Évaluation d'un réseau ville-hôpital dont l'objectif est d'optimiser la qualité du retour à domicile de la personne âgée fragile en post hospitalier sur le long terme PDF Download
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Author: Mélanie Bouchet
Publisher:
ISBN:
Category :
Languages : fr
Pages : 136
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Book Description
La Cellule Mutualiste Gériatrique repère lors de leur hospitalisation les personnes âgées nécessitant de l'aide, pour leur proposer un plan de soins personnalisé comprenant un projet de sortie et un suivi rigoureux grâce à la création de liens entre les ressources médicales et sociales, pour pérenniser une situation confortable et sécuritaire au domicile. Nous avons supposé que ce fonctionnement permettrait de réduire les réhospitalisations précoces et à long terme. L'étude pilote observationnelle rétrospective a inclus 38 patients entre le 01 janvier 2016 et le 30 avril 2018. Le critère principal d'évaluation était le nombre de réhospitalisations et/ou de passages aux urgences à 3 mois de leur sortie de l'hôpital, et en intermédiaire à 1 mois. Les autres critères secondaires étaient la durée moyenne de séjour (DMS) des hospitalisations respectives, l'évolution des actes de la vie quotidienne (ADL), de l'IMC et du moral. 18.2% des patients ont été réhospitalisés et/ou ont consulté aux urgences dans les 3 mois suivant la sortie, 11.1% à 1 mois. Le réseau de soins n'a pas eu d'impact sur la DMS. Il n'y avait pas de différence significative dans la récupération des ADL, mais on constatait une stabilité du score. 77.4% des patients avaient un bon moral à 1 mois de la sortie, et 71.3% à 3 mois. Il était impossible de conclure sur l'évolution de l'IMC. La CMG apporte une plus-value réelle à la fois dans la qualité de l'organisation d'un retour à domicile, mais aussi dans le suivi, par le biais d'un lien de qualité entre les secteurs médicaux et sociaux, jusqu'à présent fragmentés dans l'organisation des soins. Elle doit toutefois continuer à progresser dans ses initiatives.
Author: Mélanie Bouchet
Publisher:
ISBN:
Category :
Languages : fr
Pages : 136
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Book Description
La Cellule Mutualiste Gériatrique repère lors de leur hospitalisation les personnes âgées nécessitant de l'aide, pour leur proposer un plan de soins personnalisé comprenant un projet de sortie et un suivi rigoureux grâce à la création de liens entre les ressources médicales et sociales, pour pérenniser une situation confortable et sécuritaire au domicile. Nous avons supposé que ce fonctionnement permettrait de réduire les réhospitalisations précoces et à long terme. L'étude pilote observationnelle rétrospective a inclus 38 patients entre le 01 janvier 2016 et le 30 avril 2018. Le critère principal d'évaluation était le nombre de réhospitalisations et/ou de passages aux urgences à 3 mois de leur sortie de l'hôpital, et en intermédiaire à 1 mois. Les autres critères secondaires étaient la durée moyenne de séjour (DMS) des hospitalisations respectives, l'évolution des actes de la vie quotidienne (ADL), de l'IMC et du moral. 18.2% des patients ont été réhospitalisés et/ou ont consulté aux urgences dans les 3 mois suivant la sortie, 11.1% à 1 mois. Le réseau de soins n'a pas eu d'impact sur la DMS. Il n'y avait pas de différence significative dans la récupération des ADL, mais on constatait une stabilité du score. 77.4% des patients avaient un bon moral à 1 mois de la sortie, et 71.3% à 3 mois. Il était impossible de conclure sur l'évolution de l'IMC. La CMG apporte une plus-value réelle à la fois dans la qualité de l'organisation d'un retour à domicile, mais aussi dans le suivi, par le biais d'un lien de qualité entre les secteurs médicaux et sociaux, jusqu'à présent fragmentés dans l'organisation des soins. Elle doit toutefois continuer à progresser dans ses initiatives.
Author: Paméla Aloird
Publisher:
ISBN:
Category :
Languages : fr
Pages : 89
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Book Description
Aujourd’hui, 20% de la population française a plus de 65 ans. Parmi eux, les patients fragiles sujets à des consultations itératives en structures d'urgences entraînant un risque de perte d'autonomie ne fait qu'augmenter. L'initiative DOMCARE propose une aide au retour à domicile depuis les urgences de l'HIA Robert Picqué via l'Equipe Urgence Nuit (EUN) associée à une évaluation de l'environnement du patient via l'Equipe de Soutien aux Aidants à Domicile (ESAD) en attendant un relai de ville. L'objectif de ce travail est d'évaluer le dispositif DOMCARE après 9 mois de fonctionnement. Nous avons réalisé une étude observationnelle descriptive monocentrique du 1er avril au 31 décembre 2014. Tous les patients confiés à l'EUN ont été inclus. Notre cohorte comporte 108 patients, dont 32,4% hommes (n=35), l'âge moyen est de 83,2 ans. Ils vivent seuls à domicile dans 55,6% des cas (n=60). Cinquante pourcent des appels ont lieu avant 21 heures, indépendamment du jour ou du mois. Une chute entraîne l'hospitalisation dans 62% des cas (n=67), et 50% des motifs de consultation sont ostéo- articulaires. L'EUN intervient 4,7 jours en moyenne, avec l’ESAD dans 36,1% des cas (n=39). Il y a eu 0,8% de décès (n=1), et 7,4% d'échec de prise en charge (n=8) dans un délai moyen de 6,1 jours. Le coût d'une journée d'intervention de l’EUN s'élève à 95€, cependant, l'aspect financier du dispositif n'a pas pu être analysé. L'initiative DOMCARE est nous semble donc un maillon inédit et efficace de la prise en charge de la personne âgée fragile à domicile.
Author: Eric Topol
Publisher: Basic Books
ISBN: 0465094473
Category : Medical
Languages : en
Pages : 386
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Book Description
The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241547006
Category : Health & Fitness
Languages : en
Pages : 284
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Book Description
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Author: World Health Organization
Publisher:
ISBN: 9789241548120
Category : Medical
Languages : en
Pages : 166
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Book Description
These guidelines have been developed to support countries to relieve pain in their paediatric populations. These guidelines address persisting pain in children caused by conditions such as cancer, HIV/AIDS, sickle-cell disease, burns, trauma, and phantom limb pain. Recommendations -- developed following a careful and transparent appraisal of available evidence -- are presented for the pharmacological treatment of mild, moderate and severe pain. The guidelines include chapters on the various systems used to classify pain and on the evaluation of pain, which reviews the available tools for routine pain measurement in children. Provision of sustainable pain relief within health care systems is covered in a separate chapter. Since morphine and other opioid analgesics -- required for the relief of moderate-to-severe pain in children -- are listed under the 1961 UN Single Convention on Narcotic Drugs, the new guidelines include an annex explaining the Convention's requirements for the handling and procurement of opioid analgesics for the relief of pain.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9789241544825
Category : Analgesia
Languages : en
Pages : 74
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Book Description
The second edition of a guide, which introduced a simple, yet highly effective method for the relief of cancer pain. Thoroughly revised and updated, the new edition further refines the WHO method, which advocates the use of a small number of relatively inexpensive drugs, including morphine. Revisions draw on experiences with millions of patients around the world as well as new knowledge about the specific pain syndromes unique to cancer. Completely new are chapters describing the international system by which morphine and other opioids are made available for medical purposes. The book has two parts. Part one provides a practical guide to the relief of cancer pain, concentrating on drug treatment as the mainstay of pain management. The most extensive section sets out detailed guidelines for the selection and prescribing of non-opioid analgesics, opioid analgesics, drugs for neuropathic pain, and adjuvant drugs for the treatment of adverse effects, the enhancement of pain relief and the management of concomitant psychological disturbances. Information ranges from explanations of how specific drugs work, through the precautions to take in the presence of certain disorders, to a list of factors that influence the effectiveness of opioids. Concerning the use of opioids, readers are reminded that psychological dependence does not occur in cancer patients and that the only correct dose of morphine is the one that relieves the pain. Part two provides a guide to opioid availability. A discussion of the reasons why opioids continue to be underprescribed or difficult to obtain is followed by an explanation of the Single Convention on Narcotic Drugs.
Author: Marvin J. Fine
Publisher:
ISBN:
Category : Family & Relationships
Languages : en
Pages : 376
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Book Description
Author: Philip A. Pizzo
Publisher: Lippincott Williams & Wilkins
ISBN: 9780683303995
Category : Medical
Languages : en
Pages : 849
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Book Description
Recommended in the Brandon/Hill selected list of print books and journals for the small medical library - April 2001 & 2003 The Third Edition of this very popular book offers the most authoritative and comprehensive review of the impact of the HIV disease in infants, children, and adolescents.
Author: Pierre Bourdieu
Publisher: Polity
ISBN: 0745646956
Category : History
Languages : en
Pages : 398
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Book Description
In the late 1950s, like tens of thousands of young men of his generation, Pierre Bourdieu, having recently passed the agrégation in philosophy, found himself immersed in the Algerian war. Motivated by an impulse that, as he himself says, ‘was civic rather than political’, nothing seemed more important to him than to understand the Algerian situation and provide the elements that would enable others to come to an informed judgement about it. In extremely tough conditions and along with a small group of students, Bourdieu undertook a series of studies across an Algeria that was tightly patrolled by the army, leading him to discover the shocking reality of the resettlement camps and to analyse the mechanisms of destruction of Algerian society of which they were emblematic. To achieve the objectives he had set himself, Bourdieu had to carry out a genuine intellectual conversion, acquiring an ethnographic understanding of Algerian society, learning sociological analysis at a breakneck pace and inventing new instruments - both theoretical and empirical - that would enable him to understand the relations of domination specific to colonialism. These new tools also enabled him to analyse the nature of the crisis that the war had both produced and manifested. This unique volume brings together the first texts written by Bourdieu in the midst of the Algerian conflict, as well as later writings and interviews in which he returns to the topic of Algeria and the decisive role it played in the development of his work.
Author: Christian Wille
Publisher: transcript Verlag
ISBN: 3839426502
Category : Social Science
Languages : en
Pages : 385
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Book Description
Spatial and identity research operates with differentiations and relations. These are particularly useful heuristic tools when examining border regions where social and geopolitical demarcations diverge. Applying this approach, the authors of this volume investigate spatial and identity constructions in cross-border contexts as they appear in everyday, institutional and media practices. The results are discussed with a keen eye for obliquely aligned spaces and identities and relinked to governmental issues of normalization and subjectivation. The studies base upon empirical surveys conducted in Germany, France, Belgium and Luxembourg.
