Journal of epidemiology and population health最新文献

{"title":"The hidden crisis: Moral injury among French healthcare workers.","authors":"Laurent Boyer, Guillaume Fond, Bach Tran, Pierre-Michel Llorca, Antoine Duclos","doi":"10.1016/j.jeph.2024.202780","DOIUrl":"10.1016/j.jeph.2024.202780","url":null,"abstract":"<p><strong>Background: </strong>Amidst reports that one in five doctors and one in four nurses might leave their professions within three to five years due to high levels of burnout, this qualitative review explored the deeper crisis impacting healthcare workers in France, questioning whether factors beyond burnout contributed to their distress.</p><p><strong>Methodology: </strong>This study analyzed testimonies from French healthcare workers and reviewed relevant literature to uncover the underlying causes of their distress.</p><p><strong>Results: </strong>The qualitative analysis revealed profound distress among healthcare workers, stemming from a misalignment between their ethical standards, specifically the principle to 'put patients first,' and the practical realities of their work. Testimonies underscored unsustainable working conditions and economic pressures that compel healthcare workers to make decisions that compromise care quality and their own integrity. Nurses reported closing their practices due to non-profitability, forced to prioritize financial considerations over patient needs. Similarly, general practitioners expressed disillusionment, feeling disconnected from the type of medicine they aspired to practice. This distress goes beyond mere burnout, touching on deep-seated conflicts between personal values and professional demands, leading to significant attrition among healthcare workers. Comparative insights from the United States highlight a global trend where healthcare professionals face diminishing trust in systems that favor financial or operational efficiency over patient-centric care. 'Moral Injury,' as identified in our literature review, aptly describes the situation faced by French healthcare workers. It refers to the psychological distress that occurs when they cannot practice according to their ethical beliefs due to external constraints-whether from profit maximization in predominantly financialized systems like those in the United States or from funding and management gaps in public systems like those in France.</p><p><strong>Conclusion: </strong>Healthcare workers observe that the French healthcare system, once praised for its excellence and accessibility, no longer allows them to put patients at the heart of their concerns, in contradiction with their values. It is therefore essential to recognize the existence of \"Moral Injury\" to guide the structural and organizational reforms necessary to transform our healthcare system.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 6","pages":"202780"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of frailty on unplanned readmission in older adults: A systematic review.","authors":"Maryline Bourriquen, Anne-Laure Couderc, Fannie Bretelle, Patrick Villani","doi":"10.1016/j.jeph.2024.202774","DOIUrl":"10.1016/j.jeph.2024.202774","url":null,"abstract":"<p><strong>Background: </strong>Frailty and hospital readmissions are two major problems for older people because of their impact on health, quality of life and healthcare systems. The aims of this study were to investigate the relationship between frailty and unplanned readmissions at 30, 90, 180 days and 1 year in hospitalised older people, and to identify the most relevant tools for assessing readmission risk in different clinical settings to facilitate systematic identification of this high-risk population by healthcare professionals.</p><p><strong>Method: </strong>This review was based on a systematic search of the MEDLINE, EMBASE and SCIENCEDIRECT databases for articles published between January 2011 and December 2021 that examined the association between frailty and unplanned readmission in hospitalised adults aged 65 years and over using identified validated tools.</p><p><strong>Results: </strong>44 eligible studies out of 1362 were included in a descriptive analysis. Sixteen countries were represented with older adults hospitalised in medical, surgical, post-acute care and rehabilitation, and emergency departments. Up to 84.5% of frail older adults had an unplanned readmission. Of the 21 tools identified, the Hospital Frailty Risk Score (HFRS), the Frailty Index (FI), its derivatives, the Clinical Frailty Scale (CFS) and the Fried model were the most widely used and relevant tools for identifying the association between frailty and unplanned readmission.</p><p><strong>Conclusion: </strong>Frailty is widely associated with readmission risk in older adults. The HFRS, FI, CFS and Fried model appear to be the most commonly used tools to assess frailty and prevent unplanned readmissions.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202774"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of infant mortality in French Guiana: The persistence of high post neonatal mortality.","authors":"Mathieu Nacher, Celia Basurko, Lindsay Osei, Nadia Thomas, Alphonse Louis, Malika Leneuve, Dominique Dotou, Alice Tosi, Veronique Lambert, Emeline Monjardé, Gabriel Bafunyembaka Muhigirwa, Narcisse Elenga, Najeh Hcini","doi":"10.1016/j.jeph.2024.202535","DOIUrl":"10.1016/j.jeph.2024.202535","url":null,"abstract":"<p><strong>Background: </strong>Infant mortality in French Guiana, a French overseas territory, is 2.7 times greater than in mainland France. Given the importance of better understanding infant mortality we aimed to describe the early & late neonatal, and postneonatal mortality in French Guiana between 2007 and 2022.</p><p><strong>Methods: </strong>We used data from the Institut National de la Statistique et des Etudes Economiques to describe trends and performed survival analysis.</p><p><strong>Results: </strong>Overall, there were 1 073 deaths before one year of age, of which 297 (27.7 %) occurred on the first day of life. The overall proportion of early neonatal deaths was 47.1 %, late neonatal deaths was 17.3 %, and post-neonatal deaths was 35.6 %. The overall incidences were 4.6 per 1,000 for early neonatal mortality, 1.4 per 1,000 for late neonatal mortality, and 3.1 per 1,000 for post neonatal mortality. The incidence for infant mortality for French Guiana residents was thus 9.1 per 1,000.</p><p><strong>Conclusions: </strong>We show that post neonatal deaths in French Guiana are proportionally greater than in mainland France and they do not seem to decline, as they did in France. The relative proportions of post-neonatal mortality can thus help to identify important areas for action to correct excess infant mortality. Although poor pregnancy follow-up remains a problem we show that follow-up of infants is also a pressing problem that warrants increased efforts.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202535"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach to the epidemiology of people living with spinal cord injuries in France based on an original algorithm from public health insurance data.","authors":"Fanny Duchaine, Maude Espagnacq, Djamel Bensmail, Camille Regaert, Pierre Denys, Jonathan Levy","doi":"10.1016/j.jeph.2024.202773","DOIUrl":"10.1016/j.jeph.2024.202773","url":null,"abstract":"<p><strong>Introduction: </strong>French Public Health Insurance gathers health, demographic and economic data based on codes from the 10th version of the international classification of diseases (ICD-10), specific nomenclature for each health-care (medical or surgical) procedures, medical expenses and justifications for full coverage of medical care. We aimed to build an algorithm that could identify the French population of people living with spinal cord injury (SCI) relying on public health insurance metadata.</p><p><strong>Material and methods: </strong>The SNDS (in French, Système National des Données de Santé) was searched for the time-period 2012-2019, looking for: full-coverage motives, ICD-10 codes, and health-therapeutic procedures specific of our population of interest. We built a step-by-step algorithm that identified i)including codes, ii)excluding codes, iii)codes needing confirmation. A group of 3 physicians recognized as experts in this field contributed with data scientists to the selection of pertinent codes and their association. Including codes were ALD-20 (full-coverage 'paraplegia', in French, Affection de Longue Durée), G114 (spastic paraplegia), Q05.x (spina bifida), spinal cord trauma (S14.x; S24.x), vascular myelopathy (G951), degenerative myelopathies (M47.x). Autoimmune, other disabling neurological diseases with a specific ICD code, and oncologic patients were excluded. Neurological symptoms (G82.x) needed confirmation. We identified 6 categories of SCI regarding their etiology, based on ICD-10 code combinations (congenital, genetic, tumoral, traumatic, acquired and symptomatic) Finally antibiotics consumption and hospitalizations of persons identified as SCI were compared to a control sample from overall population (with a 1:5 ratio).</p><p><strong>Results: </strong>Among almost 245 000 persons with putative SCI, we identified 133 849 living individuals with SCI aged>16 (55.8% men, age 57 yo [44;70]) by 2019. Confirmed traumatic SCI were 21 459 (67% were men, age 53 yo [39;67]), acquired non-traumatic were the most frequent (n=62 561, 46.7%). SCI consumed 1.5 to 3-times more antibiotics and were 4-fold more hospitalized than controls. Also, when hospitalized, they remained twice longer in rehabilitation facilities and 3-times longer in acute care.</p><p><strong>Conclusion: </strong>Using multiple code entries, our algorithm allowed an exhaustive identification of the French adult SCI population, with an updated epidemiology. This innovative method opens the field for large-scale studies regarding medical history of persons living with SCI by the prism of medical expenses and habits.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202773"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of depressive symptoms among urban school adolescents in Vietnam: The role of youth, family, and school relationships.","authors":"Huong Thi Thu Nguyen, Bach Xuan Tran, Hoat Ngoc Luu, Laurent Boyer, Guillaume Fond, Pascal Auquier, Carl A Latkin, Tham Thi Nguyen, Melvyn W B Zhang, Roger C M Ho, Cyrus S H Ho","doi":"10.1016/j.jeph.2024.202758","DOIUrl":"10.1016/j.jeph.2024.202758","url":null,"abstract":"<p><strong>Background: </strong>Adolescents frequently encounter a spectrum of psychiatric conditions, predominantly depressive and anxiety disorders, along with various behavioral disturbances.</p><p><strong>Objective: </strong>This investigation aims to delineate the prevalence of depressive disorders among adolescents in urban Vietnam and to elucidate the interrelationships between familial and school-related dynamics and adolescent depression.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted in 2022, involving 507 students aged 15 to 17 from high schools in Hanoi, Vietnam. Reynolds Adolescent Depression Scale - Second Edition (RADS-2) was used to assess the presence of depressive symptoms. Social-demographic characteristics, adolescent-family and adolescent-school relationships, and academic environment characteristics of high school students were interviewed. Multivariate Tobit regression models were employed to discern contributory factors across four domains of RADS-2.</p><p><strong>Results: </strong>Among the 507 adolescents, the mean scores on the RADS scale were 15.1 ± 4.2 for the dysphoric mood domain, 16.4 ± 4.0 for the anhedonia-negative domain, 13.1 ± 4.4 for the negative self-evaluation domain, and 12.4 ± 3.7 for the somatic complaints domain. The analysis indicated that adolescents with suboptimal parental relationships, absence of confidants, frequent parental conflicts, exposure to parental arguments, substantial exam-related stress, or overwhelming academic demands were more likely to exhibit elevated depressive symptoms. Conversely, adolescents who were satisfied with their friendships at school and received care, support from teachers or friends, and involved in school's extracurricular activities lower exhibited levels of depression.</p><p><strong>Conclusions: </strong>Findings reveal the significant impact of family and peer relationships, as well as academic stress, on the development of depressive symptoms. These significant results inform the design and development of future interventions aimed at mitigating depression risks among high school students, emphasizing the crucial roles of both educational institutions and family dynamics.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202758"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing agreement between population-level administrative pharmaceutical databases and patient-reported medication dispensation in cardiac rehabilitation patients.","authors":"Danielle A Southern, Codie Rouleau, Stephen B Wilton, Sandeep G Aggarwal, Michelle M Graham, Erik Youngson, Finlay A McAlister, Hude Quan","doi":"10.1016/j.jeph.2024.202764","DOIUrl":"10.1016/j.jeph.2024.202764","url":null,"abstract":"<p><strong>Background: </strong>Pharmacoepidemiology has emerged as a crucial field in evaluating the use and effects of medications in large populations to ensure their safe and effective use. This study aimed to assess the agreement of cardiac medication use between a provincial medication database, the Pharmaceutical Information Network (PIN), and reconciled medication data from confirmation through patient interviews for patients referred to cardiac rehabilitation.</p><p><strong>Methods: </strong>The study included data from patients referred to the TotalCardiology Rehabilitation CR program, and medication data was available in both TotalCardiology Rehabilitation charts and PIN. The accuracy of medication data obtained from patient interviews was compared to that obtained from PIN with proportions and kappa statistics to evaluate the reliability of PIN data in assessing medication use.</p><p><strong>Results: </strong>Patient-reported usage was higher for statins (41.6 %) vs. 38.4 %), ACE/ARB, beta-blockers (75.7 %) vs. 73.7 %), DOAC (3.5 %) vs. 2.6 %), and ADP-receptor antagonists (71.0 %) vs. 68.1 %) than if PIN was used. Patient-reported usage data was lower for Ezetimibe (4.7 vs. 4.8 %), Aldosterone antagonists (5.4 %) vs. 5.5 %), digoxin (0.9 %) vs. 1.0 %), calcium channel blockers (19.2 vs. 19.9 %) and warfarin (7.2 %) vs. 8.1 %). The results indicated that the differences between the two sources were very small, with an average agreement of 95.3 % and a kappa of 0.70.</p><p><strong>Conclusion: </strong>The study's results, which show a high level of agreement between PIN and patient self-reporting, affirm the reliability of PIN data as a source for obtaining an accurate assessment of medication use. This finding is crucial in the context of pharmacoepidemiology research, where the accuracy of data is paramount. Further research to explore the complementary use of both data sources will be valuable.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202764"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 impact on incidence and stage at diagnosis of five prominent cancers: A French cancer registry-based study.","authors":"Bénédicte Demoustier, Arnaud Seigneurin, Emmanuelle Jacquet, Patricia Delafosse, Cédric Riedel, Olivier Epaulard, Mathieu Laramas","doi":"10.1016/j.jeph.2024.202555","DOIUrl":"10.1016/j.jeph.2024.202555","url":null,"abstract":"<p><strong>Background: </strong>The French healthcare system has been affected by the COVID-19 pandemic in 2020, including cancer care.</p><p><strong>Methods: </strong>In order to evaluate the impact of this pandemic on cancer incidence, the Isere Departmental Cancer Registry compared the actual 2020 incidence of melanoma, breast, colorectal, prostate and lung cancers with the expected 2020 incidence based on data collected by the Registry between 2015 and 2019, taking into account periods of lockdown and reopening. When available, cancer stages and/or prognostic scores were recorded.</p><p><strong>Results: </strong>During the period of initial confinement, a 54%, 50% and 36,8% drop in incidence was observed for breast, prostate and colorectal cancer respectively. Although their annual incidence remained stable, a worsening trend emerged as a decline in the number of low stages/scores at diagnosis in favour of higher stages/scores towards the end of 2020. In contrast, a significant 17,8% drop was observed in annual incidence of melanoma, particularly for Breslow scores < 1 (-27,4%). However, this trend was noticeable before the lockdown, as well as the 14% reduction in the incidence of lung cancer in women, but not in men.</p><p><strong>Conclusion: </strong>The incidence of certain cancers was caught up over the year but the COVID-19 pandemic seems to be associated with a change in their severity at diagnosis throughout 2020. The downward trends in female lung cancer and melanoma incidence point to complex underlying phenomena. Further analysis is still needed to assess the global impact of the COVID-19 pandemic on cancer incidence.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202555"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141539089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of health indicators: Update for people with polyhandicap.","authors":"Karine Baumstarck, Ilyes Hamouda, Any Beltran, Sibylle Del Luca, Houria El Ouazzani, Marie-Christine Rousseau","doi":"10.1016/j.jeph.2024.202547","DOIUrl":"10.1016/j.jeph.2024.202547","url":null,"abstract":"","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202547"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book reviews.","authors":"","doi":"10.1016/j.jeph.2024.202777","DOIUrl":"https://doi.org/10.1016/j.jeph.2024.202777","url":null,"abstract":"","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 5","pages":"202777"},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of depressive symptoms among undergraduate health science students at the University of Parakou, Benin.","authors":"Antoine Gbessemehlan, Rafath Rafiou Taffa, Cédric Galera, Maëlenn Guerchet, Thierry Adoukonou","doi":"10.1016/j.jeph.2024.202525","DOIUrl":"10.1016/j.jeph.2024.202525","url":null,"abstract":"<p><strong>Objectives: </strong>Research on psychological distress in African students is scarce. This study aimed at exploring the epidemiology (prevalence and correlates) of depressive symptoms among undergraduate health sciences students at the University of Parakou (Benin).</p><p><strong>Methods: </strong>We conducted a cross-sectional survey from June to July 2022 at the University of Parakou, the second-largest university in the Republic of Benin. Depressive symptoms were assessed using the Patient Health Questionnaire depression scale (PHQ-9). Information on several independent factors was collected and their associations with depressive symptoms were investigated using logistic regression models.</p><p><strong>Results: </strong>Data from 560 students were analyzed (mean age: 21.3± 2.3 years, 60 % were male, and 50.4 % were registered in the first year of study). The overall prevalence of depressive symptoms was 39.1 % [95 % CI: 35.2 %-43.1 %]. Moderate and severe depressive symptoms were observed in 15.3 % and 1.8 % of participants, respectively. In the multivariable model, being aged 21-23 (adjusted Odds Ratio=1.8, p-value: 0.007), a female (aOR=1.5, p-value: 0.050), a medical student (aOR=2.9, p-value: <0.001), a public health student (aOR=3.6, p-value: <0.001), belonging to households with higher incomes (aOR= 2.4, p<0.001), and experiencing stress (aOR=1.5, p-value: 0.048) independently increased the probability of having depressive symptoms. However, having support from close relatives (aOR= 0.5, p-value: 0.026) was associated with a lower probability of depressive symptoms.</p><p><strong>Conclusions: </strong>Our findings revealed a high prevalence of depressive symptoms among undergraduate health science students. Given the correlates identified, actions to promote coping skills in stress and encourage more parental support may be real avenues likely to help reduce the frequency and consequences of depressive symptoms.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"72 4","pages":"202525"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}