L’accompagnement-citoyen en soutien à la participation sociale des aînés ayant un traumatisme craniocérébral

Hautement valorisée par les aînés, la participation sociale a des effets bénéfiques sur leur santé biopsychosociale. Tous n’ont pas cependant les mêmes opportunités pour s’investir dans ce type d’activités; particulièrement ceux ayant un traumatisme craniocérébral (TCC) qui sont plus susceptibles d’être limités dans leurs capacités à participer à la vie de la communauté. Les initiatives les plus courantes pour aider ces personnes consistent en une assistance humaine visant àpallierleurs limitations et ne misent pas, en priorité, sur la promotion de leurs compétences. Afin d’optimiser l’aide reçue, un accompagnementcitoyen personnalisé à l’intégration communautaire (APIC) a été développé, implanté et évalué. Cet article documente l’impact de l’APIC sur la participation sociale d’aînés ayant un TCC. Une analyse de contenu thématique a été réalisée sur les données issues d’entrevues semi-dirigées auprès des participants et des journaux de bord des accompagnateurs. Les résultats montrent trois grandes retombées de l’APIC : une meilleure assurance et un plus grand sentiment d’autonomie, un goût retrouvé de s’investir dans des activités de loisirs signifiantes, et une plus grande ouverture vers de nouvelles possibilités de relations.Abstract : Highly valued by seniors, community integration has beneficial effects on their biopsychosocial health. However, not all of them have the same opportunities to engage in social participation activities, particularly those with traumatic brain injury (TBI) who are more likely to be limited in their abilities to participate in the life of the community. The most common initiatives to help these people consist of human assistance to overcome their limitations and which do not focus on skills promotion. In order to optimize the available services and resources, personalized citizen assistance for community integration (APIC) has been developed, implemented, and evaluated. This article documents the impact of APIC on the community integration of seniors with TBI. A thematic content analysis was conducted on data from semi-structured interviews with participants and from attendant logbooks. The results show three major spin-offs from APIC: better insurance and a greater sense of autonomy, a renewed taste for investing in meaningful leisure activities, and greater openness to new relationship opportunities

Employment and sociodemographic characteristics: a study of increasing precarity in the health districts of Belo Horizonte, Brazil

<p>Abstract</p> <p>Background</p> <p>The fundamental importance of human resources for the development of health care systems is recognized the world over. Health districts, which constitute the middle level of the municipal health care system in the city of Belo Horizonte, Brazil, deal with demands from all parts of the system. This research seeks to provide the essential features required in order to understand the phenomenon of increase in precarity of employment in these health districts.</p> <p>Methods</p> <p>The legal and human resource management documents used by the Municipal Health Secretariat of the City of Belo Horizonte were adopted as the corpus for this research. In order to analyse the changes in employment (2002–2006), the data were collected from ArteRH, a computerized database dealing specifically with data related to human resources, which began operating in 2001. The workers were classified into permanent and non-permanent groups, and their contractual rights were described. Employment dynamics and changes were examined, concentrating on the incorporation of workers and on their social and employment rights during the period under study. The comparative data for the two groups obtained were presented in frequency distribution tables according to type of employment, sex, age group, level of education and wages from 2002 to 2006.</p> <p>Results</p> <p>There was a clear difference between the permanent worker and non-permanent worker groups as regards existing guaranteed employment rights and social security. The increase in the number of non-permanent workers in the workforce, the growing proportion of older workers among the permanently employed and the real wage reductions during the period from 2002 to 2006 are indicative of the process of growing precarity of employment in the group studied.</p> <p>Conclusion</p> <p>It is a plausible supposition that the demand for health reforms, along with the legal limits imposed on financial expenditure, gave rise to the new types of contract and the present employment situation in the health districts in Belo Horizonte.</p

Can we quickly and thoroughly assess pain with the PACSLAC-II? : a convergent validity study in long-term care residents suffering from dementia.

Abstract : A previous study found that the modified version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-II) is a valid tool to assess pain in elderly individuals suffering from dementia and who are unable to communicate verbally. The primary objective of this study was to confirm the convergent validity of the PACSLAC-II using direct evaluation of long-term care residents in real-life situations, using two other well-validated pain assessment scales (i.e., PACSLAC and Pain Assessment in Advanced Dementia [PAINAD]). A secondary objective was to document and compare the time required to complete and score each assessment scale. During two potentially painful procedures (i.e., transfer/mobilization), 46 long-term care residents (mean age = 83 ± 10 years) suffering from dementia were observed by three independent evaluators, each using one of the assessment scales (randomly assigned). Correlational analyses and analysis of variance were used to evaluate the association between each scale and to compare scoring time. The PACSLAC (r = 0.61) and the PAINAD (r = 0.65) were both moderately associated with the PACSLAC-II (all p values < .001). The PAINAD's average scoring time (63 ± 19 seconds) was lower than the PACSLAC-II's (96 ± 2 seconds), which was lower than the PACSLAC's (135 ± 53 seconds) (all p values < .001). These results suggest that the PACSLAC-II is a valid tool for assessing pain in individuals with dementia. The time required to complete and score the PACSLAC-II was reasonable, supporting its usefulness in clinical settings

BMC Womens Health

BACKGROUND: Violence against women remains an important issue of inequality in African societies, with several consequences to health, social and economic status. This study aims to identify the factors related to the perception of intimate partner violence in Benin. METHODS: Data on intimate partner violence was collected by conducting live interviews, and from the Benin Demographic and Health Survey 2012. The dependent variable was acceptance of intimate partner violence. The independent variables were socio-demographic features such as age, level of education, matrimonial status, ethnicity, religion, place of residence and the index of economic well-being. Logistic regressions were performed and odds ratios (OR) with a confidence interval of 95% (CI95%) were estimated. RESULTS: Among the 21,574 people who answered the questions relating to violence against women by an intimate partner, the prevalence of acceptance of intimate partner violence was 15.77%. Ethnicity, level of education, administrative department of residence, religion, and socio-economic quintile were factors associated with the respondents' acceptance of violence against women by an intimate partner. CONCLUSION: Acceptance of intimate partner violence could be a major obstacle to the success of some health programs. There is a need to break the norms that support the vulnerability of women in Beninese society