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IntroductionIt has been reported that pregnant women used more cosmetics daily than non-pregnant women. Phenoxyacetic acid is the main metabolite of phenoxyethanol, the most frequent preservative in cosmetics used in Europe, previously associated with reproductive effects (longer time to conception, endocrine disruptors in newborns and poorer verbal comprehension in children). In France, specialised platforms (PREVention ENvIronment Reproduction (PREVENIR)) in university hospital maternity wards are dedicated to evaluating environmental and occupational exposures in patients with pregnancy-related pathologies and supporting targeted prevention efforts. These platforms are composed of occupational health physicians, obstetrician-gynaecologists, midwives, occupational health nurses, and occupational health and environmental engineers. To assess the efficacy of these platforms, we developed a randomised clinical trial, the protocol for which is presented in this paper. The primary objective of the PREVENIR-G Study is to compare the change in urinary phenoxyacetic acid concentrations from baseline to 3 months postintervention between an intervention group and a control group. To date, the intervention has been integrated into routine care in certain facilities; however, its efficacy remains unproven. It is therefore essential to assess the relevance of this intervention, considering both its potential benefits and any adverse effects, such as increased stress or anxiety.Methods and analysisThis study is an unblinded, randomised clinical superiority trial with two parallel groups (intervention vs no intervention) in four university maternity hospitals in France. We will include 300 pregnant women (aged 18 years or older) who are under 24 weeks of gestation (150 per group) referred to the participating PREVENIR platforms for management. The intervention will consist of clinical prevention management through the PREVENIR platforms, involving a consultation with an environmental health expert for an assessment of environmental and occupational exposures. During the consultation, targeted prevention messages will be provided based on identified exposures. The no intervention comparator will be a waiting-list control group. At the inclusion visit, patients will receive urine collection vials for samples to be collected at baseline and again at 3 months. Urine samples will be collected twice in a single day, on three separate days, during the collection week at home. In the week following the urine collection period, only participants in the intervention group will engage with the PREVENIR platforms. The primary outcome will be the difference in the urinary phenoxyacetic acid concentration between baseline and 3 months postintervention, compared between the intervention and control groups.Ethics and disseminationThe study has been approved by the hospital ethics committee (CCP Ouest 2, no. 2023-A00941-44). All participants will provide written informed consent. Results will be shared through presentations and publications.Trial registration numberNCT06642818

Background Numerous studies have been conducted over the past 15 years to assess safety culture within healthcare facilities; in general, these studies have shown the pivotal role that managers play in its development. However, little is known about what healthcare managers actually do to support this development, and how caregivers and managers represent managers’role. Thus the objectives of this study were to explore: i) caregivers and managers’ perceptions and representations of safety, ii) the role of managers in the development of safety culture as perceived by themselves and by caregivers, iii) managers’ activities related to the development of safety culture. Methods An exploratory, multicentre, qualitative study was conducted from May 2014 to March 2015 in seven healthcare facilities in France. Semi-structured interviews were conducted with managers (frontline, middle and top level) and caregivers (doctors, nurses and nurse assistants) and on-site observations of two managers were carried out in all facilities. A thematic analysis of semi-structured interviews was performed. Observed activities were categorised using Luthans’ typology of managerial activities. Results Participants in semi-structured interviews (44 managers and 21 caregivers) expressed positive perceptions of the level of safety in their facility. Support from frontline management was particularly appreciated, while support from top managers was identified as an area for improvement. Six main categories of safety-related activities were both observed among managers and regularly expressed by participants. However, caregivers’ expectations of their managers and managerial perceptions of these expectations only partially overlapped. Conclusions The present study highlights current categories of managerial activities that foster safety culture, and points out an important gap between caregivers’ expectations of their managers, and managerial perceptions of these expectations. The findings underline the need to allow more time for managers and caregivers to talk about safety issues. The results could be used to develop training programs to help healthcare managers to understand their role in the development of safety culture.

Background Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN (“Territoire de Soins Numérique”/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. Methods EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects’ territories and in five comparison territories. Three populations will be considered: “TSN-targeted people” (healthcare system users and people having characteristics targeted by the TSN projects), “TSN patient users” (people included in TSN experimentations or using particular services) and “TSN professional users” (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN implementation indicators from TSN program database. Discussion EvaTSN is a challenging French national project for the production of evidenced-based information on HI technologies impact and on the context and conditions of their effectiveness and efficiency. We will be able to support health care management in order to implement HI technologies. We will also be able to produce an evaluation toolkit for HI technology evaluation. Trial registration ClinicalTrials.gov ID: NCT02837406 , 08/18/2016.

Why did you do this work?Parvovirus B19 (PVB19) infection is a common, self-limiting illness in most healthy children. However, PVB19-induced transient aplastic crisis can render children with haemoglobinopathies or chronic haemolytic disorders (CHDs) at risk of profound anaemia and significant complications.1 This retrospective cohort study aims to evaluate clinical outcomes of PVB19 infection in children with haemoglobinopathies or CHDs, and examine the morbidity associated with this virus in this vulnerable population.What did you do?Paediatric patients (age < 18 years) with confirmed acute PVB19 (i.e. positive IgM serology or positive DNA PCR) between September 2023 and July 2024 were identified from the hospital virology laboratory. Patient records were screened to identify those with haemoglobinopathies or CHDs. Paediatric patients with confirmed or suspected PVB19 at another hospital, but referred to our local Haematology service, were also included.An electronic chart review was conducted to collect data on the following variables: demographic characteristics, haematological diagnosis, co-morbidities, duration of hospital admission, presenting Haemoglobin (Hb) and reticulocyte count, presence of other cytopaenias, transfusion requirements, additional consequential complications, and level of care and organ support required.Statistical analyses were performed using Excel and IBM SPSS.What did you find?Twenty-seven patients were eligible for inclusion. 59.3% had sickle cell disease (SCD), and 40.7% had other CHDs. The average age at presentation was 7.7 years.92.6% of patients required hospital admission, with the median (IQR) duration of hospital stay being 4 (3–7) days. 96.3% of patients presented with anaemia, and 74.1% with reticulocytopenia. 77.8% required a packed red blood cell (PRBC) transfusion. 60% of patients also developed thrombocytopenia or neutropenia, with one patient requiring a platelet transfusion. Four patients required Level 2 care, and one patient required non-invasive ventilation.The median duration of admission in SCD appeared higher than in other CHDs (4.5 days vs 3 days, p = 0.12). Similarly, the overall morbidity of PVB19 in SCD was high, with patients suffering additional complications such as painful vaso-occlusive crisis (62.5%), acute chest syndrome (18.8%), splenic sequestration (6.25%) and cerebral fat embolism (6.25%). SCD patients were more likely to need a PRBC transfusion (81.3% vs 72.8%, p = 0.662). Of note, SCD patients of the HbSS genotype presented significantly more anaemic than their counterparts with the HbSC/HbS- ß± thalassemia genotypes or other CHDs (mean Hb 40.0 g/dL vs. 66.9 g/dL, p = 0.001).What does it mean?PVB19 infection in patients with chronic haemolytic anaemias, particularly SCD, carries significant morbidity. Findings of this study align with international reports2 3 and highlight the importance of annual screening for PVB19 seroconversion in SCD and counselling PVB19-naive patients on the risks of the virus. Given the significant associated morbidity associated with PVB19, developing an effective vaccine against the virus would be a worthwhile endeavour.ReferencesSmith-Whitley K, et al. Epidemiology of human parvovirus B19 in children with sickle cell disease. 2004.Fourgeaud J, et al. Post-COVID-19 pandemic outbreak of severe parvovirus B19 primary infections in Paris, France: 10-year interrupted time-series analysis, (2012–2023). 2023.Elbadry MI, et al. Acute human parvovirus B19 infection triggers immune-mediated transient bone marrow failure syndrome, extreme direct hyperbilirubinaemia and acute hepatitis in patients with hereditary haemolytic anaemias: multicentre prospective pathophysiological study. 2021.

This dynamic collection explores the life, work, and persona of saxophonist Fred Ho, an unabashedly revolutionary artist whose illuminating and daring work redefines the relationship between art and politics. Scholars, artists, and friends give their unique takes on Ho's career, articulating his artistic contributions, their joint projects, and personal stories. Exploring his musical and theatrical work, his political theory and activism, and his personal life as it relates to politics, Yellow Power, Yellow Soul offers an intimate appreciation of Fred Ho's irrepressible and truly original creative spirit. Contributors are Roger N. Buckley, Peggy Myo-Young Choy, Jayne Cortez, Kevin Fellezs, Diane C. Fujino, Magdalena Gomez, Richard Hamasaki, Esther Iverem, Robert Kocik, Genny Lim, Ruth Margraff, Bill V. Mullen, Tamara Roberts, Arthur J. Sabatini, Kalamu ya Salaam, Miyoshi Smith, Arthur Song, and Salim Washington.

OBJECTIVESRisk management aims at reducing risks associated with hospital care to an acceptable level, both in their frequency and their impact on health. The social acceptability of risk on the part of the general population and of the health-care professionals, faced with regular information about adverse events, is undoubtedly evolving rapidly.In contrast to risk acceptability, the concept of risk perception is of limited interest to risk managers because it does not inform on the behaviors and actions resulting from these perceptions. The aim of this work was to define the concept of social acceptability of risk through an in-depth examination of a wide-ranging and multidisciplinary literature. METHODSA 1990–2010 English and French literature review was carried out in medical, epidemiological, and human and social sciences online databases, gray literature, and books. RESULTSOf the 5931 references retrieved, 203 met the inclusion criteria. We identified contributions from 5 major research fieldseconomic, sociocognitive, psychometric, sociological/anthropological, and interactionist. When assessing risks, individuals use a variety of psychological and social processes that include their perception not only of a given risk but also of their own personal and social resources. This global perception has a direct impact on the responses and actual behavior of individuals and groups, enabling them to cope with the risk and/or manage it. CONCLUSIONSSocial acceptability includes perceptions related to risks and the stated intentions of individual behavior. This concept may therefore be relevant for defining local and national patient safety priorities.

This project investigates black/Asian musical collaboration in order to illuminate a broader history of interracial and intercultural musical and political interaction in the post-Civil Rights era United States. Media coverage of events like the 1992 riots in Los Angeles has often portrayed blacks and Asians as culturally disparate and in a constant state of antagonism. In reality, the two groups share a long history of joint labor organizing, anti-racist mobilization, and cultural confluence that provides a counter-narrative to this tension. Musical performance has been a particularly fruitful venue for this merger, providing a forum through which artists have explored shared experiences of oppression, cultural similarities, and tactics for political struggle. Blending ethnography and performance and music analysis, this project traces a genealogy of black/Asian engagements, focusing on three contemporary case studies that suggest the diversity and complexity of this development. These artists combine texts, instruments, and techniques from African, Asian, African American, and Asian American musical cultures, placing them into dialogue through composition and improvisation. These bands also incorporate musicians that reflect a variety of racial and cultural backgrounds and their rehearsals and concerts become intense sites of interracial and intercultural negotiation. Exploring these contemporary nodes of Afro Asian musical history, this dissertation explicates the ways in which this conversation is musically depicted, how its performance has the potential to engender diverse audiences, and how it is shaped by the local cultural economies of the two cities. The ultimate thrust of this research is to query how the black/Asian racial divide is present in the music industry and suggest ways it simplifies musical practice, to render popular music history beyond a black/white dichotomy, and to challenge popular and scholarly narratives of African American/Asian American antagonism.

Artist. Intellectual. Activist. Chinese. Chinese American. Asian American. American. Saxophonist. Composer. Arranger. Bandleader. Writer. Producer. Luddite. Revolutionary Marxist. Bolshevik. Matriarchal socialist. Communist. Farmer. Fred Ho has a penchant for labeling himself and his work, brandishing these monikers as emblems of his political, cultural, and aesthetic fabric. He wears these epithets on his sleeve, making a loud and proud call of who he is and what he believes to all who will listen—and even those who will not. Words are important to Ho. In “What Makes ‘Jazz’ the Revolutionary Music of the Twentieth Century, and Will It Be Revolutionary for