[The missions of Biologie Sans Frontières (BSF)]. / Les missions de Biologie Sans Frontières (BSF).

« Biologie sans Frontières ¼ (BSF) is a non-governmental organisation whose mission is to develop medical biology where it is most needed, particularly in French-speaking Africa. In Guinea Conakry, with Fondation Mérieux and the Guinean Ministry of Health, BSF is in charge of training "trainers/teachers" of technicians. This training will take place at the National Health School of Kindia, a school that has been completely rehabilitated and re-equipped thanks to the support of Fondation Mérieux. This project is supported by the French Development Agency. BSF has an in-depth knowledge of the local needs in medical biology training. After an audit carried out by two BSF members, the findings were alarming: these trainers had no experience in medical biology and their theoretical knowledge was still of low level. Three training courses were then provided by BSF, the first in biochemistry, sero-immunology and immuno-hematology, the second in cyto-hematology and the last one in bacteriology-parasitology. The basic techniques have been acquired, the "student trainers" have shown great assiduity, but the level remains fragile and will require new training, which is essential to help these future teachers to provide structured, functional and above all useful practical work adapted to local practices and needs.

Exploring the Determinants of Polypharmacy Prescribing and Dispensing Behaviours in Primary Care for the Elderly-Protocol for a Qualitative Study.

Polypharmacy is becoming increasingly common, especially among the elderly. It often has a negative connotation, but is sometimes necessary or even desirable, and needed to categorize polypharmacy as appropriate or inappropriate. The challenge is in ensuring that this is considered appropriate when necessary. We aimed to develop an evidence-based intervention to reduce the risks associated with using a systematic approach, involving key stakeholders in prescribing and dispensing drugs to the elderly in primary care. The purpose of this study is to identify the key components which are perceived as influencing these behaviours. It is a qualitative study of general practitioners (GPS) and community pharmacists involved in the care of the elderly. The main inclusion criterion is the geographic location. Qualitative data will be generated from one-on-one, semi-structured interviews and processed for thematic content analysis. Our approach integrates the patient pathway in primary care. It considers the fact that GP and pharmacist behaviours are far from being independent. This study represents the first step in the process of developing an intervention theory which involves a crossover between data from the literature and the knowledge of experts, allowing us to interrogate hypotheses about the influences and mechanisms associated with prescribing and dispensing drugs to the elderly in primary care.

The Contribution of the Humanities and Social Sciences to Pharmacy Education: Literature Review and Perspectives.

BACKGROUND: Healthcare systems worldwide adapt to patients' needs and expectations, following social evolutions. Pharmaceutical practice has shifted towards activities such as therapeutic education. Such new missions require to prioritize human and social sciences, which now play a predominant role in training. OBJECTIVE: This work consists of assessing the contribution of human and social sciences to the field of pharmacy, with a twofold focus on practice and training. METHOD: A literature review was carried out according to the PRISMA guidelines focusing on the last 10 years. Selected full texts were read and analyzed to elicit the contribution of human and social sciences to pharmacy. RESULTS: Overall 36 articles were included. Three specific topics were identified during an inductive process of full text analysis: public health policy, patient care, and interprofessional collaboration. CONCLUSIONS: Although human and social sciences are essential to the evolution of the pharmacist profession, their impact on health care costs remains difficult to evaluate. Moreover, teaching human and social sciences can prove difficult to standardize. Such approaches must be supported and organized by governments and universities with a view of upscaling practices.

[Ethics and confidentiality of a patient in a medical biology laboratory]. / L'éthique et la confidentialité du patient au laboratoire de biologie médicale.

Confidentiality is based on principles of deontology and ethics, which are included in French regulations and supported by the professional orders. It contributes to the respect and dignity of the patient. If this consideration of the human person is old, it has been updated to build the framework imposed by the accreditation of medical biology laboratories. Confidentiality is thus reflected in a charter of ethics, a model of which we propose here. It reflects the commitments of healthcare professionals in the processing of biological samples from patients. Confidentiality is thus applied, in a practical way, at each phase of the laboratory's activity. In the pre-analytical phase, it organizes the reception of the patient and the taking of samples, taking into account the particular case of minors. In the analytical phase, confidentiality imposes limited access to the technical premises and the organization of the flow of personnel from outside the laboratory. Finally, in the post-analytical phase, the reporting of results is regulated, depending on the type of analyses performed and the person to whom the results are to be reported (patient or prescriber). The particular case of spermiology illustrates all these points. Finally, during these phases of sample processing, document management is also a matter of confidentiality and data protection. Confidentiality is essential to the functioning of a health care structure, but it is restrictive in its day-to-day implementation. Nevertheless, it must be combined with an awareness of all staff to address the ethical issue of human dignity.

Safety Evaluation of Individual Pillboxes to Control Cross-Contamination in the Drug Circuit in Hospitals.

This study aims to evaluate the potential role of pillboxes used for the preparation and delivery of individual daily medical treatments in the drug circuit of the Military Instruction Hospital (France) as reservoirs of bacterial contaminants. Samples were obtained from 32 pillboxes after decontamination (T1), after preparation in the pharmacy (T2), after use in two different medical units (T3), and again after usual mechanical washing (T4). Qualitative (identification and antibiotic susceptibility) and quantitative (contamination rate and number of colony forming units-CFUs) bacteriological tests were performed. Susceptible and resistant strains of environmental saprophytes were identified. The pillbox contamination rate was relatively low at T1 (13%). It was significantly increased at T2 (63%, p = 0.001 vs. T1), again at T3 (88%, p < 0.05 vs. T2, p < 0.001 vs. T1), and finally decreased dramatically at T4 (31%, p < 0.001 vs. T3, p > 0.05 vs. T1). The number of CFUs was significantly increased at T2 compared with that of T1 (36.7 ± 13.4 and 5.36 ± 3.64, respectively, p < 0.001) and again at T3 (84.4 ± 19.4, p < 0.001 vs. T1 and T2) and was significantly reduced at T4 (7.0 ± 2.0 vs. T3, p < 0.001) to a level that was not significantly different from that at T1. So, the use of pillboxes to deliver individual medications to patients in the hospital is a potential risk factor for bacterial cross-contamination.