Prevalence of victims of violence admitted to an emergency department.

OBJECTIVE: To collect data on the consultation frequency and demographic profile of victims of violence attending an emergency department (ED) in Switzerland. METHODS: We undertook screening of all admitted adult patients (>16 years) in the ED of the CHUV, Lausanne, Switzerland, over a 1 month period, using a modified version of the Partner Violence Screen questionnaire. Exclusionary criteria were: life threatening injury (National Advisory Committee on Aeronautics score > or =4), or inability to understand or speak French, to give oral informed consent, or to be questioned without a family member or accompanying person being present. Data were collected on history of physical and/or psychological violence during the previous 12 months, the type of violence experienced by the patient, and if violence was the reason for the current consultation. Sociodemographic data were obtained from the registration documents. RESULTS: The final sample consisted of 1602 patients (participation rate of 77.2%), with a refusal rate of 1.1%. Violence during the past 12 months was reported by 11.4% of patients. Of the total sample, 25% stated that violence was the reason for the current consultation; of these, 95% of patients were confirmed as victims of violence by the ED physicians. Patients reporting violence were more likely to be young and separated from their partner. Men were more likely to be victims of public violence and women more commonly victims of domestic violence. CONCLUSIONS: Based on this monthly prevalence rate, we estimate that over 3000 adults affected by violence consult our ED per annum. This underlines the importance of the problem and the need to address it. Health services organisations should establish measures to improve quality of care for victims. Guidelines and educational programmes for nurses and physicians should be developed in order to enhance providers' skills and basic knowledge of all types of violence, how to recognise and interact appropriately with victims, and where to refer these patients for follow up care in their local networks.

The TREAT-NMD Duchenne Muscular Dystrophy Registries: Conception, Design, and Utilization by Industry and Academia.

Duchenne muscular dystrophy (DMD) is an X-linked genetic disease, caused by the absence of the dystrophin protein. Although many novel therapies are under development for DMD, there is currently no cure and affected individuals are often confined to a wheelchair by their teens and die in their twenties/thirties. DMD is a rare disease (prevalence <5/10,000). Even the largest countries do not have enough affected patients to rigorously assess novel therapies, unravel genetic complexities, and determine patient outcomes. TREAT-NMD is a worldwide network for neuromuscular diseases that provides an infrastructure to support the delivery of promising new therapies for patients. The harmonized implementation of national and ultimately global patient registries has been central to the success of TREAT-NMD. For the DMD registries within TREAT-NMD, individual countries have chosen to collect patient information in the form of standardized patient registries to increase the overall patient population on which clinical outcomes and new technologies can be assessed. The registries comprise more than 13,500 patients from 31 different countries. Here, we describe how the TREAT-NMD national patient registries for DMD were established. We look at their continued growth and assess how successful they have been at fostering collaboration between academia, patient organizations, and industry.

What's so special about conversion disorder? A problem and a proposal for diagnostic classification.

Conversion disorder presents a problem for the revisions of DSM-IV and ICD-10, for reasons that are informative about the difficulties of psychiatric classification more generally. Giving up criteria based on psychological aetiology may be a painful sacrifice but it is still the right thing to do.

Le dialogisme intertextuel des contes des Grimm

Ute Heidmann Le dialogisme intertextuel des contes des Grimm Préalables pour une enquête à mener « Le caractère le plus important de l'énoncé, ou en tous les cas le plus ignoré, est son dialogisme, c'est-à-dire sa dimension intertextuelle », constate Todorov en référence à la conception dialogique du langage proposée par Bakthine. Cet article introductif postule que ce constat s'applique aussi aux contes des Grimm. En partant des recherches déjà menées sur Apulée, Straporola, Basile, Perrault, La Fontaine et Lhéritier*, il présente des concepts (réponse intertextuelle, reconfiguration générique et scénographie en trompe-l'oeil) dont il illustre l'efficacité pour l'analyse des Kinder- und Hausmärchen. L'analyse de la préface de 1812 montre que les Grimm créent une scénographie pour légitimer le genre des Kinder- und Hausmärchen en les présentant comme des contes "d'origine" qui auraient "poussé" comme des plantes dans leur région et qu'ils n'auraient fait que "collecter". Cette scénographie en trompe-l'oeil permet de dissimuler le fort impact des contes européens et notamment français sur les Kinder- und Hausmärchen. Leurs commentaires paratextuels permettent en revanche de retracer ces dialogues intertextuels qui ne se limitent pas à imiter les "voix déjà présentes dans le choeur complexe" des narrateurs des contes déjà racontés, mais qui créent des effets de sens nouveaux et significativement différents en guise de réponse aux "histoires ou contes du passé", comme l'avaient déjà fait Charles Perrault avant eux. *(dans Féeries 8 et Textualité et intertextualité des contes, Editions Classiques Garnier 2010) "The most important feature of the utterance, or at least the most neglected, is its dialogism, that is, its intertextual dimension" states Todorov in reference to Bakthin's dialogical conception of human speech. Ute Heidmann's introductory essay argues that this applies also to the Grimm's tales. Extending her former theoretical and intertextual investigation on Apuleius, Straporala, Basile, Perrault, La Fontaine and Lhéritier*, she proposes a series of conceptual options (as intertextual response, scenography, trompe l'oeil, generic reconfiguration, discursive strategy) that can efficiently be used for the work on the Kinder- und Hausmärchen, gesammelt durch die Brüder Grimm. The article shows how the Grimms skilfully construct a highly suggestive scenography and topography for the new generic form thus creating the idea of a genuine tale, having grown naturally in the earth of their own region and how it is efficiently used to dissimulate the strong impact of the European and namely the French fairy tales on the Grimm's tales. The extensive paratextual commentaries are shown to serve the same purpose. Once these strategies are "deconstructed" as such, the way is free to trace the very complex intertextual dialogues with already existing Italian, French, German tales, that underlie the Kinder- und Hausmärchen. Comparative textual analysis can then make us discover, that these dialogues are from just "imitating" "the many other voices already present in the complex chorus" of fairy tale writers and narrators: they actually create new and different meaning by responding to them. * (in Féeries 8, Textualité et intertextualité des contes, Classiques Garnier 2010)

Tableaux de bord et de suivi : conception détaillée

Le présent cahier définit les modalités pratiques du suivi des performances. I1 est avant tout destiné aux responsables d'unités cliniques des Hospices qui rencontreraient des problèmes d'interprétation. Le dispositif s'appuie aujourd'hui sur les éléments suivants : - un tableau de bord ; - un tableau synoptique ; - des tableaux de suivi des patients ; - des tableaux de suivi des activités ; - des tableaux de suivi des ressources ; - des tableaux de suivi des effets. [P. 3]

Diabète et conduite: réflexions et atelier pratique [Diabetes and driving: thoughts and educational perspectives].

In Switzerland over 200'000 people with diagnosed diabetes drive a car. Their physicians endorse many roles: usual medical care as well as informing properly about driving recommandations and handling the legal issues behing the licensing procedure. Ability to drive can be impaired in three ways: hypogylcemia, diabetes complications and hyperglycemia. Hypoglycemia is the main risk factor of vehicle accident for diabetic drivers and frequent while driving. However few accidents are reported due to hypoglycemia. Swiss medical guidelines about diabetes and driving mention the requested conditions, but practically how should we do? We sought to answear by creating a specific educationnal program focused on hypoglycemia management. Building patient knowledges through experiences is the main goal of the course diabetes and driving.

L'onomatologie d'A. Losev : une conception «à la russe» ?

Les glorificateurs russes du nom avancent des arguments nombreux pour affirmer une autre vision sur le mot et son origine et sur la langue en général. Ainsi la référence sur la nature divine du mot et de la langue, l'unité de la forme et du contenu, le lien étroit entre le mot et la pensée ou le sens. Ils ont voulu poser la question de l'ontologie de la langue pour éclaircir certains problèmes de son emploi. Rappelons, que cette réflexion fut entamée par les penseurs antiques, notamment par Platon et Aristote, continué aux premières décennies du christianisme, et reprise par la philosophie russe au début du XIXe siècle.