Étude de la santé déclarée par les personnes riveraines de sources locales de pollution environnementale : une revue de la littérature. Première partie : les indicateurs de santé déclarée

BackgroundEpidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. A first step focused on describing the indicators.MethodsThe literature on indicators of self-reported health was reviewed, leading to a discussion on data collection, selection of health effects, data processing, and construction of indicators.ResultsThe literature review concerned 51 articles. The use of self-reported health indicators allowed the studies to take into account the health concerns and complaints of populations exposed to environmental pollution. Various indicators of self-reported health were used in the studies. They measured physical, psychological and general dimensions of health. Standardized questionnaires were used less often than ad hoc questionnaires (78% of studies) developed to fit the needs of a given study. Three standardized questionnaires were used more frequently: the MOS Short-Form Health Survey (SF-36) to measure general health perceptions, the General Health Questionnaire (GHQ), and the Symptoms Checklist (SCL-90) to measure psychological distress.ConclusionThe choice of self-reported health indicators is a compromise between specificity of the studied health issues within a given environment and standardization of the questionnaires used to measure them. Such standardization is necessary to ensure the validity and the reliability of the information collected across time and situations. The psychometric properties of the measuring questionnaires are rarely estimated or verified when they are used.     

Dénutrition protéino-énergétique chez une patiente hémodialysée

The authors report the case of a 69-year old woman with stage-5 chronic kidney disease. The occurrence of protein-energy wasting contributed to the decision of initiating haemodialysis. The methods of nutritional monitoring and treatment are discussed regarding to patient's evolution, which was marked by a catabolic episode.     

Inégalités sociales de santé orale et caries précoces de l’enfant : comment prévenir efficacement ? Une revue de portée des prédicteurs de la maladie

BackgroundEarly childhood caries represent a major public health problem. In addition to their individual impact, the massive social inequalities in oral health that are at the roots and result from the disease have largely underestimated consequences for the child, his family and the community. In response to the question of “how and where to act?”, this scoping review identifies the individual characteristics associated with the disease on which it would be possible to act, using appropriate prevention strategies.MethodsThis scoping review is aimed at describing and analyzing available data in the literature on the different factors associated with early childhood caries.ResultsThe predictors of early childhood caries are represented by mediating (knowledge, attitudes and parents’ oral health practices) and moderating (psychosocial parameters, parental health literacy and alcohol consumption) factors. Twenty-eight articles fulfilled the selection criteria, twenty of which studied mediators related to early childhood caries, and fourteen of which dealt with moderators. The lower the parents’ level of knowledge and literacy in oral health, the higher a child's dmft index. Additional studies are needed to assess the role of psychosocial parameters.ConclusionParents’ knowledge and oral health literacy are the key predictors to be preferentially targeted in view of reducing social inequalities in health through actions undertaken on a local scale. The prevention of early childhood caries necessitates a combination of generic and targeted interventions.