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Epidemiology of School-Related Injuries in Belgium. A Better Knowledge for a Better Prevention

Open Journal of Preventive Medicine 2014年第6期4卷 408-420页

作者： Christelle Senterre Michèle Dramaix alain levêque Research Centre of Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles Brussels Belgium

The landmark Convention on the Rights of the Child states that children around the World have right to safe environment. In Belgium, as in many countries, children spend, on average, 4.5 weekdays at school, during nearly 8 hours per day. Studies have shown that, the risk of school-related injury exceeds the risk during leisure time. Literature reports that school accidents account for 10 to 30% of all accidents among pupils. Despite that, few papers treat of the school-related injuries. Consequently, based on 1540 accidents forms from an insurance company, injury places, mechanisms involved, body parts injured and nature of injuries were described. Head injuries, upper and lower limbs injuries were investigated in more details. Pearson’s chi-square test was used to assess the relationships between the variables and multivariate logistic regression models were used to study the three specific types of injuries cited above. Gender ratio (M/F) was equal to 1.6 with 25.9% of children under 6 years, 29.4% of 6 - 9 years, 26.9% of 10 - 12 years and 17.8% from 13 years or more. The major places of injuries were the playground (56.9%) and the physical education (19.7%). Falls were observed in 52.1% of cases and contacts were reported in 24.3%. The head injuries account for 40.6%, the upper limbs for 32.0% and the lower limbs injuries for 20.2%. The bruises and the scratches were observed in 23.8% and the wounds in 21.5%. Fractures were reported in 16.1%. In conclusion, having a routine access to the data from the insurance companies could be an important source of information for an injury surveillance system in which the school injuries will be included. Taking into account this data will require an awareness of all the concerned persons about the relevance of such a system and a harmonization of the accidental forms.

关键词： School-Related Injuries Injury Determinants Cross-Sectional Survey Epidemiology

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Open Journal of Epidemiology 2014年第2期4卷 89-114页

作者： Christelle Senterre alain levêque Danielle Piette Michèle Dramaix Research Centre of Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles Brussels Belgium Research Centre of Social Approaches to Health School of Public Health Université Libre de Bruxelles Brussels Belgium

Aims: Establish profiles of young “at risk” of injuries, first, on an overall point of view and, secondly, for some types of injuries (sport, home, road traffic, school and work injuries). Methods: We have taken nearly 50 variables into consideration: 17 variables for construction of the socioeconomic status, 9 variables for the investigation of symptoms, 11 concerning drugs, 5 for healthy habits, 3 for investigating the violence behavior, 4 concerning the school, 3 for subjective health and finally 3 for social network. We have used the principal component analysis, the multiple correspondence analysis and the weighted-frequency score for reducing the number of them. After these reductions, 15 variables were available for analyses. The relationship between injuries and investigated factors was assessed using the Pearson’s chi-square test. We also calculated odds ratio (OR) with their 95% confidence intervals (95%CI) to estimate the strengths of the associations. To further assess these relationships but also for taking into account the potentials confounding effects of some variables, logistic regression model and multinomial logistic regression model were applied. Results: The whole injury prevalence was equal to 45.6% and among the injured, the proportion of the several types was equal to 33.8% for sport injuries, 32.2% for home injuries, 16.6% for traffic injuries, 11.6% for school injuries and 5.7% for work injuries. We can say that, in light of the variables studied, the “at risk” profile for having reported an injury is being a boy, being younger, having drug experiences, with the violent profile, and declaring several symptoms. There are no consistent and marked deviations in this study from the findings obtained in previous studies. Conclusion: Analyzing injuries in general is interesting but for preventing them it is important to know in which activities children and students are engaged when they are injured.

关键词： Injuries Health Behavior Youth Epidemiology Cameroon

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Effects of air pollution on the risk of acute myocardial infarction in Charleroi, Belgium

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Open Journal of Epidemiology 2013年第2期3卷 44-52页

作者： Yves Coppieters Philippe Collart Gwennaelle Mercier Victoria Massamba Catherine Bouland alain levêque Research Center in Environmental Health School of Public Health Université Libre de Bruxelles (ULB) Brussels Belgium Research Center in Epidemiology Biostatistics and Clinical Trials School of Public Health Université Libre de Bruxelles (ULB) Brussels Belgium

Atmospheric pollution would increase morbidity and mortality rates for various respiratory illnesses in urban areas, and could also be an explanatory factor of higher rates of myocardial infarction in Charleroi compared with the other Belgian cities. The present study investigates the health effects of acute exposure to air pollution on cardiovascular morbidity/mortality in Charleroi. The study is based on comparing hospital data taken from the registry of ischaemic cardiopathies in Charleroi (1999 to 2008) to data on the air quality in this region. To measure the association between atmospheric pollution and the number of cases of myocardial infarction, Poisson regression was carried out. The excess risk of myocardial infarction was analysed according to the month of admission. For men, a decrease in the attack rate of myocardial infarction is visible during the first three years of the study, later to remain stable. For women, attack rates are stable throughout the study. Most of the pollutants vary according to season. Except for ozone, concentrations are generally higher in winter. We observe an association between the concentrations of PM10 and NO2 and morbidity/mortality by acute myocardial infarction. The increased risk for an increase of 10 μg/m3 of pollutant is 1.8% for PM10 and 4.0% for NO2. Multivariate models must still be developed and applied to our data.

关键词： Ischaemic Cardiopathies Air Pollution Environmental Risk Belgium

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Influence of Proxies on the Reported Frequency of Falls, Fear of Falling and Activity Restriction in Older People

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Health 2014年第12期6卷 1512-1521页

作者： Elise Mendes da Costa Isabelle Godin Thierry Pepersack Michèle Dramaix Yves Coppieters Martine Bantuelle alain levêque Educa-Santé Non-Profit Organisation Charleroi Belgium Geriatrics Erasme University Hospital Université Libre de Bruxelles (U.L.B.) Bruxelles Belgium Research Centre in Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles (U.L.B.) Bruxelles Belgium Research Centre in Social Approaches to Health School of Public Health Université Libre de Bruxelles (U.L.B.) Bruxelles Belgium

Introduction: In older populations, the help of a third person may be necessary for a certain number of individuals in order to fill in questionnaires. The influence of this assistance on the collected information can raise questions, among others concerning the concordance between the information provided by the persons themselves and by their proxies, or the introduction of a potential bias. Our study’s objective is to examine, among older people, the differences in the reported frequency of falls, fear of falling and activity restriction due to fear of falling, according to the fact that people had filled in a questionnaire with or without the help of a third person. Methods: The data used come from the secondary analysis of a cross-sectional survey using a self-administered questionnaire and conducted in 2006 in a Belgian semi-rural town among non-institutionalised persons aged 65 years and over. Results: Among the 501 questionnaires, 16.4% were filled in with the help of another person. In bivariate analysis, the persons who needed help reported fall history, fear of falling and activity restriction significantly more often. In multivariable analysis, when considering concurrently the covariates (sex, age, living alone and fall history for fear of falling and for activity restriction), the influence of having received help to fill in the survey was only significant for activity restriction. Conclusion: Our study shows that it is important to know whether or not a person has received help to fill in a questionnaire. This can actually influence the reported frequency of certain outcomes, even, for activity restriction, when considering simultaneously the effect of other covariates. Given the current and future ageing of our populations, it seems that more extensive exploration is needed of the influence of proxies on the collected information about falls, fear of falling and activity restriction among older people.

关键词： Accidental Falls Fear of Falling Activity Restriction Proxies Older People

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Community workers contribution for data quality improvement in routine health information system: Live births number estimation by capture recapture method

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Open Journal of Epidemiology 2014年第1期4卷 39-45页

作者： Yolaine Glèlè Ahanhanzo Alphonse Kpozèhouen Noel Moussiliou Paraiso alain levêque Michel Makoutodé Michèle Dramaix-Wilmet Epidemiology and Biostatistics Department Public Health Regional InstituteOuidahBenin Center of Research in Epidemiology Biostatistics and Clinical ResearchSchool of Public HealthUniversité Libre de BruxellesBrusselsBelgium Health Promotion Department Public Health Regional InstituteOuidahBenin Environment and Health Department Public Health Regional InstituteOuidahBenin

The lack of reliable vital statistics raises questions about the role of the health information system in acquiring such data, which are essential for planning health services and for the general management of the population’s needs. This study analyzed completeness of the vital data registration system and assessed the potential contribution of a community worker net-work to this system in rural Benin. The capture-recapture method was used in this interventional study to estimate the number of live births from three sources: the Routine Health Information System, the municipality, and community workers in two groups of villages. Log linear modelling was carried out with a Bayesian Information Criterion-weighted estimate of the number of live births. The exhaustiveness of the Routine Health Information System was improved by the contribution of the community workers from 29.3% to 42.5% in the first group, and from 61.7% to 77.5% in the second group. Estimating live births by the capture method in rural settings based on the contribution of community workers could be a more efficient alternative to censuses in acquiring reliable vital statistics.

关键词： Community Health Workers Health Information System Vital Statistics Capture-Recapture Method Benin

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Disability and Related Factors among Road Traffic Accident Victims in Benin: Study from Five Public and Faith-Based Hospitals in Urban and Suburban Areas

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Open Journal of Epidemiology 2018年第4期8卷 226-241页

作者： Yolaine Glèlè-Ahanhanzo Alphonse Kpozèhouen Noel Moussiliou Paraiso Patrick Makoutodé Chabi O. Alphonse Biaou Eric Remacle Edgard-Marius Ouendo alain levêque Epidemiology and Biostatistics Department Public Health Regional Institute Ouidah Benin Health Promotion Department Public Health Regional Institute Ouidah Benin Policies and Health Systems Department Public Health Regional Institute Ouidah Benin Humanité Inclusion Brussels Belgium Center of Research in Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles Brussels Belgium

Introduction: Road traffic accidents (RTAs) are a major public health issue in developing countries, where roads tend to be built haphazardly and accidents take a heavy toll on victims—including leaving them disabled. This study seeks to identify those factors that cause RTA victims to become disabled as a result of their injuries. Methods: This retrospective community-based study looked at RTA victims treated in five public and faith-based hospitals in Benin. Disability was evaluated using the Washington Group on Disabilities Statistics questionnaire. The independent variables were related to the victim’s socio-demographic traits, the circumstances of the accident, and post-crash response mechanisms. The proportions were compared using the chi-squared test, with a threshold of 5%. Results: The prevalence of disability among road traffic accident victims is 9.59% (CI 95%: 6.86% - 13.20%). The occurrence of disability is associated with age (p = 0.002), occupational group (p = 0.0077), the mode of transport used to transfer the victim (p p = 0.0035). The study also found that people fail to make sufficient use of post-crash response mechanisms. Conclusion: Public policy-makers should therefore focus on stepping up interventions to get more people using both protective equipment and post-crash response services.

关键词： Traffic Accident Disabled Persons Risk Factors

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Off-label use of targeted therapies in oncology

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World Journal of Clinical Oncology 2016年第2期7卷 253-257页

作者： Dominique levêque Dominique levêque Division of Pharmacyhôpital Hautepierre67000 StrasbourgFrance

Off-label use is defined by the prescription of a marketed drug outside the conditions described in the summary of product characteristics.In oncology,off-label prescribing of targeted therapies may occur in patients with other tumor types expressing the same target.Agents associated to phenotypic approaches such as therapies against the tumoral vasculature(anti-angiogenic drugs) and new immunotherapies(checkpoint inhibitors) also carry the potential of alternative indications or combinations.Off-label use of targeted therapies is little documented and appears to be in the same range than that regarding older drugs with wide variations among agents.When compared with older agents,off-label use of targeted therapies is probably more rational through tumoral genotyping but is faced with a limited clinical support,reimbursement challenges related to the very high pricing and the cost of genotyping or molecular profiling,when applicable.

关键词： Targeted therapy Monoclonal antibody Off-label anticancer drug use Reimbursement Enzyme inhibitor

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新发现藏书斋与家佣制度改革

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法语学习 2014年第4期 10-12页

作者： alain-René Lesage 王庆超

我在瓦朗斯上流社会待了一星期，过着伯爵和大公般的生活。看戏、跳舞、听音乐、赴盛宴以及同贵妇们交谈。所有这些吃喝玩乐都是总督夫妇二人为我提供的；而我极力讨东道主们的欢心，他们送我启程返回黎利亚斯时依依惜别。

关键词：制度改革书斋上流社会东道主

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19世纪初以来法国基础教育投资和学校政策的地方分权

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法国研究 2004年第2期 24-40页

作者：阿兰.卡利李兴业法语国家比较教育学会武汉大学教育科学学院

Résumé : Du point de vue de l′histoire économique d′éducation, par les méthodes de l′économie historique quantitative, cet article estime les contributions qu′ont faites les divers financeurs ( Etat, familles, villes et communes ) aux dépenses sur l′enseignement de base et aux changements des constitutions, sous le système de pouvoir central depuis deux siècles en France, et il explique aussi la double nature économique et fonctionnelle exercée par chaque financeur. Et l′article met l′accent sur l′importance de former un groupe stable des enseignants de qualité et la nécessité d′établir un organisme de finance stable, pour que la continuité sur l′enseignement et l′admi^nistration aux élèves soit garantie. Tout cela a pour but de coordonner les changements sur les relations sociales à cause de l′éducation dans les écoles différentes.

关键词： 19世纪初法国基础教育教育投资学校政策地方分权教育经济史

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查尔斯·内格雷媒体图书馆,格拉斯,法国

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世界建筑 2022年第1期 98-103页

作者：米凯利·博尼诺皮埃尔-阿兰·克罗塞特洛朗·博杜安(摄影) 史蒂文·皮科洛(译) 叶扬(译) 都灵理工大学米兰理工大学不详

穿过小街和广场,远离历史中心的商业区,向东北走,我们发现自己置身于一个越来越密集的城市空间迷宫之中。山坡愈加陡峭,众多建筑物中,我们突然瞥见一堵由细长的垂直圆柱体构成的外墙。而后,一座新建筑及建筑物下的通道,带着我们走上一... 详细信息

穿过小街和广场,远离历史中心的商业区,向东北走,我们发现自己置身于一个越来越密集的城市空间迷宫之中。山坡愈加陡峭,众多建筑物中,我们突然瞥见一堵由细长的垂直圆柱体构成的外墙。而后,一座新建筑及建筑物下的通道,带着我们走上一段台阶,通往大阶梯式的广场。

关键词：商业区阶梯式图书馆建筑物外墙广场查尔斯

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