Substance use and its association with mental health among Swiss medical students: A cross-sectional study.

Studies on mental health and substance use among medical students indicated worrying prevalence but have been mainly descriptive. To evaluate the prevalence of substance use in a sample of medical students and investigate whether mental health variables have an influence on substance use. The data were collected as part of the first wave of the ETMED-L, an ongoing longitudinal open cohort study surveying medical students at the University of Lausanne (Switzerland). N = 886 students were included and completed an online survey including measures of mental health (depression, suicidal ideation, anxiety, stress, and burnout) and use of and risk related with several substances (tobacco, alcohol, cannabis, cocaine, stimulants, sedatives, hallucinogens, opioids, nonmedical prescription drugs, and neuroenhancement drugs). We evaluated the prevalence of use of each substance and then tested the association between mental health and substance use in an Exploratory Structural Equation Modeling framework. Statistical indices indicated a four-factor solution for mental health and a three-factor solution for substance use. A factor comprising risk level for alcohol, tobacco, and cannabis use - which were the most prevalent substances - was significantly associated with a burnout factor and a factor related to financial situation and side job stress. There was a significant association between a factor comprising depression, anxiety, and suicidal ideation and a factor related to the use of sedatives, nonmedical prescription drugs and neuroenhancement drugs. Although their use was less prevalent, a factor comprising the risk level of stimulants and cocaine use was significantly but more mildly related to the burnout factor. A factor comprising stress related to studies and work/life balance as well as emotional exhaustion was not related to substance use factors. In this sample of medical students, the prevalence of substance use was substantial and poorer mental health status was related with higher substance use risk levels

The Effects of Guided Imagery & Music on Anxiety

This study examines the effects of guided imagery/music (GIM) and music only on anxiety

An Evaluative Framework of Legal Aid Models

The purpose of this Article is to place the systems for legal service to the poor in the developed countries of the world within an evaluative perspective that may be useful to planners of such systems in developing countries. Part I presents one exposition of the process of national development, with particular emphasis on the role of law and lawyers. Part II describes the major legal service systems used in the West. In Part III, some observations are offered about the relationship between a country’s development goals and its choice of a legal service program or system

The Effects of Guided Imagery & Music on Anxiety

This study examines the effects of guided imagery/music (GIM) and music only on anxiety

Concept of Formation Length in Radiation Theory

The features of electromagnetic processes are considered which connected with finite size of space region in which final particles (photon, electron-positron pair) are formed. The longitudinal dimension of the region is known as the formation length. If some external agent is acting on an electron while traveling this distance the emission process can be disrupted. There are different agents: multiple scattering of projectile, polarization of a medium, action of external fields, etc. The theory of radiation under influence of the multiple scattering, the Landau-Pomeranchuk-Migdal (LPM) effect, is presented. The probability of radiation is calculated with an accuracy up to "next to leading logarithm" and with the Coulomb corrections taken into account. The integral characteristics of bremsstrahlung are given, it is shown that the effective radiation length increases due to the LPM effect at high energy. The LPM effect for pair creation is also presented. The multiple scattering influences also on radiative corrections in a medium (and an external field too) including the anomalous magnetic moment of an electron and the polarization tensor as well as coherent scattering of a photon in a Coulomb field. The polarization of a medium alters the radiation probability in soft part of spectrum. Specific features of radiation from a target of finite thickness include: the boundary photon emission, interference effects for thin target, multi-photon radiation. The experimental study of LPM effect is described. For electron-positron colliding beams following items are discussed: the separation of coherent and incoherent mechanisms of radiation, the beam-size effect in bremsstrahlung, coherent radiation and mechanisms of electron-positron creation.Comment: Revised review paper, 96 pages, 28 figures. Description of SLAC E-146 experiment removed, discussion of CERN SPS experiment adde

Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A New Challenging Entity for Consultation-Liaison Psychiatrist.

BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a relatively newly identified autoimmune neuropsychiatric disorder that predominantly affects children and young adults. Although psychiatric symptoms are highly prevalent and frequently severe, it has mainly been reported in neurological, but not psychiatric, literature. Understanding this form of encephalitis, its quick diagnosis and which treatment to provide are of utmost importance for consultation-liaison (C-L) psychiatrists. The aim of this paper was to describe a case of anti-NMDAR encephalitis with severe psychiatric manifestations, who showed impressive recovery but required intensive involvement of the C-L psychiatry team. We emphasise the behavioural aspects, psychiatric symptoms and challenges faced by the CL consultant across the different phases of the treatment. METHODS: We report the different treatment phases for a young woman with anti-NMDAR encephalitis who developed severe neuropsychiatric symptoms, with a focus on the role and challenges faced by the C-L psychiatrist. The literature is reviewed for each of these challenges. RESULTS: This case illustrated that even extremely severely affected patients may show impressive recovery, but require long lasting psychiatric care. C-L psychiatrists are faced with numerous challenges where only little literature is available. CONCLUSION: C-L psychiatrists play a pivotal role throughout the multidisciplinary care of patients with anti-NMDAR encephalitis and should be informed about this entity