A qualitative study of a psychiatric emergency

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Is psychiatric emergency service (PES) use increasing over time?

<p>Abstract</p> <p>Background</p> <p>Several recent studies have reported a significant increase in medical emergency department (ED) use for reasons of mental health. The diagnostic profile of these patients however differs from that usually described for patients visiting the psychiatric emergency service (PES). Few studies have specifically focused upon long-term PES utilization rates. Those that do typically present data from the early 80s, suggesting that deinstitutionalization may be an important contributing factor to the increases found. The aim of this study was to assess PES use using a more recent time frame and, the effects of non-specific factors, such as population growth, on this use.</p> <p>Methods</p> <p>Visits per year at several different types of PESs were obtained; (a) for an 11-year period at a general hospital PES while the surrounding population remained stable, (b) at that same PES while the catchment area population doubled over a period of a few years, (c) for an 11-year period at two PESs without catchment areas while the surrounding population increased and (d-) for a 12-year period at a PES in a mental health facility while the surrounding population increased. Moderately conservative criteria were used to define either a trend or, a significant increase in utilization rates.</p> <p>Results</p> <p>Each site had an inherent, 7 to 15% yearly variability in the number of PES visits. Over time however, only those where the surrounding population increased (either by an increase in the catchment area size or a regional increase in the population census) showed a trend or, a significant increase in utilization rates. These increases however were modest and of the order of 12 to 19%.</p> <p>Conclusion</p> <p>Long observation periods are required in order to detect stable changes in PES utilization rates over time. As such, population growth may be but one of several factors underlying these increases. Organizational changes in mental health care delivery in the vicinity of the services that showed an increase could also have contributed. These latter would simply have redistributed (to the PES) the pre existing pool of mental health care patients, resulting in an increase that is more apparent than real.</p

Temperature dependence of second-order nonlinear relaxation of a poled chromophore doped sol-gel material

International audienceSecond-order optical nonlinearity relaxations of hybrid inorganic/organic sol-gel films doped with poled Disperse Red 1 chromophores were measured by second harmonic generation at several temperatures. The decay curves were fitted to biexponentials and Ko¨hlrausch, Williams, and Watts ~KWW! stretched exponentials. It can be concluded that the KWW model well describes chromophore thermal reorientation in hybrid sol-gel materials, as is known for all-organic polymers. Using the Arrhenius law, the activation energy of the reorientation process has been determined to be about 50 or 70 kcal mol21. A stability of roughly a decade has been extrapolated at room temperature. Another experiment at room temperature gave an estimation of the stability that was found to be in qualitative agreement. It is shown that poled chromophore-doped sol-gel materials have the potential to be stable enough for applications in telecommunication device

Stable photorefractive memory effect in sol-gel materials

International audienceWe report on the synthesis and the optical characterization of a photorefractive sol-gel material which contains nonlinear azo chromophore and carbazole charge transporting molecules. Both of these functional groups are covalently attached to the silica based backbone. Thin sol-gel films exhibit stable optically nonlinear properties: the electro-optic coefficient r13 measured at 633 nm is found to be 17 pm/V one day after corona poling and 15 pm/V after three weeks and over a period of several months. Photorefractivity is demonstrated by two beam coupling experiments without external applied electric field. Sol-gel films present a stable photorefractive memory effect with a net internal gain of 200 cm-

DR1 doped sol-gel planar waveguides for nonlinear devices operating at telecommunications wavelengths

International audienceWe report on linear and nonlinear optical properties of Disperse Red 1-doped solgel waveguides. The refractive-index and optical-propagation losses of the guiding layer were measured between 0.756 mm and 1.64 mm. The spectral broadening of the chromophore charge-transfer transition in the visible is modeled with a Voigt-profile function. In the telecommunications window the attenuation is dominated by the overtones of the O--H bonds vibration bands. The nonlinear optical coefficients were measured at different poling strengths with the Maker-fringe method. The nonlinear coefficient d33 was found to be 4.5 pm V21 at 1.58 mm for a poling field of 60 Vmm21

An examination of the temporal and geographical patterns of psychiatric emergency service use by multiple visit patients as a means for their early detection

<p>Abstract</p> <p>Background:</p> <p>Frequent users of the psychiatric emergency service (PES) place a heavy burden upon the mental health care delivery system. The aim of this study was to identify distinct temporal or geographical patterns of PES use by these patients as potential markers for their early detection.</p> <p>Methods:</p> <p>Diagnostic profiles were obtained for patients making an intermediate (4 to 10) or a high (11 or more) number of visits to a general hospital PES in Montreal (Canada) between 1985 and 2004. Between-group comparisons were made with regards to several parameters. These included the time intervals between consecutive visits, visit clustering (single, repeating, and the time interval to the first cluster) and visits made to three other services where data was similarly acquired from 2002 to 2004.</p> <p>Results:</p> <p>The two multiple visit groups differed with regards to diagnostic profiles and actual time between consecutive visits (significantly shorter in patients with 11 or more visits). Patients with 11 or more visits were more likely to have a single cluster (3 or more visits/3 months) or repeating clusters (4 visits/3 months) in their patterns of use. Personality disorders were more prevalent in patients with single clusters as they were, along with schizophrenia, in those with repeating clusters. In addition, clusters were found to occur sufficiently early so as to be potentially useful as markers for early detection. Ten percent of those with 11 or more visits and 16% of those with an intermediate number of visits frequented at least one other PES. A small number of patients, primarily those with substance abuse, made over 50% of their visits to other services.</p> <p>Conclusion:</p> <p>Temporal and geographical patterns of use differed significantly between the multiple visit groups. These patterns, combined with distinct diagnostic profiles, could potentially lead to the more rapid identification and treatment of specific sub-groups of multiple visit patients.</p

The elderly in the psychiatric emergency service (PES); a descriptive study

<p>Abstract</p> <p>Background</p> <p>The impact of an aging population on the psychiatric emergency service (PES) has not been fully ascertained. Cognitive dysfunctions aside, many DSM-IV disorders may have a lower prevalence in the elderly, who appear to be underrepresented in the PES. We therefore attempted to more precisely assess their patterns of PES use and their clinical and demographic characteristics.</p> <p>Methods</p> <p>Close to 30,000 visits to a general hospital PES (Montreal, Quebec, Canada) were acquired between 1990 and 2004 and pooled with over 17,000 visits acquired using the same methodology at three other services in Quebec between 2002 and 2004.</p> <p>Results</p> <p>The median age of PES patients increased over time. However, the proportion of yearly visits attributable to the elderly (compared to those under 65) showed no consistent increase during the observation period. The pattern of return visits (two to three, four to ten, eleven or more) did not differ from that of patients under 65, although the latter made a greater number of total return visits per patient. The elderly were more often women (62%), widowed (28%), came to the PES accompanied (42%) and reported « illness » as an important stressor (29%). About 39% were referred for depression or anxiety. They were less violent (10%) upon their arrival. Affective disorders predominated in the diagnostic profile, they were less co-morbid and more likely admitted than patients under 65.</p> <p>Conclusion</p> <p>Although no proportional increase in PES use over time was found the elderly do possess distinct characteristics potentially useful in PES resource planning so as to better serve this increasingly important segment of the general population.</p

Estivales-2013 (Les)

Les sciences humaines et sociales, sans remonter au rapport de Sophie Barluet, Le coeur en danger, sont dans une situation d’équilibre instable : et pourtant, sans une publication régulière, intensive, de ces disciplines, quel regard sur nos sociétés ? Quel recul sur notre histoire ? Comment ne pas tomber dans le présentisme et l’effet de mode ? Sans le soutien et le devenir de la librairie, maillon indépassable de la chaîne du livre, quels seront les lecteurs et les penseurs de demain ? À l’occasion des 20 ans des Presses de l’enssib, éditeur public qui, comme beaucoup d’éditeurs privés, prend ses risques et donne à penser, Les Estivales s’ouvrent cette année sur cette focale particulière, parce qu’il nous a semblé qu’il y avait une certaine urgence. Les Estivales, manifestation annuelle de l’enssib, ont pour objectif de rassembler professionnels, chercheurs et étudiants autour de questions professionnelles et de l’actualité de la recherche en sciences de l’information et des bibliothèques

CD4+CD25+ regulatory T cells inhibit natural killer cell functions in a transforming growth factor–β–dependent manner

Tumor growth promotes the expansion of CD4+CD25+ regulatory T (T reg) cells that counteract T cell–mediated immune responses. An inverse correlation between natural killer (NK) cell activation and T reg cell expansion in tumor-bearing patients, shown here, prompted us to address the role of T reg cells in controlling innate antitumor immunity. Our experiments indicate that human T reg cells expressed membrane-bound transforming growth factor (TGF)–β, which directly inhibited NK cell effector functions and down-regulated NKG2D receptors on the NK cell surface. Adoptive transfer of wild-type T reg cells but not TGF-β−/− T reg cells into nude mice suppressed NK cell–mediated cytotoxicity, reduced NKG2D receptor expression, and accelerated the growth of tumors that are normally controlled by NK cells. Conversely, the depletion of mouse T reg cells exacerbated NK cell proliferation and cytotoxicity in vivo. Human NK cell–mediated tumor recognition could also be restored by depletion of T reg cells from tumor-infiltrating lymphocytes. These findings support a role for T reg cells in blunting the NK cell arm of the innate immune system

Optical 3D-storage in sol-gel materials with a reading by Optical Coherence Tomography-technique

We report on the recording of 3D optical memories in sol-gel materials by using a non-linear absorption effect. This effect induces a local change of the optical properties of the material which is read and quantified with a high resolution full-field Optical Coherence Tomography setup. It is the first time that this technique is used for this purpose. Data recording was performed by focused picosecond (ps) single-pulse irradiation at 1064 nm with energy densities of 10 and 33 J/cm2 per pulse.Comment: 19 pages, 7 figure