1000 resultados para Modèles de prise de décision collective
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Référence bibliographique : Weigert, 460
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With an incidence of 1/6000 pregnancies, per-partum lymphoma is a rare but not an exceptional event, which gynaecologists and family physicians can be confronted in the course of their career The diagnosis, without a peripheral adenopathy, can be challenging because symptoms, such as fatigue or dyspnoea, can easily be attributed to the pregnancy. Although the therapeutic management is complex, because it involves the mother and her embryos, it can be optimal in the majority of cases. The multidisciplinary management, with modern diagnostic and therapeutic approaches, greatly improved the prognosis of these young women. Today, it generally allows the safekeeping of the baby with an outcome for the mother identical to the one observed in the population at large.
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Considerable progress was realized these last years in the understanding of the molecular mechanisms and the treatment of the GIST. Their diagnosis remains based on the morphology and immunohistochemistry. The evaluation of GIST prognosis was till know difficult to establish but a new histopronostic classification currently used allows a better therapeutic approach. The search for KIT and PDGFRA mutations is recommended to adapt a targeted therapy by KIT inhibitors. The pathologist plays a crucial role in the management of the GIST because it is on him that is based the diagnosis, the evaluation of the prognosis and the treatment (surgery and kit inhibitors).
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[Vente. Art. 1859-12-24. Paris]
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Cet article présente les résultats de la revue systématique: Mahtani KR, Heneghan CJ, Glasziou PP, Perera R. Reminder packaging for improving adherence to self-administered long-term medications.Cochrane Database Syst Rev. 2011 Sep 7;(9):CD005025. PMID 21901694
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In the past three decades, feminists and critical theorists have discussed and argued the importance of deconstructing and problematizing social science research methodology in order to question normalized hierarchies concerning the production of knowledge and the status of truth claims. Nevertheless, often, these ideas have basically remained theoretical propositions not embodied in research practices. In fact there is very little published discussion about the difficulties and limits of their practical application. In this paper we introduce some interconnected reflections starting from two different but related experiences of embodying 'feminist activist research'. Our aim is to emphasise the importance of attending to process, making mistakes and learning during fieldwork, as well as experimenting with personalized forms of analysis, such as the construction of narratives and the story-telling process.
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Résumé : Introduction : l'ostéoporose est une maladie fréquente, invalidante, sous-diagnostiquée et sous-traitée, alors qu'il existe des évidences cliniques, densitométriques et biologiques de l'efficacité de la prévention secondaire. Matériel et méthode : dans cette étude, nous décrivons les habitudes de prescription de traitements en prévention secondaire dans les 6 mois qui suivent une fracture de fragilité et définissons les catégories de femmes recevant ou non un traitement, selon le type de fractures, les antécédents fracturaires et les données socio-démographiques. Il s'agit d'une étude suisse de cohorte, prospective de 7609 femmes de 70 ans et plus, suivies de 1998 à 2000. Deux groupes de patientes ont été analysés : celles avec un événement fracturaire durant le suivi (3 sous-groupes de fractures ont été considérés fractures vertébrales, fractures du radius distal et fractures de l'humérus proximal) et celles sans fractures durant le suivi (groupe contrôle). La détermination des événements fracturaires et l'instauration d'un traitement s'est faite par l'envoi aux patientes et à leurs médecins traitants d'un questionnaire structuré. Dans cette étude, le but primaire est de décrire les attitudes médicales de prévention secondaire, le but secondaire d'analyser les motifs dé décision thérapeutique (type de fracture, antécédents de fractures), alors que le but tertiaire cherche à caractériser les femmes non traitées. Résultats, discussion : 7354 femmes ont été incluses dans cette étude, 183 dans le groupe fracture et 7171 dans le groupe contrôle. Le suivi moyen a été de 21 mois. L'introduction d'un traitement est restée rare dans chaque catégorie de fracture et a été plus importante pour le sous-groupe avec fracture vertébrale (p<0.001). La seule donnée associée à l'adjonction d'un traitement a été la présence d'un antécédent anamnestique de fracture vertébrale. La description des attitudes thérapeutiques après une fracture de fragilité, a montré que. 44 % des femmes ne reçoivent aucun traitement en prévention secondaire. Seule la fracture vertébrale et les antécédents de fracture vertébrale entraînent une modification de l'attitude thérapeutique des médecins traitants mais de façon encore insuffisante puisque plus de 50 % des femmes avec une fracture de vertèbre n'ont aucun changement dans leur prise en charge. Les femmes non traitées ne différaient pas des autres sur un plan socio-démographique. Le nombre de patientes dans chaque sous-groupe est relativement faible ce qui limite !a puissance statistique de l'analyse. Les données consistent essentiellement en du « selfreporting » ce qui peut limiter la signification de celles-ci. Les résultats sont cependant suffisamment inquiétants pour que de nouvelles campagnes d'information soient lancées auprès des médecins de .premiers recours quant à la nécessité d'instaurer un traitement efficace lors de la survenue d'une fracture clinique ou radiologique chez une femme en post-ménopause.
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In the past three decades, feminists and critical theorists have discussed and argued the importance of deconstructing and problematizing social science research methodology in order to question normalized hierarchies concerning the production of knowledge and the status of truth claims. Nevertheless, often, these ideas have basically remained theoretical propositions not embodied in research practices. In fact there is very little published discussion about the difficulties and limits of their practical application. In this paper we introduce some interconnected reflections starting from two different but related experiences of embodying 'feminist activist research'. Our aim is to emphasise the importance of attending to process, making mistakes and learning during fieldwork, as well as experimenting with personalized forms of analysis, such as the construction of narratives and the story-telling process.
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Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors worldwide and its incidence has increased over the last years in most developed countries. The majority of HCCs occur in the context of liver cirrhosis. Therefore, patients with cirrhosis and those with hepatitis B virus infection should enter a surveillance program. Detection of a focal liver lesion by ultrasound should be followed by further investigations to confirm the diagnosis and to permit staging. A number of curative and palliative treatment options are available today. The choice of treatment will depend on the tumor stage, liver function and the presence of portal hypertension as well as the general condition of the patient. A multidisciplinary approach is mandatory to offer to each patient the best treatment.
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This article studies alterations in the values, attitudes, and behaviors that emerged among U.S. citizens as a consequence of, and as a response to, the attacks of September 11, 2001. The study briefly examines the immediate reaction to the attack, before focusing on the collective reactions that characterized the behavior of the majority of the population between the events of 9/11 and the response to it in the form of intervention in Afghanistan. In studying this period an eight-phase sequential model (Botcharova, 2001) is used, where the initial phases center on the nation as the ingroup and the latter focus on the enemy who carried out the attack as the outgroup. The study is conducted from a psychosocial perspective and uses "social identity theory" (Tajfel & Turner, 1979, 1986) as the basic framework for interpreting and accounting for the collective reactions recorded. The main purpose of this paper is to show that the interpretation of these collective reactions is consistent with the postulates of social identity theory. The application of this theory provides a different and specific analysis of events. The study is based on data obtained from a variety of rigorous academic studies and opinion polls conducted in relation to the events of 9/11. In line with social identity theory, 9/11 had a marked impact on the importance attached by the majority of U.S. citizens to their identity as members of a nation. This in turn accentuated group differentiation and activated ingroup favoritism and outgroup discrimination (Tajfel & Turner, 1979, 1986). Ingroup favoritism strengthened group cohesion, feelings of solidarity, and identification with the most emblematic values of the U.S. nation, while outgroup discrimination induced U.S. citizens to conceive the enemy (al-Qaeda and its protectors) as the incarnation of evil, depersonalizing the group and venting their anger on it, and to give their backing to a military response, the eventual intervention in Afghanistan. Finally, and also in line with the postulates of social identity theory, as an alternative to the virtual bipolarization of the conflict (U.S. vs al-Qaeda), the activation of a higher level of identity in the ingroup is proposed, a group that includes the United States and the largest possible number of countries¿ including Islamic states¿in the search for a common, more legitimate and effective solution.