[Decision process in oncology: the importance of multidisciplinary meeting]

International audienceMultidisciplinary meeting (MDM) in oncology has been institutionalised in France by the Cancer Plan. This study aims to determine the place of MDM in the decision process. From November 2004 to July 2005, we observed 29 meetings at the Tours Hospital and 324 case presentations, 80 in orthopaedics, 151 in gastroenterology and 93 in chest medicine. Forty physicians attending the meetings answered a questionnaire exploring their opinions on MDM and the collegial decision. We found that MDM is mostly the place for technical discussions and that patients' wishes are rarely addressed. The different medical specialities are well represented but we observed that only physicians attend MDM. Decisions for straightforward cases are rapidly validated. For more complex clinical situations (25 to 40% of case presentations), the multidisciplinary approach allows to adapt guidelines or to choose alternative treatments. All the physicians interviewed express that MDM legitimates the medical decision. It occurs that they disagree with the RCP decision. We discuss how MDM impacts on the medical decision as well as the shift from the individual decision to the collective one, particularly in term of responsibility

Supporting Youth in African Countries to Advance Local Economies and Community Health: The SDG Lab on Microfinance for Youth and Clean Water

In the sub-Saharan African countries, a large number of young adults enters the labour market each year. Scarcity of regular employment opportunities and the wish to become an entrepreneur lead many young people to start their own business. However, young people are often not able to become regular microloan customers due to both higher risks associated with young age and lack of experience with managing finances. If microfinance products should become accessible to young people, the loans need to be accompanied by non-financial services, i.e., financial advice and mentoring. In order to advance local economies and community health, we see two distinct problems around microfinance products for young adults. First, microfinance products combined with non-financial services are not sustainable, i.e. additional external funds are needed that render these microloan products unprofitable in the long run. Second, if improvements in community water, development, and health are envisaged, then new microfinance products need to be designed to serve the purpose of supporting the SDG goals of clean water and sanitation for all. We used an existing initiative of microfinance for young entrepreneurs and applied the social innovation lab methodology to gather experts in relevant fields. The SDG lab, co-sponsored by Future Earth and Appui au Développement Autonome Microfinance Luxembourg and hosted by the University of Luxembourg, first addressed the problem of sustainability of microfinance products for young entrepreneurs. Second, the SDG lab defined actors, processes, and goals to design microfinance products for young people to support the SDG goals of clean water and sanitation for all

Phase II study of capecitabine and oxaliplatin given prior to and concurrently with preoperative pelvic radiotherapy in patients with locally advanced rectal cancer

This multicentre phase II study evaluated the efficacy and safety of preoperative capecitabine plus oxaliplatin and radiotherapy (RT) in patients with locally advanced rectal cancer (T3/T4 rectal adenocarcinoma with or without nodal involvement). Treatment consisted of one cycle of XELOX (capecitabine 1000 mg m−2 bid on days 1–14 and oxaliplatin 130 mg m−2 on day 1), followed by RT (1.8 Gy fractions 5 days per week for 5 weeks) plus CAPOX (capecitabine 825 mg m−2 bid on days 22–35 and 43–56, and oxaliplatin 50 mg m−2 on days 22, 29, 43 and 50). Surgery was recommended 5 weeks after completion of chemoradiotherapy. The primary end point was pathological complete tumour response (pCR). Sixty patients were enrolled. In the intent-to-treat population, the pCR rate was 23% (95% CI: 13–36%). 58 patients underwent surgery; R0 resection was achieved in 57 (98%) patients, including all 5 patients with T4 tumours. Sphincter preservation was achieved in 49 (84%) patients. Tumour and/or nodal downstaging was observed in 39 (65%) patients. The most common grade 3/4 adverse events were diarrhoea (20%) and lymphocytopaenia (43%). Preoperative capecitabine, oxaliplatin and RT achieved encouraging rates of pCR, R0 resection, sphincter preservation and tumour downstaging in patients with locally advanced rectal cancer

Corpus Based Approaches to Figurative Language

Since the inception of the biennial Corpus Linguistics Conferences in 2001, we have held an accompanying work-shop/colloquium on Corpus-Based Approaches to Figurative Language, with the exception of 2007. We are continuing the tradition in 2009 with the 5th Corpus Linguistics Conference at the University of Liverpool, UK, 20th-23rd July. The theme of the colloquium this year is variation and variability in metaphor. This is a broad topic that is intended to encompass matters such as, but not limited to: variation in particular types of metaphor, such as temporal metaphors, across different genres such as news items or personal blogs; degrees of entrenchment or conventionality in metaphor, again possibly across different genres/registers; the nature of mixed metaphors; and how to use corpora to get at such types of information. The colloquium was also open to contributions examining any aspect of figurative language from a corpus-based perspective, since we believe that, for example, participants who have undertaken good corpus-based studies of a particular topic, but who have used only a single genre or corpus, may find fruitful interaction with other participants who have investigated similar topics but used different genres. Such interaction is by itself an important contribution to the theme of variety and variability

Etude de l'évolution de la chimie des eaux de drainage d'un sol lors d'un épandage de pommes de retrait

* INRA Centre de Recherche d'Avignon, URD, Domaine St Paul, Site Agroparc, 84914 Avignon cedex 9 Diffusion du document : INRA Centre de Recherche d'Avignon, URD, Domaine St Paul, Site Agroparc, 84914 Avignon cedex

Le système de gestion des collectivités territoriales : entre performance et délibération

La perspective d'une transposition unilatérale vers les collectivités de la Loi Organique pour les Lois de Finances est parfois évoquée, mais elle est dans l'ensemble repoussée par les dirigeants locaux; une solution décentralisée de rationalisation de la gestion locale, est-elle imaginable? Aujourd'hui, deux approches semblent disponibles pour tenter de répondre à cette question : - l'approche de la performance par les parties prenantes, - et l'approche de la démocratie par la délibération. Peuvent-elles constituer des pistes prometteuses pour engager une nouvelle dynamique de la gestion publique ?Chapet Jean-Michel. Le système de gestion des collectivités territoriales : entre performance et délibération. In: Politiques et management public, vol. 25, n° 4, 2007. Public : nouvelles figures ? Nouvelles frontières ? Actes du seizième Colloque international Florence, 15 et 16 mars 2007organisé en collaboration avec l'Université Paris X (Laboratoires CEROS et CRDP) - Tome 2. pp. 1-19

Evaluation par IRM et FDG TEP de la réponse à la radio-chimiothérapie des cancers du col utérin localement avancés

LYON1-BU Santé (693882101) / SudocSudocFranceF