• Other research productsclose
• FR close
• English close
• COVID-19 close

The COVID-19 pandemic has dramatically transformed organizational processes in healthcare institutions, more specifically, in France, in public hospitals. While it was known for years that French public hospitals were going through a crisis (Juven et al., 2019), research is scarce when it comes to hospital administrators, except in the field of administration sociology (Schweyer, 2006, 2018). Investigating their lived experience of the crisis seemed necessary to better assess their psychological needs and specificities and more fully understand how the pandemic hit French hospitals.Our research started with a proposal from the CEO of a middle-sized French teaching hospital, who called us to help his team recall and write the story of their experience of the COVID-19 pandemic. Considering how little researchers know about hospital administrators in France, our research was exploratory and hypothesis-generating. We conducted 4 sessions of a semi-open focus group, once every three weeks between March and June ’21, completed by semi-directed individual interviews. Participation was voluntary; the administrators could enter the group and/or accept a semi-directed interview and/or both and/or none of these options. The focus group sessions and interviews were conducted on the field. The data collected is currently being thematically analyzed within an abductive framework relying on the systems psychodynamics paradigm (Petriglieri & Petriglieri, 2020).In our presentation, we will detail how the group setting, according to what W.R. Bion demonstrated (Bion, 1999), enabled the emerging of unconscious feelings and representations among the participating administrators, which were too powerful and archaic to tolerate and were therefore projected onto the figures of the CEO and deputy CEO, who were not part of the group. We will show how the discourse of a generally lacking and malevolent management, which in previous works we called the fantasy of the “malicious institution” (Haliday, 2020), hid feelings of angst and helplessness, and how we decided to interpret such unconscious movements to keep the working group, and therefore the research, going.Our main hypothesis points at the existence of “affective silos” between administrators, which are reinforced by the competitive spirit of their job and the organizational division of work. These affective silos which isolated administrators from their own feelings and from their colleagues’ were broken by the group setting, with participants being surprised to learn new things about their colleagues in the group and during the sessions.These findings need to be discussed in the light of a few methodological limitations:1°) The group explicitly asked for the CEO and deputy CEO to not participate. We will explain why we accepted such a request to maintain a good quality of collected data (i.e. a sincere as possible expression of feelings in the group), though it could be seen as reinforcing “the team”’s symptom (absence of feeling of togetherness, intense feelings of solitude in the job),2°) The difference between research and consultancy was at times blurry, especially for the CEO and deputy CEO who wished to use the research to bring “the team” together,3°) Finally, the idea that all hospital administrators, CEO and deputy CEO included, formed a “team”, was not to be taken for granted methodologically speaking. It actually turned out to be the most sensitive aspect of the research, determining a large part of the discussions in and in-between sessions 1 and 2.Our experience points at the possibility of organizing supervision groups for hospital administrators, differing from – and therefore being complementary with – psychodynamic organizational consultancy.

contribution à un site web; First lines: In the context of the COVID 19 crisis, the city-as-place approach gained new momentum as part of efforts to ensure safe distancing, accommodate demands for public space and reimagine the post-pandemic city.

Hardy, Andrew, Melody Shum and Vũ Ngọc Quyên. “The ‘F-System’ of Targeted Isolation: A Key Method In Vietnam’s Suppression of Covid-19”. CRISEA European Policy Brief, December 2020. http://crisea.eu/wp-content/uploads/2020/12/PB3-VN-containment-method-05.pdf

Objective: To determine the impact of maternal coronavirus disease 2019 (COVID-19) on prematurity, birthweight and obstetric complications. Design: Nationwide, population-based retrospective cohort study. Setting: National Programme de Médicalisation des Systèmes d'Information database in France.Population: All single births from March to December 2020: 510 387 deliveries, including 2927 (0.6%) with confirmed COVID-19 in the mother and/or the newborn.Methods: The group with COVID-19 was compared with the group without COVID-19 using the chi-square test or Fisher's exact test, and the Student's t test or Mann–Whitney U test. Logistic regressions were used to study the effect of COVID-19 on the risk of prematurity or macrosomia (birthweight ≥4500 g).Main outcome measures: Prematurity less than 37, less than 28, 28–31, or 32–36 weeks of gestation; birthweight; obstetric complications.Results: In singleton pregnancies, COVID-19 was associated with obstetric complications such as hypertension (2.8% versus 2.0%, p < 0.01), pre-eclampsia (3.6% versus 2.0%, p < 0.01), diabetes (18.8% versus 14.4%, p < 0.01) and caesarean delivery (26.8% versus 19.7%, p < 0.01). Among pregnant women with COVID-19, there was more prematurity between 28 and 31 weeks of gestation (1.3% versus 0.6%, p < 0.01) and between 32 and 36 weeks of gestation (7.7% versus 4.3%, p < 0.01), and more macrosomia (1.0% versus 0.7%, p = 0.04), but there was no difference in small-for-gestational-age newborns (6.3% versus 8.7%, p = 0.15). Logistic regression analysis for prematurity showed an adjusted odds ratio (aOR) of 1.77 (95% CI 1.55–2.01) for COVID-19. For macrosomia, COVID-19 resulted in non-significant aOR of 1.38 (95% CI 0.95–2.00). Conclusions: COVID-19 is a risk factor for prematurity, even after adjustment for other risk factors.

Objectives: We evaluated the clinical, virological and safety outcomes of lopinavir/ritonavir, lopinavir/ritonavir-interferon (IFN)-β-1a, hydroxychloroquine or remdesivir in comparison to standard of care (control) in coronavirus 2019 disease (COVID-19) inpatients requiring oxygen and/or ventilatory support.Methods: We conducted a phase III multicentre, open-label, randomized 1:1:1:1:1, adaptive, controlled trial (DisCoVeRy), an add-on to the Solidarity trial (NCT04315948, EudraCT2020-000936-23). The primary outcome was the clinical status at day 15, measured by the WHO seven-point ordinal scale. Secondary outcomes included quantification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory specimens and pharmacokinetic and safety analyses. We report the results for the lopinavir/ritonavir-containing arms and for the hydroxychloroquine arm, trials of which were stopped prematurely.Results: The intention-to-treat population included 583 participants-lopinavir/ritonavir (n = 145), lopinavir/ritonavir-IFN-β-1a (n = 145), hydroxychloroquine (n = 145), control (n = 148)-among whom 418 (71.7%) were male, the median age was 63 years (IQR 54-71), and 211 (36.2%) had a severe disease. The day-15 clinical status was not improved with the investigational treatments: lopinavir/ritonavir versus control, adjusted odds ratio (aOR) 0.83, (95% confidence interval (CI) 0.55-1.26, p 0.39), lopinavir/ritonavir-IFN-β-1a versus control, aOR 0.69 (95%CI 0.45-1.04, p 0.08), and hydroxychloroquine versus control, aOR 0.93 (95%CI 0.62-1.41, p 0.75). No significant effect of investigational treatment was observed on SARS-CoV-2 clearance. Trough plasma concentrations of lopinavir and ritonavir were higher than those expected, while those of hydroxychloroquine were those expected with the dosing regimen. The occurrence of serious adverse events was significantly higher in participants allocated to the lopinavir/ritonavir-containing arms.Conclusion: In adults hospitalized for COVID-19, lopinavir/ritonavir, lopinavir/ritonavir-IFN-β-1a and hydroxychloroquine improved neither the clinical status at day 15 nor SARS-CoV-2 clearance in respiratory tract specimens.

Contexte. La pandémie de Covid-19 a eu d’importantes répercussions sanitaires et sociales. Les acteurs de soins primaires, en particulier les spécialistes de médecine générale, prennent en charge la majorité des patients atteints de Covid-19. Un traitement précoce initié en première ligne, notamment chez les patients à risque d’aggravation, pourrait réduire les taux d’hospitalisation et de décès. Aucun traitement n’est actuellement validé dans cette indication.Objectif. Évaluer l’efficacité et la tolérance de traitements expérimentaux administrés à un stade précoce, en ambulatoire, dans le but de diminuer le risque de développer une forme sévère de la maladie chez des patients atteints de Covid-19 ayant des facteurs de risque d’aggravation et qui n’ont pas de critères d’hospitalisation.Méthodes. Essai thérapeutique contrôlé randomisé multicentrique, en ouvert, multi-bras, multi-étapes (MAMS) comprenant une phase pilote d’évaluation de la tolérance et une phase d’évaluation de l’efficacité. L’efficacité sera évaluée par la proportion de participants ayant eu une indication d’hospitalisation, une indication d’oxygénothérapie aiguë (en raison de la Covid-19), ou décédés entre J0 et J14 dans le groupe traitement expérimental par rapport au groupe témoin. Résultats attendus. Cet essai permettra d’évaluer la tolérance et l’efficacité de l’administration précoce de divers traitements dans le cadre de la Covid-19 chez des patients à risque de développer des formes graves. Il fournira également des informations susceptibles d’améliorer la recherche clinique interventionnelle impliquant la personne humaine en soins primaires et sa structuration. Context. The Covid-19 pandemic is of unprecedented magnitude and has had major social and health consequences. Primary care professionals, mainly general practitioners, ensure the care of most patients with Covid-19. An early-stage treatment administered to patients with risk factors for developing a severe disease could reduce hospitalization and death rates. No treatment is currently validated in this indication. Objectives. To evaluate the safety and efficacy of experimental candidate agents delivered in outpatient settings to reduce the risk of hospitalization or death in at-risk patients with early-stage proven Covid-19 and no indication for hospital admission. Methods. Multicentric, open-label, multi-arm, multi-stage (MAMS) randomized controlled trial with a pilot tolerability and safety phase, and a clinical efficacy phase. Efficacy will be determined by the proportion of participants who have an indication for hospital admission, administration of acute oxygen therapy (because of Covid-19) or who decease between D0 and D14 in the experimental treatment group compared to the control group. Expected results. This trial will assess the tolerance and efficacy of diverse treatments administered at an early stage of Covid-19, in patients with risk factors of developing a severe disease. It will also provide information that can contribute to increase primary care actors' ability to conduct clinical trials at the national level.

International audience; The sixteenth issue of Arabian Humanities concludes our special focus on Omani history and society. Our journal is proud to have gathered, over two issues, an impressive and diverse set of authors thanks to the fabulous commitment of three researchers: Marion Breteau, Sterenn Le Maguer and Maho Sebiane who have for long been partners of the Centre français de recherche de la Péninsule Arabique (CEFREPA). While the project had been launched before the Covid-19 pandemic and the end of the five-decade long reign of Sultan Qaboos, it is clear that many of the contributions have been impacted by these two historic events, if only through access to the field in Oman or by providing chronological milestones.In the Sultanate like elsewhere in the Arabian Peninsula, issues linked to travel have become an important matter for foreign researchers. The closure of airports due to the pandemic, the health procedures (however legitimate), and even certain specific costs have complicated our collective capacity to have access to the societies that we study. They have limited the possibility to carry out excavations for archaeologists, discover new archives or even interact, more or less formally, with colleagues who work in universities or academic institutions of the Arabian Peninsula and participate in scientific conferences.In that context, the CEFREPA’s very existence is more than ever an asset. As a French research center which has always valued its permanent presence in the Arabian Peninsula for more than four decades (first in Yemen, then in Saudi Arabia and finally in Kuwait, and has been able to establish partnerships to send researchers for long periods of time in the United Arab Emirates and in Oman), it remains a most relevant tool to reinforce local partnerships and establish fruitful observation posts. It is largely through mutual trust and patience, long standing relationships and collaborations with institutions and actors of the societies we work on, and most importantly we work with, that fieldwork makes full sense. The publications of this issue, focusing on Oman or other areas, are yet another testimony of a philosophy and methodology that despite various crises and difficulties, continues to structure our journal.

BACKGROUND: Cancer patients are thought to have an increased risk of developing severe Coronavirus Disease 2019 (COVID-19) infection and of dying from the disease. In this work, predictive factors for COVID-19 severity and mortality in cancer patients were investigated. PATIENTS AND METHODS: In this large nationwide retro-prospective cohort study, we collected data on patients with solid tumours and COVID-19 diagnosed between March 1 and 11th June 2020. The primary end-point was all-cause mortality and COVID-19 severity, defined as admission to an intensive care unit (ICU) and/or mechanical ventilation and/or death, was one of the secondary end-points. RESULTS: From April 4 to 11th June 2020, 1289 patients were analysed. The most frequent cancers were digestive and thoracic. Altogether, 424 (33%) patients had a severe form of COVID-19 and 370 (29%) patients died. In multivariate analysis, independent factors associated with death were male sex (odds ratio 1.73, 95%CI: 1.18-2.52), The Eastern Cooperative Oncology Group Performance Scale (ECOG PS) ≥ 2 (OR 3.23, 95%CI: 2.27-4.61), updated Charlson comorbidity index (OR 1.08, 95%CI: 1.01-1.16) and admission to ICU (OR 3.62, 95%CI 2.14-6.11). The same factors, age along with corticosteroids before COVID-19 diagnosis, and thoracic primary tumour site were independently associated with COVID-19 severity. None of the anticancer treatments administered within the previous 3 months had any effect on mortality or COVID-19 severity, except for cytotoxic chemotherapy in the subgroup of patients with detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR), which was associated with a slight increase of the risk of death (OR 1.53; 95%CI: 1.00-2.34; p = 0.05). A total of 431 (39%) patients had their systemic anticancer treatment (such as chemotherapy, targeted or immune therapy) interrupted or stopped following diagnosis of COVID-19. CONCLUSIONS: Mortality and COVID-19 severity in cancer patients are high and are associated with general characteristics of patients. We found no deleterious effects of recent anticancer treatments, except for cytotoxic chemotherapy in the RT-PCR-confirmed subgroup of patients. In almost 40% of patients, the systemic anticancer therapy was interrupted or stopped after COVID-19 diagnosis.

All responses to an epidemic crisis are political. At the beginning of February 2020, at the heart of the coronavirus epidemic in Wuhan, the authoritarian Chinese regime massively broadcast the humanitarian song “Believe Love Will Win”. The stated aim of the song was to emotionally support those engaged in the fight against the Covid-19 epidemic, presenting them as heroes of the Chinese nation. However, the making and broadcasting of a humanitarian song means that politics has failed. What is the reason for this? Humanitarian songs have an important place in the depoliticization of responses to crises, constructing representations and shaping official narratives. The songs and the discourses that accompany them conceal the historical and geopolitical depth of humanitarian crises by transforming political issues into moral questions.

Mierzejewski, Dominik, and Mateusz Chatys. “China’s Covid-19 Diplomacy and the South China Sea Dispute”. CRISEA European Policy Brief, October 2020. http://crisea.eu/wp-content/uploads/2020/11/20-10-15-policy-brief-CRISEA-Mierzejewski-Chatys-FINAL.pdf; At the time of the Covid-19 pandemic, China's diplomacy has been increasingly assertive in global politics and Southeast Asia in particular. In its policies toward ASEAN, Beijing has had to address situations in which small and medium powers involved in territorial disputes with China, placed the South China Sea (SCS) on the international agenda, were pressed by military reactions or moved to gain a possible extension of their continental shelf. China's responses have had two different faces. First, its multi-vector assertive policies, conflicting not only with ASEAN and the United States due to the militarization of the artificial islands in the South China Sea, but also with Taiwan, Hong Kong, India and Japan, have demonstrated the power of the Chinese Communist Party to a domestic audience. Second, China has attempted to portray itself as a positive, even benevolent force, as its ultimate goal is to limit negative reactions to China's South China Sea claims and manage the territorial issues bilaterally, an approach termed "mask diplomacy". Nevertheless, it is at the United Nations that major battles between the parties to the SCS dispute have continued during the first half of 2020.