing home will be collected after 6 months, along with information on adaptation of the person with dementia to his/her new living environment. We will use univariate regression analyses followed by stepwise linear regression models to identify which factors pertaining to life at home are associated with quality of life and adaptation after 6 months. Discussion This study will provide data on the impact of institutionalization on quality of life and the determinants of a successful institutionalization in people with dementia. This could be helpful in setting up targeted interventions to prepare admission into a nursing home before the actual admission and to accompany both the caregiver and the person with dementia throughout this process

Risk of Asthmatic Episodes in Children Exposed to Sulfur Dioxide Stack Emissions from a Refinery Point Source in Montreal, Canada

BACKGROUND: Little is known about the respiratory effects of short-term exposures to petroleum refinery emissions in young children. This study is an extension of an ecologic study that found an increased rate of hospitalizations for respiratory conditions among children living near petroleum refineries in Montreal (Canada). METHODS: We used a time-stratified case-crossover design to assess the risk of asthma episodes in relation to short-term variations in sulfur dioxide levels among children 2-4 years of age living within 0.5-7.5 km of the refinery stacks. Health data used to measure asthma episodes included emergency department (ED) visits and hospital admissions from 1996 to 2004. We estimated daily levels of SO2 at the residence of children using a) two fixed-site SO2 monitors located near the refineries and b) the AERMOD (American Meteorological Society/Environmental Protection Agency Regulatory Model) atmospheric dispersion model. We used conditional logistic regression to estimate odds ratios associated with an increase in the interquartile range of daily SO2 mean and peak exposures (31.2 ppb for AERMOD peaks). We adjusted for temperature, relative humidity, and regional/urban background air pollutant levels. RESULTS: The risks of asthma ED visits and hospitalizations were more pronounced for same-day (lag 0) SO2 peak levels than for mean levels on the same day, or for other lags: the adjusted odds ratios estimated for same-day SO2 peak levels from AERMOD were 1.10 [95% confidence interval (CI), 1.00-1.22] and 1.42 (95% CI, 1.10-1.82), over the interquartile range, for ED visits and hospital admissions, respectively. CONCLUSIONS: Short-term episodes of increased SO2 exposures from refinery stack emissions were associated with a higher number of asthma episodes in nearby children

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Caractérisation du traitement visuel des émotions chez les patients atteints de troubles bipolaire et schizophrénique : étude comportementale et étude pilote en imagerie fonctionnelle

Human brain performs many functions with different objectives. Among those, the emotional mechanisms are intended to enable survival of the subject. They are at the origin of the identification of dangerous and beneficial events for the subject, in the environment, in order to react to them. Therefore, dangerous events will be fought or fled and beneficial events will rather be reinforced by the subject. Thus, emotional mechanisms have privileged links with sensorial processes to apprehend the environment and with motor system in order to put behaviour into action. Among dysfunctions noticed in bipolar disorder and schizophrenia, we found emotional treatment alterations, even at a distance of acute decompensation. Thus, the aim of this research project is twofold: it’s to increase understanding of the impairments in the visual treatment of the emotional information, both in behavioural level and neurofunctional space, and to identify new biomarkers, specific to each disease in order to help during complex diagnosis. Our behavioural results show us schizophrenic patients are quicker but less efficient than bipolar patients. From a neurofunctional point of view, bipolar patients have an insular overactivation for neutral stimuli, implying a greater link to interoceptivity than schizophrenic and healthy groups; whereas in schizophrenia, we found a wider recruitment of associative areas (as fusiform regions) and a fronto-temporo-parietal network when comparing to bipolar patients. This work currently continues in order to verify these results, by including more participants, as originally planned.Le cerveau humain met en œuvre de nombreuses fonctionnalités ayant différents objectifs ; parmi elles, les mécanismes émotionnels ont pour but de permettre la survie de l’individu. Ils permettent d’identifier dans l’environnement des évènements dangereux et bénéfiques pour l’individu et d’y réagir. Les évènements dangereux sont combattu ou fuit et ceux bénéfiques sont renforcés par le sujet. Ainsi, les mécanismes émotionnels ont des liens privilégiés avec les processus sensoriels pour appréhender l’environnement et le système moteur pour mettre en action un comportement. Parmi les troubles connus dans la bipolarité et la schizophrénie, on note des anomalies du traitement émotionnel, même à distance des décompensations aiguës. L’objectif de ce projet est double : mieux comprendre la spécificité des déficits dans le traitement visuel des émotions dans chacune des pathologies, sur le plan comportemental et sur le plan neurofonctionnel ; et identifier de nouveaux biomarqueurs spécifiques de chacun des troubles, afin d’apporter des arguments supplémentaires lors d’un diagnostic précoce parfois difficile. Au niveau comportemental, les schizophrènes semblent plus rapides mais moins efficients que les bipolaires dans le traitement émotionnel visuel. Sur le plan cérébral, nous trouvons une hyperactivation insulaire dans la bipolarité pour les stimuli neutres qui sous-entend un plus grand lien avec l’intéroceptivité par rapport aux schizophrènes et aux sujets sains. Dans la schizophrénie on note un recrutement plus large de régions associatives (fusiformes) et d’un réseau fronto-temporo-pariétal. Ce travail se poursuit dans l’objectif afin de valider ces résultats initiaux

Natural disasters, land-use, and insurance

This paper addresses the urbanization of areas exposed to natural disasters and studies its dependency on land-use and insurance policies. In practice, we observe simple policies, consisting of a prohibited red zone and a zone without insurance tariff differentiation. Even if there are fixed damages per dwelling, the red-zone policy is relatively efficient; it implements the optimal land-use if the losses are proportional to the surface used. The main results are on the effects redefining the optimal red zone as the climate or the population changes. We expose plausible cases in which the red zone grows with a growing population

The ground for negotiation: Zoning for risk reduction around hazardous plants

The industrialists are liable for any damage they cause to neighboring households. Consequently, households do not have to pay for the risk they create by locating in exposed areas. A common and efficient self-insurance strategy for the firm is to freeze land, or to negotiate land-use restrictions. When people understand only simple messages about risk, the boundaries of the building zone are the ground for negotiation with the mayor. Typical scenarios regarding the distribution of bargaining power between the firm and the mayor are examined. In the comparative statics, we show how red zones are revised as technology or demography change. Further, we give the conditions for a purple zone (limit red zone as the population grows) and a green zone (limit inhabitable zone as the risk grows) to exist