Intérêt du dosage de la Procalcitonine sérique dans le diagnostic des arthrites et ostéomyélites aiguës de l'enfant

Les arthrites et ostéomyélites aiguës de l'enfant restent de diagnostic difficile. Nous avons évalué, au cours d'une étude prospective conduite au CHU de Nantes, l'intérêt de la procalcitonine sérique dans le diagnostic de ces pathologies. Son utilité n'a pas été démontrée et la protéine C-réactive reste le paramètre biologique le plus sensible dans notre étude. La sensibilité des prélèvements locaux a été fortement augmentée par la mise en culture immédiate sur flacon d'hémoculture, avec 78% d'identification d'agents pathogènes dans les arthrites septiques. Un diagnostic bactériologique plus précis et une prise en charge plus spécifique ont permis un traitement plus efficace de ces pathologiesNANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Etude des motivations à faire partie d'un Système d'échange local (SEL).

International audienc

The Local Exchange Trading System in France (Système d’Échange Local (SEL)): Creating a scale to measure motivations for participation in SEL practice and identification of SEL member profiles

International audienceWhile Local Exchange Trading Systems (LETS) are regularly cited in the literature on collaborative consumption, they have paradoxically rarely been studied by researchers in the field of marketing. In France, although LETS, or SELs ( Systèmes d’Échanges Locaux), continue to develop, they suffer from high member turnover. This raises the question of whether the existing SELs are responding to the underlying motivations for participation in SEL practice. What is the nature of SEL member motivations? Are these motivations different from those in collaborative consumption more generally? Is it possible to measure them and thus propose SEL member profiles based on these motivations? A qualitative study of 16 SEL members and a quantitative study of 957 SEL members revealed five types of motivations and five SEL member profiles –‘the intellectual protester’, ‘the novice SEL member’, ‘the affective idealist’, ‘the pragmatic consumer’ and ‘the accomplished SEL member’. The theoretical contributions of this study include notably the importance of the ‘for intellectual enrichment’ motivation and the creation of a reliable and valid scale for measuring motivations for participating in SEL practice. The findings have consequences for SEL management teams, who will be able to use them to reduce high turnover and improve the nature of their exchange offers, the effectiveness of their internal and external communications and the recruitment of new members

Les systèmes d'échanges locaux : création d'une échelle de mesure des motivations au sélisme et identification de profils de sélistes

International audienceWhile LETS, or Local Exchange Trading Systems, are regularly cited in the literature on collaborative consumption, they have paradoxically rarely been studied by researchers in the field of marketing. In France, although LETS, or SELs (Systèmes d’Échanges Locaux), continue to develop, they suffer from high member turnover. This raises the question of whether the existing SELs are responding to the underlying motivations for participation in SEL practice. What is the nature of SEL member motivations? Are these motivations different from those in collaborative consumption more generally? Is it possible to measure them and thus to propose SEL member profiles based on these motivations? A qualitative study of 16 SEL members and a quantitative study of 957 SEL members revealed five types of motivations and five SEL member profiles –‘the intellectual protester’, ‘the novice SEL member’, ‘the affective idealist’, ‘the pragmatic consumer’ and ‘the accomplished SEL member’. The theoretical contributions of this study include notably the importance of the ‘for intellectual enrichment’ motivation and the creation of a reliable and valid scale for measuring motivations for participating in SEL practice. The findings have consequences for SEL management teams, who will be able to use them to reduce high turnover and improve the nature of their exchange offers, the effectiveness of their internal and external communications and the recruitment of new members.Les SEL, ou Systèmes d’Echanges Locaux, sont régulièrement cités dans le cadre des travaux sur la consommation collaborative mais ont paradoxalement rarement été étudiés par les chercheurs en marketing. Alors que les SEL continuent à se développer, ils font face à un fort turnover. Au point de se demander si les SEL existant répondent aux motivations qui sous-tendent la pratique séliste. Quelle est la nature des motivations d’un séliste ? Ces motivations sont-elles différentes des motivations génériques relatives à toute forme de consommation collaborative ? Est-il possible de les mesurer et de proposer d’identifier ainsi des profils de sélistes fondés sur ces motivations ? Une étude qualitative portant sur 16 sélistes et une étude quantitative portant au total sur 957 sélistes ont permis d’identifier cinq types de motivations et cinq profils de sélistes – « les intellos contestataires », « les sélistes débutants », « les idéalistes affectifs », « les consommateurs pragmatiques » et « les sélistes accomplis ». Les apports théoriques de l’étude résident notamment dans l’importance de la motivation « S’enrichir intellectuellement » et dans la création d’une échelle de mesure des motivations au sélisme fiable et valide. Ces résultats ont des conséquences pour le pilotage des gestionnaires de SEL, qui pourront ainsi améliorer la nature des offres d’échanges, l’efficacité de leur communication interne et externe, le recrutement de nouveaux membres, mais également réduire l’important turnover

Etude de l'influence des motivations à faire partie d'un Système d'échange local (SEL) et de leurs antécédents sur la pratique séliste

International audienc

An Observational Study of the Impact of a Computerized Physician Order Entry System on the Rate of Medication Errors in an Orthopaedic Surgery Unit.

To assess the impact of the implementation of a Computerized Physician Order Entry (CPOE) associated with a pharmaceutical checking of medication orders on medication errors in the 3 stages of drug management (i.e. prescription, dispensing and administration) in an orthopaedic surgery unit.A before-after observational study was conducted in the 66-bed orthopaedic surgery unit of a teaching hospital (700 beds) in Paris France. Direct disguised observation was used to detect errors in prescription, dispensing and administration of drugs, before and after the introduction of computerized prescriptions. Compliance between dispensing and administration on the one hand and the medical prescription on the other hand was studied. The frequencies and types of errors in prescribing, dispensing and administration were investigated.During the pre and post-CPOE period (two days for each period) 111 and 86 patients were observed, respectively, with corresponding 1,593 and 1,388 prescribed drugs. The use of electronic prescribing led to a significant 92% decrease in prescribing errors (479/1593 prescribed drugs (30.1%) vs 33/1388 (2.4%), p < 0.0001) and to a 17.5% significant decrease in administration errors (209/1222 opportunities (17.1%) vs 200/1413 (14.2%), p < 0.05). No significant difference was found in regards to dispensing errors (430/1219 opportunities (35.3%) vs 449/1407 (31.9%), p = 0.07).The use of CPOE and a pharmacist checking medication orders in an orthopaedic surgery unit reduced the incidence of medication errors in the prescribing and administration stages. The study results suggest that CPOE is a convenient system for improving the quality and safety of drug management

Prescribing errors before and after CPOE implementation.

<p>* Total number of drugs prescribed</p><p>Prescribing errors before and after CPOE implementation.</p

Dispensing errors before and after CPOE implementation.

<p>*<b>Number of total opportunities for error</b></p><p>Dispensing errors before and after CPOE implementation.</p

Patients’ characteristics before-after CPOE implementation.

<p>Patients’ characteristics before-after CPOE implementation.</p

Prescribing errors before and after CPOE implementation.

<p>* Total number of drugs prescribed</p><p>Prescribing errors before and after CPOE implementation.</p