Diagnosis of intravascular catheter infection

PURPOSE OF REVIEW: To review the distinction between catheter-related and catheter-associated infections and to report the recent advances in the methods used for their diagnosis. RECENT FINDINGS: The distinction between device-associated and device-related infections affects the effective benchmarking of the rates of both types of infection. Numerous microbiological methods have been described to diagnose these infections. Studies comparing the performance of microbiological methods that avoid the removal of the intravascular device have recently suggested that they may be effective in daily life. SUMMARY: The present review summarizes recent advances in the methods currently available to diagnose intravascular catheter-related infections and their performance at the bedside

Susan Eggimann to Sir (3 October 1962)

https://egrove.olemiss.edu/mercorr_pro/1173/thumbnail.jp

Prevention of intravascular catheter infection

PURPOSE OF REVIEW: To review recent evidence supporting the guidelines for preventing catheter-related and catheter-associated infections. RECENT FINDINGS: A series of studies has confirmed, over the past few years, that education-based preventive programmes can reduce these infections by one half to two thirds. The evidence supporting some specific measures has increased for the optimal timing for set replacement, for catheter-site dressing with chlorhexidine-impregnated devices, and for the use of some coated or impregnated intravascular devices. SUMMARY: Catheter-related and associated infections are largely preventable and should not be viewed as an unaffordable tribute to technical medicine. Improvements in existing techniques and new technologies should all be integrated into a structured process of continuous improvement in the quality of care

Comparability of Health Care Responsiveness in Europe using anchoring vignettes from SHARE

The aim of this paper is to measure and to correct for the potential incomparability of responses to the SHARE survey on health care responsiveness. A parametric approach based on the use of anchoring vignettes is applied to cross-sectional data (2006-07) in ten European countries. More than 6,000 respondents aged 50 years old and over were asked to assess the quality of health care responsiveness in three domains: waiting time for medical treatment, quality of the conditions in visited health facilities, and communication and involvement in decisions about the treatment. Chopit models estimates suggest that reporting heterogenity is influenced by both individual (socio-economic, health) and national characteristics. Although correction for differential item functioning does not considerably modify countries ranking after controlling for the usual covariates, about two thirds of the respondents' self-assessments have been re-scaled in each domain. Our results suggest that reporting heterogenity tends to overestimate health care responsiveness for "time to wait for treatment", whereas it seems to underestimate people's self-assessment in the two other domains.Anchoring Vignettes, Cross-Country Comparison, Chopit Model

Evolution of the needs of older persons

Most countries in the world experienced a ma'pr increase in life expectancy during the 20th century and a resulting aging of their populations. Further gains in life expectancy are uncertain, particularly in developed countries already characterized by a high longevity, and little is known concerning the health state of future generations of the elderly. But there is no doubt that further population aging will produce larger numbers of older persons both in developed and developing countries. As the prevalence of most chronic diseases is high in old age, population needs change rapidly in health care systems still organized essentially to provide acute care to children and young adults. Old age is heterogeneous, but a large proportion of older persons is affected by multiple chronic diseases, resulting in a wide range of needs. Health systems will have to adapt to this new situation while still providing appropriate responses to acute diseases affecting all ages. Although future needs are difficult to quantify, their nature is already apparent. Providing for these needs will require a major investment in manpower, a diversification of services delivered by health care systems, changes in the training of health professionals and extensive research to define effective treatments for elderly patients with multiple co-morbiditie

Etudier la fragilité : une priorité de santé publique

L'étude de cohorte Lc65+ suit depuis 2004 plusieurs milliers de personnes pour mieux comprendre la fragilisation liée au vieillissement. Que sait-on aujourd'hui de la fragilité ? Peut-on la mesurer ? Pourquoi le faire