Raisonner la densification des espaces urbanisés face aux enjeux des continuités écologiques

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Ruptures d'approvisionnement en médicaments anti-infectieux: causes et conséquences

International audienceAnti-infective drugs stock-outs are increasingly frequent, and this is unlikely to change. There are numerous causes for this, mostly related to parameters difficult to control: i) 60 to 80% of raw material or components are produced outside of Europe (compared to 20% 30 years ago), with subsequent loss of independence for their procurement; ii) the economic crisis drives the pharmaceutical companies to stop producing drugs of limited profitability (even among important drugs); iii) the enforcement of regulatory requirements and quality control procedures result in an increasing number of drugs being blocked during production. The therapeutic class most affected by drug stock-outs is that of anti-infective drugs, especially injectable ones, and many therapeutic dead ends have recently occurred. We provide an update on this issue, and suggest 2 major actions for improvement: i) to implement a group dedicated to anticipating drug stock-outs within the anti-infective committee in each health care center, with the objectives of organizing and coordinating the response whenever a drug stock-out is deemed at risk (i.e., contingency plans, substitution, communication to prescribers); ii) a national reflection lead by scientific societies, in collaboration with government agencies, upstream of the most problematic drug stock-outs, to elaborate and disseminate consensus guidelines for the management of these stock-outs

The Member State of the European Union – Membership and Status

L’État membre de l’Union européenne a longtemps été occulté des études de droit communautaire, devenu droit de l’Union européenne. Seule l’adaptation interne de l’État était étudiée. Le « retour de l’État » marqué par le traité de Lisbonne invite cependant à penser la place que ce droit accorde à l’État membre. Ce dernier s’intègre en effet dans un ensemble normatif qui comprend un panel de droits et d’obligations réglant les modalités de son appartenance et de sa participation à l’Union européenne. L’étude de cet ensemble normatif, du point de vue de l’ordre juridique de l’Union, permet alors d’identifier deux sous-ensembles, l’un concernant l’appartenance de l’État à l’Union principalement maîtrisé par ce dernier, l’autre concernant sa participation institutionnelle à la production et l’exécution du droit de l’Union, par lequel l’Union instrumentalise l’État membre afin d’assurer l’effectivité de son droit et d’affirmer l’autonomie de son ordre juridique.Until recently, European studies did not consider the Member State of the European Union. It has mainly been studied from a national point of view. However, the Lisbon treaty suggests that the Member State is not as neglected by European Union law as one could think. The European Union legal order includes a diversity of rights and duties concerning the membership and the participation of the Member State to the European Union. The norms concerning its membership are controlled by the Member State, while the norms concerning its participation are used by the European Union in order to ensure the effectivity and the autonomy of the European legal order

Appel à la violence. Théorie et pratique de la violence dans la culture politique de la RFA des années 1960 aux années 1970

International audienc

Refus radical et pratique féministe : les Rote Zora

Héritières d’une part des enseignements et théories politiques développés lors du mouvement étudiant ouest-allemand et d’autre part de la pratique de la lutte armée au sein des Cellules Révolutionnaires, les Rote Zora se constituèrent en groupe non-mixte femmes et revendiquèrent plus d’une quarantaine d’attentats entre 1974 et 1994. Leurs combats étaient multiples : elles luttaient contre le sexisme, le racisme et le capitalisme, appréhendant ces différentes formes d’oppression dans une approche que l’on qualifierait aujourd’hui d’intersectionnelle. Usagères de la violence politique, elles affichaient néanmoins des positions antimilitaristes et critiquaient toutes relations de pouvoir. L’originalité de ce groupe sera développée à travers la notion de refus.Die Rote Zora war eine autonome Frauengruppe, die sowohl von den Lehren und politischen Theorien der deutschen Studentenbewegung, als auch von der Praxis des bewaffneten Kampfes der Revolutionären Zellen inspiriert wurde. Die Gruppierung war zwischen 1974 und 1994 aktiv und bekannte sich zu vierzig Anschlägen. Ihr Kampf richtete sich gegen Sexismus, Rassismus und Kapitalismus, wobei sie in multidimensionalen Analysen aufzuzeigen versuchten, wie diese verschiedenen Unterdrückungsformen sich überlagern konnten. Obwohl die Rote Zora Gewalt als politisches Mittel anwandte, entwickelte die Gruppe antimilitaristische Positionen und übte Kritik an den Machtverhältnissen. Die Singularität dieser Gruppe wird unter dem Aspekt der Verweigerung analysiert

Traitement d’images satellitaires à Très Haute Résolution Spatiale et identification de zones à enjeux dans l’aménagement des Trames Vertes urbaines

http://www.sfpt.fr/rfpt/index.php/RFPT/article/view/130International audienceCe travail présente la mise en place d’une chaîne de traitement d’images à très haute résolution spatiale pour l’extraction de la végétation urbaine et une mise en application méthodologique au service des aménageurs du territoire pour l’identification des connectivités écologiques, un concept politique issu des lois Grenelle de l’Environnement.Les résultats ont montré qu’il est possible d’extraire la végétation urbaine d’une image satellite Pléiades à l’aide d’une méthode simple, semi-automatisée et utilisant des outils libres tant pour des traitements raster que vecteurs. La chaîne de traitement développée permet ainsi de distinguer la végétation basse de la végétation arborée à partir d’indices radiométriques simples.La discrimination de cette végétation urbaine nous a ensuite permis de valoriser ces résultats et de développer une méthode d’identification des connectivités écologiques urbaines qui s’appuie sur la théorie des graphes. Cette nouvelle information géographique, couplée à d’autres indicateurs et documents d’urbanisme, permet de localiser les zones d’enjeux où un besoin de maintien de la biodiversité et une volonté d’urbanisation s’affrontent

Elemental abundance analyses with DAO spectrograms XXXVII. The normal A0 IV star \u3b3 Geminorum

We performed a fine analysis of the normal sharp-lined A0 IV star \u3b3 Geminorum with spectra having signal-to-noise ratios at the continuum of 500\u20131200 that were consistent with previous studies of this series. Our spectra have wavelength ranges of \u3bb\u3bb3829\u20134730, 4873\u20134931, 4983\u20135042, and 5070\u20135210. The spectra measured with the program REDUCE have a two-pixel resolution of 0.072 \uc5. We used ATLAS9 models and the program WIDTH9 to derive the abundances of the metals. Most derived abundances are close to solar with the abundances of the heaviest elements Zr, Ba, La, Ce, and Nd showing greater than solar values. This suggests by comparison with the abundances of other normal and Am stars that \u3b3 Gem might exhibit an incipient Am star phenomenon.Peer reviewed: YesNRC publication: Ye

Ambulatory Intravenous Antibiotic Therapy in Quebec: The Hôpital Charles LeMoyne Experience in 1996

From January 1, 1996 to December 31, 1996, 343 patients received outpatient intravenous antibiotic therapy at Charles LeMoyne Hospital, a 436-bed, acute care hospital in Greenfield Park, south of Montréal, Québec. The infectious diseases department saved 2660 bed-days using outpatient therapy. The mean duration of outpatient therapy was 7.76 days; 81.6% of patients were admitted to the program directly from the emergency room, or outpatient hospital clinics or private offices in the community. Hospitalized patients constituted only 18.4% of admissions to the outpatient intravenous antibiotic therapy program. Forty per cent of the surgical/medical staff participated in the program and they were able to generate a significant impact by diverting patients to outpatient therapy. Two types of patients can benefit from an outpatient intravenous antibiotic therapy program. One group of patients needs empirical short term therapy and can be switched to oral sequential therapy after two to five days of outpatient intravenous antibiotic therapy. A second group of patients needs specific long term therapy for the full duration of the antibiotic therapy. Empirical short term therapy can be managed by emergency department or hospital-based primary physicians, or medical/surgical specialists. Specific long term therapy can be managed by microbiology/infectious disease specialists or medical/surgical specialists. Hospitals that want to relieve pressure on emergency rooms and hospital bed demands should create facilities for both types of patients. Cefazolin and gentamicine/tobramycine were the most commonly used antibiotics in empirical short term therapy and in terms of number of patients treated. Ceftriaxone and vancomycin were most commonly used for long term therapy. The Drug acquisition antibiotic cost was $73,117 but constituted only 20antibiotic therapy cost. The per diem ambulatory cost was$140/patient/day

Evaluation of new bone formation in irradiated areas using association of mesenchymal stem cells and total fresh bone marrow mixed with calcium phosphate scaffold

International audienceThe consequences of the treatment of the squamous cell carcinomas of the upper aerodigestive tract (bone removal and external radiation therapy) are constant. Tissue engineering using biphasic calcium phosphate (BCP) and mesenchymal stem cells (MSC) is considered as a promising alternative. We previously demonstrated the efficacy of BCP and total fresh bone marrow (TBM) in regenerating irradiated bone defect. The aim of this study was to know if adding MSC to BCP + TBM mixture could improve the bone formation in irradiated bone defects. Twenty-four Lewis 1A rats received a single dose of 20 Gy to the hind limbs. MSC were sampled from non-irradiated donors and amplified in proliferative, and a part in osteo-genic, medium. 3 weeks after, defects were created on femurs and tibias, which were filled with BCP alone, BCP + TBM, BCP + TBM + uncommitted MSC, or BCP + TBM + committed MSC. 3 weeks after, samples were removed and prepared for qualitative and quantitative analysis. The rate of bone ingrowth was significantly higher after implantation of BCP + TBM mixture. The adding of a high concentration of MSC, committed or not, didn't improve the bone regeneration. The association BCP + TBM remains the most efficient material for bone substitution in irradiated areas