Convergences and divergences of diabetic patients' and healthcare professionals' opinions of care : a qualitative study

OBJECTIVES: To investigate opinions' convergences and divergences of diabetic patients and health-care professionals on diabetes care and the development of a regional diabetes programme. BACKGROUND: Development and implementation of a regional diabetes programme. RESEARCH DESIGN: Qualitative study using focus groups to elicit diabetic patients' and health-care professionals' opinions, followed by content analysis. SETTING AND PARTICIPANTS: Eight focus groups: four focus groups with diabetic patients (n = 39) and four focus groups with various health-care professionals (n = 34) residing or practicing in the canton of Vaud, Switzerland, respectively. RESULTS: Perceived quality of diabetes care varied between individuals and types of participants. To improve quality, patients favoured a comprehensive follow-up while professionals suggested considering existing structures and trained professionals. All participants mentioned communication difficulties between professionals and were favouring teamwork. In addition, they described the role that patients should have in care and self-management. Financial difficulties were also mentioned by both groups of participants. Finally, they were in favour of the development of a regional diabetes programme adapted to actors' needs. For patients indeed, such a programme would represent an opportunity to improve information and to have access to comprehensive care. For professionals, it would help the development of local networks and the reinforcement of existing tools and structures. DISCUSSION AND CONCLUSIONS: Acknowledging convergences and divergences of opinions of both diabetic patients and health-care professionals should help the further development of a programme adapted to users' needs, taking all stakeholders interests and priorities into consideration

Models of care for musculoskeletal health: A cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation

Background: The prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise 'evidence-practice', 'burden-policy' and 'burden-service' gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their 'readiness' for implementation and 'success' after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users' views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach. Methods: A cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge 'readiness' and 'success' and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes. Results: Twenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A 'readiness' evaluation framework assessing whether critical components across the health system had been considered prior to implementation was strongly supported, while 'success' was perceived as an already familiar evaluation concept. Perceived challenges associated with standardised evaluation included identifying, defining and measuring key 'readiness' and 'success' indicators; impacts of systems and context changes; cost; meaningful stakeholder consultation and developing a widely applicable framework. Conclusions: A standardised evaluation framework that includes a strong focus on 'readiness' is important to ensure successful and sustainable implementation of musculoskeletal MoCs

Exploration des expériences et des besoins des patients diabétiques et des professionnels de la santé du canton de Vaud: Programme cantonal Diabète Vaud

Dans le cadre de l'élaboration du Programme cantonal Diabète du canton de Vaud, nous avons mis en place une étude qualitative visant à connaître l'opinion des divers acteurs du système de santé du canton, sur la prise en charge actuelle du diabète et le développement du Programme cantonal Diabète. Nous avons recruté des patients diabétiques et des professionnels de la santé dans le but d'organiser huit focus-groupes (entretiens de groupe) : un focus-groupe de patients diabétiques et un focus-groupe de professionnels de la santé, dans chacune des quatre régions sanitaires du canton de Vaud. [Auteurs, p. 5]]]> Diabetes Mellitus, Type 2/therapy ; Health Services Needs and Demand ; Program Development ; Health Policy ; Qualitative Research ; Switzerland ; Vaud fre https://serval.unil.ch/resource/serval:BIB_07056CE592B6.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_07056CE592B61 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_07056CE592B61 info:eu-repo/semantics/submittedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_070585668125 2022-02-19T02:13:00Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_070585668125 Femtosecond-laser assisted cataract surgery: a review. info:doi:10.1111/aos.12416 info:eu-repo/semantics/altIdentifier/doi/10.1111/aos.12416 info:eu-repo/semantics/altIdentifier/pmid/24835818 Abouzeid, H. Ferrini, W. info:eu-repo/semantics/review article 2014 Acta Ophthalmologica, vol. 92, no. 7, pp. 597-603 info:eu-repo/semantics/altIdentifier/eissn/1755-3768 urn:issn:1755-375X <![CDATA[Introduced in 2008, the femtosecond laser is a promising new technological advance which plays an ever increasing role in cataract surgery where it automates the three main surgical steps: corneal incision, capsulotomy and lens fragmentation. The proven advantages over manual surgery are: a better quality of incision with reduced induced astigmatism; increased reliability and reproducibility of the capsulotomy with increased stability of the implanted lens; a reduction in the use of ultrasound. Regarding refractive results or safety, however, no prospective randomized study to date has shown significant superiority compared with standard manual technique. The significant extra cost generated by this laser, undertaken by the patient, is a limiting factor for both its use and study. This review outlines the potential benefits of femtosecond-laser-assisted cataract surgery due to the automation of key steps and the safety of this new technology

Les grands pressoirs bourguignons pré-industriels : essai de chrono-typologie

Chronotypology of the important preindustrial Burgundian wine-presses of Burgundy. This article is part of the research undertaken by the Inventaire Général and Ethnology departments at the Direction régionale des Affaires culturelles of Burgundy on the Burgundian viti-and vinicultural heritage. Two studies have already been published; the first in 1996 about architecture, tools and traditions in the Tannay area (Nièvre); the second, in 1999, about the history, archeology and ethnology of the vats and wine-presses at the Clos de Chenôve (Côte-d’Or), they have shown that a significant percentage of important wine-presses of the industrial era still exists in Burgundy. Several have been recently registered as important cultural properties (Inventaire suppl. des Monuments historiques). Our object here is to list briefly these wine presses, to draw up a typology and to understand their evolution. Three main types can be described: wine presses with lever, with lever and shaft and with a central screw. Variations are also to be considered and have been used from the Middle Age until 1950. This study raises questions about the preservation of such machines but also how to date them, since the only sources available are difficult to exploit, hence, dendrochronological analysis is often the most reliable method