Outpatient parenteral antibiotic therapy: Evaluation of practices and limits of use in rural areas in France.

OBJECTIVES: To evaluate outpatient parenteral antibiotic therapy (OPAT) practices in a French rural area. MATERIAL AND METHODS: Descriptive study assessing knowledge, practices, and limitations of OPAT use among hospital practitioners (HP), family physicians (FP), and private nurses (PN). RESULTS: OPAT (mainly ceftriaxone and penicillins) was used by 69.6%, 73.3%, and 97.7% of the 23 HPs, 45 FPs, and 46 PNs mostly for respiratory or urinary tract infections, bacteremia, and/or multidrug-resistant bacterial infections. Overall, 65.2% of HPs and 37.8% of FPs were in contact with an infectious disease specialist. Knowledge of OPAT benefits and risks was lower for FPs than HPs. The main obstacles were the patient's geographic isolation (HPs), the availability of a venous catheter, the lack of training (FPs), and the expected OPAT-associated overwork (PNs). CONCLUSION: OPAT practice is weak in rural areas. Declared obstacles constitute fields of improvement for its essential expansion.

Subspace-based self-interference cancellation for full-duplex MIMO transceivers.

This paper addresses the self-interference (SI) cancellation at baseband for full-duplex MIMO communication systems in consideration of practical transmitter imperfections. In particular, we develop a subspace-based algorithm to jointly estimate the SI and intended channels and the nonlinear distortions. By exploiting the covariance and pseudo-covariance of the received signal, we can increase the dimension of the received signal subspace while keeping the dimension of the signal subspace constant, and hence, the proposed algorithm can be applied to most of full-duplex MIMO configurations with arbitrary numbers of transmit and receive antennas. The channel coefficients are estimated, up to an ambiguity term, without any knowledge of the intended signal. A joint detection and ambiguity identification scheme is proposed. Simulation results show that the proposed algorithm can properly estimate the channel with only one pilot symbol and offers superior SI cancellation performance.

Vaccination against serogroup B Neisseria meningitidis: Perceptions and attitudes of parents.

BACKGROUND: A vaccine against serogroup B Neisseria meningitidis, major cause of bacterial meningitis in children and adults, has recently been developed. In a context of an increasing parental mistrust against vaccinations, understanding the reason for their choices is crucial in order to improve immunization coverage. Our study aimed at evaluating parental attitudes and perceptions towards serogroup B meningococcal invasive disease vaccination. METHODS: A prospective observational study was conducted in different French independent-practice medical offices (general practitioners and paediatricians) and nurseries between May 1 and December 31, 2013, using a questionnaire distributed in electronic and paper forms to parents having at least one child between the ages of 2 months and 16 years old. RESULTS: 1270 parents were included, of whom 671 (52.8%) spontaneously stated to be in favour of this vaccination. Their choice was mainly justified by the severity of the disease (63.8%) and the desire to protect their child (51.7%). In multivariate analysis, the young age of parents (OR 0.949 per additional year; p<10(-3)), the history of vaccination against serogroup C meningococcal invasive diseases (OR 6.755; p<10(-3)), and the prior knowledge of the vaccine (OR 2.081; p=0.001) were associated with vaccination acceptance. The main reasons for refusal were the lack of hindsight on this new vaccine (50.6%) and the fear of side effects (45.5%). After objective information on the disease and the vaccine, only 6.3% of the entire responding population would refuse to consider vaccination. CONCLUSIONS: The spontaneous acceptance rate of vaccination against serogroup B meningococcal invasive disease is insufficient. However, after objective information by their physician or public health authorities, only a few parents would in the end be completely resistant.