Decisional issues in antibiotic prescribing in French nursing homes: An ethnographic study

Background: Medication prescription is generally the responsibility of doctors. In nursing homes, the nursing staff is often the first to suspect an infection. Today, physicians are more confident with nursing assessment, relying primarily on nursing staff information. Very few studies have investigated the nurses’ influence on decision of medical prescription. This study investigates the role of nurses in antibiotic prescribing for the treatment of suspected infections in nursing home residents. Design and methods: An ethnographic study based on semi-structured interviews and participant observations was conducted. Sixteen nurses and five doctors working in five nursing homes in Paris, France participated between October 2015 and January 2016. Results: Given their proximity to elderly residents, registered nurses at the nursing homes occasionally assisted doctors in their medical diagnostic. However, nurses who are theoretically incompetent have met difficulties in their ability to participate in their decisions to prescribe antibiotics when managing residents’ infections.Conclusion: if proximity and nursing skills reinforce the relevance of the clinical judgment of nurses, the effective and collaborative communication between the nurse and the doctor may help the nurse to enhance their role in the antibiotic prescribing in nursing homes, which would enhance antimicrobial stewardship efficiency

Expression Map of the Human Exome in CD34+ Cells and Blood Cells: Increased Alternative Splicing in Cell Motility and Immune Response Genes

International audienceBACKGROUND: Hematopoietic cells are endowed with very specific biological functions, including cell motility and immune response. These specific functions are dramatically altered during hematopoietic cell differentiation, whereby undifferentiated hematopoietic stem and progenitor cells (HSPC) residing in bone marrow differentiate into platelets, red blood cells and immune cells that exit into the blood stream and eventually move into lymphoid organs or inflamed tissues. The contribution of alternative splicing (AS) to these functions has long been minimized due to incomplete knowledge on AS events in hematopoietic cells. PRINCIPAL FINDINGS: Using Human Exon ST 1.0 microarrays, the entire exome expression profile of immature CD34+ HSPC and mature whole blood cells was mapped, compared to a collection of solid tissues and made freely available as an online exome expression atlas (Amazonia Exon! : http://amazonia.transcriptome.eu/exon.php). At a whole transcript level, HSPC strongly expressed EREG and the pluripotency marker DPPA4. Using a differential splicing index scheme (dsi), a list of 849 transcripts differentially expressed between hematopoietic cells and solid tissues was computed, that included NEDD9 and CD74. Some of these genes also underwent alternative splicing events during hematopoietic differentiation, such as INPP4B, PTPLA or COMMD6, with varied contribution of CD3+ T cells, CD19+ B cells, CD14+ or CD15+ myelomonocytic populations. Strikingly, these genes were significantly enriched for genes involved in cell motility, cell adhesion, response to wounding and immune processes. CONCLUSION: The relevance and the precision provided by this exon expression map highlights the contribution of alternative splicing to key feature of blood cells differentiation and function

Théorie du marketing

ECON3E, ECONOMC, IRCNST5, IRCHIM5, IRMATE5A, IRMATE5B, IRPHYS5, IREMEC5A, IREMEC5N, IRELMC5T, IRELMC5G, IRELTC5A, IRELTC5B, IRELTE5A, IRELTE5B, IRINFO5 - GEST088info:eu-repo/semantics/published

L'influence de la double couche électrochimique sur la réduction de quelques anions oxygénés

Doctorat en Sciencesinfo:eu-repo/semantics/nonPublishe

Interaction of caffeine with the DNA of Chinese hamster cells

Incubation of Chinese hamster cells with labelled caffeine leads to transfer of radioactivity to DNA. This association occurs during the S phase of the cell cycle and involves parental as well as newly synthesised strands. The replacement of thymidine by BrdUrd prevents the incorporation radio-activity from caffeine into the DNA strands containing BrdUrd. Thymine is the only base which becomes labelled and data suggesting the participation of methyl groups of caffeine in the biosynthesis of thymine are presented. Ultraviolet irradiation increases the incorporation of radioactivity from caffeine to DNA. © 1977.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Chemical orientation of Rhizophagus grandis towards mates and towards prey: Dendroctonus micans

info:eu-repo/semantics/publishe

Utilisation des cellules médullaires pour améliorer la fonction cardiaque : étude dans un modèle de cardiopathie murine

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

Triathlon… super athletes and preventive sport?

peer reviewe

Chemical communication between the larvae of Dendroctonus micans KUG (Coleoptera :scolytidae)

info:eu-repo/semantics/publishe

Evaluation de l'évitabilité des infections en établissements d'hébergement pour personnes âgées dépendantes (comparaison de deux méthodes d'expertise de cas)

Les infections représentent un problème majeur dans les institutions gériatriques. L évaluation de l évitabilité de l événement infectieux est une étape clé pour orienter les efforts de prévention nécessaires à la maîtrise de ce problème. L objectif de cette étude a été de comparer à une méthode classique, une méthode originale d évaluation de l évitabilité des infections en Établissements d Hébergement pour Personnes Agées Dépendantes (EHPAD) basée sur la méthode Delphi, et de déterminer laquelle de ces deux méthodes utiliser dans le cadre d un programme de recherche sur l évitabilité du risque infectieux en EHPAD. L étude a consisté à recueillir, de façon prospective, 10 cas cliniques d infections en EHPAD, puis à en faire évaluer l évitabilité simultanément par deux groupes d experts. Un groupe a utilisé une méthode classique d expertise sur dossiers, l autre une méthode basée sur la méthode Delphi. Les résultats obtenus par la méthode Delphi ont été comparés qualitativement à ceux fournis par la méthode classique. Le taux de concordance entre les deux méthodes a été de 70%. Les deux méthodes ont retrouvé un taux d évitabilité de 20%. Cette étude nous montre que la méthode Delphi présente une concordance satisfaisante avec la méthode classique pour évaluer l évitabilité des infections en EHPAD par expertise de cas. Toutefois, en l absence de méthode de référence établie dans la littérature, nous ne pouvons pas conclure à sa validité, les deux méthodes présentant des limites. Nous proposons donc d utiliser une association des deux méthodes dans la poursuite du programme d étude de l évitabilité des infections en EHPAD.PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF