L'impact de la privatisation du système de santé sur les droits des usagers

Résumé : En 2005, la Cour suprême du Canada invalide l'article 11 de la Loi sur l'assurance hospitalisation et l'article 15 de la Loi sur l'assurance-maladie qui interdisaient, sous peine de sanctions, l'offre d'une police d'assurance couvrant les services médicaux et hospitaliers assurés par l'État. En réaction à cette décision, le gouvernement du Québec établit les fondations d'un système de santé privé en créant les Centres médicaux spécialisés. Les actes médicaux pouvant êtres posés dans ces Centres médicaux spécialisés passent de trois à cinquante-huit et ce, en seulement deux ans. Une telle augmentation de l'offre de services de soins médicaux privés nous permet d'assister à l'émergence d'une nouvelle catégorie de patients, les usagers du réseau privé. Ces usagers sont toutefois soumis à la liberté contractuelle des parties et, conséquemment, ne bénéficient pas des mêmes droits et garanties impartis aux usagers du système de santé public. Afin que le choix du gouvernement du Québec d'étendre l'offre de services de soins médicaux privés ne portent pas atteinte aux droits des usagers, il serait opportun d'adopter une Charte des droits des usagers dont pourrait bénéficier tous les patients et ce, peu importe qu'ils soient traités dans le système de santé public ou le système de santé privé.||Abstract: In 2005, the Supreme Court of Canada invalidate article 11 of Loi sur l'assurance hospitalisation and article 15 of Loi sur l'assurance-maladie which were prohibiting an insurance company to offer an insurance policy that was covering the costs of medical and hospital services already covered by the public health system. In reaction to this decision, the Quebec's govemment built the foundations of a private health system by creating the "Centres médicaux spécialisés." The treatments that can be offer in these clinics went from three to fifty-eight within a delay of only two years. Such a raise of the offer of private health services created a new category of patients, the users of the private health system. These users are submitted to contractual freedom of the parties and, therefore, do not have the same rights that are given to the users of the public health system. In order to prevent the government choice of offering private heath services from affecting the users' rights, it is necessary to adopt a Charter of patients' rights. This Charter of patients' rights would guarantee the same rights to every single user, no matter in which health system he is being treated

Synthesis of Functionalized Few-Layer Graphene Through Fast Electrochemical Expansion of Graphite

International audienc

Lung progenitors from lambs can differentiate into specialized alveolar or bronchiolar epithelial cells.

26International audienceBACKGROUND: Airways progenitors may be involved in embryogenesis and lung repair. The characterization of these important populations may enable development of new therapeutics to treat acute or chronic lung disease. In this study, we aimed to establish the presence of bronchioloalveolar progenitors in ovine lungs and to characterize their potential to differentiate into specialized cells. RESULTS: Lung cells were studied using immunohistochemistry on frozen sections of the lung. Immunocytochemistry and flow cytometry were conducted on ex-vivo derived pulmonary cells. The bronchioloalveolar progenitors were identified by their co-expression of CCSP, SP-C and CD34. A minor population of CD34pos/SP-Cpos/CCSPpos cells (0.33% +/- 0.31) was present ex vivo in cell suspensions from dissociated lungs. Using CD34 magnetic positive-cell sorting, undifferentiated SP-Cpos/CCSPpos cells were purified (>80%) and maintained in culture. Using synthetic media and various extracellular matrices, SP-Cpos/CCSPpos cells differentiated into either club cells (formerly named Clara cells) or alveolar epithelial type-II cells. Furthermore, these ex vivo and in vitro derived bronchioloalveolar progenitors expressed NANOG, OCT4 and BMI1, specifically described in progenitors or stem cells, and during lung development. CONCLUSIONS: We report for the first time in a large animal the existence of bronchioloalveolar progenitors with dual differentiation potential and the expression of specialized genes. These newly described cell population in sheep could be implicated in regeneration of the lung following lesions or in development of diseases such as cancers

Tyrosine-based rivastigmine-loaded organogels in the treatmant of Alzheimer's disease

Faculté de PharmacieOrganogels can be prepared by immobilizing an organic phase into a threedimensional network coming from the self-assembly of a low molecular weight gelator molecule. In this work, an injectable subcutaneous organogel system based on safflower oil and a modified-tyrosine organogelator was evaluated in vivo for the delivery of rivastigmine, an acetylcholinesterase (AChE) inhibitor used in the treatment of Alzheimer’s disease. Different implant formulations were injected and the plasmatic drug concentration was assayed for up to 35 days. In parallel, the inhibition of AChE in different brain sections and the biocompatibility of the implants were monitored. The pharmacokinetic profiles were found to be influenced by the gel composition, injected dose and volume of the implant. The sustained delivery of rivastigmine was accompanied by a significant prolonged inhibition of AChE in the hippocampus, a brain structure involved in memory. The implant induced only a minimal to mild chronic inflammation and fibrosis, which was comparable to poly(D,L-lactide-co-glycolide) in situ-forming implants. These findings suggest that tyrosine-based organogels could represent an alternative approach to current formulations for the sustained delivery of cholinesterase inhibitors.IRS

Adaptive optics telemetry standard: Design and specification of a novel data exchange format

Context. The amount of adaptive optics (AO) telemetry generated by visible/near-infrared ground-based observatories is ever greater, leading to a growing need for a standardised data exchange format to support performance analysis, AO research, and development activities that involve large-scale telemetry mining, processing, and curation.Aims. This paper introduces the Adaptive Optics Telemetry (AOT) data exchange format as a standard for sharing AO telemetry from visible/infrared ground-based observatories. AOT is based on the flexible image transport system (FITS) and aims to provide unambiguous and consistent data access across various systems and configurations, including natural and single- or multiple-laser guide-star AO systems.Methods. We designed AOT with a focus on two key use cases: atmospheric turbulence parameter estimation and point-spread function reconstruction. We prototyped and tested the design using existing AO telemetry datasets from multiple systems: single conjugate with natural and laser guide stars, tomographic systems with multi-channel wavefront sensors, and single- and multi-wavefront correctors in systems featuring either a Shack-Hartmann or Pyramid as the main wavefront sensor.Results. The AOT file structure has been thoroughly defined, with specified data fields, descriptions, data types, units, and expected dimensions. To support this format, we have developed a Python package that enables the data conversion, reading, writing, and exploration of AOT files; it has been made publicly available and is compatible with a general-purpose Python package manager. We have demonstrated the flexibility of the AOT format by packaging data from five different instruments, installed on different telescopes

Experimental observation of strong light-matter coupling in ZnO microcavities: influence of large excitonic absorption

We present experimental observation of the strong light-matter coupling regime in ZnO bulk microcavities grown on silicon. Angle resolved reflectivity measurements, corroborated by transfer-matrix simulations, show that Rabi splittings in the order of 70 meV are achieved even for low finesse cavities. The impact of the large excitonic absorption, which enables a ZnO bulk-like behavior to be observed even in the strong coupling regime, is illustrated both experimentally and theoretically by considering cavities with increasing thickness

Relaxation and emission of Bragg-mode and cavity-mode polaritons in a ZnO microcavity at room temperature

The strong coupling regime in a ZnO microcavity is investigated through room temperature photoluminescence and reflectivity experiments. The simultaneous strong coupling of excitons to the cavity mode and the first Bragg mode is demonstrated at room temperature. The polariton relaxation is followed as a function of the excitation density. A relaxation bottleneck is evidenced in the Bragg-mode polariton branch. It is partly broken under strong excitation density, so that the emission from this branch dominates the one from cavity-mode polaritons

Five-year outcomes of the First Distal Uninstrumented Vertebra after posterior fusion for Adolescent Idiopathic Scoliosis Lenke 1 or 2

BACKGROUND: Tilt of the First Distal Uninstrumented Vertebra (FDUV) reflects changes in the main curve and compensatory lumbar curve after posterior fusion to treat thoracic Adolescent Idiopathic Scoliosis (AIS). HYPOTHESIS: FDUV tilt 5 years or more post-fusion depends chiefly on reduction of the main curve and on other factors such as selection of the last instrumented vertebra. MATERIAL AND METHOD: A multicenter retrospective cohort of 182 patients with Lenke 1 or 2 AIS treated with posterior instrumentation and followed up for a mean of 8 years and a minimum of 5 years was studied. The patients were divided into two groups based on whether tilt of the upper endplate of the FDUV was ≤5° or >5°at last follow-up. Variables associated with tilt were identified by multiple logistic regression. RESULTS: Six variables were significantly associated with FDUVtilt: percentage of correction at last follow-up, correction loss, lumbar modifier B, number of instrumented vertebrae, inclusion within the instrumentation of the distal neutral vertebra, and inclusion within the instrumentation of the lowest vertebra intersected by the central sacral vertical line. DISCUSSION AND CONCLUSION: The main variables associated with FDUVtilt ≤5° were a final correction percentage ≥60% and absence of correction loss between the postoperative period and last follow-up. Given the stable reduction provided by contemporary instrumentations, we recommend selective thoracic fusion of Lenke 1 or 2 AIS with lumbar modifiers A, B, and C. The lowest instrumented vertebra should be either the neutral vertebra or the vertebra intersected by the central sacral vertical line if it is distal to the neutral vertebra. LEVEL OF EVIDENCE IV: Retrospective multicenter study