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Book Description
Depuis 2002, le nombre de passages aux urgences n'a cessé de croître provoquant l'engorgement de cette institution précieuse. Les pathologies traumatiques arrivent en tête des motifs d'admission avec les motifs médico-chirurgicaux. L'objectif principal de ce travail était d'étudier le parcours de soins des patients et les raisons de cette affluence aux urgences. L'objectif secondaire était d'estimer le nombre de prises en charge envisageables en ambulatoire. Matériel et Méthode Il s'agissait d'une étude transversale descriptive réalisée dans 3 structures d'urgences de Seine-Maritime dont un CHU (Rouen), un CHI (Elbeuf) et une clinique privée (Rouen). La période de l'étude s'étendait du 15 janvier au 13 février 2015. L'outil de base est un autoquestionnaire subdivisé en 2 parties : l'une destinée au patient et l'autre au médecin. Les critères d'inclusion étaient un âge inférieur à 75 ans, avoir une pathologie traumatique ou microtraumatique, être venu aux urgences par ses propres moyens et être classé CCMU 1 ou 2. Résultats 319 questionnaires ont été récoltés dont 314 exploitables. 61,9 % des patients étaient des hommes. La moyenne d'âge des patients étaient de 29,6 ans. 50,5 % des patients avaient au moins un niveau baccalauréat. 89,7 % des patients ont consulté aux urgences pour leur premier contact avec le système de soins. Ils évoquaient en moyenne 1,6 raison pour leur consultation aux urgences. 43,8 % d'entre eux venaient aux urgences car ils pensaient avoir besoin d'une radiographie et 27,5 % pour la proximité de l'hôpital. Les pathologies les plus représentées étaient les entorses (26,9 %) et les contusions (21 %). Selon les urgentistes, 79 % des patients auraient pu être pris en charge en ambulatoire (à condition de bénéficier d'une radiographie pour 25,5 % d'entre eux et à condition que le médecin de ville soit équipé matériellement pour 5,6 % d'entre eux). 3 % des patients ont dû être hospitalisés pour une prise en charge chirurgicale. Conclusion Pour les pathologies traumatiques courantes, les patients consultaient préférentiellement aux urgences, avant tout pour des raisons pratiques (prise en charge complète en un lieu unique). Cependant la plupart de ces pathologies auraient pu être prises en charge en médecine de ville. La question de la réorganisation du système de soins ambulatoire se pose (intérêt des pôles de santé pluridisciplinaires), de même que le problème de la formation des médecins généralistes.
Book Description
Depuis 2002, le nombre de passages aux urgences n'a cessé de croître provoquant l'engorgement de cette institution précieuse. Les pathologies traumatiques arrivent en tête des motifs d'admission avec les motifs médico-chirurgicaux. L'objectif principal de ce travail était d'étudier le parcours de soins des patients et les raisons de cette affluence aux urgences. L'objectif secondaire était d'estimer le nombre de prises en charge envisageables en ambulatoire. Matériel et Méthode Il s'agissait d'une étude transversale descriptive réalisée dans 3 structures d'urgences de Seine-Maritime dont un CHU (Rouen), un CHI (Elbeuf) et une clinique privée (Rouen). La période de l'étude s'étendait du 15 janvier au 13 février 2015. L'outil de base est un autoquestionnaire subdivisé en 2 parties : l'une destinée au patient et l'autre au médecin. Les critères d'inclusion étaient un âge inférieur à 75 ans, avoir une pathologie traumatique ou microtraumatique, être venu aux urgences par ses propres moyens et être classé CCMU 1 ou 2. Résultats 319 questionnaires ont été récoltés dont 314 exploitables. 61,9 % des patients étaient des hommes. La moyenne d'âge des patients étaient de 29,6 ans. 50,5 % des patients avaient au moins un niveau baccalauréat. 89,7 % des patients ont consulté aux urgences pour leur premier contact avec le système de soins. Ils évoquaient en moyenne 1,6 raison pour leur consultation aux urgences. 43,8 % d'entre eux venaient aux urgences car ils pensaient avoir besoin d'une radiographie et 27,5 % pour la proximité de l'hôpital. Les pathologies les plus représentées étaient les entorses (26,9 %) et les contusions (21 %). Selon les urgentistes, 79 % des patients auraient pu être pris en charge en ambulatoire (à condition de bénéficier d'une radiographie pour 25,5 % d'entre eux et à condition que le médecin de ville soit équipé matériellement pour 5,6 % d'entre eux). 3 % des patients ont dû être hospitalisés pour une prise en charge chirurgicale. Conclusion Pour les pathologies traumatiques courantes, les patients consultaient préférentiellement aux urgences, avant tout pour des raisons pratiques (prise en charge complète en un lieu unique). Cependant la plupart de ces pathologies auraient pu être prises en charge en médecine de ville. La question de la réorganisation du système de soins ambulatoire se pose (intérêt des pôles de santé pluridisciplinaires), de même que le problème de la formation des médecins généralistes.
Author: Christian Nickel Publisher: Springer ISBN: 331919318X Category : Medical Languages : en Pages : 398
Book Description
This book discusses all important aspects of emergency medicine in older people, identifying the particular care needs of this population, which all too often remain unmet. The up-to-date and in-depth coverage will assist emergency physicians in identifying patients at risk for adverse outcomes, in conducting appropriate assessment,and in providing timely and adequate care. Particular attention is paid to the commonpitfalls in emergency management andmeans of avoiding them. Between 1980 and 2013, the number of older patients in emergency departmentsworldwide doubled. Compared with younger patients, older people suffer from more comorbidities, a higher mortality rate, require more complex assessment and diagnostic testing, and tend to stay longer in the emergency department. This book, written by internationally recognized experts in emergency medicine and geriatrics, not only presents the state of the art in the care of this population but also underlines the increasing need for adequate training and development in the field.
Author: Lorenzo Vidino Publisher: Ledizioni ISBN: 8867056204 Category : Political Science Languages : en Pages : 108
Book Description
Over the last three years Europe and North America have been hit by an unprecedented wave of terrorist attacks perpetrated by individuals motivated by jihadist ideology. Who are the individuals who have carried out these attacks? Were they born and raised in the West? Or were they an “imported threat”, refugees and migrants? How did they radicalize? Were they well educated and integrated, or social outcasts? Did they act alone? What were their connections to the Islamic State? The answers to these and other questions have large implications for our understanding of the threat facing us and, consequently, help us design sounder policy solutions built on empirical evidence. This study, the first of its kind, seeks to analyze the demographic profile, radicalization trajectories and connections to the Islamic State of all the individuals who have carried out attacks inspired by jihadist ideology in North America and Europe in the three years since the proclamation of the caliphate in June 2014.
Author: Andrea Maloney Schara Publisher: ISBN: 9780615928791 Category : Families Languages : en Pages : 318
Book Description
"Your Mindful Compass" takes us behind the emotional curtain to see the mechanisms regulating individuals in social systems. There is great comfort and wisdom in knowing we can increase our awareness to manage the swift and ancient mechanisms of social control. We can gain greater flexibility by seeing how social controls work in systems from ants to humans. To be less controlled by others, we learn how emotional systems influence our relationship-oriented brain. People want to know what goes on in families that give rise to amazing leaders and/or terrorists. For the first time in history we can understand the systems in which we live. The social sciences have been accumulating knowledge since the early fifties as to how we are regulated by others. S. Milgram, S. Ashe, P. Zimbardo and J. Calhoun, detail the vulnerability to being duped and deceived and the difficulty of cooperating when values differ. Murray Bowen, M.D., the first researcher to observe several live-in families, for up to three years, at the National Institute of Mental Health. Describing how family members overly influence one another and distribute stress unevenly, Bowen described both how symptoms and family leaders emerge in highly stressed families. Our brain is not organized to automatically perceive that each family has an emotional system, fine-tuned by evolution and "valuing" its survival as a whole, as much as the survival of any individual. It is easier to see this emotional system function in ants or mice but not in humans. The emotional system is organized to snooker us humans: encouraging us to take sides, run away from others, to pressure others, to get sick, to blame others, and to have great difficulty in seeing our part in problems. It is hard to see that we become anxious, stressed out and even that we are difficult to deal with. But "thinking systems" can open the doors of perception, allowing us to experience the world in a different way. This book offers both coaching ideas and stories from leaders as to strategies to break out from social control by de-triangling, using paradoxes, reversals and other types of interruptions of highly linked emotional processes. Time is needed to think clearly about the automatic nature of the two against one triangle. Time and experience is required as we learn strategies to put two people together and get self outside the control of the system. In addition, it takes time to clarify and define one's principles, to know what "I" will or will not do and to be able to take a stand with others with whom we are very involved. The good news is that systems' thinking is possible for anyone. It is always possible for an individual to understand feelings and to integrate them with their more rational brains. In so doing, an individual increases his or her ability to communicate despite misunderstandings or even rejection from important others. The effort involved in creating your Mindful Compass enables us to perceive the relationship system without experiencing it's threats. The four points on the Mindful Compass are: 1) Action for Self, 2) Resistance to Forward Progress, 3) Knowledge of Social Systems and the 4) The Ability to Stand Alone. Each gives us a view of the process one enters when making an effort to define a self and build an emotional backbone. It is not easy to find our way through the social jungle. The ability to know emotional systems well enough to take a position for self and to become more differentiated is part of the natural way humans cope with pressure. Now people can use available knowledge to build an emotional backbone, by thoughtfully altering their part in the relationship system. No one knows how far one can go by making an effort to be more of a self-defined individual in relationships to others. Through increasing emotional maturity, we can find greater individual freedom at the same time that we increase our ability to cooperate and to be close to others.
Author: Sahra Gibbon Publisher: Routledge ISBN: 1134144725 Category : Health & Fitness Languages : en Pages : 387
Book Description
Biosocialities, Genetics and the Social Sciences explores the social, cultural and economic transformations that result from innovations in genomic knowledge and technology. This pioneering collection uses Paul Rabinow’s concept of biosociality to chart the shifts in social relations and ideas about nature, biology and identity brought about by developments in biomedicine. Based on new empirical research, it contains chapters on genomic research into embryonic stem cell therapy, breast cancer, autism, Parkinson’s and IVF treatment, as well as on the expectations and education surrounding genomic research. It covers four main themes: novel modes of identity and identification, such as genetic citizenship the role of institutions, ranging from disease advocacy organizations and voluntary organizations to the state the production of biological knowledge, novel life-forms, and technologies the generation of wealth and commercial interests in biology. Including an afterword by Paul Rabinow and case studies on the UK, US, Canada, Germany, India and Israel, this book is key reading for students and researchers of the new genetics and the social sciences – particularly medical sociologists, medical anthropologists and those involved with science and technology studies.
Author: Yasser Khazaal Publisher: Frontiers Media SA ISBN: 2889454967 Category : Video games in education Languages : en Pages : 311
Book Description
Recent years have seen important developments in the computer and game industry, including the emergence of the concept of serious games. It is hypothesized that tools such as games, virtual reality, or applications for smartphones may foster learning, enhance motivation, promote behavioral change, support psychotherapy, favor empowerment, and improve some cognitive functions. Computers and games may create supports for training or help people with cognitive, emotional, or behavioral change. Games take various formats, from board games to informatics to games with interactive rules of play. Similarly, computer tools may vary widely in format, from self-help or assisted computerized training to virtual reality or applications for smartphones. Some tools that may be helpful for mental health were specifically designed for that goal, whereas others were not. Gamification of computer-related products and games with a numeric format tend to reduce the gap between games and computers tools and increase the conceptual synergy in such fields. Games and computer design share an opportunity for creativity and innovation to help create, specifically design, and assess preventive or therapeutic tools. Computers and games share a design conception that allows innovative approaches to overcome barriers of the real world by creating their own rules. Yet, despite the potential interest in such tools to improve treatment of mental disorders and to help prevent them, the field remains understudied and information is under-disseminated in clinical practice. Some studies have shown, however, that there is potential interest and acceptability of tools that support various vehicles, rationales, objectives, and formats. These tools include traditional games (e.g., chess games), popular electronic games, board games, computer-based interventions specifically designed for psychotherapy or cognitive training, virtual reality, apps for smartphones, and so forth. Computers and games may offer a true opportunity to develop, assess, and disseminate new prevention and treatment tools for mental health and well-being. Currently, there is a strong need for state-of-the-art information to answer questions such as the following: Why develop such tools for mental health and well-being? What are the potential additions to traditional treatments? What are the best strategies or formats to improve the possible impact of these tools? Are such tools useful as a first treatment step? What is the potential of a hybrid model of care that combines traditional approaches with games and/or computers as tools? What games and applications have already been designed and studied? What is the evidence from previous studies? How can such tools be successfully designed for mental health and well-being? What is rewarding or attractive for patients in using such treatments? What are the worldwide developments in the field? Are some protocols under development? What are the barriers and challenges related to such developments? How can these tools be assessed, and how can the way that they work, and for whom, be measured? Are the potential benefits of such products specific, or can these additions be attributed to nonspecific factors? What are the users’ views on such tools? What are the possible links between such tools and social networks? Is there a gap between evidence-based results and market development? Are there any quality challenges? What future developments and studies are needed in the field?
Author: Romain Huret Publisher: LSU Press ISBN: 0807158453 Category : History Languages : en Pages : 243
Book Description
"There is no such thing as a 'natural' disaster," writes Romain Huret in his introduction to this multidisciplinary study of the events surrounding and the legacy of Hurricane Katrina. Though nature produced Katrina's rising waters and destructive winds, a vast array of manmade factors shaped the scope of the storm's impact as well as the local and national response to it. In Hurricane Katrina in Transatlantic Perspective, American and European scholars approach this infamous storm and its aftermath through a variety of disciplines, from music to geography to anthropology, creating a nuanced understanding of how society reacts to and later remembers times of disaster. Richard Campanella and Romain Huret examine the particular geographical and political mix that set the stage for Katrina's devastation, especially among the poorest populations of New Orleans and the Gulf South. Jean Kempf, James Boyden, Andrew Diamond, and Thomas Jessen Adams address the ideological biases and racial stereotypes that infused local and national commentary in the days and weeks after the storm. Finally, Bruce Raeburn, Sara Le Menestrel, Anne M. Lovell, and Randy J. Sparks explore the impact of this powerful tropical event on the city's institutions and cultural organizations. Hurricane Katrina in Transatlantic Perspective offers a profound and innovative collection of insights on one of the most significant environmental catastrophes in U.S. history, forcing us to examine the cultural actors that transformed a natural disaster into a humanitarian crisis.
Author: Audrey Maxit
Author: Audrey Maxit
Author: Christian Nickel
Author: 
Author: Lorenzo Vidino
Author: Andrea Maloney Schara
Author: Jean-François Muir
Author: Sahra Gibbon
Author: Pius Adesanmi
Author: Yasser Khazaal
Author: Romain Huret