Catalogue d'estampes anciennes et modernes... du cabinet de M. F. F... [Francis Foster] / [expert] Defer

[Vente. Estampes. 1858-01-18 - 1858-01-20. Paris]

Appropriateness of therapy for active Crohn's disease: results of a multidisciplinary International Expert Panel (EPACT II)

Introduction: The development of novel therapies and the increasing number of trials testing management strategies for luminal Crohn's disease (CD) have not filled all the gaps in our knowledge. Thus, in clinical practice, many decisions for CD patients need to be taken without high quality evidence. For this reason, a multidisciplinary European expert panel followed the RAND method to develop explicit criteria for the management of individual patients with active, steroid-dependent (ST-D) and steroid-refractory (ST-R) CD. Methods: Twelve international experts convened in Geneva, Switzerland in December 2007, to rate explicit clinical scenarios, corresponding to real daily practice, on a 9-point scale according to the literature evidence and their own expertise. Median ratings were stratified into three categories: appropriate (7-9), uncertain (4-6) and inappropriate (1-3). Results: Overall, panelists rated 296 indications pertaining to mild-to-moderate, severe, ST-D, and ST-R CD. In anti-TNF naïve patients, budesonide and prednisone were found appropriate for mildmoderate CD, and infliximab (IFX) when those had previously failed or had not been tolerated. In patients with prior success with IFX, this drug with or without co-administration of a thiopurine analog was favored. Other anti-TNFs were appropriate in case of intolerance or resistance to IFX. High doses steroids, IFX or adalimumab were appropriate in severe active CD. Among 105 indications for ST-D or ST-R disease, the panel considered appropriate the thiopurine analogs, methotrexate, IFX, adalimumab and surgery for limited resection, depending on the outcome of prior therapies. Anti-TNFs were generally considered appropriate in ST-R. Conclusion: Steroids, including budesonide for mild-to-moderate CD, remain first-line therapies in active luminal CD. Anti-TNFs, in particular IFX with respect to the amount of available evidence, remain second-line for most indications. Thiopurine analogs are preferred to anti-TNFs when steroids are not appropriate, except when anti-TNFs were previously successful. These recommendations are available online (www.epact.ch). A prospective evaluation of these criteria in a large database in Switzerland in underway to validate these criteria.

The INTERNORM Project: Bridging Two Worlds of Expert- and Lay-Knowledge in Standardization

This paper presents a pilot project to reinforce participatory practices in standardization. The INTERNORM project creates an interactive knowledge center based on the sharing of academic skills and experiences accumulated by the civil society, especially consumer associations, environmental associations and trade unions to strengthen the participatory process of standardization. The first objective of the project is action-oriented: INTERNORM provides a common knowledge pool supporting the participation of civil society actors to international standard-setting activities by bringing them together with academic experts in working groups and providing logistic and financial support to their participation in meetings of national and international technical committees. The second objective is analytical: the standardization action provides a research field for a better understanding of the participatory dynamics underpinning international standardization. This paper presents three incentives that explain civil society (non-)involvement in standardization that overcome conventional resource-based hypotheses: an operational incentive related to the use of standards in the selective goods provided by associations to their membership; a thematic incentive provided by the setting of priorities by strategic committees created in some standardization organization; and a rhetorical incentive related to the discursive resource that civil society concerns offers to the different stakeholders.

Critères intervenant dans le choix de l'expert judiciaire, psychiatre ou psychologue, en France

Cet article interroge les critères de choix d'un expert judiciaire par les magistrats en charge d'un dossier, à partir d'une étude empirique. Après un détour par l'international afin de spécifier les positions de ces deux acteurs sur la scène judiciaire française, les principaux critères sont décrits. Parmi eux, la célérité , la confiance, la spécialité ou la discipline démontrent que le choix de l'expert s'effectue selon plusieurs dimensions, procédurales bien sûr, mais aussi axiologiques, d'une part, et expérientielles, d'autre part. Cop. 2014 Elsevier Masson SAS.

Sistema expert en anàlisi de patrons socials

Creació d'un sistema d'anàlisi de patrons socials a partir de comportaments predictius de la nostra base de coneixement.

Estudi sobre la utilitat d'una intervenció de pacient expert en pacients amb lesions per cremades

Les lesions per cremades comporten conseqüències a nivell físic, psicològic i social. Les intervencions psicosocials per aquests pacients estan valorades de forma positiva però manquen estudis fets a l’Estat Espanyol. Les intervencions de pacient expert estan donant resultats positius en moltes patologies cròniques però no n’existeix cap per aquest tipus de lesions cròniques. L’objectiu d’aquest estudi és comprendre la utilitat d’una intervenció de pacient expert a pacients d’entre 18 i 30 anys que han patit lesions per cremades recentment. Es realitzaran 9 sessions de pacient expert des de la perspectiva bio-psicosocial. El grup focal serà un grup de 8-10 pacients de 18 a 30 anys amb un mínim del 15% de superfície corporal cremada de grau 2n profund o 3r, residents a Barcelona o rodalies. Les dades s’analitzaran per mètode mixt amb enfocament dominant qualitatiu. La recollida de dades s’obtindrà d’entrevistes, testos i anotacions realitzades prèvia a la primera sessió, al finalitzar les 9 sessions i als 6 mesos de la última sessió. Les limitacions de l’estudi són: el risc de pèrdua dels membres del grup focal a causa del retorn a la vida laboral i l’heterogeneïtat del grup en la fase d’acceptació, principis i valors personals que podrien desviar els resultats.

Programa pacient expert en obesitat

Objectiu general: desenvolupament del Programa Pacient Expert en obesitat. Objectius específics: es basaran amb el compliment de la dieta i l’activitat física, les mesures fisiològiques, la capacitat d’autogestió i el grau de satisfacció. Metodologia: - Àmbit d’estudi: Atenció Primària en Salut. - Disseny: estudi quantitatiu de tipus assaig clínic aleatoritzat. - Participants: adults amb obesitat. - Obtenció de dades: per l’anàlisi de variància per mesures repetides, l’anàlisi del discurs i l’observació estructurada. Limitacions de l’estudi: possible buit de dades per la pèrdua de participants o per la falta de continuïtat d’aquests.

Diabetes care: opinions, needs and proposed solutions of Swiss patients and healthcare professionals: a qualitative study.

AIMS: To explore, both among patients with diabetes and healthcare professionals, opinions on current diabetes care and the development of the "Regional Diabetes Program". METHODS: We employed qualitative methods (focus groups - FG) and used purposive sampling strategy to recruit patients with diabetes and healthcare professionals. We conducted one diabetic and one professional FG in each of the four health regions of the canton of Vaud/Switzerland. The eight FGs were audio-taped and transcribed verbatim. Thematic analysis was then undertaken. RESULTS: Results showed variability in the perception of the quality of diabetes care, pointed to insufficient information regarding diabetes, and lack of collaboration. Participants also evoked patients' difficulties for self-management, as well as professionals' and patients' financial concerns. Proposed solutions included reinforcing existing structures, developing self-management education, and focusing on comprehensive and coordinated care, communication and teamwork. Patients and professionals were in favour of a "Regional Diabetes Program" tailored to the actors' needs, and viewed it as a means to reinforce existing care delivery. CONCLUSIONS: Patients and professionals pointed out similar problems and solutions but explored them differently. Combined with coming quantitative data, these results should help to further develop, adapt and implement the "Regional Diabetes Program".

Summary of the opinions of the Attorney General, 2015

Compiled biennially as Official opinions of the Attorney General in the Report of the Attorney General. Report year ends December 31. Slip opinions of the Attorney General.

Summary of the opinions of the Attorney General, 2014

Compiled biennially as Official opinions of the Attorney General in the Report of the Attorney General. Report year ends December 31. Slip opinions of the Attorney General.

Summary of the opinions of the Attorney General, 2012

Compiled biennially as Official opinions of the Attorney General in the Report of the Attorney General. Report year ends December 31. Slip opinions of the Attorney General.

Summary of the opinions of the Attorney General, 2011

Compiled biennially as Official opinions of the Attorney General in the Report of the Attorney General. Report year ends December 31. Slip opinions of the Attorney General.

Summary of the opinions of the Attorney General, 2009

Compiled biennially as Official opinions of the Attorney General in the Report of the Attorney General. Report year ends December 31. Slip opinions of the Attorney General.