Intervention précoce dans la phase initiale des troubles psychotiques à Lausanne: quels problèmes et quelles solutions [Early intervention for the initial phase of psychotic disorders in Lausanne: what problems and what solutions?]

Schizophrenia has long been considered with pessimism, but the recent interest in the early phase of psychotic disorders has modified this often unjustified perception. Literature has demonstrated the benefit of the development of programs specialised in the treatment of early psychosis, which tend to be developed in many countries. It is however important to match them to local needs as well as to the structure of local health services. This paper reviews elements that justify such a development in Lausanne, Switzerland, and describe its various elements.

Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions.

OBJECTIVE: Incomplete compliance is one of several possible causes of uncontrolled hypertension. Yet, non-compliance remains largely unrecognized and is falsely interpreted as treatment resistance, because it is difficult to confirm or exclude objectively. The goal of this study was to evaluate the potential benefits of electronic monitoring of drug compliance in the management of patients with resistant hypertension. METHODS: Forty-one hypertensive patients resistant to a three-drug regimen (average blood pressure 156/ 106 +/- 23/11 mmHg, mean +/- SD) were studied prospectively. They were informed that for the next 2 months, their presently prescribed drugs would be provided in electronic monitors, without any change in treatment, so as to provide the treating physician with a measure of their compliance. Thereafter, patients were offered the possibility of prolonging the monitoring of compliance for another 2 month period, during which treatment was adapted if necessary. RESULTS: Monitoring of compliance alone was associated with a significant improvement of blood pressure at 2 months (145/97 +/- 20/15 mmHg, P < 0.01). During monitoring, blood pressure was normalized (systolic < 140 mmHg or diastolic < 90 mmHg) in one-third of the patients and insufficient compliance was unmasked in another 20%. When analysed according to tertiles of compliance, patients with the lowest compliance exhibited significantly higher achieved diastolic blood pressures (P = 0.04). In 30 patients, compliance was monitored up to 4 months and drug therapy was adapted whenever necessary. In these patients, a further significant decrease in blood pressure was obtained (from 150/100 +/- 18/15 to 143/94 +/- 22/11 mmHg, P = 0.04/0.02). CONCLUSIONS: These results suggest that objective monitoring of compliance using electronic devices may be a useful step in the management of patients with refractory hypertension, as it enables physicians to take rational decisions based on reliable and objective data of drug compliance and hence to improve blood pressure control.

Effect of Emotion and Personality on Deviation from Purely Rational Decision-Making

Human decision-making has consistently demonstrated deviation from "pure" rationality. Emotions are a primary driver of human actions and the current study investigates how perceived emotions and personality traits may affect decision-making during the Ultimatum Game (UG). We manipulated emotions by showing images with emotional connotation while participants decided how to split money with a second player. Event-related potentials (ERPs) from scalp electrodes were recorded during the whole decision-making process. We observed significant differences in the activity of central and frontal areas when participants offered money with respect to when they accepted or rejected an offer. We found that participants were more likely to offer a higher amount of money when making their decision in association with negative emotions. Furthermore, participants were more likely to accept offers when making their decision in association with positive emotions. Honest, conscientious, and introverted participants were more likely to accept offers. Our results suggest that factors others than a rational strategy may predict economic decision-making in the UG.

Market Opportunities Analysis for Logistics Solutions Provider Case Danzas Solutions

Tutkielman tavoitteena oli suunitella markkina-analyysi ja sitä käyttäen määritellä Danzasin Solutions liiketoimintayksikön mahdollisuuksia laajentaa toimintaansa Suomen terveydenhuolto/ lääke- ja elektroniikka/ telekommunikaatiosektoreilla. Danzas Solutions toimisi logistiikkaintegraattorina toimittamalla kokonaisvaltaisia logistisia ratkaisuja. Tutkimus tehtiin haastattelemalla neljää Danzasin asiakasta. Mahdollisimman laajan ja yleistettävän tuloksen saamiseksi haastateltavat valitiin logistiikan ulkoistamisasteeltaan vaihteleviksi. Tutkimus tehtiin ensin tutkimalla sekundääristä informaatiota markkinoilta ja täydentämällä sitä haastatteluista saadulla kvalitatiivisella primääri informaatiolla ja case yrityksen sisäisellä analyysillä. Painopiste tutkimuksessa oli selvittää yritysten ulkoistamiseen ja logistiikkakumppanin valintaan vaikuttavia kriteereitä. Logistiikkaintegraattorille suurimmat mahdollisuudet löytyvät elektroniikka/ telekommunikaatiosektorilta. Logistiikka tällä sektorilla on vaativaa ja yrityksillä ei ole resursseja hallita sitä itse. Terveydenhuolto/ lääkesektorilla yrityksillä on yleensä muut keinot jakeluketjun hallintaan ja ne eivät tarvitse logistiikkaintegraattorin palveluita.

Les composantes du risque : une entrée par les acteurs et le conflit lors de la mise en place des solutions : le cas de Los Chorros, Guatemala

Ce travail présente une étude de cas post-catastrophe à San Cristobal, Guatemala, où un important glissement de terrain du nom «Los Chorros» (8-10 millions de m3 de roche) affecte depuis 2009 diverses communautés et une des routes principales du pays. Les gestionnaires des risques, sur la base de leur propre évaluation, ont décidé de répondre d'une manière qui ne correspond pas aux intérêts de la population affectée. Les communautés locales ont évalué le risque de catastrophe et ont établi une autre solution suivant une conception du risque différente. Les conflits sociaux et la concurrence entre les différents acteurs du territoire, pour la définition des priorités et des solutions, révèlent les aspects sous-jacents de la société, utiles pour identifier et comprendre ce qui constitue le risque de catastrophe dans un contexte donné. Ce conflit montre que le risque de catastrophe n'est pas univoque mais un concept complexe, constitué par un grand nombre de composants. En termes de gouvernance, il met également en évidence la confrontation des savoirs et la tension qui peut exister entre les différentes approches du risque. Depuis une approche où le risque de catastrophe est considéré comme une construction sociale (les vulnérabilités étant historiquement générées par des processus sociaux, politiques, économiques et culturels), ce travail évalue d'autres modes d'interprétation, de traitement et d'intervention qui peuvent aider à améliorer les méthodes d'évaluation et de gestion des risques. Enfin, la proposition de gestion qui découle de l'exemple guatémaltèque invite à une autre manière de concevoir la gestion des risques en intégrant les différentes conceptions du risque et en visant une coordination stratégique entre les acteurs des politiques publiques, les échelles d'intervention, les experts en charge des différents aléas et la société civile, afin d'obtenir une solution acceptable pour tous les acteurs impliqués dans un territoire. -- This work analyses a post-disaster case study from San Cristobal, Guatemala where a large landslide named "Los Chorros (8 millions cubic meters of rock) affects several communities and one of the country's main west-east access highways. Risk managers, starting from their own assessment, decided to respond in a way that does not correspond to the interests of the afected population. Local communities assessed the risk disaster situation and establised another solution from a different conception of risk. These social conflict and competition for priorities and solutions for risk management reveal that disaster risk is not unequivocal but a complex and holistic concept, constituted by a large set of components. From a social constructivism approach, where disaster risk is considered as the results of social, political, economic and historic process, this thesis evaluates other modes of interpreting, shaping and managing risk that can help improve methods of risk assessment and management. Studying the logic of action of actors, who mobilize to establish a solution, enables to identify as to what constitutes a disaster. For this reason, the study focus, in particular, on the analysis of practices (practical science) implemented by all actors in San Cristobal Altaverapaz. Finally, it puts into perspective the risk management in terms of an integrative approach for policy experts that find compromise between different conceptions of risk in order to obtain a solution acceptable to all those involved.

Modeling reaction kinetics and mass transfer in ozonation in water solutions

This dissertation is based on four articles dealing with modeling of ozonation. The literature part of this considers some models for hydrodynamics in bubble column simulation. A literature review of methods for obtaining mass transfer coefficients is presented. The methods presented to obtain mass transfer are general models and can be applied to any gas-liquid system. Ozonation reaction models and methods for obtaining stoichiometric coefficients and reaction rate coefficients for ozonation reactions are discussed in the final section of the literature part. In the first article, ozone gas-liquid mass transfer into water in a bubble column was investigated for different pH values. A more general method for estimation of mass transfer and Henry’s coefficient was developed from the Beltrán method. The ozone volumetric mass transfer coefficient and the Henry’s coefficient were determined simultaneously by parameter estimation using a nonlinear optimization method. A minor dependence of the Henry’s law constant on pH was detected at the pH range 4 - 9. In the second article, a new method using the axial dispersion model for estimation of ozone self-decomposition kinetics in a semi-batch bubble column reactor was developed. The reaction rate coefficients for literature equations of ozone decomposition and the gas phase dispersion coefficient were estimated and compared with the literature data. The reaction order in the pH range 7-10 with respect to ozone 1.12 and 0.51 the hydroxyl ion were obtained, which is in good agreement with literature. The model parameters were determined by parameter estimation using a nonlinear optimization method. Sensitivity analysis was conducted using object function method to obtain information about the reliability and identifiability of the estimated parameters. In the third article, the reaction rate coefficients and the stoichiometric coefficients in the reaction of ozone with the model component p-nitrophenol were estimated at low pH of water using nonlinear optimization. A novel method for estimation of multireaction model parameters in ozonation was developed. In this method the concentration of unknown intermediate compounds is presented as a residual COD (chemical oxygen demand) calculated from the measured COD and the theoretical COD for the known species. The decomposition rate of p-nitrophenol on the pathway producing hydroquinone was found to be about two times faster than the p-nitrophenol decomposition rate on the pathway producing 4- nitrocatechol. In the fourth article, the reaction kinetics of p-nitrophenol ozonation was studied in a bubble column at pH 2. Using the new reaction kinetic model presented in the previous article, the reaction kinetic parameters, rate coefficients, and stoichiometric coefficients as well as the mass transfer coefficient were estimated with nonlinear estimation. The decomposition rate of pnitrophenol was found to be equal both on the pathway producing hydroquinone and on the path way producing 4-nitrocathecol. Comparison of the rate coefficients with the case at initial pH 5 indicates that the p-nitrophenol degradation producing 4- nitrocathecol is more selective towards molecular ozone than the reaction producing hydroquinone. The identifiability and reliability of the estimated parameters were analyzed with the Marcov chain Monte Carlo (MCMC) method. @All rights reserved. No part of the publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the author.

Répertoire général pratique de notariat, de droit civil et fiscal et de formules d'actes : recueil périodique 1° de lois et décrets, avec commentaires ; 2° de jugements, arrêts, solutions, décisions, etc. ; 3° et de formules d'actes notariés : faisant suite au Traité-pratique et formulaire général du notariat / par A. Defrénois

1878 (T3,N2172)- (T3,N3883).

Répertoire général pratique de notariat, de droit civil et fiscal et de formules d'actes : recueil périodique 1° de lois et décrets, avec commentaires ; 2° de jugements, arrêts, solutions, décisions, etc. ; 3° et de formules d'actes notariés : faisant suite au Traité-pratique et formulaire général du notariat / par A. Defrénois

Etat de collection : retirages de 1877-1878

Répertoire général pratique de notariat, de droit civil et fiscal et de formules d'actes : recueil périodique 1° de lois et décrets, avec commentaires ; 2° de jugements, arrêts, solutions, décisions, etc. ; 3° et de formules d'actes notariés : faisant suite au Traité-pratique et formulaire général du notariat / par A. Defrénois

1877 (T2,N1073)- (T2,N2171).

Recueil de divers cas de conscience, avec leurs solutions.

Contient : « Resolutions de quelques cas touchant l'usure par Mrs Porcher et de Ste Beuve, docteurs de Sorbonne »