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4 results on '"Spagnoli Jacques"'

1. Evaluation du programme cantonal de soins palliatifs dans le canton de Vaud : rapport final

Author

Cornaz, Sarah, Chabloz, Valérie, Spagnoli, Jacques, Botrugno, Fabiana, and Santos-Eggimann, Brigitte

Subjects
Palliative Care, Government Programs, Evaluation Studies, Switzerland, Vaud
Abstract

Il ressort que de l'avis largement majoritaire de tous les acteurs, institutions comme médecins privés, les soins palliatifs se sont améliorés dans le canton au cours des dix dernières années. Ce bilan positif est également confirmé par la comparaison des données qui avaient été recueillies en 2000 lors de la phase d'organisation des soins palliatifs dans le canton de Vaud. Trois éléments-clé sont évoqués comme cause de cette amélioration: les équipes mobiles en soins palliatifs (EMSP), les personnes-ressource et les formations en soins palliatifs . Cependant, des lacunes demeurent dans les institutions concernant, par exemple, l'inscription d'une définition des soins palliatifs dans les chartes institutionnelles ainsi que les différences observées entre les divers secteurs de soins et l'augmentation des déclarations de ressources inadéquates ou insuffisantes pour les soins palliatifs en comparaison à 2000. Les médecins quant à eux sont nombreux à faire part de leur difficulté à trouver le temps nécessaire à une formation spécifique mais aussi à faire reconnaître celui que requiert la coordination dans une prise en charge comprenant des soins palliatifs.

Published
2012

4. Prefrailty and Chronic Morbidity in the Youngest Old: An Insight from the Lausanne Cohort Lc65+.

Author

Danon-Hersch, Nadia, Rodondi, Nicolas, Spagnoli, Jacques, and Santos-Eggimann, Brigitte

Subjects
CARDIOVASCULAR diseases, CHI-squared test, CHRONIC diseases, CONFIDENCE intervals, EPIDEMIOLOGY, FISHER exact test, FRAIL elderly, GRIP strength, INTERVIEWING, LONGITUDINAL method, SCIENTIFIC observation, QUESTIONNAIRES, SELF-evaluation, SEX distribution, COMORBIDITY, LOGISTIC regression analysis, DATA analysis, ACTIVITIES of daily living, SECONDARY analysis, CROSS-sectional method, DATA analysis software, DESCRIPTIVE statistics, DISEASE complications, OLD age
Abstract

Objectives To estimate the prevalence of prefrailty, frailty, comorbidity, and disability in the youngest old and to identify chronic diseases associated with individual frailty criteria. Design Population-based cohort study of noninstitutionalized elderly adults at baseline; cross-sectional analysis. Setting Lausanne, Switzerland. Participants One thousand two hundred eighty-three individuals with complete data on frailty, aged 65 to 70 (58.5% women). Measurements Frailty was assessed according to an adaptation of Fried's criteria (shrinking, weakness, exhaustion, slowness, and low activity, three criteria needed for the diagnosis of frailty, 1 to 2 for prefrailty). Other outcomes were diseases diagnosed by a doctor (≥2 chronic diseases: comorbidity) and limitations in activities of daily living ( ADLs, basic and instrumental). Results At baseline, of 1,283 participants 71.1% were classified as nonfrail, 26.4% as prefrail, and 2.5% as frail. The proportion of women increased across these three groups (56.5%, 62.8%, and 71.9%, respectively; P = .01), as did the proportion of individuals with one or more chronic diseases (68.0%, 82.8%, and 90.6%, respectively; P < .001) and the proportion with basic or instrumental ADL disability (1.6%, 10.3%, and 59.4%, respectively; P < .001). Weakness (low grip strength) was the most frequent criterion (14.3%). Prefrail participants had significantly more comorbidity and ADL disability than nonfrail participants ( P < .001). When present in isolation, weakness was associated with two to three times greater prevalence of coronary heart disease, other heart diseases, diabetes mellitus, and arthritis. Similarly, a significant association was identified between exhaustion and depression. Conclusion Prefrailty is common in the youngest old. The most prevalent frailty criterion is weakness, which is associated with cardiovascular diseases. Longitudinal studies of the evolution of prefrailty should explore the role of potential interactions between individual frailty criteria and specific chronic diseases. [ABSTRACT FROM AUTHOR]

Published
2012
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