Collaboration entre médecin de famille et psychiatre pour les problèmes de santé mentale [Family physicians and psychiatrists' collaborative care for mental health problems].

The burden of disease linked to mental disorders represents more than one-fifth of years lived with disability in the world. Less than half of people suffering from mental disorders are adequately treated. Three quarter of those who receive treatment are followed by primary care. Collaborative care aims to increase the efficiency of direct general practitioner's treatment. Main components are sustainable and individualized consultation-liaison relationship (1/2 day of psychiatrist by 15 days for 10-15 general practitioners), and support of a clinical case manager for complex situations. Collaboration is bidirectional: early or crisis access to specialist care and long-term followup by general practitioner. This model is a challenge for the doctor-patient dual relationship and requires incentives in a public health perspective.

Prise en charge des patients avec des problèmes d'alcool: quelle efficacité? Quelques éléments de réponse à partir d'une revue de la littérature [Management of patients with alcohol problems: how effective? Several response factors based on a review of the literature]

What do we know about the effectiveness of various treatments of alcoholism? This review of literature shows that lack--or weaknesses--of published studies make it impossible to draw definite conclusions. Rigorous controlled studies show high rates of spontaneous remission and important uncertainties about specialised treatments of alcoholism. However, except for severe dependence that may well require a different approach, brief interventions conducted by non-specialists have proved highly effective for at-risk alcohol drinkers: based on minimal medical advice, they increase the chances of lowering alcohol consumption. General practitioners may thus represent on important link in the therapeutic chain.

Estimating biophysical variable dependences with kernels

This paper introduces a nonlinear measure of dependence between random variables in the context of remote sensing data analysis. The Hilbert-Schmidt Independence Criterion (HSIC) is a kernel method for evaluating statistical dependence. HSIC is based on computing the Hilbert-Schmidt norm of the cross-covariance operator of mapped samples in the corresponding Hilbert spaces. The HSIC empirical estimator is very easy to compute and has good theoretical and practical properties. We exploit the capabilities of HSIC to explain nonlinear dependences in two remote sensing problems: temperature estimation and chlorophyll concentration prediction from spectra. Results show that, when the relationship between random variables is nonlinear or when few data are available, the HSIC criterion outperforms other standard methods, such as the linear correlation or mutual information.

Etat des lieux et potentiel de l'agriculture urbaine en Suisse : analyse de deux projets d'agriculture urbaine sous l'angle des régimes institutionnels des ressources naturelles

Ce travail de recherche dresse un panorama de l'état du développement des pratiques d'agriculture urbaine en Suisse et analyse le potentiel que celles-ci pourraient y développer, compte tenu des particularités du contexte national. La démarche adoptée suit une logique allant du général au particulier, de la théorie à la pratique, du descriptif vers l'analytique. Dans un premier temps, l'agriculture urbaine est abordée sous un angle conceptuel, comprenant un retour historique sur la relation ville-campagne et sur l'apparition récente du terme d'agriculture urbaine, un tour d'horizon de la littérature sur le sujet, une revue de ses diverses approches scientifiques et la circonscription des enjeux de sa définition. Dans un deuxième temps, l'agriculture urbaine est envisagée sous sa forme pratique, en Suisse comme à l'étranger. En ressort un inventaire étendu de ses différents types de mises en application, auquel correspond un panel d'atouts identifiés selon les trois versants du développement durable : social, écologique et économique. En troisième lieu les spécificités du contexte helvétique sont étudiées afin de comprendre quel est le cadre dans lequel le potentiel de l'agriculture urbaine pourrait se développer. Finalement, ce sont deux cas concrets d'agriculture urbaine qui sont analysés et évalués dans les détails, selon l'approche dite des régimes institutionnels des ressources naturelles (RIRN): le « plantage » lausannois du quartier de la Bourdonnette et le Stadiongarten dans le quartier Kreis 5 à Zurich. Au fil de cette recherche, il apparaît que l'agriculture urbaine révèle toute une série d'avantages en termes de développement durable, alors même que les villes suisses sont unanimement reconnues comme présentant un déficit dans ce domaine. De même, malgré les bienfaits importants que présentent ses diverses pratiques, l'agriculture urbaine reste encore très peu répandue en Suisse, le concept lui-même n'apparaissant que très rarement dans le discours des pouvoirs publics. Le principal frein à l'agriculture en ville est identifié comme étant le manque d'espace disponible dans les agglomérations, contrainte pourtant largement surmontable en y regardant de plus près. De par sa configuration topographique, le territoire suisse est particulièrement sujet à une étroite proximité entre espaces urbains et étendues agricoles, accroissant de ce fait la problématique de l'étalement urbain et du mitage du paysage. Parmi les enjeux de la lutte contre ces phénomènes concomitants, l'agriculture urbaine aurait un rôle important à jouer. En conclusion, une série de recommandations sont proposées afin que les projets d'agriculture urbaine puissent se développer et perdurer en Suisse. Abstract : This research paper provides an overview of the state of development of urban agriculture practices in Switzerland. It analyzes their potential of expansion while taking into account the particularities of the national context. The method follows a general to particular, theory to practice and descriptive to analytical reasoning. Firstly, urban agriculture is approached through a conceptual view, including a historical overview of the relationship between town and country and of the recent appearance of the term "urban agriculture". An outline of the literature on the subject, an examination of its various scientific approaches and riding issues of its definition are elaborated as well. In a second step, urban agriculture is considered in its practical form, both in Switzerland and abroad. From this we created an extensive inventory of various types of implementations which corresponds to a panel of assets identified according to the three aspects of sustainable development: social, ecology and economics. Thirdly the specificities of Swiss context are studied in order to understand the frame in which the potential of urban agriculture could be developed. Finally, two case studies of urban agriculture are analyzed and evaluated in detail, according to the so-called institutional regimes of natural resources (RIRN) approach: the "plantage" of the Bourdonnette neighborhood in Lausanne and the "Stadiongarten" in the Kreis 5 neighborhood in Zurich. Throughout this research, urban agriculture reveals a number of advantages in terms of sustainable development, even though the Swiss cities are unanimously recognized as having a deficit in this area. As well, despite the significant benefits that are its various practices, urban agriculture is still very uncommon in Switzerland, the concept itself appearing only rarely in public debates. The main obstacle to city agriculture is identified as the lack of available space in urban areas, however this constraint can easily be surpassed. By its topographical configuration, Switzerland is particularly prone to a close proximity between urban and agricultural spaces, thereby increasing the problems of urban sprawl. Among the stakes in the struggle against these interrelated phenomena, urban agriculture could play an important role. In conclusion, a series of recommendations are proposed so that urban agriculture projects can grow and persist in Switzerland.

Retrofit Methods for Distortion Cracking Problems in Plate Girder Bridges, TR-436, 2003

This report is formatted to independently present four individual investigations related to similar web gap fatigue problems. Multiple steel girder bridges commonly exhibit fatigue cracking due to out-of-plane displacement of the web near the diaphragm connections. This fatigue-prone web gap area is typically located in negative moment regions of the girders where the diaphragm stiffener is not attached to the top flange. In the past, the Iowa Department of Transportation has attempted to stop fatigue crack propagation in these steel girder bridges by drilling holes at the crack tips. Other nondestructive retrofits have been tried; in a particular case on a two-girder bridge with floor beams, angles were bolted between the stiffener and top flange. The bolted angle retrofit has failed in the past and may not be a viable solution for diaphragm bridges. The drilled hole retrofit is often only a temporary solution, so a more permanent and effective retrofit is required. A new field retrofit has been developed that involves loosening the bolts in the connection between the diaphragm and the girders. Research on the retrofit has been initiated; however, no long-term studies of the effects of bolt loosening have been performed. The intent of this research is to study the short-term effects of the bolt loosening retrofit on I-beam and channel diaphragm bridges. The research also addressed the development of a continuous remote monitoring system to investigate the bolt loosening retrofit on an X-type diaphragm bridge over a number of months, ensuring that the measured strain and displacement reductions are not affected by time and continuous traffic loading on the bridge. The testing for the first three investigations is based on instrumentation of web gaps in a negative moment region on Iowa Department of Transportation bridges with I-beam, channel, and X-type diaphragms. One bridge of each type was instrumented with strain gages and deflection transducers. Field tests, using loaded trucks of known weight and configuration, were conducted on the bridges with the bolts in the tight condition and after implementing the bolt loosening retrofit to measure the effects of loosening the diaphragm bolts. Long-term data were also collected on the X-diaphragm bridge by a data acquisition system that collected the data continuously under ambient truck loading. The collected data were retrievable by an off-site modem connection to the remote data acquisition system. The data collection features and ruggedness of this system for remote bridge monitoring make it viable as a pilot system for future monitoring projects in Iowa. Results indicate that loosening the diaphragm bolts reduces strain and out-of-plane displacement in the web gap, and that the reduction is not affected over time by traffic or environmental loading on the bridge. Reducing the strain in the web gap allows the bridge to support more cycles of loading before experiencing fatigue, thus increase the service life of the bridge. Two-girder floor beam bridges may also exhibit fatigue cracking in girder webs.

Problems of Bridge Supporting and Expansion Devices and an Experimental Comparison of the Dynamic Behavior of Rigid and Elastomeric Bearings, HR-105, 1965

The design of satisfactory supporting and expansion devices for highway bridges is a problem which has concerned bridge design engineers for many years. The problems associated with these devices have been emphasized by the large number of short span bridges required by the current expanded highway program of expressways and interstate highways. The initial objectives of this investigation were: (1) To review and make a field study of devices used for the support of bridge superstructures and for provision of floor expansion; (2) To analyze the forces or factors which influence the design and behavior of supporting devices and floor expansion systems; and (3) To ascertain the need for future research particularly on the problems of obtaining more economical and efficient supporting and expansion devices, and determining maximum allowable distance between such devices. The experimental portion was conducted to evaluate one of the possible simple and economical solutions to the problems observed in the initial portion. The investigation reported herein is divided into four major parts or phases as follows: (1) A review of literature; (2) A survey by questionnaire of design practice of a number of state highway departments and consulting firms; (3) Field observation of existing bridges; and, (4) An experimental comparison of the dynamic behavior of rigid and elastomeric bearings.

Un guide pratique au traitement des gliomes [A practical guide for the management of gliomas]

The management of gliomas in daily clinical practice is challenging. It requires a multidisciplinary and coordinated approach involving neurosurgery, radiotherapy and, finally, chemotherapy. Important progress has been made during the last years with the introduction of a combined treatment associating standard radiotherapy with concomitant chemotherapy using temozolomide, a novel alkylating agent. For the first time in many years a new treatment strategy translated into a significant prolongation of survival. In parallel, molecular markers (e.g. loss of heterozygosity on chromosomes 1p and 19q or methylation of the methyl-guanine methyl transferase [MGMT] gene promoter) allowed for identification of distinct subtypes of glioma or prediction of treatment response. In this "Practical Guide", we describe the daily practice and aim at answering some common questions in the management of patients suffering from glioblastoma, astrocytoma, oligodendroglioma and low grade glioma. The therapeutic options presented here are based on evidences from the literature. In the absence of documented evidence, the empirical choices from our local practice are explained and justified.

Lihahygienialainsäädännön omavalvontasäädökset ja käytäntö Oy Snellman Ab:n teurastamossa ja leikkaamossa, osa I Osa 1 : Owncontrol directions in meat hygiene legislation and their practical implementation in the slaughterhouse and cutting plant of Snellman Ltd, part I

Summary: Owncontrol directions in meat hygiene legislation and their practical implementation in the slaughterhouse and cutting plant of Snellman Ltd, part I