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Many healthcare professionals prejudge the capacity of a patient suffering from Alzheimer's disease to designate a health care surrogate. Consequently they deprive themselves of a person with whom they can discuss the patient's care while also depriving the patient of support and assistance.While the task of the health care surrogate is made more difficult as a result of cognitive disorders, their role can only be beneficial in a balanced relationship.

The theme of the surrogate is not established in the practice of general practitioners yet. Their long-term relation with patients places them in a favorable position to approach this topic. The surrogate could improve the quality of patient's care. Some factors limiting the surrogate's designation are indicators of the current deficiencies of the surrogate's device.

A geriatric syndrome in its own right, malnutrition must be systematically looked for whenever an elderly patient is being treated. A marker of vulnerability, once identified it requires repeated assessment and adapted treatment. Undernutrition is often the consequence of various aetiologies justifying a full assessment and an assertive, multi-professional treatment.

Background Major and minor tranquillisers can be used to chemically restrain a patient. Use of chemical restraint (CR) has been described mainly in long care settings but there is very limited information when considering acute care hospitals. Purpose To study the prescriptions for major and minor tranquillisers in 3 clinical wards of a French teaching hospital and to determine if they can be considered CR. Materials and Methods This prospective study took place over 2 weeks in 3 different wards: geriatrics, pneumology and vascular surgery. Tranquilizers were defined as anxiolytics (minor) and neuroleptics (major). Prescriptions were checked daily and for each patient with a tranquilliser, medical records were screened to determine whether it was newly prescribed. For every newly-prescribed tranquilliser the practitioner was asked the indication, if he considered his prescription was a CR and if the patient was being physically restrained. Results 45.2% of the 137 patients included had been prescribed at least 1 tranquilliser. 54.5% of the 77 tranquillisers prescribed were introduced during the hospitalisation. Among those 42 newly-introduced tranquillisers, 9 (21.4%) were considered as CR by the prescribers. 6.6% of the patients included were chemically restrained, which is comparable with previous retrospective studies of restraint in acute care wards. The most frequently prescribed CR was alprazolam (55.6%) and the most frequent indication for CR was anxiety. In addition 88.9% of the CR drugs were prescribed ‘when required’ leaving responsibility for administration to nurses alone. None of the patients with tranquillisers had physical restraint. Conclusions This is the first prospective study on restraint in an acute care hospital. CR is used for a minority of patients; however it is mostly prescribed ‘when required’. Hence it should be used with the utmost care and prescribed with the most precise instructions in order to avoid misuse and risk of abuse. No conflict of interest.

Physical unclonable functions (PUFs) are promising primitives for the lightweight authentication of an integrated circuit (IC). Indeed, by extracting an identifier from random process variations, they allow each instance of a design to be uniquely identified. However, the extracted identifiers are not stable enough to be used as is, and hence, need to be corrected first. This is currently achieved using error-correcting codes in secure sketches that generate helper data through a one-time procedure. As an alternative, we propose key reconciliation protocols. This interactive method, originating from quantum key distribution, allows two entities to correct errors in their respective correlated keys by discussing over a public channel. We believe that this can also be used by a device and a remote server to agree on two different responses to the same challenge from the same PUF obtained at different times. This approach has the advantage of requiring very few logic resources on the device side. The information leakage caused by the key reconciliation process is limited and easily computable. Results of implementation on field-programmable gate array (FPGA) targets are presented, showing that it is the most lightweight error-correction module to date.