Differences between the healthcare systems of Quebec and France for the treatment of pain due to spinal disorders

In Quebec,Canada,the public healthcare system offers free medical services.However,patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy coverage.In contrast,private clinics provide expedited care but are relatively scarce and entail out-of-pocket expenses.Once a patient with pain caused by a spinal disorder meets a pain medicine specialist,spinal intervention is quickly performed when indicated,and patients are provided lifestyle advice.Transforaminal epidural steroid injections are frequently administered to patients with radicular pain,and steroid injections are administered on a facet joint to control low back or neck pain.Additionally,medial branch blocks are performed prior to thermocoagulation.France’s universal healthcare system ensures accessibility at controlled costs.It emphasizes physical activity and provides free physical therapy services.However,certain interventions,such as transforaminal and interlaminar epidural injections,are not routinely used in France owing to limited therapeutic efficacy and safety concerns.This underutilization may be a potential cause of chronic pain for many patients.By examining the differences,strengths,and weaknesses of these two systems,valuable insights can be gained for the enhancement of global spinal pain management strategies,ultimately leading to improved patient outcomes and satisfaction.

Early Quality Life Impairment in Alzheimer Disease’s Patients in Geriatric Department: About 214 Cases in Pitié Salpêtrière Hospital of Paris (France)

Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the quality of life of patients with AD. Methodology: Descriptive retrospective study over 14 years in the geriatric department of Pitié Salpêtrière Hospital, using the activity of daily living, Instrumental activity of daily living, neuropsychological inventory and Hoen Yahr scale evaluated at the time of diagnosis of AD according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer Disease’s and Related Disorders Association diagnostic criteria. Results: A total of 214 exploitable files had been listed. At the moment of diagnosis, the mean age was 82.1 years with extremes 68 to 95 with sex ratio 1.6 in women’s favor. The mean socio-cultural level was 4.9 with extremes about 0 to 7. There was poly pathology with a mean Cumulative Illness Rate Scale = 4.6 with extremes 0 to 16. the mean cognitive status was moderate = 22.5 with extremes 0 to 30. Quality life showed moderate impairment of IADL = 9.2 with extreme 3 to 11 compared to activity of daily living. The activity of daily living was more affected in 68 - 80-year-olds, while poly pathology impacted more on IADL in men. The cognitive impairment was more deficient in IADL when the MMSE test was low. The common disorders at the NPI were psychological, behavioral and psychotic. Conclusion: At the early diagnosis of Alzheimer’s Disease cognitive deficiencies were predominant and influenced on global Instrumental activity and psychological, behavioral disorders.

Protocol for lower back pain management: Insights from the French healthcare system

In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.

基于ABAQUS/FRANC3D的钢轨三维表面裂纹的扩展分析

为分析钢轨三维表面裂纹在轮轨载荷作用下的疲劳扩展路径和应力强度因子的变化,研究钢轨剥离掉块的损伤机理。运用Fortran语言编写用户子程序DLOAD和UTRACLOAD施加轮轨接触应力,利用有限元软件ABAQUS和FRANC3D模拟车轮在钢轨上的移动并分析钢轨三维表面裂纹的应力强度因子随车轮移动的变化情况,并基于PARIS公式和最大周向应力准则对钢轨三维表面裂纹的疲劳扩展行为进行分析。结果表明轮轨载荷仅为赫兹接触压力时,车轮在钢轨表面滚过,裂纹前缘距钢轨表面越深,越易发生扩展,裂纹主要在钢轨的深度方向扩展,可使半圆形裂纹变成长轴在深度方向的椭圆形裂纹;轮轨载荷为赫兹接触压力和滑动摩擦力共同作用时,随着车轮循环次数的增加,表面裂纹的等效应力强度因子Keq不断增大。车轮作用会使距钢轨表面越近的裂纹前缘越易发生扩展,裂纹主要向钢轨的宽度方向扩展,使半圆形裂纹变成形状较为复杂的长轴在钢轨宽度方向的近椭圆形裂纹。

激光沉积TA15钛合金的裂纹扩展行为

采用标准CT试样测定了激光沉积TA15钛合金疲劳裂纹扩展速率,结合微观组织、裂纹扩展路径以及断口形貌分析疲劳裂纹扩展机理;并基于ABAQUS与FRANC 3D联合仿真的方法,模拟裂纹尖端应力强度因子并进行寿命预测。结果表明,激光沉积制造态的裂纹扩展速率低于锻造态,裂纹主要穿过片状α相(αl),少量沿αl扩展,稳定扩展区清晰可见疲劳条纹,并伴随大量的二次裂纹,瞬断区为典型的韧性断裂。另一方面,ABAQUS与FRANC 3D联合仿真计算的应力强度因子与理论值吻合较好,预测寿命相对误差低于5%,且证实了预测结果保守,验证了模拟分析的可靠性,确保了工程应用中的安全性。

A New Accumulation Model of Coal Seams in France Extensional Basins

This paper, based on the sedimentary features of the coal seams in the typical extensional (faulted) coal basins between two inland mountainous areas of the Central Massif (France) deals with the accumulation mechanism and the corresponding sedimentary tectonic conditions of these thick coalbeds, and proposes a new coal accumulation model for the inland lacustrine basin thick coalbeds. The presence of a great number of gravity flow sediments such as detrital flow, diluted slurry flow or turbidity current sediments in the coal seams, and that of the contemporaneous gravity slump and deformation structure in the coal seam itself both indicate that the lacustrine environment in the accumulation of the thick coalbeds was characterized by the relatively deep flood and violent sedimentation. This model can not only interpret reasonably the accumulation mechanism of the thick coalbeds developed in the fault basins in the Central Massif, France, but also show its features distinctively from those of the accumulation model of the traditional thick coalbeds.

Cultural Tourism Enlightenment from France for Hebei Province, China

French is one of the best cultural tourism destinations in the world. Its development experiences in terms of cultural tourism are valuable for Hebei, whose competitiveness of cultural tourism is weak comparatively in spite of rich cultural resources. Specifically, France achieves great successes of cultural tourism through scientific planning, producing tourism products injected by cultures, and developing tourism festivals. On this basis, four suggestions are recommended to improve cultural tourism in Hebei Province based on its actual situation, namely building cultural brand of tourism, strengthening government management, and developing tourism derivatives, and reinforcing talent training.

Brief History of Chinese Medicine in France

In the 17th century,Chinese medicine appeared in France;since then,it never stopped evolving and is applied by French practitioners.Today,acupuncture is widely used in clinic treatment in France.

A Lion of France

Born in Corsica, a place reigned[统治] by the French, Napoleon was predestined[注定的] to be extraordinary. It was the historical background that shaped Napoleon’s strong belief in nationalism and his determination, which became the momentum[动力] in his personal success. Few people are born with the required knowledge and power to support their dreams, neither was Napoleon. In his early youth, he read all the books available related to the history of his hometown and France, knowing that his ambition to reverse[完全改变] the destiny of his country would be impossible unless he had learned enough lessons from the past.

Major Results and Research Challenges in Cotton Molecular Genetics at CIRAD(France)

CIRAD(Montpellier,France) develops research activities centered on tropical and sub-tropical agricultural systems.Among others crops,cotton is the focus of a series of research programs in different disciplines from economics to breeding.Major areas in genetics and breeding relate to(1) genetic diversity,(2) cultivar development through classical and molecular breeding,and(3)

2024-T4铝合金FSW接头疲劳裂纹扩展行为及寿命预测

基于ABAQUS与FRANC 3D联合仿真的方法,对2024-T4铝合金搅拌摩擦焊接头预制裂纹于不同部位的紧凑拉伸试样进行裂纹扩展分析以及寿命预测,并深入分析不同部位裂纹扩展行为存在差异性的原因.结果表明,随着裂纹长度的不断延长,裂纹尖端应力强度因子随之增大,且裂纹向前扩展路径基本沿直线扩展,ABAQUS与FRANC 3D联合仿真方法分析不同部位的裂纹尖端应力强度因子和裂纹扩展路径的理论计算和试验结果基本吻合,验证了分区域进行联合仿真的模型精度满足要求.不同部位裂纹扩展试样寿命预测结果与试验结果的相对误差均在5%左右,对焊接接头分区域联合仿真进行寿命预测是准确可行的.裂纹位于不同部位的扩展试样断口处的疲劳辉纹间距不同导致预制裂纹于3个部位的疲劳寿命由低到高为:热影响区、垂直于焊缝方向、焊核区.

To Know the World to Know Oneself——My 40 Years of Experience with France

FORTY years ago,in 1978,1 was working in a factory in Shanghai.At that time,the gateway to foreign countries seemed to me even more remote than that of paradise.I had already heard of the French Republic,but only because my father was Zheng Yonghui,an illustrious literary translator who spoke fluent French.My father was born in Vietnam(formerly under the control of the French colonial empire),but at a very young age he arrived in Shanghai,and then

The Central Academy of Fine Arts Art Museum Reproducing the Journey of Pioneering Chinese Artists Abroad in France

At the opening ceremony of this exhibition on January 12, Fan Di'an, Chairman of Chinese Artists Association and CAFA President, said:"The exhibition is a demonstration of the academic research and achievements of a generation of Chinese artists abroad in France.

Acute Renal Failure during Progressive Systemic Sclerosis in the Regional University Teaching Hospital of Brest-La Cavale Blanche (France)

Systemic scleroderma is a rare disease in which visceral manifestations occur, particularly peripheral vascular, digestive, cardiopulmonary and renal. It is pathology with a predilection for women. The present clinical case is that of a man with the renal complications of scleroderma and the difficulties of the treatment even in the developed countries like France. In the present case, the management of this disease required a high dose of corticosteroid therapy and extra-renal purification. Early detection of complications through a minimal clinical examination supplemented with paraclinic tests has proved necessary.

France’s Strategy on Migration Issues in the Mediterranean

The Mediterranean Sea is recognized by France as the most important adjacent area and also the gate to Africa,France’s vast sphere of influence beyond the Mediterranean.The political turmoil here since the Arab Spring has begun,especially emergence of a flood of refugees coming to the EU,was a serious problem for France.The current situation of EU,which is shaken over the acceptance of immigrants and refugees,is grave for France,having a strategic pillar which is to raise the own presence in global politics by obtaining the leadership in the EU.France sets out to put the migration and refugee issues to rest,to maintain EU’s political power and to seize the initiative in the EU.This article will analyze such a national strategy of France focusing on the process from Chirac’s administration to Macron’s.

A Review of Influential Chinese Artists Studying Abroad in France in the Early 1900s (II)

Editor's note : About a hundred years ago, a large number of progress young Chinese with great ambitions went to France for Work-Study programs to introduce French science and arts to China, so as to save the nation and the people. Among them, a generation of Chinese artists studying in France created splendid works which had played an essential role in the history of Chinese arts in the 20th century.

Making Cultural Integration Work——Lessons form the Successful Air France KLM Combination

The reccnt Alcatel Lucent failure is an example of how many mergers run into considerable implementing difficulties in the months following their launch. Despite promising perspectives,no coherent whole seems to come out of the merger,just as anticipated synergies have a hard time materializing.

FRANCE:TURNING TO“NEW GAULLISM”

On May 7th, Jacques Chirac, candidate of the Rally for the Republic (RPR)and Mayor of Paris, defeated the Socialist candidate Lionel Jospin in the secondround of the French presidential election and was elected the fifth president of theFifth Republic. Alain Juppe, Chirac’s close assistant and former foreign minister,was appointed as the prime minister of the new cabinet. Thus ended the formerPresident Francois Mitterrand’s Socialist rule of 14 years and ushered in an epochof Gaullist Chirac, a man who will lead France into the 21st century.

The Seminar on the changes of Fine Arts Between China and France

On March 26, the Centennial Seminar on es of Fine Arts between China and France, cosponsored by China Cultural Center in Paris,National Art Museum of China (NAMOC) and Network of International Culturalink Entities, was held at China Cultural Center in Paris? Experts from China and France conducted in-depth discussions on the theme of Centennial Exchanges of Fine Arts and. Academic Communication between China and France? The experts include Yan Zhenquan, Director of China Cultural Center in Paris, Wu Weishan, Director of NAMOC and Claude Abeille and Jean Cardot, academicians of Academy of F ine Art, Insititute of France.