Author: Jane Pariot
Publisher:
ISBN:
Category :
Languages : fr
Pages :
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INTRODUCTION: La population française vieillie, augmentant la demande de soins. Or l'accès aux soins en médecine de ville est de plus en plus difficile, les services d'urgences (SU) sont alors en première ligne, notamment en cas de pathologie aigüe. Notre étude a pour objectif de décrire la population des patients de 75 ans et plus, pris en charge dans le SU du Centre Hospitalier de Mâcon. A partir de ce descriptif, nous pourrons effectuer un comparatif par rapport à celui de 2008 ainsi qu'un focus selon l'adressage par un courrier médical.METHODES: II s'agit d'une étude prospective monocentrique conduite entre le 13 décembre 2016 et le 30 janvier 2017, incluant tous les patients âgés de 75 ans et plus, passant physiquement dans le SU de Mâcon.RESULTATS: 182 patients ont été inclus, majoritairement féminin (1111182 soit 61%) avec une moyenne d'âge de 85.6±5.7 ans. Deux patients sur trois arrivaient après avoir pris un avis médical : appel au centre 15 ou adressés avec un courrier suite à une consultation en ville. Deux patients sur trois avaient un état de santé jugé stable (CCMU 1 et 2) et 75% des patients ont été hospitalisés (GEMSA 4,5 et 6). La durée moyenne de passage était de 4h53mn, supérieure à l 'ensemble de la population (3hl2mn).En comparant les données de 2008 et celles de 2017, il apparait une augmentation significative du nombre de passages (17 à 23%; p
Author: Julien Gauthier
Publisher:
ISBN:
Category :
Languages : fr
Pages :
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Objectif : déterminer le taux et les facteurs prédictifs de réhospitalisation précoce des personnes âgées d’au moins 75 ans hospitalisées dans un service de médecine polyvalente. Méthodes : étude de cohorte rétrospective menée au centre hospitalier de Mâcon, incluant les patients âgés de 75 ans et plus hospitalisés via le service d’accueil des urgences durant le premier quadrimestre 2013. Les patients décédés durant l’hospitalisation, mutés et hospitalisés le mois précédent ont été exclus. L’influence sur la réhospitalisation à un mois d’un ensemble de données sociodémographiques, administratives et biomédicales a été analysée. Résultats : au total, 319 hospitalisations ont été incluses pour des patients d’une moyenne d’âge de 84.7 ± 5.7 ans, vivant majoritairement à domicile (80.2%) dont 8.5% sans aidant. Le taux de réhospitalisation était de 16.3% dont 2/3 étaient liés au motif d’hospitalisation initiale. Parmi les facteurs prédictifs retrouvés en analyse univariée (sexe masculin, polypathologie, polymédication, hospitalisations multiples, troubles cognitifs et recours au Centre 15), seuls la présence d’au moins deux hospitalisations dans l’année (odds ratio (OR) = 2.18, indice de confiance à 95 % (IC 95%) [1.06-4.50] ; p = 0.035) et l’existence de troubles cognitifs (OR = 2.07, IC 95% [1.03-4.16] ; p = 0.042) étaient significatifs. La sortie vers un service de soins de suite et réadaptation (SSR) et la majoration des aides à domicile n’influençaient pas la réhospitalisation : OR respectifs à 1.05 et 1.34. Conclusion : les réhospitalisations de personnes âgées d’au moins 75 ans sont fréquentes et difficiles à anticiper car peu d’éléments sont prédictifs et leur effet est modeste. Les plus influents sont d’ordre médical : présence d’hospitalisations multiples et de troubles cognitifs. Le renforcement des aides à domicile et l’orientation vers un SSR ne semblaient pas prévenir les réhospitalisations.
Author: Jean Mayaux
Publisher:
ISBN:
Category :
Languages : fr
Pages : 132
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Etude de l'hospitalisation des personnes âgées dans le service de médecine interne R1 du centre hospitalier de Mâcon : enquête rétrospective à l'aide des dossiers de toutes les personnes âgées de plus de 75 ans, hospitalisées pendant une période de 6 mois, portant sur les motifs d'hospitalisation, la pathologie de la personne âgée, en particulier la pathologie iatrogène, la thérapeutique, l'aspect social et les lettres d'hospitalisation.
Author: Linda Diann Urden
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 1242
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Focusing on critical care nursing, this full-color text provides an examination of the important aspects of critical care nursing. It is organized in ten units around alterations in body systems.
Author: Pierre Bourdieu
Publisher: Polity
ISBN: 0745646956
Category : History
Languages : en
Pages : 398
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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: Gustave Flaubert
Publisher: BookRix
ISBN: 3736808011
Category : Fiction
Languages : en
Pages : 510
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Madame Bovary is the French writer Gustave Flaubert's debut novel. The story focuses on a doctor's wife, Emma Bovary, who has adulterous affairs and lives beyond her means in order to escape the banalities and emptiness of provincial life. Though the basic plot is rather simple, even archetypal, the novel's true art lies in its details and hidden patterns. Flaubert was a notorious perfectionist and claimed always to be searching for le mot juste ("the precise word"). Long established as one of the greatest novels ever written, the book has often been described as a "perfect" work of fiction. Henry James writes: "Madame Bovary has a perfection that not only stamps it, but that makes it stand almost alone; it holds itself with such a supreme unapproachable assurance as both excites and defies judgment." Giorgio de Chirico said that in his opinion "from the narrative point of view, the most perfect book is Madame Bovary by Flaubert".
Author: Pierre Bourdieu
Publisher: John Wiley & Sons
ISBN: 0745681654
Category : Social Science
Languages : en
Pages : 456
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Much orthodox economic theory is based on assumptions which are treated as self-evident: supply and demand are regarded as independent entities, the individual is assumed to be a rational agent who knows his interests and how to make decisions corresponding to them, and so on. But one has only to examine an economic transaction closely, as Pierre Bourdieu does here for the buying and selling of houses, to see that these abstract assumptions cannot explain what happens in reality. As Bourdieu shows, the market is constructed by the state, which can decide, for example, whether to promote private housing or collective provision. And the individuals involved in the transaction are immersed in symbolic constructions which constitute, in a strong sense, the value of houses, neighbourhoods and towns. The abstract and illusory nature of the assumptions of orthodox economic theory has been criticised by some economists, but Bourdieu argues that we must go further. Supply, demand, the market and even the buyer and seller are products of a process of social construction, and so-called ‘economic' processes can be adequately described only by calling on sociological methods. Instead of seeing the two disciplines in antagonistic terms, it is time to recognize that sociology and economics are in fact part of a single discipline, the object of which is the analysis of social facts, of which economic transactions are in the end merely one aspect. This brilliant study by the most original sociologist of post-war France will be essential reading for students and scholars of sociology, economics, anthropology and related disciplines.
Author: GUSTAVE FLAUBERT
Publisher:
ISBN:
Category :
Languages : en
Pages : 352
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Author: Frantz Fanon
Publisher:
ISBN: 9780745399546
Category : Black race
Languages : en
Pages : 0
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Black Skin, White Masks is a classic, devastating account of the dehumanising effects of colonisation experienced by black subjects living in a white world. First published in English in 1967, this book provides an unsurpassed study of the psychology of racism using scientific analysis and poetic grace.Franz Fanon identifies a devastating pathology at the heart of Western culture, a denial of difference, that persists to this day. A major influence on civil rights, anti-colonial, and black consciousness movements around the world, his writings speak to all who continue the struggle for political and cultural liberation.With an introduction by Paul Gilroy, author of There Ain't No Black in the Union Jack.
Author: Honoré de Balzac
Publisher:
ISBN:
Category :
Languages : en
Pages : 628
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