Sante Publique
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Health democracy in France has consisted in recognizing individual and collective rights attributed to users of the health system and in making decision-making procedures in health more contradictory. However, this movement has encountered a number of obstacles and barriers since the adoption of the law of March 4, 2002. Seven years later, the recent Act of July 21, 2009, aims to renovate a more vigorous health democracy, including restoring regional conferences on health and governance with the autonomous powers that were conferred to them in the 2002 Act. However, nothing is yet secured; vigilance is essential and should remain high on the agenda.
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The authors review the new provisions from the law of 25 February 2008 on security measures on retention for safety and on reporting of criminal irresponsibility related to mental disorder. In doing so, they aim to bring a medical perspective to the discussion. ⋯ The concept of dangerousness, as the foundational definition of security measures, is discussed and the difficulties of its evaluation are outlined. Finally, the paper attempts to clarify the role of the psychiatrist in this new schema and to reaffirm the principles of care.
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The aim of this study was to quantify and qualify mistaken identities in a current medical records archive. The medical records are classified by identification indexes (day and month of birth, the first letter of their surname) by category where their placement is a function of the record's status defined as "current", "semi-current" or "dead". All of the medical records marked as "current" (n=43,592), dating between 12 February 2004 to 11 March 2004, were analysed. 1397 (3.2%) contained at least one error, totalling 1456 errors, or an average of 1.04 errors per record. ⋯ The immediate impact is a reduction in the workload of staff directly due to the absence of the missing file. The depth of this problem was more significant than had been suggested by the indicators, both qualitatively and quantitatively. These results should be used to advocate for the implementation of a policy on continuous quality assessment (scoring the quality of the creation of the record, and scoring the intervention).
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Public health, prevention, health education and health promotion are inseparable from the concepts of information and communication. Information should respond as much as possible to the needs of professionals, decision-makers, and consumers who are more and more concerned and conscious of its importance in light of "information overload", various dissemination channels and the multiplicity of its sources. There are numerous issues at stake ranging from comprehension, to the validation of health information, health education, health promotion, prevention, decision-making, as well as issues related to knowledge and power. ⋯ The media and consumers play an increasingly significant role in public health decision-making and in the ensuing legislative consequences and debates which come as a result. Access to information is changing, especially thanks to the Internet which is completely modifying the global scenery of knowledge and know-how. Information supports decision-making with calculated risk, and it offers the opportunity to make choices and decisions, recognising that "to choose, is sometimes to relinquish".
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The new European directive REACH constitutes a potential step forward for the prevention of health risks linked to industrial chemical production. The conflicts of interest expressed throughout its development and the compromises resulting from those opposing interest situate this directive at the cross-roads of the multiple rationales operating in the occupational health field. The precautionary principal, risk assessment, prevention, regulation, and corporate responsibility will have a role to play in the practical implementation of REACH.