Éditeur(s) : Center for the Humanities and the Public Sphere, University of Florida Center for the Humanities and the Public Sphere, University of Florida ( Gainesville, FL )
Résumé : (Biographical) Dr. Louise Ivers is Chief of Mission for Partners In Health (PIH) in Haiti, an international non-profit organization that provides direct health care and social services to poor communities around the world, supported by research and advocacy. She is an Assistant Professor of Medicine at Harvard Medical School and an Associate Physician in the Division of Global Health Equity at Brigham and Women's Hospital (BWH). She completed her residency in Internal Medicine at Massachusetts General Hospital (MGH) and a fellowship in Infectious Diseases at the combined MGH/BWH program. Dr. Ivers also received a diploma in Tropical Medicine and Hygiene from the London School of Hygiene & Tropical Medicine and a Master of Public Health from the Harvard School of Public Health. Dr. Ivers implements health programs, and is interested in improving the delivery of healthcare in resource poor settings, the provision of care to the rural and urban poor, as well as patient-oriented investigation that offers solutions to barriers to healthcare. She balances her time between management of PIH Haiti, direct clinical service, and operational research. Dr. Ivers has contributed to published articles on HIV/AIDS, food insecurity, and the prevention of mother-to-child transmission of HIV. Current projects include investigating the impact of targeted food assistance to people with HIV infection in rural Haiti, the effectiveness of ARV therapies on viral suppression in community-based programs, and humanitarian assistance in response to the January 2010 earthquake. Dr. Ivers has served as a Technical Advisor to the WHO and also mentors Haitian and American physicians.
(Funding) Sponsored by the Caleb and Michele Grimes Fund in the CLAS Dean's Office and organized by the Center for the Humanities and the Public Sphere.

Droits : All rights reserved by the source institution.

Résumé : Cette étude a pour missions essentielles de comprendre et d’expliquer comment le passage d’une langue à une autre voire le mélange des deux codes langagiers qui se côtoient au sein de la population de la Guadeloupe, département français d’outre-mer, le français et le créole, peuvent, dans le cadre des échanges médicaux éducatifs, influencer la compréhension des mécanismes de la maladie par le patient, son acceptation et sa gestion.La justification de cette étude tient du constat que la prévalence de cette maladie chronique en Guadeloupe, l’asthme bronchique, est relativement importante, que la prise en charge reste perfectible malgré les recommandations de bonnes pratiques édictées par les sociétés savantes, et que certains patients ont du mal à comprendre les termes utilisés en français par leur médecin lors de l’annonce du diagnostic, ainsi que par les éducateurs chargés de leur apporter les outils de bonne gestion de cette maladie, ce qui n’est pas sans incidents en termes de morbidité et de mortalité.L’auteur décompose sa recherche autour de cinq grands thèmes :- La description du territoire d’étude, sur le plan géographico-climatique, historico-économique, sanitaire et social, la naissance d’une ère culturelle nouvelle générant une langue partagée par plus de 95% de la population et transmise au sein des familles et dans la communauté.- La présentation de l’éducation thérapeutique, démarche considérée par la communauté scientifique comme essentielle pour améliorer la prise en charge du patient et l’autogestion de la maladie, les plans gouvernementaux successifs traitant de cette matière.- L’état des connaissances sur l’asthme bronchique en France, dans le monde et en Guadeloupe plus particulièrement.- L’impact de la langue créole dans le processus de compréhension de la maladie à travers la relation soignant-soigné, et ses conséquences chez les natifs bilingues en termes d’acquisitions des outils d’autogestion en comparaison à l’utilisation du français.- La formulation de propositions de contextualisation didactique, tant en termes de formation des professionnels de santé par la préconisation de l’utilisation de la langue créole, par l’adaptation des outils psychopédagogiques au contexte local, que d’encouragement du patient à utiliser sa langue maternelle dans l’expression de ses ressentis.La recherche montre que la langue créole, utilisée autant au cours de la consultation par le médecin traitant et par le malade que pendant les séances d’éducation thérapeutique par les éducateurs et le public, influence les indicateurs de gestion de cette maladie.En conclusion, l’auteur défend l’hypothèse selon laquelle l’utilisation de la langue créole dans les échanges médicaux éducatifs chez les adolescents asthmatiques bilingues français-créole favoriserait la compréhension des mécanismes de la maladie asthmatique, la prise de conscience de sa gravité et la nécessité de se soigner pour éviter les complications, corollaire d’une bonne qualité de vie.
In Guadeloupe, a French Overseas Territory, the population uses French and Creole linguistic codes. The main goals of this thesis are to understand and to explain how a better use of French and Creole, within the framework of educational medical exchanges, can improve the understanding of the mechanisms of the disease by the patient, its acceptance and its management.The bronchial asthma is a chronic disease, which affects an important part of the Guadeloupian population. In spite of the recommendations promulgated by the medical scholars, the care of the patients can be improved in Guadeloupe. Certain patients have difficulty understanding the terms used in French by their doctor during the announcement of the diagnosis, as well as by the educators in charge of bringing them the tools of good management of this disease what is not without incidents in terms of morbidity and mortality.The author elaborates his research around five main themes:- The thorough description of the space studied in this thesis; the geography of the land, the history of the population, the impact of the economic; the presentation of the social and health care infrastructures; and furthermore the birth of a new cultural era generating a language shared by more than 95 % of the population and passed on within families and communities.- The presentation of the therapeutic education, the approach considered by the scientific community as essential to improve the management of the patient and the self-management of the disease, the successive governmental plans dealing with this subject.- The state of the knowledge on the bronchial asthma in France, in the world and in Guadeloupe more particularly.- The impact of the Creole language in the process of understanding of the disease within the healthcare relationships and its consequences at the bilingual natives in terms of acquisitions of the tools of self-management in comparison to the use of French.- The formulation of proposals of didactic contextualization regarding the training of the healthcare professionals; the recommendation to the healthcare workers to use the Creole language; the adaptation of the psycho-pedagogical tools to the local context; the encouragement to the patients to use their native language in the expression of their feelings.- Researches show that the Creole language used during the consultation by the regular doctor, but also during the educational sessions therapeutics by the educators influence the indicators of management of this disease. In conclusion, the author defends the hypothesis according to which, the use of the Creole language in the educational medical exchanges at the bilingual asthmatic teenagers French-Creole would favor the understanding of the mechanisms of the asthmatic disease, the awareness of its gravity and the necessity of looking after oneself to avoid the complications, corollary of a good quality of life.

http://www.theses.fr/2015AGUY0827/document

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Construction works in healthcare establishments produce airborne fungal spores and considerably increase the risk of exposure of immunosuppressed patients. It is necessary to reinforce protective measures, or even to implement specific precautions, during this critical phase. The aim of these precautions is to protect both those areas, which are susceptible to dust, and patients at risk of a fungal infection particularly invasive aspergillosis. When construction works are planned in healthcare establishments, the first step consists in the characterisation of the environmental fungal risk and the second one in proposing risk management methods. It is then essential to establish impact indicators in order to evaluate the risk management precautions applied. The working group promoted by the French societies of medical mycology and hospital hygiene (SFMM & SF2H) details here both environmental and epidemiological impact indicators that can be used.
ISSN: 1156-5233

hal-00759179
https://hal.archives-ouvertes.fr/hal-00759179
DOI : 10.1016/j.mycmed.2012.01.003
PUBMED : 23177816

Éditeur(s) : HAL CCSD
Résumé : International audience
Chronic obstructive pulmonary disease (COPD) is the chronic respiratory disease with the most important burden on public health in terms of morbidity, mortality and health costs. For patients, COPD is a major source of disability because of dyspnea, restriction in daily activities, exacerbation, risk of chronic respiratory failure and extra-respiratory systemic organ disorders. The previous French Language Respiratory Society (SPLF) guidelines on COPD exacerbations were published in 2003. Using the GRADE methodology, the present document reviews the current knowledge on COPD exacerbation through 4 specific outlines: (1) epidemiology, (2) clinical evaluation, (3) therapeutic management and (4) prevention. Specific aspects of outpatients and inpatients care are discussed, especially regarding assessment of exacerbation severity and pharmacological approach.
Revue Des Maladies Respiratoires

hal-01560287
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560287
DOI : 10.1016/j.rmr.2017.03.034
PUBMED : 28552256