Extension of French vaccination mandates: from the recommendation of the Steering Committee of the Citizen Consultation on Vaccination to the law.

On 4 December 2017, French parliamentarians passed a law extending the vaccination mandates for children up to 2 years of age from three vaccinations (against diphtheria, tetanus and poliomyelitis) to 11 by adding vaccinations against pertussis, Haemophilus influenza b (Hib), hepatitis B, pneumococcal diseases, meningococcal C diseases, measles, mumps and rubella. This vote follows a recommendation made by the Steering Committee of the Citizen Consultation on Vaccination that took place in 2016. The law applies to all children born after 1 January 2018. Parents who do not fulfil the mandate will not be fined but non-vaccinated children will not be admitted to any collective child services such as nurseries or schools. No exemption other than for medical reasons will be considered. Here we describe the historical background of this evolution and its main epidemiological, sociological and policy drivers. They mainly refer to insufficient vaccine coverage, persistence of a preventable burden for some diseases and growing vaccine hesitancy in the French population. We also discuss some of the challenges and conditions of success.

[Quality assurance indicators for risk management in the follow-up of medical care received by acute ischemic stroke patients]. / Des indicateurs de qualité et de gestion des risques pour suivre la prise en charge hospitalière des accidents vasculaires cérébraux.

Although recommendations for diagnosis and treatment of stroke are available, the aim of this study was to identify indicators of quality and risk management for acute ischemic stroke hospital patients. We conducted a descriptive study of stroke patients who were diagnosed less than 12 hours before admission to the Pitié-Salpêtrière hospital's neurology and stroke unit. Data were collected using a literature review and from existing recommendation. During the study period (August 2003 through April 2005) 310 eligible patients were identified. In 87.5% of the cases, patients suffered from a cerebral infarction and in 10.3% from an intracranial haemorrhage. The initial deficit was mild to severe. The average time between the first symptoms and admission in the stroke unit was 212 +/- 130 minutes. Forty percent of patients who underwent a thrombolysis did so within the first 3 hours. The average length of stay in the stroke unit was 17.5 days. Thirty-one percent of the patients were discharged to go home, 47% to a rehabilitation unit and 8% died. Ten indicators of quality and risk management are proposed, taking in account the events before admission, hospital care, side effects, duration of stay, discharge location and the handicap.

[The development of therapeutic education in France: current public policies and treatment options]. / Le développement de l'éducation thérapeutique en France: politiques publiques et offres de soins actuelles.

Therapeutic patient education (TPE) has significantly expanded in the last few years. This article explains the major trends underpinning and supporting its development in France, and how they have rendered it a central place in the system, and provided an integral role for therapeutic education within the wider perspective of medical care and treatment options. The organisation of TPE is analysed and numerous initiatives in hospitals, medical and health care structures, social centres, cities, and non-profit organisations are described. This analysis suggests a range of proposals in order to structure and integrate TPE in a sustainable manner for the long term, as well as to expand the existing initiatives to have a broader reach across the country.

[The development of therapeutic education in France: proposals for its sustainable integration in the health system]. / Le développement de l'éducation thérapeutique en France: propositions pour une intégration durable dans le système de soins.

The significant development of therapeutic patient education (TPE) in light of the current disparities observed in the organization of health care necessitates the consideration and delineation of proposals to better integrate TPE in the French health care setting and context in the long term. These proposals take into account the fundamental values of therapeutic patient education as well as the specificities of chronic disease management. They are based on actual examples from practice in medical structures that are recognized for the implementation of TPE activities and programmes: they aim at strengthening these through networking and at facilitating the work of all health professionals regardless of the methods of practice relative to the specific medical interventions they perform. These proposals aim to enrich current thinking on the organization, value and benefits of investing in TPE.