Sante Publique
-
The combination of specialised in-patient management, the development of diagnostic and therapeutic tools, the standardisation of procedures and organisation of the dies will allow for improving the prognosis of neurological patients seen in emergency situations. In order to achieve this objective, the Networks for Diagnosing and Treating Neurological Emergencies (RAIDS-UN) in Franche-Comté (FC) aim to better the quality of in-patient management for emergency on-set neurological pathologies such as traumatic brain injuries and strokes, the preparation and structuring of the dies for diagnosis and treatment, and assistance in neurology decision making. Based upon the needs of networks which approach the problem from two different directions--the RAIDS-UN/FC network (for neurological emergencies) and the RAIDS-UN/AVC network (for prevention and treatment of strokes)--they should both be able to benefit from new information and communication technologies (ICTs) in order to promote and support innovations in practice and contribute to the improvement in quality and health promotion effectiveness. ⋯ Since 2001, the expansion of the RAIDS-UN networks has emphasised the need for the development of new professional specialties arising on the border between technology and medicine. The operation of these networks requires a strong partnership with health professionals and strategically relies upon a regional dynamic interaction which includes the hospitals, the city, the institutions and the university. It is in this manner that the RAIDS-UN networks will support other initiatives such as the Towards Unity for Health project.
-
In the recent past, the British and French health care systems have both undergone significant reforms, enveloped in a state of Urgency, resulting primarily in France from the increasing rate of growth in health expenditure and in England from malfunctioning procedures such as waiting lists. After describing current features of the National Health Service (NHS), this study extracts and considers the points of convergence and divergence in the respective policies of the two countries: similarities in the choice of priorities, decentralisation of decision-making, negotiation between actors at the local level, development of the quality concept, and the differences in formulating objectives and involving the system's users. The considerations provided here should allow for a better understanding of the developments of these respective health policies and their future evolution.
-
Comparative Study
[Children's medical records, HIV and confidentiality: practices and attitudes of physicians and families].
The aim of this study is to describe the attitudes and practices of doctors and families regarding the use of the individual child health journal, especially by exploring the contradictions between the validity and confidentiality of its content, in particular with respect to HIV infection. In order to accomplish this, both doctors (N = 380) and families (N = 242) were questioned, most of them living and working in Seine-Saint-Denis, the metropolitan district with the third highest prevalence rate of HIV. The findings indicate that: most families are not always prepared to make sure that the confidential use of the child's health journal is maintained, and even less so those affected by HIV; doctors refrain from recording certain psychological and even medical data in the child health journal for fear of the information's misuse within the social sphere; doctors as well as families expressed their preoccupations concerning the confidentiality of the child health journal, essentially with respect to its content and how it is used in various contexts. A number of possibilities are proposed by the study's participants: establish a vaccination record separate from the child health journal, educate parents on how to maintain its confidential use and train the health workers to this end.
-
The authors describe the utilisation of a quality assessment tool for palliative care administered at home. The questionnaire entitled Support Team Assessment Schedule (STAS) was translated from English for this study. It was then utilised comparatively with different quality of life evaluation instruments. ⋯ The STAS comprises nine items pertaining to the patient and his/her family, and seven items concerning the services provided. The study exhibits the results of 107 evaluations completed from 50 patients stricken with cancer or AIDS in an advanced phase. The availability of this auto clinical audit tool, employable at home or in a hospital, constitutes an essential initial step in the field of French-speaking clinical evaluation of palliative care.