Author: Cassandra Mortka
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
Book Description
Contexte : le diabète gestationnel entraine des pathologies à court et à long terme pour la mère et l'enfant à naître. L'augmentation des facteurs de risque chez les femmes enceintes, notamment, le recul de l'âge maternel, le surpoids et l'obésité, est responsable d'une augmentation de la prévalence du diabète gestationnel. En 2010, le Collège national des gynéco-obstétriciens français et la Société française de diabétologie ont rédigé des recommandations concernant les modalités de son dépistage. Objectifs : l'objectif principal de cette étude était de décrire les pratiques des médecins généralistes en termes de dépistage du diabète gestationnel. L'objectif secondaire était de trouver une méthode pour améliorer ce dépistage. Matériel et méthode : une étude quantitative observationnelle descriptive a été réalisée à l'aide d'un questionnaire diffusé via l'Union régionale des professionnels de santé, aux médecins généralistes installés en libéral dans l'ex-région Midi-Pyrénées. Résultats : 105 médecins généralistes ont répondu au questionnaire (taux de réponse de 4,44 %). L'échantillon comportait 72,1% de femmes (n=75) et la tranche d'âge la plus représentée était celle entre 30 et 40 ans (52,4 %) (n=55) avec seulement 12,4% de médecins âgés de plus de 60 ans. La zone semi-urbaine était la plus représentée dans notre échantillon (44,8 %) (n=47). L'exercice en groupe était clairement majoritaire dans notre échantillon : 52,4% en cabinet de groupe et 34,3% en maison de santé pluriprofessionnelle. Plus de la moitié des répondants étaient maître de stage universitaire (57,3%). Concernant la pratique de la gynécologie médicale et le suivi de grossesse : seulement 3,8% des répondants ne pratiquaient pas la gynécologie médicale et 62,9% réalisaient des suivis de grossesse. Une majorité suivaient moins de 5 grossesses par an (43,8%) et jusqu'à la fin du deuxième trimestre (41%). 87,6% des médecins généralistes interrogés dépistaient le diabète gestationnel lors d'un suivi de grossesse c'est-à-dire 92 médecins sur 105. Sur ces 92 médecins généralistes, 50 % dépistaient le diabète gestationnel de manière systématique. Sur les 92 médecins généralistes qui dépistaient le diabète gestationnel, 36,9% le faisaient au bon moment de la grossesse selon les recommandations c'est-à-dire au premier et au deuxième trimestre. Seulement 21,7% utilisaient la bonne méthode (Glycémie à jeun au premier trimestre et Hyperglycémie provoquée par voie orale entre 24 et 28 semaines d'aménorrhées). Sur les 92 médecins dépistant le diabète gestationnel, si 70,7% disaient connaitre les recommandations, seulement 6,5% suivaient réellement les recommandations de 2010. Discussion et conclusion : le manque de connaissance et d'adhésion à ces recommandations peut expliquer ces pratiques diverses. La non-validation par la Haute autorité de santé en France ainsi que la non-harmonisation des recommandations au niveau international et européen peut fragiliser la confiance des médecins généralistes envers les recommandations françaises. Dans tous les cas, considérant la place actuelle des médecins généralistes dans le suivi de grossesse, et celle à venir au vu du déclin démographique que connaît la gynécologie en France, il semble impératif de simplifier le message qui leur est destiné. Des progrès sont encore à réaliser concernant le dépistage du diabète gestationnel. Un rappel écrit synthétique des recommandations en vigueur pourrait être distribué à l'ensemble des médecins généralistes sous la forme d'une plaquette d'information ou d'un mémo intégré au logiciel médical.
Eat Sleep Bagpipes Repeat
Author: Mirako Press
Publisher: Createspace Independent Publishing Platform
ISBN: 9781723229053
Category :
Languages : en
Pages : 104
Book Description
This adorable music notebook is perfect for staffs, kids and musicians. The high-quality manuscript book includes 110 pages of 12 staves. Let exercise your composing skills with this well-designed music sketchbook! Enjoy!
Publisher: Createspace Independent Publishing Platform
ISBN: 9781723229053
Category :
Languages : en
Pages : 104
Book Description
This adorable music notebook is perfect for staffs, kids and musicians. The high-quality manuscript book includes 110 pages of 12 staves. Let exercise your composing skills with this well-designed music sketchbook! Enjoy!
The Man With the Golden Torc
Author: Simon R. Green
Publisher: Penguin
ISBN: 110121287X
Category : Fiction
Languages : en
Pages : 406
Book Description
New York Times bestselling author Simon Green introduces a new kind of hero, one who fights the good fight against some very old foes in the first novel in the Secret Histories series. The name’s Bond. Shaman Bond. Actually, that's just his cover. His real name is Eddie Drood, but when your job includes a license to kick supernatural arse on a regular basis, you find your laughs where you can. For centuries, his family has been the secret guardian of Humanity, all that stands between all of you and all of the really nasty things that go bump in the night. As a Drood field agent he wore the golden torc, he killed monsters, and he protected the world. He loved his job. Right up to the point where his own family declared him rogue for no reason. Now, the only people who can help Eddie prove his innocence are the people he used to consider his enemies...
Publisher: Penguin
ISBN: 110121287X
Category : Fiction
Languages : en
Pages : 406
Book Description
New York Times bestselling author Simon Green introduces a new kind of hero, one who fights the good fight against some very old foes in the first novel in the Secret Histories series. The name’s Bond. Shaman Bond. Actually, that's just his cover. His real name is Eddie Drood, but when your job includes a license to kick supernatural arse on a regular basis, you find your laughs where you can. For centuries, his family has been the secret guardian of Humanity, all that stands between all of you and all of the really nasty things that go bump in the night. As a Drood field agent he wore the golden torc, he killed monsters, and he protected the world. He loved his job. Right up to the point where his own family declared him rogue for no reason. Now, the only people who can help Eddie prove his innocence are the people he used to consider his enemies...
An Inquiry into the Existence of Guardian Angels
Author: Pierre Jovanovic
Publisher: M. Evans
ISBN: 1461729882
Category : Religion
Languages : en
Pages : 376
Book Description
A journalist's extensive investigation in the areas of near-death experiences, supernatural interventions and guardian angels.
Publisher: M. Evans
ISBN: 1461729882
Category : Religion
Languages : en
Pages : 376
Book Description
A journalist's extensive investigation in the areas of near-death experiences, supernatural interventions and guardian angels.
The Dark Design
Author: Philip Jose Farmer
Publisher: Tor Books
ISBN: 1429949147
Category : Fiction
Languages : en
Pages : 525
Book Description
A New York Times bestsesller, The Dark Design is the third novel in Hugo and Nebula award-winning science fiction legend Philip José Farmer's Riverworld series. Milton Firebrass, once Mark Twain's enemy and now his greatest ally, plans to build a giant airship that can fly to the North Pole of Riverworld. Once there, he hopes to learn the secret of the mysterious tower that dominates the landscape and find the answer to his most urgent question: could the tower contain the Ethicals, the enigmatic beings that created Riverworld? Meanwhile, Jill Gulbirra is challenged for the job of piloting the airship by none other than Cyrano de Bergerac. As if there were not enough challenges facing the crew, they soon suspect there is an agent of the Ethicals among their number, plotting their destruction.... At the Publisher's request, this title is being sold without Digital Rights Management Software (DRM) applied.
Publisher: Tor Books
ISBN: 1429949147
Category : Fiction
Languages : en
Pages : 525
Book Description
A New York Times bestsesller, The Dark Design is the third novel in Hugo and Nebula award-winning science fiction legend Philip José Farmer's Riverworld series. Milton Firebrass, once Mark Twain's enemy and now his greatest ally, plans to build a giant airship that can fly to the North Pole of Riverworld. Once there, he hopes to learn the secret of the mysterious tower that dominates the landscape and find the answer to his most urgent question: could the tower contain the Ethicals, the enigmatic beings that created Riverworld? Meanwhile, Jill Gulbirra is challenged for the job of piloting the airship by none other than Cyrano de Bergerac. As if there were not enough challenges facing the crew, they soon suspect there is an agent of the Ethicals among their number, plotting their destruction.... At the Publisher's request, this title is being sold without Digital Rights Management Software (DRM) applied.
Sweet Silver Blues
Author: Glen Cook
Publisher: Penguin
ISBN: 9780451450708
Category : Fiction
Languages : en
Pages : 324
Book Description
It should have been a simple job. But for Garrett, a human detective in a world of gnomes, tracking down the woman to whom his dead pal Danny left a fortune in silver is no slight task. Even with the aid of Morley, the toughest half-elf around, Garrett isn't sure he'll make it out alive from a land where magic can be murder, the dead still talk, and vampires are always hungry for human blood.
Publisher: Penguin
ISBN: 9780451450708
Category : Fiction
Languages : en
Pages : 324
Book Description
It should have been a simple job. But for Garrett, a human detective in a world of gnomes, tracking down the woman to whom his dead pal Danny left a fortune in silver is no slight task. Even with the aid of Morley, the toughest half-elf around, Garrett isn't sure he'll make it out alive from a land where magic can be murder, the dead still talk, and vampires are always hungry for human blood.
Unidentified
Author: Robert Salas
Publisher: Career Press
ISBN: 9781601633422
Category : Body, Mind & Spirit
Languages : en
Pages : 0
Book Description
In 1969 the U.S. Air Force issued a statement that read' "No UFO reported, investigated and evaluated by the Air Force was ever an indication of threat to our national security." This statement is patently false. It has been proven untrue by the testimony of many military officers and airmen and documentation of incidents involving UFOs and nuclear weapons, testimonies of which the U.S. Air Force was fully aware. Unidentified details many of these testimonies, some for the first time. As partial justification for its position, the Air Force cites a University of Colorado study that was contracted and paid for by federal funds. Unidentified reveals how this study was actually just another part of the plan to cover up the reality of the UFO phenomenon. For the first time, Unidentified publishes evidence that the investigators for the Colorado study knew about the UFO-related missile shutdown incidents but did not investigate them or include them in their final report.
Publisher: Career Press
ISBN: 9781601633422
Category : Body, Mind & Spirit
Languages : en
Pages : 0
Book Description
In 1969 the U.S. Air Force issued a statement that read' "No UFO reported, investigated and evaluated by the Air Force was ever an indication of threat to our national security." This statement is patently false. It has been proven untrue by the testimony of many military officers and airmen and documentation of incidents involving UFOs and nuclear weapons, testimonies of which the U.S. Air Force was fully aware. Unidentified details many of these testimonies, some for the first time. As partial justification for its position, the Air Force cites a University of Colorado study that was contracted and paid for by federal funds. Unidentified reveals how this study was actually just another part of the plan to cover up the reality of the UFO phenomenon. For the first time, Unidentified publishes evidence that the investigators for the Colorado study knew about the UFO-related missile shutdown incidents but did not investigate them or include them in their final report.
Shovel Ready
Author: Adam Sternbergh
Publisher: Broadway Books
ISBN: 0385349017
Category : Fiction
Languages : en
Pages : 274
Book Description
Since the dirty bomb hit Times Square and the city became a shell of itself, Spademan has become a hitman, not a garbage man. But when he's hired to kill the daughter of a powerful evangelist, his unadorned street life is upended.
Publisher: Broadway Books
ISBN: 0385349017
Category : Fiction
Languages : en
Pages : 274
Book Description
Since the dirty bomb hit Times Square and the city became a shell of itself, Spademan has become a hitman, not a garbage man. But when he's hired to kill the daughter of a powerful evangelist, his unadorned street life is upended.
Home Truths
Author: David Lodge
Publisher: Penguin
ISBN: 0140291806
Category : Fiction
Languages : en
Pages : 129
Book Description
From the author of the Booker Prize finalist Small World. Adrian Ludlow, a novelist with a distinguished reputation and a book on the “A” level syllabus, is now seeking obscurity in a cottage beneath the Gatwick flight path. His university friend Sam Sharp, who has become a successful screenwriter, drops in on the way to Los Angeles, fuming over a vicious profile of himself by Fanny Tarrant, one of the new breed of Rottweiler interviews, in a Sunday newspaper. Together they decide to take revenge on the interviewer, though Adrian is risking what he values most: his privacy. David Lodge's dazzling novella examines with wit and insight the contemporary culture of celebrity and the conflict between the solitary activity of writing and the demands of the media circus. “Sharp, intelligent, surprising and fun.”—The Times “Lodge is pure dazzling style, book after book, in his fusion of form and content.”—The New Republic
Publisher: Penguin
ISBN: 0140291806
Category : Fiction
Languages : en
Pages : 129
Book Description
From the author of the Booker Prize finalist Small World. Adrian Ludlow, a novelist with a distinguished reputation and a book on the “A” level syllabus, is now seeking obscurity in a cottage beneath the Gatwick flight path. His university friend Sam Sharp, who has become a successful screenwriter, drops in on the way to Los Angeles, fuming over a vicious profile of himself by Fanny Tarrant, one of the new breed of Rottweiler interviews, in a Sunday newspaper. Together they decide to take revenge on the interviewer, though Adrian is risking what he values most: his privacy. David Lodge's dazzling novella examines with wit and insight the contemporary culture of celebrity and the conflict between the solitary activity of writing and the demands of the media circus. “Sharp, intelligent, surprising and fun.”—The Times “Lodge is pure dazzling style, book after book, in his fusion of form and content.”—The New Republic
Michigan and the Cleveland Era
Author: Earl D. Babst
Publisher: Books for Libraries
ISBN: 9780836980929
Category : Biography & Autobiography
Languages : en
Pages : 0
Book Description
Profiles a number of staff members and alumni of the University of Michigan who served under the Cleveland administrations from 1885 to 1989 and again from 1893 to 1897.
Publisher: Books for Libraries
ISBN: 9780836980929
Category : Biography & Autobiography
Languages : en
Pages : 0
Book Description
Profiles a number of staff members and alumni of the University of Michigan who served under the Cleveland administrations from 1885 to 1989 and again from 1893 to 1897.
Cuisinier Gascon
Author: Pascal Aussignac
Publisher: Absolute Press
ISBN: 9781906650209
Category : Cooking
Languages : en
Pages : 256
Book Description
On moving to Britain in the late 1990's Pascal opened up his award winning restaurant Club Gascon in London's Smithfield Market. Rapidly acquiring a Michelin star, Club Gascon fast became the place to go to experience some of the best French food in the country - the food of his native South West of France, the very heart of the country's cuisine. Over 100 traditional recipes, some with modern twists and inflections, sit within a sumptuously designed and beautifully photographed book. Unashamedly sensuous food photography is accompanied by evocative images of Gascony, it's food and people, from fellow Frenchman Jean Cazals. Cuisinier Gascon is a food lover's delight and a cook's heaven - a worthy testament to the talents of both Pascal Aussignac and his native land of Gascony. 2009 World Gourmand Award: 'Best French Cookbook in UK' 2010 World Gourmand Award: 'Second Best French Cookbook in the World' Prix La Mazille 2010 First Prize in Perigueux (France) at The International Book Fair
Publisher: Absolute Press
ISBN: 9781906650209
Category : Cooking
Languages : en
Pages : 256
Book Description
On moving to Britain in the late 1990's Pascal opened up his award winning restaurant Club Gascon in London's Smithfield Market. Rapidly acquiring a Michelin star, Club Gascon fast became the place to go to experience some of the best French food in the country - the food of his native South West of France, the very heart of the country's cuisine. Over 100 traditional recipes, some with modern twists and inflections, sit within a sumptuously designed and beautifully photographed book. Unashamedly sensuous food photography is accompanied by evocative images of Gascony, it's food and people, from fellow Frenchman Jean Cazals. Cuisinier Gascon is a food lover's delight and a cook's heaven - a worthy testament to the talents of both Pascal Aussignac and his native land of Gascony. 2009 World Gourmand Award: 'Best French Cookbook in UK' 2010 World Gourmand Award: 'Second Best French Cookbook in the World' Prix La Mazille 2010 First Prize in Perigueux (France) at The International Book Fair