Description des caractéristiques et des filières de soins des personnes agées admises aux urgences ( validation d'un score de dépistage de réadmission à 6 mois)

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Description des caractéristiques et des filières de soins des personnes agées admises aux urgences ( validation d'un score de dépistage de réadmission à 6 mois)

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Liens entre les cinq grands facteurs de personnalité et le SSPT chez des policiers Français

International audienceIntroductionPost-traumatic stress disorder (PTSD) is rare among police officers, but the symptoms of PTSD are not. Personality traits can be a contributing factor of stress disorders. Based on the big five personality traits, three personality profiles can be identified: resilient, overcontrolled and undercontrolled. Resilient people are characterized by high emotional stability (low neuroticism), high social skills and self-confidence. Overcontrollers have higher scores on neuroticism and they tend to internalize their negative emotions. Undercontrollers are characterized by low conscientiousness (impulsivity), a tendency toward social withdrawal and low self-esteem.ObjectiveThe aim of this study was to examine the role of personality traits and profiles in the emergence of PTSD symptoms among French police officers.MethodParticipants were French national police officers (n = 100, M = 32.9 years, SD = 9.8, 19–57) who completed the Posttraumatic Stress Disorder Checklist Scale (PCLS) and the Big Five Inventory (BFI).ResultsResults revealed the three expected personality profiles: resilients (n = 31), overcontrollers (n = 43) and undercontrollers (n = 19). The resilients presented with the fewest PTSD symptoms and the undercontrollers with the most (particularly reexperiencing). The latter also scored the highest on neuroticism and the lowest on extraversion and agreeableness. Police officers with an undercontrolled profile were also the oldest or those who had served the longest in the police force. Neuroticism and length of service were the two predictors of PTSD symptoms for reexperiencing and avoidance.ConclusionThis study demonstrates the contribution of each personality trait and length of service to PTSD symptoms in French police officers.IntroductionLe trouble de stress post-traumatique (TSPT) est rare parmi les policiers, mais les symptômes ne le sont pas. Les traits de personnalité peuvent être un facteur médiateur des troubles liés au stress. Ils permettent habituellement d’identifier trois profils de personnalité : les « résilients » caractérisés par une forte stabilité émotionnelle, des compétences sociales et une confiance en soi élevées ; les « surcontrôlés » qui ont des scores élevés de névrosisme et une tendance à internaliser leurs émotions négatives et des « sous-contrôlés » avec un faible caractère consciencieux (impulsivité), une tendance à l’isolement social et une faible estime de soi.ObjectifL’objectif de cette étude était d’examiner le rôle de la personnalité dans l’apparition de symptômes du TSPT chez les policiers français.MéthodeLes participants étaient des policiers français (n = 100, M = 32,9 ans, ET = 9,8, 19–57) qui ont complété l’échelle de l’état de stress post-traumatique (PCLS) et l’inventaire des cinq grands facteurs de personnalité (BFI).RésultatsLes résultats ont retrouvé les trois profils de personnalité attendus : « résilients » (n = 31), « surcontrôlés » (n = 43) et « sous-contrôlés » (n = 19). Les premiers présentaient le moins de symptômes de TSPT et les derniers le plus (en particulier la répétition ou intrusion). Ils avaient également les scores les plus élevés de névrosisme et les plus bas d’extraversion et d’agréabilité. Ces policiers étaient aussi les plus âgés ou ceux qui avaient servi le plus longtemps dans la police. Le névrosisme et la durée du service étaient les deux facteurs prédictifs des symptômes de TSPT pour la répétition et l’évitement.ConclusionCette étude met en évidence la contribution de chaque trait de personnalité et durée de service pour les symptômes de TSPT chez les policiers français

Relations entre endurance, exposition aux événements traumatiques et symptômes de TSPT chez des policiers français

International audienceIntroductionExposure to traumatic events is common in police work, and its psychological impact on officers may take the form of severe PTSD symptomatology. Personality traits such as hardiness could be protective against mental health outcomes and help withstand stress and trauma.ObjectiveThis study aimed to examine the relationships between hardiness, internalizing disorders, and PTSD symptoms in a sample of French police officers.MethodParticipants were French police officers (n = 100, mean age = 32.98 years, SD = 9.85) who completed self-report measures of PTSD and psychiatric morbidity, together with an index of cumulative exposure to traumatic incidents in an occupational context.ResultsCorrelational analysis and partial correlations showed a specific relationship between hardiness and the PTSD symptom clusters of reexperiencing and avoidance, but not hyperarousal. The correlational analysis investigating relationships between hardiness and mental health outcomes yielded high negative correlations for control and commitment, but no significant finding for challenge. The results of the regression analysis indicate that only the reexperiencing and avoidance clusters were significantly mediated by control, and to a lesser extent, by commitment.ConclusionResults reveal that hardiness has a potential buffer and protective effect on PTSD symptoms among police officers.IntroductionL’exposition à des événements traumatiques est fréquente dans le travail de la police et son impact psychologique sur les agents peut prendre la forme d’une symptomatologie sévère de TSPT. Les traits de personnalité tels que l’endurance pourraient être protecteurs en matière de santé mentale et aider à faire face aux stress et aux traumatismes.ObjectifCette étude visait à examiner les relations entre endurance, troubles internalisés et symptômes de TSPT dans un échantillon de policiers français.MéthodeLes participants étaient des policiers français (n = 100, age moyen = 32,98 ans, SD = 9,85) qui ont complété des mesures en auto-évaluation du TSPT et de la morbidité psychiatrique, de l’endurance, ainsi qu’un indice d’exposition à des incidents traumatiques dans un contexte professionnel.RésultatsL’analyse des corrélations a montré une relation spécifique entre l’endurance et les symptômes de répétition (intrusion) et d’évitement du TSPT, mais pas avec l’hyperactivité neurovégétative. L’étude des corrélations entre endurance et mesures de morbidité psychiatrique montre des corrélations négatives élevées pour le contrôle et l’engagement, mais aucune corrélation significative pour la dimension challenge. Les résultats de l’analyse de régression indiquent que seuls les symptômes de répétition et d’évitement ont été significativement médiés par le contrôle et, dans une moindre mesure, par l’engagement.ConclusionLes résultats révèlent que l’endurance a un effet protecteur sur les symptômes de TSPT chez les policiers

Prevalence of and Risk Factors for Anal Oncogenic Human Papillomavirus Infection Among HIV-Infected Women in France in the Combination Antiretroviral Therapy Era

International audienceBackground. Little is known about the type-specific prevalence of anal human papillomavirus (HPV) infection and risk factors for anal high-risk (HR) HPV infection in human immunodeficiency virus (HIV)-infected women. Methods. A cross-sectional study of anal and cervical HPV infection was nested within a gynecological cohort of HIV-infected women. Specimens were tested for type-specific DNA using a polymerase chain reaction-based assay. Results. The study population consisted of 311 women with a median age of 45.3 years, of whom 42.8% originated from sub-Saharan Africa and 96.8% were receiving combination antiretroviral therapy. The median CD4 + cell count was 612/μL, and the HIV load was <50 copies/mL in 84.1%. HR-HPV types were detected in the anal canal in 148 women (47.6%) and in the cervix in 82 (26.4%). HPV-16 was the most prevalent type in both the anal canal (13.2% of women) and the cervix (5.1%). In multivariable analysis, factors associated with prevalent anal HR-HPV infection were CD4 + count <350/μL (odds ratio, 2.9; 95% confidence interval , 1.3-6.5), concurrent cervical lesions (2.6; 1.0-4.3), and cervical HR-HPV infection (1.8; 1.0-3.2). Conclusions. The high prevalence of HR-HPV types, including HPV-16, in the anal canal of HIV-positive women is concerning. Anal cancer screening should be considered for HIV-positive women as part of their routine care

Simulação do fluxo de água em uma pilha de rejeito na antiga mina de uranio em Le Cellier (Lozère França)

International audienc

Pyelonephritogenic Diffusely Adhering Escherichia coli EC7372 Harboring Dr-II Adhesin Carries Classical Uropathogenic Virulence Genes and Promotes Cell Lysis and Apoptosis in Polarized Epithelial Caco-2/TC7 Cells

Diffusely adhering Escherichia coli (DAEC) strains expressing adhesins of the Afa/Dr family bind to epithelial cells in a diffuse adherence pattern by recognizing a common receptor, the decay-accelerating factor (CD55). Recently, a novel CD55-binding adhesin, named Dr-II, was identified from the pyelonephritogenic strain EC7372. In this report, we show that despite the low level of sequence identity between Dr-II and other members of the Afa/Dr family, EC7372 induces pathophysiological effects similar to those induced by other Afa/Dr DAEC strains on the polarized epithelial cell line Caco-2/TC7. Specifically, the Dr-II adhesin was sufficient to promote CD55 and CD66e clustering around adhering bacteria and apical cytoskeleton rearrangements. Unlike other Afa/Dr DAEC strains, EC7372 expresses a functional hemolysin that promotes a rapid cellular lysis. In addition, cell death by apoptosis or necrosis was observed in EC7372-infected Caco-2/TC7 cells, depending on infection time. Our results indicate that EC7372 harbors a pathogenicity island (PAI) similar to the one described for the pyelonephritogenic strain CFT073, which carries both hly and pap operons. Cumulatively, our findings indicate that strain EC7372 can be considered a prototype of a subclass of Afa/Dr DAEC isolates that have acquired a PAI harboring several classical uropathogenic virulence genes

High prevalence of Anal Human Papillomavirus-associated cancer precursors in a contemporary cohort of asymptomatic HIV-infected women

International audienceBackground. Although human immunodeficiency virus (HIV)-infected women are at high risk for anal cancer, few data have been published on prevalence of and risk factors for anal precancer and potential screening strategies in this risk group. Methods. A cross-sectional anal screening study was nested in a gynecological cohort of HIV-infected women. Anal swab specimens were collected for cytology and human papillomavirus (HPV) testing. High-resolution anoscopy, with biopsy when indicated, was systematically performed. Results. Among the 171 enrolled women, median age was 47.3 years and 98% were receiving combination antiretroviral therapy. Median CD4 + count was 655 cells/µL and HIV load was <50 copies/mL in 89% of subjects. High-grade anal intraepithelial neoplasia or worse (HG-AIN+) was diagnosed in 12.9% (n = 21). In multivariable analysis, a history of cervical squamous intraepithelial lesion (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.1-16.4) and anal HPV-16 infection (OR, 16.1; 95% CI, 5.4-48.3) was associated with increased risk of HG-AIN+. Abnormal anal cytology and HPV-16 infection performed best as a screening strategy for HG-AIN+ histology, with positive likelihood ratios of 3.4 (95% CI, 2.3-5.1) and 4.7 (95% CI, 2.5-8.7) and negative likelihood ratios of 0.2 (95% CI, .07-.8) and 0.4 (95% CI, .2-.9), respectively. Conclusions. HIV-infected women with a history of HPV-associated cervical disease are at increased risk for HG-AIN+ and should be offered anal cancer screening. Anal cytology and HPV-16 genotyping had the best screening performance. Anal cytology is easy to perform routinely; it may be the best candidate for screening for HG-AIN among HIV-infected women