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  • Health risk behaviors and morbidity among hospital staff - comparison across hospital ward medical specialties in a study of 21 Finnish hospitals
    Health risk behaviors and morbidity among hospital staff - comparison across hospital ward medical specialties in a study of 21 Finnish hospitals

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    From:ProQuest LLC

    Document Overview:
    This study examined whether indicators of poor health and health risk behaviors among hospital staff differ between the ward specialties.Across 21 hospitals in Finland, 8003 employees (mean age 42 years, 87% women, 86% nurses) working in internal medicine, surgery, obstetrics and gynecology, pediatrics, intensive care, and psychiatry responded to a baseline survey on health and health risk behaviors (response rate 70%). Responses were linked to records of sickness absence and medication over the following 12 months.Psychiatric staff had higher odds of smoking [odds ratio (OR) 2.58, 95% confidence interval (95% CI) 2.14-3.12], high alcohol use (OR 1.55, 95% CI 1.21-1.99), physical inactivity (OR 1.30, 95% CI 1.11-1.53), chronic physical disease (OR 1.19, 95% CI 1.04-1.36), current or past mental disorders (OR 1.81, 95% CI 1.50-2.17), and co-occurring poor health indicators (OR 2.65, 95% CI 2.08-3.37) as compared to those working in other specialties. They also had higher odds of sickness absence due to mental disorders (OR 1.40, 95% CI 1.02-1.92) and depression (OR 1.61, 95% CI 1.02-2.55) at follow-up after adjustment for baseline health and covariates. Personnel in surgery had the lowest probability of morbidity. No major differences between specialties were found in the use of psychotropic medication.The prevalence of hospital employees with an adverse health risk profile is higher in psychiatric wards than other specialties.
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  • Un regard systmique : une vidence pour le mdecin gnraliste
    Un regard systmique : une vidence pour le mdecin gnraliste

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    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • Thrapeute de famille... intervenante en milieu scolaire : une fraternit obscure
    Thrapeute de famille... intervenante en milieu scolaire : une fraternit obscure

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    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • Studying the effect of the psychosocial work environment on risk of ill-health: towards a more comprehensive assessment of working conditions
    Studying the effect of the psychosocial work environment on risk of ill-health: towards a more comprehensive assessment of working conditions

    $6.95

    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • La conversation intrieure du thrapeute et les mtaphores : exercice de formation
    La conversation intrieure du thrapeute et les mtaphores : exercice de formation

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    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • Le jeu trilogique de Lausanne* et son application dans des situations de consultance
    Le jeu trilogique de Lausanne* et son application dans des situations de consultance

    $6.95

    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • Supervision au salon : Une superviseuse hors du commun
    Supervision au salon : Une superviseuse hors du commun

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    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • Les articles
    Les articles

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    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • La tisserande
    La tisserande

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    $6.95

    From:ProQuest LLC

    Document Overview:
    A global leader in serving libraries of all types, ProQuest LLC (“ProQuest”) supports the breadth of the information community with innovative discovery solutions that power the business of books and the best in research experience. More than a content provider or aggregator, ProQuest is an information partner, creating indispensable research solutions that connect people and information. Through innovative, user-centered discovery technology, ProQuest offers billions of pages of global content that includes historical newspapers, dissertations, and uniquely relevant resources for researchers of any age and sophistication—including content not likely to be digitized by others.
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  • Substantial Changes in Prescription Recommendations for Bipolar Disorder in Canada: 2002-2010
    Substantial Changes in Prescription Recommendations for Bipolar Disorder in Canada: 2002-2010

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    From:ProQuest LLC

    Document Overview:
    We examined trends in prescription recommendations for treatment of bipolar disorder (BD) in Canada during 2002-2010. Data collected by IMS Brogan in a database known as the Canadian Disease and Therapeutic Index were used for this analysis. These data are collected from a representative physician panel who record each drug recommendation and reason for recommendation in their practices for 2 consecutive days each calendar quarter of the year. Prescription patterns of medications for BD, including lithium, anticonvulsants, antipsychotic agents, anxiolytics, and antidepressants, were evaluated both for general practitioners and for specialists. The number of prescription recommendations for BD increased by 72.1% from 2002 to 2009, and then dropped by 24.8% from 2009 to 2010. This increase from 2002 to 2009, and subsequent decrease from 2009 to 2010, was observed for all classes of medications. The overall increase from 2002 to 2010 was statistically significant for the atypical antipsychotics (P = 0.04). The largest change for an individual drug during this period was a 438% increase in recommendations for quetiapine (P = 0.01). The number of prescription recommendations for BD increased substantially from 2002 to 2009 and sharply dropped in the following year. These results suggest that the influence of the concept of the bipolar spectrum and its promotion may have resulted in a substantial increase in treatment that has recently begun to wane.
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  • The Enablers and Barriers to the Use of Direct Observation of Trainee Clinical Skills by Supervising Faculty in a Psychiatry Residency Program
    The Enablers and Barriers to the Use of Direct Observation of Trainee Clinical Skills by Supervising Faculty in a Psychiatry Residency Program

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    From:ProQuest LLC

    Document Overview:
    Studies have reported that medical trainees do not get sufficient direct observation. Our study aimed to determine the frequency of direct observation and the enablers and barriers to direct observation in the department of psychiatry at a large Canadian university. Focus groups and interviews explored the role and use of direct observation, followed by a survey both of faculty and of residents. Direct observation was used in various contexts in the residents' last rotation. Missed opportunities are identified. Enablers include financial compensation, guidelines, and a discussion at the beginning of each clinical rotation. Barriers are identified at the resident, faculty, and administrative levels. Direct observation is used in many contexts in psychiatric training. While there are barriers which limit its use, our data indicate numerous potential enablers and missed opportunities for more observation.
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  • La consommation d'alcool et de drogue des tudiants suite la fusillade de Dawson : une analyse diffrencie selon le sexe
    La consommation d'alcool et de drogue des tudiants suite la fusillade de Dawson : une analyse diffrencie selon le sexe

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    From:ProQuest LLC

    Document Overview:
    Les analyses statistiques de calculs de frquences, de corrlations et de rgressions logistiques et multiples ont t ralises grce au logiciel SPSS version 14,0 pour Windows, avec niveau de significativit retenu de 0,05. Seuls les troubles anxieux et dpressifs, la dpendance l'alcool ou aux drogues, ainsi que les caractristiques sociodmographiques ont t conservs aux fins de cette tude.\n D'un point de vue thorique, ces rsultats portent croire que l'automdication des symptmes d'ESPT est une explication plausible des comportements de consommation d'alcool suite la fusillade.
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  • Suicidal Behaviours in Affective Disorders: A Deficit of Cognitive Inhibition?
    Suicidal Behaviours in Affective Disorders: A Deficit of Cognitive Inhibition?

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    From:ProQuest LLC

    Document Overview:
    Suicide has been related to affective disorders. We hypothesized that suicide could be associated with cognitive inhibition deficit. Our study aimed to systematically review all published articles that examined the relation between cognitive inhibition deficit and suicidal behaviours (that is, suicide attempt or suicidal ideation) in patients with affective disorders. We performed an English and French MEDLINE and EMBASE search, ranging from 1970 to 2010, indexed under the MeSH terms of suicide, neuropsychology, neuropsychological tests, and executive function, combined with the following title and abstract terms: neuropsychological functions, executive functioning, and executive performance. Among the 164 selected studies, 9 observational studies met the selection criteria and were included in the final analysis. The number of participants ranged from 57 to 244 (28% to 66%, respectively, were men). Executive dysfunction was more frequently found among patients with suicidal behaviours. In particular, higher cognitive inhibition deficit was observed in depressed subjects with suicide behaviours, compared with depressed subjects without any suicidal behaviour. The results of the meta-analysis showed a higher impairment in inhibition score, according to the number of perseverations in the Wisconsin Card Sorting Test (Cohen d = 0.68) than in inhibition according to the time needed to perform the TrailMaking Test part B (d = 0.01) among patients with suicidal behaviour, compared with patients with no suicidal behaviour. This systematic review and meta-analysis showed a positive association between cognitive inhibition deficit and suicide attempts in patients with affective disorders. Future research should examine whether cognitive inhibition deficit precedes the suicidal behaviour.
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  • Risk Assessment Instruments in Clinical Practice
    Risk Assessment Instruments in Clinical Practice

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    From:ProQuest LLC

    Document Overview:
    To determine whether the items in one of the most widely validated instruments of violence risk assessment, the Historical-Clinical-Risk Management-20 (HCR-20), are used in review board hearings to assess the risk of violence by people found Not Criminally Responsible on account of Mental Disorder (NCRMD). This study was conducted from October 2004 to August 2006 in Quebec's sole forensic psychiatric hospital and 2 large civil psychiatric hospitals designated for the care of people declared NCRMD in the Montreal metropolitan area. The risk assessments presented by clinicians at annual review board hearings and the boards' rationale for the release or detention of people found NCRMD were contrasted with the risk assessments conducted by the research team using the HCR-20. The final sample was comprised of 96 men. Very few of the risk factors identified by prior research (HCR-20 items) were mentioned in the hearing process, whether in clinical reports, discussions during the hearing, or in the disposition justification. The findings confirm that there remains a significant gap between research evidence and risk assessment practice.
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  • A Population-Based Study of the Use of Selective Serotonin Reuptake Inhibitors Before and After Introduction of Generic Equivalents
    A Population-Based Study of the Use of Selective Serotonin Reuptake Inhibitors Before and After Introduction of Generic Equivalents

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    From:ProQuest LLC

    Document Overview:
    Generic drugs are less expensive than their branded equivalents, but receive limited promotion. This study sought to examine how user rates of individual selective serotonin reuptake inhibitors (SSRIs) changed after the introduction of their generic equivalents. Administrative health and census data were used to examine the rates of use of all 6 SSRIs from 1996 to 2009 in the province of Manitoba (population of 1.2 million). The primary outcome measure was a comparison of the rates of use in the pre- and post-generic periods, using generalized estimating equations. Secondary analyses were stratified by specialty of physician prescriber. Escalating rates of use of branded SSRIs in the pre-generic period significantly decreased after generic versions became available (all Ps 0.001). Incident use of sertraline and paroxetine continued to decrease throughout the post-generic period (1.5% and 1.9% quarterly decreasing rates, respectively). During the years when generic sertraline, fluoxetine, and fluvoxamine were available, their use declined while branded paroxetine and citalopram use continued to increase. Use of branded citalopram, sertraline, and paroxetine prescribed by general practitioners (GPs) increased at rates significantly higher than when prescribed by psychiatrists (all Ps 0.001). The introduction of cheaper generic alternatives of SSRIs paradoxically resulted in their use diminishing rather than increasing. With the exception of escitalopram, branded SSRIs tended to be preferentially used, compared with available less expensive generic SSRIs. These patterns were more pronounced for prescriptions by GPs.
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