Search

The World Health Organization's public health emergency declaration on mpox reveals an alarming situation. A new strain of the MPXV type I virus is spreading in Africa, affecting various populations and posing challenges for diagnosis and treatment. Efforts are being made to develop specific tests, antivirals, and vaccines, but questions remain about the effectiveness of existing treatments. [Extracted from the article]

Copyright of Revista Digital de Derecho Administrativo is the property of Universidad Externado de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An acute severe flare of ulcerative colitis is observed in approximately one patient out of four with a global mortality rate of 1%. Goal of the management of this medico-surgical emergency is based on patient profile, aiming to save life of the most aged and fragile patients and to avoid salvage colectomy in the others. Medical management is standardized, based on short treatment courses starting with intravenous steroids followed by cyclosporine or infliximab in case of failure. Surgery should be discussed at each step. Postoperative morbi-mortality is closely related to the duration of the preoperative management. Drug positioning of new molecules such as védolizumab, ustekinumab and tofacitinib is not well established in acute severe ulcerative colitis. [ABSTRACT FROM AUTHOR]

Hereditary metabolic diseases (IMDs) are a group of more than 1 400 rares genetic diseases resulting from a genetic deficiency of an enzyme or transporter involved in metabolism. They most often begin in childhood. If left untreated, most of them result in significant morbidity and mortality. With advances in management, 90% of children survivent into adulthood. Within IMDs, the diet and energy metabolism disease groups require very specific dietary management and emergency management due to the risk of acute decompensation during fevers or other stresses. It is therefore essential that children and adolescents, accompanied by their families, follow an appropriate transition programme. In 2017, the G2m network published the first recommendations on transition, particularly for diet-dependent diseases. A transition booklet for young patients was developed based on this publication. Since 2019, the working group including several patient organisations has organised thematic days and meetings on transition and created a child-adult transition passport booklet. Lysosomal diseases have been the subject of recommendations based on a survey of patients, families and doctors with the aim of crea-aborting a specific transition programme called "TENALYS" (Transition ENfant Adulte dans les maladies LYSosomales). The members of the G2m network are involved in the d evelopment of other transition programmes: transition in Pompe disease as well as transversal transition programmes for rare diseases ("La Suite" at the Necker hospital and "JUMP" at the Pitié-Salpêtrière hospital). [ABSTRACT FROM AUTHOR]

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Max-Planck-Institut für Gesellschaftsforschung Discussion Papers is the property of Max Planck Institute for the Study of Societies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Oligoanalgesia is the inappropriate use of analgesics. It is a problem that is still prevalent in emergency departments. The main objective of this study was to conduct an inventory of pain management in the emergency department of the Al Mansour prefectural hospital in Casablanca and to determine the factors associated with oligoanalgesia. Material and methods: This is a cross-sectional study, carried out during the month of April 2019, through a heteroquestionnaire administered and completed by emergency room prescribers during this period. They informed their evaluation of pain via the numerical scale of patients who declared themselves to be in pain and completed their sociodemographic and clinical data as well as their management. Results: Of the 475 patients admitted to the emergency department, 64.2% presented with pain. The average age of these patients was 36 (± 17) years. Trauma was the most frequent cause of pain (55.7%). Eighty percent of the patients received analgesics. More than half of the patients (53.5%) were not relieved at discharge from the emergency department. The factors associated with this oligoanalgesia were: male gender (ORa = 1.98 [1.20-3.27]), the absence of pre-hospital analgesic medication (ORa = 3.31 [1.81-6.04]) and the absence of non-drug analgesia in the emergency room (ORa = 6.68 [2.45-15.22]). The abdominal-pelvic location of pain was a protective factor (ORa = 0.28 [0.08-0.93]). Conclusion: We confirm in this Moroccan study the public health problem represented by oligoanalgesia. [ABSTRACT FROM AUTHOR]

Résumé: La prise en charge des symptômes psycho-comportementaux liés à la démence (SPCD) est complexe et peut nécessiter un recours à un Service d'accueil et d'urgences (SAU). Cette étude a pour objectif principal d'évaluer, au niveau national, les pratiques des médecins urgentistes dans la prise en charge des SPCD, leurs connaissances et leurs compétences dans ce domaine. Cette étude observationnelle et quantitative a été réalisée entre mars 2021 et juillet 2021, au moyen d'un questionnaire en ligne auprès de l'ensemble des médecins travaillant dans un SAU en France. Parmi les 188 urgentistes ayant répondu, 72,9 % se disent confrontés souvent ou très souvent à des patients présentant des SPCD, et 82,5 % déclarent avoir peu ou aucune connaissance concernant les SPCD. La prise en charge choisie en première intention est non médicamenteuse pour 63,3 % des répondants. Quand elle est médicamenteuse, les benzodiazépines de demi-vie courte sont préférées. On note l'utilisation, non négligeable, de neuroleptiques de première et deuxième générations et d'antihistaminiques. Il semble exister une bonne connaissance, par les urgentistes, des filières dédiées aux SPCD, mais peu d'entre eux y ont recours. Cette étude encourage donc la formation des urgentistes à cette problématique et le développement des filières dédiées aux SPCD. The management of behavioral and psychological symptoms of dementia (BPSD) is complex and may fall back on an Emergency Department (ED). The main objective of this study is to review the practices of French emergency physicians for the management of BPSD, their knowledge and their skills in this domain. This observational and quantitative study was performed between March 2021 and July 2021, using an online questionnaire, among all doctors working in ED in France. Among the 188 respondents, 72.9% declared that they were often or very often confronted with patients with BPSD, and 82.5% declared that they had little or no knowledge of BPSD. The first-line treatment was non-pharmaceutical for 63.3% of the respondents. When medication was used, short half-life benzodiazepines were preferred. There was also a significant use of first- and second-generation neuroleptics and antihistamines. Emergency physicians seemed to have a good knowledge of the pathways dedicated to BPSD, but few resort to them. This study therefore promotes the formation of emergency physicians to BPSD and the development of dedicated departments. [ABSTRACT FROM AUTHOR]

Copyright of Synergies Monde Méditerranéen is the property of GERFLINT (Groupe d'Etudes et de Recherches pour le Francais Langue Internationale) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the continuous development and progress of China’s economy and society, the government also attaches more and more important to the enthusiasm and initiative of the public to participate in political life. As China is in a period of transition, various conflicts are highlighted, and the rapid development of Internet technology makes it easy to attract the large-scale attention of netizens and quickly form a strong public opinion field after the occurrence of public emergencies. Hence, how to effectively respond to and guide Internet public opinion on public emergencies has become one of the critical issues that governments at all levels need to address. This paper takes public emergencies as the research object and discusses their concepts and characteristics from the theoretical point of view; explains the current situation of the Internet public opinion on public emergencies in China and its causes; focuses on analyzing the problems and causes of the current emergency disposal of the Internet public opinion on public emergencies in China; and finally proposes specific measures to improve the construction of the emergency management system of the Internet public opinion on public emergencies in China.

High-risk societies are uncertain, ambiguous and unpredictable. Risk fluctuations are prone to the intertwining and overlapping of various accident hazards and safety risks. China is prone to the interweaving and overlapping of various accident hazards and safety risks, which leads to an increase in the number of factors affecting public safety as well [1]. Therefore, this paper will quantify specific ranking indicators in terms of frequency of hazards, degree of hazards and vulnerability to different hazards. The ranking is based on the quantified results in red, yellow and green and the hazard risk level is calculated according to the risk formula. This study will take the Chengdu-Chongqing region as an example and optimise the storage of materials in the emergency logistics base in order to maximise the precise and rapid supply of materials to the main demand points. The efficiency of emergency material deployment will be further improved and emergency materials will be well secured.

Résumé: L'expertise post-accidentelle mobilisée dans le cadre de l'incendie du site Lubrizol/NL Logistique se fonde sur un retour d'expérience d'accidents industriels construit depuis plus de 15 ans. L'Institut national de l'environnement industriel et des risques (Ineris) a pris une part active à l'évolution des pratiques dans ce domaine, notamment sur la base d'études sur des situations concrètes survenues dans l'hexagone. L'expérience acquise a montré la nécessité de renforcer la cohérence des dispositifs de gestion de l'urgence et de gestion à moyen et long termes. Au milieu des années 2000, la recherche des substances disséminées dans l'environnement ne démarrait que longtemps après un accident. Or, il est indispensable que la gestion à plus long terme et l'analyse de l'événement démarrent dès le déclenchement de l'accident, avec la réalisation de prélèvements conservatoires et la mise en œuvre d'une stratégie de prévention des risques pour la santé et l'environnement vis-à-vis des retombées, sans attendre la fin de la phase d'urgence de lutte contre un incendie et de mise en sécurité des populations. Deux difficultés ont été particulièrement mises en évidence : le besoin de caractériser des expositions qui peuvent être fugaces (air au passage d'un nuage, contamination des eaux superficielles) et le besoin de retracer l'impact d'un événement par rapport au « fond » de pollution existant. En effet, les polluants émis ne sont généralement peu spécifiques et déjà présents sur le territoire, qu'il s'agisse de produits de combustion partielle ou complète ou des produits originaux imbrûlés, même quand ceux-ci semblent spécifiques (phytosanitaires par exemple). Des réponses ont été proposées et reprises par les services de l'État dans la circulaire du 20 février 2012 relative à la gestion des impacts environnementaux et sanitaires d'événements d'origine technologique en situation post-accidentelle, qui évoque notamment la mise en œuvre d'une cellule post-accident, et qui est accompagnée d'un guide méthodologique. L'Ineris continue aujourd'hui à réfléchir à l'approfondissement de son expertise post-accidentelle, en cohérence avec ses compétences en matière d'urgence. The post-accident expert assessment implemented during the Lubrizol/NL Logistique fire is based on feedback from industrial accidents over the past 15 years. Ineris has developed practices in this field, based especially on studies of real-life French situations. Experience has shown the need to improve the consistency of emergency management and long-term risk management. In the mid-2000s, investigations into substances in the environment began long after an accident. However, the longer-term management and analysis of the event must begin immediately after the accident by collecting and preserving samples as a precautionary measure and implementing a risk prevention strategy for health and the environment with regard to atmospheric deposition, without waiting for the end of the emergency phase of fighting a fire and bringing people to safety. Two main challenges were highlighted: the need to characterize exposures that may be fleeting (smoke plume, surface water contamination) and the need to trace the impact of an event relative to the "background" existing pollution. Pollutants emitted are generally not specific and are already present in the area, whether they are partial or complete combustion products, or unburnt original products, even when these seem specific (phytosanitary for example). Responses were proposed and taken up by the authorities, in the decree of February 20, 2012 on the management of environmental and health impacts of events of technological origin in post-accident situations, which includes the implementation of a post-accident unit and is accompanied by a methodological guide. Today, Ineris continues to improve its post-accident expert assessments, in line with its emergency skills. [ABSTRACT FROM AUTHOR]

Résumé: En septembre 2019, un incendie a démarré dans le stockage de l'usine Lubrizol, spécialisée dans la fabrication d'additifs pour lubrifiant et située près de la ville de Rouen. Cet incendie a déclenché une crise importante en raison d'un panache visible de 22 km de long, qui a survolé la ville et induit des restrictions temporaires à plus de 100 km du sinistre. L'objectif de ce travail est de proposer une approche pragmatique de la gestion des incendies mettant en jeu de nombreux produits stockés à différents endroits, à différentes phases de leur cycle de vie, depuis le site du producteur jusqu'à l'utilisateur final en passant par les grands entrepôts de stockage. L'analyse proposée porte sur la gestion de crise, sur les demandes associées au développement d'un tel sinistre et aux données techniques disponibles pour y répondre. Elle expose les leçons tirées de l'incendie de l'usine Lubrizol pour l'amélioration de la gestion opérationnelle d'un tel sinistre, certes rare mais susceptible d'avoir des conséquences graves sur la santé et l'environnement à court, moyen et long termes. The Lubrizol/NL Logistique fire took place in the storage facility of the Lubrizol plant specialized in manufacturing lubricant additives close to the city of Rouen in September 2019. It triggered a significant crisis due to the 22 km-long visible fire plume that drifted over the town and induced temporary consequences over 100 km from the fire source. This paper focuses on a holistic analysis of major fire scenarios involving numerous products stored throughout their industrial life in warehouses or other storage premises, from manufacturer to end user. It covers the emergency crisis management and related demands and includes the available technical data. It also shows the lessons to be drawn from the Lubrizol case to improve operational anticipation of these rare but potentially highly impactful events, in terms of health, environmental, and sanitary issues, both in the short term from emission release to complete extinction and later, induced by post-exposure effects and all types of transfers to the environment. [ABSTRACT FROM AUTHOR]

The Tōhoku Pacific Coast earthquake on 11 March 2011 severely disrupted transport networks, suddenly jeopardising a large part of Japan, and prompting authorities to take fast action. Refugees and inhabitants of the affected areas were forced to adapt their transport needs. This unprecedented situation laid bare the need for a more resilient Japanese transportation infrastructure in order to significantly improve physical and social reconstruction capacity during an emergency situation. This paper analyses the damage and impact of the disaster on transport and its energy infrastructure, reviews the measures adopted, and assesses past and acquired resilience. [ABSTRACT FROM AUTHOR]

Disaster myths pose a great challenge in disaster risk management all over the world. These misconceptions mean barriers to disaster higher education as well. This research is designed to examine these beliefs among disaster management students at the National University of Public Service, Hungary, as well as in a control group compiled from students from three other Hungarian universities. Based on the methodology of research published by David Alexander, a questionnaire was edited with 19 false statements about disaster events. Respondents had to evaluate them on a Likert scale from 1 to 5, where 1 means "completely disagree" and 5 means "completely agree". Strong agreement was expressed for some of the misconceptions regarding disasters (e.g. unburied bodies constitute a serious health hazard), and to a lesser degree for others (e.g. disasters cannot be managed systematically). The results of the control group reached similar values to those of the test groups, however in some cases the former tend to be more skeptical about the statements. Although Hungarian students shared the same beliefs as US and Italian students, the Hungarians seem to be less critical of the statements. These disaster myths create a serious problem in disaster higher education and have a great impact on future disaster managers in the field. [ABSTRACT FROM AUTHOR]

Copyright of Épidémiologie et Santé Animale is the property of Association pour l'Etude de l'Epidemiologie des Maladies Animales (AEEMA) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To identify the determinants of the delay in the management of these emergencies and to evaluate its impact on the prognosis of the patients. Method Descriptive prospective study from November 15, 2018 to July 15, 2019 at Bethesda Hospital in Cotonou, Benin. Result The prevalence of non-traumatic abdominal surgical emergencies was 76.32%. These emergencies were dominated by acute appendicitis (61.84%) and acute peritonitis (27.63%). The mean age of the patients was 28 ± 15.43 years. The sex ratio was 0.77. Patients had a monthly income of? 100,000 FCFA (68.42%) and did not have health insurance (93.42%). The average time for surgical consultation was 6 days. In 76.32% of cases patients had consulted beyond the 72nd hour after the onset of signs. Before consulting in surgery, 89.43% of patients took a medication. The average time for surgical management was 10 hours. The delay of care was mainly related to the limited financial means of the patients, but also to the dysfunction of the host health facility. The postoperative morbidity was 22.37% and concerned more patients who consulted beyond the 72nd hour. The mortality was 5.26% and concerned the group of patients who consulted after the 72nd hour. The mean duration of hospitalization was 6.8 ± 4.04 days. The reasons for this delay in consultation were diagnostic wanderings (36.84%), the first use of self-medication (36.84%) and treatment with indigene (32.89%). The delay of care was mainly related to the limited financial means of the patients, but also to the dysfunction of the host health facility. Conclusion The prevalence of delayed management of non-traumatic abdominal surgical emergencies was high. Appropriate public health actions are needed to improve the quality of care. [ABSTRACT FROM AUTHOR]

26 Nisan 1986’da Çernobil nükleer enerji santralinde meydana gelen kaza sonucunda oluşan nükleer serpinti, aralarında Türkiye’nin de bulunduğu pek çok ülkeyi etkilemiştir. Sonuçları itibariyle çevresel problemlerin sınır aşan niteliğini gösteren bir örnek olan Çernobil kazası, ağırlıklı olarak insan sağlığı ve çevreyle ilgili problemlere yol açmıştır. Ekonomik ve dış politikaya dair yansımalarıyla birlikte uluslararası bir sorun halini alan bu kaza, kısa sürede siyasi bir krize dönüşmüştür. Kazanın öğrenilmesinden sonra etki altında kalan ülkelerin birbirinden farklı acil durum ve kriz yönetimi süreçleri söz konusu olmuştur. Bu makale, söz konusu krizde Türkiye'nin tutumunu, acil durum ve kriz yönetim süreçlerini ve kazanın Türk dış politikasına yansımalarını analiz etmektedir.

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Objectif: Depuis le début des années 2010, le President's Emergency Plan for AIDS Relief (Pepfar) et le Fonds mondial de lutte contre le VIH/sida, la tuberculose et le paludisme ont accentué leurs stratégies de gestion axée sur les résultats (GAR). Les conditions de décaissements sont de plus en plus exigeantes pour les organisations non gouvernementales (ONG) financées (atteinte d'objectifs chiffrés, réalisation de compte rendu et de contrôles des activités fréquents) et leur rémunération dépend des résultats atteints. Cet article vise à analyser les effets de ce renforcement des politiques fondées sur le new public management sur la mise en œuvre locale des activités, à travers l'exemple du dépistage du VIH à base communautaire. Méthodes: Dans trois districts sanitaires de la Côte d'Ivoire, nous avons réalisé, en 2015 et 2016, une cartographie des acteurs impliqués dans le dépistage communautaire et des entretiens semi-directifs auprès de membres des ONG dites « communautaires » (n = 18). Résultats: Le financement des organisations en charge du dépistage au niveau local transite par des organisations intermédiaires selon un système pyramidal complexe. Combiné à la lourdeur des comptes rendus d'activité et de la validation des données, cela génère des retards dans le décaissement des fonds et réduit fortement le temps effectif de mise en œuvre des activités, soit moins de la moitié du temps prévu à cet effet. Conclusion: Cette managérialisation – aussi bien du Pepfar que du Fonds mondial – produit ainsi des effets contre-productifs contre lesquels elle était censée lutter. Objective: Since the early 2010s, the President's Emergency Plan for AIDS Relief (Pepfar) and the Global Fund to Fight AIDS, Tuberculosis and Malaria have stiffened their result-based management strategies. Disbursement conditions are increasingly demanding for funded NGOs (achievement of quantified objectives, frequent reporting, and monitoring of activities), and their remuneration depends on the results achieved. This article aims to analyze the effects of this strengthening of policies based on New Public Management on local implementation of activities, based on the example of community-based HIV testing. Methods: In three health districts of Côte d'Ivoire, in 2015 and 2016, we mapped the actors involved in community-based HIV testing and conducted semi-directive interviews with members of the community-based NGOs (n = 18). Results: The funding of local HIV testing organizations is channeled through intermediary organizations according to a complex pyramid system. This, combined with cumbersome activity reporting and data validation, results in delays in the disbursement of funds and significantly reduces the actual time available to implement activities, i.e., to less than half the time planned for this purpose. Conclusion: This managerialization –of both Pepfar and the Global Fund – produces the counterproductive effects against which it was supposed to fight. [ABSTRACT FROM AUTHOR]

The article informs that bankruptcies and social plans expected in many sectors with correctness and courage of political choices and economic factors of the disaster. Topics include incredible concerns misuse of the drug and its consequences; and the domain of health, remember that the emergency plan for the public hospital of the hospital debt.

This paper aims to show the consequences of a lack of standardization in translation of titles of art works. The author examines Polish title translations of two Vincent van Gogh's paintings in order to verify how title translation strategies have been applied. The paper concludes that there are no coherent translation strategies and that Polish versions result in indirect translation. [ABSTRACT FROM AUTHOR]

Burns to the upper limb caused by contact with a hot press are associated with a compression trauma of variable severity. These burns are rare, and they mostly occur in the context of accidents at work due to mishandling. They can cause severe multi-tissue injuries requiring urgent multidisciplinary care. Their psycho-social repercussions are considerable, especially as they affect a young population. [ABSTRACT FROM AUTHOR]

On 6 July 2013, in Lac Mégantic, Quebec, the explosion of an MMA train, carrying light petroleum hydrocarbons, annihilated the downtown area of this 6000-inhabitant community. A total of 47 people lost their lives in this tragic accident and 5978 m3 of petroleum sub-products spilled into Lake Mégantic and the Chaudière River, not counting the incomplete combustion products that were dispersed with the smoke form the fire. This was the worst petroleum spill on land in Canada. The accident and the management of the environmental catastrophe revealed major deficiencies at several levels: transport safety of hazardous materials, preparedness of municipalities facing environmental emergencies, relevance and adequacy of emergency measures, environmental risk assessment, assessment of contamination and selection and speed of rehabilitation measures. This article describes the accident, the emergency measures applied and the environmental impacts of petroleum contaminants. It states and analyses the characterization data on water, soils, sediment and air supplied by the government, environmental organisations and universities. It addresses sanitary issues and solutions, such as potable water supply for some communities along the Chaudière River, surface water, groundwater, sediments and soil contamination issues, as well as the future of contaminants and their potential long-term cumulative impacts. This article proposes recommendations for signaling the deficiencies and critical needs as pertains to regulations, infrastructure, training and knowledge so the populations and municipal services may be better prepared to face future similar situations and events. [Journal translation] [ABSTRACT FROM AUTHOR]

We inhabit an Earth where disasters and hazard events are more the norm than the exception, damage is often repeated and residents of vulnerable communities are surprised at the power of Nature. The typical model for emergency management lacks the critical component of hazard mitigation, and considers people as victims instead of resources, while focusing on response instead of changing outcomes from hazards event.

Copyright of Revue Française de Gestion is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Française de Gestion is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses various topics surrounding the theme of risk, including a sociological analysis of the term, and a philosophical account of risk in contemporary societies. Themes discussed include postmodernism, disaster management, and social values, and reference is made to the work and thought of Norbert Elias, Michel Foucault, and Hermann Hesse.

Abstract: Objectives: One objective is to state more accurately the difficulties met by the anaesthesiologists in an emergency context in case of withholding or withdrawing life sustaining therapies. Study design and participants: A questionnaire addressed to anaesthesiologists of nine hospitals in the extreme West part of France. Materials and methods: The questionnaires were sent and returned by mail in order to guarantee confidentiality. Results: The participation rate was 40% with 172 questionnaires analysed. Ninety-eight per cent of the anaesthesiologists have already participated in a withholding or withdrawing life sustaining treatments, and in an emergency context in 92% of the cases. In that last case, criteria related to the severity of the clinic presentation and to the short-term death probability influence the decision made to interrupt life-sustaining therapies. For 93% of anaesthesiologists, the decision should be collegial, but 50% of them had already made such a decision alone. The withdrawal of ventilatory support was the most difficult decision to make. Withdrawing mechanical ventilation or extubating appeared impossible for 23.4 and 50% of the anaesthesiologists respectively. Providing comfort care to the patients with end of life decision was essential for 100% of the anaesthesiologists, but 11% of them used and considered analgesic and sedation after withholding or withdrawing life sustaining treatments as euthanasia. The complaint possibility worried 57% of the anaesthesiologists and influenced the writing of the process or giving information to the families respectively for 65 and 75%. The righting of the medical files could be improved for 92% of the anaesthesiologists. Conclusion: The decision of withholding and withdrawing life sustaining treatments in an emergency context is based on the conviction of short-term death probability. Withholding and withdrawing life sustaining treatments is a decision made according to the principles of collegiality and necessary comfort cares, but the procedure can still be improved, especially in the redaction of the medical file and the ethical and juridical control of these extreme situations. [Copyright &y& Elsevier]

Copyright of Sécurité Globale is the property of Editions ESKA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sociologie du Travail is the property of Association pour le Developpement de la Sociologie du Travail and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: Several studies have highlighted the assets of the influenza rapid diagnostic tests (IRDT) for the emergency department management of febrile children. The objective of this study was to determine in ambulatory pediatric setting impact of IRDT on the management of febrile children during an epidemic, especially on other diagnostic testing performed, antibiotic and antiviral treatments. Methods: During an influenza epidemic, 37 paediatricians in three different areas of France included all children presenting fever with respiratory illnesses; they performed IRDT (test QuickVue® for Influenza A and B, Quidel). Data collected were antiflu vaccination, previous asthma, symptoms, clinical signs, other diagnostic testing performed, and a follow-up two weeks later. Results: Between December, 2006 and April, 2007, 695 children entered the program. The average age of those children was 4.1 years old (SD 3.4), median 3.2 (0.07–17.5). In 41.6% of the cases, the tests proved positive. Among 13 symptoms of influenza, only five were significantly more present in the group IRDT+: shiver (68.1% versus 57.4%), asthenia (87% versus 79.9%), cough (87.5% versus 70.1%), rhinorrhea (93.4% versus 83.3%), and sleepiness (54.2% versus 43.4%). The number of laboratory tests and radiographs ordered were less frequent in group IRDT+ than in group IRDT-: respectively 0.7% versus 11.6%, and 0.7% versus 8.6% (p <0.0001). IRDT+ group received antibiotics in 7.6% of cases (22 patients, 20 for OMA) and antiviral in 64.7%. IRDT- group received respectively 18.5% antibiotics, and no antiviral (p <0.0001). Conclusion: This study confirms the difficulty of clinical influenza diagnosis, and suggests the assets of IRDT to diagnose influenza and to improve the management of influenza in ambulatory paediatric setting. [Copyright &y& Elsevier]

Abstract: Objective: The objective was to test the application of barrier precautions and hospital organization during an influenza pandemic, in accordance with the national program of influenza pandemic training and the “Influenza addendum” of the hospital guidelines in case of a major disaster. Method: A practical exercise was performed on December 18th 2007 in two areas of high viral density and one of low viral density. This exercise involved all the people in these areas, without disturbing the normal care activity. Results: Two hundred and forty-five people were evaluated. Seventy-five per cent of whom had been trained in the hospital. Hand hygiene complied with pre-established procedures in 32% of cases, was acceptable in 44%, and deficient in 24%. Surgical mask application was unacceptable in 21% of cases. These precautions were well accepted by 36% of the personnel, accepted by 54%, and a burden for 10%. The poor sealing capacity of mask FFP2 (national allocation), depending on facial features, its poor tolerance, the lack of water stations, and the presence of groups of people were all noted. Conclusion: This exercise was rated as satisfactory with a good participation. However, it revealed unexpected dysfunctions such as application of barrier precautions. Also, that the FFP2 mask was not suitable for all people, especially for children, a problem in case of a pandemic. Finally, this exercise should lead to corrective actions and to completing the various training sessions initiated in other institutions. [Copyright &y& Elsevier]

Copyright of Bulletin des bibliothèques de France is the property of ENSSIB and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Society & Leisure / Loisir & Société is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In emergency situations, a basic public health framework consists of ensuring food and water security, sanitation, access to basic medical care, including mass vaccinations, and disease prevention. [ABSTRACT FROM PUBLISHER]

Copyright of Cultures et Conflits is the property of Centre d'Etudes sur les Conflits, Revue Cultures & Conflits and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)