Transcodage des codes opératoires et diagnostiques VESKA (version 1979) en codes ICD-9-CM

Ce travail décrit les opérations théoriques et pratiques concernant le transcodage des opérations d'une part, des diagnostics d'autre part; il décrit également le programme informatique de transcodage.

Exploring the use of the Swiss medical tariffication codes (TARMED) in the establishment of the frequency of radiodiagnostic examinations.

In population surveys of the exposure to medical X-rays both the frequency of examinations and the effective dose per examination are required. The use of the Swiss medical tariffication system (TARMED) for establishing the frequency of X-ray medical examinations was explored. The method was tested for radiography examinations performed in 2008 at the Lausanne University Hospital. The annual numbers of radiographies determined from the "TARMED" database are in good agreement with the figures extracted from the local RIS (Radiology Information System). The "TARMED" is a reliable and fast method for establishing the frequency of radiography examination, if we respect the context in which the "TARMED" code is used. In addition, this billing context provides most valuable information on the average number of radiographs per examination as well as the age and sex distributions. Radiographies represent the major part of X-ray examinations and are performed by about 4,000 practices and hospitals in Switzerland. Therefore this method has the potential to drastically simplify the organisation of nationwide surveys. There are still some difficulties to overcome if the method is to be used to assess the frequency of computed tomography or fluoroscopy examinations; procedures that deliver most of the radiation dose to the population. This is due to the poor specificity of "TARMED" codes concerning these modalities. However, the use of CT and fluoroscopy installations is easier to monitor using conventional survey methods since there are fewer centres. Ways to overcome the "TARMED" limitations for these two modalities are still being explored.

Alpine tectonic evolution of a Jurassic subduction-accretionary complex: Deformation, kinematics and 40Ar/39Ar age constraints on the Mesozoic low-grade schists of the Circum-Rhodope Belt in the eastern Rhodope-Thrace region, Bulgaria-Greece

Deformation of the Circum-Rhodope Belt Mesozoic (Middle Triassic to earliest Lower Cretaceous) low-grade schists underneath an arc-related ophiolitic magmatic suite and associated sedimentary successions in the eastern Rhodope-Thrace region occurred as a two-episode tectonic process: (i) Late Jurassic deformation of arc to margin units resulting from the eastern Rhodope-Evros arc-Rhodope terrane continental margin collision and accretion to that margin, and (ii) Middle Eocene deformation related to the Tertiary crustal extension and final collision resulting in the closure of the Vardar ocean south of the Rhodope terrane. The first deformational event D-1 is expressed by Late Jurassic NW-N vergent fold generations and the main and subsidiary planar-linear structures. Although overprinting, these structural elements depict uniform bulk north-directed thrust kinematics and are geometrically compatible with the increments of progressive deformation that develops in same greenschist-facies metamorphic grade. It followed the Early-Middle Jurassic magmatic evolution of the eastern Rhodope-Evros arc established on the upper plate of the southward subducting Maliac-Meliata oceanic lithosphere that established the Vardar Ocean in a supra-subduction back-arc setting. This first event resulted in the thrust-related tectonic emplacement of the Mesozoic schists in a supra-crustal level onto the Rhodope continental margin. This Late Jurassic-Early Cretaceous tectonic event related to N-vergent Balkan orogeny is well-constrained by geochronological data and traced at a regional-scale within distinct units of the Carpatho-Balkan Belt. Following subduction reversal towards the north whereby the Vardar Ocean was subducted beneath the Rhodope margin by latest Cretaceous times, the low-grade schists aquired a new position in the upper plate, and hence, the Mesozoic schists are lacking the Cretaceous S-directed tectono-metamorphic episode whose effects are widespread in the underlying high-grade basement. The subduction of the remnant Vardar Ocean located behind the colliding arc since the middle Cretaceous was responsible for its ultimate closure, Early Tertiary collision with the Pelagonian block and extension in the region caused the extensional collapse related to the second deformational event D-2. This extensional episode was experienced passively by the Mesozoic schists located in the hanging wall of the extensional detachments in Eocene times. It resulted in NE-SW oriented open folds representing corrugation antiforms of the extensional detachment surfaces, brittle faulting and burial history beneath thick Eocene sediments as indicated by 42.1-39.7 Ma Ar-40/Ar-39 mica plateau ages obtained in the study. The results provide structural constraints for the involvement components of Jurassic paleo-subduction zone in a Late Jurassic arc-continental margin collisional history that contributed to accretion-related crustal growth of the Rhodope terrane. (C) 2011 Elsevier Ltd. All rights reserved.

Les Passions filmées: des codes en appropriation, un cinéma en canonisation

Constituant l'un des premiers « genres » de l'histoire du cinéma (dont Burch et Gaudreault ont montré le rôle fondateur dans la standardisation des procédures de montage institutionnalisées), les films mettant en scène la Vie et la Passion du Christ fixent leurs normes en s'appropriant des codes iconographiques préétablis. Dans cet article, Valentine Robert s'attache à déployer le « palimpseste » de ces Passions des premiers temps, à démêler les « séries culturelles » impliquées, à dégager les phénomènes de reprises d'une bande à l'autre, et à replacer certains de ces jeux référentiels dans leur visée de légitimation - ou doit-on dire « canonisation » ? - du médium cinématographique.

Reproducibility of Vertebral Fracture Assessment Readings From Dual-energy X-ray Absorptiometry in Both a Population-based and Clinical Cohort: Cohen's and Uniform Kappa.

Vertebral fracture assessments (VFAs) using dual-energy X-ray absorptiometry increase vertebral fracture detection in clinical practice and are highly reproducible. Measures of reproducibility are dependent on the frequency and distribution of the event. The aim of this study was to compare 2 reproducibility measures, reliability and agreement, in VFA readings in both a population-based and a clinical cohort. We measured agreement and reliability by uniform kappa and Cohen's kappa for vertebral reading and fracture identification: 360 VFAs from a population-based cohort and 85 from a clinical cohort. In the population-based cohort, 12% of vertebrae were unreadable. Vertebral fracture prevalence ranged from 3% to 4%. Inter-reader and intrareader reliability with Cohen's kappa was fair to good (0.35-0.71 and 0.36-0.74, respectively), with good inter-reader and intrareader agreement by uniform kappa (0.74-0.98 and 0.76-0.99, respectively). In the clinical cohort, 15% of vertebrae were unreadable, and vertebral fracture prevalence ranged from 7.6% to 8.1%. Inter-reader reliability was moderate to good (0.43-0.71), and the agreement was good (0.68-0.91). In clinical situations, the levels of reproducibility measured by the 2 kappa statistics are concordant, so that either could be used to measure agreement and reliability. However, if events are rare, as in a population-based cohort, we recommend evaluating reproducibility using the uniform kappa, as Cohen's kappa may be less accurate.

Les codes de l'obligations : méta-analyses pragmatologiques de l'application de méthodes en sciences sociales

Cette thèse rassemble une série de méta-analyses, c'est-à-dire d'analyses ayant pour objet des analyses produites par des sociologues (notamment celles résultant de l'application de méthodes de traitement des entretiens). Il s'agit d'une démarche réflexive visant les pratiques concrètes des sociologues. Celles-ci sont envisagées comme des activités gouvernées par des règles. Une part importante de cette thèse sera donc consacrée au développement d'un outil d'analyse « pragmatologique » (E. Durkheim), c'est-à-dire permettant l'étude des pratiques et des règles en rapport avec elles. Pour aborder les règles, la philosophie analytique d'inspiration wittgensteinienne apporte plusieurs propositions importantes. Les règles sont ainsi considérées comme des concepts d'air de famille : il n'y a pas de définitions communes recouvrant l'ensemble des règles. Pour étudier les règles, il convient alors de faire des distinctions à partir de leurs usages. Une de ces distinctions concerne la différence entre règles constitutives et règles régulatives : une règle constitutive crée une pratique (e.g. le mariage), alors qu'une règle régulative s'applique à des activités qui peuvent exister sans elle (e.g. les règles du savoir-vivre). L'activité méthodologique des sociologues repose et est contrainte par ces types de règles, qui sont pour l'essentiel implicites. Cette thèse vise donc à rendre compte, par la description et la codification des règles, du caractère normatif des méthodes dans les pratiques d'analyse de la sociologie. Elle insiste en particulier sur les limites logiques qu'instituent les règles constitutives, celles-ci rendant impossibles (et non pas interdites) certaines actions des sociologues. This thesis brings together a series of meta-analyzes, that is, analyzes that tackle analyzes produced by sociologists (notably those resulting from the application of methods in treating interviews). The approach is reflexive and aimed at the concrete practices of sociologists, considered as activities governed by rules. An important part of this thesis is therefore devoted to the development of a "pragmatological" analytical tool (Durkheim) to conduct a study of such practices and of the rules that govern them. To approach these rules, Wittgenstein-inspired analytic philosophy offers several important proposals. The rules are, at first, seen as concepts of family resemblance, assuming that there is no common definition accounting for all rules. In order to conduct the study of such rules, it is therefore necessary to discern how they are respectively used. One of these distinctions concerns the difference between constitutive rules and regulative rules: a constitutive rule creates a practice (for example marriage), while a regulative rule applies to activities that can exist outside of the rule (for example, the rules of etiquette). The methodological activity of sociologists relies on, and is constrained by these types of rules, which are essentially implicit. Through the description and codification of rules, this thesis aims to account for the normative character of methods governing analytical practices in sociology. Particular emphasis is on the logical limits established by constitutive rules, limits that render several of the sociologist's actions impossible (rather than forbidden).

Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations.

BACKGROUND: In a high proportion of patients with favorable outcome after aneurysmal subarachnoid hemorrhage (aSAH), neuropsychological deficits, depression, anxiety, and fatigue are responsible for the inability to return to their regular premorbid life and pursue their professional careers. These problems often remain unrecognized, as no recommendations concerning a standardized comprehensive assessment have yet found entry into clinical routines. METHODS: To establish a nationwide standard concerning a comprehensive assessment after aSAH, representatives of all neuropsychological and neurosurgical departments of those eight Swiss centers treating acute aSAH have agreed on a common protocol. In addition, a battery of questionnaires and neuropsychological tests was selected, optimally suited to the deficits found most prevalent in aSAH patients that was available in different languages and standardized. RESULTS: We propose a baseline inpatient neuropsychological screening using the Montreal Cognitive Assessment (MoCA) between days 14 and 28 after aSAH. In an outpatient setting at 3 and 12 months after bleeding, we recommend a neuropsychological examination, testing all relevant domains including attention, speed of information processing, executive functions, verbal and visual learning/memory, language, visuo-perceptual abilities, and premorbid intelligence. In addition, a detailed assessment capturing anxiety, depression, fatigue, symptoms of frontal lobe affection, and quality of life should be performed. CONCLUSIONS: This standardized neuropsychological assessment will lead to a more comprehensive assessment of the patient, facilitate the detection and subsequent treatment of previously unrecognized but relevant impairments, and help to determine the incidence, characteristics, modifiable risk factors, and the clinical course of these impairments after aSAH.

The Impact of Supervisor's Advice, Codes of Conduct, Accountability and Moral Attentiveness of Individuals on Discriminatory Behaviour Against Immigrants.

Past studies on the personnel selection demonstrated that a supervisor's advice to discriminate can lead to compliant behaviours. This study had the aim to extend past findings by examining what can overcome the powerful influence of the hierarchy. 50 Swiss managers participated to an in-basket exercise. The main task was to evaluate Swiss candidates (in-group) and foreigners (out-groups: Spanish and Kosovo Albanians) and to select two applicants for a job interview. Main results were the effect of codes of conduct to prevent discrimination against out-group applicants in the presence of a supervisor's advice to prefer in-group members. But, when participants were accountable to an audience, this beneficial effect disappears because participants followed the supervisor's advice. The second aim was to assess if the difference in responses between participants was related to their difference in moral attentiveness. Results showed some significant relationships but not always in the direction expected.