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.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

Warranty Practices and Costs in the Industry of Welding Machines Manufacturing

The objective of the master’s thesis is to define the warranty practices and costs in the welding machines manufacturing company and do a proposal for a warranty policy based on the practices and costs. The study include a disquisition of the warranty practices in the subsidiaries and distributor sales. The disquisition of the warranty practices introduces the information relates to warranty period, warranty costs, including repair, spare part and other costs, the practices with the replaced parts, the utilization rate of the eWarranty system and information relates to special arrangements in the warranties. The warranty costs are defined besides the group level also separately per regions and product families. From some product families the disquisition is done per products. In this study is also done a proposal for a warranty policy for the company. The proposal speaks out the length of warranty period, the compensation of the warranty costs, the practices with replaced parts and usage of eWarranty system.

Explosion-proof requirements for Electrical Machines in Chemical, Oil and Gas Industry in Russia and CIS Countries

One of the main industries which form the basis of Russian Economical structure is oil and gas. This industry is also playing a significant role for CIS countries. Oil and gas industry is developing intensively attracting foreign investments. This situation is providing sustainable development of machinery production for hazardous areas. Operating in oil and gas areas is always related with occurrence of explosion gas atmospheres. Machines for hazardous areas must be furnished with additional protection of different types. Explosion protection is regulated with standards according to which equipment must be manufactured. In Russia and CIS countries explosion-proof equipment must be constructed in compliance with GOST standards. To confirm that equipment is manufactured according to standards’ requirements and is safe and reliable it must undergo the approval procedure. Certification in Russia is governed by Federal Laws and legislation. Each CIS country has its own approval certificates and permissions for operating in hazardous areas.

Real-Time Simulation of Mobile and Industrial Machines Using the Multibody Simulation Approach

This thesis introduces a real-time simulation environment based on the multibody simulation approach. The environment consists of components that are used in conventional product development, including computer aided drawing, visualization, dynamic simulation and finite element software architecture, data transfer and haptics. These components are combined to perform as a coupled system on one platform. The environment is used to simulate mobile and industrial machines at different stages of a product life time. Consequently, the demands of the simulated scenarios vary. In this thesis, a real-time simulation environment based on the multibody approach is used to study a reel mechanism of a paper machine and a gantry crane. These case systems are used to demonstrate the usability of the real-time simulation environment for fault detection purposes and in the context of a training simulator. In order to describe the dynamical performance of a mobile or industrial machine, the nonlinear equations of motion must be defined. In this thesis, the dynamical behaviour of machines is modelled using the multibody simulation approach. A multibody system may consist of rigid and flexible bodies which are joined using kinematic joint constraints while force components are used to describe the actuators. The strength of multibody dynamics relies upon its ability to describe nonlinearities arising from wearing of the components, friction, large rotations or contact forces in a systematic manner. For this reason, the interfaces between subsystems such as mechanics, hydraulics and control systems of the mechatronic machine can be defined and analyzed in a straightforward manner.

El comentario de textos electrónicos = Commentary on electronic texts

When sat in front of a computer screen and keyboard, we read and write different kinds of texts (chats, blogs, websites,etc.) and do so differently (with links, photographs, icons, etc.). However, we still comment on as many texts as in the pastin both public and private spheres. After setting out some typical features of reading and writing electronic texts, we givesome examples of students' colloquial commentary out of school, list some of the commonest academic tasks and offersome ideas and make some recommendations for making progress in this field