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Introduction: Despite strong evidence of the benefits of physical activity on reducing the side effects of breast cancer and associated treatments, many patients tend to be physically inactive. Understanding the facilitators and barriers to their engagement in physical activity and their continuation of it represents a first step toward designing targeted interventions to increase this activity. The aim of this study is to describe the determinants of the physical activity behavior of patients participating in the RIPOSTE program.

Method: A qualitative study was conducted with ten patients undergoing invasive breast cancer surgery and participating in an adapted physical activity program based on fencing (RIPOSTE). Semi-structured interviews explored their physical activity experience and were analyzed both inductively and deductively using the Theoretical Domains Framework, examining mechanisms of behavior change.

Results: Fifty-six themes were identified as facilitators and barriers in twelve of the fourteen domains. The "Environmental Context and Resources" and "Social Influences" domains were the most predominant. The "Social/Professional Role and Identity," "Optimism," and "Reinforcement" domains were not mentioned by all participants.

Conclusion: Use of the Theoretical Domains Framework enabled the study to highlight the complexity of physical activity behavior change among cancer survivors. Our results provided a useful theoretical basis to guide the selection of modifiable factors when designing interventions to improve patients' physical activity levels.

Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a serious viral disease caused by a virus of the genus Nairovirus. It is transmitted mainly by ticks and, in some cases, by contact with infected blood or body fluids. CCHF is endemic in several parts of Africa. This study focuses on cases of CCHF in Senegal in 2023, and on the actions implemented to manage the epidemic.

Methodology: A retrospective study was conducted to analyze the 2023 CCHF epidemic in Senegal. The Syndrome Sentinel Surveillance Network (4S Network) was used to detect cases. The reference laboratory used ELISA and PCR tests to confirm diagnoses, while the health emergency operations center coordinated the response using an incident management system (IMS) implemented at the national and regional level.

Results: In 2023, Senegal reported 11 confirmed cases of CCHF in 7 regions, with a case fatality rate of 36.6%. The average time from symptom onset to laboratory diagnosis was 10 days, which sometimes led to delays in case management. Follow-up of 413 contacts was carried out, with no secondary cases identified. Preventive measures, including awareness-raising campaigns in high-risk areas, were also taken.

Conclusion: CCHF represents a persistent threat to public health in Senegal. Surveillance efforts, rapid detection, and the control measures put in place have proved essential in limiting transmission. The observed delays in diagnosis highlight the need to strengthen diagnostic capabilities and improve the responsiveness of the health care system, in particular via implementation of the 7-1-7 framework. Increased intersectoral collaboration is essential to improving containment of this emerging zoonosis.

Context: Among student nurses (SNs), who are key future actors in determining access to palliative care (PC), 30% have avoidant attitudes toward end-of-life (EOL) patients. In 2017, in response to this issue, the French Ministries of Health and Higher Education introduced a mandatory PC placement for health care students as part of a national plan to develop PC. It was in this context that all third-year SNs in our town (population of 20,000) did a 5-day placement in a mobile PC team.

Objective: To identify whether this placement changed representations of PC among the SNs we hosted, and if so, how.

Method: This was a two-stage qualitative study. It used the method of thematic analysis of verbatim comments made by SNs during the 2021-2022 academic year, on the first day (D1) and last day (D5) of their placement.

Results: The sample consisted of 31 SNs. On D1, PC and EOL were regarded in spiritual terms, and could provoke negative feelings. By D5, the SNs were using professional PC vocabulary, highlighting new perceptions of inter-professional relations, and had a better understanding of which patients needed PC and of the ethical challenges relating to EOL.

Conclusions: Our study showed an immediate benefit of this placement on professional representations among SNs. While further research is needed to clarify its long-term effects, it supports a proactive policy of including PC training in nurse education.

Belgium, like many European countries, is facing a shortage of general practitioners in rural areas. This uneven geographical distribution of doctors calls for multiple, integrated strategies to attract and retain practitioners in these regions. The rural origin of doctors is a key factor that has been largely overlooked by authorities until now. Measures such as quotas for rural students, conditional scholarships, and targeted awareness campaigns could be implemented. Financial incentives, while important, have shown mixed results and often prove ineffective in the long term if not combined with complimentary measures. The creation of single- or multi-disciplinary practices and improvements inon-call organization are essential to making work in rural areas more attractive. Quality of life also plays a decisive role. Investing in local infrastructure and supporting spousal employment are crucial measures. Finally, university curricula could include mandatory rural internships to help students become faniliar with these areas. This article presents proposals to balance the distribution of doctors and improve the attractiveness of rural areas in Belgium..