Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records.

INTRODUCTION: This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec's remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders. METHODS: Quality indicators were identified from evidence and case studies were reconstructed using data collected in health records over a 2-year observation period. Data collection was developed using a three-step iterative process: (1) feasibility analysis, (2) development of a data collection tool, and (3) application of the data collection method. The adaptation of quality-of-care indicators to remote regions was appraised according to their relevance, measurability and construct validity in this context. RESULTS: As a result of this process, 18 quality indicators were shown to be relevant, measurable and valid for establishing a critical quality appraisal of four recommended dimensions of PHC clinical processes: recognition, assessment, treatment and follow-up. CONCLUSIONS: There is not only an interest in the use of health records to assess the quality of PHC for mental health in remote regions but also a scientific value for the rigorous and meticulous methodological approach developed in this study. From the perspective of stakeholders in the PHC system of care in remote areas, quality indicators are credible and provide potential for transferability to other contexts. This study brings information that has the potential to identify gaps in and implement solutions adapted to the context.

Traducció del testament de Charles Robert Darwin

L’objectiu principal d’aquest treball és assumir el que podria ser un encàrrec real d’un text jurídic. Així que, en aquest treball es tradueix un testament. Els testaments són documents a través dels quals una persona disposa els seus béns per tal que després de la seva mort una altra se’n faci càrrec. El testament escollit ha estat el de Charles Robert Darwin, que va morir el 19 d’abril de 1882 a Down, en el comptat de Kent, Anglaterra, on hi visqué 40 anys, des del 1842 fins la seva mort. Aquest testament té unes particularitats concretes, ja que fa uns 190 anys que es va firmar. El dret successori anglès, regit per la Llei de successions de protecció de la família i tuïció de 1975 és molt diferent del dret successori català. Així doncs, coneixerem les diferències entre el dret successori català i l’anglès. També, veurem tots passos que han estat necessaris per portar a terme aquest treball.

Understanding oceanic migrations with intrinsic biogeochemical markers

Migratory marine vertebrates move annually across remote oceanic water masses crossing international borders. Many anthropogenic threats such as overfishing, bycatch, pollution or global warming put millions of marine migrants at risk especially during their long-distance movements. Therefore, precise knowledge about these migratory movements to understand where and when these animals are more exposed to human impacts is vital for addressing marine conservation issues. Because electronic tracking devices suffer from several constraints, mainly logistical and financial, there is emerging interest in finding appropriate intrinsic markers, such as the chemical composition of inert tissues, to study long-distance migrations and identify wintering sites. Here, using tracked pelagic seabirds and some of their own feathers which were known to be grown at different places and times within the annual cycle, we proved the value of biogeochemical analyses of inert tissue as tracers of marine movements and habitat use. Analyses of feathers grown in summer showed that both stable isotope signatures and element concentrations can signal the origin of breeding birds feeding in distinct water masses. However, only stable isotopes signalled water masses used during winter because elements mainly accumulated during the long breeding period are incorporated into feathers grown in both summer and winter. Our findings shed new light on the simple and effective assignment of marine organisms to distinct oceanic areas, providing new opportunities to study unknown migration patterns of secretive species, including in relation to human-induced mortality on specific populations in the marine environment.

Optimization of OSEM parameters in myocardial perfusion imaging reconstruction as a function of body mass index: a clinical approach

AbstractObjective:The present study is aimed at contributing to identify the most appropriate OSEM parameters to generate myocardial perfusion imaging reconstructions with the best diagnostic quality, correlating them with patients' body mass index.Materials and Methods:The present study included 28 adult patients submitted to myocardial perfusion imaging in a public hospital. The OSEM method was utilized in the images reconstruction with six different combinations of iterations and subsets numbers. The images were analyzed by nuclear cardiology specialists taking their diagnostic value into consideration and indicating the most appropriate images in terms of diagnostic quality.Results:An overall scoring analysis demonstrated that the combination of four iterations and four subsets has generated the most appropriate images in terms of diagnostic quality for all the classes of body mass index; however, the role played by the combination of six iterations and four subsets is highlighted in relation to the higher body mass index classes.Conclusion:The use of optimized parameters seems to play a relevant role in the generation of images with better diagnostic quality, ensuring the diagnosis and consequential appropriate and effective treatment for the patient.

Shared feature extraction for nearest neighbor face recognition

In this paper, we propose a new supervised linearfeature extraction technique for multiclass classification problemsthat is specially suited to the nearest neighbor classifier (NN).The problem of finding the optimal linear projection matrix isdefined as a classification problem and the Adaboost algorithmis used to compute it in an iterative way. This strategy allowsthe introduction of a multitask learning (MTL) criterion in themethod and results in a solution that makes no assumptions aboutthe data distribution and that is specially appropriated to solvethe small sample size problem. The performance of the methodis illustrated by an application to the face recognition problem.The experiments show that the representation obtained followingthe multitask approach improves the classic feature extractionalgorithms when using the NN classifier, especially when we havea few examples from each class