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SETTING: This paper describes an action research project with the Centre universitaire intégré de santé et de services sociaux - Capitale Nationale (CIUSSS-CN) who identified a need to assess vulnerability in their territories in order to ensure equitable distribution of the Integrated Perinatal and Early Childhood Services (SIPPE) program funds. The objective was to design and validate a multicriteria model to provide a more accurate portrait of vulnerability based on recent social realities. INTERVENTION: Our multidisciplinary research team of 7 members included experts in analytics, decision aiding, and community and public health. In collaboration with 6 CIUSSS-CN professionals, we co-constructed, during 9 workshops, a multicriteria model to aggregate the multiple dimensions of vulnerability. We used a value-focused thinking approach and applied the method MACBETH assisted by a geographic information system. OUTCOMES: Criteria, scales, and weights were validated and led to a vulnerability score for each CIUSSS-CN territory. This score provides a more accurate portrait of territorial disparities based on data and the participants' experience. The model was implemented in a dynamic user-friendly tool and serves to support decision-makers in the resource allocation process. Knowledge transfer was conducted during and after the process. IMPLICATIONS: This multidisciplinary research has served to anchor public health funding in local realities, with an emphasis on equity and stakeholder engagement. Our mixed-method approach integrating qualitative and quantitative data is adaptable to other contexts. Our results can enhance intervention effectiveness and allow for a better response to the needs of the population targeted by the SIPPE program.

RéSUMé: LIEU: Cet article décrit un projet de recherche-action avec le Centre Universitaire Intégré de Santé et de Services Sociaux - Capitale Nationale (CIUSSS-CN) qui a identifié un besoin d'évaluer la vulnérabilité sur son territoire afin d'assurer une distribution équitable des fonds du programme des Services Intégrés en Périnatalité et pour la Petite Enfance (SIPPE). L'objectif était de concevoir et de valider un modèle multicritère permettant de dresser un portrait plus précis de la vulnérabilité en fonction des réalités sociales récentes. INTERVENTION: Notre équipe de recherche multidisciplinaire de 7 membres comprenait des experts en analytique, en aide à la décision et en santé publique et communautaire. En collaboration avec 6 professionnelles du CIUSSS-CN, nous avons co-construit, au cours de 9 ateliers, un modèle d'évaluation multicritère pour agréger les multiples dimensions de la vulnérabilité. Nous avons utilisé une approche de modélisation centrée sur les valeurs et appliqué la méthode MACBETH assistée par un système d'information géographique. RéSULTATS: Les critères, les échelles et les pondérations ont été validés et ont conduit à un score de vulnérabilité pour chaque territoire de la CIUSSS-CN. Ce score fournit un portrait plus précis des disparités territoriales basé sur les données et la connaissance qu'ont les participants du terrain. Le modèle a été implémenté dans un outil dynamique et convivial servant à soutenir les décideurs dans le processus d'allocation des ressources. Le transfert de connaissances a été effectué tout au long du et après le processus. IMPLICATIONS: Cette recherche multidisciplinaire a permis d'ancrer le financement de la santé publique dans les réalités locales, en mettant l'accent sur l'équité et l'engagement des parties prenantes. Notre approche mixte intégrant des données qualitatives et quantitatives est adaptable à d'autres contextes. Nos résultats peuvent améliorer l'efficacité des interventions et permettre de mieux répondre aux besoins de la population ciblée par le programme SIPPE.

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BACKGROUND: Coronavirus disease 2019 (COVID-19) has negatively affected the mental health of frontline health care workers, including pharmacists. OBJECTIVES: The aim of this longitudinal study was to assess the psychological impact of the COVID-19 outbreak in French owner community pharmacists. METHODS: We conducted a postal-based survey to assess the psychological difficulties of the COVID-19 outbreak in French owner community pharmacists based on 3 psychologically validated self-report questionnaires: Perceived Stress Scale (PSS), Impact of Event Scale-revised (IES-R), and Maslach Burnout Inventory. The baseline assessment was during the first sanitary lockdown period and the second one 5 months later. RESULTS: The sample consists of 135 owner community pharmacists. At follow-up, 67 answered the questionnaires (response rate: 49.6%). The mean scores of the PSS and IES-R significantly decreased (P = 0.002). Fifteen pharmacists reported significant posttraumatic stress symptoms (23.1%) at baseline and 11 at follow-up (16.4%, P = 0.02). Age and sex were not significantly associated with persistent posttraumatic stress or burnout symptoms. CONCLUSION: This is the first longitudinal study that showed the psychological impact of owner community pharmacists as health care workers dealing with their community's COVID-19 outbreak. Based on validated self-report questionnaires, stress, posttraumatic stress, and burnout symptoms decreased during follow-up. It is necessary to continue monitoring psychological difficulties for health care workers, especially during consecutive waves of the COVID-19 outbreak.

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The standard in vitro cultivation procedure for Plasmodium falciparum requires gas exchange and a microaerophilic atmosphere. A novel system using a commercially available cell culture device (Petaka G3™; Celartia Ltd., Powell, OH) was assessed for long-term cultivation of a P. falciparum reference laboratory clone in normal air. Parasite growth during 30 days was similar, or better, in Petaka G3 than that in the standard cultivation method with gas exchange in a CO2 incubator. The successful cultivation of P. falciparum in the Petaka G3 device suggests that low O2 content available in hemoglobin and dissolved gas in the blood is sufficient for long-term cultivation. This finding may open the way to novel methods to cultivate and adapt P. falciparum field isolates to in vitro conditions with more ease.

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Agricultural activities involve the use of oilseed cakes as a source of proteins for livestock. Because the storage of oilseed cakes could induce the development of molds and the production of mycotoxins, a survey was conducted during the 5 months of farm storage. Mycoflora was studied by microscopic examinations, and the presence of Aspergillus fumigatus was confirmed by polymerase chain reaction. A multimycotoxin method was developed to quantify seven mycotoxins (aflatoxin B(1), alternariol, fumonisin B(1), gliotoxin, ochratoxin A, T-2 toxin, and zearalenone) in oilseed cakes by high-performance liquid chromatography coupled to mass spectrometry. Among 34 fungal species identified, A. fumigatus and Aspergillus repens were observed during 5 and 4 months, respectively. Gliotoxin, an immunosuppressive mycotoxin, was quantified in oilseed cakes up to 45 microg/kg, which was associated with the presence of toxigenic isolates of A. fumigatus.

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Agricultural activities involve the use of crop preservation such as "trench-type" silo, which can sometimes be contaminated by fungi. To investigate the exposure of livestock and farm workers to fungal spores and mycotoxins, a multimycotoxin analysis method has been developed. Six mycotoxins (aflatoxin B1, citrinin, deoxynivalenol, gliotoxin, ochratoxin A, and zearalenone) were quantified by high-performance liquid chromatography coupled to mass spectrometry after solid-phase extraction. An experimental study of fungal species and mycotoxins was conducted in corn silage (Normandy, France) during 9 months of monitoring. The results indicated the recurrence of around 20 different species, with some of them being potentially toxigenic fungi such as Aspergillus fumigatus, Aspergillus parasiticus, Fusarium verticillioides, and Monascus ruber, and the detection of aflatoxin B1 (4-34 ppb), citrinin (4-25 ppb), zearalenone (23-41 ppb), and deoxynivalenol (100-213 ppb). This suggested a possible chronic exposure to low levels of mycotoxins.

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