Social inequalities of functioning and perceived health in Switzerland: a representative cross-sectional analysis.

Many people worldwide live with a disability, i.e. limitations in functioning. The prevalence is expected to increase due to demographic change and the growing importance of non-communicable disease and injury. To date, many epidemiological studies have used simple dichotomous measures of disability, even though the WHO's International Classification of Functioning, Disability, and Health (ICF) provides a multi-dimensional framework of functioning. We aimed to examine associations of socio-economic status (SES) and social integration in 3 core domains of functioning (impairment, pain, limitations in activity and participation) and perceived health. We conducted a secondary analysis of representative cross-sectional data of the Swiss Health Survey 2007 including 10,336 female and 8,424 male Swiss residents aged 15 or more. Guided by a theoretical ICF-based model, 4 mixed effects Poisson regressions were fitted in order to explain functioning and perceived health by indicators of SES and social integration. Analyses were stratified by age groups (15-30, 31-54, ≥55 years). In all age groups, SES and social integration were significantly associated with functional and perceived health. Among the functional domains, impairment and pain were closely related, and both were associated with limitations in activity and participation. SES, social integration and functioning were related to perceived health. We found pronounced social inequalities in functioning and perceived health, supporting our theoretical model. Social factors play a significant role in the experience of health, even in a wealthy country such as Switzerland. These findings await confirmation in other, particularly lower resourced settings.

Potential Impacts of Climate Change on Ecosystem Services in Europe: the Case of Pest Control by Vertebrates. BioScience.

Global environmental changes threaten ecosystems and cause significant alterations to the supply of ecosystem services that are vital for human well-being. We provide an assessment of the potential impacts of climate change on European diversity of vertebrates and their associated pest control services. We modeled the distributions of the species that provide this service using ensembles of forecasts from bioclimatic envelope models and then used their results to generate maps of potential species richness among vertebrate providers of pest control services. We assessed how potential richness of pest control providers would change according to different climate and greenhouse emissions scenarios. We found that potential richness of pest control providers was likely to face substantial reductions, especially in southern European countries that had economies highly dependent on agricultural yields. In much of central and northern Europe, where countries had their economies less dependent on agriculture, climate change was likely to benefit pest control providers

Birth weight, weight change, and blood pressure during childhood and adolescence: a school-based multiple cohort study.

OBJECTIVE: We assessed the association between birth weight, weight change, and current blood pressure (BP) across the entire age-span of childhood and adolescence in large school-based cohorts in the Seychelles, an island state in the African region. METHODS: Three cohorts were analyzed: 1004 children examined at age 5.5 and 9.1 years, 1886 children at 9.1 and 12.5, and 1575 children at 12.5 and 15.5, respectively. Birth and 1-year anthropometric data were gathered from medical files. The outcome was BP at age 5.5, 9.1, 12.5 or 15.5 years, respectively. Conditional linear regression analysis was used to estimate the relative contribution of changes in weight (expressed in z-score) during different age periods on BP. All analyses were adjusted for height. RESULTS: At all ages, current BP was strongly associated with current weight. Birth weight was not significantly associated with current BP. Upon adjustment for current weight, the association between birth weight and current BP tended to become negative. Conditional linear regression analyses indicated that changes in weight during successive age periods since birth contributed substantially to current BP at all ages. The strength of the association between weight change and current BP increased throughout successive age periods. CONCLUSION: Weight changes during any age period since birth have substantial impact on BP during childhood and adolescence, with BP being more responsive to recent than earlier weight changes.

Institutional change and the evolution of the regulatory state: evidence from the Swiss case

This article examines institutional change in a case that was expected to be particularly resilient but showed considerable structural transformation: the institutionalization of the regulatory state in Switzerland. This process is illustrated through the establishment of independent regulatory agencies (IRAs) in four areas: banking and finance; telecommunications; electricity; and competition. The theoretical framework developed by Streeck, Thelen and Mahoney is used to explore hypotheses about the modes of institutional change, with the methodology of diachronic within-case study. Results confirm only partially the expectations, pointing to layering and displacement as the prevalent modes of change. The concluding part discusses the type and the direction of change as additional explanatory factors.

Family interactions in IVF families: change over the transition to parenthood

Objective: This article presents a study of the change over time in the family interactions of couples who conceived through in-vitro fertilisation (IVF). Background: Observational methods are rarely used to study family interactions in families who used assisted reproductive techniques, but these methods are crucial for taking account of the communication that occurs in interactions with infants. Methods: Thirty-one couples expecting their first child were seen during the fifth month of pregnancy and when the child was nine months old. Family interactions were recorded in pre- and postnatal versions of the Lausanne Trilogue Play situation. Measures of marital satisfaction and parent-to-foetus/baby attachment or 'bonding' were also used to assess family relational dynamics. Results: Results showed that family alliance, marital satisfaction and parental attachment scores in the IVF sample were all similar to or higher than those in the reference sample during pregnancy. However, at nine months postnatally, the family alliance scores were lower. While marital satisfaction decreased over the period and parent-baby attachment increased, the family alliance scores were unstable, as no association was observed between the pre- and postnatal scores. In addition, neither prenatal marital satisfaction nor parent-foetus attachment predicted the postnatal family alliance. Conclusion: The change in the family alliance over the transition to parenthood appears to be specific to our IVF sample. Given that postnatal family functioning could not be predicted by prenatal family functioning, our observational data underline the importance of offering postnatal support to these families.

Soins intégrés: comment accompagner un changement de culture [Integrated care: how to support a culture change?].

The primary care center at Lausanne University Hospital trains residents to new models of integrated care. The future GPs discover new forms of collaboration with nurses, pharmacists or social workers. The collaboration model includes seeing patients together or delegating care to other providers, with the aim of improving the efficiency of a patient-centered care approach. The article includes examples of integrated care in consultation for travelers, victims of violence, pharmacist medication adherence counseling, medicosocial team work for alcohol use disorders and nurse practitioners' primary care for asylum seekers.

The future of terrestrial mammals in the Mediterranean basin under climate change.

The Mediterranean basin is considered a hotspot of biological diversity with a long history of modification of natural ecosystems by human activities, and is one of the regions that will face extensive changes in climate. For 181 terrestrial mammals (68% of all Mediterranean mammals), we used an ensemble forecasting approach to model the future (approx. 2100) potential distribution under climate change considering five climate change model outputs for two climate scenarios. Overall, a substantial number of Mediterranean mammals will be severely threatened by future climate change, particularly endemic species. Moreover, we found important changes in potential species richness owing to climate change, with some areas (e.g. montane region in central Italy) gaining species, while most of the region will be losing species (mainly Spain and North Africa). Existing protected areas (PAs) will probably be strongly influenced by climate change, with most PAs in Africa, the Middle East and Spain losing a substantial number of species, and those PAs gaining species (e.g. central Italy and southern France) will experience a substantial shift in species composition.

Owl melanin-based plumage redness is more frequent near than away from the equator: implications on the effect of climate change on biodiversity

Climate change acts as a major new selective agent on many organisms, particularly at high latitudes where climate change is more pronounced than at lower latitudes. Studies are required to predict which species are at a high risk of extinction and whether certain phenotypes may be more affected by climate change than others. The identification of susceptible phenotypes is important for evaluating the potential negative effect of climate change on biodiversity at the inter- and intraspecific levels. Melanin-based coloration is an interesting and easily accessible candidate trait because, within certain species, reddish pheomelanin-based coloration is associated with adaptations to warm climates. However, it is unclear whether the same holds among species. We tested one prediction of this hypothesis in four owl genera (wood, scops, screech, and pygmy owls), namely that darker reddish species are more prevalent near the equator than polewards. Our comparative analysis is consistent with this prediction for the northern hemisphere, suggesting that pale reddish species may be adapted to cold climates and dark reddish species to warmer climates. Thus, climate change may have a larger negative impact on pale pheomelanic owls and favour dark pheomelanic species.

Attitude de prescription chez la femme enceinte : exemple de prise en charge d'un état dépressif

- Comment prescrire à une femme enceinte? L'attitude optimale réalise un compromis entre d'une part l'indication au traitement, et d'autre part l'importance du risque que celui-ci fait courir au foetus et à la mère. Le respect de quelques principes simples peut aider dans cette démarche: - La relative carence en connaissances dans ce domaine impose avant tout une attitude basée sur le principe de précaution. - La période (1er, 2e ou 3e trimestre) pendant laquelle le foetus sera exposé au traitement envisagé est un élément prépondérant dans la réflexion. - Le traitement de choix est celui qui, parmi les alternatives efficaces, présente le meilleur profil de sécurité pendant la grossesse selon les observations humaines disponibles. - Le rapport bénéfice/risque pour la patiente et le foetus peut s'inverser pendant la grossesse. - Toute exposition médicamenteuse problématique pendant la grossesse doit faire l'objet d'une annonce à l'un des centres suisse de pharmacovigilance. Ces données de tératovigilance sont indispensables pour alimenter les connaissances dans ce domaine. - Afin d'illustrer ces principes généraux, un exemple typique de prescription chez la femme enceinte a été choisi, mettant l'accent sur un problème de tératovigilance récemment identifié: les risques liés à certains antidépresseurs durant la grossesse.

Continent wide response of mountain vegetation to climate change

Climate impact studies have indicated ecological fingerprints of recent global warming across a wide range of habitats. Whereas these studies have shown responses from various local case studies, a coherent large-scale account on temperature-driven changes of biotic communities has been lacking. Here we use 867 vegetation samples above the treeline from 60 summit sites in all major European mountain systems to show that ongoing climate change gradually transforms mountain plant communities. We provide evidence that the more cold-adapted species decline and the more warm-adapted species increase, a process described here as thermophilisation. At the scale of individual mountains this general trend may not be apparent, but at the¦larger, continental scale we observed a significantly higher abundance of thermophilic species in 2008, compared with 2001. Thermophilisation of mountain plant communities mirrors the degree of recent warming and is more pronounced in areas where the temperature increase has been higher. In view of the projected climate change the observed transformation suggests a progressive decline of cold mountain habitats and their biota.

Value / personality - attitude - behavior hierarchy and its impact on individual performance in the context of market orientation

The purpose of this dissertation is to better understand how individual employees? values and personality traits influence their attitudes toward market orientation; how such attitudes impact their market-oriented behaviors; and how in turn, these behaviors lead to their superior individual performance. To investigate these relationships, an empirical study was conducted in the French speaking part of Switzerland and data were collected from a sample of service firms? employees from diverse departments and hierarchical levels. To a large extent, the results support the hypothesis of a hierarchical chain moving from value / personality to attitude to behavior to individual performance in relation to market orientation. Le sujet de cette thèse de doctorat est de mieux comprendre comment les valeurs et les traits de personnalité des employés influencent leurs attitudes envers l'orientation vers le marché ; comment ces attitudes ont un effet sur les comportements orientés vers le marché de ces employés et enfin, comment ces comportements conduisent à une meilleure performance individuelle. Afin d'étudier ces relations, une enquête a été conduite en Suisse romande et des données ont été collectées auprès d'un échantillon d'employés d'entreprises de service de différents départements et niveaux hiérarchiques. Les résultats sont concordants avec l'hypothèse d'une chaîne causale allant des valeurs / traits de personnalité aux attitudes, aux comportements et finalement à la performance individuelle dans le contexte de l'orientation vers le marché.