RESUMO
The history of nursing also encompasses the history of nurses' professional knowledge, the conditions of its production, and the use of it in both the health system and the city. In what appears to be an undeniable process of development and affirmation of this occupational group due to the emergence of these skills, the creation of the International School of Advanced Nursing Education (École internationale d'enseignement infirmier supérieur ; EIEIS) in Lyon in 1965 represented a major turning point for French nurses, despite it only training a small number of them. This article aims to examine, starting from the roots of this professionalization movement at the end of the nineteenth century, what this unique school brought to them collectively until its closure in 1995. By entering university for the first time, this occupational group, which had until then been under the yoke of different powers (administrative, medical, and religious), became emancipated by learning to be autonomous and even disobedient. Largely open to the world, this school also laid the foundations for a reflection on the possibility of nursing becoming an academic discipline in France, despite its work remaining incomplete due to its closure as a result of a lack of resources needed to continue its activity.
RESUMO
The history of nursing also encompasses the history of nurses' professional knowledge, the conditions of its production, and the use of it in both the health system and the city. In what appears to be an undeniable process of development and affirmation of this occupational group due to the emergence of these skills, the creation of the International School of Advanced Nursing Education (École internationale d'enseignement infirmier supérieur ; EIEIS) in Lyon in 1965 represented a major turning point for French nurses, despite it only training a small number of them. This article aims to examine, starting from the roots of this professionalization movement at the end of the nineteenth century, what this unique school brought to them collectively until its closure in 1995. By entering university for the first time, this occupational group, which had until then been under the yoke of different powers (administrative, medical, and religious), became emancipated by learning to be autonomous and even disobedient. Largely open to the world, this school also laid the foundations for a reflection on the possibility of nursing becoming an academic discipline in France, despite its work remaining incomplete due to its closure as a result of a lack of resources needed to continue its activity.
Assuntos
Educação em Enfermagem/história , Escolas de Enfermagem/história , França , História do Século XX , HumanosRESUMO
The history of the relationship between doctors and patients shows that it is possible to find traces of attention from doctors towards patients as far back as the Antiquity. Nevertheless, at that time, this solicitude is made essentially in the name of nature through the sick individual. With the Middle Ages and the rise and growing importance of Christianity, the notion of person appeared, rising beyond the physical limits of the individual. At that time, the solicitude is then made in the name of God transcending, in that way, the sick person. It is only at the end of the XIXth century, with the movement of social transformation and secularization of the medical care, that it is possible to detect the notion of subject in the medical relation as proved by the emergence of the psychoanalysis. But at the same time, the spectacular evolution of medicine in its scientific component and its increasing importance during the next century made that it focused mainly on a naturalistic vision of the world of the medical care, to the detriment, most of the time, of a personal vision taking into account the deep-rooted social characters of the sick subject. From then on, the nursing profession could be seen, at the beginning of the XXIth century, as complementary to the medicine, through the development and the implementation of a dominant personal relation type without neglecting the naturalistic relation type. This prospect could be possible on the condition of developing the scientific knowledge allowing to give consistency and thickness to this way of seeing and acting centered on the person. An approach doubtless inspired by the care, yet going further its emotional and ethical meaning, in order to understand and to act better.
Assuntos
Relações Enfermeiro-Paciente , Relações Médico-Paciente , História da Medicina , História do Século XIX , História Antiga , História Medieval , HumanosRESUMO
The nursing education in academic contexts reinforces the need for students to take ownership and control discipline « nursing ¼. In some countries the nursing education is well established and fits as well as teaching other scientific disciplines with its epistemology, its authors, methods etc. In other countries it is emerging and ways of doing are not stabilized.The seminar on « The sciences of nursing education ¼ identifies the epistemological fundamentals, clinical and scientific of the discipline to support its development in France. It aims to identify the basic content related to nursing to be acquired in initial training and mastered by all nurses.The answers to questions relating to epistemology and paradigms in nursing, learning clinical, scientific culture and research, nursing education are based on the review of models from other countries, sharing of experiences, discussions in a prospective vision. The recommendations take into account the changes required and consistent with public health goals and service to society. They are supplemented strategies for their appropriation by nurses themselves and other professions and other fields.
RESUMO
During September 2010-November 2011, a cluster of erythromycin-susceptible, tetracycline- and ciprofloxacin-resistant Campylobacter coli pulsovar 1 infections was documented, involving 10 case-patients, in Montreal, Quebec, Canada. The findings suggested sexual transmission of an enteric infection among men who have sex with men.
Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter coli/genética , Surtos de Doenças , Infecções por HIV/epidemiologia , HIV/isolamento & purificação , Homossexualidade Masculina , Adulto , Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/transmissão , Campylobacter coli/isolamento & purificação , Ciprofloxacina/uso terapêutico , Coinfecção , Farmacorresistência Bacteriana Múltipla , Eritromicina/uso terapêutico , Infecções por HIV/virologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Quebeque/epidemiologia , Estudos Retrospectivos , Tetraciclina/uso terapêuticoRESUMO
On the initiative of the World health organization, the international School of nursing university education opens in Lyon on September the 6th, 1965 and closes 30 years later. After having approached the national and international context of this creation, the study, based on archives and contemporary printed sources and various interviews of living witnesses, boarding and teaching, only-female staff present at the opening of the School, shows that it's all about pioneers and activists to the nursing cause, each of them doing it her own way. The background, the training, the personality, the educational choices and the publications of most of them give evidence of their will to contribute actively to the development and valuation of nursing as a discipline without naming it, by being inspired by foreign experiences well ahead of the french situation at the time. Good intentions to confront with the complex reality of the stakes and games of the numerous actors involved in those years realization.
Assuntos
Escolas de Enfermagem/história , Docentes de Enfermagem/história , Feminino , França , História do Século XX , Humanos , Estudantes de Enfermagem/históriaRESUMO
History is a discipline whose research methods present similarities with those of other human and social sciences, with certain specificities. The nursing profession can use these methods to showcase its history and the history of nursing care.
Assuntos
História da Enfermagem , História , Pesquisa , História do Século XIX , História do Século XX , HumanosRESUMO
Infections due to meticillin-resistant Staphylococcus aureus (MRSA) pose a serious health risk. Novel methods for assessing comparative effectiveness and safety may provide valuable insights into therapeutic choices. We did a systematic review searching electronic databases including the archives of FDA/CDER and performed a Bayesian network meta-analysis to compare parenteral antibiotics used for treating hospitalised adults with complicated skin and soft-tissue infections (cSSTIs) or hospital-acquired or ventilator-associated pneumonia (HAP/VAP). Models were adjusted for clinical heterogeneity due to between-arm differences in the proportion of patients with diabetes (for cSSTI) and in those requiring mechanical ventilation (for pneumonia). Treatments were ranked on efficacy, defined as clinical success in the modified intention-to-treat population (MITT) and in the MITT population with MRSA at baseline (MRSA m-MITT), on all-cause mortality (in pneumonia only), and on serious adverse events and withdrawals due to adverse events. We identified 24 randomised controlled trials (17 for cSSTI and 10 for HAP/VAP) comparing one of six antibiotics with vancomycin. The network meta-analysis indicated that vancomycin ranked third (of six antibiotics) in cSSTI and second (of four) in pneumonia on both efficacy and safety. However, direct pairwise meta-analyses remained inconclusive as evidenced by the adjusted median odds ratios (ORs) and their 95% credible intervals. In cSSTI, linezolid and ceftaroline were non-significantly more effective than vancomycin. Linezolid ORs were 1.15 (0.74-1.71) and 1.01 (0.42-2.14) and ceftaroline ORs were 1.12 (0.78-1.64) and 1.59 (0.68-3.74) in the MITT and MRSA m-MITT populations, respectively. For HAP/VAP, linezolid was non-significantly better than vancomycin, with ORs of 1.05 (0.72-1.57) and 1.32 (0.71-2.48) in the MITT and MRSA m-MITT populations, respectively. We suspect performance and detection bias in cSSTI trials involving linezolid, but regression methods could not adjust for this potential bias. In these clinical trials, the preferred agents for treating serious MRSA infections were ceftaroline (for cSSTI, not studied in HAP/VAP) and linezolid. However, translation of these findings into practice should consider the small size of the evidence networks and the consequent uncertainty associated with the parameter estimates, the lack of evidence for ceftaroline in patients with severe renal impairment, and the lower internal validity of some of the linezolid trials.
Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Antibacterianos/efeitos adversos , Infecção Hospitalar/microbiologia , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções dos Tecidos Moles/microbiologia , Infecções Estafilocócicas/microbiologia , Análise de Sobrevida , Resultado do TratamentoRESUMO
INTRODUCTION: Conventional cultures have implicated Staphylococcus aureus (SA) and coagulase-negative Staphylococcus (CNS) as principal pathogens in chronic rhinosinusitis (CRS). These results are questioned by recent studies in which molecular probes implicate Haemophilus influenzae instead. OBJECTIVES: To identify all bacterial species present on sinonasal mucosa using molecular culture (bacterial tag-encoded FLX amplicon pyrosequencing [bTEFAP]) and to compare them with those identified with conventional methods. METHODS: A prospective study of 18 patients undergoing endoscopic sinus surgery for CRS and 9 control patients with pituitary adenomas was conducted. Per-operative mucosal biopsies were assessed with bTEFAP by sequencing the species-specific 16S ribosomal deoxyribonucleic acid (DNA) fragment for genetic identification of bacteria and then compared with simultaneous swab culture. RESULTS: Standard cultures showed mainly SA and CNS. Molecular cultures identified up to 20 organisms per sample. Surprisingly, anaerobic species predominated (Diaphorobacter and Peptoniphilus). SA was nevertheless detected in 50%. CONCLUSION: Molecular cultures such as bTEFAP are sensitive tools for bacterial identification in CRS and suggest that anaerobe involvement may be more frequent than presumed.