Le soignant face au patient lombalgique chronique: l'expérience clinique de l'Unité Rachis à l'Hôpital orthopédique [The health professional's approach to chronic lumbago: clinical experience at the Spinal Cord Unit at the orthopedic hospital]

The treatment of back pain patients refers to the biopsychosocial model of care. This model includes illness in patient's personal and relational life. In this context, it is not only the physical symptom of the patient which is focused but also his psychological distress often hidden by algic complain. Clinical interviews conducted with back pain patients have highlighted psychosocial aspects able to influence the relationship between health care user and provider. Taking account of psychosocial aspects implies an interdisciplinary approach that identify and assesses patients' needs through adequate tools. As a result, the different health care providers implied with back pain patients have to collaborate in a structured network.

Prospective evaluation of three point of care devices for glycemia measurement in a neonatal intensive care unit.

Hypoglycemia, if recurrent, may have severe consequences on cognitive and psychomotor development of neonates. Therefore, screening for hypoglycemia is a daily routine in every facility taking care of newborn infants. Point-of-care-testing (POCT) devices are interesting for neonatal use, as their handling is easy, measurements can be performed at bedside, demanded blood volume is small and results are readily available. However, such whole blood measurements are challenged by a wide variation of hematocrit in neonates and a spectrum of normal glucose concentration at the lower end of the test range. We conducted a prospective trial to check precision and accuracy of the best suitable POCT device for neonatal use from three leading companies in Europe. Of the three devices tested (Precision Xceed, Abbott; Elite XL, Bayer; Aviva Nano, Roche), Aviva Nano exhibited the best precision. None completely fulfilled the ISO-accuracy-criteria 15197: 2003 or 2011. Aviva Nano fulfilled these criteria in 92% of cases while the others were <87%. Precision Xceed reached the 95% limit of the 2003 ISO-criteria for values ≤4.2 mmol/L, but not for the higher range (71%). Although validated for adults, new POCT devices need to be specifically evaluated on newborn infants before adopting their routine use in neonatology.

Updating the Politics of Experience: Angela Carter's Translation of Charles Perrault's Le Petit Chaperon Rouge.

AbstractThis article seeks to assess the importance of Angela Carter's little-known work as a translator of Perrault's tales in The Fairy Tales of Charles Perrault (1977) through an examination of her "Little Red Riding Hood". Carter is mostly famous today for The Bloody Chamber and Other Stories (1979), a collection of innovative and thought-provoking fairy-tale rewritings infused with feminist concerns, strategies and perspectives. Insofar as Carter was translating Perrault's tales while writing her own "stories about fairy stories", an analysis of her translations reveals them as part of an ongoing dialogue with the work of the French author. While Carter's translations consciously update and adapt the material for children whom she seeks to sensitize to gender issues, she does not so much challenge the sexual politics of her source as recognize the emancipatory potential of Perrault's contes as useful "fables of the politics of experience".RésuméCet article vise à rendre compte de l'activité méconnue de traductrice déployée par l'auteure anglaise Angela Carter conjointement à son oeuvre de fiction, et à en reconnaître l'importance dans sa trajectoire d'écrivain. Une analyse de « Little Red Riding Hood », publié dans The Fairy Tales of Charles Perrault (1977), permet d'éclairer la poétique particulière qu'elle développera dans le recueil qui l'a rendue célèbre, The Bloody Chamber and Other Stories (1979), des « histoires sur des contes de fées » qui reflètent la perspective et les stratégies féministes de l'auteure. Carter a mené de front ses traductions et réécritures, envisagées ici comme deux formes du dialogue très riche et complexe qu'elle engage à cette période avec l'oeuvre de Perrault, plutôt qu'une subversion de celui-ci. Ainsi, sa traduction modernise et simplifie le texte des contes pour de jeunes lecteurs qu'elle cherche à sensibiliser à des problématiques de genre, en leur révélant la portée émancipatrice des contes de Perrault qu'elle envisage comme « des fables utiles sur la politique de l'expérience » plutôt qu'en contestant la politique sexuelle de sa source.

Format of medical order sheet improves security of antibiotics prescription: The experience of an intensive care unit.

OBJECTIVE: To assess whether formatting the medical order sheet has an effect on the accuracy and security of antibiotics prescription. DESIGN: Prospective assessment of antibiotics prescription over time, before and after the intervention, in comparison with a control ward. SETTING: The medical and surgical intensive care unit (ICU) of a university hospital. PATIENTS: All patients hospitalized in the medical or surgical ICU between February 1 and April 30, 1997, and July 1 and August 31, 2000, for whom antibiotics were prescribed. INTERVENTION: Formatting of the medical order sheet in the surgical ICU in 1998. MEASUREMENTS AND MAIN RESULTS: Compliance with the American Society of Hospital Pharmacists' criteria for prescription safety was measured. The proportion of safe orders increased in both units, but the increase was 4.6 times greater in the surgical ICU (66% vs. 74% in the medical ICU and 48% vs. 74% in the surgical ICU). For unsafe orders, the proportion of ambiguous orders decreased by half in the medical ICU (9% vs. 17%) and nearly disappeared in the surgical ICU (1% vs. 30%). The only missing criterion remaining in the surgical ICU was the drug dose unit, which could not be preformatted. The aim of antibiotics prescription (either prophylactic or therapeutic) was indicated only in 51% of the order sheets. CONCLUSIONS: Formatting of the order sheet markedly increased security of antibiotics prescription. These findings must be confirmed in other settings and with different drug classes. Formatting the medical order sheet decreases the potential for prescribing errors before full computerized prescription is available.

The role of energy and nutritional support in the intensive care unit.

Malnutrition is common in critically ill, hospitalized patients and so represents a major problem for intensive care. Nutritional support can be beneficial in such cases and may help preserve vital organ and immune function. Energy requirements, route of delivery and potential complications of nutritional support are discussed in this paper.

U-Pb ages of magmatic rocks of the western Austroalpine Dent-Blanche-Sesia unit

Conventional U-Pb ages on zircon and monazite demonstrate that granites and gabbros intruded during a short time span of 5 Ma between 293 and 288 Ma in several polycyclic basement units of the Western Austroalpine domain. This bimodal activity reflects increasing underplating of an upwelling mantle at the base of a thinning post-Variscan continental crust.