Search results for "Santé publique et épidémiologie"
showing 10 items of 258 documents
Intersecting vulnerabilities in professionals and patients in intensive care.
2017
International audience; In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in tha…
What are the ethical dimensions in the profession of intensive care specialist?
2017
International audience; Two essential components of the profession of a medical doctor are the constant review of the patient's therapeutic project, and collaboration between healthcare professionals. The profession of intensive care unit (ICU) physician goes further in terms of responsibility, vis-à-vis the intensive treatments dispensed to the patients, and the physician's responsibilities towards the patient's family and the caregiving team, also bearing in mind that ICU care is costly in terms of human and financial resources. In this review, we address the profession of ICU physician from the perspective of the ethical questions that arise constantly, focusing on the timeframe of the r…
What are the ethical issues in relation to the role of the family in intensive care?
2017
International audience; A large proportion of patients admitted to the intensive care unit (ICU) are unable to express themselves, often due to acute illness, shock or trauma, and this precludes any communication and/or consent for care that might reflect their wishes and opinions. In such cases, the only solution for the ICU physician is to include the patient's family in the healthcare decisions. This can represent a significant burden on the family, on top of the psychological distress of the ICU environment and hospitalisation of their relatives, and many family members may suffer from anxiety, depression or symptoms of post-traumatic stress disorder (PTSD) during or after the hospitali…
Dimensions et dynamique de la coordination des soins de ville : une analyse économique
2019
Cet article vise à clarifier la notion de coordination en santé, à expliciter ses différentes dimensions et à revenir sur son statut dans un processus de production de soins. Une appréhension plus fine de la coordination permet de mieux analyser le bien-fondé, les difficultés des coordinations promues par les politiques de santé. Nous nous appuyons à la fois sur des études de terrain menées auprès de réseaux, de dispositifs de télémédecine et de MSP, et sur des approches théoriques de la coordination couvrant différents courants de l’économie des organisations.
Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications
2019
WOS: 000458513600019
Dioxin emissions and soft-tissue sarcoma: results of a population-based case-control study.
2004
International audience; BACKGROUND: In 1998, the French Ministry of Environment revealed that of 71 French municipal solid waste incinerators processing more than 6 metric tons of material per hour, dioxin emission from 15 of them was above the 10 ng international toxic equivalency factor/m3 (including Besançon, emitting 16.3 ng international toxic equivalency factor/m3) which is substantially higher than the 0.1 international toxic equivalency factor/m3 prescribed by a European directive of 1994. In 2000, a macrospatial epidemiological study undertaken in the administrative district of Doubs, identified two significant clusters of soft-tissue sarcoma and non Hodgkin lymphoma in the vicinit…
Factors Associated With Fatigue After Surgery in Women With Early-Stage Invasive Breast Cancer
2013
Abstract Learning Objectives Describe the effect of worsening fatigue after breast cancer surgery on physical functioning and psychological distress. Better identify women at risk for developing cancer-related fatigue. Direct target interventions to patients most in need. Purpose. Fatigue is one of the most frequent symptoms in patients with cancer. However, the precise determinants of fatigue are still unknown. This study was conducted to investigate factors correlated with cancer-related fatigue before surgery and just before subsequent adjuvant therapy. Methods. Patients completed the Multidimensional Fatigue Inventory (MFI-20), the European Organization for Research and Treatment of Can…
The EORTC computer-adaptive tests measuring physical functioning and fatigue exhibited high levels of measurement precision and efficiency
2013
Objectives: The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group is developing a computer-adaptive test (CAT) version of the EORTC Quality of Life Questionnaire (QLQ-C30). We evaluated the measurement properties of the CAT versions of physical functioning (PF) and fatigue (FA) and compared these with the corresponding QLQ-C30 scales. Study Design and Setting: Based on international samples of more than 1,000 cancer patients, we simulated CAT administration of varying numbers of items and compared the resulting scores with those based on all items in the respective item pools. Furthermore, the relative validity (RV) of CATs was compared with that of th…
Gender as a Modifying Factor Influencing Myotonic Dystrophy Type 1 Phenotype Severity and Mortality: A Nationwide Multiple Databases Cross-Sectional …
2016
International audience; BACKGROUND: Myotonic Dystrophy type 1 (DM1) is one of the most heterogeneous hereditary disease in terms of age of onset, clinical manifestations, and severity, challenging both medical management and clinical trials. The CTG expansion size is the main factor determining the age of onset although no factor can finely predict phenotype and prognosis. Differences between males and females have not been specifically reported. Our aim is to study gender impact on DM1 phenotype and severity.METHODS: We first performed cross-sectional analysis of main multiorgan clinical parameters in 1409 adult DM1 patients (\textgreater18y) from the DM-Scope nationwide registry and obser…
How well do questionnaires perform compared with physical examination in detecting flexural eczema? Findings from the International Study of Asthma a…
2009
International audience; BACKGROUND: Questionnaires are widely used in epidemiological studies to measure eczema symptom prevalence, but there are concerns regarding their accuracy if used as a diagnostic tool. OBJECTIVES: To compare the performance of a validated eczema symptom questionnaire and a standardized skin examination protocol employed in the second phase of the International Study of Asthma and Allergies in Childhood (ISAAC). METHODS: A total of 30,358 schoolchildren aged 8-12 years from 18 countries were examined for flexural eczema. Parents also completed an eczema symptom questionnaire. We compared prevalence estimates at the population level based on the questionnaire vs. phys…