B Acad Nat Med Paris
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Humanitarian action is undergoing profound changes. Beyond the emergency relief phase, it is becoming involved in the processes that enable victims to regain their autonomy and, more recently, in prevention and risk-reduction policies. ⋯ Moreover, local communities are increasingly seeking to achieve their humanitarian emancipation. This trend must be anticipated, specifically by profiling future aid workers, and is similar to that faced by humanitarian medicine.
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Two major changes in end-of-life management have occured in recent decades: first, because of the increase in life expectancy and the resulting aging of the population, most deaths now involve old or very old people; second, more than two-thirds of deaths occur in a hospital or an institution. Our fellow citizens are afraid of suffering and death. They wish for a peaceful death, as rapid as possible and, in recent surveys, say they favour euthanasia. ⋯ Palliative care ensures dignity in death, without anxiety of suffering, and is expanding rapidly in France. Léonetti's law of 22 April 2005 ensures the protection of the weakest, who should never be considered unworthy of life, yet is poorly known to the public and even to physicians. It now needs to be applied in practice.
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The toxicity of cancer therapies can affect all organs and tissues. Some treatments damage spermatogonial stem cells (SSCs), with a risk of infertility. ⋯ However, thawed frozen prepubertal testicular tissue must undergo a maturation process to restore sperm production. This process, currently being studied in animal models, can be achieved by in vivo transplantation of SSCs into seminiferous tubules or by testicular grafting, possibly following in vitro maturation.
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Risk factors lead to social exclusion and their accumulation can lead to homelessness. This inevitably contributes to a progressive increase in psychological distress or aggravates a pre-existing mental illness. ⋯ Proactive programs designed to facilitate access to healthcare and welfare have been created in order to offer solutions designed to enable homeless people to leave the street, through access to medical care, accommodation and civil rights. The psychiatric sector has been slow to adapt to the needs of this population, although several teams specializing in mental illness and precariousness have been created These teams explore every possible avenue to help homeless people with mental health issues to recover a psychological balance that allows them to choose a recovery pathway and thus to regain a dignified lifestyle.