how to succeed at revalidation Doctors in the UK are required to provide evidence of their fitness to practice--all doctors registered with the General Medical Council (GMC) need to revalidate to maintain their registration. How to Succeed at Revalidation contains up-to-date information on the current regulatory framework and step-by-step guidance for the entire revalidation process. Offering expert advice on how to undertake the process from the perspective of the appraisee, the appraiser, and the employer, this practical, quick-reference guide covers each of the Good Medical Practice (GMP) domains: Knowledge, Skills and Performance; Safety and Quality; Communication, Partnership and Team Work; and Maintaining Trust. Throughout the text, numerous examples describe different models of appraisal and reflection, identify activities that map to each domain, and demonstrate how revalidation requirements can be achieved in the course of daily practice. This much-needed guide: Covers regulatory processes in medicine and healthcare from both UK and international perspectives Reviews the background that led to the implementation of revalidation Discusses the new GMP requirements for all doctors in the UK Explores the possible future of revalidation How to Succeed at Revalidation is essential reading for all qualified and trainee doctors, undergraduate and postgraduate learners, tutors, and trainers seeking to navigate the revalidation process in the UK.

Dans cet ouvrage, nous avons evalue l'activite des Superoxides dismutases (SOD) et de la Glucose-6- phosphate deshydrogenase (G6PDH), enzymes dont les carences sont indicatrices du stress oxydatif, dans l'extrait globulaire, chez 50 sujets infectes par le VIH et compare aux resultats de 32 sujets temoins tous recrutes au laboratoire d'hematologie du Centre Hospitalier Universitaire (CHU) de Yaounde.

La chirurgie de l'oreille moyenne, et notamment celle des sequelles de l'otite chronique simple ou cholesteatomateuse, comprend le plus souvent un temps fonctionnel: l'ossiculoplastie. L'ossiculoplastie est la chirurgie reparatrice de la chaine des osselets qui a pour but de retablir la fonction acoustique de l'oreille moyenne. Cette chirurgie fonctionnelle, tres technique, represente le geste operatoire le plus spectaculaire pour le patient, le plus valorisant pour le chirurgien. Elle n'en reste pas moins assujettie a un vaste programme chirurgical: la tympanoplastie, dont elle n'est que l'etape ultime. Nous exposons ici une etude comparative retrospective des differents types de montage utilises dans notre service ces cinq dernieres annees. Le but de ce travail etant de tenter de definir le meilleur materiau pour chaque type d'ossiculoplastie, afin d'obtenir un resultat auditif le plus satisfaisant possible."

Dans une cellule normale, les telomeres coiffent l'extremite des chromosomes, tels les embouts des lacets de chaussures. Ils ont pour role la protection des extremites chromosomiques et la prevention contre une perte eventuelle de donnees a ce niveau, lors des divisions cellulaires. Les telomeres s'erodent avec le temps jusqu'a atteindre une taille critique et declenchent alors l'entree en senescence de la cellule. L'existence d'une enzyme transcriptase inverse, la telomerase, capable d'inverser le processus et de synthetiser de nouvelles sequences telomeriques, confere a la cellule le caractere immortel incrimine dans les cellules cancereuses. Et comme il a ete montre que dans les cellules tumorales, plusieurs mecanismes concourent a la reactivation de la telomerase, l'inhibition de cet enzyme s'est averee une voie prometteuse pour le traitement des cancers, par blocage du processus proliferatif."

Efforts to improve the quality of healthcare have failed to achieve a meaningful and sustainable improvement. Patients continue to experience fragmented, inconvenient, and unsafe care while providers are increasingly becoming overburdened with administrative tasks. The need for change is clear. Healthcare professionals need to take on new leadership roles in quality improvement (QI) projects to effect real change. The Quality Improvement Challenge in Healthcare equips readers with the skills and knowledge required to develop and implement successful operational improvement initiatives. Designed for healthcare providers seeking to apply QI in practice, this valuable resource delivers step-by-step guidance on improvement methodology, team dynamics, and organizational change management in the context of real-world healthcare environments. The text integrates the principles and practices of Lean Six Sigma, human-centered design, and neurosciences to present a field-tested framework. Detailed yet accessible chapters cover topics including identifying and prioritizing the problem, developing improvement ideas, defining the scope of the project, organizing the QI team, implementing and sustaining the improvement, and much more. Clearly explaining each step of the improvement process, this practical guide: Presents the material in a logical sequence, gradually introducing each step of the process with clearly defined workflow templates Features a wealth of examples demonstrating QI application, and case studies emphasizing key concepts to highlight successful and unsuccessful improvement initiatives Includes end-of-chapter exercises and review questions for assessing and reinforcing comprehension Offers practical tips and advice on communicating effectively, leading a team meeting, conducting a tollgate review, and motivating people to change Leading QI projects requires a specific set of skills not taught in medical school. The Quality Improvement Challenge in Healthcare bridges this gap for experienced and trainee healthcare providers, and serves as an important reference for residency program directors, physician educators, healthcare leaders, and health-related professional organizations.

Found in two-thirds of the world, rabies is a devastating infectious disease with a 99.9 percent case-fatality rate and no cure once clinical signs appear. Rabies in the Streets tells the compelling story of the relationship between people, street animals, and rabies in India, where one-third of human rabies deaths occur. Deborah Nadal argues that only a One Health approach of “interspecies camaraderie� can save people and animals from the horrors of rabies and almost certain death. Grounded in multispecies ethnography, this book leads the reader through the streets and slums of Delhi and Jaipur, where people and animals, such as dogs, cows, and macaques, interact intimately and sometimes violently. Nadal explores the intricate web of factors that bring humans and animals into contact with one another within these urban spaces and create favorable pathways for the transmission of the rabies virus across species. This book shows how rabies is endemic in India for reasons that are as much social, cultural, and political as they are biological, ranging from inadequate sanitation to religious customs, from vaccine shortages to reliance on traditional medicine. The continuous emergence (and reemergence) of infectious diseases despite technical medical progress is a growing concern of our times and clearly questions the way we think of animal and environmental health. This original account of rabies challenges conventional approaches of separation and extermination, arguing instead that a One Health approach is our best chance at fostering mutual survival in a world increasingly overpopulated by humans, animals, and deadly pathogens.

Realisation d'une enquete prospective, comparant trois groupes de parturientes, le premier comprenant des femmes gardant la meme position pendant le travail (decubitus dorsal et/ou lateral), le deuxieme compose de parturientes alternant les positions sur la table d'accouchement, et le troisieme alternant les positions et utilisant le ballon et/ou la baignoire. Resultats: 110 dossiers ont ete etudies. Le premier interet obstetrical du changement de positions pendant le travail est l'amelioration du confort des parturientes. Puis c'est la diminution du temps de travail, avec une meilleure dynamique uterine et une meilleure dilatation cervicale. Conclusion: Le suivi des parturientes devrait s'accompagner d'une prise en charge de leur mobilite et de propositions de differentes positions a adopter au cours du travail. La sage-femme joue a ce niveau un role primordial, mais egalement en consultation ou en preparation a la naissance, ou elle encourage la femme a etre active quant a sa grossesse et son accouchement. Des moyens simples sont facilement utilisables pour le realiser, qui replacent la clinique avant la technique."

Understanding Multiple Sclerosis, Second Edition is a patient-friendly chart that helps to explain multiple sclerosis (MS) with sections that define MS and describe its causes, types, symptoms, diagnosis process, and management. Featured sections: What is multiple sclerosis (MS) What causes MS Types of MS: Relapsing-Remitting (RR-MS), Primary-Progressive (PP-MS), and Secondary-Progressive (SP-MS) Symptoms of MS table: early and late How is MS diagnosed: Magnetic resonance imaging (MRI), evoked potential tests, and lumbar puncture (spinal tap) Management of MS Images included: The spinal cord and spinal nerves within the body Enlarged view of a nerve fiber Normal nerve cell and nerve cell affected by MS Comparison of a normal myelin sheath to one damaged from MS Magnetic resonance imaging (MRI) 20" x 26" heavy weight paper laminated with grommets at top corners ISBN 9781496394989

Utilise dans de nombreux domaines, les solvants organiques entrent dans la composition de divers produits. Parmi ces domaines la fabrication de chaussures represente un grand consommateur de colles, de diluants et de decapants a bases de solvants organiques. Dans le cadre de l'evaluation du risque nous nous sommes interesses a l'impact sanitaire des expositions professionnelles aux solvants organiques dans l'industrie de fabrication des colles et leurs applications dans l'industrie de chaussures dans la region de Sfax en Tunisie. Elles sont parmi les industries les plus developpees dans notre region. Les deux objectifs principaux de cette etude ont ete de hierarchiser le risque chimique des differentes expositions professionnelles aux solvants et/ou aux colles en tenant compte a la fois du secteur d'activite et du poste de travail, et d'en preciser les niveaux atmospheriques; et d'evaluer les impacts sanitaires des expositions aux principaux solvants en milieu professionnel par la mesure des indicateurs d'expositions biologiques couples a des indicateurs de neurotoxicose par des mesures posturales.

Confidence, savoir et mystere, ces trois termes peuvent etre associes au secret. Lequel parmi eux se prete le mieux a la description du secret medical? L'objet de ce travail est d'une part de mettre en evidence l'origine et la raison d'etre du secret medical en tissant des liens entre l'histoire de la medecine et les connaissances sur la structure psychologique du sujet inspiree de la theorie psychanalytique. Nous avons egalement aborde la structuration du discours medical, laquelle nous est apparu finalement peu compatible avec l'abord du contenu du secret. Enfin, nous avons tente de decrire la nature du secret, sa nature sexuelle, le savoir sur la mort qu'il recele, mais aussi le grand embarras qu'il suscite au sein de la relation entre medecin et malade.