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Etude Des Motifs De Consultation Spontanee Aux Urgences De La Roche Sur Yon
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Book Synopsis Étude des motifs de consultation spontanée aux Urgences de La Roche-sur-Yon by : Alexandre Yver
Download or read book Étude des motifs de consultation spontanée 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.
Book Synopsis Quels sont les déterminants de consultations spontanées au service des urgences des patients adultes ayant dejà consulté un médecin généraliste pour le même motif ? by : Nathalie Beauné
Download or read book Quels sont les déterminants de consultations spontanées au service des urgences des patients adultes ayant dejà consulté un médecin généraliste pour le même motif ? written by Nathalie Beauné and published by . This book was released on 2016 with total page 214 pages. Available in PDF, EPUB and Kindle. Book excerpt: On constate une augmentation du nombre de passages dans les services d'urgence français, qui pour la plupart relèvent de la médecine générale. Certains patients ont toutefois déjà consulté un médecin généraliste auparavant. Quels sont les facteurs qui les incitent alors à venir consulter aux urgences ? S'agit-il d'un manque de confiance envers le médecin généraliste consulté ou d'une surestimation de la gravité dans ce contexte de pathologie bénigne ? Etude prospective dans le service des urgences du Centre Hospitalier Alpes Léman durant 4 mois à l'aide d'un questionnaire rempli par les patients. La population cible était des adultes venant de leur domicile, ayant déjà consulté un médecin généraliste pour le même motif et n'ayant pas été adressés par celui-ci. Sur les 202 patients inclus, 75 % consultaient pour un syndrome douloureux évoluant depuis une dizaine de jours en moyenne. Le profil-type de notre population était un patient d'âge intermédiaire (46 ans), vivant accompagné, actif, sans problème financier déclaré. Leur passage aux urgences était motivé, pour 62 % des cas par une aggravation des symptômes, pour 58 % par une inefficacité du traitement mis en place par le médecin traitant, pour 43 % par une demande d'examens complémentaires et pour 39 % par le besoin d'un nouvel avis médical. La gravité évaluée (CCMU) était inférieure ou égale à 2 dans 91 % des cas et la gravité ressentie par le patient à 5,5/10. L'impossibilité de reconsulter le médecin traitant n'intervenait que pour 27 % à cause de symptômes survenant en dehors des heures ouvrables et pour 24 % par l'indisponibilité du médecin traitant. La moyenne de confiance envers ce dernier était de 6,9/10 et n'intervenait pas dans le choix de consulter aux urgences. Conclusion : Les patients de l'étude consultent essentiellement pour un syndrome douloureux insuffisamment calmé ou s'aggravant. La gravité réelle, le manque de confiance ou l'indisponibilité du médecin n'interviennent pas dans leur choix contrairement à la gravité ressentie. Deux objectifs pour les médecins généralistes peuvent en découler : mieux prendre en charge les symptômes douloureux et s'astreindre à rassurer plus efficacement ces patients.
Book Synopsis Prison Journal, 1940-1945 by : Edouard Daladier
Download or read book Prison Journal, 1940-1945 written by Edouard Daladier and published by Routledge. This book was released on 2022-02-23 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: Even after fifty years, and in spite of the reams of documents now available,it remains difficult-especially in France-to form an objective view of what things were like in the period between the wars and in 1940.The greater, the swifter, the more unexpected the disaster, the less people are willing to deal with it squarely. Once a certain threshold of suffering,shame, and humiliation is reached, actual facts become unimportant,analyses become bothersome. History falls prey to myth and rumor.People refuse to hear any more, but they still need someone to blame. In France, the strangest of bedfellows have come to speak about it in one voice, and the good people have remained mute.
Author :John Henry Lorentz Publisher :Historical Dictionaries of Asia, Oceania, and the Middle East ISBN 13 : Total Pages :570 pages Book Rating :4.F/5 ( download)
Book Synopsis Historical Dictionary of Iran by : John Henry Lorentz
Download or read book Historical Dictionary of Iran written by John Henry Lorentz and published by Historical Dictionaries of Asia, Oceania, and the Middle East. This book was released on 2007 with total page 570 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides an overview of specific events, movements, people, political and social groups, places, trends, and chronology. Allows for considerable exploration of a number of historical and contemporary topics and issues. The modern period, defined as 1800-present, is covered extensively.
Book Synopsis Goa and Portugal by : Charles J. Borges
Download or read book Goa and Portugal written by Charles J. Borges and published by Concept Publishing Company. This book was released on 1997 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: Collection of twenty-one papers presented at an international symposium on the theme "cultural relations between Portugal and Goa" at the University of Cologne, 29 May-2 June 1996; chiefly covers the 16th-18th centuries.
Book Synopsis Old Babylonian Period (2003-1595 BC) by : Douglas Frayne
Download or read book Old Babylonian Period (2003-1595 BC) written by Douglas Frayne and published by University of Toronto Press. This book was released on 1990-01-01 with total page 904 pages. Available in PDF, EPUB and Kindle. Book excerpt: A short introduction for each inscription gives its general contents, place of origin, and relative dating. Also included are a detailed catalogue of exemplars, a brief commentary, bibliography, and text in transliteration facing an English translation.
Book Synopsis Babylonian Creation Myths by : Wilfred G. Lambert
Download or read book Babylonian Creation Myths written by Wilfred G. Lambert and published by Penn State Press. This book was released on 2013-09-26 with total page 657 pages. Available in PDF, EPUB and Kindle. Book excerpt: For much of the last half of the twentieth century, W. G. Lambert devoted much of his research energy and effort to the study of Babylonian texts dealing with Mesopotamian ideas regarding creation, including especially Enuma Elish. This volume, which appears almost exactly 2 years after Lambert’s death, distills a lifetime of learning by the world’s foremost expert on these texts. Lambert provides a full transliteration and translation of the 7 tablets of Enuma Elish, based on the known exemplars, as well as coverage of a number of other texts that bear on, or are thought to bear on, Mesopotamian notions of the origin of the world, mankind, and the gods. New editions of seventeen additional “creation tales” are provided, including “Enmesharra’s Defeat,” “Enki and Ninmah,” “The Slaying of Labbu,” and “The Theogony of Dunnu.” Lambert pays special attention, of course, to the connection of the main epic, Enuma Elish, with the rise and place of Marduk in the Babylonian pantheon. He traces the development of this deity’s origin and rise to prominence and elaborates the relationship of this text, and the others discussed, to the religious and political climate Babylonia. The volume includes 70 plates (primarily hand-copies of the various exemplars of Enuma Elish) and extensive indexes.
Book Synopsis Mesopotamian Protective Spirits by : F. A. M. Wiggermann
Download or read book Mesopotamian Protective Spirits written by F. A. M. Wiggermann and published by BRILL. This book was released on 1992 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Wiggerman's study of Mesopotamian monsters bridges the gap between text and image. Wooden and clay figures of monstrous spirits such as Hairy-One (lahmu), Bison-Bull (kusarikku), and Furious-Snake (mushussu) stand guard at the entrances to buildings to protect the inhavitants from demonic intruders. Deriving his information from the ritual texts that describe the production and installation of these figures, the author identifies the monsters of the texts with objects from the archaeological record and presents a detailed discussion of the identities and histories of a variety of Mesopotamian monsters.
Book Synopsis Born in Heaven, Made on Earth by : Michael Brennan Dick
Download or read book Born in Heaven, Made on Earth written by Michael Brennan Dick and published by Eisenbrauns. This book was released on 1999 with total page 258 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pejoratively referred to as "idols" in the Hebrew Bible and in western tradition, the cult image occupied a central place in the cultures of the ancient Near East. In Mesopotamia, a ritual (mis pi) was used to "give birth" to the god represented by the cult image. In this volume, three separate essays examine the topic within different ancient Near Eastern cultures, and a fourth provides a modern analogy as counterpoint.
Book Synopsis Historical Dictionary of Pakistan by : Shahid Javed Burki
Download or read book Historical Dictionary of Pakistan written by Shahid Javed Burki and published by . This book was released on 1999 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pakistan is unlike most other countries in the emerging world. It is one of the two nations – the other being the state of Israel – founded on the basis of religion. Although it was created to provide a homeland for the Muslim community of British India, in its original form it was able to accommodate only about half of the people of Islamic faith who lived in the subcontinent. Pakistan’s birth in 1947 resulted in one of the largest movements of people in human history when some 14 million people left their homes, with 8 million Muslims leaving India for what is now Pakistan and 6 million Hindus and Sikhs moving in the opposite direction. This was the first large-scale incidence of ethnic cleansing the world was to witness. --
Book Synopsis Before the Muses by : Benjamin Read Foster
Download or read book Before the Muses written by Benjamin Read Foster and published by Eisenbrauns. This book was released on 2005 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Comprehensive collection of ancient Akkadian literature spanning three millennia. This larger, completely new, 3rd edition contains many compositions not in the previous editions; new translations of previously included compositions; incorporation of new text fragments identified or excavated since the last publication; all new footnotes; references and commentary brought up to date to reflect scholarly work of the last 10 years; and 100 more pages than the old two-volume edition.
Author :Great Britain. Department of Health Publisher :The Stationery Office ISBN 13 :9780101626828 Total Pages :94 pages Book Rating :4.6/5 (268 download)
Book Synopsis The NHS Improvement Plan by : Great Britain. Department of Health
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.
Book Synopsis The Canonical Lamentations of Ancient Mesopotamia by : Mark E. Cohen
Download or read book The Canonical Lamentations of Ancient Mesopotamia written by Mark E. Cohen and published by . This book was released on 1988 with total page 843 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Babylonian Gilgamesh Epic by : A. R. George
Download or read book The Babylonian Gilgamesh Epic written by A. R. George and published by . This book was released on 2003 with total page 412 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Babylonian Gilgamesh epic is the oldest long poem in the world, with a history going back four thousand years. It tells the fascinating and moving story of Gilgamesh's heroic deeds and lonely quest for immortality. This book collects for the first time all the known sources in the original cuneiform, including many fragments never published before. The author's personal study of every available fragment has produced a definitive edition and translation, complete with comprehensive introductory chapters that place the poem and its hero in context."--Publisher's description.
Book Synopsis The Ladybird Illustrated by : D H Lawrence
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."
Book Synopsis Cambridge Yearbook of European Legal Studies, Vol 13, 2010-2011 by : Catherine Barnard
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.
Book Synopsis Notes on the Minor Prophets by : Henry Allan Ironside
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:
