Screening of mental health and substance users in frequent users of a général Swiss emergency department

Background: The objectives of this study were to determine the proportions of psychiatric and substance use disorders suffered by emergency departments' (EDs') frequent users compared to the mainstream ED population, to evaluate how effectively these disorders were diagnosed in both groups of patients by ED physicians, and to determine if these disorders were predictive of a frequent use of ED services. Methods: This study is a cross-sectional study with concurrent and retrospective data collection. Between November 2009 and June 2010, patients' mental health and substance use disorders were identified prospectively in face-to-face research interviews using a screening questionnaire (i.e. researcher screening). These data were compared to the data obtained from a retrospective medical chart review performed in August 2011, searching for mental health and substance use disorders diagnosed by ED physicians and recorded in the patients' ED medical files (i.e. ED physician diagnosis). The sample consisted of 399 eligible adult patients (≥18 years old) admitted to the urban, general ED of a University Hospital. Among them, 389 patients completed the researcher screening. Two hundred and twenty frequent users defined by >4 ED visits in the previous twelve months were included and compared to 169 patients with ≤4 ED visits in the same period (control group). Results: Researcher screening showed that ED frequent users were more likely than members of the control group to have an anxiety, depressive disorder, post-traumatic stress disorder (PTSD), or suffer from alcohol, illicit drug abuse/ addiction. Reviewing the ED physician diagnosis, we found that the proportions of mental health and substance use disorders diagnosed by ED physicians were low both among ED frequent users and in the control group. Using multiple logistic regression analyses to predict frequent ED use, we found that ED patients who screened positive for psychiatric disorders only and those who screened positive for both psychiatric and substance use disorders were more likely to be ED frequent users compared to ED patients with no disorder. Conclusions: This study found high proportions of screened mental health and/or substance use disorders in ED frequent users, but it showed low rates of detection of such disorders in day-to-day ED activities which can be a cause for concern. Active screening for these disorders in this population, followed by an intervention and/or a referral for treatment by a case-management team may constitute a relevant intervention for integration into a general ED setting

Coupled THM analysis of long-term anisotropic convergence in the full-scale micro tunnel excavated in the Callovo-Oxfordian argillite

The main purpose of this paper is to analyse the convergence measurements of the ALC1604 in situ heating test carried out in the Callovo-Oxfordian claystone formation (COx) in the Meuse/Haute-Marne underground research laboratory (MHM URL). The concept of the test consists of horizontal micro-tunnel, equipped with a steel casing. The micro-tunnel is excavated in the direction of the horizontal principal major stress (sH). In situ observations showed anisotropic convergence with the maximum and minimum values in the horizontal and vertical directions, respectively. Coupled THM numerical analyses have been carried out to provide a structured framework for interpretation, and to enhance understanding of THM behaviour of Callovo-Oxfordian claystone. However, a special mechanical constitutive law is adopted for the description of the time-dependent anisotropic behaviour of the COx. The simulation of the test using this enhanced model provides a satisfactory reproduction of the THM long-term anisotropic convergence results. It also provides a better understanding of the observed test response.Postprint (published version

Thermo-hydro-mechanical simulation of a full-scale steel-lined micro-tunnel excavated in the callovooxfordian claystone

The paper presents an interpretation of the full-scale ALC1604 in situ heating test carried out in Callovo-Oxfordian claystone (COx) in the Meuse/Haute-Marne underground research laboratory (MHM URL). The MHM URL is a site-specific facility planned to study radioactive waste disposal in the COx. The thermo-hydro-mechanical (THM) behaviour of the host rock is significant for the design of the underground radioactive waste disposal facility and for its long-term safety. When subjected to thermal loading, the Callovo-Oxfordian claystone of low permeability (~10-20-10-21 m2) exhibits a strong pore pressure response that significantly affects the hydraulic and mechanical behaviour of the material. The observations gathered in the in situ test have provided an opportunity to examine the integrated thermo-hydromechanical (THM) response of this sedimentary clay. Coupled THM numerical analyses have been carried out to provide a structured framework for interpretation, and to enhance understanding of THM behaviour of COx. Numerical analyses have been based on a coupled theoretical formulation that incorporates a constitutive law specially developed for this type of material. The law includes a number of features that are relevant for a satisfactory description of the hydromechanical behaviour. By performing the numerical analysis, it has been possible to incorporate anisotropy of material parameters and of in situ stresses. The performance and analysis of the in situ tests have significantly enhanced the understanding of a complex THM problem and have proved the capability of the numerical formulation to provide adequate predictive capacity

Pine wilt disease: detection of the pinewood nematode (Bursaphelenchus xylophilus) as a tool for a pine breeding programme

The pinewood nematode (PWN), Bursaphelenchus xylophilus, is a serious quarantine pest first detected in Portugal and Europe in 1999. It is the causal agent of pine wilt disease (PWD). A resistance breeding programme has been initiated to contribute to control the evolution of the disease. Five hundred and four adult maritime pine, Pinus pinaster, trees were phenotypically selected as candidate trees for this programme from an area affected by PWD. To identify tolerance to the nematode, the selected trees were monitored monthly. Over the course of 1 year, 57 candidate trees died and were tested for the presence/absence of the PWN. As accuracy of detection is of major importance, an ITS-PCR-based method applied directly to wood from adult maritime pine trees was tested and compared with a standard morphological identification method. The results showed that the use of PCR to detect the pathogen provided more rapid and accurate results in comparison with the standard morphological identification. Thus, this method is suitable to be used in the survey of the breeding population for resistance/tolerance to PWD

Spin dependent photoelectron tunnelling from GaAs into magnetic Cobalt

The spin dependence of the photoelectron tunnel current from free standing GaAs films into out-of- plane magnetized Cobalt films is demonstrated. The measured spin asymmetry (A) resulting from a change in light helicity, reaches +/- 6% around zero applied tunnel bias and drops to +/- 2% at a bias of -1.6 V applied to the GaAs. This decrease is a result of the drop in the photoelectron spin polarization that results from a reduction in the GaAs surface recombination velocity. The sign of A changes with that of the Cobalt magnetization direction. In contrast, on a (nonmagnetic) Gold film A ~ 0%

Scanning SQUID microscopy of vortex clusters in multiband superconductors

In type-1.5 superconductors, vortices emerge in clusters, which grow in size with increasing magnetic field. These novel vortex clusters and their field dependence are directly visualized by scanning SQUID microscopy at very low vortex densities in MgB2 single crystals. Our observations are elucidated by simulations based on a two-gap Ginzburg-Landau theory in the type-1.5 regime.Comment: 4 pages, 5 figures, to be published in Physical Review

Macroscopic behavior of bidisperse suspensions of noncolloidal particles in yield stress fluids

We study both experimentally and theoretically the rheological behavior of isotropic bidisperse suspensions of noncolloidal particles in yield stress fluids. We focus on materials in which noncolloidal particles interact with the suspending fluid only through hydrodynamical interactions. We observe that both the elastic modulus and yield stress of bidisperse suspensions are lower than those of monodisperse suspensions of same solid volume fraction. Moreover, we show that the dimensionless yield stress of such suspensions is linked to their dimensionless elastic modulus and to their solid volume fraction through the simple equation of Chateau et al.[J. rheol. 52, 489-506 (2008)]. We also show that the effect of the particle size heterogeneity can be described by means of a packing model developed to estimate random loose packing of assemblies of dry particles. All these observations finally allow us to propose simple closed form estimates for both the elastic modulus and the yield stress of bidisperse suspensions: while the elastic modulus is a function of the reduced volume fraction $\phi/\phi_m$ only, where $\phi_m$ is the estimated random loose packing, the yield stress is a function of both the volume fraction $\phi$ and the reduced volume fraction