Personal Exposure to BC, PM and NO2 in the Paris Region Measured by Portable Sensors Worn by Volunteers

Portable sensors have emerged as a promising solution for personal exposure (PE) measurement. For the first time in Île-de-France, PE to black carbon (BC), particulate matter (PM), and nitrogen dioxide (NO2) was quantified based on three field campaigns involving 37 volunteers from the general public wearing the sensors all day long for a week. This successful deployment demonstrated its ability to quantify PE on a large scale, in various environments (from dense urban to suburban, indoor and outdoor) and in all seasons. The impact of the visited environments was investigated. The proximity to road traffic (for BC and NO2), as well as cooking activities and tobacco smoke (for PM), made significant contributions to total exposure (up to 34%, 26%, and 44%, respectively), even though the time spent in these environments was short. Finally, even if ambient outdoor levels played a role in PE, the prominent impact of the different environments suggests that traditional ambient monitoring stations is not a proper surrogate for PE quantification.

The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?

Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region. Methods We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon. Results FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities. Conclusion FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories.

Impact of First Wave COVID-19 Crisis on Dialysis Parameters of COVID-Free Hemodialysis Patients: A NephoCare France Longitudinal Retrospective Cohort Study

<b><i>Background:</i></b> Chronic hemodialysis (HD) patients are at high risk of severe COVID-19 with a high risk of death. The organization of dialysis units to treat chronic HD patients with COVID-19 is demanding to prevent virus transmission both in COVID-free patients and the staff. These constraints may have an impact on the dialysis delivery to COVID-free HD patients. We report our experience in French NephroCare (NC) centers. <b><i>Methods:</i></b> We report retrospectively dialysis and nutritional indicators among COVID-free prevalent chronic HD patients’ cohort treated in French NC units from February 2020 to April 2020. The COVID-free HD patients were split into 2 subgroups for the analysis, Paris region and other regions because the incidence of COVID-19 was different according to the French regions. <b><i>Results:</i></b> The Paris region was the most impacted by COVID-19 with 73% of all the contaminations that occurred in French NC units (<i>n</i> = 118). The dialysis frequency was not reduced all over the NC regions. 2,110 COVID-free HD patients were split into 2 subgroups including Paris region (748 patients) and other regions (1,362 patients). The weekly treatment time decreased significantly in Paris region from February to April (723–696 min [<i>p</i> &#x3c; 0.00001]) but remained stable in the other regions. The processed blood volume, KT/V, and convective volume declined significantly in the Paris region subgroup but not in other regions. The 3-month weight loss significantly increased in the whole group of patients whatever the region from 0.0 to 0.2% between February 2020 and April 2020 (<i>p</i> &#x3c; 0.00001). Ultrafiltration rate (UFR) and the normalized proteic catabolic rate remained stable all along the period. The stepwise regression analysis identified February serum albumin level and April UFR as negatively associated with 3-month weight loss. <b><i>Conclusion:</i></b> HD delivery to COVID-free HD patients was negatively impacted in the Paris region because of the strong constraints on units’ organization related to the treatment of COVID-19+ HD patients and with a higher proportion of limited care/self-care units with less staff resources. The 3-month weight loss increase may be related to the suppression of intradialytic snack that impacted mostly the more malnourished patients or patients with lower interdialytic weight gain. These consequences of the COVID-19 crisis on COVID-free HD patients must be recognized and corrected to prevent further deleterious effects on patients’ outcomes.

Outer-suburban politics and the financialisation of the logistics real estate industry: The emergence of financialised coalitions in the Paris region

Logistics real estate is a type of property rarely covered in the existing literature on the financialisation of property markets. The emergence of specialised international real estate firms, which act as developers, investors and property fund managers, means that the logistics real estate industry has taken a unique financialisation path. The present article explains the specific features of the financialisation of the logistics real estate industry and contributes to the understanding of the financialisation of outer-suburban governance. Based on a qualitative analysis of the European logistics real estate market and case studies conducted in the Greater Paris region, the article combines an analysis of the sociotechnical mediations of financial circuits in the logistics built environment with the study of emerging local public–private coalitions formed to develop logistics zones. As such, it will be seen that the domination of integrated global firms in logistics real estate depends on their capacity to form local coalitions.