Breastfeeding and return to work at a teaching hospital.

In France, return to work represents a break in the continuation of breastfeeding, especially for caregivers. The objective of this study was to describe the breastfeeding practices of hospital workers. From 378 respondents, the prevalence of breastfeeding was found to be 69 % when leaving the maternity ward, 36.5 % when returning to work, and 20.1 % at 6 months. The average duration of breastfeeding was 23.3 weeks. In total, 44 % of breastfeeding women said they stopped breastfeeding because of their work: workload, irregular hours, no breastfeeding room, and fatigue.

[Alcohol consumption by health students: Ifsi protected?] / Consommation d'alcool des étudiants en santé : Ifsi protégé ?

A study of health students at the Université de Bretagne Occidentale showed that nursing students smoked more than those in other fields. The present study of health students in the same city shows that, conversely, students in nursing training institutes (Ifsi) consumed less alcohol.

Does Decreased Diffusing Capacity of the Lungs for Carbon Monoxide Constitute a Risk of Decompression Sickness in Occupational Divers?

Long-term alterations of pulmonary function (mainly decreased airway conductance and capacity of the lungs to diffuse carbon monoxide (DLCO)) have been described after hyperbaric exposures. However, whether these alterations convey a higher risk for divers' safety has never been investigated before. The purpose of the present pilot study was to assess whether decreased DLCO is associated with modifications of the physiological response to diving. In this case-control observational study, 15 "fit-to-dive" occupational divers were split into two groups according to their DLCO measurements compared to references values, either normal (control) or reduced (DLCO group). After a standardized 20 m/40 min dive in a sea water pool, the peak-flow, vascular gas emboli (VGE) grade, micro-circulatory reactivity, inflammatory biomarkers, thrombotic factors, and plasmatic aldosterone concentration were assessed at different times post-dive. Although VGE were recorded in all divers, no cases of decompression sickness (DCS) occurred. Compared to the control, the latency to VGE peak was increased in the DLCO group (60 vs. 30 min) along with a higher maximal VGE grade (p < 0.0001). P-selectin was higher in the DLCO group, both pre- and post-dive. The plasmatic aldosterone concentration was significantly decreased in the control group (-30.4 ± 24.6%) but not in the DLCO group. Apart from a state of hypocoagulability in all divers, other measured parameters remained unchanged. Our results suggest that divers with decreased DLCO might have a higher risk of DCS. Further studies are required to confirm these preliminary results.

COVID-19 on board a cruise ship: medical management.

BACKGROUND: First, this analysis was conducted to study a coronavirus disease 2019 (COVID-19) cluster dynamic on a cruise ship in order to allow the ship physician to anticipate the duration and importance of the contaminations. Secondly, the author tries to find out if the closed environment on board allows specific conclusions about epidemic dynamics and preventative measures. MATERIALS AND METHODS: From a personal epidemiological compendium done by himself on board the author analysed different epidemic curves identified on board other ships and compared them to the epidemiologic data from the different COVID-19 contamination waves in France since 2020. All crew members were submitted to polymerase chain reaction tests on D2, D5, D8 and D15 and symptomatic cases were tested on on-board devices in the meantime. An excel file called "Log Covid" allowed for daily reporting to the ship-owner on the epidemic dynamics and the prospects on the end of crises in order to anticipate the resumption of the business in the best conditions. The jobs on board, age and geographic origin of the contaminated people were analysed, as well as their vaccination status. RESULTS: Out of a total of 118 crew members, 61 (52%) sailors were contaminated in 8 days. The symptoms were benign (pharyngitis, headaches, feverish state); no serious form of illness were reported. The passengers were repatriated to France at the earliest stage. The epidemic phase occurred in a 15-day window. The first 8 days corresponded to the ascending phase, then a faster phase of epidemic decrease of 7 days. Similarities emerged between the epidemic dynamics of this virus and other contaminations on cruise ships and epidemic phases on land in spite of important differences in numbers. CONCLUSIONS: This study can allow a ship's doctor to better understand the viral dynamics in case of a COVID- 19 cluster and to anticipate the exit of the crisis. Repeated tests during the active phase of the epidemic are necessary in case of a large cluster to know where to place oneself on a typical epidemic curve. Isolation and barrier measures advised by the ship's doctor remain the only weapons that can limit its magnitude.

[Care, a place of affectivity and emotions]. / Le soin, lieu d'affectivité et d'émotions.

Joy, fear, disgust, anger, sadness, surprise, emotions are fleeting and natural affects that catch us off guard. Care, as a face-to-face encounter with others, in a sometimes difficult context of serious or chronic pathologies, can become a place of affectivity, all the more so as care crosses the barriers of bodily intimacy. What to do with one's emotions in care?

Mapping the 'Ethical' Controversy of Human Heritable Genome Editing: a Multidisciplinary Approach.

Genome editing, for instance by CRISPR-Cas, is a major advancement of the last 10 years in medicine but questions ethically our practices. In particular, human embryo heritable genome editing is a source of great controversy. We explored how this ethical question was debated in the literature from PubMed database, in a period of 4 years (2016-2020) around the announcement of the 'CRISPR babies' Chinese experiment in November 2018. We evaluated the weight of the arguments for and against this topic, through an analysis of reviews published on this question. The most important arguments come from the technical perspective: safety issues and benefits, putative long-term effects on the future generations and the need to assess this aspect. Next, foreseeable clinical benefits and the alternatives to these methods are discussed. The number of people that would benefit from such techniques is also considered. However, social and anthropological issues are addressed in a more disparate way. Parenthood and desire for children are sometimes overlooked. Few authors mention social justice, stigmatisation and equality of access. Consent and information are more clearly addressed, as well as the question of the relationship between generations. Finally, the effects on the nature of humankind or human species are far from being consensual; the risks of enhancement, eugenics and transhumanism are raised. We conclude that the risks associated with the immaturity of the technique were at the forefront of the ethical debate on human embryo heritable genome editing. Their consequences were seen as more immediate and easier to handle than those of sociological or anthropological projections, which are more speculative in nature. Supplementary Information: The online version contains supplementary material available at 10.1007/s41649-022-00234-1.

Evolution of Global Health and Psychosocial Factors among Hospital Workers during First Year of SARS-CoV-2 Pandemic: A Longitudinal Study.

OBJECTIVES: To assess trends in overall health (mental and physical) and psychosocial factors in a population of workers (both healthcare and non-healthcare) in a French teaching hospital during the first year of the SARS-CoV-2 pandemic in France. METHODS: A validated version of the SATIN questionnaire with adapted scoring was used to collect data on health and impacts of work stressors. This questionnaire was sent to all workers at the hospital in T1 (July-August 2020) and T2 (July-August 2021) and self-administered online. RESULTS: A total of 1313 participants who completed the questionnaire at T1 and 826 at T2 were included. Overall, 568 workers completed the questionnaire at T1 and T2. We found a deterioration in overall health and especially stress and mental health in hospital workers and healthcare workers (HCWs), with a negative impact of the workload and work environment. CONCLUSIONS: The SARS-CoV-2 pandemic impacted negatively the mental health, work stressors, and psychosocial perceptions of both HCW and non-HCW in a French hospital. The study confirms that hospital workers are an important target.

Occupational asthma, rhinitis and contact urticaria in a salmon-processing worker.

We report a case of occupational allergy to salmon combining allergic asthma, allergic rhinitis and allergic contact urticaria in a 59-year-old salmon-processing worker. Parvalbumin is the most common allergen, but indeed sensitisation to tropomyosin, preservatives and spices could occur.