["Recognize nurses for what they are: invaluable"]. / « Reconnaître les infirmières pour ce qu'elles sont, c'est-à-dire inestimables ¼.

Appointed Director General of the International Council of Nurses (ICN) in February 2019, Howard Catton is committed to ensuring that the ICN can effectively represent nursing around the world. He firmly believes that nurses must be at the heart of health policy decisions. With a nursing diploma and a master's degree in labor relations, he held a number of nursing positions in England and the United States before joining the New Zealand Nurses Organisation. For ten years, he directed the political and international affairs of the UK's Royal College of Nursing, then led ICN's action during the Covid-19 pandemic, while positioning himself in favor of protecting and investing in the nursing profession.

[Sudden death in adults : Data from 305 consecutive autopsy cases in Algeria]. / Mort subite de l'adulte : données de 305 cas d'autopsies consécutives en Algérie.

BACKGROUND-AIMS: Sudden death in a young adult who showed no prodrome or complaint during his lifetime is a tragedy. The death often remains unexplained by doctors and is often the subject of a judicial investigation following which an autopsy is ordered. Our study joins several studies around the world, where the results have linked sudden death in adults to a cardiac origin. METHODS: Through a series of 305 autopsies carried out in the forensic medicine department of the Frantz Fanon hospital in the city of Bejaia in Algeria over a period of two years, 57 cases corresponded to unexplained sudden deaths, i.e. an incidence of 3 cases per 100,000 inhabitants per year. RESULTS: Sudden death was of cardiac origin in 50.8% of cases (N=28). Two epidemiologic profiles emerge in our study: the first is that of a man aged between 50 and 60 years of age, with several deleterious lifestyle habits (in particular smoking) with a cardiovascular history, previously followed by a cardiologist, who died suddenly out-of-hospital, from ischemic heart disease. The second is that of a young adult under 40 years of age, of average build, with no particular medical history, having not previously consulted a cardiologist, who died suddenly of hypertrophic cardiomyopathy. CONCLUSIONS: In many instances, we observed major anatomical lesion, which had not motivated any prior medical consultation either with a general practitioner or with a cardiologist.

Visual supplementation is an effective tool in cataract surgery counselling by eye-care practitioners.

BACKGROUND: Informed consent constitutes an important aspect of eye care. However, patients often experience difficulties understanding and retaining information presented to them during consultations. This study investigates the efficacy of pictorial aids in supplementing preoperative counselling of patients undergoing cataract surgery. METHODS: Patients attending routine pre-cataract surgery counselling were randomized to receive either a standard verbal consultation (control) or a verbal consultation with a digitalized pictorial aid illustrating key surgical steps (intervention). Patients were assessed after the consultation on their knowledge, satisfaction, anxiety and preparedness using an anonymous questionnaire. RESULTS: Seventy-six patients were recruited and randomized into the control and intervention groups. The intervention group attained better Knowledge Scores (control: 5 [2-6] vs. intervention: 6 [6]), and more patients "strongly agreed" that they were more prepared (control: 78.9% vs. intervention: 97.4%, P=0.028). A higher proportion of patients in the control group either "disagreed" or "neither disagree nor agreed (neutral)" that they were less worried (control: 15.8% vs. intervention: 0.0%, Fisher's Exact Test P=0.025). Although the consultation duration was shorter in the intervention group (21±4mins vs. 27±6mins, P<0.001), the use of digital pictorial aids during consultation resulted in more effective counselling with increased patient knowledge, easier decision-making process and reduced patient anxiety. CONCLUSION: Pictorial aids add to the repository of tools available to eye-care practitioners and are low-cost, easy to implement, and can effectively augment existing preoperative counselling processes to ensure accurate and effective preoperative counselling of patients.

[François Gros, my boss]. / François Gros, mon patron.

This article shares the author's memories of his collaborations with François Gros when the latter was Professor at the University of Paris 7, then Director of the Institut Pasteur, then President of the Pasteur-Weizmann Council. He underlines the major contributions of "his boss" in the exercise of these functions.

Cet article fait part de souvenirs de l'auteur relatifs à ses collaborations avec François Gros lorsque ce dernier était professeur à l'université Paris 7, puis directeur de l'Institut Pasteur, puis président du Conseil Pasteur-Weizmann. Il souligne les contributions majeures de «  son patron  ¼ dans l'exercice de ces fonctions.

[Genetic counselling and testing in pulmonary arterial hypertension - A consensus statement on behalf of the International Consortium for Genetic Studies in PAH - French version]. / Conseil génétique et dépistage de l'hypertension artérielle pulmonaire ­ consensus du Consortium international pour les études génétiques dans l'HTAP ­ version française.

Pulmonary arterial hypertension (PAH) is a rare disease that can be caused by (likely) pathogenic germline genomic variants. In addition to the most prevalent disease gene, BMPR2 (bone morphogenetic protein receptor 2), several genes, some belonging to distinct functional classes, are also now known to predispose to the development of PAH. As a consequence, specialist and non-specialist clinicians and healthcare professionals are increasingly faced with a range of questions regarding the need for, approaches to and benefits/risks of genetic testing for PAH patients and/or related family members. We provide a consensus-based approach to recommendations for genetic counselling and assessment of current best practice for disease gene testing. We provide a framework and the type of information to be provided to patients and relatives through the process of genetic counselling, and describe the presently known disease causal genes to be analysed. Benefits of including molecular genetic testing within the management protocol of patients with PAH include the identification of individuals misclassified by other diagnostic approaches, the optimisation of phenotypic characterisation for aggregation of outcome data, including in clinical trials, and importantly through cascade screening, the detection of healthy causal variant carriers, to whom regular assessment should be offered.

[Contraceptive Counseling: The Medical Toolbox Must Include the Full Range of Reversible Contraceptive Methods Also for Adolescent Women]. / Kontrazeptionsberatung: Die ärztliche Toolbox muss auch für Adoleszentinnen das gesamte Spektrum der reversiblen Verhütungsmethoden beinhalten.

Contraceptive Counseling: The Medical Toolbox Must Include the Full Range of Reversible Contraceptive Methods Also for Adolescent Women Abstract. When counselling adolescents, empathy and age-appropriate information on medical confidentiality are important. Addressing individual needs and wishes enables the targeted use of the necessary information and resources and is the best guarantee for successful contraception over time. The goal is to make informed decisions and to have a positive experience of successfully protected sexual and reproductive health. The range of suitable contraceptive options is very broad. To make the most of this potential, all methods should be addressed with their advantages and disadvantages, including information on sexually transmitted infections and protection against them. Concerns and questions should be answered comprehensively and openly, and the experiences with sexuality described should be approached without prejudice. Often this is also an opportunity to talk about experienced situations of sexual assault.

Knowledge exchange between patient and pharmacist: A mixed methods study to explore the role of pharmacists in patient education and counseling in asthma and pulmonary arterial hypertension.

OBJECTIVES: To better understand the role of pharmacists in patient education and counselling: describe the perception of knowledge exchange (KE) between asthma/pulmonary arterial hypertension patients and pharmacists (hospital/community) according to four dimensions (4C-typology): cure (C1), care (C2); coordination/supply chain (C3), characteristics of the pathophysiology/disease mechanisms (C4); factors correlated with KE. METHODS: A mixed methods approach was used. Part A: data from semi-structured patient interviews were processed (thematic analysis), and a questionnaire developed. Part B: completed patient questionnaires were processed by correspondence factor analysis. RESULTS: KE (4C-typology) was correlated with pathology, disease severity, disease duration, age, hospital/community pharmacist. Patients expected pharmacists to provide C2/C3 services. KE with pharmacists covered C1/C2/C3, and with physicians, C1/C2/C4. While patients perceived KE as a means of self-learning to improve self-care skills, the two-way nature meant it provided specific experiential information feedback to pharmacists. CONCLUSIONS: This 4C-typology provides a holistic framework for optimising the pharmacists' role in education and counselling of patients with chronic diseases.

[Lawsuits related to delays in the investigation and treatment of coronary artery diseases]. / Plaintes liées aux retards dans l'exploration et le traitement des coronaropathies.

Coronary disease results from the slow formation of atherosclerotic plaque, accelerated by plaque ruptures that make it serious. Cardiologists have many explorations, but with a lead time that can take several weeks. The organization of a revascularization can sometimes also be long. The medico-legal analysis reports frequent cases of acceleration of the disease in this interval, which can lead to death. It is then necessary to stratify the individual risk of each patient, if this delay is accepted. However, it is imperative to give instructions in case of the development of symptoms, remembering that at any time, it is sometimes necessary to call the emergency services (911 or others). Care teams must ensure that a process for receiving calls is organized during this period. It is sometimes preferable for the cardiologist to make the appointment personally or for him to opt directly for a coronary angiogram from the outset, if his clinical conviction is strong. It is with a complete strategy that we can reduce the risk of a medical accident and therefore of a complaint.

[Nutrition and physical activity (PA) during and after cancer treatment: Therapeutic benefits, pathophysiology, recommendations, clinical management]. / Nutrition et activité physique adaptée (APA) pendant et après les traitements du cancer : bénéfices thérapeutiques, physiopathologie, recommandations, prise en charge clinique.

Lifestyle behaviors, such as diet and physical activity, are factors that influence risk of numerous cancers. They are also decisive during and after cancer for the course of oncological treatment, but also in the immediate and long-term prognosis, and quality of life during and after treatment. Separately, physical activity and nutritional support can reduce the risk of sarcopenia and its consequences, and improve quality of life during treatment. Whan introduced early, such a combination, increases the prognostic benefits. In remission, particularly in overweight patients, the APA-diet combination reduces the risk of cancer relapse and improves cardiovascular performance. These programs require a precise assessment of capacities and habits of each patient, and interventions of trained professionals (certified exercise instructor, dietician trained in oncology). The funding conditions for these programs exist for cancer survivors and should be considered for oncological treatment period.

[Factors associated with medical residents' brief counseling]. / L'aide au sevrage tabagique : la pratique du conseil minimal par les résidents en médecine.

INTRODUCTION: Smoking is a public health problem. Physicians have an important role in the fight against smoking, particularly by means of the brief advice they can give. The aim of this work was to study the prevalence of brief advice application by medical residents and to identify factors that may condition its practice. METHODS: We conducted a descriptive and analytical study with prospective data collection that included 302 residents practicing in Tunisia who had agreed to respond to an online questionnaire submitted in February and March 2020. RESULTS: Residents' mean age was 28±2 years and the gender ratio was 0.65. Sixty-four percent of them were non-smokers. During their practice, 94% systematically identified their patients' smoking status, but 61.9% were unfamiliar with the concept of brief advice. Residents' brief advice application rate was 57.6%. In multivariate analysis, the factors impacting brief advice application were: gender (OR=0.321, p=0.0001), familiarity with brief counseling (OR=2.808, p=0.002) and having observed brief advice being given by a senior physician (OR=2.328, p=0.0001). CONCLUSION: The rate of brief advice application remains low. On this subject, improved theoretical and practical teaching during medical studies is essential.

[Urban caregivers helping students]. / Les professionnels de santé libéraux au secours des étudiants.

In this period of pandemic, urban caregivers are directly concerned by the mental or social distress of students. In addition to university health services, psychologists through associations, social workers, doctors and nurses are listening to young people for individual situations, but sometimes also for group situations. So many access to health to propose to the suffering students as well as to their families.

[Dermocorticoides and sun exposure: A misunderstanding?] / Dermocorticoïdes et exposition solaire : un malentendu ?

INTRODUCTION: Fear of dermocorticoids (DCs) or corticophobia is based on an overestimation of the risks of actual side effects and on unfounded beliefs such as DCs-induced photosensitivity among community pharmacists. The objective of this study was to assess the community pharmacy teams' fear of dermocorticoids in atopic dermatitis (DA) in sunny weather and its impact on drug use advice. MATERIAL ET METHODS: A questionnaire as a real case (a summer prescription for atopic dermatitis for an 18-month-old child) was posted on Facebook via groups of pharmacists, technicians and students. Data collected concerned the health professional, his or her reluctance to DCs, advice associated with dispensation, detailed concerns about the DC and sun association, and sources of information. RESULTS: In total, 126 participants responded (48.4% pharmacists, 40.5% technicians, 10.3% students): 12% were reluctant to DCs, 36% were reluctant to DCs and considered them photosensitizing, and 51% were not reluctant but considered them photosensitizing. The impact on the patient advice was: a suggestion to stop DC during sun exposure (28%), to stop or limit DC (dose, duration) (43%). Concerns about the association DC/sun were mainly due to UV rays (46%). Sources cited were: monographs (54%), Internet (6%), training courses (13%). CONCLUSION: The false belief of DC/sun incompatibility in DA is strong among pharmacists and impacts on patients' advice. The role of the official team in dispensing dermocorticoids is essential: training and information for professionals helps to fight false information.

[Federate the nursing profession and promote its evolution]. / Fédérer la profession infirmière et favoriser son évolution.

The recent creation of National Professional Councils (CNP) constitutes a new milestone for the nursing profession in terms of representation. After a brief historical review and an update on what exists, we will explain how these CNPs are complementary to the other entities already in place and how they will bring about changes for the profession and the quality of care.

Opinion de comité no 406 : Dépistage prénatal après FIV avec test génétique préimplantatoire des aneuploïdies.

OBJECTIFS: Examiner l'approche du dépistage génétique prénatal et du diagnostic des anomalies chromosomiques dans les grossesses conçues par fécondation in vitro à la suite d'un test génétique préimplantatoire des aneuploïdies. PROFESSIONNELS CONCERNéS: Omnipraticiens, médecins de famille, obstétriciens, sages-femmes, infirmières, spécialistes en médecine fœto-maternelle, spécialistes en fertilité, conseillers en génétique, généticiens et autres professionnels de la santé qui participent au dépistage prénatal. POPULATION CIBLE: Toute personne ou tout couple dont la grossesse est issue d'une fécondation in vitro et dont l'embryon a préalablement été soumis à un dépistage génétique préimplantatoire des aneuploïdies. DONNéES PROBANTES: Des recherches ont été effectuées dans les bases de données Medline, PubMed et Cochrane Library pour extraire la littérature publiée au plus tard en septembre 2018. DÉCLARATIONS SOMMAIRES.

[Nursing students and university: after reconnecting, integration?] / Étudiants infirmiers et université : après le rattachement, l'intégration?

With the 2009 reference frame, nurse training transformed and moved close to universities with a new organisation of teaching. Integration into the university system is not yet complete. However, it is necessary in order to modernise and enhance the value of training and the profession.

[The "Conseil national professionnel d'anatomie et cytologie pathologiques" (CNPath): At the service of the profession]. / Le Conseil national professionnel d'anatomie et cytologie pathologiques (CNPath) : une structure au service de la profession.

The « conseils nationaux professionnels ¼ (CNP) are professional boards existing since 2010. Their missions, organization and functioning have been defined by the decree 2019-17 of January 9, 2019. CNPs represent all the members of a medical specialty (or health profession). CNPs must include all the learned societies and all the representative structures and associations of the same medical specialty. Their bodies must strictly respect the parity between public and private health sectors. The main missions of CNPs include the contribution to the elaboration of the national priority directions for continuous medical education and the definition of the individual plan for continuous professional development (DPC) recommended for the specialty. CNPs also behave as a single window for ministries, State agencies, welfare system and colleges of physicians. They are likely to be strongly involved in the process of re-certification of physicians, established in July 2019. The Conseil national professionnel d'anatomie et cytologie pathologiques, termed CNPath, has been created in 2010 and officially recognized by the Ministry of Health in August 2019. The main current actions of CNPath are: the elaboration of the individual DPC scheme for the specialty and the definition of the minimal obligations requested for its validation, the long-expected recognition of the expertal consultation in pathology, the support to the nation-wide effort for the production of structured pathological reports and the launching of a plan for implementing digital pathology. An internet site is under construction, to diffuse all the relevant information and make available the documents useful to all pathologists.

[N on-pharmacological management of smoking cessation during pregnancy- CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy]. / Prise en charge non pharmacologique du sevrage tabagique pendant la grossesse ­ Rapport d'experts et recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse.

OBJECTIVES: To assess the benefit of non-pharmacological intervention promoting on smoking cessation, obstetric and neonatal outcomes, to offer pregnant women who smoke (PWS) optimal care. METHODS: We searched Medline Database, Cochrane Library and consulted international guidelines. RESULTS: "Counselling" involving globally all kind of non-pharmacological interventions has a benefit on smoking cessation (NP1) and a moderate benefit on birth weight and prematurity (NP2). The brief intervention seems ineffective on smoking cessation (NP2). The effects of motivational interviewing have not been demonstrated during pregnancy (NP2). Cognitive-behavioral interventions do not show superiority (NP2). Financial incentives have a benefit for smoking cessation and possibly for neonatal outcomes (NP1). Feedback interventions (Co tester) provide heterogeneous results (NP2). Self-help interventions (NP2) and health education (NP2) seem effective on smoking cessation. Hypnotherapy and acupuncture have been little or not studied in PWS. Moderate physical activity did not show a significant effect (NP2) on smoking cessation but seem to reduce craving for tobacco (NP3). CONCLUSIONS: We recommend asking all PWS about their smoking consumption and detailing their smoking history, offering them different types of counselling according to their preferences and involving them multidisciplinary (grade A). The systematic use of feedback is not recommended (grade C) but experience suggests that the CO tester is important in establishing a therapeutic alliance (professional consensus). The use of self-help interventions (grade C) and health education (grade B) are recommended.

Inclusion of female participants in cardiovascular research: a case study of Ontario NSERC-funded programs.

This study explored inclusion of female participants in Natural Sciences and Engineering Research Council of Canada Discovery Grant (NSERC-DG)-funded human cardiovascular research at Ontario universities between 2010-2018. Ninety-six publications were examined and 4 principal investigators were interviewed. Females were excluded/underrepresented in 63% of publications with 49% male-only and 5% female-only samples. The sex-bias appears to be explained by dependence on research knowledge and methodologies that maintain and reproduce a firmly established discourse of the male norm. Novelty Female participants were underrepresented in NSERC DG-funded cardiovascular research at Ontario universities between 2010-2018.

[Survey among livestock veterinarians from the Canton of Fribourg investigating the topics of herd-health management, counselling and the use of antimicrobial drugs]. / Umfrage bei Freiburger Nutztierärzten zu den Themen Bestandesmedizin, Beratung und Antibiotikaeinsatz.

INTRODUCTION: The work of veterinarians is continuously undergoing structural changes. A shift from purely curative individual animal care towards herd-health management is observed worldwide in the livestock sector. To illustrate the practical implementation with all its advantages and disadvantages, an online survey was conducted among all practicing livestock veterinarians in the Canton of Fribourg. A link to the survey was sent by email, it was voluntary and possible to complete the questionnaire anonymously. The survey focused on four topics: Demographic data, herd-health management, billing of counselling and use of antimicrobial drugs. Forty veterinarians from at least 79.2% (n = 19) of all veterinary practices located in the canton of Fribourg (n = 24) responded. Of these, 67.5% were practice owners or partner (n = 27) and 32.5% were employed veterinarians (n = 13). In Fribourg, only herd fertility management is included in the herd-health management on a regular basis. The quality and quantity of advanced trainings in herd-health management for veterinarians was assessed as moderate to poor. There are various options for charging herd-health management services. The amount charged was variable. The most frequently used options were hourly rates (100-300 CHF/h), "rate per cow per year excl. visit rate" (22-75 CHF/cow/year) or "rate per cow per year incl. visit rate" (85-98 CHF/ cow/year). Only one veterinarian (2.5%) charges for advisory activities not included in the the herd-health management service, which was asked for separately. However, the time required for counselling (excluding herd-health management) was estimated to be between 5.0-70.0% of the total working time (median 15.0%, interquartile range = 10.0-32.5%). Veterinarians in Fribourg are reHauptluctant to follow the international trend towards a regular, integrated herd-health management. The majority of them do not charge for consultancy outside the herdhealth management service. A nationwide survey should be considered to better assess the situation all over Switzerland.

INTRODUCTION: Les vétérinaires sont soumis à un changement structurel permanent dans leur travail et cette évolution va dans la direction de la médecine de troupeau pour le secteur des animaux de rente. Pour pouvoir décrire les avantages et les inconvénients, une enquête en ligne a été effectuée auprès de tous les vétérinaires praticiens ruraux du canton de Fribourg et des régions limitrophes. Un lien vers l'enquête a été envoyé par courriel. La participation était sur une base volontaire et les données pouvaient être anonymisées, si souhaité. L'enquête portait sur les quatre thématiques principales suivantes: données démographiques, médecine de troupeau, facturation des prestations de conseil et administration d'antibiotiques. Quarante vétérinaires, soit 79.2% (n = 19) de toutes les pratiques vétérinaires rurales fribourgeoises (n = 24), ont répondu. De ceux-ci, 67.5% étaient propriétaires ou associés ( n= 27) et 32.5 % employés (n = 13). Dans le canton de Fribourg, le suivi de fertilité est effectué seulement de manière généralisée et intégré régulièrement dans le suivi de troupeau (100%). L'offre en formation continue aux vétérinaires sur la thématique médecine de troupeau est évaluée de moyenne à médiocre. La facturation des prestations de médecine de troupeau se déroule auprès des participants à l'étude de manière différenciée, avec même de très grandes différences: le plus souvent un barème horaire (100-300 CHF/h), à la seconde place «par vache et année sans le tarif de la visite¼ (22-75 CHF/vache/an) et en troisième position «par vache et année avec le tarif de la visite inclus¼ (85-98 CHF/Vache/an). Seul un vétérinaire (2.5%) a indiqué facturer des prestations de conseil en dehors du suivi de troupeau. Cependant, l'investissement en temps pour le conseil (sans le suivi de troupeau) est estimé de 5.0 à 70% du temps total de travail (moyenne: 15.0%, écart interquartile = 10.0­32.5%). La corporation vétérinaire fribourgeoise suit la tendance internationale à l'introduction d'un suivi de troupeau intégré et régulier, avec un peu de retard. Une enquête au niveau suisse devrait permettre d'évaluer la situation au niveau national.

[Nursing leadership and the International Council of Nurses]. / Le leadership infirmier et le Conseil international des infirmières.

The development of nursing leadership constitutes a key objective for the International Council of Nurses. This international organisation proposes numerous initiatives, notably training actions, in order to obtain positive results in this area.