A large-scale galaxy structure at z = 2.02 associated with the radio galaxy MRC 0156-252

We present the spectroscopic confirmation of a structure of galaxies surrounding the radio galaxy MRC 0156-252 at z = 2.02. The structure was initially discovered as an overdensity of both near-infrared selected z > 1.6 and mid-infrared selected z > 1.2 galaxy candidates. We used the VLT/FORS2 multi-object spectrograph to target ~80 high-redshift galaxy candidates, and obtain robust spectroscopic redshifts for more than half the targets. The majority of the confirmed sources are star-forming galaxies at z > 1.5. In addition to the radio galaxy, two of its close-by companions (<6″) also show AGN signatures. Ten sources, including the radio galaxy, lie within | z − 2.020 | <0.015 (i.e., velocity offsets <1500 km s^-1) and within projected 2 Mpc comoving of the radio galaxy. Additional evidence suggests not only that the galaxy structure associated with MRC 0156-252 is a forming galaxy cluster but also that this structure is most probably embedded in a larger-scale structure

New-onset atrial fibrillation in ICU: A FROG in the throat

Lettre à l'éditeur ("International Journal of Cardiology" vol. 270, p. 189).https://www.sciencedirect.com/science/article/pii/S016752731833883X?via%3Dihu

Intersecting vulnerabilities in professionals and patients in intensive care

International audienceIn the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient's identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU

What are the ethical issues in relation to the role of the family in intensive care?

International audienceA large proportion of patients admitted to the intensive care unit (ICU) are unable to express themselves, often due to acute illness, shock or trauma, and this precludes any communication and/or consent for care that might reflect their wishes and opinions. In such cases, the only solution for the ICU physician is to include the patient's family in the healthcare decisions. This can represent a significant burden on the family, on top of the psychological distress of the ICU environment and hospitalisation of their relatives, and many family members may suffer from anxiety, depression or symptoms of post-traumatic stress disorder (PTSD) during or after the hospitalisation and/or death of a loved one in the ICU. Good communication remains the cornerstone of family satisfaction in the ICU. Information imparted to the patient and/or family should cover diagnosis, prognosis and treatment. Information should be given orally, in person, using accessible language. Several other measures that can lessen the burden on the families of patients in the ICU and help to reduce anxiety and stress are also detailed in this review. Overall, family-centred care in the ICU requires a systematic communication strategy within the healthcare team, combined with an environment that is as amenable as possible to the family's presence and involvement, in order to maximize family satisfaction with ICU care, and ensure that the patient's values and preferences are respected

What are the ethical aspects surrounding the collegial decisional process in limiting and withdrawing treatment in intensive care?

International audienceThe decision to limit or withdraw life-support treatment is an integral part of the job of a physician working in the intensive care unit, and of the approach to care. However, this decision is influenced by a number of factors. It is widely accepted that a medical decision that will ultimate lead to end-of-life in the intensive care unit (ICU) must be shared between all those involved in the care process, and should give precedence to the patient's wishes (either directly expressed by the patient or in written form, such as advance directives), and taking into account the opinion of the patient's family, including the surrogate if the patient is no longer capable of expressing themselves. A number of questions still remain unanswered regarding how decisions to limit or withdraw treatment are taken in daily practice, especially when this decision can be anticipated. We discuss here the collegial procedure for decision-making, in particular in the context of recent French legislation on end-of-life issues. We describe how collegial decision-making procedures should be carried out, and what points are covered in shared discussions regarding decisions to limit or withdraw life-sustaining therapies

Intensive care unit strain should not rush physicians into making inappropriate decisions, but merely reduce the time to the right decisions being made

International audienc

What are the ethical questions raised by the integration of intensive care into advance care planning?

International audienceA major goal of intensive care units (ICUs) is to offer optimal management, but for many patients admitted to the ICU, they are unlikely to yield any lasting benefit. In this context, the ICU physician remains a key intermediary, particularly when a decision regarding possible limitation or withdrawal of life-sustaining therapy becomes necessary. The possibility of admission to the ICU, and the type of care the patient would like to receive there, should be integrated into the healthcare project in agreement with the patient, regardless of the stage of disease that the patient suffers from. These dispositions should be recorded in the patient's file, and should respect the progressive nature of both the disease itself, and the discussions necessary in such complex situations. The ICU physician can serve as a valuable consultant for the treating physician, in particular to guide patient choices when formalizing their healthcare preferences in the form of advance care planning (ACP) or advance directives (AD). Ideally, the best time to address this issue is before the patient's clinical situation deteriorates towards an acute emergency, and providing complete and transparent information to inform the patient's choices

Les enceintes néolithiques en Pays de la Loire : nouvelles fouilles, nouvelles perspectives

National audienc

Les enceintes néolithiques en Pays de la Loire : nouvelles fouilles, nouvelles perspectives

International audienc

Les enceintes néolithiques en Pays de la Loire : nouvelles fouilles, nouvelles perspectives

International audienc