The transition of care from fertility specialists to obstetricians: maternal adjustment and postpartum depressive symptoms.

Aim: This study examines the transition from fertility to obstetrical care of women who conceived through IVF.

Materials & Methods: 33 women filled out questionnaires before IVF, during pregnancy and after birth on infertility stress, maternal adjustment and depressive symptoms. During pregnancy, they participated in an interview about their emotional experiences regarding the transition.

[Altruistic kidney donation: psychological challenges].

Altruistic kidney donation challenges ethical principles, questions the anthropological meaning of donation and is associated with important psychological aspects. Obtaining free and informed consent is essential and requires a depth evaluation by a psychologist or a psychiatrist in order to identify the motivations which stimulate the desire of donation. By means of a psychodynamic understanding of a clinical case, we illustrate the complexity of the evaluation of consent and discuss the psychological issues associated with altruistic kidney donation.

[Hegemonic model of autism: epistemological crossroads between medicine, family and politics].

The aim of this article is to make a contribution to the regional reflection with regard to autism spectrum disorders (ASDs) at a key moment in which the authorities are requested by the users, professionals in the fields of health, pedagogy and education to put forward a structured answer to a multitude of expressed needs. The question for the creation of a competence pole of an academic tertiary level is posed in order to advise in the best possible way the families who do not know how to orient themselves in the maze and contradictions of the proposed solutions and to help the professionals who are submerged by an ever increasing demand of services exceeding the means of the existing institutions and who cannot justify their choices among the various existing theoretical and scientific models.

[Psychiatry].

The novelties in clinical psychiatry are close to somatic medicine adaptation. The clinical staging concept in psychiatry (as in cancerology) is the result of an early intervention strategy in psychotic disorders. A differentiated mode of understanding of the phases of psychiatric disorders allows a prevention oriented approach.

[The community interpreter: a central role in the puzzle of the intercultural consultation].

As a consequence of growing global migration, physicians in French speaking Switzerland often face communicational difficulties with allophone patients. This paper first discusses advantages and shortcomings of various ways of dealing with this kind of situations. The indication of using professional interpreters will be addressed, as well as some specific therapeutic, linguistic and relational features of triadic consultations involving a physician, a patient and an interpreter.

[Psychiatry under constraint - the issue of planning in mental health care].

Given the important modifications of the "Loi sur l'Assurance maladie (LAMal)", this article gives a contribution to the hospital planification by identifying the main factors that have determined the current organisation of the psychiatric care network. We notice a gap between the orientations of these networks and the funding scheme forecast in the framework of the LAMal. In order to preserve the progressions of these last years and to avoid the negative effects of a too restrictive funding act for the assignment of the public psychiatry, the planification must result in a consensus between the state, the insurances and the multiple actors of the mental health.

[Action research and clinical governance: the example of the project "psychiatry and migrants" at the Vaudois University Medical Center].

Action research is a useful instrument for the organization health care and the clinical governance of psychiatric institutions. What this type of research offers can be illustrated by the cohort study of migrant patients without health insurance who consulted the Department of Psychiatry of the Vaudois university medical center (CHUV) in 2008. While giving greater visibilty to the psychological suffering and social distress of these patients, the study also enabled the authors to determine which clinical procedures were actually offered to these patients and the amount these procedures cost the department.

[Integration processes and clinical governance in the psychiatric network].

The Swiss Medical Insurance Act (LAMaL) requires the planning of psychiatric care. This necessitates a coordination between the Department of Public Health and the institutional governance. Given the difficulties to draw comparisons between a wide range of systems in a federal country, the Swiss Conference of the State Directors of Health (CDS) proposed as a first step that each canton present some of the key programs they had developed.

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.

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 sociodemographic and somatic 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.

[Follow-up of the cancer patient, maintaining self-identity].

The individual facing the diagnosis of cancer is subjected to abrupt changes with regard to his inner world, his life, habits and social relationships. The patient's capacity to cope, to integrate changes in the way of living and to face the future is determined by his personal resources. However, psychological support may also be an important mean to search for and find sense to the singular experience of the illness.

[Qualitative study of a social and health network's expectations for community treatment of severe mental health problems].

Unlabelled: Treatment of severe mental illness in the community is gaining interest under ethical, clinical and economical pressure, which has led to mental health reform and deinstitutionalisation. However, this can lead to conflicts between all the parties involved in the community. Several countries have initiated extensive efforts to coordinate health services to enhance quality of care without increasing costs.

[Stress in health care workers].

A growing body of evidence indicates that health care professionals are in need of support. Beside heavy clinical patient volume or administrative duties, stress related to the significance of contextual factors is an important source of clinician's distress. Identification of and working through such stress can be a durable source of support.

[Psychological support of cancer patients in the oncological consultation].

Due to its life threatening character, a cancer diagnosis represents an existential rupture, disturbing an individual's life trajectory perceived beforehand as a continuum. As a consequence, a patient's physical, psychological, social and spiritual equilibrium may be disturbed, calling for a support by clinicians, which surpasses biomedical treatment. A key element of support relies on patient-centered communication, which not only demands technical skills, but also a reflective approach on interpersonal factors which shape the relationship, on the choice and the idealized representation of the clinician's profession as well as its limits.

Achieving natural-looking morphology and surface textures in anterior ceramic fixed rehabilitations.

This article describes a procedure to achieve natural-looking morphology and surface textures in anterior ceramic restorations. The natural dentition serves as an atlas to interpret and mimic the orientation and location of dental anatomic structures. Transition angles and ridges; proximal slopes; labial grooves; the cervical, middle, and incisal thirds of the buccal surface; the lingual central concavity; and the lingual transition ridges should all be mimicked by the prosthetic work to achieve esthetic integration.

The interpreter's role with immigrant patients: contrasted points of view.

Immigration in Western societies sometimes leads to medical consultations without any shared language between physician and patient. The intervention of a third party is required in such cases. This paper details a study of the role of such a third party.

[Dynamic investigation and the question of early transference in a case of cancer patient].

Dynamic psychiatrists value the analysis of the physician-patient relationship as a crucial component of the diagnostic assessment of all cancer patients with a comorbid psychiatric disorder. Transference is a repetition. The feelings associated with figures from the past are being repeated with the psychiatrist.

[Improving communication skills is possible: "clinical" experience and scientific assessment].

While the importance of individualized and comprehensive care, taking into account the bio-psychosocial characteristics of the patient, has been demonstrated, this remains a considerable challenge in daily clinical practise. The Swiss Cancer League promotes since many years so called Communication Skills Training (CST). Different studies have demonstrated a positive impact of CST, illustrating that communicational competence is not only a consequence of a personal and professional development, but can be modified by an intensive and interactive training.