Conférence de Daniel Béland : « Fédéralisme et mise en œuvre de la réforme de la santé aux États-Unis »

À l’heure de la mise en application tumultueuse du Patient Protection and Affordable Care Act (aussi appelé Obamacare, ci-après PPACA), de nombreux défis se profilent pour l’administration Obama. En mai 2014, François Vergniolle de Chantal du Laboratoire des Recherches sur les Cultures Anglophones (LARCA) accueillait Daniel Béland, spécialiste des politiques publiques américaines, pour faire le point sur les aspects politiques de cette mise en œuvre dans les cinquante États fédérés. Le cadre ..

La communication présidentielle du 21e siècle aux États-Unis. Retour sur un aggiornamento stratégique

Qu’on l’appelle « campagne permanente » (permanent campaign) ou « tribune publique » (going public), l’acte discursif est au cœur des stratégies de gouvernement de la présidence américaine moderne. Dans un monde politique intensément polarisé, où les sources d’autorité potentielles sont devenues légion, où les citoyens semblent se désintéresser de la chose politique, quelle place et quelle forme donner à l’éloquence ? Cet article revient sur les transformations des stratégies de communication politique des présidents à l’ère des médias partisans (souvent symbolisée par la création de la chaîne conservatrice Fox News en 1996) et d’Internet (depuis la présidence Clinton).Whether it bears the name permanent campaign or going public, the discursive act is at the heart of the strategies of governing modern American presidency. In an extremely polarized political realm where potential sources of power have become commonplace and where citizens are obviously no longer interested in politics, what place and what form should be granted to eloquence? This article dwells on the transformations undergone by the political communication strategies of presidents in an era of partisan media often symbolized by the founding in 1996 of conservative TV channel, Fox News) and the internet (since Clinton’s presidency).Ya sea que hablemos de una « campaña permanente » (permanent campaign) o de una « tribuna pública » (going public), el acto discursivo está en el centro de las estrategias de gobierno de la presidencia norteamericana moderna. En un mundo político intensamente polarizado, en el cual las fuentes potenciales de autoridad son múltiples, donde los ciudadanos parecen desinteresarse de la cosa política ¿ qué lugar y qué forma atribuirle a la elocuencia ? Este artículo vuelve sobre las transformaciones de las estrategias de comunicación políticas de los presidentes en la era de los medios partidarios generalmente simbolizados por medio de la creación del canal conservador Fox News en 1996) y de Internet (desde la presidencia Clinton)

Les séries télévisées médicales étatsuniennes : évolutions, permanences et enjeux de l’« asymétrie réaliste »

Cet article analyse « l’asymétrie réaliste » dans les séries télévisées médicales étatsuniennes, c’est-à-dire un choix de focalisation combinant l’hypervisibilité de l’expertise médicale et l’invisibilisation des inégalités d’accès aux soins médicaux. Plus précisément, l’article étudie l’essor du canon sériel médical et l’évolution historique des choix de focalisation de ce genre en s’appuyant sur un corpus de séries médicales produites entre 1950 et nos jours aux États-Unis. L’article étudie également les enjeux épistémiques de l’asymétrie réaliste dans ce genre très populaire et dans le contexte de réception étatsunien, où la question de l’accès aux soins médicaux demeure une inquiétude permanente, notamment pour les plus pauvres.This article analyses the « asymetrical realism » of US medical TV series, understood as a choice of focalization combining the hypervisibility of medical expertise and the invisibilisation of inequalities in access to medical care. The article is based on a corpus of US medical series produced from the 1950s to this day. It tracks the rise and consolidation of the medical series canon as well as the historical evolution of focalization choices in the genre. The article analyses the epistemic stakes of asymetrical realism in this very popular genre, in the US reception context where the question of access to health care is a permanent source of concern, especially for the poorer segments of the population

La communication présidentielle du 21e siècle aux États-Unis. Retour sur un aggiornamento stratégique

Qu’on l’appelle « campagne permanente » (permanent campaign) ou « tribune publique » (going public), l’acte discursif est au cœur des stratégies de gouvernement de la présidence américaine moderne. Dans un monde politique intensément polarisé, où les sources d’autorité potentielles sont devenues légion, où les citoyens semblent se désintéresser de la chose politique, quelle place et quelle forme donner à l’éloquence ? Cet article revient sur les transformations des stratégies de communication politique des présidents à l’ère des médias partisans (souvent symbolisée par la création de la chaîne conservatrice Fox News en 1996) et d’Internet (depuis la présidence Clinton).Whether it bears the name permanent campaign or going public, the discursive act is at the heart of the strategies of governing modern American presidency. In an extremely polarized political realm where potential sources of power have become commonplace and where citizens are obviously no longer interested in politics, what place and what form should be granted to eloquence? This article dwells on the transformations undergone by the political communication strategies of presidents in an era of partisan media often symbolized by the founding in 1996 of conservative TV channel, Fox News) and the internet (since Clinton’s presidency).Ya sea que hablemos de una « campaña permanente » (permanent campaign) o de una « tribuna pública » (going public), el acto discursivo está en el centro de las estrategias de gobierno de la presidencia norteamericana moderna. En un mundo político intensamente polarizado, en el cual las fuentes potenciales de autoridad son múltiples, donde los ciudadanos parecen desinteresarse de la cosa política ¿ qué lugar y qué forma atribuirle a la elocuencia ? Este artículo vuelve sobre las transformaciones de las estrategias de comunicación políticas de los presidentes en la era de los medios partidarios generalmente simbolizados por medio de la creación del canal conservador Fox News en 1996) y de Internet (desde la presidencia Clinton)

Conférence de Daniel Béland : « Fédéralisme et mise en œuvre de la réforme de la santé aux États-Unis »

À l’heure de la mise en application tumultueuse du Patient Protection and Affordable Care Act (aussi appelé Obamacare, ci-après PPACA), de nombreux défis se profilent pour l’administration Obama. En mai 2014, François Vergniolle de Chantal du Laboratoire des Recherches sur les Cultures Anglophones (LARCA) accueillait Daniel Béland, spécialiste des politiques publiques américaines, pour faire le point sur les aspects politiques de cette mise en œuvre dans les cinquante États fédérés. Le cadre ..

Organ-specific allergen challenges in airway allergy: Current utilities and future directions

Atopy has been long used as the screening method for airway allergy. Nevertheless, aeroallergens can trigger respiratory symptoms not only in atopic patients (atopic res piratory allergy, ARA), but also in non-atopic subjects (local respiratory allergy, LRA). Moreover, ARA and LRA can coexist in the same patient, and this clinical scenario has been called dual respiratory allergy (DRA). When the clinical history cannot determine the relevance of sensitizations in ARA patients, nasal, conjunctival or bronchial aller gen challenges (NAC, CAC, and BAC, respectively) should be conducted. Moreover, these tests are required to identify patients with LRA and DRA. The clarification of the allergic triggers of airway diseases has a profound impact on the management strategies the patients can be offered. Importantly, allergen immunotherapy (AIT) remains as the only disease-modifying intervention for ARA. Recent data indicate that AIT might have a similar effect on LRA patients. Nevertheless, AIT success relies largely on the correct phenotyping of allergic individuals, and NAC, CAC, and BAC are very helpful tools in this regard. In this review, we will summarize the main indications and methodology of CAC, NAC, and BAC. Importantly, the clinical implementation of these tests might translate into precision medicine approaches and better health outcomes for patients with airway allergy.Consejería de Salud, Junta de Andalucía, Grant/Award Number: P20_00405; Instituto de Salud Carlos III, Grant/Award Number: PI20/01715, RD21/0002/0008, CM21/00262, CM20/00160, JR22/00048 and JR19/00029. Funding for open access charge: Universidad de Málaga / CBUA

Management of ocular allergy

The treatment and management of ocular allergy (OA) remain a major concern for different specialties, including allergists, ophthalmologists, primary care physicians, rhinologists, pediatricians, dermatologists, clinical immunologists, and pharmacists. We performed a systematic review of all relevant publications in MEDLINE, Scopus, and Web Science including systematic reviews and meta-analysis. Publications were considered relevant if they addressed treatments, or management strategies of OA. A further wider systematic literature search was performed if no evidence or good quality evidence was found. There are effective drugs for the treatment of OA; however, there is a lack an optimal treatment for the perennial and severe forms. Topical antihistamines, mast cell stabilizers, or double-action drugs are the first choice of treatment. All of them are effective in reducing signs and symptoms of OA. The safety and optimal dosing regimen of the most effective topical anti-inflammatory drugs, corticosteroids, are still a major concern. Topical calcineurin inhibitors may be used in steroid-dependent/resistant cases of severe allergic keratoconjunctivitis. Allergen-specific immunotherapy may be considered in cases of failure of first-line treatments or to modify the natural course of OA disease. Based on the current wealth of publications and on the collective experience, recommendations on management of OA have been proposed

Next-generation care pathways for allergic rhinitis and asthma multimorbidity:a model for multimorbid non-communicable diseases-Meeting Report (Part 1)

International audienceIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system for integrated care with organizational health literacy. MASK (Mobile Airways Sentinel NetworK) (1), a new development of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health) (2), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life integrated care pathways (ICPs) (3)-centred around the patient with rhinitis and using mHealth monitoring of environmental exposure (4).An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018. The aim was to discuss next-generation care pathways: (I) Patient participation, health literacy and self-care through technology-assisted “patient activation”; (II) Implementation of care pathways by pharmacists and (III) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) assessed by mobile technology.The EU (5) and global political agendas are of great importance in supporting health care transformation. MASK has been recognized by DG Santé as a Good Practice (6) in the field of digitally-enabled, integrated, person-centred care.The one-day meeting objectives were clear (Figure 1). The meeting was followed by a workshop. The present paper reports the background of the two-day meeting

ARIA-Versorgungspfade für die Allergenimmuntherapie 2019 = 2019 ARIA Care pathways for allergen immunotherapy

Allergen immunotherapy (MT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence- based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including health professionals. The decision to prescribe MT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as on the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomaikers that can predict MT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate phannacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow up of patients

Next-Generation Allergic Rhinitis and Its Impact on Asthma (ARIA) Guidelines for Allergic Rhinitis Based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Real-World Evidence

The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.info:eu-repo/semantics/publishedVersio