samedi 21 janvier 2012

Trois rencontres à ne pas manquer avant Noël !


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RENCONTRE/SIGNATURE
avec

Dominique Delvallée
auteur, metteur en scène Compagnie Anton TCHEKHOV
met en vente son ouvrage
LA DELIVRANCE
pièce de sensibilisation à la maltraitance
au profit du "Noël des déshérités"
Vendredi 16 décembre 2011
de 17h à 19h
***
REPRESENTATION
CHAMBRES
de Philippe Minyanapar le Théâtre du dumme Kuh
Samedi 17 décembre à 16h

Avec: Christine De Ruyter, Yvonne Perrin, Yves Walle

Mise en voix de Pina Trunzo
***
CONTES
Laissez-vous porter par la magie des contes d'ici et d'ailleurs...
Mardi 20 décembre à 16h à la librairie !
Ce livre débute par un long conte consacré à Lydéric, héros tutélaire, fierté de la ville de Lille mais aussi d'Aire-sur-la-Lys, puisque Le grand forestier de Flandre y aurait été porté en terre. On retrouvera aussi quelques-uns de nos personnages Légendaires dans des textes inspirés de Charles Deulin, Edmond Edmont, Henri Mayeur, mais aussi des plumes contemporaines telles Eugène Mordacque, Ti Fred, Philippe Valcq, Patrick Sautnier...
Quelques chants collectés au siècle dernier terminent l'ouvrage.
Le conte ne décrit pas, il suggère.., alors imprégnez-vous et laissez-vous rêver !

***
Trois rencontres à ne pas manquer !
Entrée libre / Réservations souhaitées

CONTES


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Laissez-vous porter par la magie des contes d'ici et d'ailleurs...
et surtout d'ici avec les géants, sorcières et autres héros du Nord et Pas-de-Calais
Mardi 20 décembre à 16h à la librairie !


Ce livre débute par un long conte consacré à Lydéric, héros tutélaire, fierté de la ville de Lille mais aussi d'Aire-sur-la-Lys,
puisque Le grand forestier de Flandre y aurait été porté en terre.
On retrouvera aussi quelques-uns de nos personnages Légendaires dans des textes inspirés de
Charles Deulin, Edmond Edmont, Henri Mayeur,
mais aussi des plumes contemporaines telles Eugène Mordacque, Ti Fred, Philippe Valcq, Patrick Sautnier...
Quelques chants collectés au siècle dernier terminent l'ouvrage.

Le conte ne décrit pas, il suggère.., alors imprégnez-vous et laissez-vous rêver !
***
Rencontre suivie d'un goûter pour petits et grands !
Entrée libre / Réservations souhaitées

Speed acting


Speed acting

Quatre troupes amateurs vous présentent en 15 minutes le texte de leur choix !
Qu'il soit leur projet en cours ou un coup de cœur !
Prochaine séance :
Samedi 28 janvier à 15h et à 17h

Les compagnies :

*
La compagnie des Scaphandriers d'eau de vaisselle < Contes pour enfants louches >
trois petites histoires de trois petits garçons hors du communs racontées par trois petites comédiennes, Bottiglione Nancy, Delrue Cécile et Mercier Mathilde

*
Steene Théâtre
< L’Homme des Bois de Anton Tchekhov >
La scène se passe dans la salle à manger de la maison des Sérébriakov. Entre une heure et deux heures du matin. L’orage menace. Sérebriakov a regagné sa chambre accompagné de Krouchtchov, le médecin venu le soigner pour une crise de goutte ou de rhumatisme. Voïnitski (le frère de sa première femme) et Elena (sa seconde femme) se retrouvent seuls. Avec Christian ALLARD, Brigitte DUBREUCQ, Guy CATRY, et Hélène MATTHYS
* Les Dissolvantes < RESET,
adaptation libre de Conseils pour
une jeune épouse de Marion Aubert >


Les Dissolvantes disponibles dans deux formats de flacons différents, le premier mesurant 176cm, idéal comme format familial et le second étant de 163cm, pratique, il vous suivra partout dans votre trousse de voyage. L’idéal est de réunir les deux formats pour un maximum d’efficacité. Avec humour et lucidité, elles abordent les rôles endossés ou subis par la gent féminine.
Avec Audrey Sauvage et Manue Delplace

*
L'Atelier
< Les Mangeuses de chocolat de Philippe Blasband >


ne thérapie collective pour personnes addictes au chocolat ; trois femmes font la démarche auprès d'un thérapeute (homme) et très vite, chacune d'entre elles découvre ce qui se cache derrière cette problématique, y compris le thérapeute qui lui est piégé par sa propre méthode...avec Cécile Berny, Sonia Daene, Marie-Simone De Bruycker, et Bruno Loiseau

***
Rafraichissements/grignotages entre les deux séances.
Entrée libre / Réservations souhaitées

Arlene Goldbard on the NCRP Report


Arlene Goldbard's outstanding book
I was tempted to call this "Occupy Wall Street (part 5)," but arts consultant and thinker Arlene Goldbard, author of the powerful book The New Creative Community: The Art of Cultural Development (which I think every artist ought to get as a Christmas present), has written a powerful post in reaction to the Fusing Arts, Culture and Social Change report as well as the discussion going on at Grantmakers in the Arts Forum on Equity in Arts Funding. Please, please go read it. It is entitled: "Equity in Cultural Funding: Let Them Bake Pies."

Here's a taste: Goldbard's conclusion:

An Idea That Everyone Will Hate


IN A COUPLE POSTS on Parabasis, Isaac Butler has contributed two commentaries concerning the increasingly blurred lines between the profit theatre and the nonprofit theatre. This is an issue upon which Rocco Landesman has repeatedly commented quite powerfully, both as head of the NEA and long before. This is an issue that intersects with many of my own concerns about the increasing centralization of the theatre in New York as well as the centralization of arts funding in large theatres, many of whom rather regularly transfer their productions to Broadway.
    While I was thinking about this issue and how best to address it, I came up with an idea that absolutely everybody will hate which, if I were an avant garde artist, I would see as proof that it is an excellent idea. And while I acknowledge its likelihood of universal horror, and also the complicated details that would be involved, I am going to share it anyway as a "modest proposal"" offered to provoke thought if nothing else.
    So here it is -- for simplicity's sake, I will give it a narrow focus:

  • Any theatre that transfers a production to a commercial venue automatically loses its non-profit status.
Actually, this wasn't the radical idea. Rather, it was the next step that was radical, because it makes this prohibition work both ways:

  • In order to maintain its 501(c)3 status, a non-profit theatre is not allowed to produce a play that has been done on Broadway or employ an artist who has worked in the commercial theatre, television, or film.
Yeah, that's the kicker.
     This would have the immediate negative effect of reducing artist income and, indeed, would likely substantially reduce the theatrical workforce. In fact, it might seriously cripple the theatre scene, at least for a while.
   On the other hand, it would draw a bright line between the nonprofit world and the commercial world, eventually creating a workforce focusing all of its artistic energy on developing the theatre. No longer would the nonprofit theatre be a stepping stone for playwrights, actors, directors, and designers to make a jump to commercial art forms. No longer would regional theatres across the US produce, cookie-cutter-like, the latest Broadway hit. No longer would we have articles in American Theatre making excuses for playwrights heading to Hollywood to write TV shows. No longer would theatre actors spend their time trying to land a national commercial or a bit spot on CSI. Theatre artists would have to commit, and if they wanted to do a TV series, film, or Broadway show, they would know that there was no going back.
   Imagine the amount of great theatre the world might have seen if the Steppenwolf actors had been doing play after play year after year instead of spending most of their time doing movies and TV series. Imagine if Tony Kushner had focused his enormous talent on writing play after play for Magic Theatre instead of trying to figure out a way to make a smart Broadway musical.  Imagine the richness that might have entered the theatre if the only people working in it were those who had committed their lives and talents totally to it. Imagine the collaboration that might happen between regional theatres looking to share the work of their playwrights. The nonprofit theatre world would be immeasurably enriched by being populated only by theatre artists who have committed their careers to its development.
   Yeah, I know -- the free flow of labor.
   But unless something like this happens, the nonprofit theatre will continue to be used as the minor leagues for commercial art forms that contribute to the cultural sludge that pollutes our nation. We need to quarantine the corporate values that have infected the commercial theatre. It isn't good for the art form; it isn't good for our culture.

Build a New Model


The arrival of a new year often leads to reflection on what has passed, and as a result points to new directions for what is to come in the future. For a theatre blogger who has been writing over 6 years, this is particularly true.

For a few weeks, I was considering discontinuing Theatre Ideas. Over the time I have written it, I have questioned many aspects of the theatrical status quo, and proposed ways to make it better. I have participated in important discussions, and written a few posts that have garnered  thousands of hits. And I have received several invitations to participate in convenings and submit grants as a result of writing this blog. As a result of writing this blog, my own ideas have come into greater focus.

What was getting me down is that nothing seems to really change. A topic rises to the forefront of everyone's consciousness, there is a certain amount of heat, a much smaller amount of light, and then -- pffftt! The discussion is over, and everyone goes back to talking about how to use Facebook and Twitter to market their productions, as if the only thing standing in the way of a vibrant theatre scene is just finding a way to get the word out. We're all for diversity -- yay! -- except don't ask us to do anything different. We're all for theatre for everyone -- yay! -- except don't ask us to do anything to promote it. We're all for new plays -- yay! -- but don't ask us to give up our classics. We're all for a more even distribution of funding -- yay! -- but don't actually take any money away from the richest institutions. The power of inertia seems to be bred in the bone.

It is time for me to take seriously the Buckminster Fuller quotation in the sidebar of this blog: "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." I have spent six years fighting the existing reality, which regardless remains stubbornly unchanged. My focus must now be on building a new model.

As many of you know, I have received funding to create a CRADLE pilot program in Bakersville, NC (pop 357), where I will be moving within the next few months. That is a concrete attempt to create a new model. I will blog about that process on the CRADLE blog.

I've also decided to organize my thoughts and ideas into a book with the working title "Small is Artful," which I may create a separate blog for. The book will address issues of scale in theatre as it impacts everything from location to business model to aesthetics to production methods. Whether I will publish this book myself or through a traditional publisher remains to be seen. Hell, whether I find the time to write it remains to be seen. Suffice to say that it is time to bring together the research and ideas that I have expressed over the years on this blog and put them into a more formal, organized, and portable format.

I'll continue to write here and on the CRADLE blog (where my absence has gone on for too long), but my thoughts will be focused forward to a new model, rather than engaging the current one.

In Honor of Martin Luther King


While there will be many tributes today to the vision and determination of Martin Luther King, from artists and non-artists alike, I think the best thing the arts as a field could do would be to take seriously the Fusing Arts, Culture, and Social Change report and address the inequities that are built into the non-profit arts infrastructure.

Lately, we have seen the enormously negative effects of Big Money in politics through the creation of Super Pacs and the lifting of limitations on corporate political contributions as a result of Citizens United. Well, this situation has long been in place in the arts. The wealthy and powerful dominate governing boards, and major institutions court major donations from rich individual donors and their foundations. And then we wonder why the money is centralized in elite, white, urban institutions and why those institutions present art that appeals to that demographic.

It is important that CRADLE not fall prey to this pattern. Local CRADLE organizations should have boards comprised not only of town leaders and elites, but of people representative of the population as a whole. This means choosing board members not for their ability to contribute and raise money, but for the value of their viewpoint and wisdom.

In the book The Abundant Community: Awakening the Power of Families and Neighborhoods, authors John McKnight and Peter Block call on citizens to create powerful and competent communities based on three "universal properties":

  • The Giving of Gifts -- The gifts of the people in our neighborhood are boundless. Our movement calls forth those gifts.
  • The Presence of Association -- In association we join our gifts together, and they become amplified, magnified, productive, and celebrated.
  • The Compassion of Hospitality -- We welcome strangers because we value their gifts and need to share our own. Our doors are open. There are no strangers here, just friends we haven't met.
The latter is particularly important, as it promotes what Block calls a "welcome at the edge." It isn't only the rich and powerful who have gifts to offer, but those who have been traditional ignored or marginalized. And those must be actively sought out and celebrated.

We must not continue to waste the talents of our people. We must not continue to ignore the stories of our people. We must celebrate the richness that exists in all people. And we must create an artistic infrastructure that promotes these values.

Un SMS pour vérifier la validité des médicaments en Afrique


LONDRES (AP) — Pour éviter la contrefaçon des médicaments contre le paludisme en Afrique, un entrepreneur ghanéen a eu l'idée de se servir de son téléphone portable. Bright Simmons a ainsi mis au point un système gratuit qui permet aux consommateurs de savoir immédiatement si un médicament est réellement actif en envoyant simplement par SMS un code figurant sur la boîte.
Selon des études internationales, notamment de l'Organisation mondiale de la santé (OMS), de 30 à 60% des médicaments circulant en Afrique sont soit contrefaits, soit en dessous des critères sanitaires réglementaires.
Partant de ce constat, M. Simmons a mis au point mPedigree. Ce système assigne un code unique aux médicaments patentés, imprimé au dos de la boîte sous une bande que l'on gratte. Le consommateur envoie ce code à une ligne téléphonique centrale par SMS et reçoit instantanément "OK" si le médicament est breveté et valable -d'autres informations lui sont également fournies, comme sa date d'expiration. Si le médicament n'est pas enregistré, l'utilisateur reçoit "No. Please recheck the code" ("Non. Veuillez vérifier le code", NDLR).
                  

Hépato-Gastroentérologie - Fiches à L'aide de Consultation


Salut chers visiteurs Voici une nouvelle collection de fiches résumées, pour la préparation de test, mais aussi pour la consultation quotidienne.
Chaque partie est colorée d'une couleur spécifique:

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Ver partido Madrid vs Bilbao en vivo y en directo 22 Enero - Liga


Ver partido Madrid vs Bilbao en vivo y en directo 22 
Ver  partido Madrid vs Bilbao. Resumen Madrid vs Bilbao : El Real Madrid juega en el Bernabeu ante el Athletic de Bilbao hueso duro este Bilbao pero menos a domicilio. El Madrid resentido por el resultado en copa del rey ante el Barsa querrá quitarse esa espinita clavada. El Bilbao no es mejor equipo pero ha tocado por calendario. Partido muy complicado  Madrid vs Bilbao en vivo

Ver partido Sabadell vs Las Palmas en vivo y en directo 21 Enero


Verpartido Sabadell vs Las Palmas  
Ver  partido Sabadell vs Las Palmas en vivo. Resumen Bpartido Sabadell vs Las Palmas : Las Palmas a domicilio pierde mucho nivel por lo que este partido partido Sabadell vs Las Palmas pinta que será para el Sabadell.
Informacion partido ver partido Sabadell vs Las Palmas se juega a las 18,00 horas de hoy

jeudi 19 janvier 2012

Kwashiorkor in Northern California Means Fraud




Kwashiorkor in Niger
Is it plausible that one small hospital in rural Northern California treated 1,030 cases of Kwashiorkor within a two year period?

Before you answer that, let me explain what Kwashiorkor is.  It is a severe form of protein malnutrition...starving to death actually.  It is the type of starvation you see in African children.  It is so severe that the patient needs special nutritional support including special re-feeding with vitamins and it occurs mainly in children ages 1-4.   Adults can starve to death, but they do not develop classic Kwashiorkor.

Medicare pays hospitals a flat rate based on diagnosis codes for patients.  Patients with more severe coded illnesses get paid at a much higher rate.  Shasta Regional Medical Center, located in Redding, Shasta County, California is under the microscope for billing Medicare (our tax dollars at work) for 1,030 cases of Kwashiorkor to the tune of $11,463 for each diagnosis.  This medical center is a 246 bed facility in a town of about 90,000 people.  The entire county is less than 200,000 population.  The median home price in 2010 was $245,000 and the average household income is $62,222.  Hardly the demographics for Kwashiorkor.

Patient described as kwashiorkor
Prime Healthcare Services owns 14 California hospitals, including the one in Redding.  After they took over the hospital in 2008, the diagnosis of Kwashiorkor exploded.  One of the patients that they billed Medicare for was interviewed and she said she was never malnourished and was never told she had Kwashiorkor.  She had diabetes and kidney failure and, according to her daughter, was actually overweight. There was no notation in her chart about edema swelling or nutritional consult.  She received no vitamins. 

A former medical coder at another Prime Healthcare Hospital told California Watch that she was pressured to write up patients for kwashiorkor if they had low albumin levels and were diagnosed for ordinary malnutrition.  Low albumin is very common in hospitalized patients and it can accompany a number of medical illnesses.  Coding these as kwashiorkor is fraud, plain and simple.

Most hospitals across the Country are doing their best to take care of patients and function with the byzantine regulations of Medicare and hundreds of insurance companies.  The majority of hospitals lose money on Medicare patients.   Flagrant abuse in billing, such as is suspected at Shasta Regional Medical Center, gets no sympathy from me.  I hope the CEO ends up in stripes and that all of the Prime Healthcare Hospitals are closely investigated.

Happy Holidays EverythingHealth

Happy Holidays EverythingHealth



I get a lot of pleasure out of being a health blogger and it is only possible because of you, the reader.  Thank you for visiting EverythingHealth and allowing me to keep my mind sharp by researching articles and healthy living for you to read and enjoy.

Holiday Dinner from the Boss



Marney is bossy.  Click to read her instructions for the Thanksgiving Potluck and be glad you aren't invited.

EverythingHealth tip:  Stay out of the stores today.  Rest, play games with the kids, Take a long walk in nature with the entire family and the dog and then drink the rest of the Christmas wine.

High Ratings for Personal Physicians


It's time for some good news!   A study that looked at online patient ratings  about their physicians from 2004 through 2010 showed that the average physician rating was 9.3 out of 10.  That is amazingly high and shows that patients (at least the ones who posted on Dr.Score) are very content with the care they receive from their doctor.  Even though some patients will post a nasty comment about the doctor, the overall patient satisfaction is high.  Seventy percent of doctors earned a perfect 10.

The survey asked patients to rate physicians on attitude, the thoroughness of the visit,  how well the doctor communicated and how long they sat in the waiting room.  It is not a surprise that the longer patients waited, the lower was the rating.  Forty two % of doctors were primary care physicians and the remainder were specialists outside of primary care.

Patient satisfaction is finally getting attention in medicine.  More than 60% of health care organizations are using patient satisfaction scores to determine physician incentive payments and large medical groups measure satisfaction and give the doctor feedback on a regular basis.  Medicare will also link patient satisfaction with hospital payments and hospitals who do not rate high will lose revenue.

We read a lot about the problems in health care in the United States but those issues are usually concerned with cost and access.  In fact a November Gallup poll found that 82% of adults say the quality of health care they receive is "good" or "excellent".  A 2010 study by the Clinician and Group Consumer Assessment of Healthcare Providers and Systems found that 94% of nearly 42,000 patients rated their physicians a seven or higher on a 10-point scale.  (that group needs a new name)

Another study I read shows that 90% of physicians feel stressed nearly every day.  It is good news that that stress is not being felt by the patients and that we are delivering the patient-centered care that we pledged when we took our oath.

Medical Challenge



For my non medical readers, this is an abnormal CT scan.  The CT scan takes a transverse image sliced through, so you are looking at the patient sliced in half transversely.  This is the chest area. I will orient you:

The whitish circle and v-shaped part is the vertebral column.  So you know that is the back.   Bone shows up whiter than organs.  The small whitish lines in a circle are the ribcage (more bone) sliced through.  Air shows up dark so the big dark areas are the lungs.  Notice there is darkness streaking on one side and not the other.  As my 16 year old would say: "That is messed up".  What ruptured to allow air to penetrate the muscle area? (click on the image for a better view)


1.  The diaphragm
2.  The esophagus
3.  An intercostal muscle
4.  The interventricular septum
5.  The pericardium

Medical professionals and others:  Make your diagnosis.  The answer will be posted tomorrow.

Answer to Medical Challenge


The answer to the CT scan image medical challenge is #3, Intercostal Muscle Rupture.

The image shows subcutaneous emphysema and an intercostal muscle defect between the ribs.  the patient recovered after repair of the intercostal hernia.  Subcutaneous emphysema is air under the surface of the skin.

It is not unusual for these muscles between the ribcage to be strained or even get small tears with sports, extreme coughing or trauma.  It is very unusual for the tear to be this extreme and affect the pleura around the lung and the lung itself.

Thanks for your diagnoses.

Top EverythingHealth Books of 2011


We at EverythingHealth love end of the year lists and we love reading.  Here is our pick for the best read Health (and everything)  books in 2011.  (not in order...all are terrific)
  • The Immortal Life of Henrietta Lacks, by Rebecca Skloot
  • Cutting For Stone,  by Abraham Verghese
  • Outliers,  by Malcolm Gladwell
  • The Help,  by Katheryn Stockett
  • The Checklist Manifesto,  by Atul Gawande
  • Middlesex,  by Jeffrey Eugenides
  • The Known World,  by Edward P. Jones
  • Complications,  by Atul Gawande
  • The Curious Incident of the Dog in the Night-Time,  by Mark Haddon
  • A Short History of Nearly Everything,   by Bill Bryson
If you have other favorites, let us all know.

Seven Tips for Healthy 2012 Planning


As we welcome a new year it is an opportunity to re-evaluate, consider the coming year and make intentions for improving our health and sense of well being.  EverythingHealth sifts through the latest medical literature and evidence to offer these proven recommendations for staying on top of your game.
  • If you are 50 or older and haven't had a colonoscopy, schedule one in 2012.  It's time! 
  • Go online and check your Body Mass Index (BMI).  If you are too high, plan and execute on that diet.  (contact me for a diet coach referral if needed)
  • Get rid of sugar and soft drinks.  Stevia is a natural sweetener that is safe and yummy.  The average American eats 160 lbs of sugar a year. Break the sugar habit in 2012
  • Stop smoking. For motivation go here.
  • Relax your mind.  Start yoga, meditative dance, meditation.  These practices have been shown to lower blood pressure and general stress.
  • Send one thank you note a week.  That is 52 notes in 2012.  You can send it to your child, co-worker, grocer, doctor, spouse or even an acquaintance.  The act of thanking and reaching out to others is healing for both sides.
  • Become an activist.  Find one cause that you feel passionate about and get fully involved. Here are some to consider,  but there are hundreds of other great organizations and it has to be your own interest.
                                                                Kiva.com      (micro loans to people around the world)
          Women for Women International.    (adopt a sister in a war torn nation.  Many of these women  have suffered atrocities, have no money and support many children.  If you help the women, you raise the standard for the whole community)
         U.S Humane Society  (They do wonderful work to protect animals, expose inhumane and unhealthy farming and promote legislation to make humans and animals safer)
         Foster Children -  (You don't need to adopt,  but you can get involved in a number of organizations that help these kids transition out of foster care into adulthood.  When they reach 18 the system is "done" with them.  Can you imagine your own 18 year old making it alone?  Check in your own community for programs and mentorships.)
 
Happy New Year to all of my readers!!!!
 

Nail Trauma Paronychia


My patient welcomed in the New Year by doing a midnight 21 mile run through the streets of San Francisco.  It was a clear, crisp night and what a healthy and invigorating way to celebrate New Year's Eve!  The next day, however, her 2nd toe looked like this.  It was throbbing and tender to the touch.  She did not remember any specific trauma.

By the looks of the photo, it is a paronychia, an infection around a fingernail or toenail.  This infection is probably the result of repeated trauma as her foot struck the ground and the top of the nail struck her shoe.  A little bacteria (staphylococcus) was able to take hold in the skin as it broke through the protective cuticle.

Because she is healthy, without diabetes or other immune problems, I advised frequent hot water soaks to increase blood flow and (hopefully) promote natural immune healing.  If the swelling worsens or pus appears, it can be cured by excising it to drain.  Topical antibiotics are of no use and rarely are oral antibiotics needed unless the infection is worsening.

Patients Owning Their Medical Records


Traditionally, the patient chart stayed in the doctors office and rarely did a patient get a glimpse of anything in the record.  Photocopying the chart is expensive and no physician would let a chart leave her office because the record must be held safely for a minimum of 7 years.   Now more and more offices are doing away with clunky paper charts and electronic medical records are becoming the norm.  With electronic portals, is there any reason a patient shouldn't have access to their own medical record?

A study published in the Annals of Internal Medicine reported that up to 97% of patients queried thought the ability to have "open visit chart notes" was a good thing.  Doctors weren't quite so eager.

The study found that doctors worried that open visit notes would result in greater confusion and worry among patients and they anticipated more patient questions between visits.  But the patients overwhelmingly wanted to see the notes and were not worried about being confused.   They thought seeing their own record would provide information that would help them be healthier.  They could see the treatment plans and the test results directly.

One of the study authors, Dr.  Joann Elmore at University of Washington School of Medicine, said that access to records is important for indigent patients or people who move frequently for continuity of care.

It is a new world of sharing of information and there is no reason medicine shouldn't be part of the change.  Patients have access to research studies on-line as well as multiple medical websites  to look things up. (Some  are just junk and filled with ads).   If open records helps create a dialog about good health and allows patients to understand and take ownership of their own life it can only be a good thing.

I do worry a bit about the overly obsessive patient who might misinterpret every slight lab value that is outside of normal.  They will need to understand that not everything carries the same weight in medicine and slight variations of normal can in fact be...normal.

What do you think?  Do you want to see your medical record?

Haiti Remembered


This is the 2nd anniversary of the terrible Haiti Earthquake that measured 7.0 on the scale. The disaster killed 316,000 people and displaced 1.5 million more.  Even now more than 500,000 people are still in makeshift shelters and only half of the aid pledged for reconstruction has been spent.

My organization sent medical teams and supplies to the disaster zone and our doctors and nurses continue to support a hospital with teaching and supplies.  I led a team of dedicated caregivers to Port-Au-Prince where we served under the most austere conditions.  Supplies were non existent.  There was no running water in the hospital and the magnitude of the health problems required infrastructure that was not there...and still is not there. 

The following is a reprint of a blog I did on 3/20/2010.


I can't get the stories of Haiti out of my mind.

A patient showed up at the Port Au Prince hospital ward with a massive left sided paralysis, an obvious stroke. This 48 year old woman had collapsed the day before and was now accompanied by her three grown daughters, who were most attentive and worried. I examined her in the bed with other patients and families gathered around. (There is no sense of privacy and even an exam seems to be everyone's business in Haiti). One daughter spoke broken English but I had a good translator that helped me get the information I needed.

It was a sad story. They had been on the 5th floor when the Earthquake hit. They fell straight down and dad was killed. One of the children had a crush injury to his leg and the entire remaining family was now "on the street". Just surviving must have been such a strain. Then...mom has a massive stroke.

As I was examining the patient further, one daughter handed me a quickly scrawled note. It read. "I have a problem She have a AIDS" In this private way, the daughter wanted me to know her mom had AIDS.

In a country with such poverty, lack of health care and lack of education, it is not a surprise that HIV and AIDS remains a significant problem and Haiti is the Caribbean island most affected by AIDS. There also remains a stigma and HIV infection is a big secret. Once I asked my Haitian interpreter to ask an emaciated patient if he was HIV positive and the interpreter couldn't even ask the question. It is just not done. It was a real act of bravery for that daughter to pass me the secret note.

Needless to say, AIDS will be the least of this family's problem. I can't begin to imagine how a woman with a stroke, who will likely not receive any rehabilitation, can live on the street. By the time I left, she needed 2 people to assist her out of bed into a chair...where she could not sit straight. 

This is the continued tragedy of the Earthquake and the aftermath of human misery it left.

RootsTech 2012 Opportunities


In case you haven't noticed, each of the "official" RootsTech 2012 bloggers have been given one free RootsTech registration to give away for free.
Most of them seem to have pretty much the same rules--check out the RootsTech schedule at http://www.rootstech.org/schedule and then email the blogger about a session you'd like to attend.
RootsTech 2012 will be held in Salt Lake City on February 2-4. I know a couple of SGS members attended last year's inaugural RootsTech conference and were quite impressed with the speakers and sessions.
Act fast and you may be able to win free registration to this year's conference at:
http://www.luxegen.ca/genealogy/rootstech-2012-win-free-registration [ends tonight]
http://www.geneamusings.com/2011/11/win-free-registration-to-rootstech-2-4.html  [ends tonight]
http://geniaus.blogspot.com/2011/11/rootstech-2012-official-blogger.html [ends Nov 16]
Several of the official bloggers' contests have already ended. Sorry. I missed them, too.

A Genealogy Thanksgiving


By now you all know that I follow Randy Seaver's Genea-Musings blog. Last weekend his "Saturday night genealogy fun" topic was Thanksgiving. You can read his post here.
As usual, Randy's challenge got me thinking.
What genealogy resources am I most thankful for? ....people, published works, digital databases....?
My answers to Randy's challenge are:
(1) my maternal grandmother, who helped write a history of the Boone family and got me interested in helping her with Pennsylvania resources;
(2) any collections of "minor" or previously "hidden" records for my geographical areas of interest;
(3) FamilySearch for the zillions of records they make available for FREE, especially those that can be accessed digitally.
Expanding this train of thought a bit, what am I most thankful for about SGS?
(1) our wonderful dedicated volunteers who continually amaze me by their willingness to take on hard tasks and keep SGS rolling;
(2) the support of our landlady, Verla Kwiram, who has graciously kept our rent stable for the last 4+ years;
(3) members who attend our programs and share their stories, allowing us all to keep on learning.
Thanks to all of you who keep SGS running and keep us all learning.
I hope you all have a wonderful Thanksgiving holiday and have lots to be thankful for.

October is Family History Month!


Welcome to Family History Month! As the days get shorter, wetter and cooler, it's time to return our attention to family history. What projects have you got lined up to accomplish this month? What topics do you need to learn more about? What "brick walls" do you need to get over, under, around or through?

If you haven't completed your research into your military ancestors, by all means plan on attending the SGS Fall Seminar on Saturday, October 22nd. In honor of the 150th anniversary of the start of the US Civil War, the entire day will focus on U.S. MILITARY RECORDS. The full list of presentations and registration materials are available on our website at http://seattlegenealogicalsociety.org/content/2011-fall-seminar-schedule. Note that the registration deadline is Oct. 14th for "regular price" and lunch orders. This year you can register online and pay through PayPal if you'd like. The links are on our website. Please invite your friends, as our seminars generate essential revenue for SGS.

SGS will also be holding a special LIBRARY OPEN HOUSE this month on Sunday, Oct. 16th. Do you have friends, cousins, or neighbors who might be interested in getting started on their family trees? Help SGS attract new members by inviting them to stop by on Oct. 16th. We'll have experienced researchers available to help them fill out family group sheets and ancestor charts, as well as experienced desk volunteers to provide tours of the SGS library. If you'd like to help, please email Michelle at sgsvolunteers@gmail.com.

There are several special giveaways going on right now in honor of Family History Month. Ancestry.com is giving away a prize each day through Oct 15th in honor of their 15th anniversary. You need to register each day at http://www.ancestry.com/15anniversary to be eligible. Family Tree Magazine is also offering daily drawings in their "Daily Deal & Giveaway" at http://www.familytreeuniversity.com/daily-deal-giveaway. Our own Director of Volunteers won today! If you're a fan of geni.com, they're giving away one-month "pro" subscriptions each day this month. You can check out their contest at http://www.geni.com/blog/celebrating-family-history-month-370597.html.

October is also Archives Month. While SGS has lots of archival material, it's not very accessible or organized, but we're trying. There's an Archives Fair at the downtown Seattle Public Library this Wednesday, Oct. 5th and again on Oct. 29th. Find out more at http://archivaladvocate.wordpress.com/seattle-archives-month-2011/activities/ You'll also note that there are free archival training sessions at the Puget Sound Archives and at NARA this month. Learn more at http://www.dahp.wa.gov/blog/2011/09/free-workshop-the-basics-of-archives-2/.

And if that isn't enough, Thursday, Oct. 6th, has been declared the inaugural "Day of Digital Archives" (See: http://upfront.ngsgenealogy.org/2011/09/day-of-digital-archives-october-6th.html ) What are you doing to celebrate?

Are you in my photo?


I just received notice of a new photo sharing website called "Are you in my photo?" It's at http://areyouinmyphoto.com/The purpose of the website is to allow people to post photos containing unknown people, places or things and have other people identify those unknowns for them. Their theory is that most of the photos we have are not unique; there were multiple copies printed. If the people holding the multiple copies can be connected, there's a much better chance the people (or places or things) in the photos can be identified.
In order to post photos, you have to sign up for either a free or paid account. Paid accounts allow you to enter contests, though I didn't see anything posted about contests yet.
When Dan Lynch spoke here on behalf of HQRL two years ago he encouraged the development of this type of website. It's also something SGS has considereed--posting photos of unknowns and asking for help identifying them. If this site takes off, it could be a real boon to identifying all those unlabeled photos we all have.
Check it out and share your thoughts.

Are you ready for the 1940 Census?


I was just reading Randy Seaver's blog (http://www.geneamusings.com/), which is always entertaining and often thought provoking. Today he wrote about preparing for the release of the 1940 US Census in 364 days. Reading his list of people he'd like to find and where they were living on April 1, 1940 made me realize that I have a lot of work to do. I think both of my parents were in the US Army in April 1940, but am not really positive. How the heck am I going to find them in the census? I don't have a clue where my father's family were, so will need to do a lot of prep work on them. And my mother's parents and grandparents were all in "rural" areas--i.e., places with less than 2500 population (a lot less, in their cases!).
It's interesting to see what questions were asked in the 1940 census (check out Ancestry's info page at http://www.1940census.net/1940_census_questions.php). Also frustrating to learn that "supplementary questions" were only asked of 5% of the population--two people per page of 40 names. I'm hoping that at least the census takers had to ask those supplementary questions of adults, not just anyone whose name appeared on lines 14 and 29.
Randy suggests making a list of EVERYONE in your extended family who was alive in 1940 and trying to find a 1940 address for them now, before the census records are made public. Then we'll all be ready to grab those 1940 US census pages next year on April 2nd! Sounds like a good idea to me...in my spare time.

Free Ancestry Civil War Databases


Have you heard about the FREE access that Ancestry is offering to their Civil War databases this week? The offer is good from today (April 7th) until next Thursday (April 14th). What's even better is that they've added a number of NEW resources. Here's a link to the list of CW resources now available to everyone: http://www.ancestry.com/civilwar_sub?flash=true&o_iid=47474&o_lid=47474
In addition, Footnote.com is offering free access to their Civil War records, too. Such a deal!
I spent a little time this afternoon playing with the "Civil War Draft Registration Records, 1863-1865" on Ancestry. They're organized by state (Union only), then Congressional District. After searching for a few of my Missouri names and finding nothing, I discovered that you don't have to put a name (of any kind) in the search box. I just put "Hickory County, Missouri" in the "Lived In" box on the left. Amazingly, I got quite a nice alphabetized list of all the men included in this county. Since so many of my family names are often horrendously misspelled, finding them by searching for my surnames is almost impossible. This way of searching led me to all the men in the county. Also interesting is that these records INCLUDE men who already served, with notations as to unit and length of service.
If you find other cool info in these free resources, please leave a comment.

Another limited time Freebie


Now that you've all exhausted the free Civil War resources at Ancestry.com, I'm happy to report another freebie. In honor of National Library Week, the Gale Press is offering free access to their databases. I'm not sure when a week turned into 14 days, but the free access is good from April 10th through April 24th, so there are a few days left to explore.
Just go to http://www.gale.cengage.com/NLW/ and scroll down to the database links. Of the 6 choices, I'm guessing those of most interest to SGS members will be the Gale News Vault, with over 10 million scanned and indexed pages, and the "Slavery and Anti-Slavery" archive.
Enjoy!

Archives Preservation


Do you have old photos and negatives, letters, digital photos and files?
Would you like to learn how best to preserve them?
Attend a FREE Archives Preservation Roadshow at NARA on May 14th.
Bring your questions about preserving personal or family documents (in any format) and get advice from trained archivists and museum professionals from a variety of backgrounds and institutions around the area. Get in-person information about how to preserve: Photographic prints and negatives; letters and other family documents; moving images (films) and audio; electronic documents, and digital photos; and much, much more…
For more information, check out

How do you learn?


SGS tries to offer a wide range of educational programs for our members, but only a small fraction of you ever attend any of these offerings. There seems to be a core group of members who attend our classes and presentations, but the vast majority of you stay home.
My question to you is--Why? Is it because we're not offering programs of interest to you? Is the timing or location inconvenient? Do you prefer learning from books or online rather than in a lecture setting?
While we are in a transition period (our Director of Education, Cary Bright, has resigned and we are searching for a replacement), I would like to know more about why more members don't attend our educational offerings. Please take a moment to answer the brief survey in the upper righthand corner of this page, leave a comment below, or email me directly at sgspresident@gmail.com.
Oh, and BTW, this Thursday's technology presentation focuses on webinars and podcasts. You'll be amazed at the number of FREE online offerings available.

Gathering data from living relatives


I know we've all wished a thousand times that we'd thought to ask our grandparents and/or great-grandparents about their personal histories. I'm now realizing how little I know about my own parents' lives. In digging through both of their military records, I'm discovering that what I thought I knew is not true. And it's very frustrating.
In last week's Hickory County [MO] Index newspaper, I came across a small article that was undoubtedly submitted by the Missouri State Agricultural Extension Service. They suggest talking with your family during holiday gatherings about their lives. This, of course, is what I suggested in my last blog post.
But wait; there's more!
The Greene County Extension Center has published a 20-page printable PDF called "A History of Me" that's available at http://extension.missouri.edu/greene for anyone to download and use. I'm thinking about printing it out and sending it with our Christmas letter to all my relatives. I have no idea whether any of them will sit down and write down some answers or not, but at least it might get them talking/thinking about information to leave for future generations.
Come to think of it, maybe I should sit down and complete one of these booklets about my life for my kids.

mercredi 18 janvier 2012

Langage en maternelle


LEM (Langage En Maternelle) Soissons   MAJ de l'adresse
http://www.langage-en-maternelle.fr
Syntaxe adaptée, albums-échos, SACLO, comptines, oralbums...

Postes 2012 : les dotations par académie


A vous de juger . . .    Bonne année  ! ! !

Exercices en ligne de français pour le cycle 3


Zizanie chez les momos   classe de Wolschwiller
http://www.zizaniechezlesmomos.eu/

La santé des enfants en grande section de maternelle



Le document complet (PDF) : La santé des enfants en grande section de maternelle
"La direction de l'évaluation, de la prospective et de la performance (DEPP) exerce une fonction de suivi statistique, d'expertise et d'assistance pour le ministère de l'Éducation nationale et le ministère de l’enseignement supérieur et de la recherche. Elle garantit la qualité de la production statistique."

Le pitre de la classe ne fait rire personne


Barry Boone, douze ans, est le pitre de sa classe. Malheureusement, ses jeux de mots ne font rire que lui et son amie , la jeune surdouée Angeline Persopolis. Comme il rêve de devenir un grand comique, Barry décide de s’inscrire au concours de talents qu’organise son école, bien décidé à faire reconnaître son talent.
Rester soi-même

Angeline , bien sûr , le soutient dans la préparation de cet événement. Mais décrié par ses propres parents et par ses camarades,  lassés de ses plaisanteries, Barry doute soudain de lui , et envisage sérieusement de renoncer à monter sur scène… Ses blagues feraient-elles fuir ses amis?
Un regard juste et parfois cruel du monde de l’enfance, par un auteur de littérature jeunesse très reconnu outre-Atlantique et apprécié en France par les prescripteurs.
Louis Sachar, avocat de formation, se consacre totalement à l’écriture de livres pour enfants. Il vit à Austin, au Texas, avec sa femme et leur fille.
Du même auteur chez Bayard: Des poissons dans la tête

Amos et les gouttes de pluie


Un peu de rouge, du bleu, du jaune, voici Amos. Amos est un koala multicolore qui vit dans un monde étonnant. Aujourd’hui, il a décidé d’aller se promener. Plic ! ploc ! voilà qu’il se met à pleuvoir… Amos zigzague entre les gouttes, mais la pluie tombe de plus en plus fort, les gouttes sont de plus en plus grosses. Quand soudain, ziiip ! Amos ouvre le rideau de pluie… derrière, il fait très beau ! Le soleil brille et il fleurit des parapluies… Amos en choisit un et retraverse le rideau de pluie. Il peut maintenant rentrer tranquillement. Une fois chez lui, Amos regarde par la fenêtre : à présent, il pleut des parapluies… Après le magnifique album Amos et le pays noir, Anne Cortey et Janik Coat mettent à nouveau en

Rondes et comptines pour jeux de doigts


Voici le 7e titre de cette collection à succès de comptines à chanter ! Un nouveau livre-CD sur une thématique très demandée pour les tout-petits : les jeux de doigts. « Toc, toc, Monsieur Pouce », « Tourne, petit moulin », « Je faisle tour de mon jardin »… Ce nouvel opus de la collection propose aux parents de mettre chaque comptine en scènegrâce à des jeux de doigts. Des indications précises guident les parents à chaque strophe pour proposer des gestuelles à mimer avec les enfants. Les jeux de doigts sont très demandés, particulièrement en crèche.Attention, faculté de reproduire une action, motricité fine… ce style de comptines est en effet un véritable exercice pédagogique et ludique pour les plus petits. Comme à chaque fois, des comptines originales alternentavec les grands classiques. Des comptines, toujours orchestrées par Alain Schneider !

Bientôt un médicament pour devenir ''bon''



Des scientifiques travaillent sur de nouveaux types de médicaments qui pourraient sérieusement mettre à mal la profession de gardien de prison. Le remède possède la particularité de rendre les gens "bons". L’avènement d’une société améliorée grâce aux médicaments est en marche.
Les blouses blanches pensent sérieusement que ces pilules remplaceraient une peine de prison. De ces substances, l’humanité puiserait aussi la force nécessaire pour trouver des solutions globales à ses problèmes car elles permettent d’améliorer l’empathie envers autrui. Un nouveau champ scientifique, dont il est d’ailleurs question dans une partie du livre Enhancing Human Capacities, a été ouvert.
Le Dr. Guy Kahane, une huile de l’Oxford Center for Neuroethics, affirme que "La science a ignoré la question de l’amélioration de la morale, mais la chose va de plus en plus s’imposer dans les débats car de nombreuses recherches montrent que certains médicaments influencent la réaction des gens face à un dilemme moral : ils sont plus empathiques, soudés s’ils sont dans un groupe, l’agressivité est également réduite". Mais d’après lui, il est "très improbable que les gens se ruent sur des pilules pouvant les rendre meilleurs !". Plutôt partisan pour une administration massive, il pense sérieusement que l’humanité pourrait régler ses problèmes.  
Moins enthousiaste pour un futur de bisounours médicamenteux, Ruud ter Meulen, scientifique à l’Université de Bristol, pointe notamment les problèmes rencontrés avec l’Oxytocin. "Même si elle rend plus coopératif au sein d’un groupe, elle réduit l’empathie pour les gens extérieurs au groupe". Il souhaite que de tels médicaments soient utilisés uniquement dans le milieu carcéral.
Et vous, vous seriez prêts à prendre une pilule qui rend gentil ?

Bilan thérapeutique Prescrire 2011 : trier pour mieux soigner


Le bilan thérapeutique 2011 de Prescrire est l’occasion pour les soignants de faire le tri des "nouveautés", et d'ajuster leurs stratégies et attitudes thérapeutiques en toute indépendance, pour mieux soigner.

Pour des soins de qualité, les soignants ont en permanence à trier les nouveautés, sans confondre nouveauté commerciale avec progrès thérapeutique, et sans confondre les informations fausses, biaisées ou inutiles, avec les informations solides, prouvées et opérationnelles.
Prescrire est conçu et réalisé par des soignants pour aider l’ensemble des soignants à faire évoluer en permanence leur panoplie thérapeutique, en toute connaissance de cause et en toute indépendance. Chaque progrès tangible pour les patients est bon à prendre et souligné par Prescrire.
Prescrire présente dans son numéro de janvier, en 33 pages, son bilan thérapeutique pour 2011. Ce bilan est une synthèse des textes parus dans les différentes rubriques de la revue Prescrire en 2011, textes qui sont le fruit du travail effectué à partir d’une recherche documentaire approfondie, notamment d’essais cliniques et de synthèses méthodiques. Ce bilan passe en revue les différents domaines thérapeutiques et rassemble les informations présentant un intérêt pour la pratique. Dans chaque domaine thérapeutique, les informations sont rangées en 7 groupes : "à noter dans sa liste de médicaments" ; "mieux prendre en charge" ; "nouveautés à ne pas retenir" ; "à suivre pour mieux se prononcer" ; "s’informer et informer les patients" ; "à écarter de sa liste de médicaments" ; "penser à une cause médicamenteuse".
En 2011, les nouveaux médicaments ou nouvelles indications de médicaments ont rarement apporté un mieux pour les patients. La plupart des progrès de l’année sont venus d’ailleurs : meilleure connaissances d’effets indésirables, synthèses méthodiques des données d’évaluation, essais comparatifs permettant de faire évoluer les stratégies, etc.

Dans la vie, je n’ai jamais été une grande toucheuse.


Parce que dans la vie, on le sait bien, y a grossièrement les toucheurs et les non-toucheurs. On a tous un copain comme ça (ou alors on est ce copain comme ça) qui ne peut pas s’empêcher de vous toucher, toutes les trente secondes. Il fait une blague, bam, il vous colle une tape sur l’épaule. Il commence une phrase par « Tu sais », paf, il colle sa main sur la vôtre. On a tous une grand-tante qui nous caresse les cheveux d’un air distrait en nous parlant. On connait tous quelqu’un qui ne peut pas s’empêcher de se mettre à 30 cm de vous pour vous causer. Envahissement d’espace vital, c’est juste insupportable.
Je ne suis pas de ceux-là. Sors de là, t’es dans mon cercle.
Et je me suis rendu compte que dans mon métier, j’étais une sacrée toucheuse. J’arrête pas. Je tripote mes patients à longueur de temps.
Genre je laisse une main sur leur épaule pendant que j’ausculte le dos.
Souvent, je m’assieds à côté des gens, pour l’auscultation pulmonaire. Ils sont assis sur la table en face de moi, et c’est quand même plus pratique. Alors je m’assieds à côté, à gauche, je pose ma main gauche sur l’épaule gauche, je me penche un peu et j’ausculte le dos de la main droite. Des fois, nos cuisses se touchent, du coup.
Quand ils sont couchés, je me penche. Parce que je sais pas. Déjà, si faut voir un truc, j’ai besoin d’avoir mes yeux à 5cm. Je suis myope comme une taupe, certes, mais à 30 cm avec mes lentilles, je vois quand même clair. Or, j’ai pas besoin de voir clair, j’ai besoin de voir GROS. Mes internes me reprenaient sans arrêt sur mes sutures, parce qu’au bout de 4 points je finissais systématiquement le nez collé sur la plaie.
Je regarde entre des orteils, je me penche. Nez sur le pied. Et je me dis que si j’étais patiente, j’aimerais peut-être moyen ça.
Et c’est la même chose si je regarde un pénis.
Quand ils sont couchés et que j’ausculte le cœur, je me penche aussi. Je suis mieux concentrée comme ça, allez comprendre. Si je passe sur le poumon gauche, celui le plus éloigné de moi, je me penche encore. Je suis quasiment collée au patient. « Respirez fort », je dis. Gentiment, les gens tournent la tête, parce que là, en respirant fort, ils me respirent direct sur le visage. Si j’étais patiente, je ferais pareil.
Quand ils se couchent, souvent, on dirait qu’ils s’imaginent que je vais leur sauter sur le bras pour prendre la tension. J’ai encore rien fait, j’ai rien dans les mains, je comptais pas commencer par ça, mais ils se couchent et ils me tendent leur bras raide à 45° au dessus du lit. Sauf que la tension, je la prends au repos, avec le bras le long du corps, détendu. La tension c’est fiable si les gens sont décontractés ; pas au garde à vous, raides comme la justice, avec le bras tendus et le poing serré, et la frousse d’être chez le médecin. Du coup j’attrape le bras et je le repose sur le lit, doucement, et souvent je le caresse un peu dans la foulée.
Dans ma tête à moi, dans mes gestes, c’est une façon d’exprimer « Là, là, pose, détends, relâche, tout va bien. » Mais bordel, je me rends compte que je caresse le bras. De haut en bas, du plat de la main, sans aucune raison médicale valable.

Loi sur le médicament : trop peu de progrès


Le vaste débat lancé en 2011 en France sur le médicament, au décours des révélations sur le désastre Mediator°, a laissé espérer de nombreux changements. Mais la loi finalement votée, malgré certaines avancées, s'avère en net retrait par rapport à diverses recommandations officielles, et ne vise pas assez l'intérêt premier des patients.

Le désastre Mediator° a été l’occasion d’un vaste débat en France en 2011 sur le médicament. Les missions de l'Inspection générale des affaires sociales (IGAS), du Sénat, de l'Assemblée nationale, la mission auprès du président de la République, les Assises du médicament, etc., ont montré que la France était en attente de changements très importants dans les règles et les pratiques relatives au médicament. Et que l’Europe a grand besoin aussi du même vaste changement.
Le projet de loi du gouvernement n’a retenu qu’une faible part des recommandations faites par les différentes instances citées plus haut, et s'est concentré quasi exclusivement sur l’agence du médicament et ses relations avec les firmes. Une partie de la loi se borne à faire remonter au niveau législatif des règles déjà inscrites au niveau réglementaire ou à transposer des mesures issues de la directive européenne sur la pharmacovigilance.
On y trouve quelques avancées en termes de transparence et de gestion des liens d’intérêts, de transparence des processus d’expertise et de décision, d’encadrement des dispositifs médicaux et d'études post- autorisation de mise sur le marché (AMM). Mais pratiquement pas d’avancée sur la comparaison des médicaments avec les traitements de référence notamment avant AMM, rien sur le financement public d’une recherche clinique permettant un fort développement d’une expertise indépendante, rien sur la formation des soignants en pharmacovigilance et en pharmacologie clinique, etc.
En seconde lecture au Parlement, les députés ont beaucoup affaibli le texte voté par les sénateurs et notamment supprimé les mesures qui auraient mieux permis aux victimes de médicaments d'être reconnues et prises en charge : présomption de responsabilité, actions de groupe. Le texte voté par les députés en seconde lecture est en recul même par rapport au texte qu'ils avaient voté en première lecture. C'est le cas par exemple de l'article prévoyant une comparaison des médicaments pour pouvoir être remboursés, qui est devenu très flou.
Avec des milliers de morts dus aux médicaments chaque année, et bien plus encore de victimes d'effets indésirables graves, avec une consommation de médicaments parmi les plus élevées du monde, la France a bien un problème avec le médicament, très largement au-delà du désastre Mediator°. Ce problème ne sera pas résolu par la nouvelle loi française sur le médicament.
Il reste beaucoup à faire. Les débats ouverts en 2011 en France sur le médicament montrent que d'autres avancées nécessaires sont à portée de main, en mettant au cœur des préoccupations la recherche de progrès et de protection pour les patients.
En pratique, beaucoup dépendra de la détermination de l’agence du médicament et de son encadrement à tenir le cap à long terme. Beaucoup tiendra aussi au comportement des soignants et des patients face aux médicaments. Pour tous, Prescrire poursuivra son action d'information et de formation indépendante de référence, au service avant tout de l’intérêt des patients.