Réseau primaire et santé mentale : Résultats des interventions effectuées auprès des patients identifiés et de leur réseau primaire

Les résultats d'une recherche sur l'application systématique de l'intervention en réseau comme réponse thérapeutique aux demandes de soins de 20 clients non présélectionnés d'une clinique externe de psychiatrie ont démontré que cette approche était utilisable dans un contexte de prise en charge de secteur. L'analyse détaillée de nos résultats indique également certaines tendances quant aux bénéfices additionnels de cette approche communautaire. En effet, les clients qui ont accepté l'intervention en réseau1 (les 2/3) se sont améliorés sur le plan de la symptomatologie, mais aussi au niveau de leur satisfaction personelle et de leur vie sociale, alors que ceux qui ont accepté une approche individuelle, ûe couple ou de famille, mais sans intervention en réseau, ont vu leur amélioration se limiter au plan de la symptomatologie, sans amélioration correspondante de leur satisfaction personnelle ou de leur vie sociale.The results of a study attempting the systematic application of a network intervention approach to meet the therapeutic needs of 20 non-preselected clients at an outpatient psychiatric clinic showed that this community oriented approach was not only applicable but also beneficial. While our principal objective was to see if a network approach could be adapted to the treatment of an ongoing public psychiatric service for a given sector of the population, our results indicate certains additional trends : those clients who accepted to participate in a network approach (2/3) not only showed decreased symptomatology but also increased personal satisfaction and improvements in their social life. Meanwhile those clients who underwent individual, couple, or family therapy but who did not accept a network approach showed decreases in symptomatology only, without corresponding improvement in other spheres

Common neural basis for phoneme processing in infants and adults

Investigating the degree of similarity between infants' and adults' representation of speech is critical to our understanding of infants' ability to acquire language. Phoneme perception plays a crucial role in language processing, and numerous behavioral studies have demonstrated similar capacities in infants and adults, but are these subserved by the same neural substrates or networks? In this article, we review event-related potential (ERP) results obtained in infants during phoneme discrimination tasks and compare them to results from the adult literature. The striking similarities observed both in behavior and ERPs between initial and mature stages suggest a continuity in processing and neural structure. We argue that infants have access at the beginning of life to phonemic representations, which are modified without training or implicit instruction, but by the statistical distributions of speech input in order to converge to the native phonemic categories

Accueil temporaire psychiatrique (ATP) [Document électronique] : évaluation d'une expérience pilote

Le but de cette étude est d'évaluer l'expérience pilote d'ATP sous la forme d'une recherche-action selon quatre axes : l'évaluation (a) de la cohorte expérimentale et de son évolution, (b) de la mise en oeuvre du concept de l'ATP, (c) de la place de l'ATP dans le réseau et (d) de la satisfaction des patients, des proches et des professionnels. Les résultats attendus sont la correspondance de la cohorte expérimentale par rapport à la population cible prévue et une amélioration des problèmes cliniques et sociaux. En terme de mise en oeuvre, l'adéquation de l'offre et le coût des prestations seront évalués. Sur le plan qualitatif, particulièrement dans une phase initiale du projet, l'accent sera mis sur la place de l'ATP dans le réseau de soins et la satisfaction des usagers, des proches et des professionnels impliqués. L'expérimentation du concept ATP a été réalisée dans l'institution mandatée par ARCOS, l'EMS « Foyer de la Borde » à Lausanne. L'évaluation du déroulement de l'expérience a été confiée à l'équipe de l'Unité de recherche évaluative du DUPA, mandatée également par ARCOS. [Introd. p. 3]]]> Evaluation Studies as Topic ; Community Mental Health Services ; Mental Disorders ; Social Support oai:serval.unil.ch:BIB_D961B75395DC 2022-05-07T01:28:08Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_D961B75395DC Introduction : où en est l'analyse de réseaux en histoire? Bertrand, M. Guzzi-Heeb, S. Lemercier, C. info:eu-repo/semantics/article article 2011-12 Redes. Revista hispana para el análisis de redes sociales, vol. 21, pp. 12-22 info:eu-repo/semantics/altIdentifier/pissn/1579-0185 urn:issn:1579-0185 <![CDATA[Le concept de réseau est aujourd'hui largement entré dans le vocabulaire des sciences sociales. En histoire, l'introduction du vocabulaire des réseaux a souvent été liée à des démarches situées à une échelle « micro » et travaillant à mettre en évidence l'agency individuelle. Depuis les années 1990, une analyse de réseaux plus formalisée a fait des apparitions épisodiques, et inégales selon les domaines linguistiques, dans d'autres travaux historiques fondés au contraire sur des observations systématiques à une échelle macro. Après 30 ans d'une intégration de la catégorie à la démarche historique, un véritable savoir-faire historien émerge autour des questionnements auxquels elle est associée et des méthodologies qu'elle implique. Cependant, si l'analyse de réseaux a déjà largement fait la preuve de son intérêt dans certains domaines spécifiques de l'histoire, il existe trop peu de dialogue entre ceux qui la pratiquent ; notre souhait, en donnant à voir les parentés et les différences entre des textes issus de pays et de sous-disciplines variés, est bien de promouvoir un tel dialogue

Laos - language situation

Laos features a high level of linguistic diversity, with more than 70 languages from four different major language families (Tai, Mon-Khmer, Hmong-Mien, Tibeto-Burman). Mon-Khmer languages were spoken in Laos earlier than other languages, with incoming migrations by Tai speakers (c. 2000 years ago) and Hmong-Mien speakers (c. 200 years ago). There is widespread language contact and multilingualism in upland minority communities, while lowland-dwelling Lao speakers are largely monolingual. Lao is the official national language. Most minority languages are endangered, with a few exceptions (notably Hmong and Kmhmu). There has been relatively little linguistic research on languages of Laos, due to problems of both infrastructure and administration

Clinically feasible reconstruction of 3D whole-body PET/CT data using blurred anatomical labels

We present the results of utilizing aligned anatomical information from CT images to locally adjust image smoothness during the reconstruction of three-dimensional (3D) whole-body positron emission tomography (PET) data. The ability of whole-body PET imaging to detect malignant neoplasms is becoming widely recognized. Potentially useful, however, is the role of whole-body PET in quantitative estimation of tracer uptake. The utility of PET in oncology is often limited by the high level of statistical noise in the images. Reduction in noise can be obtained by incorporating a priori image smoothness information from correlated anatomical information during the reconstruction of PET data. A combined PET/CT scanner allows the acquisition of accurately aligned PET and x-ray CT whole-body data. We use the Fourier rebinning algorithm (FORE) to accurately convert the 3D PET data to two-dimensional (2D) data to accelerate the image reconstruction process. The 2D datasets are reconstructed with successive over-relaxation of a penalized weighted least squares (PWLS) objective function to model the statistics of the acquisition, data corrections, and rebinning. A 3D voxel label model is presented that incorporates the anatomical information via the penalty weights of the PWLS objective function. This combination of FORE + PWLS + labels was developed as it allows for both reconstruction of 3D whole-body data sets in clinically feasible times and also the inclusion of anatomical information in such a way that convergence can be guaranteed. Since mismatches between anatomical (CT) and functional (PET) data are unavoidable in practice, the labels are ‘blurred’ to reflect the uncertainty associated with the anatomical information. Simulated and experimental results show the potential advantage of incorporating anatomical information by using blurred labels to calculate the penalty weights. We conclude that while the effect of this method on detection tasks is complicated and unclear, there is an improvement on the estimation task.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48971/2/m20101.pd

Evaluating quality of obstetric care in low-resource settings: Building on the literature to design tailor-made evaluation instruments - an illustration in Burkina Faso

<p>Abstract</p> <p>Background</p> <p>There are many instruments available freely for evaluating obstetric care quality in low-resource settings. However, this profusion can be confusing; moreover, evaluation instruments need to be adapted to local issues. In this article, we present tools we developed to guide the choice of instruments and describe how we used them in Burkina Faso to facilitate the participative development of a locally adapted instrument.</p> <p>Methods</p> <p>Based on a literature review, we developed two tools: a conceptual framework and an analysis grid of existing evaluation instruments. Subsequently, we facilitated several sessions with evaluation stakeholders in Burkina Faso. They used the tools to develop a locally adapted evaluation instrument that was subsequently tested in six healthcare facilities.</p> <p>Results</p> <p>Three outputs emerged from this process:</p> <p>1) A comprehensive conceptual framework for the quality of obstetric care, each component of which is a potential criterion for evaluation.</p> <p>2) A grid analyzing 37 instruments for evaluating the quality of obstetric care in low-resource settings. We highlight their key characteristics and describe how the grid can be used to prepare a new evaluation.</p> <p>3) An evaluation instrument adapted to Burkina Faso. We describe the experience of the Burkinabé stakeholders in developing this instrument using the conceptual framework and the analysis grid, while taking into account local realities.</p> <p>Conclusions</p> <p>This experience demonstrates how drawing upon existing instruments can inspire and rationalize the process of developing a new, tailor-made instrument. Two tools that came out of this experience can be useful to other teams: a conceptual framework for the quality of obstetric care and an analysis grid of existing evaluation instruments. These provide an easily accessible synthesis of the literature and are useful in integrating it with the context-specific knowledge of local actors, resulting in evaluation instruments that have both scientific and local legitimacy.</p

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic