Randomized Controlled Trial of Parent Therapeutic Education on Antibiotics to Improve Parent Satisfaction and Attitudes in a Pediatric Emergency Department

Objective: To evaluate therapeutic education delivered in a pediatric emergency department to improve parents’ satisfaction and attitudes about judicious antibiotic use. Methods: In an emergency department of a tertiary pediatric hospital, children aged 1 month to 6 years and discharged with an oral antibiotic prescription for an acute respiratory or urinary tract infection were randomized to a patient therapeutic education on antibiotic use (intervention group) or fever control (control group) delivered to the parents (in the presence of the children) by a pharmacist trained in therapeutic education. Education consisted in a 30-minute face-to-face session with four components: educational diagnosis, educational contract, education, and evaluation. The main outcome measure was parent satisfaction about information on antibiotics received at the hospital, as assessed by a telephone interview on day 14. The secondary outcome was attitudes about antibiotic use evaluated on day 14 and at month 6. Results: Of the 300 randomized children, 150 per arm, 259 were evaluated on day 14. Parent satisfaction with information on antibiotics was higher in the intervention group (125/129, 96.9%, versus 108/130, 83.0%; P=0.002, exact Fisher test). Intervention Group parents had higher proportions of correct answers on day 14 to questions on attitudes about judicious antibiotic use than did control-group parents (P=0.017, Mann-Whitney U test). Conclusion: Therapeutic education delivered by a clinical pharmacist in the pediatric emergency department holds promise for improving the use of antibiotics prescribed to pediatric outpatients. Trial Registration ClinicalTrials.gov NCT00948779 http://clinicaltrials.gov/show/NCT0094877

Pooled analysis of iron-related genes in Parkinson's disease: Association with transferrin

Pathologic features of Parkinson's disease (PD) include death of dopaminergic neurons in the substantia nigra, presence of α-synuclein containing Lewy bodies, and iron accumulation in PD-related brain regions. The observed iron accumulation may be contributing to PD etiology but it also may be a byproduct of cell death or cellular dysfunction. To elucidate the possible role of iron accumulation in PD, we investigated genetic variation in 16 genes related to iron homeostasis in three case-control studies from the United States, Australia, and France. After screening 90 haplotype tagging single nucleotide polymorphisms (SNPs) within the genes of interest in the US study population, we investigated the five most promising gene regions in two additional independent case-control studies. For the pooled data set (1289 cases, 1391 controls) we observed a protective association (OR. = 0.83, 95% CI: 0.71-0.96) between PD and a haplotype composed of the A allele at rs1880669 and the T allele at rs1049296 in transferrin (TF; GeneID: 7018). Additionally, we observed a suggestive protective association (OR. = 0.87, 95% CI: 0.74-1.02) between PD and a haplotype composed of the G allele at rs10247962 and the A allele at rs4434553 in transferrin receptor 2 (TFR2; GeneID: 7036). We observed no associations in our pooled sample for haplotypes in SLC40A1, CYB561, or HFE. Taken together with previous findings in model systems, our results suggest that TF or a TF- TFR2 complex may have a role in the etiology of PD, possibly through iron misregulation or mitochondrial dysfunction within dopaminergic neurons

A Novel Role for the SMG-1 Kinase in Lifespan and Oxidative Stress Resistance in Caenorhabditis elegans

The PTEN tumour suppressor encodes a phosphatase, and its daf-18 orthologue in Caenorhabditis elegans negatively regulates the insulin/IGF-1 DAF-2 receptor pathway that influences lifespan in worms and other species. In order to identify new DAF-18 regulated pathways involved in aging, we initiated a candidate RNAi feeding screen for clones that lengthen lifespan. Here, we report that smg-1 inactivation increases average lifespan in a daf-18 dependent manner. Genetic analysis is consistent with SMG-1 acting at least in part in parallel to the canonical DAF-2 receptor pathway, but converging on the transcription factor DAF-16/FOXO. SMG-1 is a serine-threonine kinase which plays a conserved role in nonsense-mediated mRNA decay (NMD) in worms and mammals. In addition, human SMG-1 has also been implicated in the p53-mediated response to genotoxic stress. The effect of smg-1 inactivation on lifespan appears to be unrelated to its NMD function, but requires the p53 tumour suppressor orthologue cep-1. Furthermore, smg-1 inactivation confers a resistance to oxidative stress in a daf-18-, daf-16- and cep-1-dependent manner. We propose that the role of SMG-1 in lifespan regulation is at least partly dependent on its function in oxidative stress resistance. Taken together, our results unveil a novel role for SMG-1 in lifespan regulation

Restaurer et utiliser les décors historiques du théâtre de Châtellerault : l’impossible conciliation ?

Les décors historiques du théâtre de Châtellerault, classés Monuments historiques, ont fait l’objet d’une intervention de conservation-restauration concomitante à la réhabilitation de l’édifice. Une étude préalable a tout d’abord permis de les dénombrer, de les classifier, d’en répertorier les dégradations, en même temps que des mesures élémentaires de préservation (dépoussiérage, étiquetage, stabilisation sommaire, conditionnement des toiles libres) étaient entreprises. Dans un second temps, après concertation entre la maîtrise d’ouvrage et la direction régionale des Affaires culturelles de Poitou-Charentes, un cahier des charges a été établi, prévoyant des mesures de conservation curative pour la totalité des éléments, et une intervention complète de conservation-restauration pour deux « tableaux » : la Forêt et un Intérieur bourgeois. En parallèle, un prototype de grilles de rangement a été élaboré avec le cabinet d’architecture chargé de la réhabilitation du théâtre, sur le modèle des grilles à tableaux, et installé dans l’ancien magasin aux décors. L’intérêt patrimonial de ces biens n’a de sens que s’ils sont mis en relation avec leur lieu d’origine et les équipements scéniques qui permettent de les faire fonctionner. Aussi a-t-il été décidé de continuer à les utiliser dans le cadre de « visites patrimoniales ». Les machinistes des théâtres de Châtellerault ont reçu une formation spécifique à cet effet, à laquelle a participé l’équipe du théâtre de la Reine au petit Trianon

De la sensibilisation à la pratique de l'éducation thérapeutique (application aux professionnels de la pharmacie par l'utilisation d'un test multiparamétrique d'évaluation de l'observance dans l'infection par le virus de l'immunodéficience humaine)

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Vers une pédagogie de l'uniformisation des dispensations de traitements antiretroviraux

PARIS-BIUP (751062107) / SudocSudocFranceF

Double circuit de dispensation des antirétroviraux (quel choix entre officine et hôpital)

PARIS-BIUP (751062107) / SudocSudocFranceF