9 research outputs found
Travailler auprÚs de la personne ùgée atteinte de démence: observations de huit jours à l'EMS "Les Tilleuls" : travail de Bachelor effectué dans le cadre de la formation à la Haute école de travail social de GenÚve
Ce travail de Bachelor a Ă©tĂ© distinguĂ© par le Prix Marie-Louise Cornaz 2014. Ă lâheure actuelle, la personne ĂągĂ©e atteinte de dĂ©mence sâinscrit dans un contexte de peur. En effet, les pouvoirs publics sâalarment quant Ă lâaugmentation incessante de cette maladie incurable ; les statistiques dĂ©montrent que les chiffres vont tripler dans les dĂ©cennies Ă venir, sâĂ©levant Ă 300â000 personnes atteintes en Suisse dâici 2050. Force est de constater que cette thĂ©matique touche de prĂšs les EMS ; alors, comment travailler avec cette nouvelle population, indĂ©niablement toujours plus prĂ©sente en EMS ? Ainsi quatre axes ont Ă©tĂ© dĂ©veloppĂ©s dans cette Ă©tude : - la maladie dâAlzheimer : quâest-Âce que la dĂ©mence ? - la communication : comment communiquer avec les personnes atteintes de dĂ©mence ? â la profession dâanimateur socioculturel : quel est le sens de lâanimation auprĂšs de ce public ? â les Ă©motions : que fait lâanimateur socioculturel de ses Ă©motions ? Pour mener Ă bien cette recherche, jâai utilisĂ© la mĂ©thode inductive ; en partant du terrain, soit huit journĂ©es dâobservations dans un EMS spĂ©cialisĂ© dans lâaccueil de personnes atteintes de dĂ©mence, jâai recueilli des donnĂ©es qui mâont permis de formuler ma question de recherche et mes hypothĂšses. Jâai ensuite comparĂ© mon analyse Ă diffĂ©rents auteurs traitant de ce thĂšme. Ce travail permet, entre autres, de mettre en exergue lâimportance de la profession dâanimateur auprĂšs de ce public si Ă©nigmatique, si complexe et par lĂ difficilement accessible. En outre, cette Ă©tude atteste de lâimportance dâun espace dĂ©diĂ© Ă lâĂ©motion du travailleur, afin de pouvoir ĂȘtre davantage centrĂ© sur lâautre dans sa pratique quotidienne
Establishment of a Swine Model for Validation of Perfusion Measurement by Dynamic Contrast-Enhanced Magnetic Resonance Imaging
The aim of the study was to develop a suitable animal model for validating dynamic contrast-enhanced magnetic resonance imaging perfusion measurements. A total of 8 pigs were investigated by DCE-MRI. Perfusion was determined on the hind leg musculature. An ultrasound flow probe placed around the femoral artery provided flow measurements independent of MRI and served as the standard of reference. Images were acquired on a 1.5 T MRI scanner using a 3D T1-weighted gradient-echo sequence. An arterial catheter for local injection was implanted in the femoral artery. Continuous injection of adenosine for vasodilation resulted in steady blood flow levels up to four times the baseline level. In this way, three different stable perfusion levels were induced and measured. A central venous catheter was used for injection of two different types of contrast media. A low-molecular weight contrast medium and a blood pool contrast medium were used. A total of 6 perfusion measurements were performed with a time interval of about 20-25 min without significant differences in the arterial input functions. In conclusion the accuracy of DCE-MRI-based perfusion measurement can be validated by comparison of the integrated perfusion signal of the hind leg musculature with the blood flow values measured with the ultrasound flow probe around the femoral artery
Comparison between B·R·A·H·M·S PCT direct, a new sensitive point-of-care testing device for rapid quantification of procalcitonin in emergency department patients and established reference methods - a prospective multinational trial
Background: Procalcitonin (PCT) is increasingly being used for the diagnostic and prognostic work up of patients with suspected infections in the emergency department (ED). Recently, B·R·A·H·M·S PCT direct, the first high sensitive point-of-care test (POCT), has been developed for fast PCT measurement on capillary or venous blood samples. Methods: This is a prospective, international comparison study conducted in three European EDs. Consecutive patients with suspicion of bacterial infection were included. Duplicate determination of PCT was performed in capillary (fingertip) and venous whole blood (EDTA), and compared to the reference method. The diagnostic accuracy was evaluated by correlation and concordance analyses. Results: Three hundred and three patients were included over a 6-month period (60.4% male, median age 65.2 years). The correlation between capillary or venous whole blood and the reference method was excellent: r2=0.96 and 0.97, sensitivity 88.1% and 93.0%, specificity 96.5% and 96.8%, concordance 93% and 95%, respectively at a 0.25 Όg/L threshold. No significant bias was observed (-0.04 and -0.02 for capillary and venous whole blood) although there were 6.8% and 5.1% outliers, respectively. B·R·A·H·M·S PCT direct had a shorter time to result as compared to the reference method (25 vs. 144 min, difference 119 min, 95% CI 110-134 min, p<0.0001). Conclusions: This study found a high diagnostic accuracy and a faster time to result of B·R·A·H·M·S PCT direct in the ED setting, allowing shortening time to therapy and a more wide-spread use of PCT
Evaluating the impact of targeting livestock for the prevention of human and animal trypanosomiasis, at village level, in districts newly affected with T. b. rhodesiense in Uganda
Background: Uganda has suffered from a series of epidemics of Human African Trypanosomiasis (HAT), a tsetse transmitted disease, also known as sleeping sickness. The area affected by acute Trypanosoma brucei rhodesiense HAT (rHAT) has been expanding, driven by importation of infected cattle into regions previously free of the disease. These regions are also affected by African Animal Trypanosomiasis (AAT) demanding a strategy for integrated disease control.Methods: In 2008, the Public Private Partnership, Stamp Out Sleeping Sickness (SOS) administered a single dose of trypanocide to 31 486 head of cattle in 29 parishes in Dokolo and Kaberamaido districts. This study examines the impact of this intervention on the prevalence of rHAT and AAT trypanosomes in cattle from villages that had (HAT+ve) or had not (HAT-ve) experienced a recent case of rHAT. Cattle herds from 20 villages were sampled and screened by PCR, pre-intervention and 6-months post-intervention, for the presence or absence of: Trypanosoma brucei s.l.; human infective T. b. rhodesiense; Trypanosoma vivax; and Trypanosoma congolense savannah.Results: Post-intervention, there was a significant decrease in the prevalence of T. brucei s.l. and the human infective sub-species T. b. rhodesiense in village cattle across all 20 villages. The prevalence of T. b. rhodesiense was reduced from 2.4% to 0.74% (Pâ<â0.0001), with the intervention showing greater impact in HAT-ve villages. The number of villages containing cattle harbouring human infective parasites decreased from 15/20 to 8/20, with T. b. rhodesiense infection mainly persisting within cattle in HAT+ve villages (six/eight). The proportion of T. brucei s.l. infections identified as human infective T. b. rhodesiense decreased after the intervention from 8.3% (95% CIâ=â11.1â5.9%) to 4.1% (95% CIâ=â6.8â2.3%). Villages that had experienced a recent human case (HAT+ve villages) showed a significantly higher prevalence for AAT both pre- and post-intervention. For AAT the prevalence of T. vivax was significantly reduced from 5.9% to 0.05% post-intervention while the prevalence of T. congolense increased from 8.0% to 12.2%.Conclusions: The intervention resulted in a significant decrease in the prevalence of T. brucei s.l., human infective T. b. rhodesiense and T. vivax infection in village cattle herds. The proportion of T. brucei s.l. that were human infective, decreased from 1:12âT. brucei s.l. infections before the intervention to 1:33 post-intervention. It is clearly more difficult to eliminate T. b. rhodesiense from cattle in villages that have experienced a human case. Evidence of elevated levels of AAT in livestock within village herds is a useful indicator of risk for rHAT in Uganda. Integrated veterinary and medical surveillance is key to successful control of zoonotic rHAT
Establishment of a Swine Model for Validation of Perfusion Measurement by Dynamic Contrast-Enhanced Magnetic Resonance Imaging
The aim of the study was to develop a suitable animal model for validating dynamic contrast-enhanced magnetic resonance imaging perfusion measurements. A total of 8 pigs were investigated by DCE-MRI. Perfusion was determined on the hind leg musculature. An ultrasound flow probe placed around the femoral artery provided flow measurements independent of MRI and served as the standard of reference. Images were acquired on a 1.5 T MRI scanner using a 3D T1-weighted gradient-echo sequence. An arterial catheter for local injection was implanted in the femoral artery. Continuous injection of adenosine for vasodilation resulted in steady blood flow levels up to four times the baseline level. In this way, three different stable perfusion levels were induced and measured. A central venous catheter was used for injection of two different types of contrast media. A low-molecular weight contrast medium and a blood pool contrast medium were used. A total of 6 perfusion measurements were performed with a time interval of about 20â25âmin without significant differences in the arterial input functions. In conclusion the accuracy of DCE-MRI-based perfusion measurement can be validated by comparison of the integrated perfusion signal of the hind leg musculature with the blood flow values measured with the ultrasound flow probe around the femoral artery