R��sultats du voyage du S.Y. Belgica en 1897-1898-1899 : sous le commandement de A. de Gerlache de Gomery. Rapports scientifiques publi��s aux frais du gouvernement belge, sous la direction de la Commission de la Belgica.

R54, Zoologie, Pennatuliden

R��sultats du voyage du S.Y. Belgica en 1897-1898-1899 : sous le commandement de A. de Gerlache de Gomery. Rapports scientifiques publi��s aux frais du gouvernement belge, sous la direction de la Commission de la Belgica.

R58, Botanique, diatom��es

Annales d'horticulture et de botanique, ou Flore des jardins du royaume des Pays-Bas, et histoire des plantes cultive��es les plus inte��ressantes des possessions ne��erlandaises aux Indes orientales, en Ame��rique et du Japon.

4

Mycographie suisse, ou, Description des champignons qui croissent en Suisse, particulie��rement dans le canton de Vaud, aux environs de Lausanne, par L. Secretan.

2

Mycographie suisse, ou, Description des champignons qui croissent en Suisse, particulie��rement dans le canton de Vaud, aux environs de Lausanne, par L. Secretan.

3

GEPA: Garantia d'Espai per la Perpetu��tat de l'Acc��s

L'objectiu d'aquest estudi ��s doble: la de presentar els elements fonamentals a resoldre de cara a crear un magatzem col��laboratiu que solucioni els problemes creats per la manca d'espai per a les col��leccions existents i futures, aix�� com presentar les caracter��stiques pr��ctiques d'un cas recent que l'autor coneix directament.

L'acc��s als recursos web des de les biblioteques

L���objecte central del present informe ��s descriure l���estat de la q��esti�� ���tant a Catalunya com a altres pa��sos��� de l���acc��s als recursos web des de les biblioteques. De fet, l���objectiu ��ltim ��s presentar i analitzar la situaci�� a l���estranger per tal d���adaptar les estrat��gies i els models de tractament i organitzaci�� de recursos web a la realitat i les necessitats de les biblioteques catalanes.

Els camins "verd" i "daurat" cap a l'acc��s obert: arguments a favor de combinar i relacionar

Els debats recents sobre l'acc��s obert (OA) han tendit a tractar les revistes d'OA i l'auto-arxiu com dues rutes diferents. Alguns partidaris de l'auto-arxiu fins i tot han suggerit que per si sol aquest pot conduir a l'acc��s obert complet de la literatura cient��fica mundial. En aquest article es discuteix que, de fet, cada cam�� correspon a una fase del moviment cap a l'acc��s obert; que amb el simple fet de l���auto-arxiu no n'hi ha prou, i que cal que els dip��sits proporcionin alguna capacitat de crear marques. De totes maneres, fer aix�� desembocaria, finalment, en la creaci�� d'overlay journals (o bases de dades). Per tant, els dos camins es fusionarien per crear un paisatge d'OA madur.

La r��sistance bact��rienne aux antibiotiques.

50 years ago, the introduction of penicillin, followed by many other antibacterial agents, represented an often underestimated medical revolution. Indeed, until that time, bacterial infections were the prime cause of mortality, especially in children and elderly patients. The discovery of numerous new substances and their development on an industrial scale gave us the illusion that bacterial infections were all but vanquished. However, the widespread and sometimes uncontrolled use of these agents has led to the selection of bacteria resistant to practically all available antibiotics. Bacteria utilize three main resistance strategies: (1) modification of their permeability, (2) modification of target, and (3) modification of the antibiotic. Bacteria modify their permeability either by becoming impermeable to antibiotics, or by actively excreting the drug accumulated in the cell. As an alternative, they can modify the structure of the antibiotic's molecular target--usually an essential metabolic enzyme of the bacterium--and thus escape the drug's toxic effect. Lastly, they can produce enzymes capable of modifying and directly inactivating antibiotics. In addition, bacteria have evolved extremely efficient genetic transfer systems capable of exchanging and accumulating resistance genes. Some pathogens, such as methicillin-resistant Staphylococcus aureus and multiresistant Mycobacterium tuberculosis, have become resistant to almost all available antibiotics and there are only one or two substances still active against such organisms. Antibiotics are very precious drugs which must be administered to patients who need them. On the other hand, the development of resistance must be kept under control by a better comprehension of its mechanisms and modes of transmission and by abiding by the fundamental rules of anti-infectious chemotherapy, i.e.: (1) choose the most efficient antibiotic according to clinical and local epidemiological data, (2) target the bacteria according to the microbiological data at hand, and (3) administer the antibiotic in an adequate dose which will leave the pathogen no chance to develop resistance.

Insertion dans les soins apr��s une premi��re hospitalisation dans un secteur pour psychose [Linkage to care after first hospitalisation for psychosis]

BACKGROUND: First hospitalisation for a psychotic episode causes intense distress to patients and families, but offers an opportunity to make a diagnosis and start treatment. However, linkage to outpatient psychiatric care remains a notoriously difficult step for young psychotic patients, who frequently interrupt treatment after hospitalisation. Persistence of symptoms, and untreated psychosis may therefore remain a problem despite hospitalisation and proper diagnosis. With persisting psychotic symptoms, numerous complications may arise: breakdown in relationships, loss of family and social support, loss of employment or study interruption, denial of disease, depression, suicide, substance abuse and violence. Understanding mechanisms that might promote linkage to outpatient psychiatric care is therefore a critical issue, especially in early intervention in psychotic disorders. OBJECTIVE: To study which factors hinder or promote linkage of young psychotic patients to outpatient psychiatric care after a first hospitalisation, in the absence of a vertically integrated program for early psychosis. Method. File audit study of all patients aged 18 to 30 who were admitted for the first time to the psychiatric University Hospital of Lausanne in the year 2000. For statistical analysis, chi2 tests were used for categorical variables and t-test for dimensional variables; p<0.05 was considered as statistically significant. RESULTS: 230 patients aged 18 to 30 were admitted to the Lausanne University psychiatric hospital for the first time during the year 2000, 52 of them with a diagnosis of psychosis (23%). Patients with psychosis were mostly male (83%) when compared with non-psychosis patients (49%). Furthermore, they had (1) 10 days longer mean duration of stay (24 vs 14 days), (2) a higher rate of compulsory admissions (53% vs 22%) and (3) were more often hospitalised by a psychiatrist rather than by a general practitioner (83% vs 53%). Other socio-demographic and clinical features at admission were similar in the two groups. Among the 52 psychotic patients, 10 did not stay in the catchment area for subsequent treatment. Among the 42 psychotic patients who remained in the catchment area after discharge, 20 (48%) did not attend the scheduled or rescheduled outpatient appointment. None of the socio demographic characteristics were associated with attendance to outpatient appointments. On the other hand, voluntary admission and suicidal ideation before admission were significantly related to attending the initial appointment. Moreover, some elements of treatment seemed to be associated with higher likelihood to attend outpatient treatment: (1) provision of information to the patient regarding diagnosis, (2) discussion about the treatment plan between in- and outpatient staff, (3) involvement of outpatient team during hospitalisation, and (4) elaboration of concrete strategies to face basic needs, organise daily activities or education and reach for help in case of need. CONCLUSION: As in other studies, half of the patients admitted for a first psychotic episode failed to link to outpatient psychiatric care. Our study suggests that treatment rather than patient's characteristics play a critical role in this phenomenon. Development of a partnership and involvement of patients in the decision process, provision of good information regarding the illness, clear definition of the treatment plan, development of concrete strategies to cope with the illness and its potential complications, and involvement of the outpatient treating team already during hospitalisation, all came out as critical strategies to facilitate adherence to outpatient care. While the current rate of disengagement after admission is highly concerning, our finding are encouraging since they constitute strategies that can easily be implemented. An open approach to psychosis, the development of partnership with patients and a better coordination between inpatient and outpatient teams should therefore be among the targets of early intervention programs. These observations might help setting up priorities when conceptualising new programs and facilitate the implementation of services that facilitate engagement of patients in treatment during the critical initial phase of psychotic disorders.