Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment

Background: The impact of compliance to clinical practice guidelines (CPG) on outcomes and/or costs of care has not been completely clarified.Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment.Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions.Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy.Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.Oncology; Sarcoma; Cost; Clinical guidelines; Efficacy; Medical Practices; Government Policy; Regulation; Public Health

The ocean sampling day consortium

Ocean Sampling Day was initiated by the EU-funded Micro B3 (Marine Microbial Biodiversity, Bioinformatics, Biotechnology) project to obtain a snapshot of the marine microbial biodiversity and function of the world’s oceans. It is a simultaneous global mega-sequencing campaign aiming to generate the largest standardized microbial data set in a single day. This will be achievable only through the coordinated efforts of an Ocean Sampling Day Consortium, supportive partnerships and networks between sites. This commentary outlines the establishment, function and aims of the Consortium and describes our vision for a sustainable study of marine microbial communities and their embedded functional traits

The Ocean Sampling Day Consortium

Ocean Sampling Day was initiated by the EU-funded Micro B3 (Marine Microbial Biodiversity, Bioinformatics, Biotechnology) project to obtain a snapshot of the marine microbial biodiversity and function of the world’s oceans. It is a simultaneous global mega-sequencing campaign aiming to generate the largest standardized microbial data set in a single day. This will be achievable only through the coordinated efforts of an Ocean Sampling Day Consortium, supportive partnerships and networks between sites. This commentary outlines the establishment, function and aims of the Consortium and describes our vision for a sustainable study of marine microbial communities and their embedded functional traits

Day Dress

Day dress in sheath style of turquoise blue wool knit. Knee-length, with short sleeves and banded collar. Diagonal, 2" welt pockets at side hips. Center back opening of 7 circular turquoise plastic buttons with bound buttonholes, two snaps at neckline, and two hook & eyes on collar. Lined in white synthetic. Designer's label at back neckline: "Modèle / Guy Laroche / Paris / Diffusé Par Maria Carine / Made in France" Handwritten style number label below designer label: "LR E6531 Rapp(?) 8" Retailer's(?) label at right side seam is cut: "i.m. / Made in France

Histoire de l’éthique médicale et infirmière : Contexte socioculturel et scientifique

Ce livre veut amener le lecteur à une réflexion sur les problèmes actuels de la bioéthique et de la déontologie médicales et infirmières. Il replace d’abord l’histoire de la pensée éthique dans son contexte politique et social, avant de l’inscrire dans celui des découvertes scientifiques et techniques. Passant en revue les auteurs et les pratiques de l’Antiquité, du Moyen Âge, des temps modernes et de l’époque contemporaine, il montre comment a évolué la conception que l’on se fait de la médecine et des soins infirmiers. D’une médecine cherchant d’abord à apprivoiser la nature, et de soins infirmiers centrés sur la philanthropie et la charité, on est passé à une pratique médicale et infirmière beaucoup plus interventionniste. Parallèlement à cette évolution se sont développées des préoccupations éthiques nouvelles, touchant des questions de plus en plus complexes, comme la contraception, l’avortement, l’euthanasie, l’eugénisme, la dissection ou la confidentialité des thérapeutiques. Les personnels médical et infirmier ont connu un développement important de leurs responsabilités sociales et morales. Sans renier le serment d’Hippocrate et, plus tard, le serment de Florence Nightingale, ils en sont venus à une redéfinition de leurs tâches plus respectueuse de la personnalité du patient et plus soucieuse du rôle de l’acte médical et infirmier