Gefluc Languedoc Roussillon

Dans cet article, nous présentons et analysons une expérimentation sociodidactique associant l’utilisation du smartphone à diverses activités réalisées dans le cadre d’un atelier intitulé Découvrir sa ville, proposé à des migrants nouvellement arrivés en France. Outre le fait qu’il permet aux participants de manipuler un objet qui fait partie intégrante de leur quotidien, le smartphone est bien adapté à des projets comme le nôtre qui se déroulent sur le terrain, en extérieur. Nous proposons une analyse réflexive de cette expérimentation en choisissant comme cadre d’analyse la dynamique de projet, la démarche collaborative et l’approche actionnelle.

Objectifs : tudier la religiosit des psychiatres algriens et leur attitude face aux questions religieuses en pratique clinique. Mthodes : tude descriptive transversale incluant 87 psychiatres qui ont rpondu un questionnaire anonyme auto administr diffus via un rseau social. Rsultats : Deux tiers des rpondants taient des femmes (67,8 %), l'ge moyen est de 39,3 ans ; la plupart pratiquent la psychiatrie gnrale (89,7%) avec une moyenne de 9,32 annes d'exprience. La majorit des psychiatres (95.4%) sont croyants et les deux tiers (62,1%) sont pratiquants rguliers ; les femmes tant plus croyantes et plus pratiquantes que les hommes. La religion a une importance surtout chez les psychiatres croyants et chez les pdopsychiatres mais en gnral elle n'influe pas la pratique psychiatrique. La plupart des psychiatres (96,5 %) acceptent volontiers d'aborder les questions religieuses avec les patients. Les psychiatres dans leur majorit (62,1 %) pensent que la religion a, la fois, un effet positif et ngatif sur la maladie mentale ; les psychiatres pratiquants y voient un effet positif. Deux tiers des psychiatres (64,4 %) n'ont pas cherch gagner des connaissances sur ce thme et la moiti (52,9 %) sont d'accord pour intgrer la religion dans la formation des psychiatres. Conclusion : La croyance et la pratique religieuse ne se traduisent toujours pas par l'intgration de la religion en pratique clinique. Une formation initiale et/ou une formation continue pourrait aider les psychiatres savoir comment prendre en compte la dimension religieuse lors de l'valuation clinique initiale et en thrapie.

The Allergic Rhinitis and Its Impact on Asthma (ARIA) initiative started more than 20 years ago and has developed and disseminated evidence-based guidelines and projects in the field of allergic rhinitis. This initiative is currently focused on providing patient-centred guidelines that contribute to an integrated care pathway between the various levels of care and take advantage of digital solutions, and the introduction of integrated care pathways in clinical practice has been recommended. In this article we describe the adaptation for Portugal of the ARIA Integrated Care Pathways document. After a brief review of the epidemiology and impact of allergic rhinitis in Portugal and the activities carried out in Portugal within the ARIA initiative, we describe the broad knowledge base used for the development of recommendations for the pharmacological treatment of allergic rhinitis, and these recommendations are based on the GRADE methodology, real world evidence acquired by mobile technology (mHealth) and resulting from allergenic exposure chamber studies. What follows is a summary of integrated care pathways for allergen immunotherapy produced in 2019. Allergen immunotherapy is considered an example of precision medicine where the use of mHealth technologies will improve stratification for patient selection and response monitoring. These recommendations were considered as best practices of integrated patient-centred care supported by digital systems from Directorate General for Health and Food Safety of the European Union (DG Santé) and represent the ARIA Phase 4 Change Management strategy.

The paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Community pharmacists are the most accessible healthcare professionals to the public and allergic rhinitis is one of the most common diseases managed by pharmacists. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed over the past 20 years have improved the care of allergic rhinitis patients through an evidence-based, integrated care approach. In this paper, we propose an integrated approach to allergic rhinitis management in community pharmacy following the 2019 ARIA in the pharmacy guidelines.

Abstract Background: Persistence of unhealthy behaviors may adversely affect breast cancer (BC) outcomes and quality of life. Cancer diagnosis can represent a teachable moment and a powerful catalyst to correct such behaviors. It has been suggested that some cancer patients (pts) may be motivated towards a healthier lifestyle, particularly in case of a worse cancer-related prognosis. In this study we aimed at understanding the evolution and barriers in adoption of health behaviors after BC. Methods: We analyzed 8580 pts enrolled from 2012-2015 in a nationwide, multicenter study of stage I-III BC (CANTO, NCT01993498). Pts were longitudinally assessed at diagnosis (baseline), year(y)1 and y2 post-diagnosis. Recreational physical activity (PA) was reported using the GPAQ-16. An unhealthy smoking behavior was defined as active smoker status and an unhealthy alcohol behavior as consumption of ≥1 drink/day at y1 and y2. First, we described the longitudinal evolution of health behaviors. Then, we examined factors associated with health behaviors, to define pts that fail to adopt healthy lifestyle changes. Random effect mixed models evaluated changes in PA over time. Logistic regression models estimated odds of unhealthy smoke and alcohol behavior at y1 and y2. All models were adjusted for tumor, including BC stage, clinico-behavioral and treatment characteristics. Results: Mean age at diagnosis was 55 y (SD 11), 9% pts had stage III BC, 49% were overweight/obese (body mass index [BMI] ≥25 Kg/m2), 41% did not meet PA recommendations (<10 MET-h/week), 18% were active smokers, 14% reported ≥1 drink/day. Some small increases in PA were reported in the overall cohort (mean change from baseline [95%CI], MET-h/week: to y1 +0.8 [-0.2 to +1.9]; to y2 +1.2 [+0.1 to +2.3]). Particularly, there were significant increases in PA among pts that did not use to meet PA recommendations at baseline, regardless of BC stage (mean change from baseline [95%CI], MET-h/week: to y1 +8.7, to y2 +9.7 among stage I/II pts; to y1 +12.9, to y2 +10.4 among stage III pts [all p<0.0001]). However, pts who had stage I/II BC and who were overweight/obese failed to improve their PA uptake over time (p>0.05 at both time points). Among pts who were active smokers at baseline, 37% at y1 and 30% at y2 reported reduced tobacco, and among those who used to have ≥1 drink/day at baseline, 11% at y1 and 8% at y2 reported reduced alcohol consumption. 11% pts at y1 and 12% pts at y2 had unhealthy smoke behavior whereas 13% pts at y1 and 14% pts at y2 had unhealthy alcohol behavior (Cochran-Armitage trend test: p=0.034 for smoke and p=0.193 for alcohol). Older age (adjusted odds ratio [aOR] for a 5-year increase in age, 0.69 [95%CI 0.66-0.73]) and being in a relationship (aOR vs not, 0.66 [95% CI 0.54-0.82]) were associated with reduced odds of unhealthy smoke behavior, although older pts (aOR for a 5-year increase in age, 1.34 [95%CI 1.22-1.40]) and those in a relationship (aOR vs not, 1.35 [95% CI 1.10-1.68]) were also more prone to unhealthy alcohol behavior. Lower BMI was consistently associated with higher odds of unhealthy smoke and alcohol behavior (aOR for each decreasing BMI unit: for smoke behavior, 1.05 [95%CI 1.03-1.07]; for alcohol behavior, 1.02 [95% CI 1.01-1.04]). BC stage was not associated with smoke and alcohol behavior. Conclusions: This large clinical study suggests that a substantial proportion of pts pursue a healthy lifestyle after BC. However, there are still survivors that fail to adopt positive and durable lifestyle changes. Uptake of increased levels of PA was not homogenous in this cohort, and we found an upward trend in unhealthy smoke behavior and steady rates of unhealthy alcohol behavior over time. We defined diverse behavioral profiles of pts, according, among others, to age, social status, BMI and BC characteristics. These data will help better inform targeted lifestyle interventions to improve health behaviors after BC. Citation Format: Antonio Di Meglio, Arnauld S Gbenou, Elise Martin, Laurence Vanlemmens, Charles Guenancia, Olivier Rigal, Marion Fournier, Patrick Soulie, Marie-Ange Mouret-Reynier, Carole Tarpin, Florence Boiffard, Sophie Guillermet, Sibille Everhard, Anne-Laure Martin, Sylvie Giacchetti, Thierry Petit, Florence Dalenc, Philippe Rouanet, Antoine Arnaud, Fabrice Andre, Ines Vaz-Luis. Lifestyle changes after breast cancer: A prospective study among 8580 women [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-13-03.

Over the last years we have observed considerable progress in the area of food allergy, particularly in children. This review article focusses on important contributions which have lately been published in the three journals of the European Academy of Allergy and Clinical Immunology. A better understanding of allergens as well as the mechanisms of sensitization and tolerance induction may hopefully lead to a more targeted management of food allergy in the near future.

Visual Analogue Scale (VAS) is a validated tool to assess control in allergic rhinitis patients. The aim of this study was to validate the use of VAS in the MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) app (Allergy Diary) on smartphones screens to evaluate allergic rhinitis symptoms and disease control. Each user filled 4 different VAS measuring overall, nasal, ocular, and asthma symptoms at least once. Following COSMIN guidelines, we evaluated internal consistency, (Cronbach's alpha coefficient and test-retest), reliability (intraclass correlation coefficients), sensitivity, and acceptability of the MASK-Rhinitis VAS. Between 1 August 2015 and 31 July 2016, the app was used 14 612 times in 15 countries. A total of 1225 users used it more than once, during the evaluated period. The tool resulted to be statistically satisfactory, showing excellent internal consistency (Cronbach's test > 0.84, test-retest > 0.7), reliability (>0.9), and acceptability. In addition, the tool had a good sensitivity when users (n = 521) answered the VAS twice in less than 3 hours. The MASK-rhinitis VAS is a reliable and valid tool to assess allergic control on smartphone screens, at the population level.