Vieillir, un fardeau pour les proches ?

L’aide à un proche âgé est souvent envisagée à travers la notion de burden. Or, celle-ci présente le double inconvénient de renforcer l’image de la vieillesse comme problème et d’occulter la diversité des significations que les aidants donnent à la situation. L’article, fondé sur l’analyse d’entretiens réalisés auprès d’aidants (conjoints et enfants, principalement), se propose d’élaborer une autre représentation, qui prend la forme d’une typologie mettant en relief la diversité des expériences de l’aide : aide-altération, aide-contraintes, aide-engagement et aide-satisfaction.Care for an elderly family member is often seen as a burden. Yet this perspective has the dual drawback of reinforcing the image of old age as a problem and of causing us to lose sight of the diversity of meanings that carers attribute to this situation. This article, based on the analysis of interviews with carers (spouses and children, for the most part), seeks to develop another representation of care for a family member. It takes the form of a typology that highlights the diversity of experiences : care as deterioration, care as constraint, care as commitment, and care as satisfaction

Influence of various redox conditions on the degradation of microalgal triacylglycerols and fatty acids in marine sediments

Sediment cakes, supplemented with microalgal cells (Nannochloropsis salina), were incubated for 35 days under permanently oxic, oscillating (5d:5d changeover oxic/anoxic) and strictly anoxic conditions of oxygenation in diffusively ‘‘open’’ sedimentary systems. Total lipids (TLip) and triacylglycerols (TG) concentrations were monitored by thin layer chromatography-flame ionisation detection, whereas the concentrations of the main extractable (free+ester-bound) individual fatty acids (C16:0, C16:1, C18:1) were followed using gas chromatography-mass spectrometry. Under the three conditions of oxygenation, TOC, TLip and TG showed a sharp decrease in concentration during the early days of incubation and seemed to stabilise thereafter, defining an apparent non degradable fraction (GNR). The GNR content was systematically higher in the anoxic incubation than under the oxic and oscillating conditions. The ratio of the main hydrolysis products of TG versus TG [(Free fatty acids+Monoacylglycerols+1,2-Diacylglycerols)/TG], used as an indicator of the hydrolysis of TG, showed that the presence of oxygen in the sediments (oxic and oscillating conditions) stimulates the hydrolysis of TG and the subsequent degradation of their metabolites. Unlike TOC, TLip and TG, individual fatty acids (FA) showed a continuous concentration decrease until the end of the experiment, which was fitted with a simple first order model [G(t)=G0e_kt] to yield apparent degradation rate constants. The values observed under oscillating conditions (kFA=0.019 +/- 0.001 d_1) were intermediate to those observed during oxic (kFA=0.029 +/- 0.003 d_1) and anoxic (kFA=0.011 +/- 0.001 d_1) incubations, and no significant difference between individual FA could be observed. The production of saturated and monounsaturated C16 (and to a lesser extent C18) alkanols under oscillating and anoxic redox conditions suggested that (a part of) the dominant FA were reduced to the corresponding alcohols under anoxic conditions, following their release from acylglycerols

Burial and reactivity of sedimentary microalgal lipids in bioturbated Mediterranean coastal sediments

International audienceThe fate of microalgal lipid biomarkers in marine coastal sediments when acted on by natural bioturbation processes (Carteau Bay, Gulf of Fos, Mediterranean Sea) was studied under laboratory conditions. Both dead phytoplanktonic cells (Nannochloropsis salina) and luminophores (inert fluorescent particulate tracers) were deposited at the surface of intact sediment cores which were then incubated for 22, 44 and 63 days. Sediment reworking and concentration profiles of specific lipid components of N. salina (n-alkenes, alkyl diols, sterols and fatty acids) were determined as a function of time and depth. The results show that, in the sediment investigated, bioturbation occurs essentially as a biodiffusive process and that it has a rapid and significant impact on the qualitative and quantitative record of sedimentary lipids. Whereas most of the biomarkers were detected in the entire reworked layer (0â6 cm) after 22 days, n-alkenes were never detected below 3 cm due to their low concentration and their high reactivity. For each individual lipid, the comparison of the amounts obtained from the inventories of biomarkers in the reworked zone, with the amount deposited initially at the sediment surface, allowed the determination of its extent and rate of degradation. These ranged from 72% to 99% and from 0.010 to 0.047 day-1, respectively, depending on the biomarker considered, with polyunsaturated fatty acids (PUFAs) and alkenes being degraded faster than the other components. Comparison with previous work suggests that, in biologically reworked sediments, the apparent reactivity of lipids is: (i) positively correlated with the biological mixing coefficient (Db) and, (ii) generally much higher than in non-bioturbated (anoxic) sediments. Our results also support the idea that degradation of lipids in reworked sediments involves the combined effects of aerobic and anaerobic degradation processes, but that biological mixing results in diagenetic properties more characteristic of completely oxidized conditions

Macrofaunal reworking activities and hydrocarbon redistribution in an experimental sediment system

The influence of macrofaunal reworking activities on the redistribution of particle associated hydrocarbon compounds (HC)was experimentally investigated. Two distinct hydrocarbon mixtures adsorbed on montmorillonite particles ( < 4 Am diameter)were added to the surface and deeper (2.5 cm) sediment layers. For comparison, luminophores (100–160 Amdiameter) were added in the two deposit layers. At the start of the experiment, four macrobenthic species (the bivalve Abra nitida, the polychaete Scalibregma inflatum, and the echinoderms Amphiura filiformis and Echinocardium cordatum) were added to the sediment surface. The macrofauna added rapidly transferred HC from the surface sediment down to f5 cm depth by both continuous (biodiffusion) and non-continuous (biotransport) transport. Hydrocarbon compounds initially added to the deeper sediment layer were only subject to biodiffusion-like transport. Apparent biodiffusion coefficients (Db) quantified by using a 1-D model were between 0.5 and 8.4×10−3 cm 2 d−1, and biotransport coefficients (r) ranged from 2.0 to 27.6×10−3 d−1. Thus, the four species studied did not have the same effect on particle redistribution and, consequently, on HC repartition in the sediments. E. cordatum was the most efficient reworker. The present study demonstrated the importance of particle size selectivity by benthic fauna, and verified that macrofaunal reworking activities may redeposit sediment from deeper sediment layers on the sediment surface. Both processes have obvious implications for rates and pathways during organic matter mineralisation in marine sediments

Risk Factors of Inadequate Colposcopy After Large Loop Excision of the Transformation Zone: A Prospective Cohort Study

International audienceObjective: The aim of the study was to identify the risk factors of post-large loop excision of the transformation zone (LLETZ) inadequate colposcopy. Materials and Methods: From December 2013 to July 2014, a total of 157 patients who had a LLETZ performed for the treatment of high-grade intraepithelial lesion with fully visible cervical squamocolumnar junction were included. All procedures were performed using semicircular loops. The use of colposcopy made during each procedure was systematically documented. Dimensions and volume of LLETZ specimens were measured at the time of procedure, before formaldehyde fixation. All participants were invited for a follow-up colposcopy 3 to 6 months after LLETZ. Primary end point was the diagnosis of post-LLETZ inadequate colposcopy, defined by a not fully visible cervical squamocolumnar junction and/or cervical stenosis. Results: Colposcopies were performed in a mean (SD) delay of 136 (88) days and were inadequate in 22 (14%) cases. Factors found to significantly increase the probability of post-LLETZ inadequate colposcopy were a history of previous excisional cervical therapy [adjusted odds ratio (aOR) = 4.29, 95% CI = 1.12-16.37, p = .033] and the thickness of the specimen (aOR = 3.12, 95% CI = 1.02-9.60, p = .047). The use of colpos-copy for the guidance of LLETZ was statistically associated with a decrease in the risk of post-LLETZ inadequate colposcopy (aOR = 0.19, 95% CI = 0.04-0.80, p = .024) as the achievement of negative endocervical margins (aOR = 0.26, 95% CI = 0.08-0.86, p = .027). Conclusions: Although the risk of post-LLETZ inadequate colpos-copy is increased in patients with history of excisional therapy and with the thickness of the excised specimen, it could be reduced with the use of colposcopic guidance and the achievement of negative endocervical margins. L arge loop excision of the transformation zone (LLETZ) is a routine procedure worldwide, because it is the first-line treatment of high-grade intraepithelial lesion (HSIL) of the cervix. Quality criteria for optimal LLETZ include the completeness of excision with the achievement of negative margins, while producing the minimal excised volume and depth of excision to minimize subsequent obstetrical and neonatal morbidity. 1,2 Obtaining negative margins is important, because incomplete excision exposes women to a significant risk of posttreatment residual and/or recurrent disease, particularly when the lesion involves the endo-cervical canal. 3,4 However, this risk remains higher to the general female population, even when negative margins are achieved. Women who had had a LLETZ remain therefore exposed to a 3-to 4-fold increased risk of developing subsequent cervical cancer at least for 20 years. 5-8 Thus, prolonged and careful post-LLETZ follow-up is mandatory, whatsoever the margins status. For the last decade, the value of human papillomavirus testing has been demonstrated in this indication. Although a negative human papillomavirus test has now been admitted as the best test of cure for patients, colposcopy remains needed when this test is found to be positive. 9-12 Although being the key examination in this indication, the accuracy of colposcopy performed after previous excisional therapy of HSIL is however questionable because the healing process might result in changes in the appearance of the transformation zone (TZ). However, the main limitation of post-LLETZ colposcopic examination is the possibility of inadequate colposcopy due to the inability to visualize the entire TZ. Known risk factors for inadequate colposcopy include age, severity of lesion, and estrogen status of the patient. 13 However, inadequate colposcopy is also one of the main adverse effects of excisional therapies of the cervix, including LLETZ. 13 However, data on the precise risk factors for inadequate colposcopy after LLETZ are limited because most studies have focused on the sole risk of cervical stenosis without considering the position and visibility of the squamocolumnar junction. 14-17 This point is however crucial because it is clinically essential to identify how post-LLETZ inadequate colposcopy could be avoided, thus preserving the possibility for the follow-up of these women

Le couple à l'heure de la retraite

Quand sonne l'heure de la retraite, quand disparaissent les contraintes de l'activité professionnelle, le nouveau retraité se retrouve face à lui-même… et face à son conjoint. C'est une nouvelle étape de la vie conjugale qui commence alors. Comment les personnes qui franchissent aujourd'hui le seuil de la retraite vivent-elles cette transition personnelle et conjugale ? Comment construisent-elles un nouveau monde conjugal tout en reconstruisant leur identité sociale

Chapitre III. La perte de l’identité professionnelle et la reconstruction de soi du conjoint rentrant

Face à la retraite… « Il y a beaucoup de gens qui n’existent que par leur boulot, qui n’ont aucune vie active en dehors de leur boulot et qui, du jour où on leur dit : “Monsieur, vous posez vos affaires-là, demain c’est terminé”, ils s’effondrent » explique M. Viaux. Au cours de cette recherche, nous avons entendu à plusieurs reprises des propos ana logues, complétés parfois par une anecdote : celle d’un ami devenu dépressif après sa cessation d’activité, ou d’un collègue décédé quelques mois..

Les comportements résidentiels des retraités. Quelques enseignements du programme de recherche « Vieillissement de la population et habitat »

This paper presents and analyses the key outcomes of the PUCA (Urban Development and Architecture Plan led by the French Ministry of Ecology, Energy, Substainable Development and Sea) research programme “Ageing and Living” which deals with retired people housing experiences. The approach given here refuses the stereotypes of elderly as enterprising and travelling “young seniors” or as disabled elders leaving in care institution by considering the diversity of retiree’s living conditions. Firstly, we identify different kind of housing experiences: free housing mobility (included new forms of mobility emerging from the comings and goings between different residences and from international mobility); stable housing; constrained mobility; compulsory housing; uncertain housing. Secondly, we suggest that these experiences are related to five notable concerns: economic, health, family, territory, wedded. We finally examine to what extent the retiree’s housing experiences change as they get older and emphasize the impact of national and local contexts on these experiences

Sociologie de la vieillesse et du vieillissement

3ème édition refondu