Prevalence of substance use in a Swiss psychiatric hospital: interview reports and urine screening.

BACKGROUND: Co-morbid substance misuse is common in psychiatric disorders, has potentially severe adverse consequences and may be frequently undetected. AIMS: To measure the prevalence of substance use among patients admitted to a Swiss psychiatric hospital and to examine the potential utility of routine urine drug screening in this setting. METHOD: 266 inpatients were included. 238 patients completed the interview and 240 underwent a urine drug screening. RESULTS: Lifetime prevalence of substance use among psychiatric patients was very high for alcohol (98%; 95% CI: 96-100), benzodiazepines (86%; 95% CI: 82-91) and cannabis (53%; 95% CI: 47-60), but also for "hard drugs" like cocaine (25% ; 95% CI: 19-30) or opiates (20%; 95% CI: 15-25). Regular current use of alcohol (32%; 95% CI: 26-38) or cannabis (17%; 95% CI: 12-22) was the most frequent. Substance use was associated with male sex, younger age, unmarried status and nicotine smoking. Urine screening confirms reports from patients on recent use, and remained positive for cannabis during hospitalisation, but not for cocaine nor for opiates. CONCLUSION: Substance use is frequent among psychiatric patients. Systematic interviewing of patients about their substance use remains essential, and is usually confirmed by urine screening. Urine screening can be useful to provide specific answers about recent use.

La Relevancia de las revistas de geografía física a partir de su repersentación en el Journal Citation Reports del ISI

Se han analizado las revistas internacionales de geografía física para el periodo 1989-2002, utilizando los datos publicados en el Journal Citation Reports (JCR) editado por Thomson Scientific (anteriormente ISI). El JCR clasifica las revistas en categorías, la disciplina de la geografía tiene una propia. Se ha realizado el estudio de la evolución de las revistas incluidas en esta categoría, la tipología de revistas que se reflejan en ella así como la evolución de las que disponen de un factor de impacto más elevado. Este análisis ha permitido ver cuales han sido las publicaciones más importantes durante el periodo estudiado así como realizar una prognosis de la evolución de las revistas contempladas en esta categoría. Los ámbitos temáticos que más revistas aportan son los sistemas de información geográfica y las regiones polares. Las publicaciones sobre biogeografía ocupan un lugar destacado en buena parte de los años estudiados. El valor del factor de impacto de la revista más importante para cada año ha mostrado un incremento significativo, pasando de valores inferiores a uno a finales de los años ochenta, a casi tres en 2002. Esto de debe en parte a las revistas del ámbito del Cuaternario, de incorporación reciente en la categoría de la geografía, las cuales tienen un índice elevado que ha hecho aumentar el factor de impacto de las revistas de cabecera de la categoría

Evaluation du risque de récidive dans les expertises pénales: quels outils? Quets indicateurs? Quelles pratiques [Risk assessment in forensic psychiatric reports: what kind assessment instrument? What indicator? What practical?].

Here we present results of studies conducted by the Research Unit of Legal Psychiatry and Psychology of Lausanne about risk assessment and protective factors in the evaluation of violence recidivism. It aims to help experts in considering the relevance and use of tools at their disposal. Particular attention is given to the significance of protective factors and impulsive dimensions, as to the inter-raters process that leads to the final deliberations.

Boosting Future Prospects or Softening Promises of Success? The Use of Emphatics and Hedging in the Letter to Shareholders Sections of Annual Reports

Tämä pro gradu -tutkielma käsittelee yritysten vuosikertomusten Toimitusjohtajan katsaus -osioissa esiintyvää metatekstiä. Erityisenä tutkimuskohteena ovat yrityksen tulevaisuutta käsittelevät lauseet ja niissä käytetty interpersonaalinen metateksti, jonka avulla kirjoittaja pyrkii joko vahvistamaan (emphatics-keinoin) tai heikentämään (hedging-keinoin) ilmaisujensa vahvuutta ja lukijalle niiden kautta välittyvää kuvaa viestin varmuudesta ja vakuuttavuudesta. Sijoittajille suunnattu Toimitusjohtajan katsaus käsittelee yleensä yrityksen edellisen vuoden tulosta, taloudellista asemaa sekä tulevaisuudennäkymiä. Tutkimuksen tarkoituksena oli selvittää, vaikuttaako yrityksen taloudellinen menestys vuosikertomuksen tässä osiossa käytetyn metatekstin määrään ja laatuun. Tutkimuksen teoriaosuudessa käsitellään ensiksi lyhyesti vuosikertomuksia ja niiden parissa tehtyä aiempaa kielitieteellistä tutkimusta, minkä jälkeen perehdytään tarkemmin metatekstin sekä hedging- ja emphatics-keinojen määrittelyyn. Näissä osioissa apuna toimivat muunmuassa Hylandin (1998) ja Cromptonin (1997) tutkimukset. Tutkimusaineistossa esiintyvien metatekstilajien määrittelyssä ja tunnistamisessa käytettiin apuna pääosin Crismore & Farnsworthin (1990) ja Grabe & Kaplanin (1997) tutkimuksia. Tutkimuksen aineistona oli yhteensä 23 yhdentoista amerikkalaisen yrityksen vuosikertomusta. Ne käsittivät esimerkkejä kunkin yhtiön talouden kannalta sekä erityisen hyviltä että huonoilta vuosilta. Aineistosta löydetty interpersonaalinen metateksti luokiteltiin viiteen eri ryhmään: modaaliverbit, hedging-verbit, muut hedging-keinot, emphatics-keinot ja evaluatives-keinot (eli kirjoittajan tekstistään tekemät subjektiiviset huomiot ja arviot). Tulokset osoittivat, että metatekstin käytössä ilmeni melkoista vaihtelua yksittäisten yritysten ja niiden hyvien ja huonojen vuosien välillä. Nämä eroavuudet eivät kuitenkaan vaikuttaneet merkittävästi koko aineiston kattaviin keskivertolukuihin, joiden avulla pyrittiin selvittämään hyvien ja huonojen vuosien välisiä yleisiä eroja. Tutkimuksen perusteella voidaan todeta, että Toimitusjohtajan katsaus –osioiden viittaukset yhtiön tulevaisuuteen heijastavat tavallisesti kirjoittajan varmuutta yrityksen menestyksekkäästä tulevaisuudesta riippumatta siitä, minkälainen vuosikertomuksessa käsitelty vuosi on ollut yhtiölle taloudellisesti. Yleisesti ottaen yhtiön taloudellisen tilan ei siis havaittu vaikuttavan Toimitusjohtajan katsauksessa käytetyn metadiskurssin määrään tai laatuun.

Intoxication alcoolique aux urgences : dilemmes de prise en charge. Deux situations cliniques fréquentes. [The dilemma of defining "adequate" ED care for acute alcohol intoxication. About two case reports]

L'intoxication éthylique aiguë (IEA) est un motif de recours fréquent en médecine d'urgence. Bien qu'évoluant de manière spontanément favorable dans la majorité des cas, un certain nombre de complications sont susceptibles de survenir dans ce contexte, entrainant des répercussions significatives sur le pronostic des patients. Or, les altérations neurocomportementales accompagnant classiquement ce type d'intoxication mettent régulièrement les cliniciens face à des dilemmes de prise en charge complexes à résoudre. D'autre part, si les propriétés de l'éthanol peuvent atténuer l'expression clinique de certaines pathologies, un certain nombre d'affection de nature métabolique ou neurologique sont susceptibles d'être interprétées à tort comme des IEA. La littérature médicale ne fournissant que peu d'outils d'aide à la décision dans ce domaine, il est souvent difficile de trouver un compromis acceptable entre recours excessif aux examens complémentaires et banalisation face aux patients alcoolisés. A partir de situations cliniques, le présent article propose une approche pragmatique de deux problématiques régulièrement associées à une IEA et sources d'erreur diagnostique, le traumatisme crânien et l'état d'agitation. Ainsi, une meilleure définition des conditions de recours au scanner cérébral en cas de traumatisme crânien et l'adoption d'un protocole de sédation précoce dans l'ivresse excito-motrice doivent permettre de contourner en partie les difficultés soulevées par ces patients.

An evaluation of the Swiss staging model for hypothermia using case reports from the literature.

BACKGROUND: Core body temperature is used to stage and guide the management of hypothermic patients, however obtaining accurate measurements of core temperature is challenging, especially in the pre-hospital context. The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia. The proposed temperature range for clinical stage 1 is <35-32 °C (95-90 °F), for stage 2, <32-28 °C (<90-82 °F) for stage 3, <28-24 °C (<82-75 °F), and for stage 4 below 24 °C (75 °F). However, the evidence relating these temperature ranges to the clinical stages needs to be strengthened. METHODS: Medline was used to retrieve data on as many cases of accidental hypothermia (core body temperature <35 °C (95 °F)) as possible. Cases of therapeutic or neonatal hypothermia and those with confounders or insufficient data were excluded. To evaluate the Swiss staging model for hypothermia, we estimated the percentage of those patients who were correctly classified and compared the theoretical with the observed ranges of temperatures for each clinical stage. The number of rescue collapses was also recorded. RESULTS: We analysed 183 cases; the median temperature for the sample was 25.2 °C (IQR 22-28). 95 of the 183 patients (51.9 %; 95 % CI = 44.7 %-59.2 %) were correctly classified, while the temperature was overestimated in 36 patients (19.7 %; 95 % CI = 13.9 %-25.4 %). We observed important overlaps among the four stage groups with respect to core temperature, the lowest observed temperature being 28.1 °C for Stage 1, 22 °C for Stage 2, 19.3 °C for Stage 3, and 13.7 °C for stage 4. CONCLUSION: Predicting core body temperature using clinical indicators is a difficult task. Despite the inherent limitations of our study, it increases the strength of the evidence linking the clinical hypothermia stage to core temperature. Decreasing the thresholds of temperatures distinguishing the different stages would allow a reduction in the number of cases where body temperature is overestimated, avoiding some potentially negative consequences for the management of hypothermic patients.

Efficiency of pneumatic and horizontal perforated disk meter mechanism in corn no-tillage seeders in soil with different mobilization reports

This work objectified to evaluate the efficiency of two meter mechanism of corn seeds when submitted to different forward speed and soil management system during the non-tillage seeding. It was used a factorial design in randomized blocks. The factors whose effects were examined were related to the seeders with pneumatic and horizontal disk meter mechanisms for the distribution of the seeds, to the set tractor-seeder forward speeds (4.4; 8.0 and 9.8 km h-1), and to the soil management system considering the corn no-tillage seeding over minimum tillage with chisel plow and the no-tillage system for the seeding of oat culture (Avena strigosa Schreb). It was verified that the forward speed didn't influence the initial and final stands of plants but it interfered in the regularity of longitudinal distribution of plants. The smallest speed provided the largest percentile of normal spacing between plants. The pneumatic meter mechanism presented better performance than the horizontal disk perforated in the longitudinal distribution of plants. About corn productivity aspect it's indifferent the recommendation of use for pneumatic and perforated horizontal disk meter mechanism of seeds.

Earnings management in the process of preparing corporate financial reports

Earnings management (EM) literature examines managers’ use of judgment in financial reporting and in structuring transactions to alter financial reports for a specific reason. Mainstream EM literature strongly concentrates on statistical research methodologies and it is driven by positive accounting theory. Although EM occurs in the process of preparing corporate financial reports, that process has so far largely remained a “black box” in prior literature. The purpose of this study is to analyze what EM is, how and why it unfolds and how it is intertwined in the process of preparing corporate financial reports. In order to meet the needs of the study, a qualitative case study method will be used. The contribution of this study is threefold. First, it indicates that the concept of EM is not as unam-biguous as the prior literature has assumed. I find that EM is socially constructed and more open to interpretation than absolutely dichotomous conception given by previous studies. Second, this study contributes to our knowledge of the role and the importance of actors involved in conducting EM, indicating that EM is much more actor-dependent than the prior literature has assumed. Third, this study broadens our knowledge base with regard to the processes and potential for EM in academic research.

Cemetery Committee Reports, Welland County, 1946

In 1946 the cemetery committee reported at least twice to the Welland County council. The reports included the state of cemeteries within the county boundaries and recommendations for grants to be made for their maintenance. The committee consisted of George F. Broadley, Chairman, and Herbert T. Guess, Irvin Edward Michener and Ellis P. Morningstar.