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Le Page E.,University of Rennes 2 – Upper Brittany | Deburghgraeve V.,University of Rennes 2 – Upper Brittany | Lester M.-A.,University of Rennes 2 – Upper Brittany | Cardiet I.,University of Rennes 2 – Upper Brittany | And 2 more authors.
Journal of Neurology | Year: 2015

Our study aimed to describe safety and neurological impact of alemtuzumab as last-line rescue therapy in aggressive multiple sclerosis (MS) patients, previously treated by Mitoxantrone (MITOX). Between June 2004 and October 2013, 13 patients received alemtuzumab at 20 mg/day and 3 at 12 mg/day for 5 days. EDSS, relapses, secondary progression were prospectively assessed 12 and 6 months before treatment, at baseline and every 3 months. Mean follow-up was 6.2 years [1–10]. Mean age at alemtuzumab start was 40 years [26–49] for 8 Secondary Progressive (SP) and 30 years [26–35] for 8 Relapsing-Remitting (RR) patients. MS duration was 13.7 (±3) and 8.3 (±4) years, respectively. During the 12 months before alemtuzumab, annual relapse rate was 0.75 and 3.14, respectively and the 16 patients accumulated 2–30 new gadolinium enhancing lesions. 4 patients (suboptimal responders) received alemtuzumab during MITOX and 12 patients 1–7.8 years after MITOX. Out of 8 SPMS, 2 were disease free up to last visit (4.7 and 8 years), 5 improved or stabilized but only transiently and 1 worsened. Out of 8 RRMS, 1 remained stable up to last visit (8.7 years) despite 1 relapse and active MRI at 18 months and 7 improved (1–4 point EDSS): 4 remained disease free up to last visit (12, 24, 38 months and 7 years), 2 were successfully retreated at 25 and 33 months and 1 worsened progressively 24 months after alemtuzumab. 2 patients developed Grave’s disease and 1 hypothyroidism. Alemtuzumab controls aggressive RRMS despite previous use of MITOX. © 2015, Springer-Verlag Berlin Heidelberg.


Debout C.,EHESP
Soins | Year: 2014

The focus group is a research method commonly used in nursing science with the aim of exploring in depth extremely targeted themes. This qualitative approach places the interaction between participants in the foreground. The practices of the researchers who select the focus group are notably heterogeneous. © 2014 Elsevier Masson SAS.


Monard C.,CNRS Ecosystems, Biodiversity, and Evolution Laboratory | Monard C.,Swedish University of Agricultural Sciences | Vandenkoornhuyse P.,CNRS Ecosystems, Biodiversity, and Evolution Laboratory | Le Bot B.,EHESP | Binet F.,CNRS Ecosystems, Biodiversity, and Evolution Laboratory
ISME Journal | Year: 2011

In soil, the way biotic parameters impact the relationship between bacterial diversity and function is still unknown. To understand these interactions better, we used RNA-based stable-isotope probing to study the diversity of active atrazine-degrading bacteria in relation to atrazine degradation and to explore the impact of earthworm-soil engineering with respect to this relationship. Bulk soil, burrow linings and earthworm casts were incubated with 13 C-atrazine. The pollutant degradation was quantified by liquid chromatography-mass spectrometry for 8 days, whereas active atrazine degraders were identified at 2 and 8 days by sequencing the 16S ribosomal RNA in the 13 C-RNA fractions from the three soil microsites. An original diversity of atrazine degraders was found. Earthworm soil engineering greatly modified the taxonomic composition of atrazine degraders with dominance of α-, Β-and γ-proteobacteria in burrow linings and of Actinobacteria in casts. Earthworm soil bioturbation increased the γ-diversity of atrazine degraders over the soil microsites generated. Atrazine degradation was enhanced in burrow linings in which primary atrazine degraders, closely related to Pelomonas aquatica, were detected only 2 days after atrazine addition. Atrazine degradation efficiency was not linearly related to the species richness of degraders but likely relied on keystone species. By enhancing soil heterogeneity, earthworms sustained high phylogenetic bacterial diversity and exerted a biotic control on the bacterial diversity-function relationships. Our findings call for future investigations to assess the ecological significance of biotic controls on the relationships between diversity and function on ecosystem properties and services (for example, soil detoxification) at larger scales. © 2011 International Society for Microbial Ecology. All rights reserved.


While the current professional context is marked by the evolution of clinical roles devolved to nurses and while the reform of nursing education continues, in July the first graduates received their master's degree in nursing clinical sciences. It is important to identify key international managers in advanced nursing practices who may be available to participate, particularly in the area of training. © 2011 Elsevier Masson SAS.


Le Meur N.,EHESP | Le Meur N.,French Institute of Health and Medical Research
Current Opinion in Biotechnology | Year: 2013

Recent advances in miniaturization and automation of technologies have enabled cell-based assay high-throughput screening, bringing along new challenges in data analysis. Automation, standardization, reproducibility have become requirements for qualitative research. The Bioconductor community has worked in that direction proposing several R packages to handle high-throughput data including flow cytometry (FCM) experiment. Altogether, these packages cover the main steps of a FCM analysis workflow, that is, data management, quality assessment, normalization, outlier detection, automated gating, cluster labeling, and feature extraction. Additionally, the open-source philosophy of R and Bioconductor, which offers room for new development, continuously drives research and improvement of theses analysis methods, especially in the field of clustering and data mining. This review presents the principal FCM packages currently available in R and Bioconductor, their advantages and their limits. © 2012 Elsevier Ltd.


The rapid rise in the number of coordinator posts offers nurses new career and training opportunities. It could also favour a rise in skill levels within the profession and help to transform relations between health care professionals. Copyright © 2016. Published by Elsevier Masson SAS.


In France, certified nurse clinicians have been working in various fields of activity for a number of years. Recent political decisions aim to create the role of nurse clinician specialised in oncology as well as advanced nursing practice. In this context, an explanation of the terminology and the history of this domain is necessary in order to shed light on the ongoing discussion process. © 2014 Published by Elsevier Masson SAS.


Dooris M.,University of Central Lancashire | Heritage Z.,EHESP
Journal of Urban Health | Year: 2013

Community participation and empowerment are key values underpinning the European WHO Healthy Cities initiative, now in its fifth phase. This paper provides a brief overview of the history, policy context, and theory relating to community participation and empowerment. Drawing on Phase IV evaluation data, it presents the findings in relation to the four quadrants of Davidson's Wheel of Participation- information, consultation, participation in decision making, and empowerment. The large majority of European Healthy Cities have mechanisms in place to provide information for and to consult with local people. Most also demonstrate a commitment to enabling community participation in decision-making and to empowering citizens. Within this context, the evaluation highlighted a diversity of approaches and revealed varied perspectives on how participation and empowerment can be integrated within city leadership and governance processes. The paper concludes by suggesting that there is a need to strengthen future evaluative research to better understand how and why the Healthy Cities approach makes a difference. © 2012 The New York Academy of Medicine.


Lamboray J.-L.,Constellation ASBL | Sherlaw W.,EHESP
Sante Publique | Year: 2016

An outbreak of Ebola occurred in 2014-2015 in Guinea, Liberia and Sierra Leone. Two opposing hypotheses may be put forward to explain its decline in these countries. The first of which attributes this decline to authoritarian emergency action imposed on the populations. This comprised the opening of specialized centres to fight the epidemic, directing people suspected of being contaminated to travel to such centres, and taking charge of cremating the remains of the deceased victims of Ebola. This process was founded on the supposed weaknesses of the health systems in question and sought to offer a substitute for them. The second hypothesis suggests that the reduction of the number of Ebola cases in West Africa was due to the combined efforts of civil society and the local health services facing up to this new challenge. This explanation is based on the experience of the Democratic Republic of the Congo which has confronted seven epidemics of Ebola since 1976 and which privileged the mobilization of local capacities involving both the health services and the community. This last hypothesis is built on the appreciation of local strengths and strives to mobilize and facilitate such assets. What was the impact of such radically different approaches to managing the outbreak? © S.F.S.P.. Tous droits réservés pour tous pays.


Mixed methods research uses methodologies from quantitative and qualitative approaches in a single project. Thanks to the integration of the results of the studies, complex phenomena can be explored. The designs are based on specific criteria of rigour. Strategies exist for the design of this type of research. © 2015 Elsevier Masson SAS.

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