Il y a plus de quatre ans maintenant, une grève générale qui allait s’étendre durant 44 jours était déclenchée en Guadeloupe à l’appel de la coalition LKP (Liyannaj KontPwofitasyon), « Unité contre ...l’exploitation ». Ce collectif de 48 organisations, initié le 5 décembre 2008 et toujours à l’œuvre actuellement, se donnait pour but de mobiliser la population guadeloupéenne contre la « vie chère », en désignant le système d’échange économique entre la métropole et la Guadeloupe comme responsable...
Childers, Kristen Stromberg, Seeking Imperialism's Embrace: National Identity, Decolonization, and Assimilation in the French Caribbean (Oxford/New York, Oxford University Press, 2016), 288 p. ...Seeking Imperialism's Embrace interroge les logiques impériales et coloniales caractéristiques de l'exercice du pouvoir dans les territoires insulaires de la Caraibe française et les effets des politiques assimilationnistes sur la citoyenneté des populations locales, en questionnant plus particulierement la cécité caractéristique du modele républicain envers les discriminations raciales. Le plébiscite électoral des députés communistes en provenance des DOM en 1947, qui accompagne ce premier mouvement décolonial, est alors perçu comme un moindre mal face au « soft power » étatsunien - dans la mesure oÛ celui-ci connaît un certain succes aupres des élites blanches (les békés), manifestement sensibles a une association qu'elles estiment bénéfiques pour consolider leur domination économique et raciale contre « l'oppression que représentent les fonctionnaires de couleur » (p. 71). La sixieme section propose de croiser les catégories de genre et de race en interrogeant la place de la famille dans la société antillaise, en soulignant les liens entre la matri-focalité des familles afro-caribéennes et la hiérarchie raciale.
The objective of this article is to stress the lack of valid and reliable measures concerning loyalty, and then to conceive, test and validate a relevant measurement procedure of this concept, by ...following a rigorous methodology based on the Churchill paradigm Churchill GA. A paradigm for developing better measures of marketing constructs. J Mark Res 1979;16(1):64–73. In the first part, the authors will approach problems linked to the conceptualization and to the operational aspects of loyalty in the literature. This synthesis will lead to a proposal of differentiation of the repeat purchasing behavior by the concept of brand sensitivity. The second part will deal with methodological aspects and will present the main results of this research. Finally, the article concludes on the contributions and limits of this study, as well as on future research perspectives.
Motor complications in Parkinson’s disease (PD) result from the short half-life and irregular plasma fluctuations of oral levodopa. When strategies of providing more continuous dopaminergic ...stimulation by adjusting oral medication fail, patients may be candidates for one of three device-aided therapies: deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion, or continuous duodenal/jejunal levodopa/carbidopa pump infusion (DLI). These therapies differ in their invasiveness, side-effect profile, and the need for nursing care. So far, very few comparative studies have evaluated the efficacy of the three device-aided therapies for specific motor problems in advanced PD. As a result, neurologists currently lack guidance as to which therapy could be most appropriate for a particular PD patient. A group of experts knowledgeable in all three therapies reviewed the currently available literature for each treatment and identified variables of clinical relevance for choosing one of the three options such as type of motor problems, age, and cognitive and psychiatric status. For each scenario, pragmatic and (if available) evidence-based recommendations are provided as to which patients could be candidates for either DBS, DLI, or subcutaneous apomorphine.
Abstract Development of a numerical model applicable to clinical practice, and in particular oral implantology, requires knowledge of the mechanical properties of mandibular bone. The wide range of ...mechanical parameters found in the literature prompted us to develop an inverse analysis method that takes into account the exact geometry of each specimen tested, regardless of its shape. The Young's modulus of 3000 MPa we determined for mandibular bone using this approach is lower than the values reported in the literature. This difference can be explained by numerous experimental factors, related in particular to the bone specimens used. However, the main reason is that, unlike most previously published papers on the subject, the heterogeneity of bone led us to select a specimen size at the upper end of the scale, close to clinical reality.
Summary Background Chronic heart failure (CHF) is a frequent severe disease. Disease-management programmes, which contain a therapeutic patient education component, will play a central role in ...improving delivery of care and reducing mortality and hospitalizations for CHF. Aims In order to have an up-to-date overview of medical treatment of CHF in France implemented by hospital and clinic cardiologists especially interested in CHF and therapeutic patient education, we described the prescription of cardiovascular drugs in the large ODIN cohort of CHF patients, according to age and type of CHF. Methods From 2007 to 2010 (median follow-up 27.2 months), CHF patients were prospectively enrolled in a multicentre ‘real-world’ French cohort by centres previously trained in therapeutic patient education. Patients were grouped according to age (< 60 years, 60 to < 70 years, 70 to < 80 years and ≥ 80 years) and type of CHF (characterized by level of LVEF: reduced, borderline or preserved). Medical prescription was described and mortality was assessed at long-term follow-up. Results The cohort consisted of 3237 patients (67.6 years; 69.4% men). The oldest age group had the highest LVEF. Blockers of the angiotensin-aldosterone system were prescribed progressively and significantly less frequently as the population advanced in age or as LVEF was more preserved. The mean dosages of the main prescribed CHF drugs remained ≥ 50% lower than those recommended for most drugs in all age and LVEF groups. Drug prescriptions were related to aetiology of reduced or preserved CHF. A global decrease in CHF drug prescription was observed for all medication classes except calcium blockers, according to maintenance of relatively or totally preserved LVEF. Survival was related to age but not to type of CHF. Conclusion In CHF, and despite management by cardiologists particularly interested in CHF and specifically trained to deliver therapeutic patient education, medical prescription differed substantially from guidelines. Age and type of CHF (reduced versus preserved) appeared to be important factors in lack of adherence to guidelines. However, only age influenced mortality; the type of CHF did not affect survival.
Objectives The objective of this study was to analyze the effects of Choukroun's PRF (platelet-rich fibrin), a leucocyte and platelet concentrate clinically usable as fibrin membrane or clot, on ...human primary cultures of gingival fibroblasts, dermal prekeratinocytes, preadipocytes, and maxillofacial osteoblasts. Study design For the proliferation study, these cells were cultivated with or without a PRF membrane originating from the same donor as for the cells. For osteoblasts and fibroblasts, dose-dependent effect was assessed (using 2 membranes). Cell counts and cytotoxicity tests were performed at 3, 7, 14, and 21 days, and even 28 days for osteoblasts. More osteoblast cultures were prepared in differentiation conditions according to 3 modalities (without PRF, with PRF, with PRF the first day and differentiation medium applied only after the first week of culture). Osteoblast differentiation was analyzed using Von Kossa staining and alkaline phosphatase, DNA and total cell proteins dosage. Results PRF induced a significant and continuous stimulation of proliferation in all cell types. It was dose dependent during all the experiment with osteoblasts, but only on day 14 with fibroblasts. Moreover, PRF induced a strong differentiation in the osteoblasts, whatever the culture conditions. The analysis of osteoblast cultures in differentiation conditions with PRF, using light and scanning electron microscopy, revealed a starting mineralization process in the PRF membrane itself after 14 days. Moreover, PRF leucocytes seemed to proliferate and interact with osteoblasts. Conclusions Cultures with PRF are always cocultures with leucocytes. These “chaperone leucocytes” could be the source of differential geographic regulation within the culture and explain the double contradictory effect proliferation/differentiation observed on osteoblasts.
This registry evaluated the 24-month safety and efficacy of levodopa-carbidopa intestinal gel (LCIG) treatment in advanced Parkinson's disease (PD) patients under routine clinical care.
Motor ...fluctuations, dyskinesia, non-motor symptoms, quality of life, and safety were evaluated. Observations were fully prospective for treatment-naïve patients (60% of patients) and partially retrospective for patients with ≤12 months of pre-treatment with LCIG (40% of patients). Hours of “On” and “Off” time were assessed with a modified version of the Unified Parkinson's Disease Rating Scale part IV items 32 and 39.
Overall, 375 patients were enrolled by 75 movement disorder centers in 18 countries and 258 patients completed the registry. At 24 months LCIG treatment led to significant reductions from baseline in “Off” time (hours/day) (mean ± SD = −4.1 ± 3.5, P < 0.001), “On” time with dyskinesia (hours/day) (−1.1 ± 4.8, P = 0.006), Non-Motor Symptom Scale total (−16.7 ± 43.2, P < 0.001) and individual domains scores, and Parkinson's Disease Questionnaire-8 item total score (−7.1 ± 21.0, P < 0.001). Adverse events deemed to have a possible/probable causal relationship to treatment drug/device were reported in 194 (54%) patients; the most frequently reported were decreased weight (6.7%), device related infections (5.9%), device dislocations (4.8%), device issues (4.8%), and polyneuropathy (4.5%).
LCIG treatment led to sustained improvements in motor fluctuations, non-motor symptoms particularly sleep/fatigue, mood/cognition and gastrointestinal domains, as well as quality of life in advanced PD patients over 24 months. Safety events were consistent with the established safety profile of LCIG.
•Long-term registry of LCIG treatment in patients with advanced Parkinson's disease.•LCIG was delivered over 24 months in a routine clinical care setting.•LCIG treatment reduced “Off” time and dyskinesia time over 2 years.•LCIG treatment improved non-motor symptoms and quality of life over 2 years.•Adverse drug reactions were consistent with the established safety profile of LCIG.
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