Analyse économique du traitement de l'ostéoporose post-ménopausique par hormonothérapie substitutive chez la femme

[Table des matières] 1.1. Présente étude. 1.2. Littérature relative aux études économiques d'une hormonothérapie de substitution (HTS). 1.3. Etat des connaissances relatives aux effets cliniques d'une HTS. 2. Méthode. 2.1. Représentation de l'arbre de décision. 2.2. Réalisation du modèle. 3. Matériel. 3. 1. Incidences des événements considérés : fractures du fémur proximal, cancers du sein et de l'endomètre, infarctus du myocarde. 3.2. Survie/mortalité suite aux événements considérés : fractures de la hanche, cancers du sein, cancers de l'endomètre, infarctus du myocarde, autres. 3.3. Valeurs des risques relatifs des événements considérés lors de l'application d'une HTS : fracture du fémur proximal, cancer du sein et de l'endomètre, accident cardiovasculaire. 3.4. Observance à une HTS. 3.5. Prévalence des hystérectomies à 50 ans. 3.6. Coûts : programme de prévention, HTS, du suivi, liés à l'hospitalisation primaire pour infarctus du myocarde et cancer du sein. 3.7. Hypothèses de base. 4. Résultats. 4.1. Sous les hypothèses de base : nombre et pourcentage d'événements prévenus et induits par rapport à une situation sans HTS, coûts de l'HTS et de la surveillance médicale, coûts nets des événements, coûts totaux, coûts par fracture de la hanche évitée. 4.2. Analyse de sensibilité : taux d'escompte, HTS et surveillance médicale, taux d'incidence et de survie, modulation de l'efficacité du traitement hormonal sur la prévention des infarctus du myocarde, induction plus élevée de cas de cancers du sein, observance, traitement sélectif de la population à risque de fractures. 5. Importance de l'étude considérée

Maîtrise de la qualité dans les hôpitaux universitaires: satisfaction des patients

[Table des matières] Introduction et présentation des projets / B. Burnand, JP. Vader, F. Paccaud. - La satisfaction du patient hospitalisé : un petit guide / M. Lorenzini, Y. Eggli. - "Satisfaction du patient hospitalisé": enquête exploratoire par entretien / M. Lorenzini. - Patientenzufriedenheit, Studie Kardiologie Bern/Basel: Schlussbericht / M. Langenegger. - Notfallstation und Spitalaufenthalt aus der Sicht des Patienten : eine kundenorientierte, repräsentative Erhebung / W. Langewitz, H. Weber, M. Zierath. - Satisfaction des patients hospitalisés pour cardiopathie ischémique aiguë / B. Burnand, K. Dupriez, T. Pernegger, MD. Schaller, JM. Gaspoz. - Commentaires et recommandations / B. Burnand, JP. Vader, F. Paccaud. Annexes: Questionnaire "Appréciation critique de votre séjour hospitalier". - Questionnaire de satisfaction du Service des hospices cantonaux "Votre séjour à l'hôpital - votre point de vue"; etc

Participatory Evaluation of Integrated Pest and Soil Fertility Management Options Using Ordered Categorical Data Analysis

During participatory rural appraisals, farmers at the Lake Victoria basin of Kenya and Uganda identified Striga, stemborer and declining soil fertility as three major constraints to maize production To reduce food insecurity, several innovative integrated technologies to address these constraints have been developed, including push-pull (maize intercropped with Desmodium and surrounded by napier grass), maize-soybean and maize-crotalaria rotations, and Imazapyrresistant (IR) maize seed coated with the herbicide. To let farmers evaluate the new technologies, 12 demonstration trials, comparing the different technologies, were established in four villages in Siaya and Vihiga districts (Western Kenya) and two villages in Busia (Uganda). These evaluations, where farmers' appreciation and feedback on the technology are captured, are an important step in technology development. During field days at the end of short rainy seasons of 2003 and 2004, 504 farmers individually observed and rated each treatment under the different cropping systems, with and without IR maize, and with and without fertilizer, with a maize continuous monocrop as control. Farmers scored each of the 16 treatments on an ordered scale of five categories: very poor, poor, average, good, and very good. The treatments were scored for each of the criteria farmers has previously determined (including yield, resistance to Striga and stemborer, and improvement of soil fertility). Analysis of the evaluation, using ordinal regression, show significant differences in farmers' preference by year and site. There was, however, little effect of farm and farmer characteristics such as farm size and gender of the observer. Ordinal regression of farmers' scores are not as intuitive and also bit cumbersome to use, but they have a better theoretical foundation than other methods, in particular the use of means. This paper shows how the method can be used, and concludes that, with some effort, it is a convenient way to analyse farmers' ranking of a large number of options.farmers' preference, technologies, ordinal regression, Crop Production/Industries,

Effect of Cooperative Learning Approach on Students’ Academic Achievement in English in Co-Educational Public Secondary Schools, Nakuru County, Kenya

A lot of scholarly research articles have lauded the positive significant contribution of Cooperative Learning Approach (CLA) and its effect on student’s academic achievement. However none of those studies have been conducted on English subject, therefore this study investigated how the use of CLA affects students’ academic achievement in English in public coeducational secondary schools in Nakuru County. The study adopted quasi experimental design, based on Solomon Four- group, Non-equivalent Control Group Design. The study involved two Experimental groups, E1 and E2 which were taught through CLA method and two Control groups, C1 and C2 which were taught through the Conventional methods. The target populations were students and teachers from the four co-educational public secondary schools of Nakuru County. The accessible population was 766 form three students in the four schools. The study sample size was 242 Form three students from the four co-educational public secondary schools in Nakuru County. The study used English Achievement Test (EAT) to collect quantitative data. Data was analyzed using both descriptive and inferential statistics using the Statistical Package for Social Sciences (SPSS version 24). Comparing the mean gain for the two groups of students’, it was established that students using cooperative learning approach were 12% higher in English achievement test as compared to their peers who were taught using conventional methods. The study concluded that there was statistically significant effect of cooperative learning approach on students’ achievement of English in public co-educational secondary schools in Nakuru, County Kenya (F(1,216)=113043.974, p<0.05). The study further concluded that use of cooperative learning approach improves student achievement in English compared to use conventional methods. The study recommended teachers to adopt modern constructivism approaches to teaching students especially Cooperative learning approach that is student centered. Keywords: Cooperative Learning Approach, Academic Achievement DOI: 10.7176/JLLL/64-07 Publication date: January 31st 202

La consultation des 50 ans : Prévention et promotion de la santé en entreprise

[Table des matières] I. Objectifs de l'étude. II. Méthodes. III. Résultats. 1. Description de l'état de santé des participants. 2. Tabagisme. 3. Alimentation. 4. Exercice physique et sport. 5. Alcool - médicaments. 6. Situation de vie - dépression. 7. Autres risques. 8. Mesures somatiques. 9. Valeurs de laboratoire. 10. Vaccination antidiphtérique et antitétanique. 11. Information, évaluation. 12. Préoccupation associée à la mise en place de Novartis. 13. Evaluation qualitative du modèle de consultation préventive. 14. Lieu du déroulement. 15. Modalités du déroulement de la consultation des 50 ans. 16. Entretien-conseil : instruments et difficultés. 17. Evaluation : l'opinion des participants satisfaction vis-à-vis de la consultation des 50 ans. 18. Cadre. 19. Contenu. 20. Conséquences précoces de la consultation des 50 ans. 21. Evaluation des habitudes de vie et de l'opinion des non participants. 22. Evaluation de l'opinion des participants après 12-18 mois. 23. Habitudes de vie. 24. Alimentation. 25. Exercice physique et sport. 26. Sécurité sur la route. 27. Le tabac. 28. Rôle de la consultation. IV. Commentaires. 1. Profil de risque. 2. Evaluation. 3. Opinion des participants. 4. Les non participants. 5. Impact sur la prévention et la promotion de la santé chez les participants. 6. Développements futurs du projet. V. Annexes : Questionnaire d'anamnèse; Feuille de bilan pour le médecin de famille; Questionnaire d'évaluation pour les participants; Questionnaire d'évaluation pour les non participants; Questionnaire d'évaluation à 12/18 mois; Liste des positions tarifaires établies par la FMH (14.12.94)

Variations in Arterial Blood Pressure after Kidney Transplantation

The course of hypertension within the first 2 months after kidney transplantation was correlated with renal function, plasma renin activity (PRA), and the daily maintenance dose of prednisone in 18 homograft recipients. During acute rejection blood pressure (BP) closely correlated with PRA. Patients with normal homograft function showed an increase in BP early after transplantation which in most returned to normal 3-8 weeks later. In the latter group no correlation could be found between the level of BP and PRA, however the BP correlated closely with the dose of prednisone. These observations suggest that during acute rejection the increase in BP may at least partly be mediated by a renal pressor mechanism, whereas with normal renal function the high dose of glucocorticoids may play an important role in the development of hypertension.</jats:p

Fixed-Point Analysis of the Low-Energy Constants in the Pion-Nucleon Chiral Lagrangian

In the framework of heavy-baryon chiral perturbation theory, we investigate the fixed point structure of renormalization group equations (RGE) for the ratios of the renormalized low energy constants (LECs) that feature in the pion-nucleon chiral Lagrangian. The ratios of the LECs deduced from our RGE analysis are found to be in semi-quantitative agreement with those obtained from direct fit to the experimental data. The naturalness of this agreement is discussed using a simple dimensional analysis combined with Wilsonian RGEs.Comment: 10 page