Sante Publique最新文献

Introduction: Physical activity (PA) is beneficial to maternal, fetal and neonatal health. The World Health Organization and the French National Authority for Health have issued recommendations on PA for pregnant women. The aim of this study was to describe the PA of pregnant women during physiological pregnancies in the Lyon area.

Methods: A retrospective descriptive multicenter observational study using self-administered questionnaires was conducted in the Lyon area between November 2021 and February 2022.

Results and discussion: Ten of the twelve maternity units in the perinatal network selected at random agreed to act as investigators. One hundred and fifty-three questionnaires were distributed, 102 of which were usable. Sporting activities (SA) were practiced by 64% of participants before pregnancy and 44% during pregnancy: 36% in the first trimester, 32% in the second trimester and 28% in the third trimester. Walking and hiking were the most popular sports activities, regardless of pregnancy trimester. Physical activity was mainly a leisure activity, carried out alone and outdoors. The average SA session during pregnancy lasted 64 minutes. Internet or mobile applications were often or systematically used by 40% of pregnant women as part of their SA. The car was the most frequently cited means of transport for daily commuting. Seventy-six percent of women had held a job during their pregnancy. Job-related PA was considered intense by 27% of pregnant women. Domestic chores accounted for around 7 hours a week during pregnancy. Among all PA, those related to professional and domestic activities seemed to be prioritized at the expense of leisure activities. Large-scale national studies are needed to evaluate strategies for promoting safe prenatal PA among pregnant women.

Introduction: In French Guiana, a significant proportion of the population is isolated from the health care system. Accessing health care is difficult and challenging for a number of reasons, including the transport network, intercultural context, and professional turnover. An experimental scheme to support and train health mediators has been set up and piloted by a consortium of community groups and hospitals, with the aim of improving access to health care for people living in the country's interior region.

Methods: Twenty mediators received three years of coaching in their professional stances and practices. Training modules, individual interviews, and focus groups were held throughout the pilot. These activities made it possible to collect qualitative data on three aspects: the training, network support, and relations with employers. These data were cross-referenced with the literature in the fields of mediation, interculturality, and public health. The aim was to assess the impact of such a scheme on the practice of health mediators.

Results: The program has enabled mediators to gain a better understanding of their profession, acquire the skills they need to practice it, and be recognized as professionals, notably through graduation. The creation and consolidation of a network and a shared professional culture have fostered their empowerment and their ability to offer better care adapted to the needs of the population.

Discussion: Establishing a regional and local presence would help to consolidate the profession. It would energize the network and the professional culture, which represent two clear assets for community health action. Finally, it would encourage the empowerment of mediators and, ultimately, of individuals and communities to act on the determinants of health.

This article focuses on medical deserts, i.e. an insufficient density of healthcare professionals in an area, particularly general practitioners, in relation to the healthcare access needs of the area's inhabitants. Indeed, if we consider the criterion of "localized potential accessibility" (APL) which was designed by Drees (Direction de la recherche, des études, de l'évaluation et des statistiques), one in nine French people live in a medical desert and there is a shortage of doctors in one in three communes in France. To investigate this public health problem, we propose to consider the track of developing social innovation, which is defined as an original initiative consisting of developing a new response to a poorly or unsatisfactorily addressed problem in order to modify the framework for action and social relations. We intend exploring the extent to which it can contribute to combating the emergence of medical deserts by identifying success factors. We explore this topic through the case of the Educ'Tour program, a social innovation supported by a social protection organization, the Mutualité Sociale Agricole (MSA). This program aims to reduce medical deserts in rural areas by introducing health and social care students to coordinated healthcare practice in these areas. We conclude with managerial recommendations and discuss the challenges of developing social innovation in the healthcare environment.

Introduction: Coordinated practice supports a comprehensive approach combining infection prevention and the rational use of antibiotics (RUA), both essential to tackling antibiotic resistance effectively. Over 90% of prescriptions in France are issued in primary care, mainly by general practitioners.

Purpose of the study: This study analyzes how RUA is integrated into the activities of Professional and Territorial Health Communities (CPTS; Communautés professionnelles territoriales de santé) based on a survey of health care professionals in two CPTS from three French regions chosen for their engagement in national initiatives on antibiotic resistance. A total of 488 health care professionals were selected, with a participation rate of 32,4%.

Results: The results show uneven awareness of RUA and the "One Health" concept among professionals. While antibiotic resistance is perceived as a major issue, its integration into the CPTS's objectives remains limited. The study highlights the need to improve interprofessional coordination and ongoing training to optimize RUA, adapting strategies to each profession's specific needs and strengthening collaboration with regional centers for antibiotic stewardship (CRAtb).

Conclusion: Integrating antibiotic resistance into CPTS missions appears to be a key strategy for effectively addressing this public health issue at the local level.