Patients' understanding of blood tests and attitudes to HIV screening in the emergency department of a Swiss teaching hospital: a cross-sectional observational study.

BACKGROUND: In Switzerland, patients may undergo "blood tests" without being informed what these are screening for. Inadequate doctor-patient communication may result in patient misunderstanding. We examined what patients in the emergency department (ED) believed they had been screened for and explored their attitudes to routine (non-targeted) human immunodeficiency virus (HIV) screening. METHODS: Between 1st October 2012 and 28th February 2013, a questionnaire-based survey was conducted among patients aged 16-70 years old presenting to the ED of Lausanne University Hospital. Patients were asked: (1) if they believed they had been screened for HIV; (2) if they agreed in principle to routine HIV screening and (3) if they agreed to be HIV tested during their current ED visit. RESULTS: Of 466 eligible patients, 411 (88%) agreed to participate. Mean age was 46 ± 16 years; 192 patients (47%) were women; 366 (89%) were Swiss or European; 113 (27%) believed they had been screened for HIV, the proportion increasing with age (p ≤0.01), 297 (72%) agreed in principle with routine HIV testing in the ED, and 138 patients (34%) agreed to be HIV tested during their current ED visit. CONCLUSION: In this ED population, 27% believed incorrectly they had been screened for HIV. Over 70% agreed in principle with routine HIV testing and 34% agreed to be tested during their current visit. These results demonstrate willingness among patients concerning routine HIV testing in the ED and highlight a need for improved doctor-patient communication about what a blood test specifically screens for.

Trends and characteristics of attendance at the emergency department of a Swiss university hospital: 2002-2012.

BACKGROUND: The numbers of people attending emergency departments (EDs) at hospitals are increasing. We aimed to analyse trends in ED attendance at a Swiss university hospital between 2002 and 2012, focussing on age-related differences and hospital admission criteria. METHODS: We used hospital administrative data for all patients aged ≥16 years who attended the ED (n = 298,306) at this university hospital between 1 January 2002, and 31 December 2012. We descriptively analysed the numbers of ED visits according to the admission year and stratified by age (≥65 vs <65 years). RESULTS: People attending the ED were on average 46.6 years old (standard deviation 20 years, maximum range 16‒99 years). The annual number of ED attendances grew by n = 6,639 (27.6%) from 24,080 in 2002 to 30,719 in 2012. In the subgroup of patients aged ≥65 the relative increase was 42.3%, which is significantly higher (Pearson's χ2 = 350.046, df = 10; p = 0.000) than the relative increase of 23.4% among patients <65 years. The subgroup of patients ≥65 years attended the ED more often because of diseases (n = 56,307; 85%) than accidents (n = 9,844; 14.9%). This subgroup (patients ≥65 years) was also more often admitted to hospital (Pearson's χ2 = 23,377.190; df = 1; p = 0.000) than patients <65 years. CONCLUSIONS: ED attendance of patients ≥65 years increased in absolute and relative terms. The study findings suggest that staff of this ED may want to assess the needs of patients ≥65 years and, if necessary, adjust the services (e.g., adapted triage scales, adapted geriatric screenings, and adapted hospital admission criteria).

The Literary relations between La Fontaine and the "Astrée" of Honoré d'Urfé : a dissertation presented to the faculty of the department of philosophy of the university of Pennsylvania in partial fulfilment of the requirements for the degree of doctor of philosophy / by Walther P. Fischer

Collection : Publications of the University of Pennsylvania ; n° 6

Development of hypogene and supergene alteration and copper mineralization patterns, Sar Cheshmeh porphyry copper deposits, Iran /

The formation of the Sar Cheshmeh porphyry Cu-Mo deposit is related to the culmination of calc-alkaline igneous activity in the Kerman region. The deposit comprises a suite of Late Cenozoic intrusive sub-volcanic and extrusive rocks emplaced into a folded series of Eocene andesitic lavas and pyroclastic sediments. The earliest stage of magmatism was emplacement of a large granodiorite stock about 29 m.y.b.p. This was followed by intrusion of two separate porphyritic bodies at 15 (Sar Cheshrneh porphyry) and 12 m.y.b.p. (Late porphyry) and a series of sub-volcanic dikes between 12 and 9 m.y.b.p. Magmatic activity terminated with multi-phase extrusion of a Pelean dacitic dome complex between 10 and 2.8 m.y.b.p. The country rocks and the earlier porphyritic intrusions are pervasively altered to biotite-rich potassium silicate (metasomatic and hydrothermal) sericite-clay, phyllic and chlorite-clay, argillic assemblages. These grade outwards to an extensive propylitic zone. Within the ore body, the later intra-. and post-mineral dikes only reach the propylitic grade. At least three different sets of quartz veins are present, including a sericite-chlorite-quartz set which locally retrogrades pervasive secondary biotite to sericite. In the hypogene zone, metasomatic and hydrothermal alteration is related to all stages of magmatism but copper mineralization and veining are restricted to a period of 15 to 9 m.y.b.p.related to the early intrusive phases. The copper mineralization and silicate alteration do not fit a simple annular ring model but have been greatly modified by, 1. The existence of an ititial, outer ring, of metasomatic alteration overprinted by an inner.ring of hydrothermal alteration and, 2. later extensive dilating effects of intra- and post-mineral dikes. The hydrothermal clay mineral assemblage in the hypogene zone is illite-chlorite-kaolinite-smectite (beidellite). Preliminary studies indicate that the amount of each of these clays varies vertically and that hydrothermal zonation of clay minerals is possible. However, these minerals alter to illite-kaolinite assemblages in the supergene sulfide zone and to more kaolinite-rich assemblages in the supergene leached zone. Hydrothermal biotite breaks down readily in the supergene zone and is not well preserved in surface outcrops. The distribution of copper minerals in the supergene sulfide enrichment zone is only partly related to rock type being more dependent on topography and the availability of fractures.

Voucher #2 from the Engineer Department of Port Dalhousie and Thorold Railway Extension paid to Daniel Plumsteel, Dec. 31, 1856

Voucher #2 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for surveys, paid to Daniel Plumsteel, Dec. 31, 1856.

Voucher #3 from the Engineer Department of Port Dalhousie and Thorold Railway Extension paid to Thomas Woods, Dec. 31, 1856

Voucher #3 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for sinking test pits, paid to Thomas Woods, Dec. 31, 1856.

Pay roll voucher #4 from the Engineer Department of Port Dalhousie and Thorold Railway for the month of January, Jan. 1857

Pay roll voucher #4 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for surveying for the month of January, Jan. 1857.

Voucher #5 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to George Forbes for surveys, Jan. 31, 1857

Voucher #5 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to George Forbes for surveys, Jan. 31, 1857.

Voucher #6 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to Thomas Woods for surveys, Jan. 31, 1857

Voucher #6 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to Thomas Woods for surveys, Jan. 31, 1857.

Voucher #7 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to W.G. Thompson accompanied by an abstract of vouchers and summaries of account paid by W.G. Thompson for surveys, Jan. 31, 1857

Voucher #7 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to W.G. Thompson accompanied by an abstract of vouchers and summaries of account paid by W.G. Thompson for surveys, Jan. 31, 1857.

Pay roll voucher #8 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for surveys in the month of February, Feb. 28, 1857

Pay roll voucher #8 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for surveys in the month of February, Feb. 28, 1857.

Voucher #9 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to W. G. Thompson accompanied by an abstract of vouchers for surveys, Feb. 28, 1857

Voucher #9 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to W. G. Thompson accompanied by an abstract of vouchers for surveys, Feb. 28, 1857

Pay roll voucher #10 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for the engineer corps. , Mar. 31, 1857

Pay roll voucher #10 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for the engineer corps. , Mar. 31, 1857.

Voucher #15 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to A. H. Armour for office supplies, Apr. 1, 1857

Voucher #15 from the Engineer Department of Port Dalhousie and Thorold Railway Extension to A. H. Armour for office supplies, Apr. 1, 1857.

Pay roll voucher #12 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for the office approved by F. Shanly, chief engineer, April, 1857

Pay roll voucher #12 from the Engineer Department of Port Dalhousie and Thorold Railway Extension for the office approved by F. Shanly, chief engineer, April, 1857.