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Saint-Sauveur-en-Rue, France

Riviere E.,Bordeaux University Hospital Center | Riviere E.,University of Bordeaux Segalen | Quinton A.,University of Bordeaux Segalen | Roux X.,Bordeaux University Hospital Center | And 11 more authors.
Presse Medicale

Purpose: Since 2011, the French medical students ranked after a national ranking exam (NRE) are making their career choice among 11disciplines detailing the chosen one. Before 2011, this precise choice was unknown. Our work is the first descriptive study of French medical students choice of career after the NRE, precising the medical specialty chosen and the city of practical formation. Methods: We analyzed the Excel® file transmitted by the 'Agence régionale de santé d'Aquitaine' once students choice done after the 2012NRE. A median range analysis was made for disciplines and city formation choices. For medical and surgery specialties, the analysis was compared to regional medical densities. Results: According to the median national choice, the first sixth disciplines chosen are ophthalmology, nephrology, internal medicine, radiology, cardiology and dermatology. Women are more attracted by medical gynecology, obstetrics, pediatrics, or dermatology; men mostly by neurosurgery, general surgery, nuclear medicine or cardiology. The most rated cities of formation according to their national median range of choice are Lyon, Montpellier and Paris. A majority of students (59%) moved to another city to obtain the desired specialty. Among general practitioners, 56% of students stayed in the city where they had been trained. Perspectives: Our study may provide concrete objectives for French medical students accomplishing their second cycle of medical studies, as well as supplemental data for French medical demographic management. © 2013 Elsevier Masson SAS. Source

Aminot Y.,French National Center for Scientific Research | Litrico X.,Agence regionale de sante ARS Aquitaine | Chambolle M.,Agence regionale de sante ARS Aquitaine | Pardon P.,French National Center for Scientific Research | Budzindki H.,French National Center for Scientific Research
Analytical and Bioanalytical Chemistry

Comprehensive source and fate studies of pharmaceuticals in the environment require analytical methods able to quantify a wide range of molecules over various therapeutic classes, in aqueous and solid matrices. Considering this need, the development of an analytical method to determine 53 pharmaceuticals in aqueous phase and in solid matrices using a combination of microwave-assisted extraction, solid phase extraction, and liquid chromatography coupled with tandem mass spectrometry is reported. Method was successfully validated regarding linearity, repeatability, and overall protocol recovery. Method detection limits (MDLs) do not exceed 1 ng L−1 for 40 molecules in aqueous matrices (6 ng L−1 for the 13 remaining), while subnanogram per gram MDLs were reached for 38 molecules in solid phase (29 ng g−1 for the 15 remaining). Losses due to preparative steps were assessed for the 32 analytes associated to their labeled homologue, revealing an average loss of 40 % during reconcentration, the most altering step. Presence of analytes in wastewater treatment plant (WWTP) effluent aqueous phase and suspended solids (SS) as well as in river water, SS, and sediments was then investigated on a periurban river located in the suburbs of Bordeaux, France, revealing a major contribution of WWTP effluent to the river contamination. Sorption on river SS exceeded 5 % of total concentration for amitriptyline, fluoxetine, imipramine, ritonavir, sildenafil, and propranolol and appeared to be submitted to a seasonal influence. Sediment contamination was lower than the one of SS, organic carbon content, and sediment fine element proportion was accountable for the highest measured concentrations. © 2015 Springer-Verlag Berlin Heidelberg Source

Salles N.,Bordeaux University Hospital Center | Baudon M.-P.,Agence regionale de sante ARS Aquitaine | Caubet C.,TeleSante Aquitaine | Dallay F.,Bordeaux University Hospital Center | And 9 more authors.
European Research in Telemedicine

Summary Of the three themes identified by the French Regional Program of Telemedicine, patient care in nursing homes was chosen for this study, targeting the care of elderly patients aged over 75 years with chronic wounds in the context of dependency and polypathology. Aim. - The aim of this study was to improve both elderly patients' access to care and continuity of care in the hospital and town setting, and to promote the training of caregivers. Methods. - This study (September 2012 to September 2013) is based on teleconsultations organized two and a half days per week by an expert team (comprising a geriatrician, nurse, occupational therapist, dietician, and secretary) in a gerontology center (Bordeaux University Hospital, France). After obtaining patient consent, the general practitioner (GP) and the nursing home care team connect to a virtual room with the expert center, either from the patient's room using a mobile telemedicine chariot (nursing homes with Wifi) or in a dedicated room (nursing homes without Wifi). Following each teleconsultation, a report is written and sent via a secure messaging system to the GP. Results. - In total, six nursing homes (in the French departments of Gironde and Dordogne) were included in this project. Preliminary results reported a total of 51 teleconsultations, dealing with the treatment and follow-up of pressure ulcers (57.1 %), vascular ulcers (26.3 %), and traumatic ulcers (15.8 %). These results indicate that telemedicine significantly improved wound healing and decreased dressing expenditure by reducing the pace of dressing changes (P = 0.005). Without these teleconsultations, GPs would have referred their patients to specialized consultations in 31.6 % of cases and for day hospitalizations in 47.4 % of cases. Conclusion. - The challenges of telemedicine are great in geriatrics, particularly in the monitoring of elderly patients with chronic diseases requiring repeated hospitalizations. One perspective is to expand teleconsultations to cover all geriatric syndromes (falls, confusion and behavioral disorders, malnutrition, etc.) and to provide continuing professional practice. The telemedicine tool discussed in this paper may also enable other specialists to monitorelderly patients in order to provide better continuity of care. © 2013 Published by Elsevier Masson SAS. Source

Thibault H.,Institute Of Sante Publique | Thibault H.,French Institute of Health and Medical Research | Carriere C.,Institute Of Sante Publique | Langevin C.,Institute Of Sante Publique | And 5 more authors.
Archives de Pediatrie

The Nutrition, Prevention and Health for Children and Teenagers in Aquitaine program is a regional implementation of the French National Program of Nutrition and Health (PNNS). The first of two surveys of a representative sample of Aquitaine preschools was conducted in 2004-2005. This survey showed that more than 2/3 of teachers offered a morning snack to their pupils at around 10 o'clock in the morning, mainly composed of sweet cakes, cookies, or candies. Following this initial survey, actions were implemented starting in September 2005, aiming to stop systematic morning snacks or improve their composition. The same survey was repeated during 2007-2008 in order to analyze the changes in morning snack practices in preschools between 2004-2005 and 2007-2008. Data were collected from teachers of Aquitaine's preschools who filled out questionnaires. Schools were randomly chosen according to their size and whether or not they belonged to a priority education zone (ZEP). The results show that 57.9% of teachers organized a morning snack in 2007-2008, versus 68.7% in 2004-2005. In 2004-2005, 22% of teachers considered the morning snack as " unjustified" compared to 44% in 2007-2008. The composition of morning snacks improved: 17.7% of teachers offered fruit and/or milk in 2007-2008 versus 8.5% in 2004-2005. Morning snacks composed of other foods (such as sweets, chocolate pieces, cookies, pastries, bread, fruit juice) decreased from 60.2% in 2004-2005 to 40.2% in 2007-2008. In 2007-2008, 19% of the teachers reported that children had snacks in their schoolbag versus 34% in 2004-2005. The proportion of teachers reporting children having snacks in their schoolbag decreased from 34% in 2004-2005 to 19% in 2007-2008. Comparison between these two surveys is encouraging as it shows an improvement of the perception and practices of teachers regarding morning snacks. These results encourage the partners of this program to continue the fieldwork actions. © 2010 Elsevier Masson SAS. Source

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