Model de relació entre l’atenció primària i comunitària i l’atenció hospitalària ambulatòria

Atenció primària; Atenció hospitalària; PacientAtención primaria; Atención hospitalaria; PacientePrimary care; Hospital care; PatientL’objectiu del present document és definir un model de relació entre l’atenció primària i comunitària i l’atenció hospitalària ambulatòria que doni una resposta resolutiva, equitativa i de qualitat durant tot el procés assistencial. A tal fi es defineix el diagrama del procés assistencial pel qual els metgesa especialistes de medicina de família i comunitària (MFiC) sol·liciten l’atenció, mitjançant l’ordre clínica, dels seus homòlegs d’atenció hospitalària ambulatòria (MAH). A més, s’estableixen un seguit de recomanacions relatives a la relació que s’estableix entre l’MFiC i el MAH a l’hora de contribuir a la millora de la salut de la persona atesa

Model de relació en la derivació de pacients entre l’àmbit d’atenció primària i l’àmbit d'atenció hospitalària ambulatòria

Atenció primària; Atenció hospitalària; PacientAtención primaria; Atención hospitalaria; PacientePrimary care; Hospital care; PatientL’objectiu del present document és definir un model de relació entre l’atenció primària i comunitària i l’atenció hospitalària ambulatòria que doni una resposta resolutiva, equitativa i de qualitat durant tot el procés assistencial. A tal fi es defineix el diagrama del procés assistencial pel qual els metgesa especialistes de medicina de família i comunitària (MFiC) sol·liciten l’atenció, mitjançant l’ordre clínica, dels seus homòlegs d’atenció hospitalària ambulatòria (MAH). A més, s’estableixen un seguit de recomanacions relatives a la relació que s’estableix entre l’MFiC i el MAH a l’hora de contribuir a la millora de la salut de la persona atesa

Insolents.es et Insoumis.es. Esquisses sur les droits en santé mentale : Projet d’art conscientisant. Une collaboration artistique unique entre Action Autonomie et le Musée des Beaux-Arts de Montréal

Dans une perspective de défense des droits en santé mentale axée sur l’appropriation du pouvoir, Action Autonomie a mis sur pied un projet d’art conscientisant en collaboration avec le Musée des Beaux-Arts de Montréal. Il s’agit avant tout d’une réponse de l’organisme à ses membres et aux personnes qui ont fait des demandes d’aide et d’accompagnement. Ayant comme toile de fond le témoignage de 15 personnes ayant subi des mesures de contrôle – contention physique, chimique et isolement – dans le milieu psychiatrique montréalais, ce projet se déploie à travers un cycle de sept étapes ayant mené à la création d’une oeuvre collective sur chacun des cinq droits explorés : droit à la dignité, au respect, à la liberté, à la sécurité et au consentement libre et éclairé. Chacune de ces oeuvres est accompagnée de messages et réflexions livrés par les artistes sur chacun des droits. L’objectif de ce projet était de créer cette oeuvre collective itinérante comme outil de sensibilisation et de promotion des droits en santé mentale.Action Autonomie, in collaboration with the Montreal Fine Arts Museum, set up a critical consciousness art project within a perspective of mental health rights advocacy centered on empowerment. This was, above all, the organisation’s response to its members and to individuals that had requested aid and accompaniment. Drawing inspiration from the testimonials of 15 persons who experienced control measures – physical restraint, chemical restraint and seclusion – in the Montreal psychiatric system, this project exploits a cycle of seven steps that led to the creation of a collective art work based on each of the five rights that were explored: the right to dignity, respect, freedom, safety, and free informed consent. Each art work is accompanied by the artists’ messages and reflections concerning each of these rights. The goal of this project was to create a travelling collective art work as a tool for raising awareness and for promoting mental health rights

Insolents.es et Insoumis.es. Esquisses sur les droits en santé mentale

Dans une perspective de défense des droits en santé mentale axée sur l’appropriation du pouvoir, Action Autonomie a mis sur pied un projet d’art conscientisant en collaboration avec le Musée des Beaux-Arts de Montréal. Il s’agit avant tout d’une réponse de l’organisme à ses membres et aux personnes qui ont fait des demandes d’aide et d’accompagnement. Ayant comme toile de fond le témoignage de 15 personnes ayant subi des mesures de contrôle – contention physique, chimique et isolement – dans le milieu psychiatrique montréalais, ce projet se déploie à travers un cycle de sept étapes ayant mené à la création d’une oeuvre collective sur chacun des cinq droits explorés : droit à la dignité, au respect, à la liberté, à la sécurité et au consentement libre et éclairé. Chacune de ces oeuvres est accompagnée de messages et réflexions livrés par les artistes sur chacun des droits. L’objectif de ce projet était de créer cette oeuvre collective itinérante comme outil de sensibilisation et de promotion des droits en santé mentale.Action Autonomie, in collaboration with the Montreal Fine Arts Museum, set up a critical consciousness art project within a perspective of mental health rights advocacy centered on empowerment. This was, above all, the organisation’s response to its members and to individuals that had requested aid and accompaniment. Drawing inspiration from the testimonials of 15 persons who experienced control measures – physical restraint, chemical restraint and seclusion – in the Montreal psychiatric system, this project exploits a cycle of seven steps that led to the creation of a collective art work based on each of the five rights that were explored: the right to dignity, respect, freedom, safety, and free informed consent. Each art work is accompanied by the artists’ messages and reflections concerning each of these rights. The goal of this project was to create a travelling collective art work as a tool for raising awareness and for promoting mental health rights

The interplay between infection risk factors of SARS-CoV-2 and mortality : a cross-sectional study from a cohort of long-term care nursing home residents

Covid-19 pandemic has particularly affected older people living in Long-term Care settings in terms of infection and mortality. We carried out a cross-sectional analysis within a cohort of Long-term care nursing home residents between March first and June thirty, 2020, who were ≥ 65 years old and on whom at least one PCR test was performed. Socio-demographic, comorbidities, and clinical data were recorded. Facility size and community incidence of SARS-CoV-2 were also considered. The outcomes of interest were infection (PCR positive) and death. A total of 8021 residents were included from 168 facilities. Mean age was 86.4 years (SD = 7.4). Women represented 74.1%. SARS-CoV-2 infection was detected in 27.7% of participants, and the overall case fatality rate was 11.3% (24.9% among those with a positive PCR test). Epidemiological factors related to risk of infection were larger facility size (pooled aOR 1.73; P <.001), higher community incidence (pooled aOR 1.67, P =.04), leading to a higher risk than the clinical factor of low level of functional dependence (aOR 1.22, P =.03). Epidemiological risk factors associated with mortality were male gender (aOR 1.75; P <.001), age (pooled aOR 1.16; P <.001), and higher community incidence (pooled aOR 1.19, P = < 0.001) whereas clinical factors were low level of functional dependence (aOR 2.42, P <.001), Complex Chronic Condition (aOR 1.29, P <.001) and dementia (aOR 1.33, P <0.001). There was evidence of clustering for facility and health area when considering the risk of infection and mortality (P <.001). Our results suggest a complex interplay between structural and individual factors regarding Covid-19 infection and its impact on mortality in nursing-home residents

Impact of short-term traffic-related air pollution on the metabolome – results from two metabolome-wide experimental studies

Exposure to traffic-related air pollution (TRAP) has been associated with adverse health outcomes but underlying biological mechanisms remain poorly understood. Two randomized crossover trials were used here, the Oxford Street II (London) and the TAPAS II (Barcelona) studies, where volunteers were allocated to high or low air pollution exposures. The two locations represent different exposure scenarios, with Oxford Street characterized by diesel vehicles and Barcelona by normal mixed urban traffic. Levels of five and four pollutants were measured, respectively, using personal exposure monitoring devices. Serum samples were used for metabolomic profiling. The association between TRAP and levels of each metabolic feature was assessed. All pollutant levels were significantly higher at the high pollution sites. 29 and 77 metabolic features were associated with at least one pollutant in the Oxford Street II and TAPAS II studies, respectively, which related to 17 and 30 metabolic compounds. Little overlap was observed across pollutants for metabolic features, suggesting that different pollutants may affect levels of different metabolic features. After observing the annotated compounds, the main pathway suggested in Oxford Street II in association with NO2 was the acyl-carnitine pathway, previously found to be associated with cardio-respiratory disease. No overlap was found between the metabolic features identified in the two studies

Impact of short-term traffic-related air pollution on the metabolome - Results from two metabolome-wide experimental studies

Exposure to traffic-related air pollution (TRAP) has been associated with adverse health outcomes but underlying biological mechanisms remain poorly understood. Two randomized crossover trials were used here, the Oxford Street II (London) and the TAPAS II (Barcelona) studies, where volunteers were allocated to high or low air pollution exposures. The two locations represent different exposure scenarios, with Oxford Street characterized by diesel vehicles and Barcelona by normal mixed urban traffic. Levels of five and four pollutants were measured, respectively, using personal exposure monitoring devices. Serum samples were used for metabolomic profiling. The association between TRAP and levels of each metabolic feature was assessed. All pollutant levels were significantly higher at the high pollution sites. 29 and 77 metabolic features were associated with at least one pollutant in the Oxford Street II and TAPAS II studies, respectively, which related to 17 and 30 metabolic compounds. Little overlap was observed across pollutants for metabolic features, suggesting that different pollutants may affect levels of different metabolic features. After observing the annotated compounds, the main pathway suggested in Oxford Street II in association with NO2 was the acyl-carnitine pathway, previously found to be associated with cardio-respiratory disease. No overlap was found between the metabolic features identified in the two studies.This work was supported by the grant FP7 of the European Commission ‘Enhanced exposure assessment and omic profiling for high priority environmental exposures in Europe’ (EXPOsOMICS grant 308610 to PV). The Centre for Environment and Health is supported by the Medical Research Council and Public Health England (MR/L01341X/1). Erica Ponzi is funded by a Doc.Mobility grant from the Swiss National Science Foundation (SNSF grant P1ZHP2_178207)