Apprentissage en immersion virtuelle (APIM)

Le rapport a pour but d’expliquer ce que sont les wearable devices, la réalité augmentée et la réalité virtuelle et de décrire les moyens d’utiliser cette dernière à des fins d’apprentissage, notamment à l’aide de casques de réalité virtuelle. De plus, un prototype basé sur un cas pratique a également été développé et est joint à ce document, comme exigé par la donnée du travail de Bachelor, établie en décembre 2014

Point-of-care screening for syphilis and HIV in the borderlands: challenges in implementation in the Brazilian Amazon.

BACKGROUND: Point-of-care (POC) screening for HIV and syphilis using rapid testing was implemented in indigenous communities in the triple-border area of the Brazilian Amazon. We describe the context of the early introduction of POC screening, explore hindering and enabling factors for POC implementation, and recommend strategies for feasible, viable, and sustainable syphilis and HIV screening interventions. METHODS: This was a qualitative study based on grounded theory methodology. Data were collected using in-depth interviews, semi-structured questionnaires, and field observations and were analysed using the framework approach. Qualitative information was complemented by quantitative data for descriptive purposes. RESULTS: An overall high score for vulnerability to acquiring HIV and syphilis was observed among the indigenous communities. Health professionals reported satisfactory rapid testing acceptance, although concerns were raised about the pain of the fingerprick. Counselling-related challenges included ensuring the accuracy of translations, collaborating with translators and communicating positive test results. Over 3 months, 86.7% of the syphilis-positive individuals began treatment, and all of them notified their partners. Accessibility, measured as travel time via the local transportation network, was a barrier to health care access. A lack of gasoline for boats and other transportation was also a hindering factor at all levels of implementation. CONCLUSIONS: The recommendations address the preparation phase at the coordination level as well as at the training level. Tools such as strengths, weaknesses, opportunities, and threats (SWOT) analyses; checklists; context-adapted protocols; and fact sheets are very simple methods to facilitate implementation. The findings of this study are important because they may inform the implementation of new health technologies in low-resource national disease control programmes in remote communities

"Droit en haut la pente". Vers une nouvelle urbanité dans les villes de moyenne altitude. Le cas de Haute-Nendaz

L’arrivée du tourisme hivernal dans les années 1960 a bouleversé le développement des régions alpines. Aujourd’hui, il s’agit de trouver des solutions pour pallier aux dysfonctionnements que certaines stations valaisannes connaissent : abondance de résidences secondaires, étalement urbain, omniprésence automobile ou absence d’espaces publics. Les stratégies de développement territorial doivent donc réfléchir à des solutions pour l’espace alpin. L’idée de la ville de Sion de créer un quartier d’habitation au fond de la piste de l’Ours, combinée à une liaison plaine-montagne, paraît à contre-courant. Pourquoi coloniser une nature presque vierge alors que des espaces fortement construits existent déjà ailleurs? Le téléphérique semble être une infrastructure de mobilité capable de répondre aux défis à relever face au développement actuel. Sa capacité à structurer le territoire en offrant une alternative à la voiture se révèle comme l’une de ses qualités majeures. Projetée entre Sion et Nendaz, cette installation est conçue comme un véritable transport public. Son arrivée au cœur de la station génère un nouveau dynamisme et redessine l’espace public, encourageant ainsi les propriétaires à transformer leurs biens immobiliers. “Droit en haut dans la pente” : promesse ou utopie? Une proposition quoi qu’il en soit nécessaire dans la réflexion globale sur notre héritage alpin. Il faut construire dans la montagne construite afin de la pérenniser et songer ainsi à une nouvelle urbanité alpine

Medical aspects of helicopter rescue missions involving winching of a physician

Introduction: Whereas the use of helicopters as a rapid means toreach victims and to bring them to a secure place is well-recognized,very few data are available about the value of winching physicians toprovide medical care for the victims directly on-site. We sought to studythe medical aspects of alpine helicopter rescue operations involving thewinching of an emergency physician to the victim.Methods: We retrospectively reviewed the medical reports of a singlehelicopter-based emergency medical service. Data from 1 January 2003to 31 December 2008 were analyzed. Cases with emergency callindicating that the victim was deceased were excluded. Data includedthe category (trauma or illnesses), and severity (NACA score) of theinjuries, along with the main medical procedures performed on site.Results: 9879 rescue missions were conducted between 1 January2003 and 31 December 2008. The 921 (9.3%) missions involvingwinching of the emergency physician were analysed. 840 (91%)patients suffered from trauma-related injuries. The cases of the 81 (9%)people presenting with medical emergencies were, when compared tothe trauma victims, significantly more severe according to the NACAindex (p <0.001). Overall, 246 (27%) patients had a severe injury orillness, namely, a potential or overt vital threat (NACA score between4-6, table 1). A total of 478 (52%) patients required administration ofmajor analgesics: fentanyl (443 patients; 48%), ketamine (42 patients;5%) or morphine (7 patients; 1%). The mean dose of fentanyl was 188micrograms (range 25-750, SD 127). Major medical interventions wereperformed 72 times on 39 (4%) patients (table 2).Conclusions: The severity of the patients' injuries or illnesses alongwith the high proportion of medical procedures performed directlyon-site validate emergency physician winching for advanced life supportprocedures and analgesia