Obstacles and levers related to implementing and sustaining innovative pedagogical teachings to meet the needs of primary care and support workers and patients. Descriptive qualitative research

editorial reviewe

Validity of the French version of the Core Outcome Measures Index for low back pain patients: a prospective cohort study

Purpose: Among the many questionnaires available to evaluate low back pain (LBP) patients, the Core Outcome Measures Index (COMI) has the unique advantage to investigate five dimensions using seven short questions. The aim of this study was to explore additional properties of the questionnaire in a French-speaking non-surgical population. Methods: This study was conducted on 168 patients suffering from subacute or chronic LBP and followed up for 6months in three French-speaking countries. In addition to basic psychometric properties (e.g., construct validity, floor and ceiling effect, reproducibility), internal validity was analyzed by a factor analysis using Cronbach's alpha. Responsiveness and sensitivity to change were assessed through minimal detectable change (MDC), effect size, and Minimal Clinically Important Improvement (MCII). We used an anchor-based method with receiver operating characteristic (ROC) curve analysis to assess MCII and the Patient Acceptable Symptom State. Results: Construct validity, reliability (Cronbach's alpha=0.87), reproducibility and the absence of floor and ceiling effects were confirmed. Factor analysis indicated a one-dimensional construct that validates the use of a sum score. The MDC (2.1) was inferior to the MCII (2.3). The limit below which the patient claims to be in a fair condition (Patient Acceptable Symptom State) was set at 3. Conclusions: The COMI is a self-report questionnaire with the capacity to easily and quickly explore several dimensions in patients with LBP that can be then summarized in a meaningful sum score. Additional knowledge provided by our study should encourage the widespread use of the COMI among the spine community

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Former aux défis de la première ligne

editorial reviewedBe.hiv

Un environnement capacitant: une nécessité pour pérenniser des dispositifs pédagogiques innovants. Recherche qualitative descriptive dans l'enseignement supérieur en Belgique

editorial reviewed4. Quality educatio

Mise en œuvre de dispositifs pédagogiques innovants, utiles aux acteurs de la première ligne de soins et d’aide

Parmi les membres de la Chaire Be.Hive, un groupe de chercheurs s’est fixé comme but de recherche de décrire et comprendre les enjeux, les leviers, les obstacles et les stratégies des innovateurs aux différents stades de développement et de mise en œuvre d’un dispositif pédagogique innovant (DiPI) utile aux acteurs de la première ligne de soins et d’aide (PLSA). Pour pouvoir répondre à cette question, il parait pertinent :1/ de déterminer les thématiques et les caractéristiques d’un dispositif pédagogique jugé innovant du point de vue des acteurs professionnels et des bénéficiaires des services de la PLSA et 2/ de décrire et comprendre les enjeux, les leviers, les obstacles et les stratégies des innovateurs aux différents stades de développement et de mise en œuvre des dispositifs pédagogiques co-identifiés comme innovants par tous les acteurs (enseignants, acteurs professionnels, bénéficiaires des services de la première ligne de soins et d’aide et chercheurs). En répondant successivement à ces questions au travers de différentes séquences de recherche, les résultats des premières servant de base aux suivantes. L’objectif des chercheurs est de contribuer à la construction d’une communauté d’apprentissage en collectant et en mettant à disposition des enseignants des données pertinentes pour nourrir leurs réflexions afin de leur permettre de construire des DiPI et pérennes, qui développent des savoirs et des compétences utiles aux acteurs professionnels et aux bénéficiaires de services de la PLSA. La programmation de recherche a été développée de façon heuristique par l’équipe de recherche. Elle recourt à des méthodes diverses, tant qualitatives que quantitatives. Une première séquence de recherche a permis au moyen d’entretiens de groupes avec les acteurs professionnels de la première ligne de soins et d’aide et les bénéficiaires :1/ de codéterminer 8 thématiques jugées innovantes et 2 / de co-identifier les caractéristiques d’un dispositif pédagogique jugé innovant en termes de contenu et de méthodeinfo:eu-repo/semantics/publishe

Former aux défis de la première ligne

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Impact of faecal microbiota transplantation on mouse digestive colonization with two extensively resistant bacteria

International audienceno abstrac

Risk of symptomatic venous thromboembolism in mild and moderate COVID-19: A comparison of two prospective European cohorts

International audienceBackground: Severely ill patients with SARS-CoV-2 have an increased risk of venous thromboembolism (VTE) i.e., deep vein thrombosis and pulmonary embolism. However, the VTE risk in patients with mild and moderate COVID-19, hospitalized or managed at home, remain uncertain. The aims of this study were to assess the rate and the risk factors symptomatic VTE, in patients with mild and moderate COVID-19 and to compare them to a cohort of similar patients without COVID-19. Methods: Patients presenting to the emergency department (ED) of participating centers for confirmed or probable mild or moderate COVID-19 and not having acute VTE were included. This COVID-19 cohort was retrospectively compared to a prospective cohort of similar ED patients using propensity score matching. The main outcome was the rate of symptomatic VTE within the 28 days after ED presentation. Results: A total of 2292 patients were included in the COVID-19 cohort. The 28-day incidence of symptomatic VTE was 1.3% (n = 29/2292, 95%CI: 0.9 to 1.8), 2.3% (n = 20/866, 95%CI: 1.5 to 3.5) in moderate COVID-19 patients and 0.6% (n = 9/1426; 95%CI: 0.3 to 1.2) in mild COVID-19 patients managed as outpatients. An age over 65 years and hospitalization were independent risk factors of VTE. After adjustment, patients in the COVID19 cohort had an absolute increase in over symptomatic VTE risk of +1.69% (95%CI, 0.88 to 2.51) versus patients in the comparison cohort (n = 1539). Conclusions: Patients with moderate COVID-19 presenting to the ED had a high risk of subsequent VTE. Trial registration: Ethics committee of the CHU of Angers (N degrees 2020/87)

Modulation of the Categorical Perception of speech by an auditory discrimination training

info:eu-repo/semantics/nonPublishe