Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions.

BACKGROUND: Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. METHODS: This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. RESULTS: A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. CONCLUSION: It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.

Fisiología bucal infantil: función y crecimiento de la cavidad oral del lactante

Todas las funciones que se realizan en la cavidad oral (respiración, succión, deglución, masticación y fonación), estimulan el crecimiento y desarrollo del tercio inferior de la cara. Por ello, el tipo de lactancia, así como los hábitos orales disfuncionales, pueden influir sobre la morfología definitiva de los maxilares y de la oclusión dentaria.

Attachment, psychopathology, and religion: Introduction to this special section of Mental Health, Religion, & Culture

An international conference of psychology of religion, organised at the University of Lausanne (Switzerland) on 16 May 2012, took up the theme: "Attachment, psychopathology, and religion". Four speakers were invited: Pehr Granvist, Andrew Gumley, Isabelle Rieben, and Pascal Roman. Their reworked contributions are gathered in this special section of Mental Health, Religion, & Culture. The goal of this special section is to re-examine the whole of this subject of the bond between attachment and religion and/or spirituality in the cases of those persons suffering from mental health disorders.

Déficit de yodo durante la gestación

El déficit de yodo (DY) durante la gestación puede tener importantes repercusiones en la función tiroidea tanto materna como fetal, pudiendo llegar a desencadenar un hipotiroidismo materno y neonatal. En mujeres en edad fértil, el hipotiroidismo puede reducir la fertilidad e incrementar el número de abortos espontáneos. Además, cuando consiguen un embarazo se altera la adaptación de la glándula tiroides a los cambios que se producen durante la gestación, y pueden presentar una hiperplasia tiroidea en forma de bocio. En el feto, el déficit materno de yodo constituye una de las principales causas de lesiones cerebrales y de retraso mental de carácter irreversible. Es importante que las matronas conozcan estas repercusiones e incluyan en el programa de educación sanitaria a la mujer embarazada recomendaciones para garantizar el aporte adecuado de yodo, como puede ser el consumo de pescado y la utilización de sal yodada para la condimentación de los alimentos. Además, deberán derivar al médico a aquellas mujeres que presenten una deficiencia de yodo para que realicen una suplementación si fuera necesario.

Déficit de yodo durante la gestación

El déficit de yodo (DY) durante la gestación puede tener importantes repercusiones en la función tiroidea tanto materna como fetal, pudiendo llegar a desencadenar un hipotiroidismo materno y neonatal. En mujeres en edad fértil, el hipotiroidismo puede reducir la fertilidad e incrementar el número de abortos espontáneos. Además, cuando consiguen un embarazo se altera la adaptación de la glándula tiroides a los cambios que se producen durante la gestación, y pueden presentar una hiperplasia tiroidea en forma de bocio. En el feto, el déficit materno de yodo constituye una de las principales causas de lesiones cerebrales y de retraso mental de carácter irreversible. Es importante que las matronas conozcan estas repercusiones e incluyan en el programa de educación sanitaria a la mujer embarazada recomendaciones para garantizar el aporte adecuado de yodo, como puede ser el consumo de pescado y la utilización de sal yodada para la condimentación de los alimentos. Además, deberán derivar al médico a aquellas mujeres que presenten una deficiencia de yodo para que realicen una suplementación si fuera necesario.

La collaboration interprofessionnelle à l'interface des institutions socio-éducative et psychiatrique. Jeux et enjeux de l'intervention auprès de personnes en situation de handicap mental et de troubles psychiques

La prise en charge et le suivi de personnes en situation de handicap mental souffrant de troubles psychiques et se trouvant donc à l'interface des domaines socio:éducatif et psychiatrique, constituent des défis complexes en matière de collaboration interprofessionnelle. Dans le canton de Vaud, les acteurs concernés par ce problème s'efforcent depuis de nombreuses années de créer des réseaux pluridisciplinaires visant un meilleur échange entre professionnels et le développement de compétences et de connaissances permettant d'améliorer le bien:être des bénéficiaires. Ce travail se propose ainsi d'étudier et de questionner ces modalités de travail dans une perspective socioculturelle (Vygotski, 1934/1997), afin d'en comprendre le fonctionnement, d'en éclairer les mécanismes et de fournir des pistes de réflexion aux professionnels. Il repose sur un travail de terrain mené auprès des membres du Dispositif de Collaboration Psychiatrie Handicap Mental (DCPHM) du Département de psychiatrie du CHUV, dont la mission principale est de faciliter la collaboration entre les institutions socio:éducatives et psychiatriques spécialisées dans le suivi des personnes en situation de handicap mental et souffrant de troubles psychiques. Le travail empirique est basé sur une approche qualitative et compréhensive des interactions sociales, et procède par une étude de terrain approfondie. Les données recueillies sont variées : notes de terrain et récolte de documentation, enregistrement de réunions d'équipe au sein du DCPHM et de réunions de réseau, et entretiens de différents types. L'analyse montre que le travail de collaboration qui incombe à l'équipe est constitué d'obstacles qui sont autant d'occasions de développement professionnel et de construction identitaire. Les résultats mettent en lumière des mécanismes discursifs de catégorisation concourant à la fois à la construction des patients comme objets d'activité, et à la construction d'une place qui légitime les interventions de l'équipe dans le paysage socio:éducatif et psychiatrique vaudois et la met au centre de l'arène professionnelle. -- Care and follow:up for people with mental disabilities suffering from psychological disorders : therefore at the interface between the socio:educational and psychiatric fields : represent complex challenges in terms of interprofessional collaboration. In the canton of Vaud, the caregivers involved in this issue have been trying for years to build multidisciplinary networks in order to better exchange between professionals and develop skills and knowledge to improve the recipients' well:being. This work thus proposes to study and question these working methods in a sociocultural perspective (Vygotski, 1934/1997) so as to understand how they operate, highlight inherent mechanisms and provide actionable insights to the professionals. It is based on fieldwork conducted among members of the Dispositif de Collaboration Psychiatrie Handicap Mental (DCPHM), of the Psychiatry Department at the CHUV University Hospital in Lausanne, whose main mission is to facilitate collaboration between the socio:educational and psychiatric institutions specialising in monitoring people presenting with both mental handicap and psychiatric disorder. The empirical work is based on a qualitative and comprehensive approach to social interactions, and conducted based on an in:depth field study. The data collected are varied - field notes and documentation collection, recordings of team meetings within the DCPHM and network meetings, and various types of interviews. The analysis shows that the collaborative work that befalls the team consists of obstacles, all of which provide opportunities for professional development and identity construction. The results highlight discursive strategies of categorisation which contribute both to the construction of the patients as objects of activity and to building a position that legitimates the team's interventions in the socio: educational and psychiatric landscape of canton Vaud and puts it in the centre of the professional arena.

A New Outlook on Mental Illnesses: Glial Involvement Beyond the Glue.

Mental illnesses have long been perceived as the exclusive consequence of abnormalities in neuronal functioning. Until recently, the role of glial cells in the pathophysiology of mental diseases has largely been overlooked. However recently, multiple lines of evidence suggest more diverse and significant functions of glia with behavior-altering effects. The newly ascribed roles of astrocytes, oligodendrocytes and microglia have led to their examination in brain pathology and mental illnesses. Indeed, abnormalities in glial function, structure and density have been observed in postmortem brain studies of subjects diagnosed with mental illnesses. In this review, we discuss the newly identified functions of glia and highlight the findings of glial abnormalities in psychiatric disorders. We discuss these preclinical and clinical findings implicating the involvement of glial cells in mental illnesses with the perspective that these cells may represent a new target for treatment.

Screening of mental health and substance users in frequent users of a general Swiss emergency department.

BACKGROUND: The objectives of this study were to determine the proportions of psychiatric and substance use disorders suffered by emergency departments' (EDs') frequent users compared to the mainstream ED population, to evaluate how effectively these disorders were diagnosed in both groups of patients by ED physicians, and to determine if these disorders were predictive of a frequent use of ED services. METHODS: This study is a cross-sectional study with concurrent and retrospective data collection. Between November 2009 and June 2010, patients' mental health and substance use disorders were identified prospectively in face-to-face research interviews using a screening questionnaire (i.e. researcher screening). These data were compared to the data obtained from a retrospective medical chart review performed in August 2011, searching for mental health and substance use disorders diagnosed by ED physicians and recorded in the patients' ED medical files (i.e. ED physician diagnosis). The sample consisted of 399 eligible adult patients (≥18 years old) admitted to the urban, general ED of a University Hospital. Among them, 389 patients completed the researcher screening. Two hundred and twenty frequent users defined by >4 ED visits in the previous twelve months were included and compared to 169 patients with ≤4 ED visits in the same period (control group). RESULTS: Researcher screening showed that ED frequent users were more likely than members of the control group to have an anxiety, depressive disorder, post-traumatic stress disorder (PTSD), or suffer from alcohol, illicit drug abuse/addiction. Reviewing the ED physician diagnosis, we found that the proportions of mental health and substance use disorders diagnosed by ED physicians were low both among ED frequent users and in the control group. Using multiple logistic regression analyses to predict frequent ED use, we found that ED patients who screened positive for psychiatric disorders only and those who screened positive for both psychiatric and substance use disorders were more likely to be ED frequent users compared to ED patients with no disorder. CONCLUSIONS: This study found high proportions of screened mental health and/or substance use disorders in ED frequent users, but it showed low rates of detection of such disorders in day-to-day ED activities which can be a cause for concern. Active screening for these disorders in this population, followed by an intervention and/or a referral for treatment by a case-management team may constitute a relevant intervention for integration into a general ED setting.

La función activadora de un apósito bioactivo con carga iónica sobre los fibroblastos humanos

La cicatrización de las heridas es un proceso complejo que implica diferentes fases que se solapan entre sí, incluyendo la inflamación, la epitelización, la angiognesis y la síntesis y deposición de matriz extracelular. Los fibroblastos dérmicos tienen una función esencial en la formación del tejido de granulación. Migran hasta la lesión en respuesta a citoquinas, proliferan y sintetizan las proteínas de la matriz extracelular, las cuales son la base del proceso de reparación futuro. Los oligoelementos tales como el zinc y el manganeso son necesarios para muchas funciones celulares y, por consiguiente, pueden potencialmente estimular los procesos de reparación de las heridas. En el presente estudio hemos investigado el efecto de un aposito que contiene zinc, calcio y manganeso (Trionic®) sobre la proliferación, el crecimiento, la síntesis de colágeno I y III y la migración de los fibroblastos. Los resultados obtenidos indican que los oligoelementos solubles presentes en Trionic® actúan estimulando la proliferación, el crecimiento, la biosíntesis de colágeno y la migración de los fibroblastos. Dada la participación crucial que estas funciones celulares tienen sobre el comportamiento de los fibroblastos durante el proceso de formación del tejido de granulación, concluimos que los iones Ca2+, Zn2+, y Mn2+ contenidos en Trionic® pueden proporcionar potenciales beneficios en el tratamiento de las heridas crónicas y durante la fase reparativa del proceso de cicatrización.

Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records.

INTRODUCTION: This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec's remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders. METHODS: Quality indicators were identified from evidence and case studies were reconstructed using data collected in health records over a 2-year observation period. Data collection was developed using a three-step iterative process: (1) feasibility analysis, (2) development of a data collection tool, and (3) application of the data collection method. The adaptation of quality-of-care indicators to remote regions was appraised according to their relevance, measurability and construct validity in this context. RESULTS: As a result of this process, 18 quality indicators were shown to be relevant, measurable and valid for establishing a critical quality appraisal of four recommended dimensions of PHC clinical processes: recognition, assessment, treatment and follow-up. CONCLUSIONS: There is not only an interest in the use of health records to assess the quality of PHC for mental health in remote regions but also a scientific value for the rigorous and meticulous methodological approach developed in this study. From the perspective of stakeholders in the PHC system of care in remote areas, quality indicators are credible and provide potential for transferability to other contexts. This study brings information that has the potential to identify gaps in and implement solutions adapted to the context.

La influència dels continguts numèrics a l’hora de realitzar estratègies de càlcul mental

En aquesta recerca es presenta l’anàlisi de les estratègies que usen els alumnes de 4t de primària de l’escola Barnola d’Avinyó per a resoldre operacions de suma amb nombres de fins a dues xifres. A més, permet observar la seva evolució després d’haver dut a terme una unitat didàctica orientada a treballar i millorar de manera manipulativa i dinàmica, al llarg de set setmanes, els continguts numèrics. Per tant, amb els resultats obtinguts podem valorar si el fet de treballar continguts numèrics influencia en l’ús d’estratègies de càlcul mental i contrastar-ho amb diferents autors destacats en aquest àmbit.