40 research outputs found
Early psychological care of the French victims of the Costa Concordia shipwreck
Most of the French passengers who survived the shipwreck of the cruise ship Costa Concordia were repatriatedfrom Italy to Marseille, one of the stopovers of the cruise. The shipwreck happened during the nightof 13th–14th January 2012 and entailed the forced evacuation of 4195 passengers and crewmembers.Thirty-two persons died and 2 others are still reported missing. The massive and unexpected inflow of402 French citizens in the port of Marseille required the quick setting up of welcome facilities, not only tosolve logistical problems, but also to address psychological and sometimes even medical problems. ThePrehospital Psychological Emergency Service (CUMP) and the Prehospital Emergency Medical Service(SAMU) of Marseille examined 196 persons in total, and were able to avoid a great number of emergencyadmissions deemed necessary because of difficult psychological situations (death, missing or lost persons,acute stress). The objective of this report is to rapidly present the emergency committee as a whole andto describe in more detail the work that the CUMP accomplished during the 36 hours necessary to takecharge of the majority of the French passengers of the Costa Concordia.Most of the French passengers who survived the shipwreck of the cruise ship Costa Concordia were repatriatedfrom Italy to Marseille, one of the stopovers of the cruise. The shipwreck happened during the nightof 13th–14th January 2012 and entailed the forced evacuation of 4195 passengers and crewmembers.Thirty-two persons died and 2 others are still reported missing. The massive and unexpected inflow of402 French citizens in the port of Marseille required the quick setting up of welcome facilities, not only tosolve logistical problems, but also to address psychological and sometimes even medical problems. ThePrehospital Psychological Emergency Service (CUMP) and the Prehospital Emergency Medical Service(SAMU) of Marseille examined 196 persons in total, and were able to avoid a great number of emergencyadmissions deemed necessary because of difficult psychological situations (death, missing or lost persons,acute stress). The objective of this report is to rapidly present the emergency committee as a whole andto describe in more detail the work that the CUMP accomplished during the 36 hours necessary to takecharge of the majority of the French passengers of the Costa Concordia
Clinical factors of drug resistance in juvenile myoclonic epilepsy
Juvenile myoclonic epilepsy is a comparatively benign form of idiopathic generalised epilepsy. Little is known about the prevalence of difficult to treat or drug resistant patients. Among 155 consecutive patients with newly diagnosed juvenile myoclonic epilepsy evaluated between 1981 and 1998 and followed up for at least 1 year (61men, 94 women; aged 15-70 years, mean 33 (SD 10.3); onset of juvenile myoclonic epilepsy at the age of 14.5 (SD 3.7), range 6-26; follow up 1-52 years, mean 13.5 (SD 9.9)), there were 15 pseudoresistant patients (9.7%: lack of compliance (eight), insufficient treatment (three), abnormal lifestyle (four)) and 24 patients (15.5%) who had persisting seizures despite adequate therapy and lifestyle. Clinical features associated with drug resistance were (1) the presence of psychiatric problems (58.3% v 19%; χ(2) p<0.001) and (2) independently, the combination of seizure types (Fischer's exact 2 by 4, p=0.0026). Three types were present in 62.5% of resistant patients versus 23.3% in non-resistant patients (χ(2), p=0.0001). None of the resistant patients had myoclonic jerks as the only seizure type or a combination of absences and myoclonic jerks. Family history of epilepsy, age at onset of seizures, sex, presence of photoparoxysmal response, results of conventional neuroimagings (CT and MRI), and delayed diagnosis were not significantly associated with drug resistance. There is thus a significant subgroup of patients with juvenile myoclonic epilepsy who pose difficult therapeutic problems, and the prevalence of resistant cases may be increased in the experience of a referral epilepsy centre.

A double-blind comparison of the efficacy and safety of milnacipran and fluoxetine in depressed inpatients
This double-blind, randomised, multicentre study compared the antidepressant efficacy and safety of two doses of milnacipran (100 mg/day and 200 mg/day) and fluoxetine (20 mg/day) in 289 inpatients with endogenous depression. After a placebo washout period of 4-7 days, assessments were performed weekly during the first 4 weeks, and then after 6, 8 and 12 weeks, using the 17-item Hamilton Depression Rating Scale (HDRS), the Montgomery- Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression (CGI). HDRS total score was reduced by a mean of 14.8 in the milnacipran 100 mg/day group, 12.9 in the milnacipran 200 mg/day group and 12.1 in the fluoxetine 20 mg/day group. MADRS total score decreased by 17.4, 15.8 and 14.6, respectively. No significant difference could be shown between the three treatment groups for either the HDRS or MADRS total scores. However, the time-by-time change showed a trend in favour of milnacipran 100 mg/day, which was found significantly superior to fluoxetine at day 28 for several converging parameters (MADRS, CGI-3). Overall, efficacy ratings for all parameters were highest for milnacipran 100 mg/day, followed by milnacipran 200 mg/day and fluoxetine 20 mg/day. Side-effect profiles were not significantly different between groups except for a significantly greater frequency of dose-related increase in heart rate ≤ 100 bpm in milnacipran recipients and a significantly greater weight loss in fluoxetine recipients
Development of an investment decision tool for biogas production from agricultural waste
Three Gros Michel mutants (‘IBP 5-B’ ‘IBP 5–61’ and ‘IBP 12’) from the Cuban Instituto de BiotecnologÃa de las Plantas, two semi-dwarf Gros Michel varieties (‘Highgate’ and ‘Cocos’) and a Thai accession (‘Hom Thong Mokho’) were evaluated in Australia over a five year period. They were screened for their resistance to Fusarium wilt Race 1 (FocR1) caused by the pathogen Fusarium oxysporum f.sp. cubense, as well as resistance to yellow Sigatoka (Pseudocercospora musae Zimm [teleomorph Mycosphaerella musicola Leach]). They were also grown for a plant and ratoon crop in the tropics (17°S) and a plant crop in the subtropics (28°S) with no disease pressure to record their agronomic characteristics. They were compared with Australian industry standards, ‘Williams’ (AAA, Cavendish subgroup) and ‘Lady Finger’ (AAB, Pome subgroup). In the subtropics the Gros Michel mutants and semi-dwarf accessions were sensitive to cold and very susceptible to FocR1 and yellow Sigatoka while their agronomic performance in the tropics was good, with ‘Highgate’ having the best bunch weight on a shorter, more manageable plant. Of the six accessions evaluated, ‘Hom Thong Mokho’ showed the highest level of resistance to FocR1 although it had poor cold tolerance, as did the other Gros Michel selections, and consequently had low productivity compared to ‘Williams’ and even ‘Lady Finger’. However in the warmer, more humid tropics ‘Hom Thong Mokho's performance was much better and it was less susceptible to yellow Sigatoka than the other Gros Michel selections. Subsequent genetic analysis by Christelová et al. (2011) has revealed that although ‘Hom Thong Mokho’ is marketed as a Gros Michel variety in Asia, it is closer to the Rio subgroup (AAA) of dessert bananas
Reflection on the psychiatric financial allocation in France
International audienceFor 25 years work has been underway in France for the implementation of ă an alternative to public financing of health care. In the absence of ă progress, some regional health agencies are engaged in work related to ă the reallocation of public finances between psychiatric institutions. We ă propose a reflection with suggestion on the method proposed by the ă Provence Alpes Cote d'Azur Regional Health Agency. Without questioning ă the need for a reallocation of resources between psychiatric ă institutions, the method proposed here needs to evolve further to be ă applied in a legitimate and appropriate manner. There is a kind of ă urgency for a reallocation of resources between psychiatric institutions ă in France, but it implies a collective thinking and especially the ă definition of evaluation procedures for the selected models. These ă conditions are necessary to guarantee the quality of French psychiatry ă and equity in access to psychiatric care. (C) 2016 L'Encephale, Paris
Assessment of psychiatric inpatient satisfaction: A systematic review of self-reported instruments.
International audienceBACKGROUND: There is a growing concern about satisfaction with inpatient psychiatric services. There are currently numerous satisfaction instruments available to psychiatric inpatients, but little guidance on which among them to select. AIMS: To provide an overview of the psychometric properties and the content of satisfaction instruments available to psychiatric inpatients. METHODS: Systematic searches of Medline database to identify inpatient satisfaction questionnaires. Assessment of the instruments according to relevant psychometric properties. RESULTS: Fifteen satisfaction instruments were identified. The target population differed according to the instrument. Methods used to generate items were heterogeneous. These instruments were based on a mixed approach including patients' points of view, expert opinions, and literature reviews, causing the content of questionnaires to vary. Reliability and validity were not systematically tested. CONCLUSION: The validation of a common inpatient satisfaction instrument is a major challenge. Recommendations for the future development of satisfaction instruments may include: item generation based exclusively on the patient's point of view; a validation process on a large and representative population; and an instrument combining generic (core questionnaire) and specific (additional modules) approaches