Un service d'urgence en psychiatrie : quelle interface pour l'accès aux soins ?: Etude statistique de l'activité d'un service d'urgence de 1999 à 2003

Article en ligne : http://www.john-libbey-eurotext.fr/en/revues/medecine/ipe/e-docs/00/04/21/59/article.phtmlInternational audienceEmergency psychiatric services: what interface is needed to access care? Statistical study into the activities of an emergency ward from 1999 to 2003.Emergency reception is a core issue in the question of access to psychiatric care. Reception facilities are not restricted to an institution, but are rather an interface between the various types of demand and the array of possible courses of treatment in psychiatry. At the specialised hospital at Saint-Jean-de-Dieu in Lyon, the emergency ward and department for medical information inventoried arrivals in their emergency reception over a period of 5 years (1999-2003) asking doctors to fill in a form giving precise details on the profile of patients dealt with. The data compiled represents 14,689 emergency situations corresponding to 6,568 patients. Different patient profiles were established revealing differing demands on emergency care. In emergency reception a crisis reception service and chronicity reception service coexist. Emergency reception is a crucial interface for patients of the first category (crisis profile) to access care, but a “substitute” structure for the second group (chronic). This raises the idea of creating reception areas specifically directed at chronic mental distress.L'accueil des urgences est au cœur de la problématique de l'accès aux soins en psychiatrie. Loin d'être exclusivement un lieu de soin institutionnel, il se présente comme une interface entre une demande multiforme de prise en charge et la multiplicité des parcours de soin en psychiatrie. Au CHS Saint-Jean-de-Dieu à Lyon, le service des urgences et le DIM ont recensé, pendant 5 ans (de 1999 à 2003), les passages dans l'UAU de leur établissement grâce à une fiche remplie par les médecins et renseignant de façon précise le profil des patients reçus en urgence. Les données collectées représentent 14 689 situations d'urgences correspondant à 6 568 patients. Différents profils de patients ont pu être établis et amènent à constater une consommation différenciée de l'urgence. À l'UAU cohabitent un accueil de la crise et un accueil de la chronicité. L'urgence est une interface indispensable pour l'accès aux soins pour les patients de la première catégorie (profil de crise) mais une structure de « substitution » pour la deuxième population (chroniques). Cela amène à penser la création de lieux d'accueil spécifiques de la détresse psychique chroniqu

Quantitative estimates of preventable and treatable deaths from 36 cancers worldwide: a population-based study.

BACKGROUND: Cancer is a leading cause of premature mortality globally. This study estimates premature deaths at ages 30-69 years and distinguishes these as deaths that are preventable (avertable through primary or secondary prevention) or treatable (avertable through curative treatment) in 185 countries worldwide. METHODS: For this population-based study, estimated cancer deaths by country, cancer, sex, and age groups were retrieved from the International Agency for Research on Cancer's GLOBOCAN 2020 database. Crude and age-adjusted cancer-specific years of life lost (YLLs) were calculated for 36 cancer types. FINDINGS: Of the estimated all-ages cancer burden of 265·6 million YLLs, 182·8 million (68·8%) YLLs were due to premature deaths from cancer globally in 2020, with 124·3 million (68·0%) preventable and 58·5 million (32·0%) treatable. Countries with low, medium, or high human development index (HDI) levels all had greater proportions of YLLs at premature ages than very high HDI countries (68·9%, 77·0%, and 72·2% vs 57·7%, respectively). Lung cancer was the leading contributor to preventable premature YLLs in medium to very high HDI countries (17·4% of all cancers, or 29·7 million of 171·3 million YLLs), whereas cervical cancer led in low HDI countries (26·3% of all preventable cancers, or 1·83 million of 6·93 million YLLs). Colorectal and breast cancers were major treatable cancers across all four tiers of HDI (25·5% of all treatable cancers in combination, or 14·9 million of 58·5 million YLLs). INTERPRETATION: Alongside tailored programmes of early diagnosis and screening linked to timely and comprehensive treatment, greater investments in risk factor reduction and vaccination are needed to address premature cancer inequalities. FUNDING: Erasmus Mundus Exchange Programme and the International Agency for Research on Cancer. TRANSLATIONS: For the German, French, Spanish and Chinese translations of the abstract see Supplementary Materials section

Appareil de fixation d'un référentiel optique sur une personne

L'invention concerne un appareil de fixation d'un référentiel optique sur une personne, cet appareil comprenant un corps muni de moyens de fixation à la personne et de moyens de maintien du référentiel optique

Appareil de fixation d'un référentiel optique sur une personne

L'invention concerne un appareil de fixation d'un référentiel optique sur une personne, cet appareil comprenant un corps muni de moyens de fixation à la personne et de moyens de maintien du référentiel optique

Comparison of Flame Describing Functions Measured in Single and Multiple Injector Configurations

International audienceRecent investigations of combustion instabilities in annular systems indicate that considerable insights may be gained by using information gathered in single-sector experiments. Such experiments are, for example, employed to measure flame describing functions (FDFs). These data may be used in combination with low-order models to interpret instabilities in multiple injector annular systems. It is known, however, that the structure and dynamical behavior of an isolated flame do not necessarily coincide with those of a flame placed in an annular environment with neighboring side flames. It is then worth analyzing effects that may be induced by the difference in lateral boundary conditions and specifically examining the extent to which FDF data from single-sector experiments portrays the dynamical response of the flame in the annular environment. These issues are investigated with a new setup that comprises a linear arrangement of three injectors. The central flame is surrounded by two identical side flames in a rectangular geometry with key dimensions identical to those of the annular system. The describing function of the central flame is determined with techniques recently developed in single sector experiments. Differences between FDFs determined in the two test facilities, sometimes modest and in other cases less negligible, are found to depend on the flames' spatial extension and interactions. The general inference is that the FDFs measured in a single-injector combustor are better suited if the flame-wall interaction is weak. Nonetheless, a multi-injector system would be more appropriate for a more precise FDF determination

Real-Time Approximative Thermal Simulation for Wire Arc Additive Manufacturing

International audienceWire Arc Additive Manufacturing (WAAM) is a rising metal additive manufacturing technology. Having access to a real-time simulation of the WAAM process is an increasing challenge since it would make it possible to do live monitoring or to more efficiently adjust process parameters during the CAM operations. One major difficulty to overcome to create a real-time simulation is the importance of thermal conditions. Numerous works showed that thermal conditions of the manufactured part during the process have a direct impact on the quality and the geometry of the part. At the same time, it is a well-known fact that precise thermal simulations in complex and evolving conditions are much slower than real time. The proposed approach is based on the idea that defects happen only when the thermal conditions are far from their usual value. Under this assumption, a real-time approximative thermal simulation is sufficient to simulate the thermal side of the WAAM process. Such a simulation, which is a first step in simulating in real time the whole WAAM process, is proposed in this paper

Evaluation of a decision-support tool for part orientation in EBM additive manufacturing

The activity of part orientation is of crucial importance in terms of impact on the quality of parts in powder bed additive manufacturing. To support the decision-making of Computer Aided Manufacturing (CAM) operators, several knowledge and software models are proposed. Even if they seem to help operators in orientation process, their operational effectiveness still needs to be scientifically assessed. This paper proposes to evaluate the efficiency of a part orientation software in assisting CAM engineers in part orientation choice. The related software is based on the mathematization of action rules issued from a knowledge model. The knowledge involved to carry out the orientation activity is analyzed based on the users' expertise. To do this, an empirical approach based on a case study is made with participants of different levels of skills. Several design scenarios including various part typologies to be oriented are submitted to engineers, before their manufacturing with Electron Beam Melting (EBM) technology. Two means of orientation are thus used for comparison, namely a manual orientation and a computer-aided orientation software. Based on the orientation results, an analysis of the software usage is undertaken. As an underlying result of our study, we have come up with an evaluation approach that can be reused in other contexts and with other software

Critical evaluation of folate data in European and international databases: recommendations for standardization in international nutritional studies

Scope: The objective was to perform an inventory and critical evaluation of folate data in selected European and international databases. The ultimate aim was to establish guidelines for compiling standardized folate databases for international nutritional studies. Methods and results: An ad hoc questionnaire was prepared to critically compare and evaluate folate data completeness, quantification, terminologies, and documentation of 18 European and international databases, and national fortification regulations. Selected countries participated in the European Prospective Investigation into Nutrition and Cancer (EPIC) project and European Food Information Resource Network (EuroFIR). Folate completeness was generally high. ‘Total folate’ was the most common terminology and microbiological assay was the most frequently reported quantification method. There is a lack of comparability within and between databases due to a lack of value documentation, the use of generic or non-appropriate terminologies, folate value conversions, and/or lack of identification of synthetic folic acid. Conclusion: Full value documentation and the use of EuroFIR component identifiers and/or INFOODS tagnames for total folate (‘FOL’) and synthetic folic acid (‘FOLAC’), with the additional use of individual folates, will increase comparability between databases. For now, the standardized microbiological assay for total folate and HPLC for synthetic folic acid are the recommended quantification methods

An innovative method to estimate lifetime prevalence of carcinogenic occupational circumstances: the example of painters and workers of the rubber manufacturing industry in France

International audienceBACKGROUND - Existing methods to estimate lifetime exposure to occupational carcinogenic agents could be improved. OBJECTIVE - We propose a new method to estimate the lifetime prevalence of exposure to occupational carcinogens using the example of painters and workers of the rubber industry in France. METHODS - From census, we calculated the proportion of painters and rubber industry workers using predefined occupational codes related to each occupation by sex and 10-year age group in 1982, 1990, 1999, 2007, and 2013. Using a beta-regression model, we obtained the yearly prevalence of exposure by 10-year age group over the period 1967–2007. We estimated the age- and sex-specific lifetime prevalence of exposure of the population in 2017 over 1967–2007, summing up the estimated prevalence of exposure for years 1967, 1977, 1987, 1997, and 2007 combined with a sex- and age-specific turnover factor. Corresponding population-attributable fractions were estimated for lung and bladder cancers in 2017. RESULTS - In 2017, we estimated that 5.6 and 0.2% of men in France had ever worked as a painter or in the rubber industry, respectively, during their working time. The lifetime prevalence of ever having worked as a painter or in the rubber industry was much lower in women: 1.8% and 0.1%, respectively. We estimated that 950 lung cancer and 40 bladder cancer cases were attributable to these occupations in 2017. SIGNIFICANCE - Based on accurate data and taking into account evolution of specific jobs over time, the proposed method provides good estimates of lifetime prevalence of exposure to occupational carcinogens. It could be applied in any other country with similar data