Tonnesenmacpherson3740

They mobilize essentially individual indicators and analyze few other determinants from a socio-ecological perspective. Conclusion Taking into account the different types and levels of determinants, in a multidimensional approach, would make it possible to identify the social, relational and territorial factors, as well as their respective weight and their links, to refine the health promotion actions and to favor levers of access to less sedentary lifestyles and lasting changes in everyday practices.Introduction The objectives of this work were 1) to develop and validate a questionnaire to understand several dimensions of the use of CAM practitioners in France and 2) to evaluate the test-retest reliability of each of its items.Purpose of research Development and validation (face validity) A questionnaire was created and then analyzed by 7 experts, including 3 social scientists. Before finalization, the questionnaire was tested on a sample of 43 individuals via cognitive interviews. Test-retest reliability 322 individuals completed the questionnaire twice (at least 9 days apart). The reliability of the 107 categorical variables that compose the questionnaire was assessed by unweighted Gwet's AC1 coefficient. Results A short and clear questionnaire, suitable for collecting the targeted information, was methodically developed. In total, excluding descriptive items characterizing the population, the questionnaire includes 114 items, 107 of which are closed and 7 open. 107 of these items are conditional. The average filling time was less than 3 minutes. Of the 107 categorical items, 1 item was associated with moderate test-retest reliability, 9 items with good reliability and 97 with very good reliability. Conclusion A reliable and valid questionnaire to evaluate the use of CAM practitioners in France is available. It may allow the collection of data necessary to assess the public health issue that this phenomenon represents.Background Although integrated care is drawing considerable attention from health care policy makers, little is known about integration of oral health care services into primary care in Quebec. Therefore, the objective of this study was to compile information and compare the aspects of primary oral health care in two public health care organizations. Method An environmental scan was carried out in one rural and one urban primary health care organizations in Quebec. Data were collected from organizations' websites, operational documents, observational notes on facility visits, primary care meeting minutes, online pages of professional orders and face to face interviews (N = 74) and focus groups (N = 5), between November 2016 and October 2018. Thematic and Prior's documentation analyses were used to analyse the data. Results Three themes were identified normative aspects of integrated care delivery, integration trajectories, and integration initiatives. In both organizations, the integration of oral health into primary care rooted in public health sectors and dental teams were the key players. While urban center showed informal linkages between dental and non-dental primary care providers, the rural organization succeeded in coordination processes, even though these were also informal. Conclusion The majority of primary oral health care services are delivered in the public health sectors and the sustainability of integration initiatives in other primary health care sectors remains to be demonstrated. A better management of resources, as well as partnerships between public health care organizations and universities, could contribute to this integration.Objectives Violence in emergency services has become a central issue in the daily work of hospital employees. While the use of video surveillance and the training of professionals in conflict management are the most common methods used, there are few cases using the setting up of a third part such as a mediator. We conducted a qualitative study with professionals to examine their representations associated with mediation. Ado-Trastuzumab emtansine Method Semi-directive interviews were conducted with professionals from four emergency units. The topics discussed in interviews were the definition of mediation and the missions that the mediators should fulfil. The content of 38 semi-directive interviews was analysed according to the inductive approach of the grounded theory. A content analysis was made, followed by an analysis aiming to bring out types and convergences/divergences. Results Professionals were not aware of the definition of mediation and of its missions. They linked to it an instrumental theme, making mediation a tool for conflict prevention and management, a tool for communication with patients about their care, and about the organisation of emergency unit. The upcoming presence of mediators was seen as an help. A potential competition between professionals and mediators in the tasks performed was identified. Conclusion The study shows a favourable opinion towards mediation. It has allowed to identify obstacles to the well-functioning of the missions assigned to mediators. One of the challenges is the integration of this new actor, the mediator.Introduction General practitioners regularly need specialized advice for therapeutic adaptation, ECG interpretation or to facilitate referral to the local cardiologist. Tele-expertise could amplify these possibilities of coordination between professionals. An experiment in tele-expertise in cardiology was carried out by the URML in Pays de la Loire between 2016 and 2017. This experiment allowed GPs to seek the advice of a liberal cardiologist via a link card. The cardiologist received the card, accompanied by the ECG and responded within 48 hours. Objectives The objective was to study the acceptability of the experiment and to study the impact on the coordination of health care professionals and on delays. Method This evaluation required a mixed methodology with a before/after the experiment survey, semi-directive interviews with GP and cardiologists, ad hoc data collection and data from national health insurance claim database. Results In 15 months of experimentation, 22% of GPs and 52% of liberal cardiologists of the territory participated.