Download or read book Evaluation de la prise en charge de l insuffisance cardiaque dans le service d Unit M dicale Post Accueil du CHU de Besan on written by Louis-Antoine Mouchel and published by . This book was released on 2009 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rationnel : L'insuffisance cardiaque est un problème de santé publique majeur et méconnu. Sa prévalence croît avec le vieillissement de la population. Le mauvais pronostic de l'insuffisance cardiaque s'est récemment amélioré grâce à l'utilisation de classes thérapeutiques majeures. Des études récentes ont cependant révélé une large sous-prescription de ces traitements. Ce travail a pour objectif d'évaluer notre prise en charge de l'insuffisance cardiaque à la lumière des recommandations internationales. Patients et méthodes : Il s'agit d'une étude rétrospective et observationnelle menée dans le service d'Unité Médicale Post-Accueil du CHU de Besançon, incluant tous les patients hospitalisés pour insuffisance cardiaque entre le 1er mai 2006 et le 30 avril 2007. Résultats : Soixante quatre patients ont été inclus : 47 femmes et 17 hommes (sex ratio = 0.36), âgés de 84,8 ans en moyenne (+ ou - 8.7). Pendant l'hospitalisation, seulement 18,7 % des patients ont eu une échocardiographie et 10,9 % ont reçu des dérivés nitrés. La durée d'hospitalisation était de 11,1 jours en moyenne, 10,6 jours pour les patients de plus de 80 ans. Malgré une large prescription d'IEC (65,6 % ), seulement 18,8 % des patients ont reçu la triade IEC-diurétiques-bêtabloquants préconisée, principalement à cause d'une sous-prescription des bêtabloquants (31,2 % ). Sur les 12 mois de suivi, les réhospitalisations ont été fréquentes (65,6 % ), la mortalité a été de 34,3 %. Conclusion : Notre étude révèle une adéquation insuffisante entre les recommandations et leur application. Une amélioration de la prise en charge globale repose sur l'optimisation des prescriptions médicamenteuses, la meilleure accessibilité de l'échocardiographie, la planification des interventions thérapeutiques à domicile et le développement des programmes d'éducation thérapeutique.

Download or read book Leparcours de soins du patient insuffisant cardiaque au centre hospitalier universitaire de Besan on written by Marie de Lentaigne de Logivière and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : L'insuffisance cardiaque est une pathologie chronique évolutive émaillée d'épisodes aigus de décompensation. Il s'agit de la première cause d'hospitalisation après l'âge de 65 ans, entraînant un coût important pour la santé publique. Si son approche thérapeutique est actuellement bien codifiée, l'organisation hospitalière des soins l'est beaucoup moins. La persistance d'un taux élevé de décès et de réhospitalisations précoces après une décompensation cardiaque aiguë en est une des conséquences. Comprendre et structurer le parcours de soins de l'insuffisant cardiaque (IC) apparaît comme un enjeu de santé publique. Méthode: Il s'agit d'une étude rétrospective, uni-centrique, réalisée au sein du CHU de Besançon. Une fiche de recueil de données sur le parcours de soins, le traitement entrepris, les caractéristiques clinico-biologiques des patients atteints d'insuffisance cardiaque aiguë, a été réalisée pour les patients quel que soit leur service de prise en charge. Le critère d'évaluation principal consiste en la réalisation d'une photographie représentant une vision globale du parcours de soins du patient insuffisant cardiaque depuis son admission jusqu'à sa sortie d'hospitalisation. Les objectifs secondaires sont de comparer deux populations de patients (selon qu'ils aient ou non bénéficié d'une prise en charge en cardiologie) et d'étudier l'impact de la pandémie liée au Sars CoV2 sur leur parcours de soins. Résultats : 55 patients hospitalisés au CHU de Besançon pour un épisode d'insuffisance cardiaque aiguë ont été inclus sur la principale période d'étude de octobre à décembre 2019 (avant la pandémie liée au Sars-Cov-2) et 50 patients ont été inclus sur w1e seconde période de octobre à décembre 2020 (pendant la pandémie au Sars-Cov-2). La moyenne d'âge des patients est de 79 ans. Il y a une majorité d'hommes (60%). La principale étiologie est la cardiopathie ischémique (31,5%). Le délai moyen de prise en charge entre l'apparition des symptômes et l'hospitalisation est de sept jours. 65% des patients sont passés par le service d'accueil des urgences (SAU). 71% ont bénéficié d'une échocardiographie pendant leur hospitalisation. La FEVG était plus souvent altérée dans les services de cardiologie. Le traitement a été optimisé chez 46% des patients, dont 19% des patients de la population « sans prise en charge dans un service de cardiologie ». Le devenir des patients insuffisants cardiaques reste inquiétant, 45% des patients ont été réhospitalisés et 29% sont décédés dans l'aimée. Conclusion : Actuellement, l'absence de structuration dai1s le parcours de soins du patient insuffisant cai·diaque au CHU de Besançon ne favorise pas la délivrance optimale des soins. Plusieurs axes d'amélioration sont mis en évidence dans cette analyse afin de réduire les risques de réhospitalisations et de décès précoces dans les suites d'une hospitalisation pour insuffisance cai·diaque. Si le premier consiste au renforcement de l'éducation thérapeutique afin de raccourcir les délais entre l'apparition des premiers symptômes et l'hospitalisation, il apparait ensuite essentiel que l'ensemble des patients puisse bénéficier d'une consultation spécialisée dans un délai bref, quel que soit le service initial de prise en charge. Les traitements seront à cette occasion optimisés selon les recommandations scientifiques actuelles. Enfin, la sortie et le suivi post hospitalisation du patient doivent être anticipés et discutés entre les différents acteurs du parcours de soins.

Download or read book Critical Care Nursing written by Linda Diann Urden and published by Saunders. This book was released on 2010 with total page 1242 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Children s Socio Economic Rights Democracy And The Courts written by Aoife Nolan and published by Bloomsbury Publishing. This book was released on 2011-09-15 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is concerned with children's economic and social rights (sometimes referred to simply as children's social rights). Despite increased academic interest in both children's rights and socio-economic rights over the last two decades, children's social and economic rights remain a comparatively neglected area. This is particularly true with regard to the role of the courts in the enforcement of such social rights. Aoife Nolan's book remedies this omission, focussing on the circumstances in which the courts can and should give effect to the social and economic rights of children. The arguments put forward are located within the context of, and develop, long-standing debates in constitutional law, democratic theory and human rights. The claims made by the author are supported and illustrated by concrete examples of judicial enforcement of children's social and economic rights from a variety of jurisdictions. The work is thus rooted in both theory and practice. The author brings together and addresses a wide range of issues that have never previously been considered together in book form. These include children's socio-economic rights; children as citizens and their position in relation to democratic decision-making processes; the implications of children and their rights for democratic and constitutional theory; the role of the courts in ensuring the enforcement of children's rights; and the debates surrounding the litigation and adjudication of social and economic rights. This book thus represents a major original contribution to the existing scholarship in a range of areas including human (and specifically social) rights, legal and political theory and constitutional law. 'Children's rights were often thought to be synonymous with economic and social welfare prior to the adoption of the Convention on the Rights of the Child in 1989. Ironically, since that time, remarkably little scholarship has been devoted to the vitally important economic and social rights dimensions of children's rights. Nolan's book singlehandedly remedies that neglect and does so in a sophisticated, nuanced and balanced way. It provides a superb account of the pros and cons of judicial activism in promoting these rights.' Philip Alston, John Norton Pomeroy Professor, NYU Law School 'Thus far the burgeoning literature on the judicial enforcement of socio-economic rights has failed to engage in a sustained, systemic manner with this topic from the perspective of children and the complexity of their status as citizens within contemporary democracies. This book fills this gap and makes a major contribution to the literature in the three interrelated areas of the judicial review of socio-economic rights claims, children's rights, and democratic theory. Nolan navigates skilfully through the dense, but rich literature in these areas as well as relevant international and comparative law. In so doing she illuminates both the pitfalls and potential of resorting to courts in a partial response to the multifaceted and deeply entrenched global phenomenon of child poverty.' Professor Sandra Liebenberg, HF Oppenheimer Professor of Human Rights Law, University of Stellenbosch Law Faculty. Winner of the Kevin Boyle Book Prize 2012, awarded by the Irish Association of Law Teachers to a book that is deemed to have made an outstanding contribution to the understanding of law.

Download or read book Cheshire Parish Registers V 3 written by London Issued to the Subscribers by and published by Legare Street Press. This book was released on 2021-09-10 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.

Download or read book A Primer on Property Tax written by William J. McCluskey and published by John Wiley & Sons. This book was released on 2012-10-04 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt: 'The chapters in this book explore in detail the choices regarding both the structure and administration of the property tax, drawing on the extensive knowledge the authors have acquired in studying property taxes around the world. The chapters provide a wide-ranging treatment of the design choices and administrative tasks, both in terms of the breadth of design options and administrative tasks covered and the depth of the discussion. The authors describe the range of design choices, discuss the associated issues and the advantages and disadvantages for each, and present the criteria to help choose among the options.’ From the book’s Foreword by David L. Sjoquist, Professor of Economics and Dan E. Sweat Scholar Chair in Educational and Community Policy, Georgia State University Property taxation is a key element in providing a solid foundation and a stable funding source for basic public services. Developing and implementing a property tax system is a complex task. This complexity is compounded by the diversity of legal, cultural and historical contexts of policymakers and tax administrators. The World Development Report (1999-2000), Entering the 21st Century puts fiscal decentralization at the top of the development agenda. This makes local taxation - and especially the property tax option - of critical importance to both tax and land policy, as well as the broader development agenda. A Primer on Property Tax: Administration and Policy provides the reader with an analysis of issues surrounding property tax, including economics, law, public finance, decentralisation, valuation, GIS and property tax reform. A key strength of the book lies in the vast international experience of the authors and the book will provide for the first time material which is topical, cutting-edge and highly relevant to many of the disciplines involved in property taxation. The authors examine the criteria applied to evaluate the strengths and weaknesses of property tax, discuss the main valuation methods and the economic principles underpinning them and review the legal and administrative aspects of property tax worldwide.

Download or read book The NHS Improvement Plan written by Great Britain. Department of Health and published by The Stationery Office. This book was released on 2004 with total page 94 pages. Available in PDF, EPUB and Kindle. Book excerpt: This document sets out the priorities for the NHS up to 2008 based on the process of reform set out in the NHS Plan (Cm. 4818-I ISBN 0101481829). It is in three sections. The first 'Laying the foundations' looks at the progress so far in NHS reform. The second section 'Offering a better service' sets out the objectives of the policy under the headings of personalised care, supporting people with long-term conditions, and a healthier and fitter population. One of the aims is to change the NHS from a sickness service to a service that gives a higher priority to the prevention of disease and a reduction of health inequalities. The third section is called 'Making it happen' and it covers investment and diversity of provision, staff and working practices and information systems.

Download or read book Notebook written by Funny Notebooks Bekaydesign and published by . This book was released on 2019-12-08 with total page 102 pages. Available in PDF, EPUB and Kindle. Book excerpt: Notebook 6x9" This cool Notebook is perfect for recording your Notes, eg Ideas for traveling and holidays, new creative ideas, checklists, new tasks and even getting started for something even bigger! This notebook is a thoughtful and useful gift for world travelers, teachers, colleagues, young moms and dads, newlyweds, bachelors, best friends and graduates. Features and Use of this Notebook: 6 Inches x 9 Inches - Fits easily in backpacks, tote bags and handbags. 100 Pre-Made Pages - 90 White GSM Quality Paper Premium Designed Matte Cover - absorbs scratches For use as a travel journal, checklist book, to set goals, record, create lists and more! Buy this beautiful notebook today and get started! To find other books from us, just click on the author's name under the title.

Download or read book Cambridge Yearbook of European Legal Studies Vol 13 2010 2011 written by Catherine Barnard and published by Bloomsbury Publishing. This book was released on 2011-12-15 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Cambridge Yearbook of European Legal Studies provides a forum for the scrutiny of significant issues in EU Law, the law of the European Convention on Human Rights, and Comparative Law with a 'European' dimension, and particularly those issues which have come to the fore during the year preceding publication. The contributions appearing in the collection are commissioned by the Centre for European Legal Studies (CELS) Cambridge, a research centre in the Law Faculty of the University of Cambridge specialising in European legal issues. The papers presented are at the cutting edge of the fields which they address, and reflect the views of recognised experts drawn from the University world, legal practice, and the institutions of both the EU and its Member States. Inclusion of the comparative dimension brings a fresh perspective to the study of European law, and highlights the effects of globalisation of the law more generally, and the resulting cross fertilisation of norms and ideas that has occurred among previously sovereign and separate legal orders. The Cambridge Yearbook of European Legal Studies is an invaluable resource for those wishing to keep pace with legal developments in the fast moving world of European integration. INDIVIDUAL CHAPTERS Please click on the link below to purchase individual chapters from Volume 13 through Ingenta Connect: www.ingentaconnect.com SUBSCRIPTION TO SERIES To place an annual online subscription or a print standing order through Hart Publishing please click on the link below. Please note that any customers who have a standing order for the printed volumes will now be entitled to free online access. www.hartjournals.co.uk/cyels/subs Editorial Advisory Board: Albertina Albors-Llorens, John Bell, Alan Dashwood, Simon Deakin, David Feldman, Richard Fentiman, Angus Johnston, John Spencer Founding Editors: Alan Dashwood and Angela Ward Ius Commune Prize 2012 Alexandre Saydé wrote Chapter 15 in this volume entitled: 'One Law, Two Competitions: An Enquiry into the Contradictions of Free Movement Law' and we are delighted to announce that he has been awarded the Ius Commune Prize 2012.

Download or read book Health for all Children written by David M B Hall and published by OUP Oxford. This book was released on 2006-09-07 with total page 423 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since publication of the fourth edition of this highly successful book, there have been a number of Government initiatives, reports and policies on how the health of children can best be protected and promoted. This revised fourth edition incorporates recent material on the National Service Framework, 'Every Child Matters', the public health report 'Choosing Health', and the Children Act. It has also been informed by new research on a variety of topics including Sure Start, obesity, Sudden Infant Death Syndrome (SIDS) and language acquisition. Health for all Children 4/e (revised) continues the themes of previous editions, in particular highlighting the growing evidence that behavioural problems and educational failure are not inevitable, and can be prevented. Thus the role of screening for developmental problems, while not ignored, is set in the context of what can be done to promote language development, reading, and enthusiasm for learning. Changes made to the fourth edition, and continued in this revised edition, include dealing with the health care needs of children of school age as well as pre-school children. It also outlines the needs of special groups of children, including those who are vulnerable or disabled and those living in unusual circumstances. The legislative framework is outlined and hallmarks of good practice described. Promoting children's health is a key focus, with updated information on nutrition and injury prevention, and emphasis on the importance of parent education and support, language, and literacy skills, with a review of behavioural management programmes for parents. It also describes the duties laid on PCTs with regard to education and social services support. This established and successful book continues to be essential reading for all health professionals who work with children, whether in the community or at the receiving end of referrals. It will also provide vital background knowledge for those charged with the responsibility of planning, commissioning and monitoring. This revised fourth edition provides the most up to date evidence in a rapidly changing field.

Download or read book Socialism Perestroika and the Dilemmas of Soviet Economic Reform written by John E Tedstrom and published by Routledge. This book was released on 2021-12-13 with total page 239 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book highlights that Soviet economic planners and politicians must come to recognize the need to make fundamental changes, not simply incremental refinements, in the failing Soviet system. It examines the dynamics of the process of perestroika and the complexity of individual economic issues.

Download or read book The Ladybird Illustrated written by D H Lawrence and published by . This book was released on 2020-11-09 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Ladybird is a long tale or novella by D. H. Lawrence. It was first drafted in 1915 as a short story entitled The Thimble. Lawrence rewrote and extended it under a new title in December 1921 and sent the final version to his English agent on 9 January 1922. It was collected with two other tales, The Captain's Doll and The Fox, and the three novellas were then published in London by Martin Secker in March 1923 under the title The Ladybird and in New York by Thomas Seltzer as The Captain's Doll in April 1923."

Download or read book Notes on the Minor Prophets written by Henry Allan Ironside and published by . This book was released on 1955 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: