A new curriculum using active learning methods and standardized patients to train residents in smoking cessation

Physicians can play a key role in smoking cessation but often fail to advise smokers effectively, mainly because they lack counseling skills. We need effective training programs starting during residency to improve physicians' smoking cessation interventions and smokers' quit rates. To achieve this goal, we developed a curriculum using active learning methods and the stages-of-change model. A randomized trial demonstrated that this program increased the quality of physician's counseling and smokers' quit rates at 1 year. This paper describes the educational content and methods of this program. Participants learn to assess smokers' stage of change, to use counseling strategies matching the smoker's stage, and to prescribe pharmacological therapy. This 2 half-day training program includes observation of video-clips, interactive workshops, role plays, practice with standardized patients, and written material for physicians and patients. Participants reached learning objectives and appreciated the content and active methods of the progra

Tabakentwöhnung. 2.Teil: Empfehlungen für die tägliche Praxis

Der praktizierende Arzt muss bei jedem Raucher abklären,wie stark er von Nikotin abhängig und wie weit er bereits motiviert ist, mit Rauchen aufzuhören. Damit kann der Arzt dann gezielt intervenieren. Bei Rauchern, die noch nicht zum Aufhören entschlossen sind, wird die Intervention beschränkt bleiben, bei Rauchern hingegen, die sich zum Aufgeben entschlossen haben oder gar aktiv darauf vorbereiten, wird sie wesentlich weiter gehen. Bei Rauchern, die sich zum Aufgeben vorbereiten, erhöht eine unterstützende medikamentöse Behandlung- ikotinersatzpräparate oder Bupropion - die Chancen für einen Langzeiterfolg signifikant. Gute Kenntnisse über die richtige Dosierung, günstige Kombinationen sowie allfällige Kontraindikationen sind für eine erfolgreiche Anwendung dieser Präparate und die Vermeidung von Rückfällen wichtig. [Autoren]]]> Smoking Cessation ; Practice Guidelines as Topic oai:serval.unil.ch:BIB_FE1DBCA82FE3 2022-05-07T01:30:49Z phdthesis 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_FE1DBCA82FE3 L-canavanine, an inhibitor of inducible nitric oxide synthase, improves venous return in endotoxemic rats Fishman, Daniel Université de Lausanne, Faculté de médecine info:eu-repo/semantics/doctoralThesis phdthesis 1996 eng https://serval.unil.ch/resource/serval:BIB_FE1DBCA82FE3.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_FE1DBCA82FE30 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_FE1DBCA82FE30 info:eu-repo/semantics/restrictedAccess Restricted: indefinite embargo Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_FE1DD5022EF7 2022-05-07T01:30:49Z <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_FE1DD5022EF7 Transgenic mouse models for tumors of melanocytes and retinal pigment epithelium info:doi:10.1111/j.1600-0749.1999.tb00746.x info:eu-repo/semantics/altIdentifier/doi/10.1111/j.1600-0749.1999.tb00746.x info:eu-repo/semantics/altIdentifier/pmid/10231194 Beermann, F. Hunziker, A. Foletti, A. info:eu-repo/semantics/review article 1999-04 Pigment Cell Research, vol. 12, no. 2, pp. 71-80 info:eu-repo/semantics/altIdentifier/pissn/0893-5785 <![CDATA[Cutaneous and ocular melanomas are due to malignant transformation of neural crest-derived melanocytes. The rising incidence of this tumor in humans has stimulated experiments to devise suitable mouse models. In the past years, transgenic mouse lines have been generated using different oncogenes - Ha-ras, SV40 T antigen (Tag), ret - which develop benign lesions of melanocytes, melanoma, and/or eye tumors. Pigment cell tumors in humans, although rather rare, can also develop from the retinal pigment epithelium (RPE), a cell layer of neuroectodermal origin. We, therefore, established transgenic models for this ocular tumor. Regulated by the promoter of tyrosinase-related protein-1 (TRP-1), two oncogenes, ret and SV40 Tag, were targeted to the developing RPE in transgenic mice. The TRP-1/ret transgenic mice displayed microphthalmia and benign tumors of the RPE. Expression of SV40 T antigen (TRP-1/Tag) led to malignant tumors, which were invasive and metastasized to inguinal lymph node and spleen

Désaccoutumance au tabac. 1ère partie: Processus de désaccoutumance et bénéfices de l'arrêt

Le tabagisme est un problème clinique et de santé publique crucial en raison de sa prévalence élevée dans la population de patients ambulatoires et hospitaliers, et de ses conséquences majeures sur la mortalité, la morbidité et les coûts. Les conseils ciblés et non stigmatisant, ainsi que les traitements pharmacologiques (substituts nicotiniques et bupropion), sont efficaces pour promouvoir l'arrêt du tabac et ont un très bon rapport coût-efficacité._ La désaccoutumance au tabac est devenue une activité essentielle de la pratique clinique, en raison de l'importance épidémiologique et sociale des maladies liées au tabac d'une part, de l'apparition de méthodes et de produits permettant de faciliter la désaccoutumance à la nicotine d'autre part. Le risque de maladies lié au tabac est plus grand que la plupart des fumeurs ne l'imaginent. Le médecin praticien occupe une position privilégiée de conseiller et d'accompagnateur du processus de désaccoutumance vis-à-vis de ses patients._ L'aide à la désaccoutumance se base sur la connaissance du stade auquel se trouve le fumeur (indifférence, intention ou préparation) et sur la détermination de son degré de dépendance à la nicotine, évaluée en fonction de la consommation tabagique et du délai entre le réveil et la première cigarette de la journée. L'intervention médicale doit s'adapter à ces deux critères et amener le fumeur à progresser d'un stade de la désaccoutumance vers le suivant. _ L'intervention médicale en désaccoutumance représente l'activité la plus rentable dans le domaine de la prévention. La prise en charge des fumeurs doit tenir compte du processus de changement de comportement et de la dépendance nicotinique. L'arrêt du tabac est en effet un processus dynamique à travers 5 stades de motivation à cesser de fumer, ayant une probabilité croissante de devenir ex-fumeur. [auteurs]]]> Smoking Cessation fre oai:serval.unil.ch:BIB_DFF4297386F2 2022-08-13T01:31:17Z 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_DFF4297386F2 Clinical spectrum of tuberculous optic neuropathy. info:doi:10.1007/s12348-012-0079-5 info:eu-repo/semantics/altIdentifier/doi/10.1007/s12348-012-0079-5 info:eu-repo/semantics/altIdentifier/pmid/22614321 Davis, E.J. Rathinam, S.R. Okada, A.A. Tow, S.L. Petrushkin, H. Graham, E.M. Chee, S.P. Guex-Crosier, Y. Jakob, E. Tugal-Tutkun, I. Cunningham, E.T. Leavitt, J.A. Mansour, A.M. Winthrop, K.L. Hills, W.L. Smith, J.R. info:eu-repo/semantics/article article 2012 Journal of Ophthalmic Inflammation and Infection, vol. 2, pp. 183-189 info:eu-repo/semantics/altIdentifier/eissn/1869-5760 <![CDATA[PURPOSE: Tuberculous optic neuropathy may follow infection with Mycobacterium tuberculosis or administration of the bacille Calmette-Guerin. However, this condition is not well described in the ophthalmic literature. METHODS: Ophthalmologists, identified through professional electronic networks or previous publications, collected standardized clinical data relating to 62 eyes of 49 patients who they had managed with tuberculous optic neuropathy. RESULTS: Tuberculous optic neuropathy was most commonly manifested as papillitis (51.6 %), neuroretinitis (14.5 %), and optic nerve tubercle (11.3 %). Uveitis was an additional ocular morbidity in 88.7 % of eyes. In 36.7 % of patients, extraocular tuberculosis was present. The majority of patients (69.4 %) had resided in and/or traveled to an endemic area. Although initial visual acuity was 20/50 or worse in 62.9 % of 62 eyes, 76.7 % of 60 eyes followed for a median of 12 months achieved visual acuities of 20/40 or better. Visual field defects were reported for 46.8 % of eyes, but these defects recovered in 63.2 % of 19 eyes with follow-up. CONCLUSION: Visual recovery from tuberculous optic neuropathy is common, if the diagnosis is recognized and appropriate treatment is instituted. A tuberculous etiology should be considered when evaluating optic neuropathy in persons from endemic areas

Use of hormone replacement therapy by menopausal women: a comparison between primary care patients and the general population

Summary.: Objectives: To compare frequency and patterns of hormone replacement therapy (HRT) between primary care patients and the local community. Methods: Comparison of data from a questionnaire survey of 107 peri- and postmenopausal patients in an academic primary care clinic during 1998 to similar data from a sample (n=241) of an ongoing annual epidemiological survey representative of the general population. Results: Mean age, menopause status, age of initiation of HRT, and prior use of contraceptive pill were similar in both groups. Current HRT use tended to be lower among patients in the clinic than in the community. HRT users in the clinic were more likely to have had a surgical menopause (34.4% vs. 16.1%, p=0.04) and to have used hormones for shorter periods than in the general population. Differences remained significant after adjustment in multivariate analysis. Conclusions: Compared to the general population, patterns of HRT use in the outpatient clinic were more restrictive than recommendations on HRT that were published at the time. This is an example of how comparison of health issues between patients in medical care and a local epidemiological survey can help to understand clinical practic

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

Physics case for an LHCb Upgrade II - Opportunities in flavour physics, and beyond, in the HL-LHC era

The LHCb Upgrade II will fully exploit the flavour-physics opportunities of the HL-LHC, and study additional physics topics that take advantage of the forward acceptance of the LHCb spectrometer. The LHCb Upgrade I will begin operation in 2020. Consolidation will occur, and modest enhancements of the Upgrade I detector will be installed, in Long Shutdown 3 of the LHC (2025) and these are discussed here. The main Upgrade II detector will be installed in long shutdown 4 of the LHC (2030) and will build on the strengths of the current LHCb experiment and the Upgrade I. It will operate at a luminosity up to 2×1034 cm−2s−1, ten times that of the Upgrade I detector. New detector components will improve the intrinsic performance of the experiment in certain key areas. An Expression Of Interest proposing Upgrade II was submitted in February 2017. The physics case for the Upgrade II is presented here in more depth. CP-violating phases will be measured with precisions unattainable at any other envisaged facility. The experiment will probe b → sl+l−and b → dl+l− transitions in both muon and electron decays in modes not accessible at Upgrade I. Minimal flavour violation will be tested with a precision measurement of the ratio of B(B0 → μ+μ−)/B(Bs → μ+μ−). Probing charm CP violation at the 10−5 level may result in its long sought discovery. Major advances in hadron spectroscopy will be possible, which will be powerful probes of low energy QCD. Upgrade II potentially will have the highest sensitivity of all the LHC experiments on the Higgs to charm-quark couplings. Generically, the new physics mass scale probed, for fixed couplings, will almost double compared with the pre-HL-LHC era; this extended reach for flavour physics is similar to that which would be achieved by the HE-LHC proposal for the energy frontier

LHCb upgrade software and computing : technical design report

This document reports the Research and Development activities that are carried out in the software and computing domains in view of the upgrade of the LHCb experiment. The implementation of a full software trigger implies major changes in the core software framework, in the event data model, and in the reconstruction algorithms. The increase of the data volumes for both real and simulated datasets requires a corresponding scaling of the distributed computing infrastructure. An implementation plan in both domains is presented, together with a risk assessment analysis