Exposition coloniale internationale de Paris. Commissariat général

Comprend : Afrique équatoriale française ; Afrique occidentale française / par Robert Delavignette ; bois gravés de Germaine Bernard ; Indochine / ouvrage publié sous la direction de M. Sylvain Lévi ; Ile de la Réunion, Côte française des Somalis, Établissements français de l'Inde ; Établissements français du Pacifique austral. Nouvelle Calédonie et dépendances. Nouvelles Hébrides, îles Wallis et Futuna. Établissements français de l'Océanie ; Guadeloupe, Guyane, Martinique, Saint-Pierre et Miquelon ; Madagascar et dépendances / par M. Delelée-Desloges ; illustrations de M. Le Scouezec ; Territoires africains sous mandat de la France. Cameroun et Togo / Victor Chazelas ; Suzanne Truitard

Exposition coloniale internationale de Paris. Commissariat général

Comprend : Afrique équatoriale française ; Afrique occidentale française / par Robert Delavignette ; bois gravés de Germaine Bernard ; Indochine / ouvrage publié sous la direction de M. Sylvain Lévi ; Ile de la Réunion, Côte française des Somalis, Établissements français de l'Inde ; Établissements français du Pacifique austral. Nouvelle Calédonie et dépendances. Nouvelles Hébrides, îles Wallis et Futuna. Établissements français de l'Océanie ; Guadeloupe, Guyane, Martinique, Saint-Pierre et Miquelon ; Madagascar et dépendances / par M. Delelée-Desloges ; illustrations de M. Le Scouezec ; Territoires africains sous mandat de la France. Cameroun et Togo / Victor Chazelas ; Suzanne Truitard

The effect of non-medical factors on variations in the performance of colonoscopy among different health care settings

BACKGROUND: Previous published studies have shown significant variations in colonoscopy performance, even when medical factors are taken into account. This study aimed to examine the role of nonmedical factors (ie, embodied in health care system design) as possible contributors to variations in colonoscopy performance. METHODS: Patient data from a multicenter observational study conducted between 2000 and 2002 in 21 centers in 11 western countries were used. Variability was captured through 2 performance outcomes (diagnostic yield and colonoscopy withdrawal time), jointly studied as dependent variables, using a multilevel 2-equation system. RESULTS: Results showed that open-access systems and high-volume colonoscopy centers were independently associated with a higher likelihood of detecting significant lesions and longer withdrawal durations. Fee for service (FFS) payment was associated with shorter withdrawal durations, and so had an indirect negative impact on the diagnostic yield. Teaching centers exhibited lower detection rates and longer withdrawal times. CONCLUSIONS: Our results suggest that gatekeeping colonoscopy is likely to miss patients with significant lesions and that developing specialized colonoscopy units is important to improve performance. Results also suggest that FFS may result in a lower quality of care in colonoscopy practice and highlight the fact that longer withdrawal times do not necessarily indicate higher quality in teaching centers.

Counselor motivational interviewing skills and young adult change talk articulation during brief motivational interventions.

The process of eliciting client language toward change (change talk [CT]) is implicated as a causal mechanism in motivational interviewing (MI) and brief motivational interventions (BMI). We investigated the articulation of counselor behaviors and CT during BMI with young men. We coded 149 sessions using the Motivational Interviewing Skill Code and summarized these codes into three counselor categories (MI-consistent [MICO], MI-inconsistent [MIIN], other) and three client categories (CT, counter CT [CCT], follow/neutral [F/N]). We then computed immediate transition frequencies and odds ratios using sequential analysis software. CT was significantly more likely following MICO behaviors, whereas MIIN behaviors only led to CCT and F/N. This strongly supports the use of MI skills to elicit CT during BMI with young men, whose speech also predicted counselor behaviors (particularly CT to MICO and CCT to MIIN). Additional analyses showed that among MICO behaviors, reflective listening may be a particularly powerful technique to elicit CT.

Avaliação de atributos físicos e estoques de carbono e nitrogênio em solos com queima e sem queima de canavial

O Brasil é o maior produtor mundial de cana-de-açúcar, de modo que mudanças no seu manejo podem afetar sobremaneira o ambiente. Há quase um século, as pesquisas são baseadas em áreas sob queima da biomassa foliar (palhada) dessa cultura. Mas a supressão da queimada é um novo conceito no manejo da palhada. Portanto, há poucos resultados sobre o manejo desse material. O objetivo do estudo foi comparar teores de C e N e estabilidade de agregados e densidade do solo nos manejos com queima (Cq) e sem queima (Sq) da palhada. Estudou-se um solo argiloso (Latossolo Vermelho = LVdf) e dois solos arenosos (Argissolo Vermelho-Amarelo = PVAd e Neossolo Quartzarênico = RQo) submetidos aos manejos Cq e Sq. Em cada solo foi estabelecida uma área experimental em blocos ao acaso com seis repetições. A quantidade de palhada adicionada em três colheitas foi 40 t ha-1 em matéria seca e, um ano após a terceira colheita, a acumulação foi 4,5 t ha-1 (11 %) no LVdf e 3,6 t ha-1 (9 %) no RQo. Isso representou 1,60 e 1,35 t ha-1 em C e 0,022 e 0,021 t ha-1 em N, respectivamente. Houve aumento no teor de C nos solos Sq, concorrendo em seqüestro de C na camada 0-20 cm de 6,3 e 4,7 t ha-1, respectivamente em LVdf e RQo. Assim, a taxa de seqüestro de C no compartimento cobertura + solo (0-20 cm) foi de 2,63 e 2,02 t ha-1 ano-1 no LVdf e RQo, respectivamente. Também houve aumento no teor de macroagregados em solos Sq comparados a solos Cq: 814 e 693 g kg-1 no LVdf e 516 e 420 g kg-1 no RQo. Ocorreu compactação superficial no PVAd e RQo em decorrência do uso de máquina colhedora em solo Sq. Nos solos estudados, o manejo sem queima da cana-de-açúcar resultou em melhorias nas propriedades dos solos e promoveu seqüestro de C e N na cobertura e nas camadas superficiais dos solos.

Dank der Apotheker verbesserte Kontrolle der Risikofaktoren für kardiovaskuläre Krankheiten.

Der Apotheker kann - allein oder in Zusammenarbeit mit weiteren Gesundheitsfachpersonen - zur besseren Kontrolle der Risikofaktoren für kardiovaskuläre Krankheiten beitragen. Dies ist das Fazit eines kürzlich in "Archives of Internal Medicine" erschienenen systematischen Reviews [1], durchgeführt von der Apothekerin Dr. Valérie Santschi, PhD, Mitarbeitern der McGill-Universität Montréal und des "Institut universitaire de médecine sociale et préventive " (IUMSP) des "Centre Hospitalier Universitaire Vaudois" (CHUV) Lausanne. Das Review kommt zum Schluss, dass es relevant ist, den Apotheker systematischer in die Prävention und Behandlung von KVK zu integrieren. [Ed.]