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For a long time, patients with liver metastases from colorectal cancer were considered to be incurable. Over the last 30 years, the benefits of surgical resection and systemic chemotherapy have been established. To date, surgical resection remains the only treatment that can ensure long-term survival and cure in some patient. However, only a minority of patients with liver metastases are amenable to surgery and after resection of liver metastases, recurrences are still observed in two third of patients. Therefore, efforts have been made to increase the number of patients that could be candidates for surgery and to decrease the risk of recurrence after surgical resection. Shrinkage of tumours after administration of pre-operative chemotherapy and the availability of new surgical technique, including portal vein embolization, cryotherapy and radiofrequency ablation, now allows the treatment, with curative intent, of metastases initially considered as non-resectable. Chemotherapy regimens have been developed to decrease the risk of postoperative recurrence.

Old French recommendations were to treat all pharyngitis cases to prevent acute rheumatic fever. 85 to 90% of cases were treated (8 to 9 millions/year), of which 3/4 unnecessary. Furthermore, penicillin V the drug of first choice was prescribed only to 5 to 10% of patients. Considering the preocupating increase of bacterial resistances and the disponibility of performane Group A Beta-Hemolytic Streptococcus Rapid Diagnostic Test (Negative Predictive Value above 95%), the new management strategy is proposed in two ways. Firstly, the free delivery of RDT to practitioners which was associated in Burgundy with a dramatic prescription decrease to 41% without benefice lost for patients. Considering these good results the French authorities decided the generalization of RDT use in 2002 and more than 15,000 practitioners have been concerned by the formations delivered in 3 months. Secondly, the short course treatment assays initiated by our group have been validated and since 2002 the AFSSAPS recommend the preferential use of compounds which obtained the authorization of use in short course with a new indication incitating to document GABHS pharyngitis by the RDT use.

This paper aims to assess current interventions in psychiatric rehabilitation in the French-speaking world and to discuss future developments. We review examples of policies and practices in Quebec and Europe and discuss the role and involvement of professionals; namely, the psychiatrists and the nursing staff. We also present different rehabilitation strategies and techniques used in the French-speaking world, such as case management, social-skills training, cognitive therapies for psychotic symptoms, family interventions, and return-to-work interventions. In conclusion, we invite psychiatrists to play a more active role in rehabilitation. We recommend the creation of small, specialized units closely linked to the needs of clients, and we propose to integrate social and medical interventions, rather than opposing them.