A Descriptive Study of Gambling Among Emerging Adult Males in French-Speaking Switzerland.

The aims were twofold: to examine the gambling habits of emerging adult males in the French-speaking regions of Switzerland and to what extent these habits predict problem gambling within this population. We also evaluated problem gambling rates and provided data concerning variables such as gambling location, level of information about problem gambling and awareness of treatment centers. 606 Swiss male conscripts, aged 18-22 years, completed a self-report questionnaire. This was administered during their army recruitment day in 2012. Problem gambling was assessed through the Problem Gambling Severity Index (PGSI) (Ferris and Wynne 2001). 78.5% of the respondents were lifetime gamblers, 56.1% were past-year gamblers. Four out of ten past-year gamblers played in private spaces and in back rooms. The PGSI indicated that 10.8% of past-year gamblers presented with moderate gambling problems, whilst 1.4% appeared to be problem gamblers. The majority of respondents had never received information about problem gambling. Moreover, they were unaware of the existence of treatment centers for problem gambling in their region. PGSI scores were significantly predicted by the variety of games played. Problem gambling rates among young men appear to be higher than those of the general Swiss population. This confirms that emerging adult males are a particularly vulnerable population with regards to gambling addiction. The implications of this are considered for youth gambling-prevention programs.

Managing the Sick Child in the Era of Declining Malaria Transmission: Development of ALMANACH, an Electronic Algorithm for Appropriate Use of Antimicrobials.

OBJECTIVE: To review the available knowledge on epidemiology and diagnoses of acute infections in children aged 2 to 59 months in primary care setting and develop an electronic algorithm for the Integrated Management of Childhood Illness to reach optimal clinical outcome and rational use of medicines. METHODS: A structured literature review in Medline, Embase and the Cochrane Database of Systematic Review (CDRS) looked for available estimations of diseases prevalence in outpatients aged 2-59 months, and for available evidence on i) accuracy of clinical predictors, and ii) performance of point-of-care tests for targeted diseases. A new algorithm for the management of childhood illness (ALMANACH) was designed based on evidence retrieved and results of a study on etiologies of fever in Tanzanian children outpatients. FINDINGS: The major changes in ALMANACH compared to IMCI (2008 version) are the following: i) assessment of 10 danger signs, ii) classification of non-severe children into febrile and non-febrile illness, the latter receiving no antibiotics, iii) classification of pneumonia based on a respiratory rate threshold of 50 assessed twice for febrile children 12-59 months; iv) malaria rapid diagnostic test performed for all febrile children. In the absence of identified source of fever at the end of the assessment, v) urine dipstick performed for febrile children <2 years to consider urinary tract infection, vi) classification of 'possible typhoid' for febrile children >2 years with abdominal tenderness; and lastly vii) classification of 'likely viral infection' in case of negative results. CONCLUSION: This smartphone-run algorithm based on new evidence and two point-of-care tests should improve the quality of care of <5 year children and lead to more rational use of antimicrobials.

CNDOL: A fast and reliable method for the calculation of electronic properties of very large systems. Applications to retinal binding pocket in rhodopsin and gas phase porphine.

Very large molecular systems can be calculated with the so called CNDOL approximate Hamiltonians that have been developed by avoiding oversimplifications and only using a priori parameters and formulas from the simpler NDO methods. A new diagonal monoelectronic term named CNDOL/21 shows great consistency and easier SCF convergence when used together with an appropriate function for charge repulsion energies that is derived from traditional formulas. It is possible to obtain a priori molecular orbitals and electron excitation properties after the configuration interaction of single excited determinants with reliability, maintaining interpretative possibilities even being a simplified Hamiltonian. Tests with some unequivocal gas phase maxima of simple molecules (benzene, furfural, acetaldehyde, hexyl alcohol, methyl amine, 2,5 dimethyl 2,4 hexadiene, and ethyl sulfide) ratify the general quality of this approach in comparison with other methods. The calculation of large systems as porphine in gas phase and a model of the complete retinal binding pocket in rhodopsin with 622 basis functions on 280 atoms at the quantum mechanical level show reliability leading to a resulting first allowed transition in 483 nm, very similar to the known experimental value of 500 nm of "dark state." In this very important case, our model gives a central role in this excitation to a charge transfer from the neighboring Glu(-) counterion to the retinaldehyde polyene chain. Tests with gas phase maxima of some important molecules corroborate the reliability of CNDOL/2 Hamiltonians.

Cigarette électronique : le point en 2015 [Electronic cigarette: what do we know in 2015?].

La cigarette électronique produit de la vapeur à inhaler contenant du propylène-glycol, des arômes et de la nicotine libérée rapidement. 6,7% de la population suisse, surtout des fumeurs, ont essayé la cigarette électronique et 0,1% l'utilise quotidiennement. Malgré l'incertitude due au bas niveau de preuves, la cigarette électronique pourrait être efficace pour cesser ou réduire le tabagisme. La sécurité de la cigarette électronique est démontrée à court terme mais pas à long terme ; sa toxicité semble très inférieure à celle du tabac. Les non-fumeurs et les jeunes utilisent peu la cigarette électronique qui ne semble pas les amener au tabagisme. Les mesures de santé publique recommandées sont la régulation du produit avec contrôle de la qualité ainsi que l'interdiction d'usage dans les lieux publics, de publicité et de vente aux mineurs. Electronic cigarettes are devices producing vapour containing propylene-glycol, flavourings and quickly delivered nicotine. 6.7% of the Swiss population, mainly smokers, experimented the electronic cigarette while 0.1% use it daily. Despite uncertainty due to the low level of evidence, electronic cigarettes might be effective for smoking cessation and reduction. The safety of electronic cigarettes is demonstrated at short-term but not at long-term; however its eventual toxicity is likely to be much lower than tobacco. Use of electronic cigarettes by non-smokers and youth who do not smoke is low and seems unlikely to lead them to tobacco use. Recommended public health measures include product regulation with quality control, ban in public places, prohibition of advertising and sales to minors.

Lésions induites par les pistolets à impulsion électrique de type Taser [Health Risks Concerning Electronic Control Devices]

Les pistolets à impulsion électrique (PIE) sont de plus en plus fréquemment utilisés en Europe ces dernières années, le modèle le plus connu étant le Taser®. Les connaissances scientifiques concernant les PIE et leurs effets potentiels restent toutefois limitées. Nous avons conduit une revue de littérature afin d'évaluer les implications potentielles de leur utilisation en termes de sécurité, de morbidité et de mortalité. Une exposition unique chez un individu sain peut généralement être considérée comme peu dangereuse. Les sujets à risque de complications sont les individus exposés à de multiples décharges, les personnes sous l'influence de substances psychoactives, ceux qui montrent des signes d'agitation extrême, ou encore les individus présentant des comorbidités médicales. L'éventail des complications pouvant survenir lors de leur exposition est large et inclut les lésions provoquées par les impacts des électrodes, les traumatismes liés à la chute induite par la paralysie transitoire ou des complications cardiovasculaires. Dans ce contexte, les personnes exposées doivent être examinées attentivement, et les éventuelles lésions traumatiques doivent être exclues. The use of electronic control devices (ECD), such as the Taser®, has increased in Europe over the past decade. However, scientific data concerning the potential health impact of ECD usage remains limited. We reviewed the scientific literature in order to evaluate the safety, mortality, and morbidity associated with ECD use. Exposure of a healthy individual to a single ECD electroshock can be considered generally safe. Complications can, however, occur if the patient is subject to multiple electroshocks, if the patient has significant medical comorbidities, or when exposure is associated with drug abuse or agitated delirium. The broad spectrum of potential complications associated with ECD exposure includes direct trauma caused by the ECD electrodes, injuries caused by the transient paralysis-induced fall, and cardiovascular events. An ECD-exposed patient requires careful examination during which traumatic injuries are actively sought out.

Déclaration et traitement des événements indésirables en médecine interne [Incident-reporting electronic-based system in internal medicine].

How to recognize, announce and analyze incidents in internal medicine units is a daily challenge that is taught to all hospital staff. It allows suggesting useful improvements for patients, as well as for the medical department and the institution. Here is presented the assessment made in the CHUV internal medicine department one year after the beginning of the institutional procedure which promotes an open process regarding communication and risk management. The department of internal medicine underlines the importance of feedback to the reporters, ensures the staff of regular follow-up concerning the measures being taken and offers to external reporters such as general practioners the possibility of using this reporting system too.

Experts' consensus on use of electronic cigarettes : a Delphi survey from Switzerland

Objectifs: Dans certains pays, les cigarettes électroniques contenant de la nicotine (e-cigarettes) sont considérées comme des produits de consommation courante, sans régulation spécifique. Dans d'autres (comme en Suisse), la vente d'e-cigarettes contenant de la nicotine est interdite, malgré l'importante demande de nombreux fumeurs de pouvoir les obtenir. Au vu du manque de données scientifiques sur l'efficacité et la sécurité à long-terme de ces produits, les spécialistes de la lutte contre le tabagisme se trouvent divisés sur la question de leur régulation. Afin d'obtenir un consensus parmi ces experts que nous puissions transmettre aux autorités sanitaires, nous avons réalisé une étude d'avis d'experts sur le plan national. Méthode : Nous avons utilisé une méthodologie Delphi, à l'aide de questionnaires électroniques, afin de synthétiser l'opinion d'experts suisses sur la question de la cigarette électronique. Participants : 40 experts suisses représentant l'ensemble de la Suisse. Mesures : Nous avons mesuré le degré de consensus entre les experts au sujet de recommandations touchant à la régulation, la vente et l'utilisation de l'e-cigarette contenant de la nicotine, ainsi que leur opinion générale sur le produit. De nouvelles recommandations et déclarations ont été formulées en tenant compte des réponses et des commentaires des participants. Résultats : Un consensus entre les experts a établi que l'e-cigarette contenant de la nicotine devrait être accessible en Suisse, mais seulement dans des conditions spécifiques. La vente devrait être réservée aux adultes, en utilisant des standards de qualité, une limite de concentration maximale de nicotine, et être accompagnée d'une liste d'ingrédients autorisés. La publicité devrait être restreinte et l'utilisation de l'e- cigarette devrait être interdite dans les lieux publics. Conclusions : Ces recommandations permettent de regrouper trois principes : 1) le principe de réalité, étant donné que le produit est déjà disponible sur le marché ; 2) le principe de prévention, puisque l'e- cigarette procure une alternative au tabac pour les fumeurs actuels, et 3) le principe de précaution, afin de protéger les mineurs et les non-fumeurs, étant donné que les effets à long-terme ne sont pas encore connus. Les autorités suisses devraient mettre en place une législation spécifique afin d'autoriser l'e- cigarette contenant de la nicotine.

Video Gaming Disorder and Sport and Exercise in Emerging Adulthood: A Longitudinal Study.

Among the negative consequences of video gaming disorder, decreased participation in sport and exercise has received little attention. This study aimed to assess the longitudinal association between video gaming disorder and the level of sport and exercise in emerging adult men. A questionnaire was completed at baseline and 15-month follow-up by a representative national sample of 4,933 respondents. The seven items of the Game Addiction Scale were used to construct a latent variable representing video gaming disorder. Level of sport and exercise was also self-reported. Cross-lagged path modeling indicated a reciprocal causality between video gaming disorder and the level of sport and exercise, even after adjusting for a large set of confounders. These findings support the need for better promotion of sport and exercise among emerging adults in order to contribute to the prevention of video gaming disorder, and to raise the level of sport and exercise activity in addicted gamers.

Pathological video game use among young Swiss men: the use of monothetic and polythetic formats to distinguish between pathological, excessive and normal gaming

There is no agreement about the distinction between pathological, excessive and normal gaming. The present study compared two classifications for defining pathological gaming: the polythetic format (gamers who met at least half of the criteria) and monothetic format (gamers who met all criteria). Associations with mental, health and social issues were examined to assess differences between subgroups of gamers. A representative sample of 5,663 young Swiss men filled in a questionnaire as part of the ongoing Cohort Study on Substance Use Risk Factors (C-SURF). Game use was assessed with the Game Addiction Scale. Mental, social and physical factors (depression, anxiety, aggressiveness, physical and mental health, social and health consequences), gambling and substance use (illicit drug use, alcohol dependence and problematic cannabis use) were also assessed. The results indicated that monothetic gamers shared problems with polythetic gamers, but were even more inclined to mental health issues (depression, anxiety, and aggressiveness) and were more vulnerable to other dependencies like substance use, alcohol dependence or gambling. A second analysis using Latent Class Analysis confirmed the distinction between monothetic and polythetic gamers. These findings support the use of a monothetic format to diagnose pathological gaming and to differentiate it from excessive gaming.

Fatigue resistance of denture teeth

AIMS: There is no standard test to determine the fatigue resistance of denture teeth. With the increasing number of patients with implant-retained dentures the mechanical strength of the denture teeth requires more attention and valid laboratory test set-ups. The purpose of the present study was to determine the fatigue resistance of various denture teeth using a dynamic load testing machine. METHODS: Four denture teeth were used: Bonartic II (Candulor), Physiodens (Vita), SR Phonares II (Ivoclar Vivadent) and Trubyte (Dentsply). For dynamic load testing, first upper molars with a similar shape and cusp inclination were selected. The molar teeth were embedded in cylindrical steel molds with denture base material (ProBase, Ivoclar Vivadent). Dynamic fatigue loading was carried out on the mesio-buccal cusp at a 45° angle using dynamic testing machines and 2,000,000 cycles at 2Hz in water (37°C). Three specimens per group and load were submitted to decreasing load levels (at least 4) until all the three specimens no longer showed any failures. All the specimens were evaluated under a stereo microscope (20× magnification). The number of cycles reached before observing a failure, and its dependence on the load and on the material, has been modeled using a parametric survival regression model with a lognormal distribution. This allowed to estimate the fatigue resistance for a given material as the maximal load for which one would observe less than 1% failure after 2,000,000 cycles. RESULTS: The failure pattern was similar for all denture teeth, showing a large chipping of the loaded mesio-buccal cusp. In our regression model, there were statistically significant differences among the different materials, with SR Phonares II and Bonartic II showing a higher resistance than Physiodens and Trubyte, the fatigue resistance being estimated at around 110N for the former two, and at about 60N for the latter two materials. CONCLUSION: The fatigue resistance may be a useful parameter to assess and to compare the clinical risk of chipping and fracture of denture tooth materials.