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Abstract Background Inappropriate drug prescribing causes preventable drug-related adverse events that result in increased morbidity and mortality, additional costs and diminished quality of life. Numerous initiatives have been launched to improve the quality of drug prescribing and safeguard the security of drug administration processes in nursing homes. Against the backdrop of implementation of telemedicine services, the focus of the present work is to evaluate the impact of a telemedication review carried out by a hospital physician and pharmacist as part of the telemedicine offer. Methods The present study is a randomized controlled clinical trial. A total of 364 patients will be randomized into two groups: (1) an experimental group (182 patients) benefiting from a telemedication review using tele-expertise and (2) a control group (182 patients) receiving standard care. The primary endpoint will be rate of all-cause unplanned hospital admissions occurring within 3 months of randomization. The secondary endpoints will be rate of unplanned admissions at 6 months, patient quality of life, incidence of behavioral disturbances, number of falls, number of residents prescribed at least one inappropriate medication, nursing staff satisfaction, proposed medication reviews and their acceptability rate, characteristics of patients whose general practitioners have taken account of tele-expertise, efficacy of tele-expertise as compared to standard prescription and acceptability and satisfaction surveys of participating caregivers. Discussion In the literature, various studies have investigated the utility of structured medication review processes, but outcome measures are heterogeneous, and results vary widely. Medication review can detect medication-related problems in many patients, but evidence of clinical impact is scant. Incremental cost-effectiveness ratios will be used to compare the cost and effectiveness of the experimental strategy and that of standard care. Our approach, involving the combination of an acceptability survey and a mixed-method (qualitative and quantitative) satisfaction survey, is particularly innovative. The results of this randomized trial are expected to confirm that medication review using tele-expertise has potential as a worthwhile care management strategy for nursing home residents. Trial registration Clinicaltrials.gov NCT03640845 ; registered August 21, 2018 (Clinicaltrials.gov NCT03640845 ).

Abstract Background Although participation of children with rare diseases in school is considered beneficial, it poses new challenges for the educational system, but also for the affected children and their families. The aim of this study is to identify which aspects of the schooling experience may have an impact on the health-related quality of life of children with rare diseases. Method A qualitative study was conducted using the social-critical paradigm as theoretical perspective. Participants (n = 28) included children with rare diseases (n = 8), parents (n = 12) and school staff (n = 8). Data was obtained through in-depth interviews and focus groups and analysed through discourse analysis as methodological orientation. Results Participants’ discourses placed value on the social benefits of inclusion of children with rare diseases in schooling. Discourses also highlighted how the low numbers of children with rare diseases and the delay, or lack, of a clear diagnosis are among the difficulties experienced in the pursuit of the adaptations that children and teachers need to promote a healthy and normalized school experience. The issues identified in their health-related quality of life were summarized in seven categories: Attendance, Knowledge, Participation, Acceptance, Discrimination, Safety, Health-Related Support. Conclusion Children with rare diseases remain, in many cases, invisible at the educational level due to the low numbers of children affected, limiting the kind of resources available to the child and teaching staff. This situation requires inter-disciplinary and inter-sector measures between health services and educational environments to articulate a comprehensive approach focused on children’s clinical needs.

Human Papillomavirus (HPV) vaccination is one of the most publicly mistrusted vaccines in Europe, with countries such as France struggling with low vaccine uptake due to parental questioning of vaccine risks and benefits. However, limited evidence exists on adolescent girls’ perceptions of the risks and benefits of HPV vaccination. The aim of this qualitative study was to provide an in-depth exploration and comparison of French mothers (n = 21) and adolescent girls’ (n = 36) perceptions of the risks and benefits of HPV vaccination. A thematic analysis showed that adolescent girls and mothers perceived the risks and benefits of HPV vaccination differently, with girls reporting positive and beneficial views and emotions toward vaccination and mothers expressing concerns about possible risks. Adolescent girls also reported that both perceptions and actual risks and benefits may vary from one individual to another. Vaccine safety was also understood differently, with mothers reporting a widespread view that vaccines are unsafe and focusing on controversial side effects and girls discussing short-term consequences of vaccination (e.g. pain, fever) and administration and storage issues. Strategies to improve uptake of HPV vaccination should consider and address both the mothers’ and daughters’ perceptions and understandings of HPV vaccination.

Background Due to a decades-long crisis of confidence in vaccination, in 2017 France extended the number of mandatory early childhood vaccines from 3 to 11. Aims To describe the opinions of hospital staff physicians (HSPs) regarding this measure, quantify the proportion who would have preferred measures based on education, and study the factors associated with the latter opinion. Methods Cross-sectional nationwide survey with a standardized questionnaire in 2018–2019 among HSPs in 14 French public hospitals. The factors associated with HSPs’ preference for education and persuasion over mandatory vaccination were analyzed with simple and multiple Poisson regressions. Results The analyses included 1,795 HSPs (participation rate of 86%). Among them, 84% considered the extension of mandatory childhood vaccination essential given the epidemiological context at the time; in a later question, 40% would have preferred education and persuasion. Multiple regressions showed that the latter tended to be younger and less trustful of sources of information about vaccination. They were more likely to think that information on the rationale behind the national vaccination policy lacked clarity and that the extension of mandatory vaccines was not essential, even in the current epidemiologic situation. Conclusion Although most HSPs agreed that the extension of mandatory childhood vaccines was essential, some were ambivalent about its coercive philosophy. Further research is necessary to better understand the reasons of this ambivalence. A fraction did not understand the French vaccination strategy well. Efforts to explain its details to HSPs and an overhaul of their initial training on vaccination are still needed.

Cell–cell adhesion is a fundamental feature of multicellular organisms. To ensure multicellular integrity, adhesion needs to be tightly controlled and maintained. In plants, cell–cell adhesion remains poorly understood. Here, we argue that to be able to understand how cell–cell adhesion works in plants, we need to understand and quantitatively measure the mechanics behind it. We first introduce cell–cell adhesion in the context of multicellularity, briefly explain the notions of adhesion strength, work and energy and present the current knowledge concerning the mechanisms of cell–cell adhesion in plants. Because still relatively little is known in plants, we then turn to animals, but also algae, bacteria, yeast and fungi, and examine how adhesion works and how it can be quantitatively measured in these systems. From this, we explore how the mechanics of cell adhesion could be quantitatively characterised in plants, opening future perspectives for understanding plant multicellularity.

Chronic pain affects the quality of life of those affected. The need to investigate alternative and complementary methods to the pharmacological one to alleviate chronic pain is evident, so virtual reality and binaural tones have become a topic of interest in this field in recent years. This study aims to analyze the contributions of the combination of these two techniques in pediatric patients with chronic pain. For this, data on psychophysiological responses (heart rate and galvanic skin response) and pain perception are collected during and after interaction with this technology using a mixed pre- and posttest experimental methodology. The physiological data and answers in the Pediatric Pain Questionnaire (PPQ) have been collected in a sample of n = 13 healthy participants and n = 9 pediatric patients with chronic pain. The results show a significant difference between baseline and after applying virtual reality and binaural beats, md = 1.205 (t = 3.32; p

The chlorophyll/carotenoid index (CCI) is increasingly used for remotely tracking the phenology of photosynthesis. However, CCI is restricted to few satellites incorporating the 531 nm band. This study reveals that the Moderate Resolution Imaging Spectroradiometer (MODIS) broadband green reflectance (band 4) is significantly correlated with this xanthophyll-sensitive narrowband (band 11) (R2=0.98,p

ObjectiveWe aimed to investigate whether anakinra, an interleukin-1receptor inhibitor, could improve outcome in moderate COVID-19 patients.MethodsIn this controlled, open-label trial, we enrolled adults with COVID-19 requiring oxygen. We randomly assigned patients to receive intravenous anakinra plus optimized standard of care (oSOC) vs. oSOC alone. The primary outcome was treatment success at day 14 defined as patient alive and not requiring mechanical ventilation or extracorporeal membrane oxygenation.ResultsBetween 27th April and 6th October 2020, we enrolled 71 patients (240 patients planned to been enrolled): 37 were assigned to the anakinra group and 34 to oSOC group. The study ended prematurely by recommendation of the data and safety monitoring board due to safety concerns. On day 14, the proportion of treatment success was significantly lower in the anakinra group 70% (n = 26) vs. 91% (n = 31) in the oSOC group: risk difference-21 percentage points (95% CI, -39 to -2), odds ratio 0.23 (95% CI, 0.06 to 0.91), p = 0.027. After a 28-day follow-up, 9 patients in the anakinra group and 3 in the oSOC group had died. Overall survival at day 28 was 75% (95% CI, 62% to 91%) in the anakinra group versus 91% (95% CI, 82% to 100%) (p = 0.06) in the oSOC group. Serious adverse events occurred in 19 (51%) patients in the anakinra group and 18 (53%) in the oSOC group (p = 0·89).ConclusionThis trial did not show efficacy of anakinra in patients with COVID-19. Furthermore, contrary to our hypothesis, we found that anakinra was inferior to oSOC in patients with moderate COVID-19 pneumonia.

18F-FDG PET provides high sensitivity for the pre-surgical assessment of drug-resistant temporal lobe epilepsy (TLE). However, little is known about the metabolic connectivity of epileptogenic networks involved. This study therefore aimed to evaluate the association between metabolic connectivity and seizure outcome in surgically treated TLE. Methods: The study included 107 right-handed patients that had undergone a presurgical interictal 18F-FDG PET assessment followed by an anterior temporal lobectomy and were classified according to seizure outcome 2 years after surgery. Metabolic connectivity was evaluated by seed correlation analysis in left and right epilepsy patients with a Class Engel IA or > IA outcome and compared to age-, sex- and handedness-matched healthy controls. Results: Increased metabolic connectivity was observed in the >IA compared to the IA group within the operated temporal lobe (respective clusters of 7.5 vs 3.3 cm3 and 2.6 cm3 vs 2.2 cm3 in left and right TLE), and to a lower extent with the contralateral temporal lobe (1.2 vs 0.7 cm3 and 1.7 cm3 vs 0.7 cm3 in left and right TLE). Seed correlations provided added value for the estimated individual performance of seizure outcome over the group comparisons in left TLE (AUC of 0.74 vs 0.67). Conclusion: Metabolic connectivity is associated with outcome in surgically treated TLE with a strengthened epileptogenic connectome in patients with non-free-seizure outcomes. The added value of seed correlation analysis in left TLE underlines the importance of evaluating metabolic connectivity in network related diseases.

A reprint of an essay from ODO: Journal of Yoruba and Related Studies, Jan­uary, 1955, No. l.

If education is an inalienable right for children and young people with disabilities, securing employment plays a key role in their inclusion into adult life. A broad study was conducted to analyse the transition between the end of compulsory education and the beginning of employment in young people with disabilities in the Autonomous Community of the Balearic Islands. This article addresses the two key issues that arise from the study: first, the basic elements that intervene in conceptualising the topic and, second, an evaluation of the current situation in the community. (Contains 3 tables, 3 figures and 3 footnotes.)

Creativity researchers are increasingly interested in understanding when, how, and for whom creativity can be beneficial. Previous reviews have demonstrated that creativity research largely ignores the study of its impact on factors that promote health, and well‐being among populations of adults. It is unclear, in fact, whether this gap in research also extends to creativity research among young children. This paper addresses this issue. Early childhood is a crucial stage for the cognitive development of young children who remain highly sensitive to stress, and adversity. It is therefore essential to identify and promote factors that are beneficial to early childhood resilience, thereby contributing to documenting more of the effects of creative activities on positive outcomes. This paper presents a review with a bibliometric analysis of 1000 randomly selected articles from the Web of Science, without bias towards any specific peer‐reviewed journal. The analysis of 454 included articles shows that approximately 80% of the included studies focus on creativity as an outcome (replicating previous findings with a larger sample), with only 3.78% investigating creative activities as predictors among young children. In this small percentage, most of the studies addressed creative activities in young children related to resilience outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite seasonal influenza vaccination (SIV) being recommended to healthcare professionals to protect themselves and their patients, uptake is low, especially among nurses. We sought to study self-vaccination behaviours, attitudes and knowledge about SIV among nurses in Southeastern France. Methods: A cross-sectional survey with community and hospital-based hospital nurses was conducted with the same standardised questionnaire. Multi-model averaging approaches studied factors associated with the following dependent variables: self-reported SIV uptake; and considering SIV a professional responsibility. Results: 1539 nurses completed the questionnaire (response rate: 85%). SIV was the most frequently cited vaccine (49%) regarding nurses’ unfavourable opinions towards specific vaccines. Thirty-four percent of nurses reported being vaccinated at least once during the 2015–2016 or 2016–2017 seasons. A lack of perceived personal vulnerability to influenza, a fear of adverse effects, and a preference for homeopathy constituted the main deterrents of SIV. Nurses held various misconceptions about the SIV, but 69% considered its benefits to be greater than its risks. The multi-model averaging approach showed that considering SIV as a professional responsibility was the main factor associated with SIV uptake among nurses (Nagelkerke’s partial R-squared: 15%). This sense of responsibility was strongly associated with trust in various vaccine information sources. Conclusion: Nurses had low SIV uptake rates and held various concerns and a lack of knowledge surrounding the vaccine. This is concerning considering the impact that these factors can have on nurses and patients’ health, especially considering the increased role that nurses could have surrounding SIV in the near future.

Europe is increasingly described as the region in the world with the least confidence in vaccination, and particularly in the safety of vaccines. The aim of this systematic literature review was to gather and summarise all peer-reviewed and grey literature published about determinants of Human Papillomavirus (HPV) vaccine hesitancy in Europe. Ten thematic categories were identified across the 103 articles which were included in the review. Participants from European studies most commonly reported issues with the quantity and quality of information available about HPV vaccination; followed by concerns about potential side effects of the vaccine; and mistrust of health authorities, healthcare workers, and new vaccines. Comparative analyses indicated that confidence determinants differed by country and population groups. This evidence supports the need to develop context-specific interventions to improve confidence in HPV vaccination and design community engagement strategies aiming to build public trust.

Abstract Background Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but their SIV rates remain far below public health targets. We aimed to identify temporal trajectories of SIV uptake over a 10-year period among French people with diabetes and describe their clinical characteristics. Methods We identified patients with diabetes in 2006 among a permanent, representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06–2015/16), using SIV reimbursement claims and group-based trajectory modelling to identify SIV trajectories and to study sociodemographic, clinical, and healthcare utilization characteristics associated with the trajectories. Results We identified six trajectories. Of the 15,766 patients included in the model, 4344 (28%) belonged to the “continuously vaccinated” trajectory and 4728 (30%) to the “never vaccinated” one. Two other trajectories showed a “progressive decrease” (2832, 18%) or sharp “postpandemic decrease” (1627, 10%) in uptake. The last two trajectories (totalling 2235 patients, 14%) showed an early or delayed “increase” in uptake. Compared to “continuously vaccinated” patients, those in the “progressively decreasing” trajectory were older and those in all other trajectories were younger with fewer comorbidities at inclusion. Worsening diabetes and comorbidities during follow-up were associated with the “increasing” trajectories. Conclusions Most patients with diabetes had been continuously vaccinated or never vaccinated and thus had stable SIV behaviours. Others adopted or abandoned SIV. These behaviour shifts might be due to increasing age, health events, or contextual factors (e.g., controversies about vaccine safety or efficacy). Healthcare professionals and stakeholders should develop tailored strategies that take each group’s specificities into account.

Abstract Background The quality of phantom images was previously shown to be higher on digital (Vereos Philips®) compared to analog PET (Ingenuity Philips®) cameras. This study aimed to determine the extent to which this difference still remains significant on normal brain 18F-FDG PET images. Methods Relative noise and contrast as well as border sharpness (a spatial resolution index) of central (striata) and peripheral (occiput) gray-matter structures were compared between 10 sets of normal brain 18F-FDG PET images recorded and reconstructed on digital and analog last-generation PET cameras, together with a subjective visual analysis of image quality provided by experienced physicians. Results Compared with analog PET, digital PET provided marked improvements in image quality parameters. The median relative noise was decreased (− 22%), while gray/white-matter contrast was increased (+ 27%/+ 41% for central/peripheral gray-matter structures), with these results being consistent with visual analysis. In addition, a clear enhancement in image sharpness was further documented for digital PET owing to the possible use of a 1-mm3 voxel size (+ 24%/+ 21%). Conclusions On normal brain 18F-FDG images and compared with a last-generation analog PET, the fully digital PET camera offers marked improvements in image noise and contrast, as well as significant potential for further enhancing spatial resolution.

Abstract Background France is the European country with the lowest level of confidence in vaccines. Measurement of patients’ acceptability towards a future therapeutic HIV vaccine is critically important. Thus, the aim of this study was to evaluate patients’ acceptability of a future therapeutic HIV vaccine in a representative cohort of French patients living with HIV-AIDS (PLWHs). Methods This multicentre study used quantitative and qualitative methods to assess PLWHs’ opinions and their potential acceptance of a future therapeutic HIV vaccine. Cross-sectional study on 220 HIV-1 infected outpatients, aged 18–75 years. Results The participants’ characteristics were similar to those of the overall French PLWH population. Responses from the questionnaires showed high indices of acceptance: the mean score for acceptability on the Visual Analog Scale VAS was 8.4 of 10, and 92% of patients agreed to be vaccinated if a therapeutic vaccine became available. Acceptability depended on the expected characteristics of the vaccine, notably the duration of its effectiveness: 44% of participants expected it to be effective for life. This acceptance was not associated with socio-demographic, clinical (mode of contamination, duration of disease), quality of life, or illness-perception parameters. Acceptability was also strongly correlated with confidence in the treating physician. Conclusion The PLWHs within our cohort had high indices of acceptance to a future therapeutic HIV vaccine. Trial registration This study was retroactively registered on ClinicalTrials.gov with ID: NCT02077101 in February 21, 2014.

Abstract Background Many methods have been developed to quantify cell shape in 2D in tissues. For instance, the analysis of epithelial cells in Drosophila embryogenesis or jigsaw puzzle-shaped pavement cells in plant epidermis has led to the development of numerous quantification methods that are applied to 2D images. However, proper extraction of 2D cell contours from 3D confocal stacks for such analysis can be problematic. Results We developed a macro in ImageJ, SurfCut, with the goal to provide a user-friendly pipeline specifically designed to extract epidermal cell contour signals, segment cells in 2D and analyze cell shape. As a reference point, we compared our output to that obtained with MorphoGraphX (MGX). While both methods differ in the approach used to extract the layer of signal, they output comparable results for tissues with shallow curvature, such as pavement cell shape in cotyledon epidermis (as quantified with PaCeQuant). SurfCut was however not appropriate for cell or tissue samples with high curvature, as evidenced by a significant bias in shape and area quantification. Conclusion We provide a new ImageJ pipeline, SurfCut, that allows the extraction of cell contours from 3D confocal stacks. SurfCut and MGX have complementary advantages: MGX is well suited for curvy samples and more complex analyses, up to computational cell-based modeling on real templates; SurfCut is well suited for rather flat samples, is simple to use, and has the advantage to be easily automated for batch analysis of images in ImageJ. The combination of these two methods thus provides an ideal suite of tools for cell contour extraction in most biological samples, whether 3D precision or high-throughput analysis is the main priority.

Over the last two decades, education privatization has become a widespread phenomenon, affecting most education systems and giving place to a consistent increase in private school enrolment globally. However, far from being a monolithic phenomenon, privatization advances through a variety of context-sensitive policy processes that translate into multiple policy outcomes. This paper aims at understanding why and how education privatization unfolds in a broad variety of settings and, to this purpose, examines the different manifestations of education privatization on the light of Cultural Political Economy (CPE). The conceptual and analytical tools provided by CPE prove to be particularly well suited to explore such a multi-faceted and multi-scalar phenomenon. CPE has helped us to capture the intersect and tension between different drivers (global and local, material and ideational) of education privatization through the evolutionary mechanisms of variation, selection and retention. On the basis of a systematic literature review methodology, encompassing 227 research papers, the article identifies and systematizes six different paths towards education privatization--understood as groups of frequently associated circumstances, mechanisms and courses of action leading to privatization. Conceived as ideal types, these different paths ultimately allow for a richer understanding of education privatization and show that the international diffusion of education privatization norms and discourses is far from producing policy convergence at a global scale.

This paper addresses the rise and consequences of an emerging global education industry (GEI), which represents new forms of private, for profit involvement in education across the globe. The paper explores the emergence within the GEI of new and varied, largely transnational, markets in education by focusing on three examples of the GEI at work. The first example addresses the issue of Charter Schools, what they have come to represent, how they have been implemented, and, especially, the impact they have had on public schooling more broadly. While they have taken different forms in different places, they have succeeded in installing the idea of quasi-markets in education, which has been directly instrumental in opening up opportunities for private investment in education. The second example concerns the ways that the increasingly global standardisation of education policies, provision and practices, presents lucrative opportunities for investment and profit. The forms and consequences of such standardisation are described in the contrasting cases of Qatar, Mongolia and Indonesia. The third example concerns low-fee private schools in the Global South. Far from such schools being seen as local initiatives, the paper shows how they have become a major opportunity for profitable investment by international corporations.

Although the literature on school choice rationalities is extensive, different authors interpret the processes of school choice for poor families in different ways. Positions vary between those that consider that poor families have the same capacity to choose as middle class families and those that value structural factors as constraints for choice. The objective of this article is to identify different school choice rationalities of low income families in the context of a highly marketized education system such as Chile. Beyond the restrictions of a different nature that poor families face, this social group mostly expresses high levels of reflexivity and complex sets of preferences when it comes to choosing schools for their children. This article tries to overcome the dualistic division that prevails in school choice literature between choice as an outcome of utility maximization for all, and choice as a denial for deprived groups.

This Forum discusses the significant growth of international large-scale assessments (ILSAs) since the mid-1990s. Addey and Sellar's contribution ("A Framework for Analysing the Multiple Rationales for Participating in International Large-Scale Assessments") outlines a framework of rationales for participating in ILSAs and examines the multiple localised meanings attached to ILSA participation. This framework is discussed under seven headings: (1) evidence for policy; (2) technical capacity building; (3) funding and aid; (4) international relations; (5) national politics; (6) economic rationales; and (7) curriculum and pedagogy. It shows how ILSAs can serve multiple purposes--a flexibility that has contributed to the rapid growth of the phenomenon. Steiner-Khamsi ("Focusing on the Local to Understand Why the Global Resonates and How Governments Appropriate ILSAs for National Agenda Setting") focuses on the local to understand why the global resonates and discusses how governments appropriate ILSAs for national agenda setting. Lingard (International Organisations' Rationales for Large Scale Assessments") examines the rationales of international organisations and the contribution of media coverage to the increasing significance of ILSAs. Finally, Verger ("Theorising ILSA Participation") theorises rationales for ILSA participation according to three frames for understanding global education policy: rationalism, neo-institutionalism and political economy approaches.

This article relies on short field works realized in different public spaces in the city of Ibadan, Nigeria. It provides a reflection on young Western white female students’ integration in these public spaces and in their research groups. We try to understand to what extent our position may have been both restrictive and useful for the understanding of our fieldworks.