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Book Description
Dans une population vieillissante, les patients fragiles porteurs de pathologies chroniques sévères invalidantes sont fréquemment rencontrés dans un service d'urgences. Il est important mais difficile d'évaluer leur autonomie de façon rapide et objective. Il existe de nombreux outils référencés évaluant chacun un domaine particulier de l'autonomie ou étant applicable a certaines catégories de patients. L'évaluation de l'autonomie rentre dans la décision médicale d'orientation et de mise en oeuvre des thérapeutiques en situation d'urgence. L'objectif de ce travail était de repérer la description, réalisée par les urgentistes, de l’autonomie des patients fragiles au service d’accueil des urgences et évaluer s'il y a un impact sur leur orientation. Il s'agit d'une étude de cohorte observationnelle prospective monocentrique aux urgences du centre hospitalier de Douai, avec un recueil rétrospectif des dossiers de tout patient fragile porteur d'une pathologie chronique sévère, de mars a avril 2018 ; avec essai d'élaboration d'un score d'évaluation de l'autonomie sur 13 points. Le critère de jugement principal était la recherche une corrélation entre l'évaluation de l'autonomie des patients fragiles porteurs de pathologies chroniques sévères selon le score et leur orientation. 120 dossiers ont été utilisés pour l'étude. Il n'y avait pas de relation statistiquement significative entre l'évaluation de l'autonomie selon le score étudié et l'orientation des patients (p = 0,67). Il existe une relation linéaire statistiquement significative entre l'avancée en âge et la progression dans la perte d'autonomie (p = 0,02). Il n'existe pas de corrélation entre l'évaluation de l'autonomie et l'obtention d'un avis spécialisé (p = 0,42). Les patients conservant une autonomie de déplacement ont tendance a être significativement plus hospitalisés (p = 0,01). L'évaluation de l'autonomie des patients fragiles porteurs de pathologies chroniques sévères est fondamentale en Médecine d'Urgence, afin de les orienter au mieux. La formation initiale a cette évaluation de l'autonomie reste indispensable. Un score complet et rapide applicable en SAU serait une aide décisionnelle importante.
Book Description
Dans une population vieillissante, les patients fragiles porteurs de pathologies chroniques sévères invalidantes sont fréquemment rencontrés dans un service d'urgences. Il est important mais difficile d'évaluer leur autonomie de façon rapide et objective. Il existe de nombreux outils référencés évaluant chacun un domaine particulier de l'autonomie ou étant applicable a certaines catégories de patients. L'évaluation de l'autonomie rentre dans la décision médicale d'orientation et de mise en oeuvre des thérapeutiques en situation d'urgence. L'objectif de ce travail était de repérer la description, réalisée par les urgentistes, de l’autonomie des patients fragiles au service d’accueil des urgences et évaluer s'il y a un impact sur leur orientation. Il s'agit d'une étude de cohorte observationnelle prospective monocentrique aux urgences du centre hospitalier de Douai, avec un recueil rétrospectif des dossiers de tout patient fragile porteur d'une pathologie chronique sévère, de mars a avril 2018 ; avec essai d'élaboration d'un score d'évaluation de l'autonomie sur 13 points. Le critère de jugement principal était la recherche une corrélation entre l'évaluation de l'autonomie des patients fragiles porteurs de pathologies chroniques sévères selon le score et leur orientation. 120 dossiers ont été utilisés pour l'étude. Il n'y avait pas de relation statistiquement significative entre l'évaluation de l'autonomie selon le score étudié et l'orientation des patients (p = 0,67). Il existe une relation linéaire statistiquement significative entre l'avancée en âge et la progression dans la perte d'autonomie (p = 0,02). Il n'existe pas de corrélation entre l'évaluation de l'autonomie et l'obtention d'un avis spécialisé (p = 0,42). Les patients conservant une autonomie de déplacement ont tendance a être significativement plus hospitalisés (p = 0,01). L'évaluation de l'autonomie des patients fragiles porteurs de pathologies chroniques sévères est fondamentale en Médecine d'Urgence, afin de les orienter au mieux. La formation initiale a cette évaluation de l'autonomie reste indispensable. Un score complet et rapide applicable en SAU serait une aide décisionnelle importante.
Author: Jojo Moyes Publisher: Penguin ISBN: 1101606371 Category : Fiction Languages : en Pages : 385
Book Description
From the #1 New York Times bestselling author of The Giver of Stars and the forthcoming Someone Else's Shoes, discover the love story that captured over 20 million hearts in Me Before You, After You, and Still Me. They had nothing in common until love gave them everything to lose . . . Louisa Clark is an ordinary girl living an exceedingly ordinary life—steady boyfriend, close family—who has barely been farther afield than their tiny village. She takes a badly needed job working for ex–Master of the Universe Will Traynor, who is wheelchair bound after an accident. Will has always lived a huge life—big deals, extreme sports, worldwide travel—and now he’s pretty sure he cannot live the way he is. Will is acerbic, moody, bossy—but Lou refuses to treat him with kid gloves, and soon his happiness means more to her than she expected. When she learns that Will has shocking plans of his own, she sets out to show him that life is still worth living. A Love Story for this generation and perfect for fans of John Green’s The Fault in Our Stars, Me Before You brings to life two people who couldn’t have less in common—a heartbreakingly romantic novel that asks, What do you do when making the person you love happy also means breaking your own heart?
Author: Yrjö Engeström Publisher: Lehmanns Media ISBN: 3865410693 Category : Philosophy Languages : en Pages : 492
Book Description
"Developmental work research is an innovative approach to the study and reshaping of work and learning. It expands cultural-historical activity theory by bringing it to the domains of work, technology and organizations. The world of work is in turmoil, increasingly dominated by 'runaway objects' generated by globalization and greed (global markets are such massive objects out of control). Yet it is the object that motivates work and generates visons of better future. The use values of objects have not vanished, although they are more difficult to grasp than perhaps ever before. Developmental work research rediscovers and expands use values in runaway objects. In workplace interventions it engages practitioners in expansive re-forging of the objects of their work."--Cover.
Author: Geo Maher Publisher: Duke University Press ISBN: 0822354527 Category : History Languages : en Pages : 347
Book Description
Since being elected president in 1998, Hugo Chávez has become the face of contemporary Venezuela and, more broadly, anticapitalist revolution. George Ciccariello-Maher contends that this focus on Chávez has obscured the inner dynamics and historical development of the country’s Bolivarian Revolution. In We Created Chávez, by examining social movements and revolutionary groups active before and during the Chávez era, Ciccariello-Maher provides a broader, more nuanced account of Chávez’s rise to power and the years of activism that preceded it. Based on interviews with grassroots organizers, former guerrillas, members of neighborhood militias, and government officials, Ciccariello-Maher presents a new history of Venezuelan political activism, one told from below. Led by leftist guerrillas, women, Afro-Venezuelans, indigenous people, and students, the social movements he discusses have been struggling against corruption and repression since 1958. Ciccariello-Maher pays particular attention to the dynamic interplay between the Chávez government, revolutionary social movements, and the Venezuelan people, recasting the Bolivarian Revolution as a long-term and multifaceted process of political transformation.
Author: Alan D. Lopez Publisher: World Bank Publications ISBN: 0821362631 Category : Medical Languages : en Pages : 511
Book Description
Strategic health planning, the cornerstone of initiatives designed to achieve health improvement goals around the world, requires an understanding of the comparative burden of diseases and injuries, their corresponding risk factors and the likely effects of invervention options. The Global Burden of Disease framework, originally published in 1990, has been widely adopted as the preferred method for health accounting and has become the standard to guide the setting of health research priorities. This publication sets out an updated assessment of the situation, with an analysis of trends observed since 1990 and a chapter on the sensitivity of GBD estimates to various sources of uncertainty in methods and data.
Author: Guttorm Fløistad Publisher: Springer Science & Business Media ISBN: 940093517X Category : Philosophy Languages : en Pages : 317
Book Description
This publication is a continuation of two earlier series of chroni cles, Philosophy of the Mid-Century (Firenze 1958/59) and Con temporary Philosophy (Firenze 1968), edited by Raymond Klibansky. Like the other series, these chronicles provide a survey of significant trends in contemporary philosophical discussion from 1970 to 1985. The need for such surveys has, I believe, increased rather than decreased over the last years. The philosophical scene appears, for various reasons, more complex than ever before. The continuing process of specialization in most branches, the emergence of new schools of thought, the convergence of interest (thought not neces sarily of opinion) of different traditions upon certain problems, the increasing attention being paid to the history of philosophy in discussions of contemporary problems, and the growing signifi cance for philosophical discourse of the social, political and cul tural situation in various regions of the world are the most impor tant contributory factors. Surveys of the present kind are a valu able source of knowledge of this complexity and may as such be an assistance in renewing the understanding of one's own philo sophical problems. The surveys, it is to be hoped, may also help to strengthen a world-wide Socratic element of modern philosophy, the dialogue or Kommunikationsgemeinschaft. So far, five volumes have been prepared for the new series.
Author: Council of Europe Publisher: Council of Europe ISBN: 928717962X Category : Political Science Languages : en Pages : 58
Book Description
The linguistic integration of migrants affects every aspect of settling in a new country (employment, health, etc.). The aim of this collection of texts is to propose a number of specific measures member states can take to help adult migrants become acquainted with the language of the host country. The main focus is on organising language courses that meet migrants’ real communication needs. It is not enough for authorities simply to consider the technical aspects of such courses, they should also design and conduct them in accordance with the fundamental values of the Council of Europe. A number of issues concerning the linguistic integration of adult migrants are presented here, beginning with the notion of linguistic integration itself. Family reunion, the nature of citizenship and the function of language tests, among others, are dealt with from the point of view of language and language use. Readers are invited to reflect on the type of language competences that need to be acquired as well as an appropriate use of the Common European Framework of Reference for Languages. The collection also sets out approaches and instruments designed to assist in implementing effective policies.
Author: Nicky Stanley Publisher: Jessica Kingsley Publishers ISBN: 9781853029837 Category : Education Languages : en Pages : 278
Book Description
Student life is a time of change and adjustment, and their families as well as staff need resources to help them provide support for students experiencing mental health difficulties. This book explores how the needs of students can best be met by student and community mental health services.
Author: Mary C. Comerio Publisher: Univ of California Press ISBN: 052091872X Category : Social Science Languages : en Pages : 313
Book Description
Whenever a major earthquake strikes or a hurricane unleashes its fury, the devastating results fill our television screens and newspapers. Mary C. Comerio is interested in what happens in the weeks and months after such disasters, particularly in the recovery of damaged housing. Through case studies of six recent urban disasters—Hurricane Hugo in South Carolina, Hurricane Andrew in Florida, the Loma Prieta and Northridge earthquakes in California, as well as earthquakes in Mexico City and Kobe, Japan—Comerio demonstrates that several fundamental factors have changed in contemporary urban disasters. The foremost change is in scale, and as more Americans move to the two coasts, future losses will continue to be formidable because of increased development in these high-hazard areas. Moreover, the visibility of disasters in the news media will assure that response efforts remain highly politicized. And finally, the federal government is now expected to be on the scene with personnel, programs, and financial assistance even as private insurance companies are withdrawing disaster coverage from homeowners in earthquake- and hurricane-prone regions. Demonstrating ways that existing recovery systems are inadequate, Comerio proposes a rethinking of what recovery means, a comprehensive revision of the government's role, and more equitable programs for construction financing. She offers new criteria for a housing recovery policy as well as real financial incentives for preparedness, for limiting damage before disasters occur, and for providing a climate where private insurance can work. Her careful analysis makes this book important reading for policymakers, property owners, and anyone involved in disaster mitigation.
Author: Quentin Dessaint
Author: Quentin Dessaint
Author: Jojo Moyes
Author: Yrjö Engeström
Author: Philipp Fluri
Author: Geo Maher
Author: Alan D. Lopez
Author: Guttorm Fløistad
Author: Council of Europe
Author: Nicky Stanley
Author: Mary C. Comerio