La vérité de l'équilibre budgétaire et des comptes des collectivités locales face à la crise sanitaire

Deux circulaires interministérielles, publiées en avril et août 2020, introduisent, à titre dérogatoire au regard des circonstances exceptionnelles créées par la crise sanitaire actuelle du coronavirus, des règles particulières d'imputation, dans le budget et la comptabilité des collectivités locales, des dépenses qu'elles ont supportées du fait de cette crise. Ces règles dérogatoires posent le problème de la vérité de l'équilibre budgétaire et des comptes des collectivités locales.Alternate : Two interministerial circulars, which were published in April and August of 2020, by way of derogation owing to the exceptional present Covid-19 sanitary situation, provide for specific allocation measures to be included in local territorial budgets and accountancy as regards the expenses running during this crisis. These exceptional rules bring up the issue of the truthfulness of the budgetary balance and of the accounts stated by local communities.

Physicians' Distress Related to Moral Issues and Mental Health In-Between Two Late Waves of COVID-19 Contagions.

In addition to the sanitary constrains implemented due to the pandemic, frontline physicians have faced increased workloads with insufficient resources, and the responsibility to make extraordinary clinical decisions. In 108 physicians who were at the forefront of care of patients with COVID-19 during the first two years of the pandemic, mental health, moral distress, and moral injury were assessed twice, in between two late waves of COVID-19 contagions, according to their adverse psychological reactions, in-hospital experience, sick leave due to COVID-19, quality of sleep, moral sensitivity, clinical empathy, resilience, and sense of coherence. Three months after the wave of contagions, the adverse emotional reactions and moral distress decreased, while moral injury persisted. Moral distress was related to clinical empathy, with influence from burnout and sick leave due to COVID-19, and moral injury was related to the sense of coherence, while recovery from moral distress was related to resilience. The results suggest that measures to prevent physician infection, as well as strengthening resilience and a sense of coherence, may be helpful to prevent persistent mental damage after exposure to a sanitary crisis.

The role of the palliative care mobile team nurse during the COVID-19 crisis

In 2020, the COVID-19 pandemic had an impact on treatment teams, including the palliative care mobile team (PCMT). During the first epidemic wave, some institutions decided to deploy professionals working in these PCMT to care services to strengthen the workforce. The health executive and the head of department of the PCMT 37, in agreement with the management of the university hospital of Tours, decided to maintain the whole PCMT in their usual duty, enabling them to continue their mission, within and outside the hospital. Whilst, looking back at the period, we thought about the specific roles played by the nurses of PCMT during the COVID crisis, from February to December 2020. We managed to bring out three major axes that structured our actions: (a) an efficient compagnionship, which helped the reshuffled teams regain their professional identity and the notion of teamwork. (b) practical training around symptoms related to COVID-19 and end of life with an adjustment on representations on palliative care, with the aim of avoiding that COVID patients are all considered terminally ill (c) through mediation, a support for people working on site to get to grips with the various recommendations. Relying on our reflexive practice, on our capacity to adapt and on our experience of coping with uncertainty, we were able to be proactive and hence, play a relevant role in this sanitary crisis. © 2022 Elsevier Masson SAS;En 2020, la pandémie COVID-19 a impacté l'organisation des équipes de soin y compris celle des équipes mobiles de soins palliatifs (EMSP). Lors de la première vague épidémique, certaines institutions ont fait le choix de déployer les professionnels de ces équipes dans les services de soins pour renforcer les effectifs. Le cadre de santé et le chef de service de l'EMSP37 en accord avec la direction du Centre Hospitalier Universitaire de Tours, ont décidé de maintenir dans leurs fonctions l'ensemble des professionnels de leur équipe, permettant la poursuite des missions intra et extra hospitalières. A posteriori, nous avons réfléchi aux fonctions spécifiques exercées par les infirmières d'EMSP dans la crise COVID de février à décembre 2020. Nous avons pu ainsi dégager trois grands axes ayant structuré nos actions: (a) un compagnonnage solidaire et étayant afin d'aider les équipes remaniées à retrouver leur identité professionnelle et la notion de collectif;(b) des formations pratiques autour des symptômes liés à la COVID-19 et à la fin de vie avec un ajustement sur les représentations sur les soins palliatifs, dans l'objectif d'éviter que les patients COVID soient tous considérés en phase terminale (c) une aide à l'appropriation des multiples recommandations par un travail de médiation. C'est en nous appuyant sur notre pratique réflexive, notre capacité d'adaptation et notre habitude à composer avec l'incertitude, que nous avons pu être force de propositions et ainsi tenir une place pertinente dans cette crise sanitaire. © 2022 Elsevier Masson SAS

The power of language in political communication in times of COVID: Multilingual contrastive analysis of the speeches of Pedro Sánchez, Boris Johnson, Giuseppe Conte and Antonio Costa at the beginning of the pandemic

In this paper, within the framework of Applied Linguistics and Critical Discourse Analysis, we will carry out a multilingual contrastive analysis of the speeches given by the political leaders of Spain, the United Kingdom, Italy, and Portugal at the beginning of 2020, when they announced tough measures to face the health crisis caused by COVID-19. Our initial hypothesis is that they will employ different linguistic resources to persuade the audience, since, at the beginning of the pandemic, political parties joined their forces to make citizens aware of the necessity of working together to face the crisis. The aim of our research is to use real samples of language to detect similarities and differences among the texts, as well as forms of persuasion and/or mass manipulation, and to observe if the sender's ideology is manifested in the discourse. To do so, the research will be based on a qualitative study of the four discourses, but complemented with the data provided by Sketch Engine, which includes the words and collocations most used in each corpus. The results show that, except for some slight differences in the way they appeal to fear, in general the four speeches use similar persuasion techniques, as part of messages that appeal to patriotism, unity in the fight against the virus, and social responsibility. © 2022 Universita degli Studi di Milano. All rights reserved.

El poder del lenguaje en la comunicación política en tiempos de COVID: análisis contrastivo multilingüe de los discursos de Pedro Sánchez, Boris Johnson, Giuseppe Conté y Antonio Costa en los inicios de la pandemia

In this paper, within the framework of Applied Linguistics and Critical Discourse Analysis, we will carry out a multilingual contrastive analysis of the speeches given by the political leaders of Spain, the United Kingdom, Italy, and Portugal at the beginning of 2020, when they announced tough measures to face the health crisis caused by COVID-19. Our initial hypothesis is that they will employ different linguistic resources to persuade the audience, since, at the beginning of the pandemic, political parties joined their forces to make citizens aware of the necessity of working together to face the crisis. The aim of our research is to use real samples of language to detect similarities and differences among the texts, as well as forms of persuasion and/or mass manipulation, and to observe if the sender's ideology is manifested in the discourse. To do so, the research will be based on a qualitative study of the four discourses, but complemented with the data provided by Sketch Engine, which includes the words and collocations most used in each corpus. The results show that, except for some slight differences in the way they appeal to fear, in general the four speeches use similar persuasion techniques, as part of messages that appeal to patriotism, unity in the fight against the virus, and social responsibility. © 2022 Universita degli Studi di Milano. All rights reserved.

Pandemic: Return to the Past or Window into the Future?

"The article analyzes political, social, economic and cultural consequences of the COVID-19 pandemic for French society. The national strategies of the state management of the sanitary crisis that have developed in the world are investigated: the strategy of ""zero tolerance to coronavirus"";the strategy of free circulation of the virus;the strategy determined by the formula ""stop and go"". France, like many other Western countries, chose the last one, which implied a combination of harsh measures (lockdown, self-isolation, mandatory vaccination, introduction of sanitary passes) with relaxation caused by the demands of business and society. The increased role of the State in the fight against the pandemic is revealed. The political context of the pandemic crisis settlement is revealed: centralization of power;tight control of the head of state over the activities of the Cabinet of Ministers;dominance of political power over the professional medical community;reduction of the parliament's role. It is shown that under conditions of the sanitary crisis, the process of informatization of production and services accelerated, significant shifts occurred in the labor market, and there was an increase in social and socio-spatial inequality. The problem of the middle class, which continues to fragment, is acute. The pandemic and especially the methods of combating it caused a protest in French society: the French did not just express disbelief in the effectiveness of the vaccine, with their speeches they demonstrated distrust of the authorities and state institutions. The pandemic has shown that France is in dire need of a new social compromise that would take into account not only the interests of global corporations, but also people who have remained beyond the threshold of the information economy. The issue of reviewing the lowest salaries and raising the status of a number of professions is acute."

Temporary ICUs during the COVID-19 pandemic first wave: description of the cohort at a French centre.

BACKGROUND: During the COVID-19 first wave in France, the capacity of intensive care unit (ICU) beds almost doubled, mainly because of the opening of temporary ICUs with staff and equipment from anaesthesia. OBJECTIVES: We aim to investigate if the initial management in temporary ICU is associated with a change in ICU mortality and short-term prognosis. DESIGN: Retrospective single-centre cohort study. SETTING: Surgical ICU of the Bichat Claude Bernard University Hospital during the COVID-19 "first wave" (from 18 March to 10 April 2020). PATIENTS: All consecutive patients older than 18 years of age with laboratory-confirmed SARS-CoV-2 infection and/or typical radiological patterns were included during their first stay in the ICU for COVID-19. INTERVENTION: Patients were admitted to a temporary ICU if no room was available in the classical ICU and if they needed invasive mechanical ventilation but no renal replacement therapy or Extracorporeal Membrane Oxygenation (ECMO) in the short term. The temporary ICUs were managed by mixed teams (from the ICU and anaesthesiology departments) following a common protocol and staff meetings. MAIN OUTCOME MEASURE: ICU mortality RESULTS: Among the 59 patients admitted, 37 (62.7%) patients had initial management in the temporary ICU. They had the same characteristics on admission and the same medical management as patients admitted to the classical ICU. ICU mortality was similar in the 2 groups (32.4% in temporary ICUs versus 40.9% in classical ICUs; p=0.58). SAPS-II and ECMO use were associated with mortality in multivariate analysis but not admission to the temporary ICU. CONCLUSION: In an overload context of the ICU of a geographical area, our temporary ICU model allowed access to intensive care for all patients requiring it without endangering them.

The role of the palliative care mobile team nurse during the COVID-19 crisis

In 2020, the COVID-19 pandemic had an impact on treatment teams, including the palliative care mobile team (PCMT). During the first epidemic wave, some institutions decided to deploy professionals working in these PCMT to care services to strengthen the workforce. The health executive and the head of department of the PCMT 37, in agreement with the management of the university hospital of Tours, decided to maintain the whole PCMT in their usual duty, enabling them to continue their mission, within and outside the hospital. Whilst, looking back at the period, we thought about the specific roles played by the nurses of PCMT during the COVID crisis, from February to December 2020. We managed to bring out three major axes that structured our actions: (a) an efficient compagnionship, which helped the reshuffled teams regain their professional identity and the notion of teamwork. (b) practical training around symptoms related to COVID-19 and end of life with an adjustment on representations on palliative care, with the aim of avoiding that COVID patients are all considered terminally ill (c) through mediation, a support for people working on site to get to grips with the various recommendations. Relying on our reflexive practice, on our capacity to adapt and on our experience of coping with uncertainty, we were able to be proactive and hence, play a relevant role in this sanitary crisis. © 2022 Elsevier Masson SAS En 2020, la pandémie COVID-19 a impacté l'organisation des équipes de soin y compris celle des équipes mobiles de soins palliatifs (EMSP). Lors de la première vague épidémique, certaines institutions ont fait le choix de déployer les professionnels de ces équipes dans les services de soins pour renforcer les effectifs. Le cadre de santé et le chef de service de l'EMSP37 en accord avec la direction du Centre Hospitalier Universitaire de Tours, ont décidé de maintenir dans leurs fonctions l'ensemble des professionnels de leur équipe, permettant la poursuite des missions intra et extra hospitalières. A posteriori, nous avons réfléchi aux fonctions spécifiques exercées par les infirmières d'EMSP dans la crise COVID de février à décembre 2020. Nous avons pu ainsi dégager trois grands axes ayant structuré nos actions: (a) un compagnonnage solidaire et étayant afin d'aider les équipes remaniées à retrouver leur identité professionnelle et la notion de collectif;(b) des formations pratiques autour des symptômes liés à la COVID-19 et à la fin de vie avec un ajustement sur les représentations sur les soins palliatifs, dans l'objectif d’éviter que les patients COVID soient tous considérés en phase terminale (c) une aide à l'appropriation des multiples recommandations par un travail de médiation. C'est en nous appuyant sur notre pratique réflexive, notre capacité d'adaptation et notre habitude à composer avec l'incertitude, que nous avons pu être force de propositions et ainsi tenir une place pertinente dans cette crise sanitaire. © 2022 Elsevier Masson SAS

La place de l’infirmière d’équipe mobile de soins palliatifs dans la crise COVID-19

Résumé En 2020, la pandémie COVID-19 a impacté l’organisation des équipes de soin y compris celle des équipes mobiles de soins palliatifs (EMSP). Lors de la première vague épidémique, certaines institutions ont fait le choix de déployer les professionnels de ces équipes dans les services de soins pour renforcer les effectifs. Le cadre de santé et le chef de service de l’EMSP37 en accord avec la direction du Centre Hospitalier Universitaire de Tours, ont décidé de maintenir dans leurs fonctions l’ensemble des professionnels de leur équipe, permettant la poursuite des missions intra et extra hospitalières. A posteriori, nous avons réfléchi aux fonctions spécifiques exercées par les infirmières d’EMSP dans la crise COVID de février à décembre 2020. Nous avons pu ainsi dégager trois grands axes ayant structuré nos actions : (a) un compagnonnage solidaire et étayant afin d’aider les équipes remaniées à retrouver leur identité professionnelle et la notion de collectif ;(b) des formations pratiques autour des symptômes liés à la COVID-19 et à la fin de vie avec un ajustement sur les représentations sur les soins palliatifs, dans l’objectif d’éviter que les patients COVID soient tous considérés en phase terminale (c) une aide à l’appropriation des multiples recommandations par un travail de médiation. C’est en nous appuyant sur notre pratique réflexive, notre capacité d’adaptation et notre habitude à composer avec l’incertitude, que nous avons pu être force de propositions et ainsi tenir une place pertinente dans cette crise sanitaire. Summary In 2020, the COVID-19 pandemic had an impact on treatment teams, including the palliative care mobile team (PCMT). During the first epidemic wave, some institutions decided to deploy professionals working in these PCMT to care services to strengthen the workforce. The health executive and the head of department of the PCMT 37, in agreement with the management of the university hospital of Tours, decided to maintain the whole PCMT in their usual duty, enabling them to continue their mission, within and outside the hospital. Whilst, looking back at the period, we thought about the specific roles played by the nurses of PCMT during the COVID crisis, from February to December 2020. We managed to bring out three major axes that structured our actions: (a) an efficient compagnionship, which helped the reshuffled teams regain their professional identity and the notion of teamwork. (b) practical training around symptoms related to COVID-19 and end of life with an adjustment on representations on palliative care, with the aim of avoiding that COVID patients are all considered terminally ill (c) through mediation, a support for people working on site to get to grips with the various recommendations. Relying on our reflexive practice, on our capacity to adapt and on our experience of coping with uncertainty, we were able to be proactive and hence, play a relevant role in this sanitary crisis.

Administrative Improbity and Sanitary Crisis: socio-legal interlocutions under the responsibility of the public agent

This article investigates the theme of administrative improbity, dialoguing with the doctrinal constructions of Administrative Law and the sociological perspective of Pierre Bourdieu. It analyzes how improbas actions are implemented in the institutional space of the Public Administration in order to understand the risks of such practices during the period of sanitary crisis COVID-19, considering the normative regulation of Law No. 13.979 / 20. The construction of some indicators is useful to think about building mechanisms aimed at prevention. The methodology used was bibliographic research with analysis of cases judged by the Court of Justice of the State of Rio Grande do Sul. It was concluded that the improbas actions have specific dynamics and, somehow, in the regular state administrative field, to suggest measures to mitigate the risks of bureaucratic pathology.

Difference between Impacts of COVID-19 on Women and Men's Psychological, Social, Vulnerable Work Situations, and Economic Well-Being.

The SARS-CoV-2 virus changed social reality worldwide, affecting people's health and work life, particularly their anxiety levels. The purpose of this study is to verify the situation of women in terms of anxiety and social determinants in Spain during the pandemic. The sample consisted of 4686 people (3500 women and 1186 men). The tools used were the State-Trait Anxiety Inventory (STAI) and an ad hoc questionnaire to assess the work and mental situation of the participants. The results indicate a higher rate of anxiety among women than among men and reveal a relationship between higher levels of anxiety and more vulnerable work situations in terms of higher unemployment rates, contract changes, etc. Furthermore, there was a higher percentage of women than men in the sectors where the health crisis has had a greater impact and presence, with repercussions on the physical, mental, and social health of the entire population and especially on women. It is necessary to take into account the social determinants of health, not only at the structural level, in terms of the socio-economic and political contexts, to avoid and limit the axes of inequality such as gender.

Psychological Impact of Exposure to the COVID-19 Sanitary Crisis on French Healthcare Workers: Risk Factors and Coping Strategies.

Background: COVID-19 sanitary crisis is associated with emotional difficulties such as depression, anxiety and reactional post-traumatic symptoms among healthcare workers. Indeed, healthcare workers were particularly exposed to COVID-19 sanitary crisis. This study aimed to investigate the effects of exposure to COVID-19 sanitary crisis on affective symptoms (anxiety, post-traumatic stress, burnout) among French healthcare workers and the mediating role of cognitive emotion regulation strategies (positive re-evaluation and set in perspective) and coping strategies (active coping, planning, instrumental support, emotional support, emotional expression, positive reappraisal, acceptance, denial, blame, humor, religion, distraction, substance use, behavioral disengagement). Method: This cross-sectional survey-based study collected demographic data and mental health measurements from 1,010 volunteers (838 women) who consented online to participate, from March 24 to June 28, 2020, in France. Participants filled out online questionnaires and visual analogic scales that evaluate affective symptoms related to the COVID-19 sanitary crisis, namely symptoms of post-traumatic stress, burnout, emotion regulation abilities, and coping abilities. Results: The majority (57.8%) of the participants presented post-traumatic symptoms. Depending on the sub-dimensions evaluated, a proportion of participants reported moderate (25.9-31.2%) to severe (17.2-40.7%) burnout symptoms. We found a significant effect of the level of exposure to COVID-19 on affective symptoms. Being a woman, having a lower job position and having less experience were associated with higher level of affective symptoms. Moreover, coping strategies had a mediating effect on the relation between stress and burnout, supporting the coping reserve model. Conclusion: Post-traumatic and burnout symptoms were highly prevalent among French healthcare workers at the beginning of the COVID-19 crisis. Exposure to COVID-19 is a determining factor. We can thus promote both coping training and a good environment to limit the emotional consequences of exposure to COVID-19.

[Hymenoptera venom allergy: Management of venom extracts shortage or sanitary crisis (Covid-19 pandemic). Stinging Insects Task Force recommendations]. / Allergie aux venins d'hyménoptères : conduite à tenir en cas de pénurie d'extraits de venins ou de crise sanitaire (pandémie Covid-19). Recommandations du Groupe de Travail Insectes Piqueurs (GTIP).

Recurrent venom extracts shortages as well as the COVID-19 pandemic have prompted the SFA/Anaforcal Stinging Insects Task Force to develop recommendations on venom immunotherapy (VIT), in accordance with international guidelines, to be able to offer and maintain VIT to patients with life-threatening risks. How to diagnose allergy to hymenoptera venoms, indications and duration of VIT, maintenance intervals and doses, interchangeability of venom extracts and monitoring of patients on VIT have been adapted to this time of crisis, allowing clinicians to treat their patients with the most benefit and lowest constraint. These recommendations are temporary and will be reviewed after returning to a normal situation.