Download or read book Quelles sont les motivations des patients consultant au service d accueil des urgences pour des motifs relevant d une consultation de m decine g n rale written by Anais Mikolajczyk and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Salles d'attente bondées, brouhaha incessants, temps d'attente allongés, couloirs obstrués : les urgences saturent. L'encombrement des urgences est au coeur de l'actualité. Cette situation de saturation crée de multiples insatisfactions, que ce soit pour les usagers ou pour le personnel médical. Une des causes évoquées est le mésusage des urgences par des consultations jugées inappropriées ou de dernier recours. Etude qualitative auprès de patients adultes consultant aux urgences pour des motifs de médecine générale, pendant les horaires de permanence de soins. Etude tri-centrique réalisée au CH de Riom et Vichy, et au CHU de Clermont-Ferrand du 11/03/2017 au 28/04/2017. Entretiens semi-dirigés réalisés le jour de leur consultation aux urgences, auprès de 76 patients. La définition de l'urgence pour les patients est complexe. La traumatologie aux urgences fait l'unanimité. Ils élargissent la définition de l'urgence avec l'absence d'alternatives médicales. Pour le patient, la notion d'urgence réelle ne caractérise que très raremnt la définition de l'urgence. La motivation principale de consultation au SAU est la facilité d'accès aux soins et la facilité organisationnelle. C'est également le point d'accès aux ressources hospitalières. L'offre de soins en ambulatoire ne permet pas de répondre à la demande des patients : pénurie de médecins traitants, délai de consultations trop longs, accès difficile aux examens complémentaires et aux spécialistes...Cela se répercute sur le nombre de consultations aux urgences. Les patients sont conscients que l'encombrement des urgences est responsable d'un temps d'attente plus long. Ils l'expliquent par un manque de personnels au SAU et par un excès de consultations jugées inappropriées. Les patients ne définissent plus l'urgence comme une urgence réelle ou ressentie mais comme une nécessité de consulter immédiatement pour avoir des réponses rapides à leur problème de santé. Notre système de soins doit être réorganisée.

Download or read book Pr valence des consultations traumatologiques aux urgences pouvant relever de la m decine g n rale written by Audrey Hurstel and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : La traumatologie est le principal motif de recours aux urgences (48% des passages). En médecine générale, cette proportion est inferieure à 1% de l'activité et représente 11.6% des recours non programmés. L'objectif principal était de déterminer la prévalence des consultations traumatologiques aux urgences pouvant être prises en charge en ambulatoire. Méthode : L'étude était épidémiologique, ouverte, prospective, réalisée simultanément aux urgences des Hôpitaux de Chambéry, Annecy et Grenoble (Hôpital Sud), en semaine de 8h à 18h. Les critères d'inclusions étaient : être majeur, avoir déclaré un médecin traitant et consulter aux urgences pour un motif traumatologique sans avoir reçu d'avis médical préalable. Les patients ont été classés en 2 groupes : prise en charge possible par médecin traitant (MT) versus prise en charge aux urgences (U). Ce classement a été réalisé par l'application de 10 critères décisionnels obtenus par la méthode Delphi. Un questionnaire a été soumis à chaque patient portant sur les motivations de venue aux urgences. Résultats : 1847 patients se sont présentés aux urgences, 954 ont consulté pour un motif traumatologique, 288 ont été inclus (30.2%). La prise en charge en ambulatoire par le MT était possible pour 176 patients (61.1% - IC : 55.5-66.7). La nécessité de réaliser des examens complémentaires est la motivation principale pour 28.5% (IC : 23,3-33,7) des patients. Conclusion : La majorité des consultations traumatologiques spontanées aux urgences pourrait être prise en charge en ambulatoire. Les pistes possibles seraient éducation à la santé, amélioration de la disponibilité du MT et développement de filières hospitalières dédiées.

Download or read book D terminants de l urgence ressentie par le patient en m decine ambulatoire written by Claire Coffinier and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contexte : La fréquentation croissante des urgences depuis plusieurs années pose la question de l'organisation des soins en amont. Les soins non programmés en médecine ambulatoire sont de plus en plus importants, et il paraît essentiel de comprendre d'où vient le ressenti de l'urgence par les patients, pour pouvoir y répondre de manière appropriée. Méthode : Étude qualitative avec 9 entretiens de patients consultant en médecine générale sur des créneaux réservés aux SNP. Les entretiens avaient lieu avant ou après la consultation médicale. Une fois anonymisés ils ont été retranscrits puis codés avec le logiciel NVIVO. L'analyse avait pour but d'identifier la trajectoire de soins des patients, les déterminants médicaux et non médicaux de l'urgence ressentie, ainsi que la place qu'accorde le patient à son médecin traitant dans la gestion de l'urgence. Résultats : Plusieurs facteurs intrinsèques au patient (antécédents, histoire familiale, personnalité) et extrinsèques (environnement, entourage, moment d'apparition des symptômes) impactent sur l'urgence ressentie. Mais c'est surtout la peur et l'inquiétude face aux symptômes inhabituels et interprétés comme urgents qui amènent à la consultation. Malgré l'éducation thérapeutique effectuée au préalable, celle-ci n'empêche pas l'apparition de la peur et des doutes. Le patient est en quête d'une réassurance, d'un diagnostic et d'une conduite à tenir la plus rapide possible. Il grade l'urgence en plusieurs niveaux de gravité selon lesquels il s'orientera différemment soit vers les urgences soit vers le médecin généraliste pour avoir les réponses à ses interrogations. En cas d'indisponibilité du médecin traitant le patient adoptera d'autres stratégies dont le recours à l'entourage, à d'autres professionnels de santé voire aux urgences (souvent citées...) même si les symptômes ne relèvent pas de ces structures. Conclusion : Les nouvelles habitudes de soins tendant vers l'immédiateté incitent les médecins généralistes à, en plus de l'éducation thérapeutique qui semble insuffisante, travailler sur leurs disponibilités en accordant les créneaux nécessaires et suffisants au quotidien pour les SNP. Le but est d'associer la prise en charge thérapeutique de l'événement aigu à la réassurance cognitive et affective pour gérer l'urgence ressentie par le patient et ses conséquences sur le système de santé.

Download or read book tude des motifs de consultation spontan e aux Urgences de La Roche sur Yon written by Alexandre Yver and published by . This book was released on 2019 with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction :depuis plusieurs années, le nombre de recours aux urgences augmente continuellement amenant ces services à une surcharge d'activité. Le service des urgences du CHD de La Roche-sur-Yon n'est pas épargné par ce constat, dans un département dont la démographie médicale est en recul. Malgré la présence d'une permanence des soins ambulatoires sur le territoire vendéen, nous constatons une hausse du nombre de patients consultant sans avis médical préalable. Nous avons voulu identifier leurs motivations et analyser la pertinence de ces consultations. Matériel et Méthode : étude prospective monocentrique durant une semaine basée sur un questionnaire standardisé distribué aux patients majeurs consultant, sans avis médical préalable, le service d'accueil des urgences du CHD de La Roche-sur-Yon. Un questionnaire à l'attention des médecins prenant en charge le patient est également distribué. Résultats : l'étude repose sur l'analyse de 248 questionnaires. Les consultations étaient appropriées dans 45,2 % des cas avec seulement 13,7 % de patients hospitalisés. Près d'un quart des patients n'ont pas eu d'examen complémentaire. Les motifs de consultation relevaient majoritairement de la prise en charge de symptômes douloureux et du besoin supposé d'examens. Les patients ont déclaré être suivi par un médecin généraliste dans 82,7 % des cas mais 17,3 % d'entre eux n'ont pas réussi à le joindre. Discussion : la faible proportion d'hospitalisations, le nombre de patients n'ayant pas eu d'examen complémentaire et la part d'examens prescrits pouvant être réalisés en ville rendent les consultations spontanées aux urgences inappropriées. La motivation des patients à consulter aux urgences peut s'expliquer par la nécessité supposée d'examens et la présence d'un plateau technique facile d'accès. De plus, du fait de sa démographie actuelle, la médecine générale est indisponible pour la prise en charge des soins non programmés qui sont alors traités aux urgences, souvent après plus de 12h d'évolution. Les délais de prise en charge des patients, ne nécessitant pas d'examen complémentaire, sont plus importants aux urgences comparés à examen en médecine de ville. Conclusion : la promotion de la permanence des soins ambulatoires auprès de la population et le développement de structures pouvant prendre en charge les soins non programmés en journée nous semble pertinent pour délester les services d'urgences.

Download or read book Comprehensive Cervical Cancer Control written by World Health Organization and published by World Health Organization. This book was released on 2006 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Health Workforce Policies in OECD Countries written by OECD and published by Org. for Economic Cooperation & Development. This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Foreword and Acknowledgments -- Executive summary -- Key findings -- Analytical framework of health labour markets -- Trends in health labour markets and policy priorities to address workforce issues -- Education and training for doctors and nurses: What's happening with numerus clausus policies? -- Trends and policies affecting the international migration of doctors and nurses to OECD countries -- Geographic imbalances in the distribution of doctors and health care services in OECD countries -- Skills use and skills mismatch in the health sector: What do we know and what can be done

Download or read book Evolution of Awareness written by Kia Marlene and published by . This book was released on 2022-03-08 with total page 444 pages. Available in PDF, EPUB and Kindle. Book excerpt: Evolution of Awareness, the debut poetry collection from Kia Marlene, is a book about a spiritual journey towards enlightenment. The collection consists of 6 chapters, titled "The Egg," "The Caterpillar," "Intermission (heartbreak&love)," "The Cocoon," "The Butterfly," and a chapter titled "Knock Knock." Through numerous poems this book outlines various thoughts, questions and eventual answers concerning our collective greater purpose in life, self love, consciousness, and personhood. The author intends for this book to help broaden the reader's general perception, view of their environment, awareness, and sense of self.

Download or read book Office Emergencies written by Marjorie A. Bowman and published by . This book was released on 2003 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inside, you'll find practical information on how to handle the most common emergencies that present in primary care offices and urgent care centers -- whether in person or over the telephone.

Download or read book Human Resources For Health In Europe written by Dubois, Carl-Ardy and published by McGraw-Hill Education (UK). This book was released on 2005-12-01 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book analyses how the current regulatory processes and practices related to key aspects of the management of the health professions may facilitate or inhibit the development of effective responses to challenges facing health care systems in Europe. The authors document how health care systems in Europe are confronting existing challenges in relation to the health workforce and identify the strategies that are likely to be most effective in optimizing the management of health professionals in the future.

Download or read book Cancer Pain Relief written by World Health Organization and published by World Health Organization. This book was released on 1996 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Zacarias My Brother written by Abd Samad Moussaoui and published by Seven Stories Press. This book was released on 2011-01-04 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: Zacarias Moussaoui was arrested in the United States in August 2001. He is currently in a federal prison in Virginia, charged with "conspiring with Osama bin Laden and Al-Qaeda to murder thousands of innocent people in New York, Virginia, and Pennsylvania." Moussaoui , who trained to be a pilot in Oklahoma, admits to being a member of Al-Qaeda but denies involvement in the events of September 11. He has opted to defend himself. Written by his brother, Zacarias, My Brother tells the story of Zac’s life from birth to the time in 1996 when he broke contact with his family and became deeply involved with Muslim fundamentalists in London. It is a unique document about what it is to grow up a Muslim in Western Europe today and how an extremist is made. In Zacarias, My Brother, author Abd Samad Moussaoui describes the struggle that young Arab men and their families endure in Europe, seeking an education and equal opportunity, only to find most avenues of assimilation effectively barred to people of color. At the same time, he authoritatively details the techniques of the extremist sects that recruit potential terrorist cadres. Members of the Wahhabi sect have perfected a rhetoric that appeals to the wounded pride of these young Arab men, Moussaoui writes—for example, offering funds to help them complete their education. Moussaoui deplores the route taken by his brother. He is not in any way an apologist for terrorism. Even so, he shows convincingly that normal young men can end up terrorists, and suggests how and why this happens. Moussaoui shows with gripping clarity how Wahhabism distorts true Islamic faith and the threat it poses to Islam. And his book strongly suggests that the best defense against terrorist groups like the Wahhabi sect in the future is anything people can do to end racism.

Download or read book World Health Organization Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses written by World Health Organization and published by . This book was released on 2012 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Iheoma My Dear written by Gloria Ernest Samuel and published by . This book was released on 2016 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Nature and Culture in the Democratic Republic of Congo written by and published by . This book was released on 2004 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Vulnerability to Drug Abuse written by Meyer Glantz and published by Amer Psychological Assn. This book was released on 1992 with total page 533 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text offers insights into the complex and disturbing questions of drug abuse by examining the range of factors that affect vulnerability, focusing specifically on factors and patterns associated with the transition from drug use to drug abuse.

Download or read book Geosimulation written by Itzhak Benenson and published by John Wiley & Sons. This book was released on 2004-08-20 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt: Geosimulation is hailed as ‘the next big thing’ in geographic modelling for urban studies. This book presents readers with an overview of this new and innovative field by introducing the spatial modelling environment and describing the latest research and development using cellular automata and multi-agent systems. Extensive case studies and working code is available from an associated website which demonstrate the technicalities of geosimulation, and provide readers with the tools to carry out their own modelling and testing. The first book to treat urban geosimulation explicitly, integrating socio-economic and environmental modelling approaches Provides the reader with a sound theoretical base in the science of geosimulation as well as applied material on the construction of geosimulation models Cross-references to an author-maintained associated website with downloadable working code for readers to apply the models presented in the book Visit the Author's Website for further information on Geosimulation, Geographic Automata Systems and Geographic Automata Software http://www.geosimulationbook.com

Download or read book Cervical Cancer Screening in Developing Countries written by World Health Organization and published by World Health Organization. This book was released on 2002 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cervical cancer is the second most common cancer among women worldwide, with 80 per cent of deaths occurring in developing countries. It is an important area for cancer control programmes because of the burden of the disease and the potential for effective prevention via screening. This publication is based on a comprehensive consultation undertaken by WHO in 2001, involving leading experts in the field of cancer epidemiology, screening and treatment. It focuses on the current situation in low and middle income countries, discusses the efficacy of screening methods available, and assesses potential future developments.