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Peer-reviewed

The PsyCoLaus study: methodology and characteristics of the sample of a population-based survey on psychiatric disorders and their association with genetic and cardiovascular risk factors.

ABSTRACT: BACKGROUND: The Psychiatric arm of the population-based CoLaus study (PsyCoLaus) is designed to: 1) establish the prevalence of threshold and subthreshold psychiatric syndromes in the 35 to 66 year-old population of the city of Lausanne (Switzerland); 2) test the validity of postulated definitions for subthreshold mood and anxiety syndromes; 3) determine the associations between psychiatric disorders, personality traits and cardiovascular diseases (CVD), 4) identify genetic variants that can modify the risk for psychiatric disorders and determine whether genetic risk factors are shared between psychiatric disorders and CVD. This paper presents the method as well as somatic and sociodemographic characteristics of the sample. METHODS: All 35 to 66 year-old persons previously selected for the population-based CoLaus survey on risk factors for CVD were asked to participate in a substudy assessing psychiatric conditions. This investigation included the Diagnostic Interview for Genetic Studies to elicit diagnostic criteria for threshold disorders according to DSM-IV and algorithmically defined subthreshold syndromes. Complementary information was gathered on potential risk and protective factors for psychiatric disorders, migraine and on the morbidity of first-degree family members, whereas the collection of DNA and plasma samples was part of the original somatic study (CoLaus). RESULTS: A total of 3,691 individuals completed the psychiatric evaluation (67% participation). The gender distribution of the sample did not differ significantly from that of the general population in the same age range. Although the youngest 5-year band of the cohort was underrepresented and the oldest 5-year band overrepresented, participants of PsyCoLaus and individuals who refused to participate revealed comparable scores on the General Health Questionnaire, a self-rating instrument completed at the somatic exam. CONCLUSIONS: Despite limitations resulting from the relatively low participation in the context of a comprehensive and time-consuming investigation, the PsyCoLaus study should significantly contribute to the current understanding of psychiatric disorders and comorbid somatic conditions by: 1) establishing the clinical relevance of specific psychiatric syndromes below the DSM-IV threshold; 2) determining comorbidity between risk factors for CVD and psychiatric disorders; 3) assessing genetic variants associated with common psychiatric disorders and 4) identifying DNA markers shared between CVD and psychiatric disorders.

Handbook for the design of intercultural policies: summary of the original Spanish version

Local governments need minimum common criteria to manage the social dynamics of diversity. This Handbook defends the strategy of interculturality as a public political approach, based on a way to interpret interculturality as a positive resource, as a public cultural and a collective good. It is an approach that promotes the equitative interaction as a way to generate a cohesive common public space. This Handbook provides the reader with the conceptual and practical instruments to help (and inspire) those territories which would like to integrate interculturality as an urban project.It aims to serve as a ground for discussion to jointly work in local administrations and other government levels, fororganizations and institutions, as well as for cultural, political and citizens collectives. Results are presented asan action by the Red de Ciudades Interculturales (RECI), within the Intercultural Cities framework by the Councilof Europe, with the collaboration of Obra Social "La Caixa".

Training needs in adolescent medicine of practising doctors: a Swiss national survey of six disciplines.

OBJECTIVE: To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. DESIGN: Cross-sectional postal survey. SETTING: Switzerland. PARTICIPANTS: National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. MAIN OUTCOME MEASURES: Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. RESULTS: A total of 1367 questionnaires were returned, representing a response rate of 73.9%. Clear interest in adolescent medicine was reported by 62.1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71.4%), acne (67.1%), obesity (64.6%), depression-anxiety (68.1%) and communication with adolescents (61.7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62.4%), eating disorders (56.3%), depression-anxiety (53.7%) and obesity (52.6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. CONCLUSIONS: Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).

Competitiveness Survey of a Biofuel Power Plant

Työn tarkoituksena on tarkastella Euroopan siirtymätalousalueelta kotimaisen biopoltto-ainevoimalaitoksen kilpailukykyä potentiaalisimmiksi markkinakohteiksi arvioitujen nykyisten Eu-valtioiden osalta. Työ tehdään osana kokoluokaltaan 3,5 MWth/1,0 MWe pienvoimalaitoksen tuotekehityshanketta, joka on käynnistynyt Varkaudessa tämän vuoden maaliskuussa. Potentiaalisimpien siirtymätalousmaiden valintakriteereinä on käytetty aiempia tutkimuksia ja raportteja. Huomio keskitetään kiinteän biopolttoaineen resursseihin ja biopolttoaineisiin pohjautuvalle energiantuotannolle asetettuihin tavoitteisiin. Edellä mainittujen kriteerien pohjalta tarkasteltaviksi valittujen valtioiden osalta tehtiin tarkemmat kilpailukykyanalyysit, otettiin yhteyttä markkina-alueeltaalan ammattilaisiin ja kartoitettiin potentiaalisimmat markkinakohteet. Tavoitteena on arvioida varteenotettavin kilpailija kiinteisiin biopolttoaineisiin pohjautuvalle sähkön ja lämmön yhteistuotannolle, jonka perusteella laaditaan mallivoimalaitoksen kilpailukykyisen hinnan määrittämiseksi tiettyyn takaisinmaksuaikaan ja korkotekijään perustuen. Lopulta tehdään maakohtaisesti yhteenveto merkittävimmistä markkinapotentiaaliin vaikuttavista kilpailutekijöistä, arvioidaan potentiaalisin kohdemaa sekä esitetään mahdollinen investoinnin rahoitusvaihtoehto ja keinoja markkinoida tuotetta potentiaalisille asiakkaille.

Análisis de necesidades en formación intercultural en la Administración Pública

The multicultural nature of our society requests new professional requirements at the Public Administration. There are news users that present specifics needs and conditions provoked by the legal situation and cultural origin. The research has two aims: 1) The assessment of Intercultural Competencies of the public employees of el Servicio de Empleo de Cataluña and 2) The design of a training program for the development of this competencies. The scope where are more needed this competencies are the capacity to solve intercultural problems, the intercultural communication, the knowledge of cultures and the migratory phenomena, and the role played by thestereotypes and the bias

Coping with an HIV infection. A multicenter qualitative survey on HIV positive adolescents' perceptions of their disease, therapeutic adherence and treatment.

HIV-positive adolescents face a number of challenges in dealing with their disease and its treatment. In this qualitative study, twenty-nine HIV-positive adolescents aged 13 to 20 years (22 girls), who live in Switzerland, were asked, in a semi-structured interview (duration of 40-110 minutes), to describe their perceptions and experiences with the disease itself and with therapeutic adherence. While younger adolescents most often thought of their disease as fate, older adolescents usually knew that they had received it through vertical transmission, although the topic appeared to be particularly difficult to discuss for those living with their HIV-positive mothers. Based on their attending physician's assessment, 18 subjects were judged highly adherent, 4 fairly and 7 poorly adherent. High adherence appeared linked with adequate psychological adjustment and effective coping mechanisms, as well as with the discussion and adoption of explicit medication-taking strategies. The setting and organisation of health care teams should allow for ongoing discussions with HIV-positive adolescents that focus on their perceptions of their disease, how they cope with it and with the treatment, and how they could improve their adherence.

Intercultural Competence of Masters of Science in Business Administration and in Technology

Tutkielman tavoitteena on selvittää minkälaista kulttuurienvälistä kompetenssia Lappeenrannan teknillisestä yliopistosta vastavalmistuneilla kauppatieteenmaistereilla sekä diplomi-insinööreillä tulisi olla työnantajien näkökulmasta. Tutkimuksen tarkoituksena on myös tarkastella, että voidaanko kaikkia Lappeenrannan teknillisestä yliopistosta valmistuvia kutsua Kansainvälisiksi Huippuosaajiksi sekä kuinka Lappeenrannan teknillinen yliopisto voisi parantaa vastavalmistuvien kulttuurienvälistä kompetenssia. Teoreettinen osa tarkastelee kulttuurienvälisen kommunikaation tärkeimpiä elementtejä, kulttuurienvälistä kompetenssia ja vastavalmistuneiden kauppatieteenmaistereiden sekä diplomi-insinöörien tarvitsemaa ammatillista osaamista. Empiria koostuu kymmenen työnantajien teemahaastattelun tuloksista. Lopuksi johtopäätöksissä empirian tuloksia verrataan teorian löydöksiin. Tulokset osoittavat että kulttuurienvälinen kompetenssi koostuu kolmesta dimensiosta: henkilökohtaisista ominaisuuksista, tiedosta ja kommunikointikyvystä. Henkilökohtaisiin ominaisuuksiin sisältyvät empaattisuus, epävarmuuden sietokyky sekä avoin ja utelias asenne. Tieto - ulottuvuus koostuu yleisestä ja erityisestä kulttuuritiedosta, kielitaidosta sekä ammatillisesta osaamisesta. Kommunikointikykyyn puolestaan sisältyvät hyvät vuorovaikutustaidot. Työnantajat olettavat nykyään vastavalmistuneilla olevan ammatillisen osaamisen ja kielitaidon lisäksi, kulttuuritietoutta sekä kansainvälistä kokemusta. Lappeenrannan teknillinen yliopisto voisi parantaa vastavalmistuneiden kulttuurienvälistä kompetenssia tarjoamalla kulttuurienvälisen kommunikaation opetusta.

Survey of management of first-ever seizures in a hospital based community

Résumé Contexte: Bon nombre d'études épidémiologiques concernant les premières crises comitiales ont été effectuées principalement sur des populations générales. Cependant, les patients admis dans un hôpital peuvent présenter des éléments cliniques différents. Nous avons donc mené une étude prospective auprès de sujets dans une population hospitalière ayant subi une première crise d'épilepsie, afin d'étudier leur pronostic et le rôle des examens complémentaires (examen neurologique, imagerie cérébrale, examens sanguins, EEG) dans le choix de l'administration d'une médication antiépileptique. Méthodes : Sur une période d'une année, nous avons suivi 177 patients adultes, admis consécutivement, ayant présenté une crise d'épilepsie dont l'évaluation aiguë a été effectuée dans notre hôpital. Pendant 6 mois, nous avons pratiqué pour chaque patient un suivi du traitement antiépileptique, des récidives de crises et d'un éventuel décès. Résultats : L'examen neurologique était anormal dans 72.3% des cas, l'imagerie cérébrale dans 54.8% et les examens sanguins dans 57.1%. L'EEG a montré des éléments épileptiformes dans 33.9% des cas. L'étiologie la plus fréquemment représentée était constituée par des intoxications. Un traitement antiépileptique a été prescrit chez 51% des patients. 31.6% des sujets suivis à six mois ont subi une récidive ; la mortalité s'est élevée à 17.8%. Statistiquement, l'imagerie cérébrale, l'EEG et l'examen neurologique étaient des facteurs prédictifs indépendants pour l'administration d'antiépileptiques, et l'imagerie cérébrale le seul facteur associé au pronostic. Conclusions : Les patients évalués en aigu dans un hôpital pour une première crise comitiale présentent un profil médical sous-jacent, qui explique probablement leur mauvais pronostic. L'imagerie cérébrale s'est avérée être le test paraclinique le plus important dans la prévention du traitement et du pronostic. Mots-clés : première crise d'épilepsie, étiologie, pronostic, récidive, médication antiépileptique, population hospitalière Summary Background: Epidemiological studies focusing on first-ever seizures have been carried out mainly on community based populations. However, since hospital populations may display varying clinical features, we prospectively analysed patients with first-ever seizure in a hospital based community to evaluate prognosis and the role of complementary investigations in the decision to administer antiepileptic drugs (AED). Methods: Over one year, we recruited 177 consecutive adult patients with a first seizure acutely evaluated in our hospital. During six months' follow-up data relating to AED treatment, recurrence of seizures and death were collected for each patient. Results:. Neurological examination was abnormal in 72.3%, neuroimaging in 54.8% and biochemical tests in 57.1%. Electroencephalogram (EEG) showed epileptiform features in 33.9%. Toxicity represented the most common aetiology. AED was prescribed in 51% of patients. Seizure recurrence at six months involved 31.6% of patients completing the follow-up; mortality was 17.8%. Statistical analysis showed that brain CT, EEG and neurological examination are independent predictive factors for AED administration, but only CT scan is associated with outcome. Conclusions: Patients evaluated acutely for first- ever seizure in a hospital setting have severe underlying clinical conditions apparently related to their relatively poor prognosis. Neuroimaging represents the most important paraclinical test in predicting both treatment administration and outcome.

Mediació intercultural i institucions escolars: l'exemple del Quebec

L’increment de la multiplicitat cultural ha comportat que, en diversos països, s’elaborin diferents actuacions per aproximar posicions i millorar la comunicació entre progenitors i professionals de les institucions escolars, així com per facilitar l’adaptació del currículum a la diversitat cultural. Una de les opcions preses, amb cert èxit però no exempta d’errors,és la dels anomenats «mediadors interculturals». Una societat on aquesta figura, amb els noms d’agents de liaison i de milieu, s’ha desenvolupat és el Quebec. L’estudi dels seus encerts i limitacions, específicament a les institucions escolars, creiem que pot ser un referent a partir del qual cal reflexionar, atès el notable increment d’aquesta pràctica a Catalunya.

La figura del mediador intercultural a les institucions escolars catalanes: perfil real i ideal segons els propis actors

A Catalunya, en els darrers anys, han anat proliferant una sèrie de «professionals» que realitzen, amb més o menys adequació a la definició teòrica, la funció de mediadors inter-culturals. Primerament, es tractava de gitanos, però darrerament, fruit de l’increment de la presència d’infants d’origen immigrant a les escoles catalanes, s’ha vist créixer el nombre i el protagonisme dels estrangers pel reconeixement que se’ls ha donat des de l’Administració i des de les institucions. Els mediadors han intentat intervenir en qüestions com ara la participació dels pares d’origen minoritari, l’adaptació del currículum a la diversitat cultural, la negociació de conflictes culturals, la desescolarització, l’absentisme i l’abandonament escolar dels alumnes durant el període d’escolarització obligatòria, la traducció lingüística i la interpretació sociocultural, etc. Concretament, la nostra recerca ha consistit en vint-i-set entrevistes en profunditat a mediadors interculturals de tot Catalunya.