[Pharmaceutical supply chain of a New Caledonian hospital: Overview, risk assessment and future prospects]. / Approvisionnement pharmaceutique au centre hospitalier territorial de Nouvelle-Calédonie : état des lieux, évaluation et perspectives.

INTRODUCTION: The supply circuit for health products in New Caledonia has characteristics and specificities linked to its geographical situation (extended delivery time, freight forwarder) and its local policy (own currency, fundings, legislation and custom fees). A risk management approach should provide an upgrade of the supply process safety. METHODS: A system overview is carried out thanks to the processes description (operational and cross-functional). A risk map associated with the FMEA methodology (Failure Mode Effects Analysis) identifies the most critic modes of failure, for which safety action must be taken. A specific rating is introduced when the mode of failure concerns sensitive health products. RESULTS: The mapping identified 32 modes of failure which may affect the clinical management of the patients. Concerning sensitive health products, 11 modes of failure were deemed "to be monitored". None of the failure modes were considered as "to treat as a priority". CONCLUSION: The security process is ensured by the logistics and accounting unit, internal to the pharmacy structure. Securisation might include deployment of a data exchange system, sensitive health products identification or collaboration with neighbouring countries to import health products. Supply chain reinforcement mesures can be implemented by the public authorities, but should also be sought through territorial collaboration or via the PharmApprOM community of practice bringing together pharmacists in French overseas regions.

[Access to the kidney transplantation waiting list for peritoneal dialysis patients in New-Caledonia and Wallis and Futuna]. / Accès à la liste d'attente de greffe rénale des patients en dialyse péritonéale de Nouvelle-Calédonie et Wallis et Futuna.

INTRODUCTION: Since 2012, a deceased donor kidney transplant program exists for dialysis patients living in New-Caledonia in collaboration with Royal Prince Alfred Hospital in Sydney, Australia. This program has reduced the time spent out-of-territory for a renal transplantation and has reduced the economic burden of end stage renal disease in New-Caledonia. We have realised a photography of kidney transplants evaluation for patients in peritoneal dialysis in New-Caledonia and Wallis and Futuna. The first aim was to describe access to kidney transplants evaluation for dialysis patients. A second aim was to compare patients with a conformed kidney transplant evaluation and patients without transplant evaluation with no obvious reasons identified. METHOD: All patients in peritoneal dialysis in New-Caledonia and Wallis and Futuna at the 2018, 31st july were included. A standardised form was filled by two nephrologists. The computerised shared medical record was used to collect information. A kidney transplant evaluation was adequate for patients registered on transplant waiting list, patients with medical contraindications identified or patients with evaluation exams begun less than 6 months. RESULTS: In total, 61 patients were included. The average age was 62 years old. The chronic kidney disease care average time was 6.7 years and the dialysis average time was 2.0 years. Among them, 11 (18 %) were registered on the waiting list, 26 (43 %) had at least one kidney transplant medical contraindication, 3 (5 %) had begun transplant exam since less than 6 months and 21 (34 %) had no transplant exam begun or transplant exam begun since more than 6 months without medical contraindication identified. Among those 21 patients, the three most common reasons were a faulty programming transplant exam (67 %; n = 14), a remote living place (48 %; n = 10) and an intercurrent health event (29 %; n = 6). Among patients living in Noumea and suburbs, 74 % had a conformed transplant evaluation against 44 % in patients living outside Noumea and suburbs (P = 0.058). Nearly one in two patients not on the waiting list had have no information about kidney graft or the information was not recorded in the medical record. CONCLUSION: This study showed two main factors of a non-conformed transplantation evaluation: living outside Noumea and suburbs and a non-efficient planning of pre-transplant assessment exams. There is also a lack of information to the patient. These risk factors for late registration and non-registration must be considered by the healthcare teams. This study will provide a point of reference to assess the impact of actions to improve access to renal transplantation deployed in New-Caledonia.

The genus Indigofera (Leguminosae) in New Caledonia: two new species and a key for the species.

Indigoferamonieriana M.Pignal & L.P.Queiroz, sp. nov. and Indigoferadumbeana M.Pignal & L.P.Queiroz, sp. nov., two new species from New Caledonia, are described and illustrated. Both new species have been collected for a long time, but most herbarium specimens were named as the Australian species Indigoferaaustralis, even though they clearly stand apart from this species and the other New Caledonian species of the genus. Indigoferamonieriana can be diagnosed by the tall virgate shrubby habit, leaves with an articulate rachis and 7-11 widely obovate to orbiculate leaflets with greyish undersurface and almost invisible venation. Indigoferadumbeana can be recognized by the arborescent habit, leaves with 15-19 elliptical leaflets, small, c. 6 mm long flowers, and ellipsoid seeds. Preliminary IUCN assessments are provided for both species. A key is provided for all species of Indigofera recorded from New Caledonia.

RésuméIndigoferamonieriana M.Pignal & L.P.Queiroz, sp. nov. et Indigoferadumbeana M.Pignal & L.P.Queiroz, sp. nov., deux nouvelles espèces de Nouvelle-Calédonie, sont décrites et illustrées. Toutes deux sont récoltées depuis longtemps, mais la plupart des spécimens d'herbier sont rapportés à Indigoferaaustralis, une espèce australienne, même si elles se distinguent clairement de cette espèce et des autres espèces du genre de la Nouvelle-Calédonie. Indigoferamonieriana peut être caractérisée par son port arbustif élevé, ses feuilles avec un rachis articulé et 7­11 folioles largement obovales à orbiculées, une face abaxiale grisâtre et une nervation presque invisible. Indigoferadumbeana se reconnaît à son port arborescent, à ses feuilles avec 15­19 folioles elliptiques, à ses fleurs de petite taille (environ 6 mm de long) et à ses graines ellipsoïdes. Des statuts UICN préliminaires sont proposés. Une clé est fournie pour toutes les espèces d'Indigofera répertoriées en Nouvelle-Calédonie.

[Traffic accidentability and risky driving behavior in young people in New Caledonia. Results of study Situation Sociale et Comportements de Santé des Jeunes en Nouvelle-Calédonie]. / Accidentalité et prise de risque sur la route en Nouvelle-Calédonie. Résultats de l'étude Situation sociale et comportements de santé des jeunes en Nouvelle-Calédonie.

BACKGROUND: New Caledonia has one of the highest global rates of death from road accidents: 240 deaths per million inhabitants in 2011 with a majority of young people. However, research on driving behaviors has remained rare. METHODS: A cross-sectional survey based on face-to-face questionnaire with 1400 male and female youth aged 16 to 25 was conducted in 2007. It was used to measure the frequency of accidents and to compute a score of driving behaviors and their associations with socio-demographic characteristics, lifestyles as well as other health behaviors. RESULTS -  CONCLUSION: A total of 10.6% of boys and 6.5% of girls reported a car accident in the previous twelve months period. Among male participants risky driving behavior was associated with having a degree (ORa=2, 95% CI [1.1-3.8]), sport practices (ORa=3.7, 95% CI [1.9-7.05]), involvement in a fight in the last twelve months (ORa=2.2, 95% CI [1.4-3.4]) and precocity of cannabis use (ORa=1.8, 95% CI [1.2-2.8]). Youth living in couple and those with children presented with higher risk-taking scores. Among female participants, young age at cannabis initiation (ORa=3.1, 95% CI [1.5-6.4]) and at sexual debut (ORa=2.4, 95% CI [1.1-5.1]) were associated with driving risk-taking. Finally, younger age at first alcohol intoxication was associated with risky behavior on the road in both sexes. These results highlighted the multidimensional nature of risk-taking behaviors on the road and showed that they are part of, for boys and girls, a larger pattern of risky behaviors. Such results suggest to include behaviors on the road in a comprehensive approach of prevention.

Resurrection of New Caledonian maskray Neotrygon trigonoides (Myliobatoidei: Dasyatidae) from synonymy with N. kuhlii, based on cytochrome-oxidase I gene sequences and spotting patterns.

The maskray from New Caledonia, Neotrygon trigonoides Castelnau, 1873, has been recently synonymized with the blue-spotted maskray, N. kuhlii (Müller and Henle, 1841), a species with wide Indo-West Pacific distribution, but the reasons for this are unclear. Blue-spotted maskray specimens were collected from the Indian Ocean (Tanzania, Sumatra) and the Coral Triangle (Indonesia, Taiwan, and West Papua), and N. trigonoides specimens were collected from New Caledonia (Coral-Sea). Their partial COI gene sequences were generated to expand the available DNA-barcode database on this species, which currently comprises homologous sequences from Ningaloo Reef, the Coral Triangle and the Great Barrier Reef (Coral-Sea). Spotting patterns were also compared across regions. Haplotypes from the Coral-Sea formed a haplogroup phylogenetically distinct from all other haplotypes sampled in the Indo-West Pacific. No clear-cut geographic composition relative to DNA-barcodes or spotting patterns was apparent in N. kuhlii samples across the Indian Ocean and the Coral Triangle. The New Caledonian maskray had spotting patterns markedly different from all the other samples. This, added to a substantial level of net nucleotide divergence (2.6%) with typical N. kuhlii justifies considering the New Caledonian maskray as a separate species, for which we propose to resurrect the name Neotrygon trigonoides.

Gymnocranius superciliosus and Gymnocranius satoi, two new large-eye breams (Sparoidea: Lethrinidae) from the Coral Sea and adjacent regions.

Two related perciform fish species of the subfamily Monotaxinae (Sparoidea: Lethrinidae) Gymnocranius superciliosus sp. nov. and Gymnocranius satoi sp. nov. are described from specimens and tissue samples from the Coral Sea and adjacent regions. G. superciliosus sp. nov. is distinct from all other known Gymnocranius spp. by the following combination of characters: body elongated (depth 2.7-3.1 in standard length), caudal fin moderately forked with a subtle middle notch, its lobes slightly convex inside, distinctive blackish eyebrow, snout and cheek with blue speckles, and dorsal, pectoral, anal and caudal fins reddish. G. satoi sp. nov. is the red-finned 'Gymnocranius sp.' depicted in previous taxonomic revisions. While colour patterns are similar between the two species, G. satoi sp. nov. is distinct from G. superciliosus sp. nov. by the ratio of standard length to body depth (2.4-2.5 vs. 2.7-3.1) and by the shape of the caudal fin, which is more shallowly forked, its lobes convex inside and their extremities rounded. The two species are genetically distinct from each other and they are genetically distinct from G. elongatus, G. euanus, G. grandoculis, and G. oblongus sampled from the Coral Sea and adjacent regions.