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1.
Ernesto Lopez-Valeiras Jacobo Gomez-Conde Rogerio Joao Lunkes 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(2):129-134
Objective
Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems.Methods
We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis.Results
Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure.Conclusions
The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior. 相似文献2.
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A. Grateau M. Le Maréchal H. Labussière-Wallet S. Ducastelle-Leprêtre F.-E. Nicolini X. Thomas S. Morisset M. Michallet F. Ader 《Médecine et maladies infectieuses》2018,48(3):202-206
Objectives
To study the management of chronic disseminated candidiasis (CDC) in patients presenting with acute leukemia.Patients and methods
Single-center retrospective study of acute leukemia patients (2006–2015) to investigate three aspects of CDC: its impact on the time interval between diagnosis and hematopoietic stem cell transplantation, when required (non-parametric Wilcoxon-Mann-Whitney test); its impact on overall survival (Cox proportional hazard regression model); antifungal therapeutic strategies implemented.Results
A total of 639 patients presenting with acute leukemia were included; 144 were transplanted and 29 developed CDC. CDC did not significantly increase the time interval between diagnosis and transplantation, nor did it impact the overall survival of recipients. An improved overall survival was observed in non-transplanted acute leukemia patients presenting with CDC.Conclusion
CDC should not postpone transplantation if antifungal treatment is optimized. 相似文献5.
Background
Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics.Methods
This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the “Health Belief Model”.Results
The weighted national prevalence of “ever-use” of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening.Conclusion
Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear. 相似文献6.
Martin Emmert Fatemeh Taheri-Zadeh Benjamin Kolb Uwe Sander 《Health policy (Amsterdam, Netherlands)》2017,121(1):17-26
Background
Evidence from the US has demonstrated that hospital report cards might generate confusion for consumers who are searching for a hospital. So far, little is known regarding hospital ranking agreement on German report cards as well as underlying factors creating disagreement.Objective
This study examined the consistency of hospital recommendations on German hospital report cards and discussed underlying reasons for differences.Methods
We compared hospital recommendations for three procedures on four German hospital report cards. The agreement between two report cards was determined by Cohen’s-Kappa. Fleiss’ kappa was applied to evaluate the overlap across all four report cards.Results
Overall, 43.40% of all hospitals were labeled equally as low, middle, or top performers on two report cards (hip replacement: 43.2%; knee replacement: 42.8%; percutaneous coronary intervention: 44.3%). In contrast, 8.5% of all hospitals were rated a top performer on one report card and a low performer on another report card. The inter-report card agreement was slight at best between two report cards (κmax = 0.148) and poor between all four report cards (κmax = 0.111).Conclusions
To increase the benefit of public reporting, increasing the transparency about the concept of – medical – “quality” that is represented on each report card seems to be important. This would help patients and other consumers use the report cards that most represent one’s individual preferences. 相似文献7.
Eduarda Barreira André Novo Josiana A. Vaz Ana M.G. Pereira 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(10):590-610
Objectives
Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over.Design
Systematic review.Data source
PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included.Study selection
A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over.Results
The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes.Conclusions
Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus. 相似文献8.
A. Bouaziz I. Uçkay S. Lustig A. Boibieux D. Lew P. Hoffmeyer P. Neyret C. Chidiac T. Ferry 《Médecine et maladies infectieuses》2018,48(3):207-211
Objective
The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.Patients and methods
Retrospective (2000–2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.Results
Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1.022–4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome.Conclusion
Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure. 相似文献9.
C. Wintenberger B. Guery E. Bonnet B. Castan R. Cohen S. Diamantis P. Lesprit L. Maulin Y. Péan E. Peju L. Piroth J.P. Stahl C. Strady E. Varon F. Vuotto R. Gauzit 《Médecine et maladies infectieuses》2017,47(2):92-141
Objectives
Reducing antibiotic consumption has now become a major public health priority. Reducing treatment duration is one of the means to achieve this objective. Guidelines on the therapeutic management of the most frequent infections recommend ranges of treatment duration in the ratio of one to two. The Recommendation Group of the French Infectious Diseases Society (SPILF) was asked to collect literature data to then recommend the shortest treatment durations possible for various infections.Methods
Analysis of the literature focused on guidelines published in French and English, supported by a systematic search on PubMed. Articles dating from one year before the guidelines publication to August 31, 2015 were searched on the website.Results
The shortest treatment durations based on the relevant clinical data were suggested for upper and lower respiratory tract infections, central venous catheter-related and uncomplicated primary bacteremia, infective endocarditis, bacterial meningitis, intra-abdominal, urinary tract, upper reproductive tract, bone and joint, skin and soft tissue infections, and febrile neutropenia. Details of analyzed articles were shown in tables.Conclusion
This work stresses the need for new well-conducted studies evaluating treatment durations for some common infections. Following the above-mentioned work focusing on existing literature data, the Recommendation Group of the SPILF suggests specific study proposals. 相似文献10.
Seyyed Mostafa Nachvak Safoora Hedayati Najmeh Hejazi Ali Motamedi-Motlagh Hadi Abdollahzad 《Nutrition Clinique et Métabolisme》2018,32(2):122-128
Objective
Malnutrition is a concerning problem among hospitalized patients in intensive care units (ICUS): it can lead to increase infection, hospital costs and mortality. Inadequate energy intake is one of the most important risk factors in the etiology of malnutrition during the hospital stay. The aim of this study was to assess nutritional care and energy balance in patients hospitalized in Iranian intensive care units.Methods
This study was conducted on 124 patients in two general hospitals in Amol, a city in the north of Iran, from May 2015 to February 2016. Anthropometric indices such as mid-arm muscle circumference (MAMC), mid-upper-arm circumference (MUAC), triceps skinfold thickness (TSF) and calf circumference were measured at admission and discharge. Energy and protein needs and intake were measured daily during each patient's ICU stay. Two questionnaires — Subjective Global Assessment (SGA) and Sequential Organ Failure Assessment (SOFA) — were used to assess nutritional status.Results
Formula made in-house was the main formula for tube feeding in Iran's hospitals. The energy and protein intake of patients in ICUS was significantly less than their requirements. The rate of malnutrition was 39.6% on admission and 83.1% on discharge, based on the SGA and mean SOFA score, which decreased significantly during patients’ ICU stay. All of the patients’ anthropometric measurements decreased significantly during their ICU stay.Conclusions
The present study showed that nutrition support for Iranian ICUs patients was inappropriate. A consideration of nutritional care to prevent malnutrition and other complications is necessary in ICUS. 相似文献11.
D. Vandroux N. Allou J. Jabot G. Li Pat Yuen E. Brottet B. Roquebert O. Martinet 《Médecine et maladies infectieuses》2018,48(2):141-144
Background
Coronavirus OC43 infection causes severe pneumonia in patients presenting with comorbidities, but clinical signs alone do not allow for viral identification.Objectives
To analyze acute manifestations of Coronavirus OC43 infections and outcomes of patients admitted to an intensive care unit (ICU).Patients and methods
Retrospective and monocentric study performed during a Coronavirus OC43 outbreak. We used multiplex PCR to detect an OC43 outbreak in Reunion Island during the 2016 Southern Hemisphere's winter: seven admissions to the ICU.Results
Mean age of patients was 71 [67;76] years, SAPS II was 42 [28;53], pneumonia severity index 159 [139;182] vs 73 [40.5;107] for patients in medical wards, and 43% required mechanical ventilation. Comorbidities were diabetes mellitus (87%), chronic respiratory failure (57%), and chronic renal failure (29%). One patient died from Haemophilus influenzae co-infection.Conclusion
As for MERS Co-V infections, underlying comorbidities impacted the clinical outcomes of OC43 infections. 相似文献12.
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Objectives
Although regularly looked for in blood donors, HTLV infections are very rare in Reunion. We aimed to describe HTLV infections locally.Patients and methods
HTLV infections were identified from the database of the Reunion University Hospital administrative database (PMSI) between 2000 and 2016. Diagnosis was performed with HTLV 1/2 enzyme immunoassay test and confirmed by Western blot.Results
We reported three asymptomatic and four symptomatic HTLV infections, including two tropical spastic paraparesis/HTLV-1 associated myelopathies (TSP/HAM) and two adult T-cell leukemia/lymphoma (ATLL), diagnosed between 2000 and 2016.Conclusion
Reunion is a low HTLV prevalence area, which could be explained by its settlement history. The present report underlines the local circulation of HTLV and symptomatic infections. 相似文献14.
Xavier Continente Anna Pérez Albert Espelt Carles Ariza María José López 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):332-335
Objective
We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain.Methods
A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire.Results
More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR = 1.56; 95% confidence interval: 1.19-2.05).Conclusions
These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity. 相似文献15.
N. Masdoua L. Boublenza H. Hassaine J. Ngou A. Nahet M. Segondy F. Razik D. Regagba N. Sadouki D. Mouhammedi 《Médecine et maladies infectieuses》2017,47(1):38-41
Objectives
We aimed to characterize HPV infections and cervical lesions in Western Algeria.Patients and methods
A total of 96 cervical samples obtained from women at risk of HPV infection (HIV-1-infected or presenting with a gynecological disease) were analyzed to characterize this infection and search for cytological abnormalities.Results
A total of 60% of women at risk had an HPV infection. The rate of high-risk HPV (HR-HPV) infection among these women was 84.5% and that of intraepithelial lesions was 29.3%. The frequency of HPV infection was significantly higher among HIV-1-infected patients. An association between the presence of HR-HPV and the polygamy of the partner was observed. An association between cytological abnormalities and the use of oral contraceptives was observed among HIV-1-infected women.Conclusion
Given the high frequency of HPV infection in this at risk population, close monitoring and regular gynecological screening are essential. 相似文献16.
V. Perut H. Aumaître E. Pichard O. Patey P. Andre Y. Welker O. Bouchaud C. Rabaud D. Salmon Ceron 《Médecine et maladies infectieuses》2017,47(1):50-57
Objectives
To assess the organization, activity, and funding of transversal infectious diseases (ID) activity in French hospitals.Methods
Cross-sectional questionnaire-based survey conducted in 2013–2014.Results
The questionnaire was returned by 66 hospitals (response rate: 63%). A transversal ID consultancy activity was present in 65 hospitals (98%) and had existed for a median of 6 years. The median team size for transversal ID activity was equivalent to 0.8 full-time physicians. Among the 16 hospitals (25%) with a full-time physician dedicated to transversal ID activity, only 6 university hospitals received dedicated funding. Teams with a transversal ID activity received a median of 35 calls for advice (IQR = 20–60) per week from other hospital departments, and 14 calls from external structures. They participated in multidisciplinary meetings (75%), dedicated staff meetings (bacteriologists, pharmacists, or infection control physicians – 51%), and promoted antibiotic stewardship (antibiotic usage guidelines (72%) and auditing (62%)). Eleven teams (17%) prepared an annual report of their transversal ID activity, and 30 teams (46%) recorded the number of calls for advice. Twenty-one teams cross-charged their in-hospital transversal ID consultancy, and 5 teams invoiced their external consultancy, with a recovery of the relevant funds by 8 teams.Conclusion
Although most French hospitals that responded to this survey had a transversal ID consultancy activity, not all had implemented an antibiotic stewardship program. Few teams conducted standardized data collection or cross-charged their transversal ID activity. Moreover, teams rarely received specific funding for a full-time ID physician dedicated to transversal ID activity. 相似文献17.
C. Poulalhon L. Rotelli-Bihet C. Raso R. Aubry A. Fagot-Campagna P. Tuppin 《Revue d'épidémiologie et de santé publique》2018,66(1):33-42
Aim
Only limited data are available concerning the diseases managed and the hospital pathway before death. The aim of this study was to describe diseases, hospitalisations, and use of palliative care one year before death as well as place of death in France.Methods
French health insurance general scheme beneficiaries who died in 2013 were identified in the National Health Insurance Information System (SNIIRAM) with a selection of information concerning their various hospital stays, including hospital palliative care (HPC) and nursing home care. Diseases were identified by algorithms from reimbursement data recorded in the SNIIRAM database.Results
A total of 347 253 people were included (61% of all deaths in France). The mean age of death was 77 years (SD 15.1). Diseases managed before death were cardiovascular/neurovascular diseases (56%), cancers (42%), neurological and degenerative diseases (25%), diabetes (21%) and chronic respiratory diseases (20%). Deaths occurred in hospital in 60% of cases: 51% in acute wards, 6% in rehabilitation units, 3% in hospital at home (HaH), and 13% in nursing homes. During the year preceding death, 84% of people were hospitalised at least once and 29% received HPC. People receiving HPC more often died in hospital than people not receiving HPC (69% vs. 44%).Conclusion
Health administrative data from the SNIIRAM database can refine our knowledge of the care pathway prior to death and of the use of hospital palliative care and can be useful to evaluate the new governmental palliative care plan recently deployed in France. 相似文献18.
C. Vandererven A.-P. Bellanger J.-F. Faucher P. Marguet 《Médecine et maladies infectieuses》2017,47(4):261-265
Introduction
Tick bites, which may lead to Lyme disease, often prompt patients to consult their primary care physicians (PCPs). The aim of the present study was to assess how and how often PCPs in the Franche-Comté region of France manage tick bites.Material and methods
Standardized questionnaires were sent to a random sample of 400 PCPs in the Franche-Comté region, requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details and practice-related information about tick-bite prophylaxis, Lyme serology, and tick-borne encephalitis vaccination.Results
The crude response rate was 54.5% of the PCPs contacted. Tick-bite prophylaxis was prescribed as per current guidelines. However, Lyme serology seemed to be largely overprescribed for tick bites and in case of erythema migrans. A clear lack of knowledge about tick-borne encephalitis vaccination was also observed.Discussion
PCPs provide the first line of care for patients presenting with tick bites. This study showed that although PCPs of the Franche-Comté region manage tick bites as per current guidelines, they need further training on Lyme serology limitations and availability of tick-borne encephalitis vaccination. 相似文献19.
H. Coignard-Biehler C. Rapp J.M. Chapplain B. Hoen D. Che P. Berthelot F. Cazenave-Roblot C. Rabaud P. Brouqui C. Leport 《Médecine et maladies infectieuses》2018,48(2):95-102
Context
In 2012, the French Infectious Diseases Society (French acronym SPILF) initiated the “Coordination of epidemic and biological risk” (SPILF-COREB - Emergences [SCE]) group to support the readiness and response of healthcare workers (HCWs) to new alerts.Objective
To present the SCE group, its functioning, and the main support it provided for frontline HCWs.Methods
A multidisciplinary group of heads of infectious disease departments from reference hospitals was created to build a network of clinical expertise for care, training, and research in the field of epidemic and biological risk (EBR). The network developed a set of standardized operational procedures (SOPs) to guide interventions to manage EBR-suspect patients.Results
A working group created the SOP aimed at frontline HCWs taking care of patients. Priority was given to the development of a generic procedure, which was then adapted according to the current alert. Five key steps were identified and hierarchized: detecting, protecting, caring for, alerting, and referring the EBR patient. The interaction between clinicians and those responsible for the protection of the community was crucial. The SOPs validated by the SPILF and its affiliates were disseminated to a wide range of key stakeholders through various media including workshops and the SPILF's website.Conclusion
SPILF can easily adapt and timely mobilize the EBR expertise in case of an alert. The present work suggests that sharing and discussing this experience, initiated at the European level, can generate a new collective expertise and needs to be further developed and strengthened. 相似文献20.
Erica Kintz Julii Brainard Lee Hooper Paul Hunter 《International journal of hygiene and environmental health》2017,220(1):57-67