La violence entre collègues au bloc opératoire : une revue intégrative des écrits

La violence horizontale (VH) touche plusieurs infirmières soignantes. Au Québec, de nombreuses infirmières rapportent des incidents de violence soit d’ordre physique, psychologique ou sexuel perpétrés par différents membres de l’équipe de soins. Plusieurs conséquences graves de la violence horizontale ont été répertoriées, face aux patients, aux victimes et à la profession infirmière. En effet, les infirmières du bloc opératoire sont les plus souvent affectées par la VH. Ce phénomène semble encore méconnu par les infirmières, ainsi elles ont normalisé et toléré la VH en la considérant comme étant une composante du bloc opératoire. Malgré les efforts visant à combattre ce phénomène, la VH est un problème croissant et persistant dans le milieu de travail infirmier. Cette revue intégrative des écrits vise à d’établir l’état des connaissances se rapportant au phénomène de la violence entre collègues au bloc opératoire afin de mieux comprendre ce problème et de proposer des pistes de solutions visant à le résoudre. Les résultats des articles recensés ont été analysés et catégorisés selon des thèmes cohérents au modèle conceptuel de Almost (2006). Ces thèmes sont : le concept de la violence entre collègues qui est divisé en trois sous thèmes (la prévalence de cette problématique, les sources de la violence entre collègues et ses manifestations), les caractéristiques du bloc opératoire, les conséquences de la violence entre collègues qui sont aussi divisées en trois sous thèmes (les conséquences sur la qualité et la sécurité des soins, les conséquences sur les victimes et les conséquences sur l’établissement de santé) et, finalement, les solutions qui ont été proposées pour lutter contre la violence entre collègues dans le milieu de travail. Cette revue a permis d’émettre plusieurs recommandations afin de contrer la violence entre collègues.Horizontal violence (HV) affects many nurses around the world. In Quebec, many nurses report incidents of physical, psychological or sexual violence perpetrated by other members of their health care teams. The consequences of horizontal violence affect patients, victims, and the nursing profession as a whole. Operating room (OR) nurses are the most often affected by HV. Nurses often don’t seem to recognize the problem as a problem; they seem to normalize and tolerate HV by considering it a part of the operating room culture. Despite efforts to combat this phenomenon, VH is a persistent and growing problem in the nursing workplace. This integrative review of the literature aims to establish the state of knowledge related to this problem and to propose solutions to address it. The results of the articles reviewed were analyzed and categorized according to themes consistent with Almost's (2006) conceptual model. These themes are: the concept of violence between colleagues, which is divided into three sub-themes (the prevalence of this problem, the sources of violence between colleagues, and its manifestations), the characteristics of the operating room, the consequences of violence between colleagues, which are also divided into three sub-themes (the consequences on the quality and safety of care, the consequences for the victims, and the consequences for the health care institution), and, finally, the solutions that have been proposed to combat violence between colleagues in the work environment. This review provided several recommendations to address violence between colleagues

Analyse Microstructurelle du Marché des changes : Spécifications Théorique et Empirique

Numéro de référence interne originel : a1.1 g 112

Physicochemical Characterization of Geopolymer Binders and Foams Made from Tunisian Clay

Illito-kaolinitic clay rich in hematite from south Tunisia was investigated in view of producing geopolymer materials. Geopolymers with two different densities were elaborated: cement and foam. The effects of activator concentrations on compressive strength, water absorption (durability), open porosity, and bulk density of geopolymers cement were examined, in order to assure optimal geopolymerization conditions. Geopolymer cements aged 28 days with optimum performances were achieved for 13 M of alkaline solution concentration. At these conditions, the compressive strength of prepared geopolymer reaches 27.8 MPa. The addition of silica fume to reactant geopolymer mixture induces modification of geopolymer density and decrease in the compressive strength of the final product. Geopolymer materials based on calcined Tunisian clay can be suggested as sustainable and cost-effective cement that may be applied to alternate Portland cement in many construction applications

0275: Diagnosis, complications and management of infective endocarditis: experience of Tunisian military hospital

BackgroundInfective endocarditis (IE) is lethal if not aggressively treated with antibiotics alone or in combination with surgery. The epidemiology of this condition has substantially changed over the past four decades, especially in industrialized countries. Once a disease that predominantly affected young adults with previously well-identified valve disease – mostly chronic rheumatic heart disease – IE nowadays tends to affect older patients and new at-risk groups, including intravenous-drug users, patients with intracardiac devices and degenerative valvular heart disease…ObjectivesWe aimed to evaluate demographic data, underlying cardiac abnormalities, clinical profile, microbiological features, treatments and complications of IE.MethodsA retrospective study of all cases with the diagnosis of definite endocarditis according to Duke Criteria admitted to The Tunisian Military Hospital between January 2001 and December 2007.ResultsThe study included 53 patients (32 males and 21 females; mean age 44.5±16.5 years). Infective endocarditis developed on a native valve in 48 patients (90%), a mechanical prosthetic valve in 5 patients (5%). Rheumatic heart disease in 26 cases (49%) was the most common preexisting valvular abnormality in native valve endocarditis. The mitral valve was the most commonly affected valve 23 (43.4%). Fever occurred in 50 (94%) of the cases. Trans-thoracic and/or trans-esophageal echocardiography showed vegetation and/or abcess in 33 patients (62.2%). Streptococci in 17 cases (32%) and Staphylococci in 13 cases (24%) were the most common causative agents. Twenty-six patients (49%) underwent surgical treatment. Cardiac complications occurred in 13% of cases, vascular complications in 18% of cases, cerebrovascular accidents in 15% of cases and septic metastatic complications in 15% of cases.ConclusionsIE usually occurred on rheumatic heart disease. Its diagnosis is based on hemocultures and echocardiography. There are deficiencies in applying prophylaxis, which is a justification for the improvement of patient management through education

Effects of intensified training and tapering periods using different exercise modalities on judo-specific physical test performances

This study investigated the effects of intensified training and tapering periods using different exercise modalities on judo athletes' physical fitness. Fifty-nine adolescent male and female judo athletes (age 15 ± 1 years) were randomly assigned to one of three experimental groups or one control group (CG). Experimental groups (kumi-kata [KG], uchi-komi [UG] and running [RG]) trained four times per week over four weeks of intensified training (in addition to their usual technical-tactical judo training; CG underwent only the usual training) followed by 12 days of tapering. The countermovement jump test (CMJ), isometric and dynamic judogi chin-up tests (JCT), uchi-komi speed test (UST), Special Judo Fitness Test (SJFT) and Judo Physical Fitness Test (JPFT) were administered before and after the intensified period and after tapering. The CMJ performance was superior in KG compared with UG, RG and CG. Isometric JCT performance was superior in KG compared with RG and CG. Regarding UST, performance was superior in UG compared with RG and CG. The same performance was superior with respect to the same groups considering pre-training to tapering change. The SJFT index did not differ between groups or time-points. The JPFT index increased after intensified and tapering periods compared with before training, with KG eliciting higher values compared with CG. Coaches and conditioning coaches could administer kumi-kata high-intensity interval training to enhance athletes' judo-specific physical fitness

Management of Perinatal Testicular Torsion: A Single Centre Experience

Perinatal testicular torsion (PTT) is a rare entity. The management of PTT is controversial, due to the low viability of the testis and the possibility of bilateral torsion. This is a review of our experience with six cases of PTT, highlighting diagnostic and therapeutic difficulties of this condition

Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis?

Background: Sarcoidosis is a multisystem granulomatous disease. Co-existence with spondyloarthritis (SA) has been more described as an adverse effect of anti-TNF α therapy than an association. We report herein a case of a typical sarcoidosis confirmed by histological proofs and an advanced SA with a bamboo column. Case Presentation: A 48-years-old woman presented with inflammatory back pain for 5 years and ankle swelling for 1 year. On physical examination, she had an exaggerated dorsal kyphosis and disappearance of lumbar lordosis with limitation in motion of the cervical and lumbar spine. Laboratory tests did not show an inflammatory syndrome or hypercalcemia. Plain radiographies of the spine and pelvic revealed a triple ray appearance with sacroiliitis grade 4. Chest radiography and CT confirmed the presence of bilateral hilar lymph nodes and parenchymal nodes. Bronchoscopy and biopsies were performed showing non-calcified granulomatous reaction without cell necrosis. The diagnosis of SA was performed based on 9 points of Amor criteria associated with pulmonary sarcoidosis. She was treated with 15 mg per week of methotrexate and 1mg/kg/day of prednisone for pulmonary disease with good outcomes. Conclusions: Sarcoidosis may be associated to SA besides paradoxical drug effect. The same physio pathological pathways mediate by TNF α are arguments for association than hazardous coincidence

Nutritional risk factors for postmenopausal osteoporosis

Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis.Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and witnesses.Methods: We conducted a comparative cross-sectional study including 60 postmenopausal women and screening for osteoporosis by a bone densitometry, recruited the outpatient service of Rheumatology of the Institute KASSAB.Results: We have identified excessive supply of saturated fatty acids (SFA) in the osteoporotic compared with controls (13.27% vs 10.23%, p= 0.002) and an inadequate intake of monounsaturated fatty acids (MUFA) (12.6% vs 16.16%, p=0.012).A low calcium intake is another factor of risk of osteoporosis (574.27 ± 336.9 mg/day vs 782.45 ± 340.54 mg/day; p= 0.021). This is explained by the low consumption of milk and milk products objectified in the osteoporotic group (p= 0.001). We also found a negative relationship between inadequate intakes of potassium and osteoporosis (2241.55 ±1049.85 mg/day vs 2988.17 ± 1146.52 mg/day; p= 0.011). This may be due to the low consumption in fruit and vegetables, sources of potassium, found in the osteoporotic group (p= 0.003).We found a significant increase in the consumption of the VVPO group in the osteoporotic toward women witness (2.23 ± 0.99 number of times/day vs 1.67 ± 0.76 number of times/day; p= 0.019). A high consumption of coffee appears also as a risk factor since the osteoporotic group consume almost twice than controls (p= 0.002).Conclusion: Nutritional risk factors of osteoporosis are all the most important that they are editable and can take their place in a prevention of public health policy.Keywords: Osteoporosis; Menopause; Risk factors; Nutritio