[Nurse practitioner: experience of implementation in primary care].

The growth and continuing evolution of care needs, linked in particular to the aging of the population and the increase in chronic illnesses, have prompted the Canton of Vaud to promote innovative care models and new professional profiles, including recognition of the role of nurse practitioner (NP). Unisanté is actively involved in promoting and integrating this new role, with the support of the canton. A postgraduate training program for primary care NPs is currently being developed, and the opening of an innovative health center has made it possible to establish this role in the primary care medical practice.

[Drugs: minors and harm reduction?].

The use of controlled substances (narcotics and psychotropic substances) poses increased risks for minors. However, minors are generally excluded from existing harm reduction services (e.g.

[Driving under the influence…].

Prescribing medicines containing controlled substances (SSC : narcotics and psychotropic substances) can have legal consequences as per the Road Traffic Act. We set forth the physician's duties as well as the risks incurred by the patient. We recommend that rules regarding SSC, which can influence the capacity or the ability to drive, be clarified.

Synchrony of biomarker variability indicates a critical transition: Application to mortality prediction in hemodialysis.

Critical transition theory suggests that complex systems should experience increased temporal variability just before abrupt state changes. We tested this hypothesis in 763 patients on long-term hemodialysis, using 11 biomarkers collected every two weeks and all-cause mortality as a proxy for critical transitions. We find that variability-measured by coefficients of variation (CVs)-increases before death for all 11 clinical biomarkers, and is strikingly synchronized across all biomarkers: the first axis of a principal component analysis on all CVs explains 49% of the variance.

The "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) Core Outcome Set: International Consensus on Outcomes to Measure in Efficacy and Effectiveness Trials of Alcohol Brief Interventions.

Objective: The purpose of this study was to report the "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs).

Method: A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560 different approaches. These outcomes were classified into outcome categories, and 150 participants from 19 countries participated in a two-round e-Delphi outcome prioritization exercise.

Capturing T Lymphocytes' Dynamic Interactions With Human Neural Cells Using Time-Lapse Microscopy.

To fully perform their functions, T lymphocytes migrate within organs' parenchyma and interact with local cells. Infiltration of T lymphocytes within the central nervous system (CNS) is associated with numerous neurodegenerative disorders. Nevertheless, how these immune cells communicate and respond to neural cells remains unresolved.

Assessing quality indicators related to mental health emergency room utilization.

Background: This descriptive study compared 2014-15 to 2005-06 data on the quality of mental health services (MHS) in relation to emergency room (ER) use to assess the impact of the 2005 Quebec MH reform regarding access, continuity and appropriateness of care for patients with mental illnesses (PMI).

Methods: Data emanated from the Quebec Integrated Chronic Disease Surveillance System (Quebec/Canada). Participants (865,255 for 2014-15; 817,395 for 2005-06) were age 12 or over, with at least one MI, including substance use disorders (SUD), diagnosed during an ER visit, outpatient treatment or hospitalization.

Clinical and paraclinical patterns of presentation, and sensitivity of diagnostic scores for pulmonary embolism at the emergencies: retrospective study on the impact of age at the University hospitals of Strasbourg (France).

Unlabelled: The diagnosis of pulmonary embolism remains difficult. The objective of this study was to analyze the effect of age on the clinical presentation mode and the sensitivity of the diagnostic scores.

Methods: In retrospect, all patients discharged with a documented diagnosis of pulmonary embolism from the adult emergency service of the Regional university hospital of Strasbourg (France) over a year were considered.

A tool for exploring the dynamics of innovative interventions for public health: the critical event card.

Objectives: Public health interventions are increasingly represented as complex systems. Research tools for capturing the dynamic of interventions processes, however, are practically non-existent. This paper describes the development and proof of concept process of an analytical tool, the critical event card (CEC), which supports the representation and analysis of complex interventions' evolution, based on critical events.

Isolated bilateral transverse agenesis of the distal segments of the lower limbs at the level of the knee joint in a human fetus.

Congenital limb anomalies occur in Europe with a prevalence of 3.81/1,000 births and can have a major impact on patients and their families. The present study concerned a female fetus aborted at 23 weeks of gestation because she was affected by non-syndromic bilateral absence of the zeugopod (leg) and autopod (foot).

[Ethical and social issues associated with genomic medicine].

Genomic medicine is often presented as a new paradigm for personalized healthcare. Encompassing both a translational approach in research and a vision of future medical practice, genomic medicine may have important impact on the way healthcare professionals diagnostics, treat and prevent diseases. We discuss some ethical and social issues raised by the prospect of genome-based medical practice, namely: changing definitions of disease and identity, assessment of clinical validity and utility of genome screening, mastery of genomic information by healthcare professionals and its communication to patients, and questions related to the costs of genomic medicine for future healthcare.

The cultivation of wild food and medicinal plants for improving community livelihood: The case of the Buhozi site, DR Congo.

This study aims to demonstrate the effect of farming technology on introducing medicinal plants (MP) and wild food plants (WFP) into a traditional agricultural system within peri-urban zones. Field investigations and semi-structured focus group interviews conducted in the Buhozi community showed that 27 health and nutrition problems dominated in the community, and could be treated with 86 domestic plant species. The selected domestic MP and WFP species were collected in the broad neighboring areas of the Buhozi site, and introduced to the experimental field of beans and maize crops in Buhozi.

[The spirit of community medicine: students learning from students].

At the University of Lausanne third-year medical students are given the task of spending a month investigating a question of community medicine. In 2009, four students evaluated the legitimacy of health insurers intervening in the management of depression. They found that health insurers put pressure on public authorities during the development of legislation governing the health system and reimbursement for treatment.

[Addiction: are women and men equal?].

When illicit drugs are taken, men and women have a different biological response to drug used. Likewise, gender differences show more stigmas, more complex familial environment, and more history of sexual abuse for drug addicted women. The expression of psychiatric co-morbidities differs according to gender, with increased mood disorders, eating disorders, anxiety, and post traumatic disorders among drug addicted women.

[Population health profile at the age of 65-70].

Despite the promise of a large number of baby-boomers soon reaching the age of 65, little is known regarding the population health in the 65-70 years age group. Baseline data from the Lausanne cohort Lc65+, representative of the community-dwelling population born before the first world war, indicate that most individuals aged 65-70 have medical diagnoses of chronic diseases; many present comorbidities and geriatric syndromes are already present in a sizable proportion. However, the prevalence of dependence in basic activities of daily living is still low.

[A brief motivational intervention targeting multi-risk behaviours among young people].

Teenagers and young adults often combine alcohol, tobacco, cannabis or other drugs use and related hazardous behaviours. This article presents a brief motivational intervention (BMI) targeting multiple substance use and related behaviours. The values and projects that can enter into conflict with the substance use are discussed in order to introduce a change perspective.

[Controlled drinking for alcohol-dependent patients].

Controlled drinking should be included in the treatment of alcohol-dependent patients. Research has showed that treatment plans which allow controlled drinking as a possible outcome yield better results in the long run than those in which abstinence is imposed. Controlled drinking can be a goal in itself, a step towards abstinence or a way of limiting alcohol-related problems.