Ch\u00e8res et chers coll\u00e8gues,<\/p>\n
Voici sous forme d\u2019ab\u00e9c\u00e9daire un nouveau billet de ce blog<\/a> tenu depuis maintenant plus de cinq ans.<\/p>\n Anonymisation<\/p>\n Il est rassurant de savoir que si nos donn\u00e9es sont utilis\u00e9es \u00e0 des fins de recherche ou vendues, elles seront anonymis\u00e9es. Il est moins rassurant d\u2019apprendre que la r\u00e9identification est assez simple et rapide si l\u2019on en croit cet article de Nature<\/em><\/a>. Extrait\u00a0: \u00ab\u00a0Using our model, we find that 99.98% of Americans would be correctly re-identified in any dataset using 15 demographic attributes. Our results suggest that even heavily sampled anonymized datasets are unlikely to satisfy the modern standards for anonymization set forth by GDPR.\u00a0\u00bb<\/em><\/p>\n Anthropoc\u00e8ne<\/p>\n Sommes-nous entr\u00e9s dans une nouvelle \u00e8re, l\u2019anthropoc\u00e8ne, l\u2019\u00e8re g\u00e9ologique fa\u00e7onn\u00e9e par les actions humaines\u00a0? R\u00e9ponse ici<\/a>. Et depuis quand\u00a0? R\u00e9ponse l\u00e0<\/a>.<\/p>\n Pour le scientifique anglais centenaire James Lovelock, c\u00e9l\u00e8bre auteur de l\u2019hypoth\u00e8se Ga\u00efa, nous quittons d\u00e9j\u00e0 l\u2019anthropoc\u00e8ne pour entrer dans le novac\u00e8ne, titre de son dernier livre (voir ici<\/a>. Extrait\u00a0: \u00ab\u00a0Lovelock is looking forward to humanity being overtaken in cleverness by its computer progeny. This will usher in the end of the \u201cAnthropocene\u201d \u2013 the era in which humans became able to make large-scale alterations to the planetary environment \u2013 and the beginning of the \u201cNovacene\u201d. The new age will be marked by the unpredictable marvels to be unleashed by robots (or \u201ccyborgs\u201d, as Lovelock prefers to call them, but of a purely electronic sort) that can think 10,000 times faster than we do, and will program themselves and their descendants in ways that will be beyond all human understanding.\u00a0\u00bb<\/em>)<\/p>\n Antivaccins<\/p>\n Sur France Culture une \u00e9mission<\/a> sur les premiers adversaires de la vaccination, qui r\u00e9v\u00e8le de grandes constantes dans les arguments utilis\u00e9s d\u00e8s les d\u00e9buts de cette m\u00e9thode pr\u00e9ventive, dont l\u2019efficacit\u00e9 et la s\u00fbret\u00e9 ne sont pourtant pas en mettre en doute (voir par exemple ici<\/a>).<\/p>\n La pauvret\u00e9 et la d\u00e9sinformation limitent l\u2019acc\u00e8s \u00e0 la vaccination, comme le d\u00e9plore l\u2019UNICEF\u00a0(voir ici<\/a>. Extrait : \u00ab\u00a0<\/em>A dangerous stagnation in vaccination rates is putting children at risk of preventable diseases around the world, the UN children\u2019s agency has warned, blaming conflict, inequality and complacency.<\/em><\/p>\n One in 10 children, totalling 20 million globally, missed out on basic immunisation against the life-threatening infections of measles, diphtheria and tetanus last year, says Unicef.<\/em><\/p>\n Since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at about 86% globally. It needs to be at 95% to prevent outbreaks.<\/em><\/p>\n Most unvaccinated children live in the poorest countries or in nations riven by conflict. But in the affluent world, complacency about the childhood diseases which have slipped from view and suspicion of vaccines have led to falls in immunisation coverage and deaths and damage from measles.<\/em><\/p>\n Unicef\u2019s data shows that almost 350,000 measles cases were reported globally last year, more than doubling from 2017. Countries with violent conflicts such as the Democratic Republic of the Congo and Somalia had serious outbreaks, but the country with the highest incidence of measles was Ukraine, where vaccination rates slumped to 54% in 2010 and were low for several years before recovering. Vaccine shortages played a part, but so did mistrust of doctors and credence in the theories of anti-vaxxers.)<\/em><\/p>\n Science<\/em><\/a> d\u00e9plore que la bataille contre la polio ne soit pas encore gagn\u00e9e.<\/p>\n Celle contre les h\u00e9patites pourrait l\u2019\u00eatre d\u2019ici 2030, \u00e0 condition d\u2019y mettre les moyens\u00a0(voir ici<\/a>).<\/p>\n AP-HP<\/p>\n LeCHU francilien vient de publier son rapport annuel 2018<\/a>. Quelques chiffres cl\u00e9s\u00a0: 7,5 Md\u20ac de budget de fonctionnement (dont 59 % de masse salariale), 382 M\u20ac d\u2019investissement (seulement), 8,3 millions de prises en charge, 20\u00a0000 lits, dont pr\u00e8s de 3\u00a0000 d\u2019h\u00f4pitaux de jour, 210 m\u00e9tiers, premier employeur d\u2019Ile-de-France\u2026<\/p>\n En avril dernier, la restitution des d\u00e9bats organis\u00e9s dans diff\u00e9rents h\u00f4pitaux de l\u2019AP-HP traduisait le malaise des personnels (voir ici<\/a> l\u2019article de Lib\u00e9ration<\/em>).<\/p>\n Avicenne<\/p>\n The Times Literary Supplement<\/em><\/a> nous propose un bref r\u00e9sum\u00e9 de la pens\u00e9e et de l\u2019influence du c\u00e9l\u00e8bre philosophe et m\u00e9decin musulman d\u2019origine persane, dont la vie s\u2019est d\u00e9roul\u00e9e \u00e0 la fin du 10e<\/sup>et au d\u00e9but du 11e<\/sup>\u00a0 si\u00e8cle de notre\u00a0\u00e8re. Extrait\u00a0:\u00ab\u00a0Avicenna is one of the few philosophers to have become a major influence on the development of a completely foreign philosophical culture. Once his works were translated into Latin he became second only to Aristotle as an inspiration for thirteenth-century medieval philosophy, and (thanks to his definitive medical summary the Canon, in Arabic Q\u0101n\u016bn) second only to Galen as a source for medical knowledge in Europe. \u00bb<\/em><\/p>\n B\u00e9b\u00e9s sans bras<\/p>\n Le point de vue de Catherine Hill pour le JIM<\/em><\/a>, qui argumente scientifiquement sur les donn\u00e9es en relativisant ces clusters pr\u00e9sent\u00e9s selon la m\u00e9thode du tireur texan\u00a0: d\u00e9finir la cible apr\u00e8s avoir tir\u00e9.<\/p>\n Brenner (Sydney)<\/p>\n Celui qui \u00e9tait surnomm\u00e9 \u00ab\u00a0l\u2019enfant terrible de la biologie mol\u00e9culaire\u00a0\u00bb vient de nous quitter \u00e0 l\u2019\u00e2ge de 92 ans. Sa n\u00e9crologie<\/a> dans The Guardian<\/em>cite notamment son travail en collaboration avec Fran\u00e7ois Jacob sur les ARN\u00a0messagers.<\/p>\n Burn-out<\/p>\n Le burn-out, ou \u00e9puisement professionnel, est consid\u00e9r\u00e9 par certains comme une d\u00e9pression centr\u00e9e sur le travail. Pour Maria A. Oquendo et coll., il convient au contraire de bien diff\u00e9rencier les deux (voir ici<\/a>.Extrait\u00a0: \u00ab\u00a0When is exhaustion an expression of burnout, and when is it equivalent to the fatigue seen in MDD? When is reduced satisfaction in performance attributable to the anhedonia of MDD, and when is it attributable to burnout? Is depersonalization a symptom of burnout or a coping strategy, as suggested in Rotenstein et al? Of note, a study stating that burnout can lead to suicidal ideation had important methodological limitations. Further, a study in a similar population showed that suicidal ideation was associated with depression rather than burnout. Given risks associated with suicidal ideation, it is imperative that the presence of suicidal ideation lead to an evaluation to rule out MDD. To better understand the association between burnout and MDD and distinguish one from the other, it is essential to develop tools that could aid in the conduct of a strict differential process to determine the source of the symptom profile.\u00a0\u00bb<\/em><\/p>\n PourThe Lancet<\/em><\/a>, qui rapporte des cas fr\u00e9quents de burn-out chez les m\u00e9decins chinois, \u00ab\u00a0there are tremendous controversies and barriers in dealing with physician burnout. Despite wide discussions and many publications, there are striking differences in the understanding of what constitutes burnout. Lisa Rotenstein and colleagues\u00a0<\/em>reported<\/em><\/a>\u00a0<\/em>at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, and there was substantial variability in prevalence estimates of burnout among physicians and variation in burnout assessment and study quality. The 11th Revision of ICD (<\/em>ICD-11<\/em><\/a>) in May, 2019, provided a more detailed definition of burnout, characterising it as a syndrome of three dimensions\u2014feelings of energy depletion or exhaustion, increased mental distance from one’s job or feelings of cynicism or negativism about one’s job, and reduced professional efficacy. Notably, burnout has been further emphasised in ICD-11 as an occupational phenomenon rather than a medical condition. The need for health system reform in response to physician burnout cannot be delayed.<\/em>\u00a0\u00bb<\/em><\/p>\n Si le ph\u00e9nom\u00e8ne de burn-out est universel, il comporte des aspects particuliers li\u00e9s aux styles de management nationaux, comme l\u2019affirme le Dr Patrick L\u00e9geron pour Challenge<\/em><\/a>, \u00e0 l\u2019occasion du proc\u00e8s de France T\u00e9l\u00e9com. Le titre de l\u2019entretien\u00a0: \u00ab\u00a0Burn-out: “il y a un gros probl\u00e8me de management \u00e0 la fran\u00e7aise”, selon Patrick L\u00e9geron.\u00a0\u00bb<\/p>\n Calories<\/p>\n Dans The Economist<\/em><\/a>, Peter Wilson montre les limites de fonder les r\u00e9gimes alimentaires sur la notion de calorie, car l\u2019organisme n\u2019est pas un four br\u00fblant les aliments. Extraits\u00a0:\u00ab\u00a0<\/em>The calorie \u2013 which comes from \u201ccalor\u201d, the Latin for \u201cheat\u201d \u2013 was originally used to measure the efficiency of steam engines: one calorie is the energy required to heat 1kg of water by one degree Celsius. Only in the 1860s did German scientists begin using it to calculate the energy in food. It was an American agricultural chemist, Wilbur Atwater, who popularised the idea that it could be used to measure both the energy contained in food and the energy the body expended on things like muscular work, tissue repair and powering the organs. In 1887, after a trip to Germany, he wrote a series of wildly popular articles in\u00a0<\/em>Century, an American magazine, suggesting that \u201cfood is to the body what fuel is to the fire.\u201d He introduced the public to the notion of \u201cmacronutrients\u201d \u2013 carbohydrates, protein and fat \u2013 so called because the body needs a lot of them. (\u2026)<\/em><\/p>\n The simplicity of calorie-counting explains its appeal. Metrics that tell consumers the extent to which foods have been processed, or whether they will suppress hunger, are harder to understand. Faced with the calorie juggernaut, none has gained wide acceptance.<\/em><\/p>\n The scientific and health establishment knows that the current system is flawed. A senior adviser to the UN\u2019s Food and Agriculture Organisation warned in 2002 that the Atwater \u201cfactors\u201d of 4-4-9 at the heart of the calorie-counting system were \u201ca gross oversimplification\u201d and so inaccurate that they could mislead consumers into choosing unhealthy products because they understate the calories in some carbohydrates. The organisation said it would give \u201cfurther consideration\u201d to overhauling the system but 17 years later there is little momentum for change. It even rejected the idea of harmonising the many methods that are used in different countries \u2013 a label in Australia can give a different count from one in America for the same product.<\/em>\u00a0\u00bb<\/em><\/p>\n L\u2019insecte est-il par ailleurs l\u2019avenir de l\u2019alimentation\u00a0? (voir ici<\/a>)<\/p>\n Canicule<\/p>\n Sur le site theconversation.com<\/a>, R\u00e9my Slama explique les effets de la canicule sur l\u2019organisme.<\/p>\n Chinois<\/p>\n Les Chinois sont d\u00e9sormais ceux qui publient le plus d\u2019articles en langue anglaise dans les revues de science, technique et m\u00e9decine (voir ici<\/a>).<\/p>\n Classements<\/p>\n Les meilleurs h\u00f4pitaux du monde class\u00e9s par Newsweek<\/em><\/a>, en fonction de leur notori\u00e9t\u00e9 aupr\u00e8s des professionnels, l\u2019avis des patients et les indicateurs de r\u00e9sultat. La Mayo Clinic est en t\u00eate.<\/p>\n Bloomberg<\/a> a \u00e9tabli de son c\u00f4t\u00e9 le classement des pays en bonne sant\u00e9. L\u2019Espagne est sur la plus haute marche du podium, devant l\u2019Italie et l\u2019Islande.<\/p>\n <\/p>\n Coop\u00e9ration v. concurrence<\/p>\n Plong\u00e9e journalistique<\/a> \u00e9difiante au sein de la chirurgie cardiaque infantile aux USA. De l\u2019int\u00e9r\u00eat d\u2019avoir moins de centres mais plus exp\u00e9riment\u00e9s et aux effectifs plus nombreux, et de privil\u00e9gier la coop\u00e9ration plut\u00f4t que la concurrence. L\u2019\u00e9thique doit l\u2019emporter sur l\u2019int\u00e9r\u00eat de l\u2019\u00e9tablissement.<\/p>\n D\u00e9penses de sant\u00e9 en France<\/p>\n La cartographie m\u00e9dicalis\u00e9e des d\u00e9penses de sant\u00e9 \u00e9tablie par la Caisse nationale d\u2019assurance maladie et fond\u00e9e sur les donn\u00e9es 2017 a \u00e9t\u00e9 publi\u00e9e en juin dernier. Elle offre aussi une perspective historique sur une p\u00e9riode de 6 ans. Voir ici<\/a> les principales donn\u00e9es, qui confirment le poids grandissant des pathologies chroniques. Les maladies psychiatriques et les psychotropes constituent le premier poste de d\u00e9penses, devant les cancers.<\/p>\n Doigt<\/p>\n Le rapport de la longueur du deuxi\u00e8me doigt sur celle du quatri\u00e8me serait le reflet de l\u2019exposition du f\u0153tus \u00e0 la testost\u00e9rone et serait pr\u00e9dictif de plusieurs caract\u00e9ristiques \u00e0 l\u2019\u00e2ge adulte. C\u2019est du moins ce qui a \u00e9t\u00e9 pr\u00e9tendu, mais, pour Science<\/em><\/a>, on peut fortement en douter\u00a0:\u00ab\u00a0The idea that the lengths of human fingers reveal so much stems from the work of evolutionary biologist John Manning, now at Swansea University in the United Kingdom. But the field he inspired has ballooned beyond what he could have imagined. More than 1400 papers in just over 20 years have linked the finger ratio to attributes such as personality, cognitive abilities, and sexual orientation as well as to risk of illnesses such as cardiovascular disease, cancer, and amyotrophic lateral sclerosis. Researchers have even tried to use ratios gleaned from stenciled handprints on cave walls to determine whether the artists behind ancient paintings were men or women.<\/em><\/p>\n But the notion has also riled plenty of critics, who argue that researchers who rely on the 2D:4D comparison have been seduced by a simplistic, faulty measure. Some doubters contend that the difference in ratios between the sexes is an illusion resulting from men\u2019s larger hands or that the measure itself is statistically problematic. \u201cI\u2019m skeptical about every single finding involving that ratio,\u201d says physiologist and biostatistician Douglas Curran-Everett of National Jewish Health in Denver.\u00a0\u00bb<\/em><\/p>\n Empathie<\/p>\n Science<\/em><\/a> rend compte d\u2019un livre de Sara Konrath expliquant que l\u2019empathie s\u2019apprend.<\/p>\n Escande (Jean-Paul)<\/p>\n Notre coll\u00e8gue dermatologue, 80 ans, reprend du service \u00e0 la clinique des C\u00e8dres de Brive (voir ici<\/a>).<\/p>\n \u00c9thique<\/p>\n DanielleOfri, m\u00e9decin \u00e0 l\u2019h\u00f4pital Bellevue de New York d\u00e9clare dans une tribune<\/a> du New York Times<\/em>que si le syst\u00e8me hospitalier tient c\u2019est en raison de l\u2019\u00e9thique professionnelle des soignants qui ne comptent ni leurs heures ni leurs efforts, malgr\u00e9 les t\u00e2ches qui s\u2019empilent les unes sur les autres, notamment administratives, et malgr\u00e9 la p\u00e9nurie de personnels soignants. Mais le syst\u00e8me craque et doit \u00eatre r\u00e9form\u00e9.\u00a0 Extraits : \u00ab By now, corporate medicine has milked just about all the \u201cefficiency\u201d it can out of the system. With mergers and streamlining, it has pushed the productivity numbers about as far as they can go. But one resource that seems endless \u2014 and free \u2014 is the professional ethic of medical staff members.This ethic holds the entire enterprise together. If\u00a0doctors and nurses\u00a0clocked out when their paid hours were finished, the effect on patients would be calamitous. Doctors and nurses know this, which is why they don\u2019t shirk. The system knows it, too, and takes advantage. The demands on medical professionals have escalated relentlessly\u00a0in the past few decades, without a commensurate expansion of time and resources.\u00a0(\u2026)<\/em><\/p>\n In a factory, if 30 percent more items were suddenly dropped onto an assembly line, the process would grind to a halt. Imagine a plumber or a lawyer doing 30 percent more work without billing for it. But in health care there is a wondrous elasticity \u2014 you can keep adding work and magically it all somehow gets done. The nurse won\u2019t take a lunch break if the ward is short of staff members. The doctor will\u00a0\u201csqueeze in\u201d the extra patients. (\u2026)<\/em><\/p>\n But it\u2019s not fine. This month the World Health Organization recognized the serious effects of<\/em>\u00a0<\/em>burnout from chronic workplace stress<\/em><\/a>. <\/em>Burnout levels among doctors are at new\u00a0<\/em>high<\/em><\/a>s, far<\/em>\u00a0<\/em>worse than among the general population<\/em><\/a>, <\/em>and\u00a0<\/em>increasing relentlessly<\/em><\/a>. <\/em>Burnout among nurses is similarly rising and is<\/em>\u00a0<\/em>highest among those on the front line of patient care<\/em><\/a>.\u00a0<\/em>Doctors<\/em><\/a>\u00a0<\/em>and\u00a0<\/em>nurses<\/em>\u00a0<\/em><\/a>commit suicide at higher rates than in almost any other profession. Higher levels of burnout are also associated with\u00a0<\/em>more medical errors and compromised patient safety<\/em><\/a>. (\u2026)<\/em><\/p>\n The health care system needs to be restructured to reflect the realities of patient care. From 1975 to 2010, the\u00a0<\/em>number of health care administrators increased 3,200<\/em><\/a>\u00a0<\/em>percent. There are nowroughly<\/em>\u00a0<\/em>10 administrators for every doctor<\/em><\/a>.\u00a0<\/em>If we converted even half of those salary lines to additional nurses and doctors, we might have enough clinical staff members to handle the work. Health care is about taking care of patients, not paperwork.<\/em>\u00bb<\/em><\/p>\n Faux<\/p>\n L\u2019empire du faux s\u2019\u00e9tend. Faux textes<\/a>, fausses vid\u00e9os<\/a>, fausse viande<\/a>\u2026<\/p>\n Greengard (Paul)<\/p>\n Prix Nobel de physiologie et m\u00e9decine en 2000, avec Arvid Carlsson et Eric R. Kandel, pour ses travaux sur la transmission synaptique, Paul Greengard vient de mourir \u00e0 l\u2019\u00e2ge de 93 ans. Voir ici l\u2019article n\u00e9crologique<\/a> du NYT<\/em>.<\/p>\n Hauts potentiels<\/p>\n Non, \u00eatre tr\u00e8s intelligent n\u2019est pas une maladie (voir ici<\/a>).<\/p>\n Helmholtz<\/p>\n Sur le site de Books, un rappel<\/a>sur la place consid\u00e9rable mais oubli\u00e9e de Hermann von Helmholtz dans l\u2019histoire des sciences.<\/p>\n Histoire de la psychiatrie<\/p>\n Dans The New Yorker<\/em><\/a>, Jerome Groopman fait la recension de Mind Fixers<\/em>, le livre de Anne Harringtonsur l\u2019histoire r\u00e9cente de la psychiatrie, sur les difficult\u00e9s de cette discipline \u00e0 trouver une \u00e9tiologie aux troubles mentaux, et sur ce qui la distingue et ce qui la rapproche des autres disciplines m\u00e9dicales.<\/p>\n Impact factor<\/em><\/p>\n Les conseils<\/a> de John Ioannidis pour \u00ab\u00a0gonfler\u00a0\u00bb et manipuler l\u2019impact factor <\/em>d\u2019une revue.<\/p>\n Inconduite scientifique<\/p>\n John Carlisle, anesth\u00e9siste anglais, a mis au point \u00e0 ses moments perdus une m\u00e9thode pour d\u00e9tecter la fabrication de donn\u00e9es. Il n\u2019est pas infaillible mais il a d\u00e9j\u00e0 d\u00e9masqu\u00e9 plusieurs fraudeurs, selon Nature<\/em><\/a>.<\/p>\n Innovation<\/p>\n Cet article de Science<\/em><\/a> montre qu\u2019aux \u00c9tats-Unis l\u2019innovation repose de plus en plus sur la recherche publique.<\/p>\n Journalisme<\/p>\n En 1887, une journaliste am\u00e9ricaine de 23 ans, Nellie Bly, se faisant passer pour une malade, a d\u00e9crit les horreurs observ\u00e9es dans un asile newyorkais. A la suite de son reportage saisissant, le budget de cet h\u00f4pital a \u00e9t\u00e9 largement augment\u00e9 (voir ici<\/a>).<\/p>\n Kaiser Foundation<\/p>\n Cette organisation non gouvernementale met en ligne un guide<\/a> pour lire une facture de soins aux \u00c9tats-Unis. Ce n\u2019est pas simple du tout.<\/p>\n Lacan (Sibylle)<\/p>\n La sortie de la traduction anglaise du livre de Sibylle Lacan Un P\u00e8re<\/em>, est l\u2019occasion pour la London Review of Books<\/em><\/a> de rappeler les rapports difficiles entre Sibylle et son p\u00e8re, et l\u2019attitude parfois \u00e9tonnante de ce dernier.<\/p>\n Lieber Institute<\/p>\n Un article du Washington Post<\/em><\/a> sur la plus grande collection de cerveaux post-mortem des \u00c9tats-Unis. Extrait : \u00ab\u00a0Since opening in 2011, the institute has amassed more than 3,000 of these post-mortem brains that they are studying to better understand the biological mechanisms behind such neuropsychiatric disorders as schizophrenia, major depression, substance abuse, bipolar disorder and post-traumatic stress disorder. About 100 brain banks exist across the country for all sorts of brain diseases. But Lieber, founded with the support and funding of a wealthy couple whose daughter suffered a psychotic break in her 20s, is the biggest collection dedicated specifically to mental conditions.\u00a0\u00bb<\/em><\/p>\n Loi sant\u00e9<\/p>\n La loi n\u00b0 2019-774 du 24 juillet 2019 relative \u00e0 l’organisation et \u00e0 la transformation du syst\u00e8me de sant\u00e9 est consultable ici<\/a>. Beaucoup reste \u00e0 faire\u00a0: les d\u00e9crets d\u2019application, bien s\u00fbr, et surtout les ordonnances, qui vont pr\u00e9ciser de nombreux articles de la loi.<\/p>\n Lune<\/p>\n Le 20 juillet 1969, l\u2019Homme marchait sur la lune. De nombreux articles sont parus pour c\u00e9l\u00e9brer le 50e<\/sup>anniversaire de cet \u00e9v\u00e9nement. The Lancet<\/em><\/a> revient sur les grandes \u00e9tapes de la m\u00e9decine spatiale. The Atlantic<\/em><\/a> d\u00e9crit le r\u00f4le de l\u2019informatique embarqu\u00e9e \u00e0 bord d\u2019Appolo 11, qui, contrairement \u00e0 ce qui est souvent dit, n\u2019\u00e9tait pas rudimentaire et avait une puissance de calcul tr\u00e8s \u00e9lev\u00e9e. Le National Geographic<\/em><\/a> livre un atlas des diff\u00e9rentes lunes de notre syst\u00e8me solaire.<\/p>\n Lynch (Henry T.)<\/p>\n Un des pionniers de l\u2019\u00e9tude g\u00e9n\u00e9tique des cancers nous a quitt\u00e9 \u00e0 l\u2019\u00e2ge de 91 ans. Comme le rappelle le NYT<\/em><\/a>, \u00ab\u00a0a half-century ago, when researchers said cancers were caused by exposure to toxins in the environment, Dr. Henry T. Lynch begged to differ.\u00a0<\/em>Many cancers, he said, were hereditary. To prove his point he traveled to gatherings of families that he suspected had histories of hereditary cancer.\u00a0\u00bb <\/em><\/p>\n Management par projet<\/p>\n Critiqu\u00e9 lorsqu\u2019il est une simple transposition de ce qui se fait dans d\u2019autres domaines, il peut \u00eatre adapt\u00e9 avec int\u00e9r\u00eat \u00e0 l\u2019h\u00f4pital, selon Alice Albrand et Marc Frachette (voir ici<\/a>).<\/p>\n M\u00e9decines alternatives<\/p>\n Au Moyen Age d\u00e9j\u00e0, les m\u00e9decines alternatives avaient leurs adeptes (voir ici<\/a>).<\/p>\n Mescaline<\/p>\n Pour Books<\/em><\/a>, qui cite un ouvrage de Mike Jay, la mescaline serait la premi\u00e8re drogue psych\u00e9d\u00e9lique, dont l\u2019usage remonte aux civilisations pr\u00e9colombiennes.<\/p>\n Mortalit\u00e9 par cancer en France<\/p>\n Pour Le Monde<\/em><\/a>, qui cite un rapport<\/a> de Sant\u00e9 publique France et de l\u2019Institut national du cancer (INCA), r\u00e9alis\u00e9s conjointement avec le r\u00e9seau des registres des cancers (Francim) et les Hospices civils de Lyon, la mortalit\u00e9 relative par cancer est en baisse mais leur incidence est en forte hausse. Extrait\u00a0: \u00ab\u00a0Des chiffres d\u2019autant plus pr\u00e9occupants que leur analyse montre qu\u2019entre 1990 et 2018, si l\u2019on fait abstraction de l\u2019augmentation de la population et de son vieillissement, les nouveaux cas ont augment\u00e9 de 45 % chez la femme et de 6 % chez l\u2019homme. Cependant, quand on efface les effets d\u00e9mographiques, les taux de mortalit\u00e9 ont diminu\u00e9, de fa\u00e7on plus prononc\u00e9e chez l\u2019homme (\u2013 1,8 % par an) que chez la femme (\u2013 0,8 % par an).\u00a0\u00bb<\/em><\/p>\n Notre-Dame<\/p>\n A l\u2019issue d\u2019une longue enqu\u00eate, The New York Times<\/em><\/a> d\u00e9crit comment l\u2019effondrement de Notre-Dame de Paris a \u00e9t\u00e9 \u00e9vit\u00e9 de justesse.<\/p>\n Novlangue<\/p>\n Les amateurs se d\u00e9lecteront de ce guide<\/a> sur la QVT.<\/p>\n Numerus clausus<\/p>\n Le Monde<\/em><\/a> s\u2019interroge sur la fin du numerus clausus \u00e0 l\u2019entr\u00e9e des \u00e9tudes m\u00e9dicales\u00a0: \u00ab\u00a0cette promesse spectaculaire pourrait susciter quelques d\u00e9sillusions. La commission des affaires sociales du S\u00e9nat a d\u00e9j\u00e0 mis en garde contre une \u00ab communication gouvernementale potentiellement trompeuse quant \u00e0 la suppression du numerus clausus et \u00e0 ses cons\u00e9quences. Et dans le monde universitaire et m\u00e9dical, l\u2019affaire semble entendue, jusque dans les rangs feutr\u00e9s des doyens de facult\u00e9 de m\u00e9decine : cette \u00ab suppression \u00bb du numerus clausus serait en r\u00e9alit\u00e9 largement en trompe-l\u2019\u0153il.\u00a0\u00bb<\/em><\/p>\n Opiac\u00e9s<\/p>\n \u00ab\u00a0Newly unsealed documents in a landmark lawsuit Tuesday in Cleveland show the pressure within drug companies to sell opioids in the face of numerous red flags during the height of the epidemic. The release of the exhibits \u2014 sworn depositions of executives, internal corporate emails and experts\u2019 reports \u2014 also reveals the ignored concerns of some employees about the huge volume of pain pills streaming across the nation. \u00bb<\/em>Ainsi commence une enqu\u00eate<\/a> du Washington Post<\/em>sur la crise des opiac\u00e9s aux \u00c9tats-Unis.<\/p>\n Des m\u00e9decins et professionnels de sant\u00e9 alertent dans le JDD<\/em><\/a> sur le risque d\u2019une telle \u00e9pid\u00e9mie en France.<\/p>\n Opinion v. preuve<\/p>\n Lorsque des recommandations sont \u00e9tablies, il faut bien distinguer opinions et preuves\u00a0: \u00ab\u00a0The experience of experts can be useful when developing guidelines, but structures need to be in place to avoid opinion being confused with evidence \u00bb<\/em>, d\u00e9clarent Holger J Sch\u00fcnemann et coll. dans The\u00a0<\/em>British Medical Journal<\/em><\/a>.<\/p>\n P value<\/em><\/p>\n The New England Journal of Medicine<\/a>\u00a0<\/em>annonce une nouvelle politique en mati\u00e8re de statistiques aux d\u00e9pends du P et en faveur des intervalles de confiance, pr\u00e9cisant\u00a0: \u00ab Journal editors and statistical consultants have become increasingly concerned about the overuse and misinterpretation of significance testing and P values in the medical literature. <\/em>Along with their strengths, P values are subject to inherent weaknesses, as summarized in recent publications from the American Statistical Association. (\u2026) Finally, the notion that a treatment is effective for a particular outcome if P<0.05 and ineffective if that threshold is not reached is a reductionist view of medicine that does not always reflect reality. \u00bb<\/em><\/p>\n Pas<\/p>\n Et si la r\u00e8gle des 10\u00a0000 pas par jour\u00a0s\u2019av\u00e9rait fausse (voir ici<\/a> et l\u00e0<\/a>).<\/p>\n Perte de sens<\/p>\n Sur le site ManagerSante.com, Fr\u00e9d\u00e9ric Spinhirny, philosophe et directeur des ressources humaines \u00e0 l\u2019h\u00f4pital Necker-Enfants Malades, signe un article<\/a> intitul\u00e9 \u00ab\u00a0Peut-on r\u00e9-enraciner le management \u00e0 l\u2019h\u00f4pital ?\u00a0\u00bb Extrait\u00a0: \u00ab L\u2019une des origines de la perte de sens est l\u2019absence de contact avec l\u2019activit\u00e9 r\u00e9elle. (…) le temps perdu en proc\u00e9dures inutiles ou en r\u00e9unions de coordinations fait privil\u00e9gier l\u2019accessoire et l\u2019insignifiant au d\u00e9triment de l\u2019essentiel. \u00bb<\/em><\/p>\n Philosophie<\/p>\n Un article de Peter Adamson dans The New York Review of Books<\/em><\/a> sur un ouvrage relatant les d\u00e9buts de la philosophie en Gr\u00e8ce.<\/p>\n Plastique<\/p>\n Selon