17 research outputs found
Patient-centered approach and non-pharmaceutical interventions (NPIs) in general practice
L’essor des interventions non médicamenteuses (INM) a du sens et interpelle sur les besoins et les attentes des médecins et des usagers. Ces solutions de santé, nées de bouleversements sociétaux et économiques, doivent être « repensées » pour être intégrées dans des parcours de soins coordonnés. L’approche centrée patient est au coeur de cette démarche. La communauté médicale territoriale, en particulier les acteurs des soins primaires, doit se mobiliser pour élaborer des modalités d’enseignement et d’évaluation de ces INM par une recherche appropriée.The rise of non-pharmacological interventions (NPIs) makes sense and challenges the needs and expectations of physicians and users. These health solutions, born of societal and economic upheavals, must be “redesigned” to be integrated into coordinated care pathways. The patient-centered approach is at the heart of this approach. The territorial medical community, especially primary care stakeholders, must mobilize to develop methods for teaching and evaluating these NPIs through appropriate research
Patient-centeredness to anticipate and organize an end-of-life project for patients receiving at-home palliative care: a phenomenological study
Violence ressentie par les médecins généralistes (enquête qualitative dans les Pyrénées-Orientales)
La violence envers les professionnels de santé est mise en évidence depuis plus de vingt ans et semble s'aggraver depuis quelques années, en France. 822 agressions de médecins en 2011 et 13 cas dans les Pyrénées Orientales. Pour 'étudier ce phénomène social préoccupant, nous avons choisi de réaliser une enquête qualitative exploratoire sur le ressenti des médecins généralistes face à un phénomène violent, dans les Pyrénées Orientales. 10 entretiens semi-directifs ont été réalisés auprès des médecins et analysés selon une analyse phénoménologique sémio-pragmatique. Les unités de sens ont été classés en catégories de Peirce, afin de restituer le sens général de l'entretien et la logique interne du médecin . Nos résultats répondent à notre hypothèse: les médecins généralistes des PO sont victimes d'agression dans leur pratique. Cependant, ils n'ont pas de sentiment d'insécurité car ils adaptent leur exercice professionnel et évitent les situations à risque. Le sentiment de peur revient le plus fréquemment dans es entretiens. Les profils de patients agressifs sont les toxicomanes et les patients psychiatriques, dont la prise en charge spécialisée est nécessaire. La notion de milieu sécurisé est représentée par un exercice. professionnel de groupe, en milieu rural avec un local et des horaires adaptés. Beaucoup de médecins ne font plus de gardes par peur d'être agressés, notamment les médecins femmes. Le risque est de créer des zones géographiques sous-médicalisées. La régulation médicale des gardes de secteur et la création d'une maison médicale de garde à Perpignan ont représenté un changement considérable pour les médecins qui se sentent mieux protégés. Les autorités sanitaires ont pris des mesures au niveau n tional avec la mise en place d'un protocole visant à améliorer les conditions de sécurité des professionnels de santé. L'information des praticiens sur les mesures de sécurité existantes doit être renforcée.MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF
Psychosomatique en médecine générale
MONTPELLIER-BU MĂ©decine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU MĂ©decine (341722104) / SudocSudocFranceF
Les urgences en médecine générale (étude qualitative dans les Pyrénées Orientales)
MONTPELLIER-BU MĂ©decine UPM (341722108) / SudocMONTPELLIER-BU MĂ©decine (341722104) / SudocSudocFranceF
Organic semiconductor core-shell nanoparticles designed through successive solvent displacements
This study reports for the first time the elaboration of core-shell organic nanoparticles through successive solvent displacements. The concept has been applied to generate donor-acceptor nanoparticles with the commonly used organic semiconductors P3HT and PCBM. The strategy is based on the sequential nanoprecipitation of P3HT and PCBM. Starting from a P3HT:PCBM solution in THF, the first solvent displacement with DMSO triggers the formation of the P3HT core while the second displacement with water generates the PCBM shell. The core-shell morphology is evidenced by both DLS and TEM. Efficient quenching of the P3HT photoluminescence is observed after the second solvent displacement procedure, confirming the formation of a well-defined PCBM shell around the P3HT core. Studying the emission of such core-shell nanoparticles leads to an estimation of the diffusion length of photogenerated excitons in P3HT of around [similar]14 nm
Core-shell nano-particles designed by successive solvent displacement - Application to pi-conjugated materials for exciton diffusion length measurements
National audienc
MoO3 Thickness, Thermal Annealing and Solvent Annealing Effects on Inverted and Direct Polymer Photovoltaic Solar Cells
Several parameters of the fabrication process of inverted polymer bulk heterojunction solar cells based on titanium oxide as an electron selective layer and molybdenum oxide as a hole selective layer were tested in order to achieve efficient organic photovoltaic solar cells. Thermal annealing treatment is a common process to achieve optimum morphology, but it proved to be damageable for the performance of this kind of inverted solar cells. We demonstrate using Auger analysis combined with argon etching that diffusion of species occurs from the MoO3/Ag top layers into the active layer upon thermal annealing. In order to achieve efficient devices, the morphology of the bulk heterojunction was then manipulated using the solvent annealing technique as an alternative to thermal annealing. The influence of the MoO3 thickness was studied on inverted, as well as direct, structure. It appeared that only 1 nm-thick MoO3 is enough to exhibit highly efficient devices (PCE = 3.8%) and that increasing the thickness up to 15 nm does not change the device performance
Microfluidic supercritical antisolvent continuous processing and direct spray-coating of poly(3-hexylthiophene) nanoparticles for OFET devices.
We report for the first time the use of a microfluidic supercritical antisolvent process (μSAS) to synthesize semiconducting polymer nanoparticles (NPs) of poly(3-hexylthiophene) (P3HT). Solvent-free P3HT NPs with average diameters as small as 36 ± 8 nm are obtained. They are continuously spray-coated on substrates to fabricate OFET devices, demonstrating hole mobility through the nanoparticle film equivalent to that of conventional spin-coated P3HT
Microfluidic Supercritical Antisolvent Continuous Processing of Poly(3-hexylthiophene) Nanoparticles
Organic electronic devices are promising alternatives to conventional inorganic technologies. Ink-based processes can easily be used to obtain active films, e.g. by spray-drying or roll-to-roll techniques. But their industrial development might be limited by the use of chlorinated solvents. An alternative consists in using solvent-dispersed NPs of organic semi-conductor. Previous work have demonstrated that it was possible to obtain organic semi-conducting dispersions of P3HT and/or [6,6]-Phenyl C61-Butyric acid Methyl ester (PCBM) NPs using an antisolvent approach. For organic photovoltaic devices, the nano-morphology has to be controlled in order to have donor and acceptor domains size in the range of the exciton diffusion length (10 nm). However, conventional synthesis approaches are based on slow solvent / antisolvent mixing process, whereas strong mixing is required to access small sizes and narrow size distributions. Admittedly, micromixing has a significant effect over particles size and size distribution since homogeneous concentration distribution and high degree of supersaturation can only be reached by intense micromixing. This can be achieved by performing antisolvent processes at microscale using microfluidic devices and/or by using supercritical fluids as antisolvents.By coupling both, we will present in here the first demonstration of a supercritical antisolvent process performed within a microsystem, so called µSAS. The µSAS process was applied to the processing of P3HT NPs as small as 36 ± 8 nm. The designed set-up includes a spraying nozzle at the outlet of the back pressure regulator allowing depositing P3HT NPs films onto a substrate. The µSAS process benefits from both the advantages of supercritical antisolvent approaches and microscale processes (fast mixing, high supersaturation, etc.) and can be successfully used to synthesize semi-conducting polymeric NPs, which size are compatible with the diffusion-length of excitons in active layer of photovoltaic devices