Home emergency response team for the seriously ill palliative care patient: feasibility and effectiveness.

OBJECTIVES: To characterise trajectories associated with a new team organisation combining critical care and palliative care approaches at home. METHODS: We describe the pattern of an emergency response team 24/7 directed to patients with advanced illness presenting a distressing symptom at home, who wanted to stay at home and for whom hospitalisation was considered inappropriate by a shared medical decision-making process in an emergency situation. To assess preliminary impact of this Programme, we conducted a descriptive study on all consecutive patients receiving this intervention during the first year (between 6 September 2021 and 5 September 2022). RESULTS: Among the 352 patients included, main advanced illnesses were cancer (41%), dementia (28%) or chronic organ failure (10%). They were critically ill with acute failures: respiratory (52%), neurological (48%) or circulatory (20%). Main distressing symptoms were breathlessness (43%) and pain (17%). Median response time from call to home-visit (IQR) was 140 (90-265) min. Median length of follow-up (IQR) was 4 (2-7) days. Main outcomes were death at home (72%), improvement (19%) or hospitalisation (9%) including three visits to emergency department (1%). CONCLUSIONS: Our study supports that shared decision-making process and urgent care at home are feasible and might prevent undesired hospitalisations.

[The role of private geriatricians in the health care system (2/2): comprehensive qualitative analysis using semi-structured interviews]. / Rôle des gériatres libéraux dans le système de santé (2/2) : analyse qualitative compréhensive par entretiens semi-dirigés.

Private geriatricians report heterogeneous practices, while the specialty as a whole is questioning its model. We conducted semi-structured interviews to understand how private geriatricians viewed their role in the health care system. They report a certain homogeneity in their conception of their role, which corresponds to that of geriatricians as a whole: there seems to be a professional identity for geriatrics.

[Role of private geriatricians in the health care system (1/2): quantitative descriptive analysis by questionnaire]. / Rôle des gériatres libéraux dans le système de santé (1/2) : analyse quantitative descriptive par questionnaire.

Private practice geriatrics is a little known practice modality. We conducted a questionnaire survey to try to describe the role of private geriatricians in the health care system. Although few in number, private geriatricians report very different practices, including their conception of their role. This is the first monograph on the activity of private geriatricians, and the results have motivated us to propose a comprehensive analysis of this role.

Perceptions on the role of research integrity officers in French medical schools.

Researchers, organizations, and governments are trying to foster research integrity. In France, the law recently permitted the appointment of research integrity officers (RIOs) in each university, to promote research integrity and handle misconducts. Since we assumed that having adequate bodies to deal with research integrity could foster research integrity, we wanted to understand how this might work more concretely. We interviewed 11 newly appointed RIOs in medical schools about how they perceive their role and cope with their responsibilities. We analyzed data following the Paillé and Muchielli's thematic analysis approach. The RIOs report a strong and interesting appropriation of concepts of research integrity, which allows them to warrant their role. Although they report that they did not seek their appointment, they show a real desire to cope with their responsibilities. They are willing to build a role which is currently poorly defined. They assert their legitimacy through their position and experience. They identify themselves with a preventive and corrective role, in an altruistic way. They emphasize their independent and collective role, congruent with other actors. The RIOs intend to be enablers of a responsible conduct of research. These results are encouraging about the potential impact of RIOs to foster research integrity.

[Intention of geriatric interns to train and go into private practice]. / Intention des internes de gériatrie à se former et à s'installer en libéral.

Geriatrics is a recent medical specialty in France, and private practice, possible, is still a minority. The specialized studies diploma, created in 2017, provides for the possibility of completing a semester of internship in private practice. According to our study, 62% of geriatric interns in training would consider doing a semester outside the hospital and 42.7% would consider setting up in private practice. Proportions which vary according to the year in which the national qualifying tests were taken and the internship subdivision.