Search

Copyright of Canadian Journal of Civil Engineering is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Book reviewed in this articles: Politique sociale, développement et Etat providence Stiglitz, Joseph E. Making globalization work. Vij, Ritu (sous la direction de). Globalization and welfare: A critical reader. Deacon, Bob. Global social policy and governance. Castles, Francis G. (sous la direction de). The disappearing State? Retrenchment realities in an age of globalisation. Carr, Fergus; Massey, Andrew (sous la direction de). Public policy and the new European agendas. Faverel-Dapas, Brigitte; Quintin, Odile. L'Europe sociale. Van Langendonck, Jef (sous la direction de). The right to social security. Riedel, Eibe (sous la direction de). Social security as a human right: Drafting a general comment on Article 9 ICESCR: Some challenges. Fitzpatrick, Pamela; Ripley, Fiona; Singh, Anne. Migration and social security handbook: A rights guide for people entering and leaving the UK. Berkel, Rik van; Valkenburg, Ben. Making it personal: Individualising activation services in the EU. Serrano Pascual, Amparo; Magnusson, Lars (sous la direction de). Reshaping welfare states and activation regimes in Europe. Sinn, Hans-Werner, et al. Redesigning the welfare state: Germany's current agenda for an activating social assistance. Marston, Greg; McDonald, Catherine (sous la direction de). Analysing social policy: A governmental approach. Wallace, Mike; Fertig, Michael; Schneller, Eugene (sous la direction de). Managing change in the public services. Riesco, Manuel (sous la direction de). Latin America: A new developmental welfare state model in the making? Krömmelbein, Silvia; et al. Einstellungen zum Sozialstaat: Repräsentative Querschnittsuntersuchung zu grundsätzlichen gesundheits- und sozialpolitischen Einstellungen in der Bevölkerung. Dobner, Petra. Neue soziale Frage und Sozialpolitik. Travail, revenus, famille, exclusion Spicker, Paul. The idea of poverty. Lang, Kevin. Poverty and discrimination. Marx, Ive. A new social question? On minimum income protection in the post-industrial era. Bischoff, Joachim. Allgemeines Grundeinkommen: Fundament für soziale Sicherheit? Leisering, Lutz; Buhr, Petra; Traiser-Diop, Ute. Soziale Grundsicherung in der Weltgesellschaft: Monetäre Mindestsicherungs-systeme in den Ländern des Südens und des Nordens: Weltweiter Survey und theoretische Verortung. Stähler, Nikolai. Employment protection and unemployment: A theoretical analysis evaluating recent policy proposals. Kemp, Peter A. (sous la direction de). Housing allowances in comparative perspective. Problèmes de l'âge Pension funds investment perspectives. Immergut, Ellen M.; Anderson, Karen M.; Schulze, Isabelle (sous la direction de). The handbook of West European pension politics. Questions de santé Dussault, Gilles; Fournier, Pierre; Letourmy, Alain (sous la direction de). L'assurance maladie en Afrique francophone: améliorer l'accès aux soins et lutter contre la pauvreté. Beau, Pascal. Lettre ouverte au Ministre de la santé. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses topics presented in several articles of this issue related to climate strategies from a European and Canadian perspective based on the 2011 United Nations Climate Change Conference held in Durban, South Africa.

Presents an abstract of the article 'Jarnvagsdokumentation,' by Britt Johan, published in the journal "Tidskrift for Dokumentation." Description of the organization for railroad documentation in Europe; Publication of a monthly bulletin of documentation with the collaboration of the French, Belgian, Swiss, and Italians; Comparison with railroad documentation in the U.S.

Copyright of Collected Papers of the Faculty of Law in Split / Zbornik Radova Pravnog Fakulteta u Splitu is the property of Split Faculty of Law and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Collected Papers of the Faculty of Law in Split / Zbornik Radova Pravnog Fakulteta u Splitu is the property of Split Faculty of Law and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Papers: Revista de Sociologia is the property of Universitat Autonoma de Barcelona and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper aims to present the main information presented at the 9th Meeting about addictovigilance in 2016 by four healthcare professionals and addiction experts on the issue of new psychoactive substance use. A new psychoactive substance (NPS) is defined as a narcotic or psychotropic drug, in pure form or in preparation, that is not controlled by the United Nations drug conventions, but which may pose a public health threat comparable to that posed by substances listed in these conventions. The emergence of NPS consumption is a worldwide concern. Although NPS are less consumed than established drugs, there has been a sharp increase in their use over the last few years, notably of synthetic cathinones, synthetic cannabinoids and, more recently, synthetic opioids. The latter in particular are involved in deaths in Europe. However, "established" drugs (MDMA [methylenedioxymethamphetamine], amphetamines, LSD, methamphetamine) are far from being dethroned by the more recent substances: they are considered "a safe bet" already "tried and tested" by many consumers over the years. MDMA, in particular, also known as ecstasy, which has been used as a recreational drug since the 1990s, saw its consumption decrease until 2010, and then increase again, especially in higher amounts; inexpensive and easily accessible, it is increasingly associated with emergency admissions or deaths in France. The perpetual appearance of new substances on the drug market is obligating to improve knowledge on these products, particularly by focusing on their analytical identification, and also by monitoring their use and harms., (Copyright © 2020 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.)

Originator GCSF (Neupogen) has been used to mobilize progenitor stem cells and treat therapy-induced neutropenia in Canadian stem cell transplant settings for years. Although its benefit is not in question, viable alternatives are available. Biosimilar GCSF (Zarzio) is widely in use in Europe since 2009 and was recently approved in the U.S.for the same five indications as Neupogen. Zarzio is reported as safe, equally efficacious, more accessible and cost effective without negatively impacting patient outcomes. This paper summarizes the supporting evidence.

Euthanasia and assisted suicide are not part of French laws of bioethics and lack, for the time being, definition and normative framework other than their criminal prosecution. To transform them into a right, these concepts certainly call for an ethical and legal debate. This paper aims to question the ideas to be considered, the conceptual bases and normative tools that may be useful to the discussion.

Background: Bipolar disorder is a complex disease which requires multiple healthcare resources and complex medical care programs including pharmacological and non pharmacological treatment. If mood stabilizers remain the corner stone for bipolar disorder treatment, the development of atypical antipsychotics and their use as mood stabilizers has significantly modified therapeutic care. At the present time, psychiatrists have a large variety of psychotropic drugs for bipolar disorder: mood stabilizers, atypical antipsychotics, antidepressants, anxiolytics… However, despite the publication of guidelines on pharmacological treatment, with a high degree of consensus, everyday clinical practices remain heterogeneous. Moreover, there are few longitudinal studies to describe therapeutic management of bipolar disorder, whatever the phase of the disease is. Indeed, most of the studies are carried out on a specific phase of the disease or treatment. And there is no study comparing French and European practices., Objectives: In this paper, we aim to present the comparison of the management of pharmacological treatments of bipolar disorder between France and Europe, using the data of the observational Wide AmbispectiVE study of the clinical management and burden of bipolar disorder (WAVE-bd study)., Methods: The WAVE-bd study is a multinational, multicentre and non-interventional cohort study of patients diagnosed with BD type I or type II, according to DSM IV-TR criteria, in any phase of the disorder, who have experienced at least one mood event during the 12 months before enrolment. In total, 2507 patients have been included across 8 countries of Europe (480 in France). Data collection was retrospective (from 3 to 12 months), but also prospective (from 9 to 15 months) for a total study length of 12 to 27 months. Main outcome measures were the healthcare resource use and pharmacological treatments., Results: Our results show differences in the therapeutic management of bipolar disorder between France and other European countries. Regarding healthcare resource use, our results show that French patients consult more frequently a psychiatrist or a psychologist and less frequently a general practitioner or the emergency ward in comparison with patients from other European countries. In the whole European population, including France, atypical antipsychotics are widely used. Only 25% of the patients receive lithium and more than 50% of the patients receive antidepressants, while their use in bipolar disorder remains controversial. Most of the patients receive polymedication. Considering all phases of the disease pooled, less lithium and less atypical antipsychotics are prescribed to French patients, whereas they receive more antidepressants and more benzodiazepines than patients from other European countries. On the over hand, prescription of anticonvulsants and electroconvulsive therapy are equal. Moreover, data analyses by polarity of the episodes globally confirm these trends. There are a few exceptions: mixed states, in which lithium is twice more prescribed in France in comparison to other countries; depressive states, in which antidepressants are even more prescribed in other countries than in France; and less prescription of anticonvulsants in manic, mixed and euthymic phases in France., Conclusion: The WAVE-bd study is the first observational study conducted on a large sample of bipolar I and II patients that compares therapeutic management between France and other European countries. The differences observed in therapeutic care across the different phases of the disease show that treatments differ depending on the countries studied, but also according to the preventive or curative phases, polarity of the bipolar disorder, comorbidities, impact of guidelines, and care organization. Although French patients have been treated by less lithium and less atypical antipsychotics than other European patients, they receive more antidepressants and more benzodiazepines. Finally, patients generally receive polymedication and the diversity in prescriptions shows how bipolar disorder is a complex disorder., (Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Under the 1985 White Paper on the completion of the single market, several pharmaceutical harmonisation measures were unanimously adopted, in favor of biotech products and on pricing transparency, legal status of prescription, wholesale distribution and advertising. The European pharmaceutical harmonisation was extended to Norway and Iceland, to new accession member states and through major international conferences with the US and Japan (ICH). Starting in 1995, the European medicines agency has produced an efficient marketing authorisation system for new human and veterinary medicines. The system was extended to pediatric medicines and advanced therapies. The monitoring of drug adverse effects (pharmacovigilance) has been gradually strengthened.

Cancer during pregnancy is relatively rare, but its incidence has been increasing over recent years. A European study has been launched in 2005 by F. Amant (KUL) to register all pregnant patients with a cancer diagnosis with or without treatment during pregnancy (surgery, chemotherapy and/or radiotherapy). All infants exposed to chemotherapy and/or radiotherapy are also followed up by pediatricians, neurologists, cardiologists and psychologists. In Belgium, French- and Dutch- language hospitals are working in close collaboration to follow these pregnant patients. The national results are summarized in this paper.

European Commission Regulation (EC) No. 152/2009 imposes optical microscopy as the reference method for official controls to detect traces of animal protein in animal feed. Since 1 July 2004, the one-solvent technique has been the only authorised variant of optical microscopy. Its detection limit is 0.1% of meat-and-bone meal. Other techniques--using molecular biology (polymerase chain reaction, immunology), microscopy or near-infrared imaging--have been developed in the past ten years to supplement the official method, which has certain limitations. This paper compares and discusses the different techniques, highlighting the strengths of each technique in order to propose a feasible control scheme to improve the sensitivity and specificity of the technique for the detection of processed animal protein in livestock feed.

The new guidelines from the European Atherosclerosis Society and the European Society of Cardiology include a number of updated items. In this paper, we summarize 4 of these changes that we consider to be the most pertinent. Firstly, cardiovascular risk is now stratified according to 4 (previously 2) categories: "very high risk" (patients with cardiovascular disease, patients with diabetes > 40 years old who have at least one other risk factor, patients with kidney failure, or patients in primary prevention with a SCORE value > or = 10%); "high risk" (patients in primary prevention with a SCORE value > or = 5% and < 10% or patients with a particularly serious risk factor such as familial hypercholesterolaemia or patients with diabetes < 40 years old without any other risk factor); "moderate risk" (primary prevention with SCORE > or = 1% and < 5%); and "low risk" (primary prevention with SCORE < 1%). The SCORE value for patients in primary prevention is estimated using the SCORE table (calibrated for Belgium). Risk in this table may now be corrected according to HDL cholesterol level. Secondly, the therapeutic targets for each category are now more stringent: LDL cholesterol < 70 mg/dl (or reduced by at least 50%) if the risk is "very high"; < 100 mg/dl if the risk is "high"; and < 115 mg/dl if the risk is "moderate". Thirdly, for patients at "high" or "very high" risk, particularly in patients with combined dyslipidaemia, two further therapeutic targets should be considered: non-HDL cholesterol and apolipoprotein B levels. Fourthly, the follow-up of efficacy (lipid profile) and tolerance (hepatic and muscular enzymes) is described in more details so as to harmonize case management in clinical practice.

Self-measurement of blood pressure at home is increasingly used in the diagnostic and therapeutic approach of hypertension. This technique allows multiple measurements of blood pressure away from the clinical setting, making it possible to improve the evaluation of cardiovascular risk. Recently new guidelines on the use of self-measured blood pressure have been made available by the European Society of Hypertension, as summarized in the present paper.

This paper engages into a global assessment of statistics and their potential uses, ranging from 19th century accounts of "suicidal acts" by the central services of criminal justice in France, to European comparative data on suicide in the years 2000. The most recent facts and figures about teenagers' suicides in France are taken into account, thanks to the Inserm records on deaths by suicide and to public polls on suicidal attempts., (Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.)

Psychiatric literature documenting increased rates of psychotic illness among migrants in European countries has been more and more reported during the past two decades. Social causes to this phenomenon have been highlighted. In this paper, we review and discuss this literature from the cultural psychiatry perspective. We can point three limitations to these works : the definition of the studied groups, the cultural validity diagnoses, and the psychic impact of migration and its complexity not being considered enough. The above considerations lead us to go forward with studies addressing this question. The need to construct methodologies addressing psychiatric epidemiology, transcultural psychiatry and human sciences is underlined.

Allergic diseases represent a major health problem in Europe. They are increasing in prevalence, severity and costs. GA2LEN (Global Allergy and Asthma European Network), an FP6 Network of Excellence, was created in 2005 as a vehicle to ensure excellence in research bringing together research and clinical institutions to combat fragmentation in the European research area and to tackle Allergy in its globality. GA2LEN benefited greatly from the voluntary efforts of researchers who are strongly committed to this model of pan-European collaboration. The network was organized in order to increase networking for scientific projects in allergy and asthma around Europe and to make GA2LEN the world leader in the field. Besides these activities, research has been jointly made and the first papers are being published. GA2LEN achievements in general can be grouped as those for a durable infrastructure built up during the project phase those which are project-related work based on these novel infrastructures, and the development and implementations of guidelines. The major achievements of GA2LEN are reported in this paper.

Between the years 1346 and 1353, a terrible epidemic swept over Western Asia, the Middle East, Africa, and Europe, causing catastrophic losses of population everywhere, both in the rural areas and in towns and cities. The Black Death was a disease of such magnitude that it not only shook the Old World to its economic and social foundations but changed the course of human history. The authors considered and analyzed many studies on the Black Death published in different languages. In the present paper they report medical and epidemiological specificities of the pandemic as well as its geographical origins and the routes of its spread.

In the second half of the 20th century, the development of experimental pharmacology led to the discovery of powerful new therapeutic agents, but production has since faltered, particularly in Europe. The purpose of this paper is to review how the gap in the production of novel medicines between Europe and the USA could be filled by proper use of molecular biology data. The European program entitled 'The Innovative Medicines Initiative' could facilitate the translation of information from benchtop to bedside.

This paper reviews literature data on iron replacement (loading) for peritoneal dialysis patients. The 3 main sources of clinical guidelines (American NKF-K/DOQI, European EBPG and French AFSSAPS) agree about the definition of iron deficience, but are not similar about the haemoglobin/hematocrit targets for EPO treatment, and for the route of iron administration (oral versus intravenous). Iron requirements are less in PD HD patients. That could be explained by several factors: less blood losses, preservation of a residual renal function, better digestive iron absorption due to a greater hepcidin excretion. Intravenous route for iron sucrose is more efficient than oral route. Taking into account the iron requirements for PD patients, monthly 200 mg iron sucrose infusions over 5 mn seem to be safe and sufficient for most patients.

Remarkably, although 60% of new cancer cases and over 70% of cancer deaths occur in patients aged 65 years and older in Europe, standard treatment strategies have been mostly validated in younger adults. This demographic trend has led to the emergence of a new medical discipline, geriatric oncology and the development worldwide of geriatric oncology programs for the individualized management of elderly cancer patients. Elderly cancer patients represent an increasing share of the population and strategies for treating cancer must evolve to face this ineluctable reality. Treatment should take into account the highly heterogeneous physiological age of the elderly, their individual life expectancy, functional reserves, social support and preferences. French geriatric oncology programs have been mostly based on the interdependence of geriatricians, oncologists and auxiliary nursing people. This approach represent the best way to offer patients optimal management; oncologists and geriatricians collaborate to assess both global health status by means of Comprehensive Geriatric Assessment (CGA) and tumor stage by means of Comprehensive Tumor Assessment (CTA) and to initiate individualized care plans, involving comprehensive management and follow-up of all identified problems. This paper focuses on progress observed in the field of geriatric oncology both in France and worldwide.

After a review of medical literature on domestic violence during pregnancy, this paper shows the results of a survey carried out in 16 European countries. The percentage of women reporting domestic violence during pregnancy varies with the country; it is specially high in Russia, Poland and Czech Republic. Women who live without partner, those whose the couple has been separated during the pregnancy or those living in an overcrowded house have been more often victim of domestic violence. Domestic violence is significantly related to preterm birth risk.

Background: After a large increase during the 19th and the 20th century, for two decades the gap in life expectancy between sexes has been reducing in most industrialised countries. In France, where it was specially large, it stopped increasing in the early 1980s and decreased in the most recent years. The paper investigates reasons for these recent trends in France and in the industrialised countries., Methods: Two types of data are used for analysis. Death probabilities from life tables are used for calculating male excess mortality by age and estimating the role of various age groups in life expectancy differences by sex. Sex- and cause-specific mortality rates from INED database for France and from WHO database for other countries are used to assess the part played by various causes of death in the gender gap and its evolution., Results: In France, the stabilisation of the gap is mainly related to the decrease in cardiovascular mortality for men who benefit from the same progress but later than women. In the most recent years, the reduction of the gap is due to the trend reversal of male cancer mortality which is now decreasing, specially because of the reduction of lung cancer mortality. In European countries, taken as examples (England & Wales, Sweden, Switzerland, Italy) cardiovascular mortality is also the main responsible for the decreasing differences. Conversely, in Japan, the gap is still increasing specially for mortality from cancer and respiratory diseases., Conclusions: The recent gap narrowing between male and female life expectancy in France is not a specific case. It does not mean that female health situation is worsening but it is related to an acceleration of progress for males. This reduction will most probably go on in the next years, except if females would enjoy dramatic progression in old age mortality.

Objective: This paper aims to describe and to analyse disparities between men and women for "premature" mortality rates (deaths before 65 year-old). The study is particularly focused on "avoidable" causes of death. These types of deaths are greatly related to risk behaviours such as alcohol abuse, tobacco abuse or dangerous driving. Taking account of these indicators ("premature" and "avoidable" mortality) enables to study health status discrepancies by gender and to characterize specific public health issues in France including high rates of "premature" mortality and risk behaviours., Methods: The analysis is based on exhaustive mortality data from 1980 to 1999 supplied by the Centre for epidemiology of medical causes of death (CepiDc-INSERM). Specific causes of death closely related to risk behaviours are classified as "avoidable": lung and upper airways cancers, cirrhosis, alcoholic psychosis, traffic accidents, aids and suicide. The contribution of these categories in the global male overmortality was assessed according to different demographic and geographic characteristics., Results: Within "premature" mortality, males experience greater burden of "avoidable" mortality (sex-ratio: 4 versus 2). The gender differences are mainly due to injuries and suicides in the younger age groups and to tobacco and alcohol-related cancers (lung and upper airways) in the 45-64 years age group. The recent decline in "premature" mortality sex-ratio is explained by an increase of these two cancers for females. Among european countries, the French male overmortality is especially marked and mainly attributable to "avoidable" causes of death., Conclusion: "Avoidable" and "premature" mortality provide useful tools for the follow-up of health status in France particularly because of high risk behaviours and prevention inadequacy. Reducing gender discrepancies will depend mainly on public health policies in terms of primary prevention.

The pharmacokinetic content of the drug registration file is now well standardized. The objectives of the pharmacokinetic documentation is to provide evidence supporting the dosing regimen in patients, to take into account the pathophysiological states of the populations at risk and to anticipate drug-drug interactions. Recommendations on study design and evaluation of parameters of interest are listed in various documents Issued by the Committee for Proprietary Medicinal Products and the International conferences on Harmonization, i.e. the Concept Papers, the Points to Consider and Notes for Guidance. The pharmacokinetic data of the registration file are used to document many sections of the Summary of the Product Characteristics.

In 1918-19 the so-called spanish influenza pandemic killed about 20 to 40 millions people all over the world. In France the loss of life was reckoned between 125,000 and 250,000 civilians and 30,000 soldiers though the epidemiological data have been incomplete. The virus allegedly came from the United States of America with the American forces which landed in the western harbours of France and probably with Indochina's troops or Chinese workers hired in the French factories. The disease spread in three waves from April 1918 to February 1919. The second wave was the most severe in September, October and November. Half of the dead occured among the 20-40 old people as the older people were more disease-resistant. Lethal forms were due to respiratory complications which often killed in a few days. The government did to preventive measures that were unequally applied as the treatment could be only symptomatic. The reactions of people were astonishingly cautions probably because the papers were ordered not to deal with the epidemic as long as the war lasted for.Some new serological studies and molecular biology techniques led up to clarify the strain of the 1918 influenza virus without further understanding of its special virulence.

Continuing education in dentistry is gaining importance. No dentist can nowadays claim to have obtained enough knowledge in studies and professional career alone to cope with new technologies and changing patient's demands. In many countries, discussions are ongoing or have taken place between protagonists and antagonists of a mandatory continuing education for dentists. This paper describes the regulations concerning continuing education in some European countries. In some countries, participation is mandatory, and more countries are planning to do so. In other countries, incentives exist, but in the majority, continuing education is still on a voluntary basis or regarded as a moral obligation.

This paper offers an analysis of the analogies between the physical and the political body during the Sixteenth and the Seventeenth centuries. Focusing on a meaningful pattern of medical, legal and political treatises, this study aims to outline the deep roots of an organic image of the human society widespread until the Englightenment and the crisis of the Old Regime.

Central venous catheters are widely used as vascular accesses for chronic haemodialysis. Different factors may lead to catheter use, whether clinical such as emergency dialysis, or related to practices specific to each dialysis unit or country. The Dialysis Outcomes and Practice Patterns Study is an observational study of more than 10,000 representative patients treated by haemodialysis followed over a two-year period in the United States, Japan, and in five European countries (France, Germany, Italy, Spain, United Kingdom). DOPPS data from the United States and Europe about catheters are reported in this paper. Catheter use is less frequent in Europe than in the US, both in incident and prevalent patients, and in patients who have been seen by a nephrologist in the pre-dialysis period. Tunneled and untunneled catheters are each associated with a significantly higher frequency of access infection compared to native arteriovenous fistulae and grafts. Patients with important comorbidities such as diabetes, cardiovascular diseases, malnutrition or dementia are more likely to be dialysed with tunneled catheters. Furthermore, patients initiating hemodialysis with a tunneled catheter display higher mortality risk compared to patients starting hemodialysis with a permanent access. In summary, DOPPS data indicate that central venous catheters are used for chronic haemodialysis in patients with a high level of morbidity, and that their utilisation is associated to an additional risk, particularly of infection, and to a lower survival for tunneled catheters. Appropriate care should limit the utilisation of central venous catheters to clinically undisputable indications.

Introduction: How can we explain that the proportion of methicillin-resistant Staphylococcus aureus (MRSA) varies between the European countries, ranging from < 1% in Scandinavia to > 30% in Spain, France and Italy? This paper is aimed at attempting to determine factors at the origin of the spreading of endemic MRSA strains as of the early 1980s. Those strains are characterized by their ability to develop resistance to current antibiotics and make treatment of severe and deep infections more complex., Current Knowledge and Key Points: Differences in the virulence of MRSA strains and that of susceptible strains appear unlikely. MRSA prevalence seems to be a growing problem, especially in Southern Europe where rates of resistance to other anti-staphylococcal antibiotics are high. General policies for antibiotic therapy as well as the implementation of strategies for prevention and control of MRSA might be responsible for such rates. Indeed, once MRSA is introduced into a facility without control program, this multiresistant bacteria rapidly spreads within the hospital and becomes endemic, expanding its reservoir. FUTURE PROSPECTS ET PROJECTS: Due to the introduction of new methods in microbiology and communication, infection control measures including procedures for isolation and identification of MRSA reservoirs are still feasible; however, their implementation requires human and material resources. Areas requiring improvement in the detection of MRSA outbreaks are identified in this paper, with particular emphasis on the need for national surveillance of MRSA prevalence and reappraisal of MRSA control strategies in French hospitals.

Introduction: The origins of the EAMA (European Academy for Medicine of Aging) course are described in this paper by the Scientific Committee of this new post-graduate teaching activity., Current Knowledge and Key Points: Innovations are constantly introduced to improve training methodology so as to enable the students to update their knowledge, help them improve their skills in data gathering and in the critical interpretation of information, and exchange geriatric experience and know-how. To reach such goals, an interactive teaching method is implemented by the professors, with world experts being called in to ensure scientific soundness and quality. Evaluations by students and teachers are regularly carried out with the aim of perfectly adjusting their training methodologies and increasing the scientific level of exchanges., Future Prospects and Projects: If the students progress, so do the teachers....

Emergency medicine has emerged as a specific medical specialty for 30 years. To be efficient, the emergency clinician frequently needs the contribution of radiological examinations. This is the reason why emergency radiology has emerged as a new radiologic subspecialty. The aim of this paper is to review the recent history of emergency medicine and to summarize the present state of the radiological organisation for emergency care in the Western countries.

The frequency of new cases of myelomeningocele has largely decreased in the last 10 years in several countries of western Europe; the emergence of widespread prenatal diagnosis is probably one of the main reasons. However, the outcome of spina bifida which eludes the prenatal diagnosis, or in cases where termination was refused by parents, remains badly known. To our knowledge, there is no recent data on the outcome of children with spina bifida. Moreover, available data, depending on their European or American origin, indicate different functional outcomes. This led us to re-evaluate the mechanisms involved in the prenatal diagnosis of spina bifida and the outcome of our patients with spina bifida. The aim of this paper is to give a short description of the "rules and principles" of prenatal diagnosis as it is applied in our centres, as well as a brief overview of the outcome of 137 cases of spina bifida. In the retrospective study, three major aspects were evaluated: 1) frequency and types of surgeries and their benefits; 2) socio-psychological adaptation of the patients; 3) educational level and learning disabilities.

This paper and the next, report on the experience of adolescent care in an ambulatory and multidisciplinary center based on a bifocal medical and psychological strategy. Two thirds of the adolescents are referred by a physician. The most common reasons are one or several somatic symptoms with a background of emotional complaints. Those reasons are consistent with the general adolescent health problems as revealed by studies of large national samples. It appears critical to read the adolescent complaint in a psychological register together with the somatic aspects. Initially, the adolescents are however rarely open for awareness of their psychological needs. This justifies care in a center where the initial medical management may secondarily result in psychological management.

The present paper surveys the discussions conducted by official statisticians regarding the ideal structure according to which a national data collection system should have been designed if it was to meet the challenges put up by the various transformation Western countries have undergone since the beginning of the 19th century. Arguments in favour of coordination, centralization, or decentralization have emerged for the first time in 1832 Britain, when the Statistical Bureau of the Board of Trade was created. Up to 1945, this debate went on, the industrial take-off, the economic crises, and the world wars all being occasions for its protagonists to put forward their preferred view. The perspective we take here is original in two respects: on the one hand, instead of confining ourselves to the major statistical systems (those of France, Britain, and the USA), we intend to evoke a large number of cases and, from this comparative standpoint, propose a general account of the drive towards centralization; on the other hand, instead of restraining our-selves to the 19th century, we cover the entire time-frame extending from 1800 to 1945.