An intercomparison of measured pressure-broadening, pressure shifting parameters of carbon dioxide and their temperature dependence

International audienceAn intercomparison of measured pressure-broadening and pressure-shifting coefficients for carbon dioxide absorption lines was done. The work focuses on collision systems where a significant number of data can be found (CO2-N2, CO2-O2, CO2-air, and CO2-CO2) and yield information important to applications related to Earth's atmosphere. The literature was searched for measured line shape parameter data for the collision systems mentioned above. Databases were created for each perturbing gas with the ro-vibrational transition as the key. Using these databases intercomparisons of the measurements of half-widths, their temperature dependence, and line shifts were made. The data allow the investigations of trends in the data with respect to the vibrational and the rotational quantum numbers, various line shape models, and isotopologue effects

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

A Dietary Intervention of Bioactive Enriched Foods Aimed at Adults at Risk of Metabolic Syndrome: Protocol and Results from PATHWAY-27 Pilot Study

Around a quarter of the global adult population have metabolic syndrome (MetS) and therefore increased risk of cardiovascular mortality and diabetes. Docosahexaenoic acid, oat beta-glucan and grape anthocyanins have been shown to be effective in reducing MetS risk factors when administered as isolated compounds, but their effect when administered as bioactive-enriched foods has not been evaluated. Objective: The overall aim of the PATHWAY-27 project was to evaluate the effectiveness of bioactive-enriched food consumption on improving risk factors of MetS. A pilot study was conducted to assess which of five bioactive combinations provided within three different food matrices (bakery, dairy or egg) were the most effective in adult volunteers. The trial also evaluated the feasibility of production, consumer acceptability and gastrointestinal tolerance of the bioactive-enriched food. Method: The study included three monocentric, parallel-arm, double-blind, randomised, dietary intervention trials without a placebo. Each recruiting centre tested the five bioactive combinations within a single food matrix. Results: The study was completed by 167 participants (74 male, 93 female). The results indicated that specific bioactive/matrix combinations have effects on serum triglyceride or HDL-cholesterol level without adverse effects. Conclusion: The study evidenced that bioactive-enriched food offers a promising food-based strategy for MetS prevention, and highlighted the importance of conducting pilot studies

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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 &lt; 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

Évaluation de la mise en place d'un programme d'éducation thérapeutique médicamenteuse au centre d'évaluation et de traitement de la douleur du CHU de Nantes (analyse de la satisfaction chez 31 patients)

Objectifs : La prise en charge pluridisciplinaire de la douleur chronique est une priorité de santé publique et l'éducation thérapeutique est un élément indispensable de cette prise en charge. Un programme d'éducation thérapeutique médicamenteuse a été mis en place au Centre d'Evaluation et de Traitement de la Douleur du CHU de Nantes mais il n'avait encore jamais été évalué. Nous avons analysé la satisfaction des patients vis-à-vis de ce programme puis nous avons proposé des perspectives d'amélioration du programme et de son outil d'évaluation. Description : Notre étude a porté sur 31 patients hospitalisés au CETD entre le 30 Mai et le 2 Septembre 2011. La satisfaction a été évaluée sur l'ambiance des séances, l'accueil des participants, l'organisation matérielle et l'utilité des séances. Les patients ont aussi été interrogés sur les points forts et les points faibles du programme. Nous avons réfléchi à l'élaboration d'un nouvel outil d'évaluation pour permettre de mesurer l'efficacité du programme. Nous avons veillé à ce qu'il respecte les critères suivants : spécificité par rapport aux séances, représentativité de l'ensemble des notions abordées et cohérence avec les objectifs généraux du programme. Conclusion : La satisfaction vis-à-vis du programme d'éducation thérapeutique médicamenteuse est très forte : 97% des patients étaient en grande partie satisfaits des séances et 94% les ont trouvées utiles, ce qui montre l'importance de l'éducation thérapeutique médicamenteuse et sa légitimité au sein du CETD. Le programme d'éducation thérapeutique médicamenteuse a été amélioré, tant dans son contenu que dans sa forme, grâce aux points forts et points faibles formulés par les patients. Un outil d'évaluation permettant de mesurer l'efficacité du programme a été élaboré. Il respecte les critères précédemment cités et permettra une évaluation plus complète et de qualité du programme. Ce travail fera l'objet d'une prochaine thèse.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

CBT program to reduce recidivism risk for road crashes among adolescents and young adults: Results of a randomized controlled study and prospects

International audienceRoad crashes are the first cause of mortality for young adults aged 18–25 years and the human factor contributes to 90–95% of events. The present study was carried out to determine the efficacity of the ECARR2 recurrence prevention program among adolescents and young adults at high risk of having a new traffic crash in the following months. A total of 288 participants having had a traffic crash that required going to the emergency room, at high risk of accident recurrence (ECARR≥5) were randomly allocated to either the intervention group (n = 144) or the control group (n = 144). Results: revealed that the risk of recurrence was highest during the first 6 months (66% of recurrences). In per-protocol analysis population, at 6 months after inclusion, the accident recurrence rate was 14.2% ± 3.3% in the intervention group, and 23.5% ± 4.0% in the control group. The intervention had an effect per se, independently of the other predictors (p = 0.020). This effect was mediated by the three interaction variables: BDI, Impulsive Behavior Scale lack of perseverance, and Orientation to Happiness engagement. It was therefore through these dimensions that the intervention had an effect. In conclusion, the ECARR score predicts the risk of recurrence, risk which is the highest during the first 6 months. Finally, results confirm the predictive validity of the ECARR scale. The ECARR score had an effect on the risk of recurrence regardless of group (p = 0.045) and was predictive of recurrence (p = 0.045). A brief psychological intervention such as ECARR2 program, offered to young people ar hight risk of having a new crash, just after the crash, seems to halve the risk of recurrence at 6 months. Future research should improve the brief psychological intervention and its access via a mobile application or few hours in high school or in a driving school given

Pathway-27 : Etude Pilote sur les effets de substances bioactives en lien avec des marqueurs du Syndrome Métabolique

Introduction et but de l’étude : Le projet Pathway-27 permettra d’évaluer l’efficacité de l’acide docosahexaénoïque (DHA), seul ou en combinaison avec deux autres composés bioactifs (B-glucane (BG) et anthocyanes (AC)), dans la réduction des facteurs de risque du Syndrome Métabolique (SM). Ces composés dits « bioactifs » (BEF) ont été incorporés dans 3 matrices alimentaires différentes (produits laitiers, produits céréaliers et produits à base d’oeufs) seuls ou en association DHA +/- BG ou DHA +/- AC.L’objectif est d’appréhender les synergies possibles et les interactions BEF – matrice. Ces différentes matrices seront utilisées lors d’une étude d’intervention nutritionnelle multicentrique. Le but de cette étude européenne, randomisée, en double aveugle, est d'identifier le BEF qui induit une modification la plus favorable des paramètres lipidiques. Le BEF sélectionné sera ensuite testé sur une cohorte de huit cents sujets.Matériel et méthodes : Soixante-dix hommes et femmes à risque de SM ont été recrutés au Centre de Recherche en Nutrition Humaine Auvergne (CRNH-Auvergne) de Clermont-Ferrand (France). Les volontaires ont été divisés en 5 groupes recevant, pendant 4 semaines, une matrice alimentaire enrichie en DHA, BG, ou AC seul ou en association. Les marqueurs cliniques du SM ont été mesurés. De plus, des approches « omiques » seront utilisées pour examiner les changements métaboliques et potentiellement identifier de nouveaux marqueurs d'effets.Conclusion : Les résultats obtenus permettront de comprendre l’effet matrice sur la bioactivité des nutriments testés