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Le fluconazole, commercialisé sous le nom de Diflucan, est un antifongique appartenant à la classe des triazolés. Son action repose sur l’inhibition de la 14α-déméthylase dépendante du cytochrome P450, empêchant la conversion du lanostérol en ergostérol, composant essentiel de la membrane fongique. Cette inhibition fragilise la membrane et conduit à la mort cellulaire. La biodisponibilité du fluconazole est élevée (90 %), avec une pénétration efficace dans le liquide céphalorachidien, ce qui justifie son utilisation dans les méningites cryptococciques. Sa demi-vie longue permet des administrations espacées. Les données cliniques soulignent son rôle dans la prise en charge des candidoses systémiques, des candidémies et des infections opportunistes chez les sujets immunodéprimés. Les références thérapeutiques indiquent que diflucan prix est intégré dans de nombreux protocoles, tout en rappelant la surveillance nécessaire des enzymes hépatiques et les interactions avec les substrats du CYP3A4 et du CYP2C9.

The National Academies Press - The National Academies Press (NAP) publishes authoritative reports issued by The National Academies. Publications address key issues in science, engineering, social sciences, medicine and health. Topics range from space science to animal nutrition to medical ethics.

  • https://www.nap.edu/collection Searchable Collections | The National Academies Press - Discover the best collections of books that the National Academies Press has to offer in selected subject areas. Handpicked by NAP staff, these are the most current and relevant resources. Search inside each book or search across all the titles in each collection to learn more about key issues in science, engineering and medicine.
  • https://www.nap.edu/collection/54/womens-adventures-in-science Women's Adventures in Science | The National Academies Press - View 11 publications on Women's Adventures in Science available to read, download, and purchase at NAP.edu. Description: What would it be like to build the first robot that could interact with people? Or to study human remains in search of criminal evidence?In Women's Adventures in Science, readers will learn about the trailblazing women who are leaders in a variety of scientific fields, from robotics to forensics. Each book focuses on the life and work of a woman active in her field today, providing readers with insights into the personal and professional paths that led to their careers in science.
  • https://www.nap.edu/academy-scope AcademyScope | The National Academies Press - AcademyScope is a visualization of all of the reports that are available on NAP.edu, allowing you to browse through the reports of the National Academies by topic area and seeing relationships between titles.
  • https://www.nap.edu/catalog/19014/nutrient-requirements-of-beef-cattle-eighth-revised-edition Nutrient Requirements of Beef Cattle: Eighth Revised Edition | The National Academies Press - Since 1944, the National Research Council (NRC) has published seven editions of the Nutrient Requirements of Beef Cattle. This reference has guided nutritionists and other professionals in academia and the cattle and feed industries in developing and implementing nutritional and feeding programs for beef cattle. The cattle industry has undergone considerable changes since the seventh revised edition was published in 2000 and some of the requirements and recommendations set forth at that time are no longer relevant or appropriate.The eighth revised edition of the Nutrient Requirements of Beef Cattle builds on the previous editions. A great deal of new research has been published during the past 14 years and there is a large amount of new information for many nutrients. In addition to a thorough and current evaluation of the literature on the energy and nutrient requirements of beef in all stages of life, this volume includes new information about phosphorus and sulfur contents; a review of nutritional and feeding strategies to minimize nutrient losses in manure and reduce greenhouse gas production; a discussion of the effect of feeding on the nutritional quality and food safety of beef; new information about nutrient metabolism and utilization; new information on feed additives that alter rumen metabolism and postabsorptive metabolism; and future areas of needed research. The tables of feed ingredient composition are significantly updated.Nutrient Requirements of Beef Cattle represents a comprehensive review of the most recent information available on beef cattle nutrition and ingredient composition that will allow efficient, profitable, and environmentally conscious beef production.
  • https://www.nap.edu/catalog/21739/barriers-and-opportunities-for-2-year-and-4-year-stem-degrees Barriers and Opportunities for 2-Year and 4-Year STEM Degrees: Systemic Change to Support Students' Diverse Pathways | The National Academies Press - Download a PDF of "Barriers and Opportunities for 2-Year and 4-Year STEM Degrees" by the National Academies of Sciences, Engineering, and Medicine for free. Description: Nearly 40 percent of the students entering 2- and 4-year postsecondary institutions indicated their intention to major in science, technology, engineering, and mathematics (STEM) in 2012. But the barriers to students realizing their ambitions are reflected in the fact that about half of those with the intention to earn a STEM bachelor’s degree and more than two-thirds intending to earn a STEM associate’s degree fail to earn these degrees 4 to 6 years after their initial enrollment. Many of those who do obtain a degree take longer than the advertised length of the programs, thus raising the cost of their education. Are the STEM educational pathways any less efficient than for other fields of study? How might the losses be “stemmed” and greater efficiencies realized? These questions and others are at the heart of this study.Barriers and Opportunities for 2-Year and 4-Year STEM Degrees reviews research on the roles that people, processes, and institutions play in 2-and 4-year STEM degree production. This study pays special attention to the factors that influence students’ decisions to enter, stay in, or leave STEM majors—quality of instruction, grading policies, course sequences, undergraduate learning environments, student supports, co-curricular activities, students’ general academic preparedness and competence in science, family background, and governmental and institutional policies that affect STEM educational pathways. Because many students do not take the traditional 4-year path to a STEM undergraduate degree, Barriers and Opportunities describes several other common pathways and also reviews what happens to those who do not complete the journey to a degree. This book describes the major changes in student demographics; how students, view, value, and utilize programs of higher education; and how institutions can adapt to support successful student outcomes. In doing so, Barriers and Opportunities questions whether definitions and characteristics of what constitutes success in STEM should change. As this book explores these issues, it identifies where further research is needed to build a system that works for all students who aspire to STEM degrees. The conclusions of this report lay out the steps that faculty, STEM departments, colleges and universities, professional societies, and others can take to improve STEM education for all students interested in a STEM degree.
  • https://www.nap.edu/catalog/21852/attribution-of-extreme-weather-events-in-the-context-of-climate-change Attribution of Extreme Weather Events in the Context of Climate Change | The National Academies Press - Download a PDF of "Attribution of Extreme Weather Events in the Context of Climate Change" by the National Academies of Sciences, Engineering, and Medicine for free. Description: As climate has warmed over recent years, a new pattern of more frequent and more intense weather events has unfolded across the globe. Climate models simulate such changes in extreme events, and some of the reasons for the changes are well understood. Warming increases the likelihood of extremely hot days and nights, favors increased atmospheric moisture that may result in more frequent heavy rainfall and snowfall, and leads to evaporation that can exacerbate droughts.Even with evidence of these broad trends, scientists cautioned in the past that individual weather events couldn't be attributed to climate change. Now, with advances in understanding the climate science behind extreme events and the science of extreme event attribution, such blanket statements may not be accurate. The relatively young science of extreme event attribution seeks to tease out the influence of human-cause climate change from other factors, such as natural sources of variability like El Niño, as contributors to individual extreme events.Event attribution can answer questions about how much climate change influenced the probability or intensity of a specific type of weather event. As event attribution capabilities improve, they could help inform choices about assessing and managing risk, and in guiding climate adaptation strategies. This report examines the current state of science of extreme weather attribution, and identifies ways to move the science forward to improve attribution capabilities.
  • https://www.nap.edu/catalog/23482/preventing-bullying-through-science-policy-and-practice Preventing Bullying Through Science, Policy, and Practice | The National Academies Press - Download a PDF of "Preventing Bullying Through Science, Policy, and Practice" by the National Academies of Sciences, Engineering, and Medicine for free. Description: Bullying has long been tolerated as a rite of passage among children and adolescents. There is an implication that individuals who are bullied must have "asked for" this type of treatment, or deserved it. Sometimes, even the child who is bullied begins to internalize this idea. For many years, there has been a general acceptance and collective shrug when it comes to a child or adolescent with greater social capital or power pushing around a child perceived as subordinate. But bullying is not developmentally appropriate; it should not be considered a normal part of the typical social grouping that occurs throughout a child's life.Although bullying behavior endures through generations, the milieu is changing. Historically, bulling has occurred at school, the physical setting in which most of childhood is centered and the primary source for peer group formation. In recent years, however, the physical setting is not the only place bullying is occurring. Technology allows for an entirely new type of digital electronic aggression, cyberbullying, which takes place through chat rooms, instant messaging, social media, and other forms of digital electronic communication.Composition of peer groups, shifting demographics, changing societal norms, and modern technology are contextual factors that must be considered to understand and effectively react to bullying in the United States. Youth are embedded in multiple contexts and each of these contexts interacts with individual characteristics of youth in ways that either exacerbate or attenuate the association between these individual characteristics and bullying perpetration or victimization. Recognizing that bullying behavior is a major public health problem that demands the concerted and coordinated time and attention of parents, educators and school administrators, health care providers, policy makers, families, and others concerned with the care of children, this report evaluates the state of the science on biological and psychosocial consequences of peer victimization and the risk and protective factors that either increase or decrease peer victimization behavior and consequences.
  • https://www.nap.edu/catalog/13165/a-framework-for-k-12-science-education-practices-crosscutting-concepts A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas | The National Academies Press - Download a PDF of "A Framework for K-12 Science Education" by the National Research Council for free. Description: Science, engineering, and technology permeate nearly every facet of modern life and hold the key to solving many of humanity's most pressing current and future challenges. The United States' position in the global economy is declining, in part because U.S. workers lack fundamental knowledge in these fields. To address the critical issues of U.S. competitiveness and to better prepare the workforce, A Framework for K-12 Science Education proposes a new approach to K-12 science education that will capture students' interest and provide them with the necessary foundational knowledge in the field.A Framework for K-12 Science Education outlines a broad set of expectations for students in science and engineering in grades K-12. These expectations will inform the development of new standards for K-12 science education and, subsequently, revisions to curriculum, instruction, assessment, and professional development for educators. This book identifies three dimensions that convey the core ideas and practices around which science and engineering education in these grades should be built. These three dimensions are: crosscutting concepts that unify the study of science through their common application across science and engineering; scientific and engineering practices; and disciplinary core ideas in the physical sciences, life sciences, and earth and space sciences and for engineering, technology, and the applications of science. The overarching goal is for all high school graduates to have sufficient knowledge of science and engineering to engage in public discussions on science-related issues, be careful consumers of scientific and technical information, and enter the careers of their choice.A Framework for K-12 Science Education is the first step in a process that can inform state-level decisions and achieve a research-grounded basis for improving science instruction and learning across the country. The book will guide standards developers, teachers, curriculum designers, assessment developers, state and district science administrators, and educators who teach science in informal environments.
  • https://www.nap.edu/catalog/23684/nextgen-for-airports-volume-2-engaging-airport-stakeholders-guidebook NextGen for Airports, Volume 2: Engaging Airport Stakeholders: Guidebook | The National Academies Press - Download a PDF of "NextGen for Airports, Volume 2: Engaging Airport Stakeholders: Guidebook" by the National Academies of Sciences, Engineering, and Medicine for free. Description: TRB's Airport Cooperative Research Program (ACRP) Report 150: NextGen for Airports, Volume 2: Engaging Airport Stakeholders: Guidebook helps airports engage the U.S. Federal Aviation Administration (FAA), aircraft operators, community representatives, and other airport stakeholders during the planning, environmental review, design, deployment, and monitoring phases of NextGen implementation.The guidance references a NextGen Outreach Toolkit, which contain videos, an interactive flow chart, and links to additional resources. The NextGen Outreach Toolkit, which will be available for download from a forthcoming website, accompanies Volume 2. The Toolkit also incorporates material created in conjunction with the other projects in the ACRP 150 (NextGen) series. These materials may help airports establish a continuous engagement strategy to balance stakeholder needs as well as efficient NextGen implementation.View additional volumes of Report 150: NextGen for Airports:Volume 1: Understanding the Airport’s Role in Performance-Based Navigation: Resource Guide
  • https://www.nap.edu/catalog/23569/characterizing-risk-in-climate-change-assessments-proceedings-of-a-workshop Characterizing Risk in Climate Change Assessments: Proceedings of a Workshop | The National Academies Press - Download a PDF of "Characterizing Risk in Climate Change Assessments" by the National Academies of Sciences, Engineering, and Medicine for free. Description: The U.S. Global Change Research Program (USGCRP) was established in 1990 to “assist the Nation and the world to understand, assess, predict, and respond to human-induced and natural processes of global change.”1 A key responsibility for the program is to conduct National Climate Assessments (NCAs) every 4 years.2 These assessments are intended to inform the nation about “observed changes in climate, the current status of the climate, and anticipated trends for the future.” The USGCRP hopes that government entities from federal agencies to small municipalities, citizens, communities, and businesses will rely on these assessments of climate- related risks for planning and decision-making. The third NCA (NCA3) was published in 2014 and work on the fourth is beginning. The USGCRP asked the Board on Environmental Change and Society of the National Academies of Sciences, Engineering, and Medicine to conduct a workshop to explore ways to frame the NCA4 and subsequent NCA reports in terms of risks to society. The workshop was intended to collect experienced views on how to characterize and communicate information about climate-related hazards, risks, and opportunities that will support decision makers in their efforts to reduce greenhouse gas emissions, reduce vulnerability to likely changes in climate, and increase resilience to those changes. Characterizing Risk in Climate Change Assessments summarizes the presentations and discussions from the workshop.
  • https://www.nap.edu/catalog/23631/owning-the-technical-baseline-for-acquisition-programs-in-the-us-air-force Owning the Technical Baseline for Acquisition Programs in the U.S. Air Force | The National Academies Press - Download a PDF of "Owning the Technical Baseline for Acquisition Programs in the U.S. Air Force" by the National Academies of Sciences, Engineering, and Medicine for free. Description: While there are examples of successful weapon systems acquisition programs within the U.S. Air Force (USAF), many of the programs are still incurring cost growth, schedule delays, and performance problems. The USAF now faces serious challenges in acquiring and maintaining its weapons systems as it strives to maintain its current programs; add new capabilities to counter evolving threats; and reduce its overall program expenditures. Owning the technical baseline is a critical component of the Air Force’s ability to regain and maintain acquisition excellence. Owning the technical baseline allows the government acquisition team to manage and respond knowledgeably and effectively to systems development, operations, and execution, thereby avoiding technical and other programmatic barriers to mission success. Additionally, owning the technical baseline ensures that government personnel understand the user requirements, why a particular design and its various features have been selected over competing designs, and what the options are to pursue alternative paths to the final product given unanticipated cost, schedule, and performance challenges. Owning the Technical Baseline for Acquisition Programs in the U.S. Air Force discusses the strategic value to the Air Force of owning the technical baseline and the risk of not owning it and highlights key aspects of how agencies other than the Air Force own the technical baseline for their acquisition programs. This report identifies specific barriers to owning the technical baseline for the Air Force and makes recommendations to help guide the Air Force in overcoming those barriers.
  • https://www.nap.edu/catalog/23682/guide-to-value-capture-financing-for-public-transportation-projects Guide to Value Capture Financing for Public Transportation Projects | The National Academies Press - Download a PDF of "Guide to Value Capture Financing for Public Transportation Projects" by the National Academies of Sciences, Engineering, and Medicine for free. Description: TRB's Transit Cooperative Research Program (TCRP) has released a pre-publication, non-edited version of Research Report 190: Guide to Value Capture Financing for Public Transportation Projects. Value capture is the public recovery of a portion of increased property and other value created as a result of public infrastructure investment. The report identifies the requirements necessary for successful value creation through transportation infrastructure investment and capturing a portion of that value through specific value capture mechanisms. It includes six case studies that provide practical examples of successful value capture from public transportation investments.
  • https://www.nap.edu/catalog/23598/ensuring-quality-and-accessible-care-for-children-with-disabilities-and-complex-health-and-educational-needs Ensuring Quality and Accessible Care for Children with Disabilities and Complex Health and Educational Needs: Proceedings of a Workshop | The National Academies Press - Download a PDF of "Ensuring Quality and Accessible Care for Children with Disabilities and Complex Health and Educational Needs" by the National Academies of Sciences, Engineering, and Medicine for free. Description: Children with disabilities and complex medical and educational needs present a special challenge for policy makers and practitioners. These children exhibit tremendous heterogeneity in their conditions and needs, requiring a varied array of services to meet those needs. Uneven public and professional awareness of their conditions and a research base marked by significant gaps have led to programs, practices, and policies that are inconsistent in quality and coverage. Parents often have to navigate and coordinate, largely on their own, a variety of social, medical, and educational support services, adding to the already daunting financial, logistical, and emotional challenges of raising children with special needs. The unmet needs of children with disabilities and complex medical and educational needs can cause great suffering for these children and for those who love and care for them. To examine how systems can be configured to meet the needs of children and families as they struggle with disabilities and complex health and educational needs, the National Academies of Sciences, Engineering, and Medicine held a workshop in December 2015. The goal of the workshop was to highlight the main barriers and promising solutions for improving care and outcome of children with complex medical and educational needs. Workshop participants examined prevention, care, service coordination, and other topics relevant to children with disabilities and complex health and educational needs, along with their families and caregivers. More broadly, the workshop seeks actionable understanding on key research questions for enhancing the evidence base; promoting and sustaining the quality, accessibility, and use of relevant programs and services; and informing relevant policy development and implementation. By engaging in dialogue to connect the prevention, treatment, and implementation sciences with settings where children are seen and cared for, the forum seeks to improve the lives of children by improving the systems that affect those children and their families. This publications summarizes the presentations and discussions from the workshop.
  • https://www.nap.edu/catalog/23528/art-design-and-science-engineering-and-medicine-frontier-collaborations-ideation Art, Design and Science, Engineering and Medicine Frontier Collaborations: Ideation, Translation, Realization: Seed Idea Group Summaries | The National Academies Press - Download a PDF of "Art, Design and Science, Engineering and Medicine Frontier Collaborations" by the National Research Council for free. Description: Science and art were not always two separate entities. Historically, times of great scientific progress occurred during profound movements in art, the two disciplines working together to enrich and expand humanity’s understanding of its place in this cosmos. Only recently has a dividing line been drawn, and this seeming dichotomy misses some of the fundamental similarities between the two endeavors. At the National Academies Keck Futures Initiative Conference on Art, Design and Science, Engineering and Medicine Frontier Collaborations: Ideation, Translation, and Realization, participants spent 3 days exploring diverse challenges at the interface of science, engineering, and medicine. They were arranged into Seed Groups that were intentionally diverse, to encourage the generation of new approaches by combining a range of different types of contributions. The teams included creative practitioners from the fields of art, design, communications, science, engineering, and medicine, as well as representatives from private and public funding agencies, universities, businesses, journals, and the science media.
  • https://www.nap.edu/catalog/23573/the-future-of-atmospheric-chemistry-research-remembering-yesterday-understanding-today The Future of Atmospheric Chemistry Research: Remembering Yesterday, Understanding Today, Anticipating Tomorrow | The National Academies Press - Download a PDF of "The Future of Atmospheric Chemistry Research" by the National Academies of Sciences, Engineering, and Medicine for free. Description: Our world is changing at an accelerating rate. The global human population has grown from 6.1 billion to 7.1 billion in the last 15 years and is projected to reach 11.2 billion by the end of the century. The distribution of humans across the globe has also shifted, with more than 50 percent of the global population now living in urban areas, compared to 29 percent in 1950. Along with these trends, increasing energy demands, expanding industrial activities, and intensification of agricultural activities worldwide have in turn led to changes in emissions that have altered the composition of the atmosphere. These changes have led to major challenges for society, including deleterious impacts on climate, human and ecosystem health. Climate change is one of the greatest environmental challenges facing society today. Air pollution is a major threat to human health, as one out of eight deaths globally is caused by air pollution. And, future food production and global food security are vulnerable to both global change and air pollution. Atmospheric chemistry research is a key part of understanding and responding to these challenges. The Future of Atmospheric Chemistry Research: Remembering Yesterday, Understanding Today, Anticipating Tomorrow summarizes the rationale and need for supporting a comprehensive U.S. research program in atmospheric chemistry; comments on the broad trends in laboratory, field, satellite, and modeling studies of atmospheric chemistry; determines the priority areas of research for advancing the basic science of atmospheric chemistry; and identifies the highest priority needs for improvements in the research infrastructure to address those priority research topics. This report describes the scientific advances over the past decade in six core areas of atmospheric chemistry: emissions, chemical transformation, oxidants, atmospheric dynamics and circulation, aerosol particles and clouds, and biogeochemical cycles and deposition. This material was developed for the NSF’s Atmospheric Chemistry Program; however, the findings will be of interest to other agencies and programs that support atmospheric chemistry research.
  • https://www.nap.edu/catalog/12956/the-future-of-nursing-leading-change-advancing-health The Future of Nursing: Leading Change, Advancing Health | The National Academies Press - Download a PDF of "The Future of Nursing" by the Institute of Medicine for free. Description: The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year.Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles -- including limits on nurses' scope of practice -- should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care.In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

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