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This research aims to explore the relationship between attitudes, satisfaction, happiness, and involvement and student learning outcomes based on gender and the undertaken study program (sport and non-sport) after the covid-19 pandemic. This research is a cross-sectional study. A total of 380 students in Indonesia participated in this study. The research results show that online learning on campus was perceived positively by students of both sports and non-sports study programs. There are no significant differences in the variables of student satisfaction, happiness, involvement, and learning achievements based on gender and study program. There is a significant relationship between satisfaction with online learning, life happiness, and involvement in lectures with learning outcomes. In addition, the satisfaction variable in online learning has a direct and indirect impact on student learning outcomes through the involvement variable. The happiness of life variable has a direct impact only on the involvement variable but not on the learning achievement variable., Esta investigación tiene como objetivo explorar la relación entre las actitudes, la satisfacción, la felicidad y la implicación y los resultados de aprendizaje de los estudiantes en función del género y el programa de estudios realizado (deportivo y no deportivo) tras la pandemia de covid-19. Esta investigación es un estudio transversal. En este estudio participaron un total de 380 estudiantes de Indonesia. Los resultados de la investigación muestran que el aprendizaje en línea en el campus fue percibido positivamente por los estudiantes de programas de estudio tanto deportivos como no deportivos. No existen diferencias significativas en las variables satisfacción, felicidad, implicación y logros de aprendizaje de los estudiantes en función del género y programa de estudio. Existe una relación significativa entre la satisfacción con el aprendizaje en línea, la felicidad con la vida y la participación en clases con los resultados del aprendizaje. Además, la variable satisfacción en el aprendizaje en línea tiene un impacto directo e indirecto en los resultados de aprendizaje de los estudiantes a través de la variable participación. La variable felicidad de vida tiene un impacto directo sólo en la variable participación pero no en la variable logro de aprendizaje.

Introduction: Percutaneous coronary interventions (PCI) are often performed in multimorbid patients with heterogeneous characteristics and variable clinical outcomes. We aimed to identify distinct clinical phenotypes utilizing machine learning and explore their relationship with long-term recurrent and weighted outcomes. Methods: This prospective observational cohort study enrolled all-comer PCI patients in 2020-2021. Multiple imputation k-means clustering was utilized to detect specific phenotypes. The study endpoints were patient-oriented and device oriented composite endpoints (POCE, DOCE), its individual components, and major bleeding. We applied semiparametric regression models for recurrent and weighted endpoints. Results: The study included a total of 643 patients. We unveiled three phenotype clusters: 1) inflammatory (n = 44, with high white blood cell counts, high values of C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio), 2) high erythrocyte sedimentation rate (ESR) (n = 204), and 3) non-inflammatory (n = 395). For ACS-only population, we four distinct phenotypes (high-CRP, high-ESR, high aspartate-aminotransferase, and normal). For all-comer PCI patients, identified phenotypes had a higher risk of POCE (mean ratio (MR) 1.42 (95% confidence interval (CI) 1.11–1.81) and MR 2.01 (95% CI 1.58–2.56), respectively), DOCE (MR 1.61 (95% CI 1.20–2.16), MR 2.60 (95%CI 1.94–3.48), respectively), and stroke (hazard ratio (HR) 2.86 (95% CI 1.10–7.4), 6.83 (95% CI 2.01–23.2)). Similarly, high-ESR and high-CRP phenotypes of ACS patients were significantly associated with the development of clinical composite outcomes. Conclusion: Machine learning unveiled three distinct phenotype clusters in patients after PCI that were linked with the risk of recurrent and weighted clinical endpoints. German Clinical Trial Registry number: DRKS00020892.

Aims To assess the prevalence of alcohol use disorder (AUD), substance use, mental health and social status 7 years following an Emergency Department (ED) admission for alcohol intoxication. To assess gender differences in these prevalences. Methods Cohort of 631 patients aged 18-30 years admitted for alcohol intoxication in 2006-2007 at a tertiary referral hospital in Switzerland, contacted for an interview in 2014. Assessment consisted of demography, Alcohol Use Disorders Identification Test-Consumption, Mini International Neuropsychiatric Interview for AUD, Patient Health Questionnaire (depression, anxiety) and lifetime/past year use of tobacco/illegal drugs. Gender differences were assessed with Chi-square tests, t-tests and Wilcoxon tests. Results In 2014, 318/631 (50.4%) completed the interview. Study completers were not different from non-completers on baseline characteristics (all P >0.2). Of study completers, 36.8% were unemployed, 56.9% reported hazardous alcohol use, 15.1% alcohol dependence, 13.2% harmful use, 18.6% depression, 15.4% anxiety disorder. Prevalence of any use (lifetime/past year) was93.4%/80.2% for tobacco, 86.6%/53.1% for cannabis, 54.7%/22.6% for cocaine, 25.6%/13.5% for sedatives, 40.9%/11.0% for stimulants, 21.7%/7.2% for opioids. Men reported significantly more binge drinking, AUD, cannabis use (past year) and more lifetime cannabis, cocaine and stimulants use (all P <0.05). There was no gender difference in the prevalence of hazardous alcohol use and tobacco use. The prevalence of psychiatric disorders was significantly higher in women (P <0.05). Conclusions Seven years after being admitted for alcohol intoxication, young patients are likely to present substance misuse, mental health disorders and social problems, suggesting that they should be offered secondary prevention measures while in the ED. Short summary We studied a cohort of patients aged 18-30 and admitted for alcohol intoxication in 2006-2007 at a tertiary hospita

Ce travail de bachelor est consacré à la question du développement d’hébergements touristiques low-cost à Genève. Il cible les spécificités locales qui freinent le développement de ce type d’hébergement afin de mieux comprendre pourquoi est-ce que l’offre économique est limitée à Genève lorsque nous la comparons avec les établissements haut de gamme. Il vise également à déterminer des solutions qui pourraient être mise en place afin de favoriser la construction d’établissements de ce type dans le canton.

Our objective was to identify patient characteristics associated with inappropriate hospital days in a cohort of elderly medical inpatients. This prospective cohort study included a total of 196 patients aged 75 years and older, who were consecutively admitted over eight months to the internal medicine service of a regional, non-academic public hospital located in a rural area of Western Switzerland. Patients with severe cognitive impairment, terminal disease, or previously living in a nursing home were excluded. Data on demographics, medical, physical, social and mental status were collected at admission. A blinded hospitalization review was performed concurrently using a modified version of the Appropriateness Evaluation Protocol (AEP). Subjects' mean age was 82.4 years; 63.3% were women. Median length of stay was 8 days. Overall, 68 patients (34.7%) had at least one inappropriate day during their stay, including 18 patients (9.2%) whose hospital admission and entire stay were considered inappropriate. Most inappropriate days were due to discharge delays (87.1%), primarily to nursing homes (59.3%). Univariate analysis showed that subjects with inappropriate days were more likely to be living alone (69.1 vs 48.4%, p=0.006), and receiving formal in-home help (48.5 vs 32.8%, p=0.031). In addition, they were more impaired in basic and instrumental activities of daily living BADLs, and IADLs, p<0.001 and p=0.015, respectively), and more frequently had a depressed mood [29.4 vs 10.9%, p=0.001 with a score ≥ 6 at the Geriatric Depression Scale (GDS), short form]. Using multivariate analysis, independent associations remained for patients living alone (OR 2.6, 95%CI 1.2-5.8, p=0.016), those with a depressed mood (OR 2.8, 95%CI 1.1-7.3, p=0.032), with BADL dependencies (OR 1.5, 95%CI 1.2-1.8, p=0.001), and IADL dependencies (OR 1.3, 95%CI 1.0-1.6, p=0.032). Cardiovascular (OR 0.2, 95%CI 0.1-0.7, p=0.008) and pulmonary admission diagnoses (OR 0.1, 95%CI 0.0-0.7, p=0.022) we

Real-time crowd motion planning requires fast, realistic methods for path planning as well as obstacle avoidance. In a previous work (Morini etal. in Cyberworlds International Conference, pp. 144-151, 2007), we introduced a hybrid architecture to handle real-time motion planning of thousands of pedestrians. In this article, we present an extended version of our architecture, introducing two new features: an improved short-term collision avoidance algorithm, and simple efficient group behavior for crowds. Our approach allows the use of several motion planning algorithms of different precision for regions of varied interest. Pedestrian motion continuity is ensured when switching between such algorithms. To assess our architecture, several performance tests have been conducted, as well as a subjective test demonstrating the impact of using groups. Our results show that the architecture can plan motion in real time for several thousands of characters

The objectives of this prospective cohort study were to 1) determine the prevalence of depressed mood, 2) identify the characteristics associated with it, and 3) evaluate the recognition rate of depressed mood by clinicians. The study population was a cohort of 401 elderly patients, aged 75 years and older, admitted to the internal medicine service of a tertiary care academic medical center in Western Switzerland over six months. We excluded patients with severe cognitive impairment, terminal disease or those living in a nursing home. Data on demographics, medical, physical, social and mental status were collected upon admission. Presence of depressed mood was defined as a score ≥ 6 on the Geriatric Depression Scale (GDS), short form (15-item). An independent re-viewer performed a discharge summary abstraction to assess recognition rate. Subjects' mean age was 82.4 years, 60.9% were women. Overall, 90 patients (22.4%) had an abnormal GDS score (≥6). Compared to those without a depressed mood, these subjects were (all p<0.05) older (83.5 vs 82.0 years), more frequently living alone (66.7 vs 55.0%), dependent in both basic activities of daily living (BADL) and instrumental ADL (48.9 vs 36.0%, and 91.1 vs 84.9%, respectively), and cognitively impaired (47.8 vs 27.7% with MMSE score<24). In addition, they had more comorbidities (Charlson index 1.6 vs 1.2). In multivariate analysis, an independent association remains for subjects living alone (OR 1.8, 95%CI 1.1-3.0), with cognitive impairment (OR 1.9, 95%CI 1.1-3.2), and comorbidities (OR 1.3 per point, 95%CI 1.1-1.5). Detection rate during the index hospitalization was only 16.7% (15/90). In conclusion, depressed mood was frequent but rarely detected in this population. These findings emphasize the need to improve screening efforts, and to develop additional strategies such as using a pre-screening question to enhance clinical recognition

Objective: : The objective of this retrospective study over a 5-year period was to assess the success rate of airway management by residents. Criteria of successful airway management were both the adherence to a standardized protocol of pre-hospital airway management and successful endotracheal intubation (ETI) in rescue missions. Methods: : The minimal level of training time required for residents rotating in the pre-hospital emergency team was either 1 year in our university department of anesthesiology, or 3 years of internal medicine including 20 ETIs under supervision in the operating room. According to a strict protocol detailing indications and drugs to be administered, residents performed rapidsequence intubation (RSI) except in cases of cardiopulmonary arrests where ETI was performed without drugs. Adherence to the protocol of airway management was evaluated according to data provided by the residents. Successful endotracheal tube placement was confirmed only in transported patients with a combination of clinical signs, infrared capnography, and a chest X-ray on hospital admission. Results: : A total of 13,537 rescue missions were reviewed. The protocol adherence was 96.1%. ETI was attempted in 753 patients, and successful placement was confirmed in 98.2%. Conclusion: : Pre-hospital airway management (protocol adherence and proper endotracheal tube placement) was successful overall in 94.3% of rescue missions. Our results support the efficacy of a pre-hospital emergency rescue system reinforced by residents

A design strategy for the development of Ag(I)-based materials for thermally activated delayed fluorescence (TADF) is presented. Although Ag(I) complexes usually do not show TADF, the designed material, Ag(dbp)(P2-nCB) [dbp = 2,9-di-n-butyl-1,10-phenanthroline, and P2-nCB = nido-carborane-bis(diphenylphosphine)], shows a TADF efficiency breakthrough exhibiting an emission decay time of τ(TADF) = 1.4 μs at a quantum yield of ΦPL = 100%. This is a consequence of three optimized parameters. (i) The strongly electron-donating negatively charged P2-nCB ligand destabilizes the 4d orbitals and leads to low-lying charge (CT) states of MLL′CT character, with L and L′ being the two different ligands, thus giving a small energy separation between the lowest singlet S1 and triplet T1 state of ΔE(S1-T1) = 650 cm-1 (80 meV). (ii) The allowedness of the S1 → S0 transition is more than 1 order of magnitude higher than those found for other TADF metal complexes, as shown experimentally and by time-dependent density functional theory calculations. Both parameters favor a short TADF decay time. (iii) The high quantum efficiency is dominantly related to the rigid molecular structure of Ag(dbp)(P2-nCB), resulting from the design strategy of introducing n-butyl substitutions at positions 2 and 9 of phenanthroline that sterically interact with the phenyl groups of the P2-nCB ligand. In particular, the shortest TADF decay time of τ(TADF) = 1.4 μs at a ΦPL value of 100%, reported so far, suggests the use of this outstanding material for organic light-emitting diodes (OLEDs). Importantly, the emission of Ag(dbp)(P2-nCB) is not subject to concentration quenching. Therefore, it may be applied even as a 100% emission layer. © 2017 American Chemical Society.

The development of organic light emitting diodes (OLEDs) and the use of emitting molecules have strongly stimulated scientific research of emitting compounds. In particular, for OLEDs it is required to harvest all singlet and triplet excitons that are generated in the emission layer. This can be achieved using the so-called triplet harvesting mechanism. However, the materials to be applied are based on high-cost rare metals and therefore, it has been proposed already more than one decade ago by our group to use the effect of thermally activated delayed fluorescence (TADF) to harvest all generated excitons in the lowest excited singlet state S1. In this situation, the resulting emission is an S1→S0 fluorescence, though a delayed one. Hence, this mechanism represents the singlet harvesting mechanism. Using this effect, high-cost and strong SOC-carrying rare metals are not required. This mechanism can very effectively be realized by use of CuI or AgI complexes and even by purely organic molecules. In this investigation, we focus on photoluminescence properties and on crucial requirements for designing CuI and AgI materials that exhibit short TADF decay times at high emission quantum yields. The decay times should be as short as possible to minimize non-radiative quenching and, in particular, chemical reactions that frequently occur in the excited state. Thus, a short TADF decay time can strongly increase the material's long-term stability. Here, we study crucial parameters and analyze their impact on the TADF decay time. For example, the energy separation ΔE(S1–T1) between the lowest excited singlet state S1 and the triplet state T1 should be small. Accordingly, we present detailed photophysical properties of two case-study materials designed to exhibit a large ΔE(S1–T1) value of 1000 cm−1 (120 meV) and, for comparison, a small one of 370 cm−1 (46 meV). From these studies—extended by investigations of many other CuI TADF compounds—we can conclude that just small ΔE(S1–

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440-443)

Le parent atteint de cancer présente une grande vulnérabilité. Cette fragilité est causée par une multitude de facteurs. Le bouleversement induit par le cancer n'impacte pas uniquement le patient, mais également l'ensemble de sa famille. Le but de ce travail est de déterminer comment l'infirmière soutient le jeune parent atteint de cancer dans la mobilisation de ses stratégies de coping face à l'impact de la maladie afin que ce dernier maintienne l'exercice de son rôle parental. Démontrer la plus-value de l'intégration de la famille dans les soins. Dans la promotion du maintien de l'exercice du rôle parental, l'infirmière est amenée à prendre connaissance de l'histoire de la famille, de sa dynamique et de ses capacités d'adaptation à la maladie. Elle offre du soutien et de la guidance dans les stratégies de coping mises en place par le patient, sans jugement et sans vouloir apporter à tout prix sa vision.

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440-443)

The aim of the study was to describe the drinking patterns and alcohol consumption of patients screened by the Michigan Alcoholism Screening Test (MAST) in a sample of medical patients from a general hospital of a French-speaking, wine-drinking country. Data were recorded using a structured interview administered to 103 consecutively admitted 20-75-year-old MAST-positive patients and 103 age-matched and sex-matched MAST-negative controls admitted to the same ward. Relevant differences between MAST-positive and MAST-negative patients included the frequent report of recent and total abstinence in MAST-positive patients (23% versus 4% in controls), their tendency to drink alone, and less often during mealtimes, at home, or with family or friends than MAST-negative patients. Alcohol consumption was significantly higher in MAST-positive patients of both sexes with 250 and 270 g per week being the optimal discriminative cut-off level of consumption for men and women, respectively (kappa coefficient, 0.70 and 0.81, respectively). Regular drinking was the predominant drinking status of both MAST-positive and MAST-negative patients. This study suggests that a screening test such as the MAST, developed in an English-speaking country may be useful in a French-speaking, wine-drinking country. The test identified patients with drinking patterns that are culturally abnormal, yet in certain respects similar to those of alcoholic patients from other drinking cultures. These findings therefore emphasize the worldwide relevance of the concept of the alcohol dependence syndrome in addition to the transcultural usefulness of alcoholism screening tests

We examined the cause of death during a 12-month period (1995/96) in all consecutive patients admitted to hospital with leptospiral infection in Seychelles (Indian Ocean), where the disease is endemic. Leptospirosis was diagnosed by use of the microscopic agglutination test and a specific polymerase chain reaction assay on serum samples. Seventy-five cases were diagnosed and 6 patients died, a case fatality of 8%. All 6 patients died within 9 days of onset of symptoms and within 2 days of admission for 5 of them (5 days for the 6th). On autopsy, diffuse bilateral pulmonary haemorrhage (PH) was found in all fatalities. Renal, cardiac, digestive and cerebral haemorrhages were also found in 5, 3, 3 and 1 case(s), respectively. Incidentally, haemoptysis and lung infiltrate on chest radiographs, which suggest PH, were found in 8 of the 69 non-fatal cases. Dengue and hantavirus infections were ruled out. In conclusion, PH appeared to be a main cause of death in leptospirosis in this population, although haemorrhage in other organs may also have contributed to fatal outcomes. This cause of death contrasts with the findings generally reported in endemic settings

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440-443)

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440-443)

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440-443)

BACKGROUND: In Western countries, leptospirosis is uncommon and mainly occurs in farmers and individuals indulging in water-related activities. In tropical countries, leptospirosis can be up to 1000 times more frequent and risk factors for this often severe disease may differ. METHODS: We conducted a one-year population-based matched case-control study to investigate the frequency and associated factors of leptospirosis in the entire population of Seychelles. RESULTS: A total of 75 patients had definite acute leptospirosis based on microagglutination test (MAT) and polymerase chain reaction (PCR) assay (incidence: 101 per 100,000 per year; 95% confidence interval [CI]: 79-126). Among the controls, MAT was positive in 37% (past infection) and PCR assay in 9% (subclinical infection) of men aged 25-64 with manual occupation. Comparing cases and controls with negative MAT and PCR, leptospirosis was associated positively with walking barefoot around the home, washing in streams, gardening, activities in forests, alcohol consumption, rainfall, wet soil around the home, refuse around the home, rats visible around the home during day time, cats in the home, skin wounds and inversely with indoor occupation. The considered factors accounted for as much as 57% of the variance in predicting the disease. CONCLUSION: These data indicate a high incidence of leptospirosis in Seychelles. This suggests that leptospires are likely to be ubiquitous and that effective leptospirosis control in tropical countries needs a multifactorial approach including major behaviour change by large segments of the general public

Background Prehospital oligoanalgesia is prevalent among trauma victims, even when the emergency medical services team includes a physician. We investigated if not only patients' characteristics but physicians' practice variations contributed to prehospital oligoanalgesia. Methods Patient records of conscious adult trauma victims transported by our air rescue helicopter service over 10 yr were reviewed retrospectively. Oligoanalgesia was defined as a numeric rating scale (NRS) >3 at hospital admission. Multilevel logistic regression analysis was used to predict oligoanalgesia, accounting first for patient case-mix, and then physician-level clustering. The intraclass correlation was expressed as the median odds ratio (MOR). Results A total of 1202 patients and 77 physicians were included in the study. NRS at the scene was 6.9 (1.9). The prevalence of oligoanalgesia was 43%. Physicians had a median of 5.7 yr (inter-quartile range: 4.2-7.5) of post-graduate training and 27% were female. In our multilevel analysis, significant predictors of oligoanalgesia were: no analgesia [odds ratio (OR) 8.8], National Advisory Committee for Aeronautics V on site (OR 4.4), NRS on site (OR 1.5 per additional NRS unit >4), female physician (OR 2.0), and years of post-graduate experience [>4.0 to ≤5.0 (OR 1.3), >3.0 to ≤4.0 (OR 1.6), >2.0 to ≤3.0 (OR 2.6), and ≤2.0 yr (OR 16.7)]. The MOR was 2.6, and was statistically significant. Conclusions Physicians' practice variations contributed to oligoanalgesia, a factor often overlooked in analyses of prehospital pain management. Further exploration of the sources of these variations may provide innovative targets for quality improvement programmes to achieve consistent pain relief for trauma victims

Self-reported drinking habits were examined in a random sample of 1067 persons aged 25-64 years in the Seychelles, a country in epidemiological transition where consumption of home-brewed, mostly unregistered beverages has been traditionally high. Alcohol consumption was calculated from respondents reporting at least one drink per week (‘regular drinkers'). Among men, 51.1% were regular drinkers and had average intake of 112.1 ml alcohol a day. Among women, 5.9% were regular drinkers and had 49.7 ml alcohol a day. Frequency of drinking, but not amount per drinker, was slightly less in the 25-34-year than older-age categories. Home-brews (mostly palm toddy and fermented sugar cane juice) were consumed by 52% of regular drinkers and accounted for 54% of the total alcohol intake reported by all regular drinkers. Based on the reported consumption by regular drinkers only, the average annual alcohol consumption amounted respectively to 20.7 litres and 1.2 litres per man and woman aged 25-64 years, or, using extrapolation, 13.2 litres and 0.8 litres per man and woman respectively of the total population. These values may underestimate the true figures by half, since reported beer consumption accounted for 53% of beer sales. Socio-economic status was associated strongly and inversely with home-brew consumption, but slightly and positively with consumption of commercially marketed beverages. Alcohol intake was associated with smoking, high-density lipoprotein cholesterol, carbohydrate-deficient transferrin and blood pressure, but not with age and body mass index. In conclusion, these data show high alcohol consumption in the Seychelles with an important gender difference, a large proportion of alcohol derived from home-brews, and opposite tendencies for the relationships between socio-economic status and home-made or commercially marketed beverages

Background. Home hospital is advocated in many western countries in spite of limited evidence of its economic advantage over usual hospital care. Heart failure and communit‐acquired pneumonia are two medical conditions which are frequently targeted by home hospital programs. While recent trials were devoted to comparisons of safety and costs, the acceptance of home hospital for patients with these conditions remains poorly described. Objective. To document the medical eligibility and final transfer decision to home hospital for patients hospitalized with a primary diagnosis of heart failure or community‐acquired pneumonia. Design. Longitudinal study of patients admitted to the medical ward of acute care hospitals, up to the final decision concerning their transfer. Setting. Medical departments of one university hospital and two regional teaching Swiss hospitals. Patients. All patients admitted over a 9 month period to the three settings with a primary diagnosis of heart failure (n = 301) or pneumonia (n = 441). Measurements. Presence of permanent exclusion criteria on admission; final decision of (in)eligibility based on medical criteria; final decision regarding the transfer, taking into account the opinions of the family physician, the patient and informal caregivers. Results. While 27.9% of heart failure and 37.6% of pneumonia patients were considered to be eligible from a medical point of view, the program acceptance by family physicians, patients and informal caregivers was low and a transfer to home hospital was ultimately chosen for just 3.8% of heart failure and 9.6% of pneumonia patients. There were no major differences between the three settings. Conclusions. In the case of these two conditions, the potential economic advantage of home hospital over usual inpatient care is compromised by the low proportion of patients ultimately transferred

Alcohol-dependent subjects tend to report lower level of response to alcohol (LR) in the years before the disorder developed, compared to control subjects. The Self-Rating of the Effects of alcohol (SRE) score is a quick and valid retrospective estimate of LR. This study examined the associations between alcohol abuse or dependence and early experience of alcohol as measured on retrospective SRE score (relating to the first five times alcohol was imbibed), and the presence of alcohol abuse or dependence, in patients attending primary care. Higher Early SRE score (i.e. greater early tolerance of alcohol) was obtained in patients with an alcohol-related diagnosis than in patients without those diagnoses. Using a cut-off of 2 on the Early SRE score, the Early SRE score could discriminate between patients with and without an alcohol diagnosis with moderate to high sensitivity (84%) and modest specificity (57%)

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440-443)

Introduction: Leadership skills are described by the American College of Surgeons’ ATLS course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders.Methods: We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders.Results: We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differ

Introduction: Leadership skills are described by the American College of Surgeons’ ATLS course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders.Methods: We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders.Results: We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differ

Destiné aux enseignants de musique, ce dossier présente une réflexion autour des moyens possibles pour l’enseignement du rythme, ainsi qu’une proposition de démarche en lien avec cet enseignement. Puisant ses racines dans les percussions corporelles, la démarche en question est accompagnée d’une proposition de support écrit et de suggestions d’exercice permettant de travailler indépendamment la réalisation et l’écriture de séquences rythmiques simples. La première partie de ce travail est constituée d’une présentation de diverses approches pédagogiques de l’enseignement du rythme et propose une synthèse de ces approches tout en en faisant émerger les concepts utiles à l’appropriation du rythme. Elle traite également de différents concepts musicaux et psychomoteurs indissociables de la pratique du rythme et présente par là les éléments auxquels l’on se doit d’être attentif dans ce type d’apprentissage. Y sont traités les concepts de pulsation, de coordination, de dissociation et de ressenti. La deuxième partie s’attache quant à elle à la présentation de la démarche susmentionnée. Construite dans une conception progressive des apprentissages liés au rythme, elle ne s’attarde pas sur les considérations théoriques de l’étude de la musique, mais uniquement sur le modèle qu’elle propose. Elle présente un certain nombre d’exercices dont le but n’est pas de fournir au praticien une méthode, mais un moyen de mener un groupe d’individus vers une appropriation complète de certains concepts liés au rythme, tout en laissant la place à de nombreuses régulations et adaptations liées à l’hétérogénéité du groupe en question. Le support proposé dans cette démarche a été pensé pour être modulable et modifié selon les besoins et envies de son utilisateur. Ce dossier est donc une proposition d’outil utile à l’apprentissage du rythme et tenant compte de certains aspects cruciaux de celui-ci.

Contexte : La naissance d’une fratrie prend forme à l’arrivée du deuxième enfant. Un bouleversement chez l’aîné qui lui demande de s’adapter. Les relations fraternelles favorisent le développement psycho-social des enfants et influencent leurs compétences sociales. Objectifs : Identifier les besoins de l’aîné et ceux des parents durant cette période, le soutenir dans son processus d’adaptation et ses premiers contacts avec le cadet. Méthode : Critères d’inclusion : Type de participants : Enfant d’âge préscolaire ; Types de résultats : réactions comportementales de l'aîné, stratégies d’adaptation, facteurs influençant le comportement ; Type de contexte: services de santé touchant la périnatalité; Types de recherches : qualitatives ou quantitatives. Stratégies de recherche : Bases de données consultées : CINAHL, PubMED, PsyINFO et Maternity and infant care. La recherche a amené 35 articles écrits entre 1983 et 1996. Le manque d'études récentes sur le sujet n’a pas permis d’obtenir des articles plus actuels. Synthèse des données : articles analysés selon les grilles de Fortin (2010) qui a permis une sélection de 9 articles pertinents sur le sujet. Résultats : Trois grandes thématiques ressortent: Les stratégies de coping de l'enfant, le processus d'attachement ainsi que les facteurs influençant les comportements de l'aîné. Conclusion : La connaissance des stratégies d’adaptation en lien avec l’âge de l’enfant ainsi que le processus d’attachement fraternel permet à l’infirmière d'établir des interventions auprès de l’aîné et des parents.

Introduction: Following a disaster, up to 50% of mass casualties are children. The number of disaster increases worldwide, including in Switzerland. Following national order, the mapping of the various risks of disaster in Switzerland will be completed by the end of 2012. Pre-hospital disaster drills and plans are well established and regularly tested. In-hospital disaster plans are much less frequently tested, if only available. Pediatric in-hospital full scale disaster exercises have never been reported in Switzerland. Based on our local constraints, we set up and evaluated a disaster plan during two full scale exercises. Methods: In a university hospital treating more than 35 000 pediatric emergencies per year, two exercises involving mock victims of a disaster aged 9 to 14 years old were successively set up over a period of 3 years. The exercises were planned during the day, without modification of the normal emergency room activities. The hospital staff was informed and trained in advance. Variables such as the alarm timing and transmission, triage set-up and function, special disaster medical records utilization, communication and victims' identification were assessed. Family members participated in the second exercise. An evaluation team observed and record exercises activities, identifying strength and weaknesses. Results: On two separate occasions, a total of 44 mock patients participated, were triaged, admitted and treated in the hospital according to usual standards of care. Alarm transmission was not appropriate during the first exercise. Triage overload occurred on one occasion. In-hospital communication needed readjustment. Identification and in-hospital tracking of the children remained problematic. Hospital employees showed great enthusiasm and stressed the positive effect of full scale exercises on their knowledge of the hospital disaster plan. Conclusions: Performing real life disaster exercises in a pediatric hospital was very beneficial. The disa

Pierre-Nicolas Carron, Lionel Trueb, Bertrand YersinEmergency Service, University Hospital Center, Lausanne, SwitzerlandAbstract: Simulation is a promising pedagogical tool in the area of medical education. High-fidelity simulators can reproduce realistic environments or clinical situations. This allows for the practice of teamwork and communication skills, thereby enhancing reflective reasoning and experiential learning. Use of high-fidelity simulators is not limited to the medical and aeronautical fields, but has developed in a large number of nonmedical organizations as well. The techniques and pedagogical tools which have evolved through the use of nonmedical simulations serve not only as teaching examples but also as avenues which can help further the evolution of the concept of high-fidelity simulation in the field of medicine. This paper presents examples of high-fidelity simulations in the military, maritime, and aeronautical fields. We compare the implementation of high-fidelity simulation in the medical and nonmedical domains, and discuss the possibilities and limitations of simulators in medicine, based on recent nonmedical applications.Keywords: high-fidelity simulation, crew resource management, experiential learning

L'image qu'un pays a dans le monde est importante à plusieurs titres. Elle peut soutenir la commercialisation de biens et de services exportés, elle revêt un caractère tout particulier dans le cadre des promotions touristique et économique et elle peut aussi être de nature à contribuer aux relations qu'un pays entretient avec d'autres pays aux niveaux politique, économique ou culturel. L'image de la Suisse a fait l'objet d'études dans de nombreux pays, dont les Etats-Unis, l'Allemagne et la Chine, auprès d'échantillons représentatifs de la population ainsi qu'auprès de groupes de leaders d'opinion et cet ouvrage présente de manière synthétique les principaux résultats de ces études. Après une description de l'image globale de la Suisse auprès des personnes interrogées et une analyse des associations faites à l'évocation de la Suisse, une partie importante est consacrée aux dimensions qui caractérisent l'image du pays en différenciant notamment entre les dimensions liées à la Suisse en tant qu'espace socioculturel et les dimensions liées aux aspects économiques. Pour terminer, un dernier chapitre analyse l'impact de faits ayant marqué l'actualité helvétique, comme le grounding de Swissair, sur l'image de la Suisse dans les pays étudiés.

Tout acte terroriste constitue pour nos sociétés démocratiques une véritable agression psychologique et émotionnelle, capable d'engendrer de profondes blessures au sein de la population. D'un point de vue sémantique, le terrorisme atteint ici son but ultime, en instaurant un climat d'insécurité, de crainte et de terreur. L'acte lui-même, autant que la menace d'un attentat terroriste, si imprécise soit-elle, suffit à influencer profondément nos activités professionnelles, nos loisirs et nos déplacements. Le caractère profondément intrusif et violent du terrorisme peut favoriser dès lors l'apparition de troubles psychiatriques ou de comportements à risque. Le médecin de premier recours est appelé à jouer ici un rôle clé, tant dans le dépistage de réactions pathologiques, que dans l'accompagnement des patients et dans le soutien de la population générale.

info:eu-repo/semantics/nonPublished

info:eu-repo/semantics/nonPublished

[Table des matières] I. Mise en perspective et méthodologie. II. Données démographiques : intoxications volontaires: descriptif succinct. III. Effets indésirables, descriptifs. 1. Médicaments. 2. Effets indésirables. 3. Imputabilité. 4. Gravité. 5. Evitabilité. 6. Responsabilité de l'évitabilité. 7. Destination des patients à la sortie de l'hôpital. 8. Caractéristiques des patients. 9. Durée de séjour et coûts. 10. Durée d'hospitalisation. 11. Jours d'hospitalisation imputables et évitables. 12. Coût des hospitalisations. IV. Associations. 1. Effets indésirables et médicaments incriminés. 2. Nombre de médicaments consommés. 3. Profil clinique des patients. V. Validation.

Appartient à l’ensemble documentaire : MssSGE1, Biographie

Collection : D'un certain prix, Collection : D'un certain prix, Contient une table des matières, Avec mode texte

[3], IV, [1], 51 s., 23 cm., Königsberg Pr.