The waiting room: vector for health education? the general practitioner’s point of view

BACKGROUND: General practitioners (GPs) play a central role in disseminating information and most health policies are tending to develop this pivotal role of GPs in dissemination of health-related information to the public. The objective of this study was to evaluate use of the waiting room by GPs as a vector for health promotion. RESULTS: A cross-sectional study was conducted on a representative sample of GPs using semi-structured, face-to-face interviews. A structured grid was used to describe the documents. Quantitative and qualitative analysis was performed. Sixty GPs participated in the study. They stated that a waiting room had to be pleasant, but agreed that it was a useful vector for providing health information. The GPs stated that they distributed documents designed to improve patient care by encouraging screening, providing health education information and addressing delicate subjects more easily. However, some physicians believed that this information can sometimes make patients more anxious. A large number of documents were often available, covering a variety of topics. CONCLUSION: General practitioners intentionally use their waiting rooms to disseminate a broad range of health-related information, but without developing a clearly defined strategy. It would be interesting to correlate the topics addressed by waiting room documents with prevention practices introduced during the visit

Risk factors for child abuse: levels of knowledge and difficulties in family medicine. A mixed method study

Additional file 2. Risk factors for child abuse reported in the literature

Kubernetes et l'informatique en périphérie?

Cloud Computing infrastructures have highlighted the importance of container orchestration software to manage the life cycle of distributed applications. With the advent of Edge Computing era, DevOps expect to find features that made the success of containerized applicationsin the cloud, also at the edge. However, orchestration systems have not been designed to deal withresources geo-distribution aspects such as latency, intermittent networks, locality-awareness, etc. In other words, it is unclear whether they could be directly used on top of such massively distributed infrastructures or whether they must be revised. In this paper, we provide reflections regarding Kubernetes, the well-known container orchestration platform. More precisely, we provide two contributions. First, we discuss results we obtained during an experimental campaign we made to analyze the impact of WAN links on the vanilla Kubernetes. Second, we analyze ongoing initiatives that propose to revise part of the Kubernetes design to better address geo-distribution aspects.Les infrastructures de Cloud Computing ont mis en évidence les technologies de type conteneur et notamment des logiciels d’orchestration qui facilitent grandement la gestion du cycle de vie des applications distribuées. Avec l’avènement de l’informatique en périphérie (fog/edge computing), il est fortement envisageable que les ingénieurs DevOps attendent de trouver ces memes fonctionnalités dans ces nouvelles infrastructures. Cependant, les systèmes d’orchestration disponibles n’ont pas été conçus pour traiter les aspects de géo-distribution des ressources tels que la latence, les réseaux intermittents, la localité, etc. En d’autres termes, il n’est pas certain qu’ils puissent être utilisés directement sur des infrastructures massivement distribuées au travers plusieurs sites géo-graphiques. Dans cet article, nous présentons une étude préliminaire autour det Kubernetes, le standard open-source de-facto d’orchestration. Plus précisément, nous fournissons deux contributions. Tout d’abord, nous discutons plusieurs résultats obtenus lors d’une campagne expérimentale que nous avons menée pour analyser l’impact des liens WAN sur le code de Kubernetes natif. Deuxièmement, nous analysons les initiatives en cours qui revisitent la solution vanilla afin de mieux aborder les aspects de géo-distribution. Si ces approches pourraient être appropriées pour certains cas d’utilisation, elles sont malheureusement incomplètes pour d’autres et il convient donc de proposer de nouvelles approches

Kubernetes et l'informatique en périphérie?

Cloud Computing infrastructures have highlighted the importance of container orchestration software to manage the life cycle of distributed applications. With the advent of Edge Computing era, DevOps expect to find features that made the success of containerized applicationsin the cloud, also at the edge. However, orchestration systems have not been designed to deal withresources geo-distribution aspects such as latency, intermittent networks, locality-awareness, etc. In other words, it is unclear whether they could be directly used on top of such massively distributed infrastructures or whether they must be revised. In this paper, we provide reflections regarding Kubernetes, the well-known container orchestration platform. More precisely, we provide two contributions. First, we discuss results we obtained during an experimental campaign we made to analyze the impact of WAN links on the vanilla Kubernetes. Second, we analyze ongoing initiatives that propose to revise part of the Kubernetes design to better address geo-distribution aspects.Les infrastructures de Cloud Computing ont mis en évidence les technologies de type conteneur et notamment des logiciels d’orchestration qui facilitent grandement la gestion du cycle de vie des applications distribuées. Avec l’avènement de l’informatique en périphérie (fog/edge computing), il est fortement envisageable que les ingénieurs DevOps attendent de trouver ces memes fonctionnalités dans ces nouvelles infrastructures. Cependant, les systèmes d’orchestration disponibles n’ont pas été conçus pour traiter les aspects de géo-distribution des ressources tels que la latence, les réseaux intermittents, la localité, etc. En d’autres termes, il n’est pas certain qu’ils puissent être utilisés directement sur des infrastructures massivement distribuées au travers plusieurs sites géo-graphiques. Dans cet article, nous présentons une étude préliminaire autour det Kubernetes, le standard open-source de-facto d’orchestration. Plus précisément, nous fournissons deux contributions. Tout d’abord, nous discutons plusieurs résultats obtenus lors d’une campagne expérimentale que nous avons menée pour analyser l’impact des liens WAN sur le code de Kubernetes natif. Deuxièmement, nous analysons les initiatives en cours qui revisitent la solution vanilla afin de mieux aborder les aspects de géo-distribution. Si ces approches pourraient être appropriées pour certains cas d’utilisation, elles sont malheureusement incomplètes pour d’autres et il convient donc de proposer de nouvelles approches

[The person of trust, a new tool in the physician-patient relationship.]

THE NOTION OF A PERSON OF TRUST: Introduced by the law dated March 4th 2002, the person of trust is there to accompany the patient in all his/her measures of care; this person is also conceived as an helper in medical decisions or when the patient participates in biomedical research protocols. DESIGNATION MODALITIES: Any adult, unprotected patient can designate a person of trust, whose intervention is not only limited to hospitalisation (the nursing staff are obliged to propose such a person), but can also intervene during care at home or at the doctor's. The designation is made in writing and can be revoked at any time. The person of trust can be a relative, a friend or even the treating physician. A SPECIFIC ROLE: The person of trust can be of help in medical measures in routine medicine when the patients needs to be accompanied, and in the case of diagnosis or serious prognosis, and when the patient is incapable of expressing him/herself

Aggregate VM: Why Reduce or Evict VM’s Resources When You Can Borrow Them From Other Nodes?

Hardware resource fragmentation is a common issue in data centers. Traditional solutions based on migration or overcommitment are unacceptably slow, and modern commercial or research solutions like Spot VM may reduce or evict VM’s resources anytime. We propose an alternative solution that does not suffer from these drawbacks, the Aggregate VM. We introduce a new distributed hypervisor design, the resource-borrowing hypervisor, which creates Aggregate VMs: distributed VMs that temporarily aggregate fragmented resources belonging to different host machines, which require mobility of virtual CPUs, memory and IO devices. We implement a prototype, FragVisor, which runs guest software transparently. We also propose minimal modifications to the guest OS that can enable significant performance gains. We evaluate FragVisor over a set of microbenchmarks and IaaS-style real applications. Although Aggregate VMs are not a perfect fit for every type of applications, some workloads enjoy significant speedups compared to overcommitted scenarios (up to 3.9x with 4 distributed vCPUs). We further demonstrate that FragVisor is faster than a state-of-the-art competitor, GiantVM (up to 2.5x)

Medico-legal reasoning in disability assessment: A focus group and validation study

<p>Abstract</p> <p>Background</p> <p>Decisions on disability pensions are based, among others, on medical reports. The way these medical assessments are performed is largely unclear. The aim of the study was to determine which grounds are used by social insurance physicians (SIPs) in these assessments and to determine if the identification of these grounds can help improve the quality of assessments in social insurance practice. The article describes a focus group study and a questionnaire study with SIPs in four different countries.</p> <p>Method</p> <p>Using focus group discussions of SIPs discussing the same case in Belgium, the Netherlands, Norway and Slovenia (N = 29) we determined the arguments and underlying grounds as used by the SIP's. We used a questionnaire study among other SIPs (N = 60) in the same countries to establish a first validation of these grounds.</p> <p>Results</p> <p>Grounds in the focus groups were comparable between the countries studied. The grounds were also recognized by SIPs who had not participated in the focus groups. SIPs agreed most on grounds with regard to the claimant's health condition, and about the claimant's duty to explore rehabilitation and work resumption, but less on accepting permanent incapacity when all options for treatment were exhausted.</p> <p>Conclusion</p> <p>Grounds that SIPs use refer to a limited group of key elements of disability evaluation. SIPs interpret disability in social insurance according to the handicapped role and strive at making their evaluation fair trials. ICF is relevant with regard to the health condition and to the process of evaluation. Identification of grounds is a valuable instrument for controlling the quality of disability evaluation. The grounds also appear to be internationally comparable which may enhance scientific study in this area.</p