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BackgroundIn nursing homes, infections and antibiotic prescriptions are frequent. Nursing home nurses (NHNs) and advanced practice registered nurses (APRNs) could promote antibiotic stewardship (ABS). Few studies have explored nurses’ knowledge, perceptions and practices towards ABS in nursing homes and none has investigated the potential evolution of their roles.ObjectivesTo explore French nurses’ perceptions on ABS, current and future potential roles in ABS in nursing homes, as well as facilitators and barriers.MethodsWe conducted a qualitative study in north-eastern France between October 2020 and March 2021 using semi-structured individual interviews with NHNs and a focus group with APRNs. Transcripts of the interviews were analysed using a thematic analysis.ResultsTwenty NHNs and seven APRNs participated. They were aware of antibiotic misuse and potential adverse events but lacked knowledge on some ABS aspects. NHNs’ current ABS roles ranged from the detection of clinical infectious signs to clinical monitoring of residents, with some heterogeneity between nurses. They had positive opinions towards playing a more prominent role in ABS. In the future, with additional training, changes in the legislative framework and greater multidisciplinary teamwork, NHNs thought they could prescribe laboratory microbiological analyses and some targeted antibiotic treatments. APRNs thought they could prescribe first-line antibiotics for urinary tract infections.ConclusionsFrench NHNs’ current ABS roles could be expanded and new roles might be considered while taking into account several facilitators and barriers. According to APRNs, they could help to compensate for the limited presence of doctors in nursing homes and develop infectious diseases skills.

The 'AntibioCharte' randomised controlled study aimed at assessing the impact of a multifaceted antibiotic stewardship intervention targeting French general practitioners with higher-than-average antibiotic use. The intervention included a public commitment charter signed by the general practitioner, a non-prescription pad, and a patient information leaflet.We conducted a qualitative study to evaluate general practitioners' fidelity in the intervention and its acceptability by patients and general practitioners.This investigation was performed in northeastern France from July 2019 to May 2020, among the AntibioCharte intervention group after a 1-year implementation period. General practitioners' fidelity in the charter was assessed by direct observations; general practitioners' fidelity in the other tools, and acceptability of both general practitioners and patients were assessed through semi-structured face-to-face individual interviews.Twenty-seven general practitioners and 14 patients participated. General practitioners' fidelity varied according to the tool: the charter was clearly displayed in most waiting rooms; the non-prescription pad was used throughout the intervention period by most general practitioners while the leaflet was used by fewer general practitioners. Both general practitioners and patients found the charter's content and form relevant, but few general practitioners felt themselves publicly engaged. The waiting room may not be appropriate to display the charter as some general practitioners forgot it and patients did not always read the displayed documents. General practitioners appreciated the pad and found that it could help them change their practices. It was perceived as a good tool to educate patients and manage their expectations for antibiotics. Patients appreciated the pad too, especially information on the infections' symptoms and their duration. Still, some patients feared that it could encourage doctors not to prescribe antibiotics. Unlike general practitioners, who considered the leaflet redundant with the information given during the consultation, patients found it useful to raise awareness on antibiotics' specificities and risks, and remind them of good practices.The AntibioCharte intervention was overall well accepted by general practitioners and patients. The non-prescription pad was the best perceived tool. Trial registration number ClinicalTrials.gov: NCT04562571.

The improvement of ultrasound scan techniques is enabling ever earlier prenatal diagnosis of developmental anomalies. In France, apart from cases where the mother's life is endangered, the detection of "particularly serious" conditions, and conditions that are "incurable at the time of diagnosis" are the only instances in which a therapeutic abortion can be performed, this applying up to the 9th month of pregnancy. Thus numerous conditions, despite the fact that they cause distress or pain or are socially disabling, do not qualify for therapeutic abortion, despite sometimes pressing demands from parents aware of the difficulties in store for their child and themselves, in a society that is not very favourable towards the integration and self-fulfilment of people with a disability. Cleft lip and palate (CLP), although it can be completely treated, is one of the conditions that considerably complicates the lives of child and parents. Nevertheless, the recent scope for making very early diagnosis of CLP, before the deadline for legal voluntary abortion, has not led to any wave of abortions. CLP in France has the benefit of a exceptional care plan, targeting both the health and the integration of the individuals affected. This article sets out, via the emblematic instance of CLP, to show how present fears of an emerging "domestic" or liberal eugenic trend could become redundant if disability is addressed politically and medically, so that individuals with a disability have the same social rights as any other citizen.

Art and biotechnologies : From observation to the creation of the monster Because of his appearance, the monster displays his exceptionality, etymologically, he is a sign or an omen. With the constitution of medical science in the sixteenth and seventeenth centuries, the monster loses the attractiveness of the marvelous. The study and examination of the monster have given little by little birth to teratology and have generated new forms of representation. Thus, various illustrators, artists as well as scientists, created nomenclatures of the different human types. As soon as the nineteenth century, the monster was perceived as the unadapted, the deviant, the degenerate, a conception amplified by evolutionism and hereditarism. An iconographic representation of the decadent and the abnormal was created while the monster as such disappeared from public space. Today, biomedical technologies are available which make it possible to modify one’s body to conform to existing norms, but also perhaps to transform it in a more radical way. Bio-art which draws its inspiration from the biotechnologies which currently modify our world, tend to lay stress on the potentialities provided by these new ways of using living forms. This form of art called biotech generates contemporary chimera, new monsters which incite us to elaborate a new ethical thought., Du fait de son apparence, le monstre exhibe son exceptionnalité, étymologiquement il est un signe ou un présage. Avec la constitution des sciences médicales et de la vie aux XVIe et XVIIe siècle, le monstre perd l’attrait du merveilleux. L’étude et l’examen dont il fait l’objet donnent naissance peu à peu à la tératologie et génèrent de nouvelles représentations. Ainsi, divers illustrateurs, artistes comme scientifiques, créent des nomenclatures des différents types humains. Dès le XIXe siècle, le monstre se comprend comme l’inadapté, le déviant, le « dégénéré », conception amplifiée par l’évolutionnisme et l’héréditarisme. Il se crée une iconographie du décadent et de l’anormal alors même que le monstre disparaît de l’espace public. Aujourd’hui, il existe des technologies biomédicales permettant de modifier son corps pour se conformer aux normes, mais peut-être aussi pour le transformer plus radicalement. Le bio-art, qui s’inspire des biotechnologies qui altèrent actuellement notre monde, tend à mettre l’accent sur les potentialités contenues dans ces nouveaux usages du vivant. Cet art dit biotech génère des chimères contemporaines, de nouveaux monstres qui nous enjoignent à une pensée éthique., Etter Valérie, Le Dref Gaëlle. Art et biotechnologies : de l’observation à la création du monstre. In: Histoire de l'art, N°67, 2010. Art, science et technologie. pp. 123-131.

En 1858, Alfred Russel Wallace (1823-1913) et Charles Darwin (1809-1882) font état conjointement de leur théorie de l’évolution naturelle . L’idée d’un système de rapports nécessaires et permanents entre les êtres qui composent le monde animal et végétal disparaît . Wallace et Darwin admettent tous deux, outre l’idée transformiste déjà largement admise et ayant été en particulier développée par Lamarck au début du siècle, « la lutte pour l’existence » comme loi naturelle générale du monde viv...