Le Groupe Prévention et Traitement des Plaies des Hospices-CHUV [The Hospices-CHUV's Wound Prevention and Treatment Group]

The treatment of wounds is a challenge that caregivers of all specialities encounter daily in the care of an ageing population and chronically ill patients. An interdisciplinary group has been created in recent years within the Hospices-CHUV to assist caregivers in their care of patients with wounds. This group has developed a variety of tools to assist decision-making and offers a range of continuing education for those employees involved in wound care. The authors describe the approach of the group and the documents produced during the first two years of experience.

Schistosomiasis epidemiology and control: how did we get here and where should we go?

Although a disease of great antiquity, scientific studies of schistosomiasis began only 150 years ago. The complete life-cycle was not described until just before the First World War, making it possible at last to plan proper community control programmes. Inadequate tools prevented their effective implementation until well after the Second World War when new tools became available, thanks to the newly formed World Health Organization. Molluscicides spearheaded control programmes until the late 1970s but were then replaced by the newly developed, safe drugs still used today. Whatever the method used, the initial goal of eradication was, in the light of experience and cost, gradually replaced by less ambitious targets; first to stop transmission and then to reduce morbidity. The most successful programmes combined several methods to minimise reinfection after chemotherapy. Comparisons between different programmes are difficult without using appropriate, standardised diagnostic techniques and the correct epidemiological measurements. Some examples will be presented, mainly from our studies on Schistosoma mansoni in Kenya. Drug resistance on a scale comparable with malaria has not occurred in schistosomiasis but the likely withdrawal of all drugs except praziquantel leaves its control extremely vulnerable to this potential problem. An effective, affordable vaccine for use in endemic countries is unlikely to be ready for at least 5 years, and developing strategies for its use could take a further decade or more, judging from experience with drugs and molluscicides. In the interim, by analogy with malaria, the most cost-effective approach would the use of drugs combined with other methods to stop transmission, including molluscicides. The cost of molluscicides needs to be reduced and fears allayed about their supposedly adverse ecological effects.

What Works in Health Promotion for Older People

The primary purpose of the Cross-Border conference was the pooling of experience and expertise in relation to health promotion initiatives currently being implemented in Northern Ireland and in the Republic. The main focus of the conference was the identification of effective health promotion strategies and projects designed to achieve health gain and social gain for older people in both parts of the island Download the Report here

Good Practice Guides

This series of Good Practice Guides is designed to share important information about health inequalities and some of the evidence-based measures that can be taken to reduce the stark differences in health and wellbeing within populations. It is recognised that leadership and coordinated, effective action at a number of levels can reduce this gap. Ensuring concerted, evidence-based action on health and wellbeing inequalities demands the efforts of government, statutory organisations and the community, voluntary and private sectors. The Good Practice Guides were developed to inform and support joined-up working across these sectors. It is known that health inequalities are closely linked with degrees of social disadvantage and with the unequal distribution of power, income, goods and services. According to the World Health Organization, there are also powerful social and psychological factors and life circumstances that can serve to compound health and wellbeing inequalities. The topics included in the Good Practice Guide series reflect the wider determinants of health and the range of approaches necessary to reduce health inequalities. This first set of three guides is designed, in part, to test their usefulness. There are many other issues and areas where evidence of what works may be needed. It is envisaged that further guides will follow on other issues. All of the guides will be kept under review and amended in light of experience.

Video Gaming in Children Improves Performance on a Virtual Reality Trainer but Does Not yet Make a Laparoscopic Surgeon.

Background: In children, video game experience improves spatial performance, a predictor of surgical performance. This study aims at comparing laparoscopic virtual reality (VR) task performance of children with different levels of experience in video games and residents. Participants and methods: A total of 32 children (8.4 to 12.1 years), 20 residents, and 14 board-certified surgeons (total n = 66) performed several VR and 2 conventional tasks (cube/spatial and pegboard/fine motor). Performance between the groups was compared (primary outcome). VR performance was correlated with conventional task performance (secondary outcome). Results: Lowest VR performance was found in children with low video game experience, followed by those with high video game experience, residents, and board-certified surgeons. VR performance correlated well with the spatial test and moderately with the fine motor test. Conclusions: The use of computer games can be considered not only as pure entertainment but may also contribute to the development of skills relevant for adequate performance in VR laparoscopic tasks. Spatial skills are relevant for VR laparoscopic task performance.

Conocimientos de la Enfermedad de Chagas por parte de los profesionales sanitarios de tres hospitales en la provincia de Almería

Background: Health professionals who care for patients with imported diseases often lack enough training. The aim of the study is to assess the knowledge of Chagas disease among doctors and nurses attending at-risk pregnant women in our province. Method: descriptive study through a performed anonymous and voluntary knowledge questionnaire for 278 physicians and nurses working at maternity and children's health services in the three hospitals in the province. In Poniente Hospital was established in 2007 a program of screening for the disease in pregnant women. For statistical analysis, quantitative variables were described using the mean and standard deviation. For comparison of qualitative variables we used the chi-square test or Fisher exact test as appropriate. Differences in age and years of experience depending on the hospital were measured by Brown-Forsythe robust test. Results: 116 (41.7%) professionals agreed to participate in the study. 80 (69%) were women and 36 (31%)men,mean age 36.78 years. By professional categories, physicians have a mean of 73.9% correct responses, the nurses 50.7%. Poniente Hospital had the highest percentage of correct answers on aspects of the geographical distribution of the disease (73.7%), the mechanisms of transmission (86%) and diagnosis (82.5%). Conclusions: The Poniente Hospital professionals generally have a better Knowledge about Chagas disease compared with two other professionals hospitals, which probably is related to the existence of the screening program for the disease.

Análise de Reantabilidade através da Margem de Contribuição

Este trabalho versa sobre a análise de rentabilidade através da margem de contribuição e tem por objectivo evidenciar como a margem de contribuição pode ser utilizada pelos gestores, na rentabilidade dos clientes, dos produtos, dos canais de distribuição e dos segmentos de mercado em que as empresas operam. O estudo está assente num referencial teórico que faz incursões nos principais conceitos conexos ao tema principal nomeadamente: análise custo – volume – resultado, métodos apuramento dos resultados na óptica da absorção e da contribuição, e a curva ABC. Na aplicação prática, procurámos utilizar alguns instrumentos de gestão nomeadamente o ponto de equilíbrio, apuramento dos resultados por segmentos de clientes, negócios e territórios de comercialização e a aplicação da curva de experiência ABC. O caso de estudo incide sobre a empresa nacional de moagem (Moave S.A) e restringe-se ao plano de produção e embalagem através do pequeno ensaque. O processo de colecta de dados foi obtido directamente das informações fornecidas pela Direcção da empresa, nomeadamente os produtos a serem embalados, a estrutura de custos, o plano de produção, a capacidade máxima da máquina e o calendário de trabalho diário e mensal. Os resultados evidenciaram que a utilização da margem de contribuição como ferramenta de gestão, constitui um importante instrumento de análise e avaliação da rentabilidade dos produtos, dos clientes, dos canais de distribuição bem como dos territórios de comercialização. This work focuses on the analysis of profitability through contribution margin and aims to highlight the contribution margin can be used by managers, in the profitability of customers, products, distribution channels and market segments in which companies operate. The study is based on the referential theoretical that makes inroads in key concepts related to the main topic, namely: cost analysis – volume – result, methods of clearance results in optical absorption and contribution, and ABC. In practice, we try to use some management tools in the balance, such as breakeven point, clearance of results by segments of customers, business and marketing territories and the application of experience curve ABC. The case study focuses on the national milling company (Moave s.a), and restricts itself to plan production and packaging through small bagging. The process of collecting data was obtained directly from the information provided by the management of the undertaking, in particular the products to be packed, the cost structure, the production plan, the maximum capacity of the machine and the daily work schedule and monthly. The results showed that the use of the contribution margin as a management tool constitutes an important instrument of analysis and assessment of the profitability of products, customers, distribution channels and marketing territories.

Some last thoughts on compositional data analysis

One of the disadvantages of old age is that there is more past than future: this,however, may be turned into an advantage if the wealth of experience and, hopefully,wisdom gained in the past can be reflected upon and throw some light on possiblefuture trends. To an extent, then, this talk is necessarily personal, certainly nostalgic,but also self critical and inquisitive about our understanding of the discipline ofstatistics. A number of almost philosophical themes will run through the talk: searchfor appropriate modelling in relation to the real problem envisaged, emphasis onsensible balances between simplicity and complexity, the relative roles of theory andpractice, the nature of communication of inferential ideas to the statistical layman, theinter-related roles of teaching, consultation and research. A list of keywords might be:identification of sample space and its mathematical structure, choices betweentransform and stay, the role of parametric modelling, the role of a sample spacemetric, the underused hypothesis lattice, the nature of compositional change,particularly in relation to the modelling of processes. While the main theme will berelevance to compositional data analysis we shall point to substantial implications forgeneral multivariate analysis arising from experience of the development ofcompositional data analysis…

Alfabetização de crianças caboverdianas em língua portuguesa como língua não materna : o ensino da leitura

abstract: Cape Verde is a country of bilingual characteristics, where coexist two languages: the mother tongue – the Creole of Cape Verde (CCV) or the Capeverdian Language (LCV) and the Non Maternal language – the Portuguese that is the official language and, therefore, the language used in the process of education and learning. This situation generates conflicts so much to linguistic level as to cultural level. The two languages presents some lexical resemblances, what drives, many times, to misconceptions and linguistics errors that complicate children in the learning, in particular, of reading that constitute the base for the learning of others knowledge. The learning of reading, in the Non Maternal language, requires a development of the oral language in Portuguese Language, which stimulates the reasoning of the child through playful exercises and cognitivists and construtivists approaches. In this way, the competences of phonological processing in the acquisition of the competences of reading are important for the discrimination of written text and favor the learning and the development of reading. The child, through the discovery, begins to elaborate concepts in the way to obtain a relation with the written language, by functional form. Adopting a methodology of case study and through questionnaires, direct observation and collect of documentary information, this dissertation presents and analyzes connected aspects to the literacy of capeverdian children in the beginning of the schooling and to the learning of reading as basic support for the learning of Non Maternal language. The subsidies collected by the study, presented in this dissertation will contribute for the education progress of reading and, also, for implement successfully the learning of reading of the students, developing to practical of reading and the expectations in uncover the multiplicity of the dimensions of experience in that domain and contribute for a relative comprehension of written and reading modes.

Alfabetização de crianças caboverdianas em língua portuguesa como língua não materna : o ensino da leitura

abstract: Cape Verde is a country of bilingual characteristics, where coexist two languages: the mother tongue – the Creole of Cape Verde (CCV) or the Capeverdian Language (LCV) and the Non Maternal language – the Portuguese that is the official language and, therefore, the language used in the process of education and learning. This situation generates conflicts so much to linguistic level as to cultural level. The two languages presents some lexical resemblances, what drives, many times, to misconceptions and linguistics errors that complicate children in the learning, in particular, of reading that constitute the base for the learning of others knowledge. The learning of reading, in the Non Maternal language, requires a development of the oral language in Portuguese Language, which stimulates the reasoning of the child through playful exercises and cognitivists and construtivists approaches. In this way, the competences of phonological processing in the acquisition of the competences of reading are important for the discrimination of written text and favor the learning and the development of reading. The child, through the discovery, begins to elaborate concepts in the way to obtain a relation with the written language, by functional form. Adopting a methodology of case study and through questionnaires, direct observation and collect of documentary information, this dissertation presents and analyzes connected aspects to the literacy of capeverdian children in the beginning of the schooling and to the learning of reading as basic support for the learning of Non Maternal language. The subsidies collected by the study, presented in this dissertation will contribute for the education progress of reading and, also, for implement successfully the learning of reading of the students, developing to practical of reading and the expectations in uncover the multiplicity of the dimensions of experience in that domain and contribute for a relative comprehension of written and reading modes.

Attitudes towards morphine use among Swiss nurses and physicians

Background: There is little information regarding risk perception and attitudes on morphine use in Switzerland. Objectives: We aimed at assessing such attitudes in a sample of health professionals in the French-speaking part of Switzerland. Study design: Cross-sectional study. Setting: five non-university hospitals of the French-speaking canton of Valais, Switzerland. Methods: 431 nurses and 40 physicians (age range: 20-63). Risk perception and attitudes towards morphine use were assessed using a validated questionnaire. Results: Over half of participants showed a negative attitude regarding most adverse events related to morphine, while less than one third showed a similar attitude regarding other statements. On bivariate analyses, participants working in geriatrics showed a more negative attitude towards use of morphine than participants working in medicine and surgery. Non-Swiss participants also showed a more negative attitude than Swiss regarding use of morphine. Conversely, no differences were found between genders, profession (nurses or physicians), years of experience (<=14 and >14) and religion (catholic vs. others/no religion). These findings were further confirmed by multivariate adjustment. Limitations: possible selection bias due to responders only. Results limited to French speaking participants. Conclusion: Attitudes regarding morphine uses are mainly driven by its potential adverse effects and vary according to specialty and nationality. Educational measures directed at health professionals working in geriatrics or coming from abroad might reduce the high morphinophobia levels observed in these groups.

Slip-Form Paving as Developed and Pioneered in Iowa,1961.

Summarizes Iowa's 14 years of experience in pioneering and developing slip-form paving methods

Monitoring inflammatory bowel disease activity: clinical activity is judged to be more relevant than endoscopic severity or biomarkers.

BACKGROUND: There is increasing evidence for the clinical relevance of mucosal healing (MH) as therapeutic treatment goal in inflammatory bowel disease (IBD). We aimed to investigate by which method gastroenterologists monitor IBD activity in daily practice. METHODS: A questionnaire was sent to all board-certified gastroenterologists in Switzerland to specifically address their strategy to monitor IBD between May 2009 and April 2010. RESULTS: The response rate was 57% (153/270). Fifty-two percent of gastroenterologists worked in private practice and 48% worked in hospitals. Seventy-eight percent judged clinical activity to be the most relevant criterion for monitoring IBD activity, 15% chose endoscopic severity, and 7% chose biomarkers. Seventy percent of gastroenterologists based their therapeutic decisions on clinical activity, 24% on endoscopic severity, and 6% on biomarkers. The following biomarkers were used for IBD activity monitoring: CRP, 94%; differential blood count, 78%; fecal calprotectin (FC), 74%; iron status, 63%; blood sedimentation rate, 3%; protein electrophoresis, 0.7%; fecal neutrophils, 0.7%; and vitamin B12, 0.7%. Gastroenterologists in hospitals and those with ≤ 10 years of professional experience used FC more frequently compared with colleagues in private practice (P=0.035) and those with > 10 years of experience (P<0.001). CONCLUSIONS: Clinical activity is judged to be more relevant for monitoring IBD activity and guiding therapeutic decisions than endoscopic severity and biomarkers. As such, the accumulating scientific evidence on the clinical impact of mucosal healing does not yet seem to influence the management of IBD in daily gastroenterologic practice.

Alteritzar la singularitat: veus per a una pedagogia de l'experiència

Parte de la investigación en torno a la realidad educativa que se ha desarrollado durante los últimos años se caracteriza por intentar encontrar formas de interpretación orientadas a significar los procesos formativos centrados en las vivencias singulares de los agentes que participan de la educación así como en la posibilidad que éstas ofrecen de devenir experiencia, eso es,vivencia concienciada. A raíz de las mismas podemos observar como la biografía apunta a ser una de las más emblemáticas formalizaciones del proceso de narración de vivencias. Pero, aún cuando la misma se perfila como una de las narraciones que más promueven la interpretación e intercambio de vivencias, posibilitando la reflexión e, incluso, formación mediada, la biografía todavía presenta como forma teorética algunos escollos. Los cuales, pueden ser utilizados como preguntas base para formular una voz de las pedagogías de la experiencia. Justamente, interrogarse y repensar su factibilidad es el tema que se ensaya en el presente artículo.

Stand Out In A Crowd! Merchandising Your Job Talents,

You want a job. And you believe that somewhere, some employer has precisely the job you want - one that fully utilizes your knowledge and abilities and provides challenge and opportunities for advancement. To find that job, you need to perform a well-planned job search. You have a product to sell - your knowledge, skills and experience . . . YOURSELF! What you need to know is how to market yourself most effectively. Whether you are just out of school and ready to start your career or looking for a new position after 20 years of experience, some of the techniques presented in this booklet may help you. NOTE: ENGLISH