Anatomie chirurgicale du foie: ce qu'il faut savoir [Surgical anatomy of the liver: what you need to know]

A precise knowledge of arterial, portal, hepatic and biliary anatomical variations is mandatory when a liver surgery is planned. However, only certain variations must be searched when a precise intervention is planned. The main liver resection and biliary interventions will be precised. Related anatomical variations will be precised.

General Practitioners' willingness to pay for continuing medical education in a fee-for-service universal coverage health care system

Background: Sponsoring of physicians meetings by life science companies has led to reduced participation fees but might influence physician's prescription practices. A ban on such sponsoring may increase participation fees. We aimed to evaluate factors associated with physicians' willingness to pay for medical meetings, their position on the sponsoring of medical meetings and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners in one state in Switzerland, identified through their affiliation to a medical association. The questionnaire evaluated physicians' willingness to pay for medical meetings, their perception of a bias in prescription practices induced by commercial support, their opinion on the introduction of a binding legislation and alternative financing options, their frequency of exchange with sales representatives and other relevant socioeconomic factors. We built a multivariate predictor logistic regression model to identify determinants of willingness to pay. Results: Of the 115 physicians who responded (response rate 26%), 48% were willing to pay more than what they currently pay for congresses, 79% disagreed that commercial support introduced a bias in their prescription practices and 61% disagreed that it introduced a bias in their colleagues' prescription practices. Based on the multivariate logistic regression, perception of a bias in peers prescription practices (OR=7.47, 95% CI 1.65-38.18) and group practice structure (OR=4.62, 95% CI 1.34-22.29) were significantly associated with an increase in willingness to pay. Two thirds (76%) of physicians did not support the introduction of a binding legislation and 53% were in favour of creating a general fund administered by an independent body. Conclusion: Our results suggest that almost half of physicians surveyed are willing to pay more than what they currently pay for congresses. Predictors of an increase in physicians' willingness to pay were perception of the influence of bias in peers prescription practices and group practice structure. Most responders did not agree that sponsoring introduced prescribing bias nor did they support the 2 introduction of a binding legislation prohibiting sponsoring but a majority did agree to an independent body that would centrally administer a general fund.

Body dissatisfaction on top of depressive mood among adolescent with severe dysmenorrhea

Purpose: Dysmenorrhea is the leading cause of recurrent short-term school absenteeism among adolescent girls. Yet, studies of menstrual symptoms in the light of adolescent psychological background seldom appear in the recent literature. This study aims to determine whether adolescent girls with severe dysmenorrhea (SD) have different body perception on top of poorer psychological health. Methods: We analyzed data from the Swiss Multicentre Adolescent Survey on Health (SMASH 2002) among a nationally representative sample of adolescents (n = 7548; 3340 females) aged 16 to 20 years attending post-mandatory education. Dysmenorrhea was defined as presence of abdominal or back pain during menstruation on the last 12 months. The severity of dysmenorrhea was defined according to the impact on daily activity and was assessed by 3 questions on the way menstruations interfere with daily life: 1) "You feel well and have normal activities", 2)"you must stay at home" and 3) "you feel restricted in your school or professional activities". Studied variables were: depressive symptoms, suicidal attempt, sexual abuse, health perception in general, body satisfaction, desire to modify body shape, and disordered eating behavior (DEB) with restrictive or bulimic tendency. Controlling variables included socio-economic status (SES) as measured by both parent's level of education, gynecological age (age-age at menarche), academic track (student/apprentice) and age. Results: 12.4% (95% CI: 11.0-14) declared severe dysmenorrhea, 74.2% (95% CI: 71.8-76.5) mild to moderate dysmenorrhea and 13,4% (95% CI: 11.5-15.5) had no dysmenorrhea. Compared to their peers, controlling for confounding variables, subjects with SD were more numerous to report depressive symptoms (AOR: 1.73; 95% CI: 1.39-2.15), to feel in poor health (AOR: 1.44; 95% CI: 1.14-1.81). Moreover, the proportion of those reporting dissatisfaction with their body appearance was higher (AOR: 1.48; 95% CI: 1.00-2.18). Conclusion: Patients with SD not only show a different profile than their peers in terms of their mental health and health perception, but also a distinct relation to their body. Therefore clinicians should pay particular attention to patients with SD and offer them a global evaluation keeping in mind what can be associated with SD.

Ad-Pay: Programa de control de bons d'hores

Sistema de fidelització de clients mitjançant bons d’hores que el client anirà recarregant i del que se li descomptaran les feines que se li vagin fent. També ha d’ajudar a assegurar-se el cobrament de les feines realitzades. L’aplicació és capaç de mantenir una cartera de clients amb el seu saldo de bons, fer les imposicions de diners i introduir els albarans de les feines produïdes. També mostra dades interessants perquè el gerent de l’empresa client pugui treure les estadístiques necessàries per explotar al màxim la capacitat de la seva empresa.

The Part-time pay penalty in a segmented labor market

This paper is the first to examine the implications of switching to PT work for women's subsequent earnings trajectories, distinguishing by their type of contract: permanent or fixedterm. Using a rich longitudinal Spanish data set from Social Security records of over 76,000 prime-aged women strongly attached to the Spanish labor market, we find that PT work aggravates the segmentation of the labor market insofar there is a PT pay penalty and this penalty is larger and more persistent in the case of women with fixed-term contracts. The paper discusses problems arising in empirical estimation (including a problem not discussed in the literature up to now: the differential measurement error of the LHS variable by PT status), and how to address them. It concludes with policy implications relevant for Continental Europe and its dual structure of employment protection.

Sistema didàctic per millorar l'aprenetatge de la representació del espai arquitectònic amb ajuts "on line"

El projecte ha tingut com a finalitat cobrir un buit en la formació dels estudiants pel que respecta a les seves limitacions en l’aprenentatge de les diferents estratègies i metodologies de treball. Aquest buit ens ha fet pensar en l’elaboració d’un sistema didàctic que possibiliti una comunicació fluida amb l’alumne i que pugui anar més enllà de l’àmbit específic de les aules. Es per això que la nostra proposta té com a referent un aprofitament més racional del temps de treball de l’estudiant. Per tal d’arribar a aquesta finalitat ens hem plantejat un grup d’objectius concrets ordenats segons els dos nivells d’assoliment següents: Nivell 1: - Definir un material didàctic que pugui transmetre de la manera més objectiva possible les eines necessàries per tal que l’alumne resolgui un conjunt de problemes concrets. - Proporcionar a l’estudiant un procediment didàctic basat en un grup de tasques amb un material de suport on ha de posar a prova l’aplicabilitat dels conceptes donats a les classes teòriques. - Partir d’un sistema que permeti a l’alumne tenir una referència constant de recolzament teòric fora de les aules quan està resolent les pràctiques assignades en el curs. - Definir unes característiques funcionals del material utilitzat en l’activitat pràctica de tal manera que sigui un instrument efectiu per al control del propi estudiant sobre el seu procés d’avaluació. Nivell 2: - Fer servir una metodologia d’activitats pràctiques on es puguin accentuar les capacitats de resposta creativa individual de l’estudiant. - Plantejar l’intercanvi d’experiències i propostes d’estratègies per a la resolució dels temes pràctics mitjançant sessions de seminaris prèvies a les pràctiques. - Promoure unes relacions transversals amb altres àrees de coneixement de tal manera que l’alumne pugui vincular la seva resposta a les activitats pràctiques proposades per altres assignatures, amb els coneixements adquirits a la nostra assignatura.

An investigation on the pay-off to generic competences for core employees in Catalan manufacturing firms

The aim of this paper is to measure the returns to human capital. We use a unique data set consisting of matched employer-employee information. Data on individuals' human capital include a set of 26 competences that capture the utilization of workers' skills in a very detailed way. Thus, we can expand the concept of human capital and discuss the type of skills that are more productive in the workplace and, hence, generate a higher payoff for the workers. The rich information on firm's and workplace characteristics allows us to introduce a broad range of controls and to improve previous research in this field. This paper gives evidence that the returns to generic competences differ depending on the position of the worker in the firm. Only numeracy skills are reward independent of the occupational status of the worker. The level of technology used by the firm in the production process does not directly increase workers’ pay, but it influences the pay-off to some of the competences. JEL Classification: J24, J31

Can You Home Again? Desertion and Control of Hometowns in Civil Wars

What allows an armed group in a civil war to prevent desertion? This paper addresses this question with a focus on control in the rearguard. Most past studies focus on motivations for desertion. They explain desertion in terms of where soldiers stand in relation to the macro themes of the war, or in terms of an inability to provide positive incentives to overcome the collective action problem. However, since individuals decide whether and how to participate in civil wars for multiple reasons, responding to a variety of local conditions in an environment of threat and violence, a focus only on macro-level motivations is incomplete. The opportunities side of the ledger deserves more attention. I therefore turn my attention to how control by an armed group eliminates soldiers’ opportunities to desert. In particular, I consider the control that an armed group maintains over soldiers’ hometowns, treating geographic terrain as an important exogenous indicator of the ease of control. Rough terrain at home affords soldiers and their families and friends advantages in ease of hiding, the difficulty of using force, and local knowledge. Based on an original dataset of soldiers from Santander Province in the Spanish Civil War, gathered from archival sources, I find statistical evidence that the rougher the terrain in a soldier’s home municipality, the more likely he is to desert. I find complementary qualitative evidence indicating that soldiers from rough-terrain communities took active advantage of their greater opportunities for evasion. This finding has important implications for the way observers interpret different soldiers’ decisions to desert or remain fighting, for the prospect that structural factors may shape the cohesion of armed groups, and for the possibility that local knowledge may be a double-edged sword, making soldiers simultaneously good at fighting and good at deserting.

Agenda for Change: What Will It Mean For You? (PDF 53 KB)

A Guide for Staff

GP Contract - The New GP Contract - What It Means To You

GP Contract - The New GP Contract - What It Means To You

Drug Problems - Can Substitute Prescribing Services Help You? Leaflet

Drug Problems - Can Substitute Prescribing Services Help You? Leaflet

Consent - Patient Information Leaflet- Consent - it's up to you (PDF 15 KB)

Consent - Patient Information Leaflet- Consent - it's up to you