Centre-Val De Loire Region Research Articles

Current distribution of the Reeves’ muntjac Muntiacus reevesi (Ogilby, 1839) in France

Abstract The Reeves’ muntjac Muntiacus reevesi is an ungulate native to China and Taiwan that has been released into the wild in several continental European countries and the United Kingdom. We present recent records of the species in mainland France. We also investigated the dispersal rate and density of the established population in the Centre-Val de Loire region. The number of observations of M. reevesi was low in the period 2008–2016, increased sharply until 2019 and then decreased until 2023. From a comparison between the distribution in 2008–2012 and 2013–2017, the dispersal rate was estimated at an average of 3.2 km/year, and 7.6 km/year between 2013–2017 and 2018–2023. Based on a camera trap protocol, the population density was assumed to be very low in forested areas but estimated with a lack of robustness due to a single observation. Further efforts must be made to better assess the risk of an increase in the wild population of Reeves’ muntjac in the Centre-Val de Loire region. To prevent potential impacts, rapid control measures can be put in place in the large area (10,800 km2) where muntjacs are now rapidly spreading.

How the mechanism of recognition and its effects on well-being at work can shape an inclusive climate

PurposeThis study aims to explore the relationships between recognition, inclusion, and well-being at work. Inclusion involves integrating individuals within a group while recognizing their unique skills and need for belonging. Recognition and inclusion are sources of well-being at work.Design/methodology/approachWe used a qualitative methodology based on a structural approach to investigate the social representations of 1,611 employees of a public organization located in the Centre-Val de Loire region of France.FindingsOur results suggest that recognition is a central mechanism of inclusion, primarily manifested through satisfaction of the individual’s need to belong. We conclude with a proposed heuristic schema of the connections between the constructs studied.Research limitations/implicationsThis paper proposes a new perspective to the work of Shore et al. (2018) by addressing the knowledge gap in the literature concerning the role of recognition in determining an inclusive climate and optimizing well-being at work. This is done using qualitative methodology, drawing on the Dazibao framework of data collection.Originality/valueBringing a new perspective to the work of Shore et al. (2018) by helping to fill the knowledge gap relating to the place of recognition in determining an inclusive climate and well-being at work. It does so through a qualitative methodology based on the Dazibao framework of data collection.

Advantages and limits of remote consultations for HIV pre-exposure prophylaxis health pathway: ePrEP qualitative study

ObjectiveBecause of a high rate of HIV diagnosis and restricted medical access in the Centre-Val de Loire region in France , remote consultations (RC) with a community-based approach has been implemented to promote access to healthcare. Our study aimed to determine whether RC could improve access to pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) as part of the healthcare pathway associated with PrEP. Materials and MethodsA qualitative approach involving semi-structured interviews with 17 MSM and 3 physicians from specialized sexual health centres was performed, with a mean duration of interview over one hour. The research focused on the health pathway associated with PrEP, from initial awareness to ongoing prescription and follow-up. ResultsTransitioning PrEP consultations to RC is feasible, but concerns about a potential decline in care quality compared to traditional sexual health centres follow-ups were noted. Both MSM and physicians recognized that RC could complement face-to-face approaches, especially in terms of organizational benefits. In rural areas, access to specialists through RC was seen as a partial solution, though it could be hindered by barriers in accessing laboratory testing and pharmacy services, like fear of stigmatization. More generally, distrust of medication and the difficulty of discussing sexuality with a GP were highlighted, which could limit the uptake of PrEP without access to specialists. ConclusionsThe initiation and uptake of PrEP among MSM are more effectively influenced by initiatives that provide information, reassurance, and facilitate initial procedures, rather than solely through RC. A strategy combining digital and community-based approaches, along with medical expertise, is recommended to increase PrEP utilization among MSM.

Toward an Operational Monitoring of Oak Dieback With Multispectral Satellite Time Series: A Case Study in Centre-Val De Loire Region of France

Toward an Operational Monitoring of Oak Dieback With Multispectral Satellite Time Series: A Case Study in Centre-Val De Loire Region of France

Liquid chromatography - high-resolution quadrupole time-of-flight mass spectrometry analysis of pesticides in French agricultural soils

ABSTRACT Agricultural soils are not controlled in France for the massive use of pesticides. The quadrupole mass spectrometer is used for targeted analysis of a few dozen pesticides, while the high-resolution time-of-flight quadrupole mass spectrometer (QTOF-MS) allows both targeted and non-targeted analysis of hundreds of pesticides. In this study, a targeted method was developed in soils using pressurised-liquid extraction (PLE) and liquid chromatography (LC) coupled with a QTOF-MS. This method development was necessary to carry out next suspect and non-target screening in soils and has been validated for triazines, phenylureas and emerging pesticides in soils. The internal calibration of pesticides was validated for low levels (0.5 to 12.5 µg L−1) and high levels (12.5 to 400 µg L−1) using labelled internal standards. The determination coefficient (R2) of calibration curve of each pesticide was greater than 0.99. Excepted DCPU and IPPU, the mean recoveries of pesticides in five reference soils spiked at 40 µg kg−1 and 10 µg kg−1 were greater than 93.5% and 106.2%, and the variation coefficients lower than 14.7% and 22.5%, respectively. So, multiplier factors were applied to the quantification results of DCPU and IPPU, respectively, 2.5 and 1.7 for correction. This validated method has been applied to a selection of 40 French soils of Centre-Val de Loire region. The limit of quantification (LOQ) of pesticides varied between 0.005 and 0.175 µg kg−1 in soils. Seven pesticides were the most detected in soils. Seventeen pesticides were detected between 10 and 50% of cases and very low detection frequencies (<10%) were found for 10 pesticides in soils. The mean concentrations were 0.730 µg kg−1 dw for triazines, 1.367 µg kg−1 dw for phenylureas and 7.638 µg kg−1 dw for emerging pesticides. DCPMU and epoxiconazole were detected in all the 40 soils.

In vitro exposure to triazoles used as fungicides impairs human granulosa cells steroidogenesis

Triazoles are the main components of fungicides used in conventional agriculture. Some data suggests that they may be endocrine disruptors. Here, we found five triazoles, prothioconazole, metconazole, difenoconazole, tetraconazole, and cyproconazole, in soil or water from the Centre-Val de Loire region of France. We then studied their effects from 0.001 µM to 1000 µM for 48 h on the steroidogenesis and cytotoxicity of ovarian cells from patients in this region and the human granulosa line KGN. In addition, the expression of the aryl hydrocarbon receptor (AHR) nuclear receptor in KGN cells was studied. Overall, all triazoles reduced the secretion of progesterone, estradiol, or both at doses that were non-cytotoxic but higher than those found in the environment. This was mainly associated, depending on the triazole, with a decrease in the expression of CYP51, STAR, CYP11A1, CYP19A1, or HSD3B proteins, or a combination thereof, in hGCs and KGN cells and an increase in AHR in KGN cells.

Accessing specialty consultations and procedures in Centre-Val de Loire region

In the Centre-Val de Loire region, the demography of specialty care is characterized by a strong deficit and many territorial inequalities that lead to significant difficulties in accessing care. The study has being conducted at the level of the Professional Territorial Health Communities (CPTS) which structuring the region, which is the ideal framework for implementing public health actions resulting from this study. The aim of this study was to objectify these difficulties and their geography, based on the calculation of the comparative consumption index (CCI), in order to measure the differences between expected consumption and observed consumption, and to quantify the number of “missing” doctors to meet the needs of the population. The study shows a deficit in care-seeking for specialty care, in particular an incompatibility between care needs and care offers in the living environment, as well as strong territorial inequalities, with marked differences between private consumption and hospital consumption. The region experiences a deficit of 25% of liberal medical specialists in order to meet the needs of its population. Accessibility to care is not only defined by the proximity of doctors, and their density; the proximity of areas of activity being a factor associated with better access to health care. This study also makes it possible to identify priority areas of action, specialty by specialty, to strengthen access to specialty care, and propose a fairer distribution of the care offer, in particular through interns’ internships, and the coordinated and territorial organization of specialist doctors.

COVID-19 seroprevalence among local authority workers from Orléans Métropole, the Community of Communes of the Terres du Val de Loire, the local public service management centre of the Loiret department and the Region Centre Val de Loire: a prospective epidemiological study

ObjectiveTo evaluate the SARS-CoV-2 seroprevalence among local authority workers, depending on their position and potential interaction with the public.MethodsA cohort of volunteer participants was recruited among local authority workers of...

Understanding Inequalities in the Uptake of Supportive Care to Improve Practices in the Cancer Care Continuum.

(1) Background: While inequalities in the prevalence of cancer, access to care, and survival have been well documented, less research has focused on inequalities in the uptake of supportive oncology care. Given its contribution to improving the quality of life of people affected by cancer, access to such care is a major public health issue. The present study focuses on the access and uptake of those supportive oncology care services. (2) Methods: This study is based on qualitative research methodology, using a thematic analysis tree on NVivo© analysis software. First, an exploratory survey was conducted with users of oncology services, and professionals from these services and supportive oncology care. Then, individual interviews were conducted in June 2022 among people who are currently being treated or have been treated for cancer. (3) Results: The experiences of the 33 respondents revealed that significant variations in the uptake of supportive oncology care are underpinned by identifiable disparities in their healthcare pathways: in their assimilation of information, difficulties in accessing oncology care, personal reluctance and motivations, perceived needs and benefits, and use of other medicines. (4) Conclusion: This study aims to gain some insight into disparities in the uptake of supportive care in the Centre-Val de Loire region (France). Thus, it provides a better understanding of the complex ways in which these inequalities in supportive oncology care uptake are constructed.

Ressenti des patients atteints de cancer pendant le premier confinement COVID-19 : quel impact sur le parcours de soins, l’état mental et l’accès aux soins oncologiques de support ?

The COVID-19 pandemic disrupted the organisation of the healthcare system. Very little data is available regarding the impact of the COVID-19 pandemic on patients' perceptions of their healthcare pathway. The objective of this survey was to evaluate cancer patients' perceptions of the impact of the first COVID-19 lockdown on continuity of care, their mental condition, as well as their access to Supportive Care in Cancer (SCC). Between June 2nd and 30th, 2020, an anonymous questionnaire was sent out to the patients who visited 17 healthcare establishments in the Centre-Val de Loire region. Our survey questioned 861 patients, amongst which 839 were selected. The population was predominantly female (58%). Breast cancer was the most represented (27%). Approximately three patients out of four considered that their care was maintained during the lockdown. In total, 348 patients (44%) reported an altered mental status. Approximately 1/4th of patients benefited from SCC. More than half of the patients felt that SCC was not relevant to their situation, although 40% of these patients expressed mental issues. Our survey highlighted a negative impact on patients' mental condition and a low use of SCC in spite of existing needs. This demonstrates the necessity of evaluating the patients' needs and offering adequate SCC at various stages of the healthcare pathway, as well as the need for a clearly identifiable offer for the healthcare professionals and the patients.

Difficulties and opportunities in producing broiler chickens for short circuits in the Centre Val de Loire region

Difficulties and opportunities in producing broiler chickens for short circuits in the Centre Val de Loire region

Lessons Learned from the Covid-19 Crisis: Recommendations for Action to Optimize Occupational Health in Mental Health Professionals in Europe.

ObjectiveThe Covid-19 health crisis has disrupted the organization and functioning of European mental health and psychiatric services, impacting the working conditions – already difficult before the epidemic – of professionals working therein. The Psy-GIPO2C project investigated the impact of the pandemic on these professionals. The Psy-GIPOC2C project has been co-funded by the Agence Nationale de la Recherche française (ANR, French National Research Agency) and the Centre-Val de Loire region (France).MethodThis research took the form of a collaborative mixed methods study. The data collected through qualitative and quantitative research were analyzed during a working session held by the research consortium, which resulted in the formulation of recommendations for action to optimize the occupational health of European mental health professionals.ResultsThis research made it possible to identify and explain the extent to which, and the ways in which, the reorganization of European mental health services has impacted the mental health of the professionals working therein, and, in particular, to highlight the fact that the unprecedented use of digital devices has generated stress, and even tension, within these services.ConclusionsIt is important to promote well-being at work among European mental health professionals, by involving them in the development of ad hoc measures (in addition to the existing psychological support measures available) to enable them to recharge their batteries. It is also important to support current and future professionals in their appropriation of digital tools for professional use.

Development and sustainability of the forestry and wood industry in the Centre-Val de Loire region

Development and sustainability of the forestry and wood industry in the Centre-Val de Loire region

Prescription de contraception æstro-progestative en schéma continu/étendu/flexible : étude de pratique professionnelle dans la région Centre Val de Loire

ObjectivesTo date, oral contraceptives remain the most frequently prescribed contraceptive method. New combined oral contraceptive (COC) regimens (continued, extended or flexible) were developed to try and space out or avoid withdrawal bleedings in order to meet women's expectations and improve their quality of life. However, there is no recommendation published regarding the management of the prescription. The purpose of our study was to describe provider's prescription habits when it comes to new COC regimens. MethodsThis is a descriptive observational study. A questionnaire was sent to gynecologists, general practitioners and midwives employed or in training in the Centre Valde Loire region. Prescription habits and knowledge about new oral contraceptive regimens were evaluated. Results83% of health professionals frequently prescribed new COC regimens. Most frequent indications were endometriosis, severe menstruation-associated symptoms, patient's desire for amenorrhea or patient's request. The extended regimen (hormone-free interval not every month) was the most frequently used. Provider's knowledge about indications and benefits of those new regimens were satisfactory. However, scientific societies guidelines were poorly acquired. ConclusionsNew COC regimens are frequently proposed by health care professionals with large variability in terms of prescription model. Along with reinforcement of COC prescription guidelines for healthcare professionals, further researches are needed to better understand differences in tolerability and acceptability in terms of quality of life of the several potential regimens.

Opportunities and Challenges for Professionals in Psychiatry and Mental Health Care Using Digital Technologies During the COVID-19 Pandemic: Systematic Review.

BackgroundThe COVID-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies.ObjectiveAs part of a research project that was cofunded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, the aim of this systematic literature review was to investigate how such uses of digital technologies have been developing.MethodsThis systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was carried out in the MEDLINE (ie, PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results for the year 2020. After applying inclusion and exclusion criteria, first on titles and abstracts and then on full texts, 61 articles were included.ResultsThe analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For many psychiatric and mental health professionals, the pandemic has been an opportunity to build up their experience of remote care and, thus, better identify the possibilities and limits of these digital technologies.ConclusionsNew uses of such technologies essentially consist of a transition from the classic consultation model toward teleconsultation and make less use of the specific potential of artificial intelligence. As professionals were not prepared for these uses, they were confronted with practical difficulties and ethical questions, such as the place of digital technology in care, confidentiality and protection of personal data, and equity in access to care. The COVID-19 health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular to promote the autonomy and empowerment of mental health service users.

Diurnal variation and potential sources of indoor formaldehyde at elementary school, high school and university in the Centre Val de Loire region of France

Formaldehyde (HCHO) is one of the abundant indoor pollutants and has been classified as a human carcinogen by the International Agency for Research on Cancer (IARC). Indoor HCHO at schools is particularly important due to the high occupancy density and the health effects on children. In this study, high time resolved measurement of formaldehyde concentration was conducted in the classrooms at elementary school, high school and university under normal students' activities in three different locations in the Region Centre Val de Loire-France. Indoor average formaldehyde concentrations at those three educational institutions were observed to be in the range 10.96–17.95 μg/m3, not exceeding the World Health Organization (WHO) guideline value of 100 μg/m3. As expected, ventilation was found playing an important role in the control of indoor formaldehyde concentration. After opening windows for 30 min, formaldehyde level decreased by ~25% and 38% in the classroom at the elementary school and the high school, respectively. In addition to the primary sources, the objective of this study was also to determine potential secondary sources of indoor formaldehyde in these schools by measuring the other volatile organic compounds (VOCs) present in the classrooms by a Proton Transfer Reaction Time-of-Flight Mass Spectrometry (PTR-ToF-MS). The measurements suggest that the release of residue from tobacco smokers is one of the major sources of indoor HCHO at the high school, which increases HCHO by ~55% averagely within 1 h. Moreover, the control experiments conducted in the university suggests that VOCs such as that released from cleaning products like terpenes, can contribute to the increase of indoor formaldehyde levels through chemical reactions with ozone. This study confirms simple recommendations to reduce the indoors HCHO concentration in schools: use ventilation systems, limit the emissions like cigarette smoke or cleaning products. It also points out that the secondary sources of formaldehyde must be also considered in the classroom.

Biomass-Origin Carbon Capture, Storage and Utilization in Greenhouses: The Co2serre Project in Centre-Val De Loire (France)

To achieve the objective of the Paris Agreement to limit global warming to well below 2oC, there is a growing need to reduce drastically greenhouse gases emissions and even better to set up also negative emissions. Capturing and storing or valorizing carbon dioxide from biomass origin is a way to obtain negative emissions. The CO2SERRE project investigates techno-economic and environmental feasibility of implementing a “BCCUS” (i.e. CCUS for CO2 of biomass origin) pilot in France, in the Centre-Val de Loire Region. The concept consists in capturing CO2 from a biomass cogeneration plant in Orleans, valorizing it in local greenhouse farms, and storing the unused CO2 in geological reservoirs in the region. In addition to generating negative emissions, this concept promotes local and circular economy. To feed the techno-economic and environmental feasibility assessment, each stage of the CCUS chain is considered and assessed (capture, transport, geological storage, and use in greenhouses). Work carried out so far provides useful insights on technical feasibility of the process. However, the key challenge is the viability of the project on both economic and environmental sides. The LCA and TEA analyses, taking into account the whole CCUS chain, are under development and their outputs will address conditions for feasibility of the CO2SERRE concept. A preliminary assessment of geological storage capacity in the region have shown that targeted reservoir would be able to store the equivalent of the total emissions of the region Centre-Val de Loire. Thus, a longer term perspective for CO2SERRE project is to create a new technical and economic network in the region with platforms gathering CO2 emitter, users and storage.

Prevalence of Malnutrition and Frailty in Elderly Cancer Patients and Resulting Impact on Primary Treatment Recommendations in Colorectal and Breast Cancer

Objectives To estimate the prevalence of malnutrition in elderly cancer patients and its association with frailty and primary cancer treatment recommendations in patients with the two most prevalent cancers (colorectal cancer, CRC and breast cancer, BC) in the Centre-Val de Loire region of France. Methods The entire cohort of 704 patients aged 75 years or older presenting with cancer who underwent comprehensive geriatric assessment (CGA) between 2014 and 2017 was included. Nutritional status, frailty (defined by the Balducci classification system based on CGA parameters and comorbidity), and pathological criteria were analyzed in terms of the cancer treatment recommendations suggested by geriatricians both in the whole cohort and in those with CRC and BC. Results In the whole group of 704 patients (84.3 +/- 4.8 years), the prevalence of malnutrition was 62.9%, and was higher in CRC than in BC patients (71.1% vs 55.4%, P &lt; 0.01). In a multivariate analysis, malnutrition and frailty (as determined by the Balducci classification system) were independently related in CRC patients (OR: 7.28, 95%CI, 1.58~34.03; P = 0.012) and were unrelated to metastasis [odds ratio (OR): 1.34, 95%CI, 0.56~3.18; P = 0.5]. By contrast, malnutrition in BC patients was related exclusively to the extent of metastasis (OR: 3.52, 95%CI, 1.50~8.24; P = 0.002). It was also demonstrated that geriatricians had a greater tendency to suggest only palliative care to CRC patients presenting with malnutrition (15.4% vs 2.7%, P = 0.006) than to BC patients (9.8% vs 5.4%, NS). Conclusion Malnutrition in elderly cancer patients is prevalent, especially in those with colorectal cancer, where malnutrition is frailty-related and may strongly impact on cancer treatment strategies.

Suivi ophtalmologique des patients diabétiques en région Centre-Val de Loire : une étude issue du Système national des données de santé (SNDS)

The main objective of this study was to investigate the rate of ophthalmological screening for diabetic retinopathy in diabetic individuals in the Centre-Val de Loire (CVDL) region. This study secondarily aimed to identify factors associated with regular ophthalmological screening. Data were extracted from the French national healthcare database (SNDS). Individuals were identified on the basis of reimbursements for antidiabetic medications. Patients who were identified as having at least one reimbursed eye examination between 2015 and 2016 were considered as having regular follow-up. In total, 118,181 diabetic individuals residing in CVDL were identified in the SNDS, and 74,048 had undergone ophthalmological screening. The rate of eye examination was 62.7% between 2015 and 2016 and was highly variable within the region (from 65.6% in Loiret to 54.0% in Cher). The main factors associated with regular eye screening were: follow-up with an established primary care physician (OR=2.88), regular follow-up with a diabetologist (OR=2.14), and regular follow-up with an internist (OR=1.57). This study suggests that ophthalmological screening for diabetic retinopathy in individuals with diabetes in the CVDL region could be significantly improved, particularly in rural areas. Factors influencing compliance with follow-up are multiple but appear mainly related to the patients' quality of overall medical management. These findings highlight the need for public health policies to improve detection and prevention of diabetic retinopathy by promoting comprehensive medical care for diabetic individuals.

Identifying professional and territorial health communities by analyzing healthcare spatial realities

Professional and Territorial Health Communities aim at organizing the coordination of health professionals of primary and specialty care, in order to better structure care pathways and improve healthcare access. The flow of patients to specialty care outlines territories whose scale and organization can serve as a basis to identify these communities' territories. The analysis of patient flows to specialty care professionals in Centre-Val de Loire region in 2015 (SNIIRAM data) made it possible to classify medical specialties according to their scale of attractiveness (i.e. regional, departmental and sub-departmental specialties). Among sub-departmental specialties, 5 have been merged to identify common poles of attraction. These empirical poles have been compared to health professionals' perception of territories where they practice in order to refine the territorial subdivision of the region. Patient flows to the General Hospitals (PMSI date) were then defined to compare them with the private practice patient poles. In the region, twenty or so attraction poles can be identified in the six departments of the region. Local areas have been divided into 5 classes, according to their degree of attraction to a pole. Attraction poles seem to be consistent with health professionals' habits. The concordance with hospital patient poles reinforced the relevance of this division. Patients flows respond to a real territorial logic which, confronted to health professionals' real-life practices, draws territories relevant for a first approach of the Professional and Territorial Health Communities.