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1.
Soins Gerontol ; 25(141): 24-27, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32200986

RESUMEN

In their daily practice, professionals are called upon to meet older people who are more in distress than others. In order to best meet their needs, it is necessary first to define these difficulties and then to consider the mechanisms that can provide assistance adapted to the requirements and needs of the people. Access to hospital health care services and coordination support mechanisms, as defined by the law of 26 July 2019, can contribute to this assistance, without criteria limiting access to care. Examples of prevention and coordination actions carried out by the Access to Health Care, Rights and Education Network.


Asunto(s)
Accesibilidad a los Servicios de Salud/organización & administración , Servicios de Atención de Salud a Domicilio/organización & administración , Anciano , Francia , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Humanos
2.
Soins Gerontol ; 25(141): 38-40, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32200989

RESUMEN

How can we respond differently to the demographic challenge of the growing population of seniors with cognitive-behavioural problems? The gerontology pole of the University Hospital Centre of Nîmes has installed a simulation room through a call for projects that has made it possible to develop nursing skills to improve care.


Asunto(s)
Competencia Clínica , Terapia Cognitivo-Conductual , Enfermería Geriátrica , Anciano , Investigación Biomédica , Francia , Hospitales Universitarios , Humanos , Personal de Enfermería en Hospital/educación , Dinámica Poblacional , Entrenamiento Simulado
3.
J Frailty Aging ; 9(1): 44-50, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150213

RESUMEN

BACKGROUND: In older people, diabetes is associated with an increased risk of falls and frailty. The value of using posturography for evaluating the risk of falling is unclear. In theory, a time-scale analysis should increase the metrological properties of the posturography assessment. OBJECTIVES: This study aimed to determine which posturographic parameters can be used to identify fall-risk patients in a frail diabetic older population and to assess their interest in comparison to usual clinical trials for gait and balance. DESIGN: This is a prospective observational cohort. SETTINGS: frail or pre-frail diabetic patients, in Bordeaux, France. PARTICIPANTS: 84 patients were included in the study (mean age 80.09 years, 64.5% of men).Criteria for inclusion were: age over 70 years, diabetes mellitus for over 2 years, and at least one of the Fried's frailty criteria. MEASUREMENTS: Gait and balance assessments were undertaken at baseline: Static posturography, the timed up and go test, short physical performance battery, and (gait) walking speed. Raw data from posturography were used for wavelet analysis. Data on self reported new falls were collected prospectively during 6 months. RESULTS: The posturography parameter most useful was area of 90% confidence ellipse of statokinesigram (COP90area): area under the ROC curve AUC = 0.617 (95% CI, 0.445-0.789) and OR=1.003 (95%CI 1.000-1.005) p =0.05. The optimum clinical test was the time to walk over 4m AUC=0.735 (95%CI, 0.587-0.882) and OR=1.42 (95%CI 1.08-1.87) p= 0.013. CONCLUSION: Posturography has limited utility for assessment of falls risk in frail older people with diabetes. Gait and balance clinical assessments such as walking speed continue to retain their value.


Asunto(s)
Accidentes por Caídas , Diabetes Mellitus/epidemiología , Anciano Frágil/estadística & datos numéricos , Balance Postural/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Francia/epidemiología , Humanos , Masculino , Estudios Prospectivos , Reproducibilidad de los Resultados , Medición de Riesgo/métodos
5.
Rev Infirm ; 69(257): 25-26, 2020 Jan.
Artículo en Francés | MEDLINE | ID: mdl-32146960

RESUMEN

Long considered as a paediatric pathology, cystic fibrosis concerns in France more adults than children since 2015. Considering this demographic shift, the way healthcare is organized requires constant adaptation, particularly in the care of adults where new needs are rapidly emerging.


Asunto(s)
Continuidad de la Atención al Paciente , Fibrosis Quística/terapia , Adulto , Francia , Humanos
6.
Rev Infirm ; 69(257): 29-30, 2020 Jan.
Artículo en Francés | MEDLINE | ID: mdl-32146962

RESUMEN

For more than twenty years, the association "Étoiles des neiges" has placed sport at the heart of its actions and promotes its practice adapted for all: children, teenagers, adults and transplant patients. If in 1999, when it launched its projects, young people suffering from cystic fibrosis were rather exempt from sport, since then it has been recognized as one of the pillars of its care. The association deploys its Sport projects to all the CRCMs in France.


Asunto(s)
Fibrosis Quística , Deportes , Adolescente , Adulto , Niño , Francia , Humanos
7.
J Dent Educ ; 84(3): 367-376, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176342

RESUMEN

The aim of this study was to evaluate the contribution of virtual reality to the conventional analogic training environment and show the complementarity of conventional techniques and virtual reality in the learning of dental students. All 88 first-year dental students at a dental school in France in early 2019 were randomly assigned to one of two groups: group 1 (n = 45) was assigned to cavity preparations on a haptic simulator (Virteasy) and group 2 (n = 43) was assigned to conventional practical work on plastic analogue teeth (Kavo). Following three training sessions, the students in group 1 took a final exam on the same plastic analogue teeth exercise. The results showed improvement in the drilling skill of both groups. The simulator-trained group (group 1) had similar results to the plastic analogue-trained group (group 2) in the final test on a plastic analogue tooth. In this study, virtual reality allowed an assessment based on objective criteria and reduced the subjectivity of evaluations conducted on plastic analogue teeth. Considering the saving of supervision and teaching time as well as the material gain offered by virtual reality, the learning methods of haptic simulators are educational options that should be considered by dental educators.


Asunto(s)
Preparación de la Cavidad Dental , Educación en Odontología , Entrenamiento Simulado , Competencia Clínica , Simulación por Computador , Francia , Humanos , Estudiantes de Odontología , Interfaz Usuario-Computador
8.
Crit Care ; 24(1): 109, 2020 03 18.
Artículo en Inglés | MEDLINE | ID: mdl-32188500

RESUMEN

BACKGROUND: Candidemia is an opportunistic infection associated with high morbidity and mortality in patients hospitalized both inside and outside intensive care units (ICUs). Identification of patients at risk is crucial to ensure prompt antifungal therapy. We sought to assess risk factors for candidemia and death, both outside and inside ICUs. METHODS: This prospective multicenter matched case-control study involved six teaching hospitals in Switzerland and France. Cases were defined by positive blood cultures for Candida sp. Controls were matched to cases using the following criteria: age, hospitalization ward, hospitalization duration, and, when applicable, type of surgery. One to three controls were enrolled by case. Risk factors were analyzed by univariate and multivariate conditional regression models, as a basis for a new scoring system to predict candidemia. RESULTS: One hundred ninety-two candidemic patients and 411 matched controls were included. Forty-four percent of included patients were hospitalized in ICUs, and 56% were hospitalized outside ICUs. Independent risk factors for candidemia in the ICU population included total parenteral nutrition, acute kidney injury, heart disease, prior septic shock, and exposure to aminoglycoside antibiotics. Independent risk factors for candidemia in the non-ICU population included central venous catheter, total parenteral nutrition, and exposure to glycopeptides and nitroimidazoles. The accuracy of the scores based on these risk factors is better in the ICU than in the non-ICU population. Independent risk factors for death in candidemic patients included septic shock, acute kidney injury, and the number of antibiotics to which patients were exposed before candidemia. DISCUSSION: While this study shows a role for known and novel risk factors for candidemia, it specifically highlights important differences in their distribution according to the hospital setting (ICU versus non-ICU). CONCLUSION: This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients' management strategies and fungal epidemiology.


Asunto(s)
Antifúngicos/uso terapéutico , Candidemia/mortalidad , Unidades de Cuidados Intensivos/estadística & datos numéricos , Anciano , Estudios de Casos y Controles , Catéteres Venosos Centrales , Infección Hospitalaria , Femenino , Francia , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Suiza
10.
J Environ Manage ; 261: 110162, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32148259

RESUMEN

This paper contributes to the growing literature regarding the role of Information and Communication Technologies as well as Innovation on driving the level of carbon dioxide emissions and economic growth in context of the 21st conference of the Parties to the Climate convention (COP21). Drawing the data from 13 selected G-20 countries (including Argentina, Canada, China, France, Germany, Italy, Japan, Mexico, Republic of Korea, Russian Federation, Turkey, United Kingdom, United States) during the period of 15 years, our study achieves significant results. First, only five factors impede the carbon emissions namely energy price, foreign direct investment, technology, spending on innovation and trade openness while the remainder of determinants contribute to contamination of environment, including financial development. Second, when it comes to economic growth, information and communication technological and financial development are positive driving factors. Our results do reject the absence of Environmental Kuznets Curve (EKC) from our sample. Finally, our study empirically suggests that the work of controlling consumption of oil and environmentally friendly process including manufacture-trading in these economies will limit the amount of pollution.


Asunto(s)
Dióxido de Carbono , Desarrollo Económico , Argentina , Canadá , China , Francia , Alemania , Italia , Japón , México , República de Corea , Federación de Rusia , Turquia , Reino Unido
11.
Bull Cancer ; 107(3): 308-321, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32035648

RESUMEN

INTRODUCTION: Health care utilization of people with lung cancer (LC) the last year of life, their causes of death and place of death and the associated expenditure have been poorly described together. Then we conducted an observational study. METHODS: People with LC covered by the French health Insurance general scheme (77% of the population) who died in 2015 were identified in the national health data system, together with their health care utilization and, in 95% of cases, their causes of death. RESULTS: A total of 22,899 individuals were included (mean age: 68 years, SD±11.4), 72% of whom died in short-stay hospitals (SSH), 4% in hospital-at-home, 8% in Rehab hospital, 2% in skilled nursing homes and 14% at home. One-half of these people had also a chronic respiratory tract disease and 18% another cancer. Hospital palliative care (HPC) was identified for 65% of people, but for only 9% prior to their end-of-life stay. During the last month of life, 49% of people had two or more SSH stays, 15% were admitted to an intensive care unit, 23% received a chemotherapy session (13% during the last 14 days). The main cause of death was cancer for 92% of individuals (LC for 82%) The mean expenditure during the last year of life was €43,329 per individual. DISCUSSION: This study indicates high rates of intensive care unit admissions and chemotherapy during the last month of life and a SSH hospital-centered management with intensive use of HPC mainly during the end-of-life stay.


Asunto(s)
Gastos en Salud , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Neoplasias Pulmonares/economía , Neoplasias Pulmonares/terapia , Anciano , Anciano de 80 o más Años , Causas de Muerte , Comorbilidad , Cuidados Críticos/economía , Cuidados Críticos/estadística & datos numéricos , Quimioterapia/economía , Quimioterapia/estadística & datos numéricos , Femenino , Francia/epidemiología , Mortalidad Hospitalaria , Humanos , Cobertura del Seguro/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Cuidados Paliativos/estadística & datos numéricos , Características de la Residencia , Cuidado Terminal/estadística & datos numéricos , Factores de Tiempo
12.
Bull Cancer ; 107(3): 333-343, 2020 Mar.
Artículo en Francés | MEDLINE | ID: mdl-32037013

RESUMEN

INTRODUCTION: Health researchers often face difficulties related to participants' recruitment for their research. However, a new strategy emerges: offering patients-but also citizens who are not ill-the possibility to volunteer as participants to hasten research processes. The French platform "Seintinelles" aims to fulfill this goal and bring together citizens who volunteered to participate to cancer related research. The "Seintinelles Barometer" aims to describe these volunteers' profile. METHODS: The Seintinelles Barometer data were collected through a web-based auto-questionnaire proposed to the "Seintinelles" members from June 2017 to November 2018. RESULTS: The sample presents a high level of overrepresentation of women. Participants are characterized by a high level of education. About a third of the participants had suffered from cancer. Two profile of volunteers emerged: the « patients ¼ and the « supportive citizens ¼. DISCUSSION: The Seintinelles Barometer participants manifest a strong wish to be involved in cancer related research. Therefore, this platform seems to be a promising tool for the development of community-based research in the field of cancer.


Asunto(s)
Escolaridad , Neoplasias , Desarrollo de Programa , Sujetos de Investigación , Adulto , Factores de Edad , Salud de la Familia , Femenino , Francia , Voluntarios Sanos/educación , Voluntarios Sanos/psicología , Voluntarios Sanos/estadística & datos numéricos , Humanos , Masculino , Estado Civil/estadística & datos numéricos , Persona de Mediana Edad , Motivación , Neoplasias/epidemiología , Ocupaciones/estadística & datos numéricos , Selección de Paciente , Densidad de Población , Sujetos de Investigación/educación , Sujetos de Investigación/psicología , Sujetos de Investigación/estadística & datos numéricos , Factores Sexuales , Encuestas y Cuestionarios
13.
Environ Sci Technol ; 54(5): 2565-2574, 2020 03 03.
Artículo en Inglés | MEDLINE | ID: mdl-32022554

RESUMEN

We developed a method to better estimate the carbon stocks of in-use harvested wood products (HWP) by using the Eora multiregional input-output tables to link global HWP production and end uses, compared to existing global-scale studies that focused on semifinished HWP. Using the new method, we allocated global HWP to country-specific end uses, including solid HWP used in (1) construction, (2) furniture production, and (3) other end uses, and as (4) household and sanitary paper and (5) other paper and paper products, while the HWP carbon stocks in these end uses were estimated using the Stock Change Approach. We reported that HWP produced globally contained an annual average of 277.7 teragram carbon in 1992-2015, of which 63.0, 12.6, 76.7, 9.1, and 116.3 teragram carbon were consumed by the above five end uses, respectively. By 2015, the carbon stocks of global in-use HWP produced since 1992 accumulated to 2938 teragrams of carbon, of which the above five HWP end uses accounted for 1489, 268, 890, 0, and 291 teragrams of carbon, respectively. Country-specific HWP production and consumption varied significantly, with the eight leading consuming countries (United States, China, Japan, Canada, Germany, Russia, United Kingdom, and France) accounting for 69% of the global in-use HWP carbon stocks.


Asunto(s)
Carbono , Madera , Canadá , China , Francia , Alemania , Japón , Federación de Rusia , Reino Unido
14.
Euro Surveill ; 25(6)2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32070465

RESUMEN

A novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) causing a cluster of respiratory infections (coronavirus disease 2019, COVID-19) in Wuhan, China, was identified on 7 January 2020. The epidemic quickly disseminated from Wuhan and as at 12 February 2020, 45,179 cases have been confirmed in 25 countries, including 1,116 deaths. Strengthened surveillance was implemented in France on 10 January 2020 in order to identify imported cases early and prevent secondary transmission. Three categories of risk exposure and follow-up procedure were defined for contacts. Three cases of COVID-19 were confirmed on 24 January, the first cases in Europe. Contact tracing was immediately initiated. Five contacts were evaluated as at low risk of exposure and 18 at moderate/high risk. As at 12 February 2020, two cases have been discharged and the third one remains symptomatic with a persistent cough, and no secondary transmission has been identified. Effective collaboration between all parties involved in the surveillance and response to emerging threats is required to detect imported cases early and to implement adequate control measures.


Asunto(s)
Trazado de Contacto , Infecciones por Coronavirus , Control de Infecciones , Neumonía Viral , Vigilancia de la Población , Adulto , Betacoronavirus/aislamiento & purificación , China/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Medición de Riesgo , Viaje
15.
Bull Cancer ; 107(2): 181-190, 2020 Feb.
Artículo en Francés | MEDLINE | ID: mdl-32005357

RESUMEN

The Paul Strauss Center day-care accompaniment department ("SSAJ") is an oncologic supportive day-care, also an alternative to conventional hospitalization. In order to follow the SSAJ department's activity, in the "ambulatory turnover" context, we compared the 2008 and 2016 four first months activity. In 2016, there was an average of 4.96 patients per day versus 5.62 in 2008 (P<0.001); average day incoming of 653€ per stay in 2016 versus 775€ in 2008 (P<0.001). In 2016, there was an average 63.9 % of imagery done versus 27.7 % in 2008 (P<0.001). The 2016 average patient following period was of 84.7 days versus 67.6 days in 2008 (P=0.019). Average time between first day-care visit and death was 161.7 days in 2016 versus 133.5 days in 2008 (P=0.0033). Average day activity is lower in 2016 than 2008, nonetheless number of total stays and inpatients has increased on the four months period. The SSAJ intervenes more precociously in 2016 than 2008. Hospital technical platform is better used, but average per-stay incoming has statistically lowered. The SSAJ limits and prepares complete hospitalizations. Inpatient close reevaluation after a "shorter-willing" stay, home issues anticipation and identification with the home-care team, and worsening prevention gives this activity all its meaning.


Asunto(s)
Instituciones Oncológicas/estadística & datos numéricos , Centros de Día/estadística & datos numéricos , Neoplasias/terapia , Anciano , Antineoplásicos/uso terapéutico , Centros de Día/economía , Diagnóstico por Imagen/estadística & datos numéricos , Francia , Humanos , Persona de Mediana Edad , Neoplasias/diagnóstico por imagen , Alta del Paciente/estadística & datos numéricos , Transferencia de Pacientes/estadística & datos numéricos
16.
Bull Cancer ; 107(2): 191-199, 2020 Feb.
Artículo en Francés | MEDLINE | ID: mdl-32035649

RESUMEN

INTRODUCTION: Cancer management is a public health issue in France. Its incidence is stabilizing even decreasing, but the prevalence increases. Public policies give at the general practitioner (GP) a central role in oncological care: it must be present at all stages of the disease, from screening to post-cancer. METHODS: One-year prospective monocentric study in a cancer institute. Distribution of a questionnaire to unplanned hospitalized patients and collection of socio-demographic and medical data in their files. RESULTS: Fifty-four percent of the study patients did not consult their GP for the health problem that motivated hospitalization. Sixty-nine percent of patients surveyed believe that GP is not the primary care physician for the management of complications and adverse effects of oncology treatments. A large majority of patients have metastatic cancer while only 40 % followed by the support care team. DISCUSSION: GP's are not yet integrated into the active management of cancer for study patients. The symptoms that GP's say they can easily manage are the most frequent reasons for hospitalization.


Asunto(s)
Actitud , Médicos Generales , Hospitalización/estadística & datos numéricos , Neoplasias/psicología , Grupo de Atención al Paciente , Anciano , Instituciones Oncológicas , Urgencias Médicas/epidemiología , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/terapia , Estudios Prospectivos , Evaluación de Síntomas
19.
Medicine (Baltimore) ; 99(3): e18726, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011450

RESUMEN

Immune-checkpoint inhibitor (ICI) efficacy in patients with non-small cell lung cancer (NSCLC) harboring molecular alterations remains poorly elucidated. This study was undertaken to determine ICI efficacy against epidermal growth-factor receptor (EGFR)/anaplastic lymphoma kinase (ALK)/c-ros oncogene 1 (ROS1)-mutated NSCLC patients in the real-world setting.In this retrospective, multicenter study on adults with ICI-treated EGFR-mutated or ALK- or ROS1-translated NSCLCs, we analyzed clinical characteristics and outcomes: ICI-treatment duration, and progression-free survival (PFS), objective response rate, duration of response, and overall survival (OS) from immunotherapy initiation.Fifty-one NSCLC patients (mean age, 58.0 years) were included from 20 French centers: 61% were never-smokers and 59% were women. Among them, 82% had EGFR-activating mutations, 16% ALK translocations, or 2% ROS1 translocations. Before ICI therapy, patients had received a median of 3 treatment lines (including tyrosine-kinase inhibitor). The median PFS was 2.1 (95% confidence interval [CI], 1.5-3.2) months for the entire cohort, 2.2 (95% CI, 1.4-3.2) for EGFR-mutated patients, and 2.4 (95% CI, 2.1-not reached) months for ALK-translocated patients. The median OS was 14.7 (95% CI, 12.1-19.2) months for the entire population and 13.9 (95% CI, 8.8-20.0) and 19.2 (95% CI, 13.1-not reached) months for EGFR-mutated and ALK-translocated patients, respectively. Seven (13.7%) patients were treated with ICI for >9 months. Toxicities were reported in 22% (11/51), including 8% (4/51) grade ≥3.In this real-world setting, analysis of ICI PFS against EGFR-mutated or ALK-translocated NSCLC patients appeared close to that observed in pretreated unselected NSCLC patients. The more promising OS probably linked to post-ICI treatments. Large prospective studies on these patient subsets are needed.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Neoplasias Pulmonares/tratamiento farmacológico , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Adenocarcinoma/enzimología , Adenocarcinoma/genética , Quinasa de Linfoma Anaplásico/genética , Receptores ErbB/genética , Femenino , Francia , Humanos , Neoplasias Pulmonares/enzimología , Neoplasias Pulmonares/genética , Masculino , Persona de Mediana Edad , Proteínas Tirosina Quinasas Receptoras/genética , Estudios Retrospectivos , Translocación Genética
20.
J Environ Manage ; 255: 109886, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32063323

RESUMEN

The Rhône River (France) has been used for energy production for decades and 21 dams have been built. To avoid problems due to sediment storage, dam flushing operations are periodically organized. The impacts of such operations on suspended particulate matter (SPM) dynamics (resuspension and fluxes) and quality (physico-chemical characteristics and contamination), were investigated during a flushing operation performed in June 2012 on 3 major dams from the Upper Rhône River. The concentrations of major hydrophobic organic contaminants (polychlorinated biphenyls, polycyclic aromatic hydrocarbons - PAHs, bis(2-ethylhexyl)phthalate [DEHP] and 4-n-nonylphenol), trace metal elements, particulate organic carbon (POC) and particle size distribution were measured on SPM samples collected during this event as well as on those obtained from 2011 to 2016 at a permanent monitoring station (150 km downstream). This allows to compare the SPM and contaminant concentrations and fluxes during the 2012 dam flushing operations with those during flood events and baseflow regime. At equal water discharge, mean SPM concentrations during flushing were on average 6-8 times higher than during flood events recorded from 2011 to 2016. While of short duration (19 days), the flushing operations led to the resuspension of SPM and contributed to a third of the mean annual SPM flux. The SPM contamination was generally lower during flushing than during baseflow or flood, probably due to the fact that flushing transports SPM only issued from resuspended sediment, with no autochtonous particles nor eroded soil. The only exception are PAHs and DEHP with higher concentrations during flushing, which must be issued from the resuspension of legacy-contaminated sediments stored behind the dams before the implementation of emission regulations. During flushing, the variations of POC and contaminant concentrations are also mostly driven by particle size. Finally, we propose a list of recommendations for the design of an adequate monitoring network to evaluate the impact of dam flushing operations on large river systems.


Asunto(s)
Hidrocarburos Policíclicos Aromáticos , Contaminantes Químicos del Agua , Monitoreo del Ambiente , Francia , Sedimentos Geológicos , Ríos
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