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Copyright of Revue Française de Gestion is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Vie et Sciences de l'Entreprise is the property of ANDESE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Psoriasis is a chronic inflammatory skin disease affecting almost 1% of children, starting the first months of life. In some journals, this prevalence is reported to be between 0.4 and 0.7%. We are reporting a case of childhood psoriasis in a 2-year-old patient. The case was observed in the Dermatology unit at the Hubert Koutoukou Maga National University Hospital of Cotonou (CNHU-HKM). The case clinical description will allow us to show the difficulties in establishing a diagnosis and how little are the treatment choices available in our clinical settings. [ABSTRACT FROM AUTHOR]

Introduction. The strategies developed by the management of public medical institutions are based on state regulations in various areas: type of services provided, human resources, etc., decisions need to be coordinated with central and/or local public authorities, to which the institution is subordinated. However, it is necessary for the process of developing and implementing strategies to include a number of mandatory steps at institutional level, which must be taken by the institution's management. Material and methods. The aim of the study is to assess the experience of public hospital managers in developing and implementing management strategies. An assessment grid was applied for this purpose. The questions were classified into six fields: setting management strategy, added value strategy, analysis of institutional environment, institutional policies and strategic objectives, resources needed, strategy assessment. Results. In the absence of the regulation on the structure and main rules for the development of institutional strategies, the study demonstrates a very different approach of the top management regarding the strategic process in public hospitals. Conclusions. The different and sometimes erroneous approach to strategy development by the top managers results in a weak institutional strategic process.

Introduction. According to the normative provisions, the Board of Directors (hereinafter the BD) is an administrative and supervisory body of public hospitals, which, in addition to other exclusive (quite limited) duties, is responsible for the examination and approval of the plans of activity of the hospital. However, just as the expressions "strategic plan" or "strategy" do not appear in this task, sometimes the involvement of the BD in the examination and approval of institutional strategic documents are omitted. Material and methods. The purpose of the study is to evaluate the experience of the BD members of the public hospitals in the North region, regarding the involvement in the institutional strategic process. They expressed their opinion on the perceived role in the process of elaboration and implementation of institutional strategies; the vision, mission and set of institutional values, strategic areas, the performance of which they monitor; communication with stakeholders in the strategic context; taking corrective action in a timely manner, etc. The strategies / strategic plans of the medical institutions included in the study were analyzed too. Results. The results of the study show that the involvement of BD members of the public hospitals in the institutional strategic process is often formal and declarative. Conclusions. The study emphasizes a superficial attitude of the BD members on the strategic process or the fact that they do not have the necessary competencies to examine the institutional strategies.

Résumé: Dans le cadre du retraitement comptable des établissements, la nouvelle unité d'œuvre (UO) des pharmacies à usage intérieur (PUI) de la base d'Angers introduit une appréciation plus exhaustive des activités pharmaceutiques et plus proche du référentiel de la Société française de pharmacie clinique que la précédente [5, 6]. Il est attendu de cette redéfinition de l'UO une meilleure analyse des organisations pharmaceutiques au sein des établissements. L'objectif de ce travail est de s'interroger sur l'intérêt de l'UO à rendre compte des évolutions organisationnelles de la pharmacie à usage intérieur (PUI) du groupe hospitalier Paul Guiraud (GHPG) en faveur du déploiement quantitatif et qualitatif des activités de pharmacie clinique. Matériel et méthode. Il s'agit d'une étude rétrospective observationnelle sur données. Les données sont issues des rapports d'activités des années 2017 [3], 2021 [4] de la PUI du GHPG, de deux études de temps travaillés conduites en interne, des données d'hospitalisation temps plein du GHPG [2] et des données de temps travaillés colligées et pondérées par l'ANAP auprès de neuf PUI d'établissements psychiatriques. Elles ont été analysées avec le logiciel SPSS (v.28.0.1). Résultats et discussion. L'étude comparative sur les temps travaillés en matière de dispensation globale (activité de référence) et de conciliations médicamenteuses (l'une des activités de pharmacie clinique) entre la PUI du GHPG d'une part et les PUI des établissements psychiatriques de l'échantillon test d'autre part, révèle une plage de valeurs dans laquelle s'inscrit la PUI du GHPG. En ce sens, quand bien même les PUI seraient distinctes par leur organisation, leurs activités, leur taille ou leurs moyens, l'étude de temps travaillé et pondéré révèle une certaine homogénéité des PUI d'établissements psychiatriques. Au cours de la période d'étude, les dispensations augmentent de 10 % lorsqu'elles sont exprimées en nombre d'actes, diminuent de 3 % en temps pondéré et leur part au sein de l'UO diminue de 4,8 % passant de 42 % à 40 %. En ce sens, l'UO rend compte de deux phénomènes inverses : l'augmentation du périmètre références produits et clients liés à l'épidémie de Covid-19 et la diminution des lits et places liés à la crise de la psychiatrie publique. Conformément au projet de service et de pôle, les activités de pharmacie clinique augmentent de 2 % lorsqu'elles sont exprimées en nombre d'actes, croissent de 26 % en temps pondéré et leur part au sein de l'UO augmente de 26 % passant de 5,8 % à 7,3 %. En ce sens, l'évolution de l'UO rend compte des modifications organisationnelles en faveur du déploiement des activités de pharmacie clinique. Perspectives. L'évolution de l'UO illustre la réorganisation mise en œuvre ces 5 cinq dernières années. Peut-elle guider un pharmacien gérant et un décideur local dans la mise en œuvre du décret d'application n° 2019-489 du 21 mai 2019 relatif aux PUI ? Et éclairera-t-elle le chemin à parcourir dans le cadre de la coopération pharmaceutique associée à une mutualisation des fonctions techniques et logistiques, une robotisation de la dispensation et un déploiement des activités de pharmacie clinique dans les établissements partenaires encore non couverts... ? As part of the French public hospital accounting restatement, the new work's unit (UO) for pharmacy is more exhaustive and closer to the Société Française de Pharmacie Clinique frame of reference than the oldest one [5, 6]. Redefinition is expected to result in a better understanding of pharmacy organisations. The objective of this work was to examine the interest of the UO in reporting on organisational changes in our pharmacy Groupe Hospitalier Paul Guiraud (GHPG) in favour of quantitative and qualitative development of clinical pharmacy activities. Material and method. This was an observational retrospective study on database. Data was recorded from 2017 [3] and 2021 [4] annual activity reports of pharmacy GHPG, two internal studies on working time, full time hospitalization data during the study period [2] and weighted time calculations by ANAP among 9 psychiatric hospital pharmacies. Data analysis was done using SPSS software (release 28.0.1). Results and discussion. The comparative study based on pharmaceutical dispensing weighted time (reference activity) and medication reconciliation weighted time (one activity of clinical pharmacy) between pharmacy GHPG and the 9 psychiatric hospital pharmacies, shows that both are in the same range. Although our organizations, activities, resources, sizes and budgets are different, weighted time of two main activities are close and reveals some homogeneity between psychiatric hospital pharmacies corpus. During the study period, pharmaceutical dispensing increased by 10% when expressed in number of acts, decreased by 3% in weighted time and their share within the UO reduced by 4.8% from 42% to 40%. In this respect, the UO reports two opposite trends: the increase of health products in the formulary and extension of customers related to the COVID-19 pandemic and the decrease in beds related to the crisis of public psychiatry. Clinical pharmacy activities increased by 2% when expressed in number of acts, increased by 26% in weighted activities and their share within the UO increased by 26% from 5.8% to 7.3%. In that respect UO evolution reflects organizational changes in favour of clinical pharmacy activities deployment. Perspectives. New UO illustrates the reorganization implemented over the last 5 years. But can it guide pharmacist manager and local decision-maker in decree n° 2019-489 05/21/2019 implementation related to hospital pharmacy? And will it shed light on the path to be taken within the framework of pharmaceutical cooperation associated with a pooling of technical and administrative functions, robotic dispensing, and deployment of clinical pharmacy activities in partner facilities that are not yet covered...? [ABSTRACT FROM AUTHOR]

This study aimed at reporting the epidemiological, diagnostic and therapeutic aspects of urethral prolapse in young girls. This was an observational, descriptive, retrospective study conducted in the Urology Department of the Zinder National Hospital between 2014 and 2021 on 11 cases of urethral prolapse in young girls. The mean age of the patients was 5.81 years, (ranging from 3 to 9 years). The presenting complaint was genital haemorrhage in 10 cases and a request for medical expertise for suspected sexual abuse in one case. Management was medical in one case and surgical in 10 cases. The surgical technique was excision of the prolapsed mucosa followed by a muco-mucosal suture on a Foley catheter. The urethral catheter was removed three days after surgery and the patients were discharged after passive voiding trials the catheter. No complications were recorded. Although being a rare condition, easily diagnosed clinically, urethral prolapse remains unknown to many practitioners in rural areas, thus delaying its management. The classic and definitive treatment is surgical by complete excision of the prolapsed mucosa. Surgical outcome in the short and long term is satisfactory. [ABSTRACT FROM AUTHOR]

The Moroccan public hospital is crucial in providing healthcare, and its mission is to improve the population’s health. It is currently in a conclusive phase, given its decisive role in the success of the ambitious overhaul. In this sense, human resources are a crucial foundation, as they guarantee quality and safety of care. Indeed, the continuous upgrading of skills is a real challenge for healthcare workers, among other things, because their practice must meet the evolving requirements of the health system and be in line with the population’s specific needs. Lifelong learning for healthcare workers is a crucial issue. This study aims to identify the place of lifelong learning among health professionals in Moroccan public hospitals. The results indicate that all healthcare professionals interviewed know the importance of training to provide quality and safe care. However, only a quarter of them understands lifelong learning as a concept. Moreover, several lifelong learning practices are concrete and implemented despite certain obstacles. There is now a clear need to continue the historical process of improving the quality of training for healthcare workers by building an explicit system that focuses on lifelong learning while integrating a knowledge management approach. This research provides a good and more accurate overview of lifelong learning among healthcare workers. It also initiates reflection and debate on health professionals’ need for lifelong learning, and it’s a real opportunity to raise awareness about structuring lifelong professional training while integrating a knowledge management approach.

Introduction: psychiatric disorders affect the highest number of incarcerated individuals. Indeed, detention conditions in Senegal have been criticized for several years by referring, in particular, to overcrowding. These conditions probably play a determining role in the occurrence of mental disorders in this population. This work describes the socio-demographic and clinical characteristics of these inmates followed on an outpatient basis in the Department of Psychiatry of the National University Hospital Center in Fann. Method: we conducted a retrospective and descriptive study. Data were collected from all the inmates presenting to the External Consultation Unit of the Department of Psychiatry of the National University Hospital Center of Fann between 1st January 2005 and 31st December 2010. Results: our study population consisted of 62 inmates, 92% men and 8% women. The average age of patients was 32 years, nearly three-quarters (72.6%) of individuals were single. In the majority of cases they were in a precarious employment situation and 69.3% of them had not completed secondary education. Insomnia was the leading reason for consultation (29%) followed by auditory verbal hallucinations (22.6%). Physical aggression and/or threats to fellow inmates were observed in 17.7% of cases. The main diagnostic categories found were schizophrenic disorders (32.3%) and depressive disorders (27.4%). Between 2005 and 2010, the number of consultations increased threefold/year, from 7 to 19. Conclusion: this study showed that the incarcerated population, followed on an outpatient basis in the Department of Psychiatry, were young, mostly male and single, with low level of education and disadvantaged professional status. Similar cases have been reported in the international literature. Considering Senegal’s socio-economic situation and health systems development, we note that, although the number of consultations has increased over the years, only inmates with severe mental disorders are followed in specialized health services. Given the number of incarcerated subjects, the biography background of these subjects, the conditions of detention and the absence of some diseases, a survey should be conducted in prisons in order to assess mental healthcare needs of incarcerated subjects and the specific issues that could affect them. [ABSTRACT FROM AUTHOR]

Multifocal tuberculosis is rare in immunocompetent subjects. It is characterized by the involvement of at least two extra-pulmonary sites, associated or not with lung disease. It is often difficult to diagnose. We here report a case of multifocal tuberculosis in a non-immunocompromised black African subject at the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) in Cotonou, Benin. The study involved a 23-year-old man, with no particular previous history, admitted with diffuse abdominal pain associated with alteration of general state. Clinical examination showed severe malnutrition and medium-volume ascites. Imaging tests (chest X-ray, ultrasound and computed tomography (CT) scan) showed multiple lung, liver, pancreatic, bone, lymph nodes and colic lesions suggesting multimetastatic tumor. Colonoscopy then showed budding lesion of the cecum. GeneXpert test showed Koch´s bacilli. The anatomopathological examination of colic biopsies and GeneXpert sputum test confirmed multifocal tuberculosis. The patient received antituberculosis treatment and nutritional support. However he died. Multifocal tuberculosis is a serious disease that is difficult to diagnose. Then it is frequently mis-diagnosed in tropical areas, especially when it occurs in immunocompetent patients. [ABSTRACT FROM AUTHOR]

Copyright of Industrial Relations / Relations Industrielles is the property of Universite Laval, Department of Industrial Relations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: rheumatoid arthritis (RA) dramatically affects the quality of life of patients. The objective of our study was to study the link between the activity of the disease and the quality of life of Guinean (Conakry) and Cameroonian patients with RA. Methods: pilot multicentric cross- sectional study (Ignace Dean National Hospital of Conakry in Guinea and Efoulan Yaoundé District Hospital in Cameroon) for 15 months (1st October 2016 to 30th January 2018). The diagnosis of RA was based on the criteria of the ACR/EULAR. Disease activity was assessed by DAS 28. The EMIR questionnaire and the Steinbrocker score were used to assess quality of life. Results: fifty-two patients, 82% of whom were women. The total EMIR score was 5.06±0.50 as a relatively impaired quality of life. Alteration of quality of life was more marked on psychic components (6.78±0.99) and pain (5.37±0.99). The work component was the least affected (4.03±0.98). DAS28 was significantly related to psychic components (p=0.036, R=0.29), pain (p=0.076, R=0.25), physical (p=0.0029, R=0.41), and at the overall quality of life (total EMIR) (p=0.027, R=0.31). Conclusion:the most significant of RA on quality of life was related to pain (EVA-pain) and RA activity (DAS 28).The results of this pilot study will have to be confirmed by a largest study. [ABSTRACT FROM AUTHOR]

Blood transfusion is a medical procedure used to treat patients with labile blood product. Each transfusion of globular concentrate exposes recipients to the risk of red blood cell alloimmunization. The test for red cell antibodies (RCA) ensures the immunohaematological safety of transfused patients. In Benin, this test is not performed in a systematic way or included either in the pre-transfusion or in the post-transfusion tests. The purpose of this study is to determine the presence of red cell antibodies among polytransfused patients. RCA was performed using indirect antiglobulin test on gel-filtration in 51 polytransfused patients including 26 selected in the Department of Hematology and 25 in the Department of Nephrology at the National Hospital and University Center of Cotonou. After phenotyping alloimmunized patients, tests for detecting signs of hemolysis were performed. Clinical data as well as those on transfusion were collected from transfusion registries and medical records. The prevalence of alloimmunization in our study population was 13.73%. The antibodies identified had the following characteristics: association of anti-RH1 and anti-RH3, anti LE1, association of anti-RH3 and anti-FY1. Alloantibodies were more frequent in patients who had received more than 15 packed red blood cells. Laboratory tests showed signs of hemolysis in one alloimmunized patient. There was no correlation between age, sex, clinical diagnosis and the occurrence of red blood cell alloimmunization. The test for red cell antibodies should be systematically performed in polytransfused patients in order to ensure better transfusion recipient safety in Benin. [ABSTRACT FROM AUTHOR]

Bronchopulmonary tumors (BPTs) are the most common cancers. They are associated with poor prognosis. They are usually caused by occupational exposure, but this is often underestimated. The purpose of this study is to assess the rate of bronchopulmonary tumors (BPT) probably due to occupational exposure and to investigate the relationship between the type of exposition and the histological type of BPT. We conducted a retrospective epidemiological study, in the Department of Pneumology at the Public Hospital Institution (EPH) in Rou'ba. Between January 2014 and June 2019, we collected 357 cases with histologically confirmed BPT. Medical and professional history collections were carried out. The job-exposure matrix was used to identify the various exposures. The study population consisted of 357 patients, with an average age of 63.9±11.1 years and a male to female sex-ratio of 7.4; 76.5% of patients were smokers or former smokers, on average 42 P/A. Non-small-cell lung carcinoma was confirmed histologically in 88.8% of patients. All occupational categories studied would be responsible for 50.7% of exposure-related primary lung cancers, of which 26.5% were due to occupational exposure of heavy-duty drivers and gear drivers. Occupational exposure as a leading cause of bronchopulmonary cancers (CBP) is not negligible but often unrecognized due to its multifactorial factors and the latency period from the time of exposure to onset of disease symptoms, with an impact on the histological type of bronchopulmonary cancer. [ABSTRACT FROM AUTHOR]

Background: The public health sector in South Africa has been facing severe financial cutbacks and financial constraints in recent times. The nurse manager (NM) is faced with the task of managing and reducing expenditure in the nursing sector without compromising the quality care. This requires skills and understanding of financial management. Aim: This study aimed to explore the financial management roles of NMs and to identify financial management development needs necessary for NMs’ practice. Setting: The study was conducted in KwaZulu-Natal. A total of eight hospitals from the five health districts were included. Methods: The study used the naturalistic paradigm with a constructivist grounded theory approach. Interviews were used to initially gather data from six NMs who were purposively selected. Theoretical sampling was used to further recruit financial managers, chief executive officers, assistant nurse managers and operational managers. The final sample consisted of 18 participants. Results: Financial management of the hospitals is the primary function of the financial managers and the chief executive officers. However, the role of NMs extends to the performance and participation in various activities relating to the financial functioning of the hospital. These include financial planning, financial monitoring, financial decision-making and financial control. Conclusion: Nurse managers have a financial management function in public health care organisations but lack the necessary skills, knowledge and competencies to function in this role and require additional training. Recommendations included that a competency framework be developed to improve the financial management competencies of NMs.

Introduction: PLHA who smoke have twice the never-smoker mortality rate and have an increased risk of developing non-AIDS diseases. The prevalence of tobacco smoking is higher among PLHA than in the general population. The purpose of this study was to assess the prevalence of smoking among PLHA, to describe the clinical and spirometric features of smokers and ex-smokers and to assess their knowledge and attitudes toward smoking. Methods: we conducted a cross-sectional, descriptive and analytical study among PLHA followed up in the Outpatient Department of the National University Hospital Center of Fann from 15 July to 15 December 2015. Results: three hundred (300) PLHA were included in the study. Sex ratio was 0.8. Out of the study population, 15% were smokers and 23.7% were ex-smokers. The average age of patients was 44.38±9.55 years. The quasi-totality of the smokers (91.1%) had already started smoking before the detection of the serological status and 35.6% of them had increased tobacco use after. Respiratory symptoms among smokers were dominated by respiratory distress (64.4%). Smokers who underwent spirometry had obstructive ventilatory impairment not improved by beta-2-mimetic agents (67%) and restrictive disease (28.1%). Out of ex-smokers, 40.8% reported that their serological status was the reason for smoking cessation. Conclusion: people may begin or increase smoking after knowledge of serological status. In PLHA, smoking causes cardiovascular and respiratory diseases as well as complications. [ABSTRACT FROM AUTHOR]

Meningiomas are frequently encountered tumours in neurosurgery. However, there is a paucity of data concerning their epidemiology, their clinical characteristics and their treatment compared to gliomas. This study aims to identify the epidemiological profile and to assess the quality of treatment of intracranial meningiomas (ICM) at the National Hospital Center in Nouakchott, Mauritania. We conducted a retrospective study of patients who had undergone surgery for the treatment of ICM between September 2013 and September 2016. Thirty-two patients had undergone surgery for the treatment of ICM (26.6%). The average age was 45.12 (± 13.8 years) among whom 75% were women. The average length of stay in hospital had been 13 days (± 7 days). The mean time between symptom onset and diagnosis had been 10 months (±5months). The mean size of ICM had been 5.07cm (±2.00cm) ranging from 2.5cm to 10.5cm. Complementary MRI had been performed in 46.8% of patients after brain CT scan. In our series, 38% of ICM had grown on brain convexity. The mean surgical time had been 23.91 days (±17days). The quality grade of surgical resection assigned according to Simpson score was Grade I (66%), Grade II (19%), Grade III (6%), Grade IV (9%). The histological grade assigned according to the 2007 WHO classification was Grade I (93%), Grade II-III (7%). The overall operative mortality was (n=3, 9.4%). The development of technical equipment in the department of neurosurgery, radiology and of equipment in anesthesia and intensive care will contribute to improve outcomes and to reduce mortality rates. [ABSTRACT FROM AUTHOR]

The article focuses on the urgent crisis in public psychiatry within the country, highlighting the historical context and progression of the field. It discusses the transformation of psychiatric care, the impact of management principles from the private sector on public hospitals, the rise of behavioral policing, and the influence of standardized treatments, leading to a degradation of patient care and a shortage of personnel.

The article offers several pharmacovigilance news briefs. Topics include examines in 2007, a French study showed that several percentage of hospital admissions were due to an adverse drug effect and considered a new study of the same type has just been published as it was carried out in 141 short-stay units in 61 public hospitals.

Résumé Objectifs La stimulation cardiaque au Burkina Faso devient une réalité. Le but de notre étude était d’évaluer cette activité sur cinq ans et apprécier l’impact de la collaboration avec des hôpitaux de la région d’Auvergne dans son développement. Matériel et méthodes Étude prospective dans laquelle les patients appareillés et suivis depuis juin 2011 ont été inclus consécutivement. Les données collectées portaient sur les indications, le délai de prise en charge, le type de stimulation, les complications, le coût du traitement, l’éducation et la qualité de vie du patient opéré. Résultats Soixante-neuf patients ont été appareillés de juin 2011 à juin 2016 dont 45,5 % de femmes. L’âge moyen était de 69 ans avec des extrêmes de 35 et de 89 ans. La quasi-totalité des patients (94 %) était symptomatique (54 % de syncopes et 30 % de vertiges et lipothymies). L’indication principale de la stimulation cardiaque définitive était le bloc auriculo-ventriculaire complet d’origine dégénérative (83 %). Le délai moyen entre l’indication et l’appareillage était de 8,2 jours et seulement 4 % des patients ont bénéficié d’une stimulation temporaire. L’absence de prise en charge financière constituait le principal motif du retard à la prise en charge. Durant la période de l’étude, les deux structures de santé ont bénéficié d’un appui en matériel de stimulation, d’un plateau technique, et de formations et stages pratiques réguliers. Cette collaboration a permis de pallier l’insuffisance en ressources matérielles, humaines et financières. Nous avons enregistré comme complications, un cas d’extériorisation de boîtier, deux cas d’hématome d’évolution bénigne et deux cas de déplacement de sonde. La qualité de vie des patients s’est nettement améliorée, tous les patients opérés n’étaient plus symptomatiques. Conclusion L’organisation de la stimulation cardiaque au Burkina Faso est une réalité. Des efforts doivent toujours être faits pour pérenniser l’activité et renforcer la collaboration avec des hôpitaux du Nord. Objectives Cardiac stimulation becomes a reality in Burkina Faso. The aim of our study was to evaluate this activity over five years and to appreciate the impact of collaboration with French hospitals of Auvergne area in its development. Materials and methods Prospective study including consecutively patients who underwent pacemaker implantation since June 2011. Data collected included indications, time to care, type of stimulation, complications, cost of treatment, and education and quality of life of the patient. Results Sixty-nine patients received definitive pacemaker from June 2011 to June 2016, of whom 45.5% were women. The mean age was 69 years (extremes 35 to 89 s). Almost all patients (94%) were symptomatic (54% syncope and 30% dizziness and lipothymias). The main indication for definitive cardiac pacing was complete atrioventricular block of degenerative origin (83%). The mean time between indication and surgery was 8.2 days, and only 4% of patients received temporary stimulation. The lack of financial support was the main reason for the delay in taking charge. During the study period, the two health centers received support in the form of stimulation equipment, a technical platform, and regular training and practical training. This collaboration made it possible to overcome the lack of material, human and financial resources. We recorded as complications a case of case exteriorization, two cases of benign local hematoma and two cases of probe displacement. The quality of life of the patients improved markedly, none of patients undergoing surgery remained symptomatic. Conclusion The organization of cardiac stimulation in Burkina Faso is a reality. Efforts must be made to sustain the activity and strengthen collaboration with hospitals in the north. [ABSTRACT FROM AUTHOR]

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Copyright of Revue Française d'Administration Publique is the property of Direction de l'Information Legale et Administrative and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

How costs and tariffs have become pivotal policy instruments to govern public hospitals in France since the early 1980’s? What kind of controversies do they produce and what feedback effect do these controversies have on these instruments? These are the questions I propose to answer in this PhD dissertation by analysing the genealogy, the uses and the transformations of several policy devices: information system, cost accounting, budgetary regulation instrument and pricing payment system. Combining a sociology of policy instruments and science and technology studies, these devices are analysed in the multiple sites where they spread: ministry of Health, public agency, research centres in management studies, hospital federations, patients organizations and public hospitals. The dissertation exposes how these devices have turned public hospitals into accounting and financial entities. I specially focus on the pricing payment system (called T2A) which is analysed as a qualculation instrument as it qualifies and quantifies patients, stays in hospitals, diseases, and public hospital itself. The dissertation shows how this qualculation process produces metrological controversies in which actors put into question the way things are qualculated.

INTRODUCTION: The 1998 and 2003 Demographic and Health Surveys suggested increasing rates of dissatisfaction with health services in South Africa. The goal of this analysis was to examine national healthcare satisfaction rates in 2010. METHODS: We conducted weighted logistic regression analysis of data from 22,959 household representatives who participated in the nationally-representative 2010 General Household Survey (GHS). RESULTS: In total, 88.5% of participants were somewhat or very satisfied with their last visit to their usual healthcare provider, including 84.6% of those visiting a public provider and 97.3% of those consulting a private provider. Satisfaction rates were lower for black South Africans (87.0%) and low income households (86.3% of households with monthly incomes less than 2500 rands) than for white South Africans (96.0%) and high income households (94.0% of those with monthly incomes of at least 8000 rands) (p=0.001). However, after adjusting for provider type, there were few differences in satisfaction rates by race/ethnicity and income level. CONCLUSION: The analysis suggests that differences in satisfaction with healthcare services in South Africa by racial/ethnic group and income level are due in large part to different rates of use of private providers.

Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Anthropologie et Sociétés is the property of Anthropologie et Societies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Française de Gestion is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: C’est dans une actualité récemment alimentée par le scandale des prothèses PIP, que la Cour de cassation a rendu un arrêt le 12 juillet 2012 qui réoriente le débat. Alors que les patients recherchent une responsabilité partagée entre le fournisseur de prothèses et le chirurgien, dans cette affaire de prothèse testiculaire défectueuse, la haute juridiction vient d’écarter la responsabilité du praticien. Mais cette jurisprudence ne s’applique qu’en droit privé, c’est-à-dire pour la médecine libérale, alors que s’agissant des actions dirigées contre l’hôpital public, le régime de responsabilité diffère. [ABSTRACT FROM AUTHOR]

This article presents an analysis of causation in the administrative jurisprudence of France on liability of public hospitals during a period called the medical revolution, in the late twentieth century. These were years of great change related to advances in medical science, public health services and reform of law administrative. And, it was found that, given the difficulties in the area of establishing causation, on the one hand, and advances in medical science, on the other hand, the judge had to developed innovative legals tools like the presumption of guilt and the presumption of causality. This tendency could be justified because relaxes the requirement of absolute certainty in causation, perhaps, in an attempt to consider the severity of the harm usually inflicted to patients by mistakes made in hospitals run by the government. This orientation suggest that the administrative judges during the 1990s had the ability to anticipate to the new causation analysis developed years later. This advanced position of the administrative French judge can throw lights, from a compared and historical perspective, on current studies that in this matter are realized in the countries which administrative jurisprudence has inspired traditionally by that of the State Council and administrative French courts, since it has happened in Colombia. In addition, in the XXI century has begun to admit a degree of uncertainty in this area and probabilistic causality has accepted. Currently, the guideline seems to be the consolidation of the distinction between causality, on the one hand, and the imputation of administrative responsibility, on the other. [ABSTRACT FROM AUTHOR]

Résumé: Objectif: Décrire la demande en anesthésistes-réanimateurs remplaçants (ARR), les conditions d’accueil et de travail de ces professionnels dans les centres hospitaliers généraux de la région Rhône-Alpes (CHGRA). Investigation et mesures: 1) Enquête téléphonique auprès de toutes les directions des CHGRA ; 2) proposition de remplacement pour une période de cinq jours sans participation à la permanence des soins (PDS) ; 3) évaluation de l’accueil administratif et médical ; des conditions de travail, de critères subrogés évaluant la qualité d’organisation et des soins ; 4) mesure de la taille et de l’activité des établissements sur le logiciel ű Platines Ƈ (ministère de la Santé). Résultats: Parmi les 32 directions des CHGRA interrogées, 28 ont déclaré être en recherche d’ARR mais seulement 11 (34 %) ont accepté une période d’adaptation avant la participation à la PDS (CHG1), pendant que 17 (53 %) refusaient cette clause (CHG2) et quatre ne recherchaient pas d’ARR (CHG3). L’accueil de l’ARR, le fonctionnement et les normes professionnelles étaient très diversement effectués dans les 11 CHG1 dans lesquels un remplacement a été effectué. Aucune direction hospitalière n’a effectué d’entretien d’évaluation. Il n’y avait pas de différences de taille ou d’activité entre les trois groupes de CHG. Conclusion: Le besoin d’ARR est très fréquent dans les CHGRA et cette pratique n’est pas encadrée. Aucune stratégie d’intégration de l’ARR et de recrutement n’a été identifiée. Cela questionne sur ce que l’institution attend de l’anesthésie-réanimation dans les hôpitaux publics. [ABSTRACT FROM AUTHOR]

Résumé: Propos: Analyser les résultats du système de gestion et d’analyse des publications scientifiques (SIGAPS) au sein de l’Assistance publique–Hôpitaux de Paris (AP–HP) et comparer la production scientifique entre les différentes disciplines médicales et chirurgicales du CHU de Paris. Méthodes: Toutes les publications importées par SIGAPS depuis PubMed entre 2006 et 2008 ont été incluses. Les données suivantes ont été prises en compte et analysées : service hospitalier d’origine, nombre d’articles publiés, nombre de titulaires dans l’unité, score SIGAPS. Résultats: Au total, 38 709 publications ont été analysées. Les 747 services étaient composés de 5719 titulaires (1895 [33,1 %] PU–PH, MCU ou PHU ; 2772 [48,4 %] PH et 1052 [18,4 %] CCA ou AHU). Le nombre moyen de titulaires par service était de 7,7±6,7 (min-max : 1–69). La moyenne du nombre total de publications par service était de 51,8±49,4 (min-max : 1–453). Le score SIGAPS moyen était plus important en médecine qu’en chirurgie (621,2±670,1 vs. 401±382,2 ; p =0,01) mais pas le nombre moyen d’article par titulaires entre ces deux filières (8,1±8,3 en médecine vs. 6,6±6,2 ; p =0,08). Le nombre de moyen de publication par temps plein était de 7,9±7,8 (1–45), soit un nombre moyen de 2,7±2,6 par temps plein et par an. Conclusion: L’AP–HP a une production scientifique relativement importante mais avec un nombre moyen de 2,7 articles par temps plein par an. Il n’existait pas de différence notable entre les disciplines médicales et chirurgicales. [ABSTRACT FROM AUTHOR]

The article studies the evolution of psychiatric confinement forms and regulations using the public psychiatric hospital Centre Hospitalier du Vinatier near Lyon, France, as an example from the end of the 19th century to circa 2013. The authors examine the hospital's medical and administrative records from its inception to circa 1995. The law of June 30, 1838 concerning the establishment of psychiatric facilities in each French department and security concerns in French public psychiatry, as well as the controversy over the opening of secure hospital units and how it may impact the rights and dignity of psychiatric patients, are discussed.

Abstract: Purpose: In-patients characteristics generate cost differences between hospitals. In France, there are few data on the characteristics on the patients referred to hospitals by their general practitioners (GPs) and none on the predictors of referral to the public or for-profit hospitals. The aim of this study was to analyze those characteristics and the predictors of referral to the public or for-profit hospitals. Methods: We collected, prospectively, the request for hospitalizations made by the GPs of the Sentinelles network in France, from 2007 to 2009. Patients’ characteristics and also the reasons for that request were analyzed. A logistic regression was used to compare the population between local hospitals. Results: Ten thousand seven hundred and eighteen statements were collected. The median age was 73years. Patients were women in 51% of the cases, and only 14% of the hospitalizations had been planned. Hospitalization in the public sector was preferred for young children and the elderly (P <0.001). When compared to the patients referred to the private sector, patients addressed to the public sector were more often seen for emergencies (OR: 2.3 [2.0–2.8]), by a doctor different from their referring GP (OR: 1.7 [1.4–2.1]) and out of the GP''s office. The reasons for hospital admission were different depending on the sector of hospitalization (P <0.001), patients addressed to the public sector hospitals presented with greater comorbidity or more complex diagnosis (for example: feeling ill, fainting or syncope and fever) or a greater disability (for example: stroke, neurological and psychiatric diseases). Conclusion: This study suggests that GPs send their patients to the public or for-profit hospitals according to criteria of severity, comorbidity and disability. [Copyright &y& Elsevier]

Abstract: Objective: Observational study relating to the inscriptions with universitary diplomas (DU) in relation with anesthesiology and intensive care during the year 2010–2011. We had in mind to know the profile and the motivations of the students concerned. Method: A questionnaire was put on line and the registered students with the various diplomas were contacted by e-mail. Different items investigated concerned: demography, type of exercise of the students, heading of diplomas, scientific level of the students, their motivations at the time of the inscription and finally practical organization. Results: We collected 265 questionnaires, that is to say 42 % of answers. The demographic distribution of the registered voters was the followed: 71% of MD, 28% of residents. These doctors exerted for the majority with the public hospital (87%). The inscriptions concerned intensive care diplomas in 90% of the cases. The total scientific level of the students was high, since 46% of them had a diploma other than their medicine thesis. The students were registered for the majority of them “to widen their field of competence” (65%) or “in complement of their initial training” (46%). The other reasons were: “to make up a deficit of their initial training (26%)”, “as continuous medical training” (16%) and finally “for the university validation of an asset” (10%). The rate of total satisfaction of the diplomas was very high (96%). Financial aid was assumed by the institution for 46% of students. Residents were less financially helped than senior practitioners. The overall costs of the DU/DIU, including the registration fee, transport and lodging, were important (>500 euros in 61% of the cases). Conclusion: DUs related to our specialty are much appreciated. They interest a majority of senior doctors, but also a considerable number of residents, which poses the problem of the place of these additional trainings within the framework of initial training. The principal motivations of the registered voters are to supplement their initial training or to widen their field of competence, much more than to make up a deficit of this initial training. Lastly, the total financial expenses associated with these diplomas remain important and appear inversely proportional to the incomes of the registered students. [Copyright &y& Elsevier]

Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Management international / International Management / Gestiòn Internacional is the property of Management International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: Burnout is one of the main chronic health problems with negative consequences on health care givers but also on quality of care. The main goal of Physician Health Survey was to study the frequency of burnout among salaried physicians and pharmacists and to compare anesthesiologists and intensivists (AI) with other practitioners (OP). The secondary end points were to analyze risk factors of burnout in each group. Material and methods: An anonymous, self-administered questionnaire was diffused via a specific website. Burnout was measured using the Copenhagen Burnout Inventory (CBI). Several different factors were examined: work/family conflict, salary satisfaction, quality of teamwork, interpersonal relationships, workplace influence, workload and perceived health. The role of each factor was calculated by multivariate logistic regression and comparisons were made between AI and OP. Results: Among the 3196 responses, CBI revealed an elevated score of burnout in 38.4% in AI and in 42.4% in OP. In each group, a great gap was displayed between the CBI results and the self-assessment of burnout (15%). Among AI, risk factors of burnout were high quantitative demand (ORadj=3.40; CI95 1,34–8,63), Work/family conflict (ORadj=; 3.12 CI95 1.60–6.08), low quality of teamwork (ORadj=1.99; CI951.14–3.47) and tense Relation within team (ORadj=1.92; CI95 1.25–2.95). All these factors are observed also among OP. Female gender, young age and dissatisfaction with pay have significant influence but different in the two groups. Claims of recurrent harassment by superiors is a risk factor for burnout only for the AP (adj.OR=1.83; CI95 1.04–3.22). Discussion: Burnout affected near one about two salaried physicians and pharmacists in France. AI were not more concerned by burnout than OP but all of whom have difficulty identifying their own levels of psychological stress and burnout. Decreasing the level of different risk factors i.e. by improving the quality of teamwork should lead to reduce burnout frequency. [Copyright &y& Elsevier]

Abstract: Objectives: This paper considers the specific administrative procedures set up by managers of public healthcare establishments and those responsible for health and welfare policies to care for low-income pregnant women for whom 100% of the “price per act” (T2A) is refunded. What are the limitations and what improvements can be suggested? Patients and method: The results are based on an analysis of data from semi-structured interviews, legislation and documents. Results: The State, health insurance systems, public health establishments, local authorities, charities and outpatient services are involved in handling low-income parturients in different services and different establishments, both locally and regionally. A health and welfare policy comprising specific, coordinated actions and measures has been developed. The T2A “price per act” system may threaten its survival: the limited number of front-line facilities is often saturated and demand is increasing, treatment is often reduced to reactive management leading to unwanted readmissions, ethics are sometimes called into question and there is a risk of patient selection. Discussion and conclusion: This pilot study provided some encouraging information but also indicated the limitations of the approach adopted. However, it was still of interest to see whether it was possible to use this approach, which did not require considerable resources, to reveal useful markers. This appeared to be the case. Regional Health Agencies (ARS) and local authorities could support the system. Additional funding is needed. [Copyright &y& Elsevier]

Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article discusses the history of hospitals in France. It examines the historical differences in the names and constructions of medical care facilities that were available to the population. There were differences in the types of places established both inside and outside of the metropolitan areas. For example, the places set up for medical care either in the center of cities were known as "xenodochia," while those that were situated at the entrance to the city or on the side of roads were known as "hospitalia" and were open to travelers and religious pilgrims. The history and differences of these establishments is examined in the Ardenne and Mosane regions of Belgium.

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Abstract: Introduction: General practitioners report difficulties to work efficiently with hospital physicians. We created a phone number dedicated to general practitioners to contact directly a hospital physician in the general internal medicine department entitled “quick diagnostic and therapeutic assistance”. The aim of this study was to assess the first year activity of this professional support and its impact on general practitioners. Results: We received 663 phone calls from February 2005 to February 2006. This led to a simple medical advice (41%), and immediate (26%) or delayed (32%) consultation or admission. Results of the mail survey showed that this “quick diagnostic and therapeutic assistance” was helpful for the general practioners. Conclusion: Quick diagnostic and therapeutic assistance improve the quality of clinical care through better continuity of care between the public hospital and the general practitioners. [ABSTRACT FROM AUTHOR]