La participation des consommateurs à la construction de l'autorité des normes internationales : vers une économie politique internationale de la traduction

Cette thèse explore les implications politiques de la montée en puissance des normes internationales sur nos sociétés contemporaines et pose la problématique des dynamiques participatives des représentants des consommateurs au sein des formes de pouvoir non étatique à l'aide du cas de l'Organisation internationale de normalisation (ISO). Le renforcement du pouvoir des normes internationales et autres spécifications techniques soulève d'importants enjeux démocratiques qui portent aussi bien sur la représentativité des acteurs qui les élaborent, sur l'articulation des prérogatives publiques et privées dans la gouvernance de la mondialisation, que sur le rôle de l'expertise dans la reconnaissance de ces nouvelles formes de pouvoir. La participation du monde associatif intervient sur ces différents enjeux de manière complexe. Cette recherche s'inscrit à la suite des études en relations internationales/économie politique internationale sur les formes d'autorité non étatique et s'inspire du concept de traduction issu de la sociologie des sciences et techniques pour mettre en lumière le rôle des spécifications techniques dans la construction d'une société de consommation centrée sur la liberté de choix et la façon dont les associations de consommateurs se saisissent des arènes de normalisation pour y faire valoir des préoccupations collectives, leur expertise et leur identité. Cette thèse défend l'idée que les consommateurs participent à la construction de l'autorité des normes internationales par leur rôle dans la traduction qui permet de relier les spécifications techniques au fonctionnement des marchés, au cadre réglementaire de la loi et aux préoccupations sociétales. L'analyse repose sur une observation ethnographique des délibérations d'un comité technique de l'ISO, une recherche-­‐action, la réalisation d'entretiens et la consultation de documents d'archives de l'ISO. -- This thesis explores the political significance of the rise of international standards on contemporary societies and questions the participatory dynamics of consumers' representatives within nonstate forms of power, using the case of the International organization for standardization (ISO). The power granted to international standards and other technical specifications raises important democratic issues regarding the representativity of standard-­‐ writers, the public-­‐private relationships involved in this form of governance or the expertise sustaining the recognition of such new forms of power. The participation of civil society associations affect such issues in complex ways. This research relies on international relations/international political economy approaches of nonstate authority and takes inspiration from the concept of translation developed by science and technology studies to highlight the crucial role played by technical specifications in building a consumer society based on the freedom of choice as well as how consumers' associations take stock of standardization arenas to promote collective issues and claim their expertise and identity. This thesis argues that consumers contribute to the construction of the authority of international standards through their role in the translation that links international standards to the market society, the regulatory state as well as to societal preoccupation. The analysis is based on an ethnographic observation of deliberations within an ISO technical committee, a research-­‐action, interviews as well as on the consultation of ISO archives.

Laryngotracheal reconstruction for pediatric glotto-subglottic stenosis.

BACKGROUND: The management of pediatric laryngotracheal stenosis (LTS) can be challenging, and laryngotracheal reconstruction (LTR) with cartilage interposition grafting remains the mainstay of surgical treatment for pediatric LTS in most experienced centers. The purpose of this study was to report the results of this procedure in a center where primary cricotracheal resection is frequently performed. METHODS: A retrospective chart review was performed on 45 patients who underwent LTR in our hospital between October 1997 and July 2012. Demographic characteristics and information on the preoperative status, stenosis, and operation were collected. Primary outcomes were measured as overall (ODR) and operation-specific (OSDR) decannulation rates and secondary outcomes as morbidity, mortality, and postoperative functional results. RESULTS: ODR and OSDR were 86.7% (39/45) and 66.7% (30/45), respectively. Re-stenosis was observed in 11/45 (24%) patients, all of whom were endoscopically or surgically treated. Revision surgery was performed in 10 patients, 6 for re-stenosis and 2 for peristomial tracheomalacia. Two children died of mucous obstruction of tracheostomy tube at 3 and 6 months postoperatively (4.4%). Respiratory, voice, and swallowing functions were excellent or good in 86, 75, and 84% of patients, respectively. CONCLUSIONS: LTR for pediatric LTS has high decannulation rates with acceptable morbidity and mortality in selected patients. Most LTR procedures were double-stage for lower grade subglottic stenoses associated with glottic involvement that required stenting. Careful preoperative evaluation and adequate surgical indications are extremely important to achieve high decannulation rates.

Paralysies laryngées unilatérales [Unilateral laryngeal paralysis].

Investigations, diagnosis and treatment of laryngeal paralysis depend upon history taking and examination of phonation, swallowing and of the pharyngo-larynx. In unilateral paralysis, the main symptom is dysphonia. Dysphagia lasting more than 10 days may indicate a proximal vagus nerve lesion. Voice and swallowing therapy may be undertaken. If this remains insufficient after one month, a temporary or definitive vocal fold medialisation may be considered. Paralysis is considered to be definitive if lasting for more than 12 months. A minimal of one-year follow-up is indicated in case of idiopathic paralysis.

Work Meaningfulness as a Key Enhancer of Ethical Values in Business

Despite abundant research on work meaningfulness, the link between work meaningfulness and general ethical attitude at work has not been discussed so far. In this article, we propose a theoretical framework to explain how work meaningfulness contributes to enhanced ethical behavior. We argue that by providing a way for individuals to relate work to one's personal core values and identity, work meaningfulness leads to affective commitment - the involvement of one's cognitive, emotional, and physical resources. This, in turn, leads to engagement and so facilitates the integration of one's personal values in the daily work routines, and so reduces the risk of unethical behavior. On the contrary, anomie, that is, the absence of meaning and consequently of personal involvement, will lead to lower rational commitment rather than affective commitment, and consequently to disengagement and a-morality. We conclude with implications for the management of ethical attitudes.

A temporal hierarchy for conspecific vocalization discrimination in humans.

Introduction: Discrimination of species-specific vocalizations is fundamental for survival and social interactions. Its unique behavioral relevance has encouraged the identification of circumscribed brain regions exhibiting selective responses (Belin et al., 2004), while the role of network dynamics has received less attention. Those studies that have examined the brain dynamics of vocalization discrimination leave unresolved the timing and the inter-relationship between general categorization, attention, and speech-related processes (Levy et al., 2001, 2003; Charest et al., 2009). Given these discrepancies and the presence of several confounding factors, electrical neuroimaging analyses were applied to auditory evoked-potential (AEPs) to acoustically and psychophysically controlled non-verbal human and animal vocalizations. This revealed which region(s) exhibit voice-sensitive responses and in which sequence. Methods: Subjects (N=10) performed a living vs. man-made 'oddball' auditory discrimination task, such that on a given block of trials 'target' stimuli occurred 10% of the time. Stimuli were complex, meaningful sounds of 500ms duration. There were 120 different sound files in total, 60 of which represented sounds of living objects and 60 man-made objects. The stimuli that were the focus of the present investigation were restricted to those of living objects within blocks where no response was required. These stimuli were further sorted between human non-verbal vocalizations and animal vocalizations. They were also controlled in terms of their spectrograms and formant distributions. Continuous 64-channel EEG was acquired through Neuroscan Synamps referenced to the nose, band-pass filtered 0.05-200Hz, and digitized at 1000Hz. Peri-stimulus epochs of continuous EEG (-100ms to 900ms) were visually inspected for artifacts, 40Hz low-passed filtered and baseline corrected using the pre-stimulus period . Averages were computed from each subject separately. AEPs in response to animal and human vocalizations were analyzed with respect to differences of Global Field Power (GFP) and with respect to changes of the voltage configurations at the scalp (reviewed in Murray et al., 2008). The former provides a measure of the strength of the electric field irrespective of topographic differences; the latter identifies changes in spatial configurations of the underlying sources independently of the response strength. In addition, we utilized the local auto-regressive average distributed linear inverse solution (LAURA; Grave de Peralta Menendez et al., 2001) to visualize and statistically contrast the likely underlying sources of effects identified in the preceding analysis steps. Results: We found differential activity in response to human vocalizations over three periods in the post-stimulus interval, and this response was always stronger than that to animal vocalizations. The first differential response (169-219ms) was a consequence of a modulation in strength of a common brain network localized into the right superior temporal sulcus (STS; Brodmann's Area (BA) 22) and extending into the superior temporal gyrus (STG; BA 41). A second difference (291-357ms) also followed from strength modulations of a common network with statistical differences localized to the left inferior precentral and prefrontal gyrus (BA 6/45). These two first strength modulations correlated (Spearman's rho(8)=0.770; p=0.009) indicative of functional coupling between temporally segregated stages of vocalization discrimination. A third difference (389-667ms) followed from strength and topographic modulations and was localized to the left superior frontal gyrus (BA10) although this third difference did not reach our spatial criterion of 12 continuous voxels. Conclusions: We show that voice discrimination unfolds over multiple temporal stages, involving a wide network of brain regions. The initial stages of vocalization discrimination are based on modulations in response strength within a common brain network with no evidence for a voice-selective module. The latency of this effect parallels that of face discrimination (Bentin et al., 2007), supporting the possibility that voice and face processes can mutually inform one another. Putative underlying sources (localized in the right STS; BA 22) are consistent with prior hemodynamic imaging evidence in humans (Belin et al., 2004). Our effect over the 291-357ms post-stimulus period overlaps the 'voice-specific-response' reported by Levy et al. (Levy et al., 2001) and the estimated underlying sources (left BA6/45) were in agreement with previous findings in humans (Fecteau et al., 2005). These results challenge the idea that circumscribed and selective areas subserve con-specific vocalization processing.

Swimming prevents vulnerable atherosclerotic plaque development in hypertensive 2-kidney, 1-clip mice by modulating angiotensin II type 1 receptor expression independently from hemodynamic changes.

Exercise is known to reduce cardiovascular risk. However, its role on atherosclerotic plaque stabilization is unknown. Apolipoprotein E(-/-) mice with vulnerable (2-kidney, 1-clip: angiotensin [Ang] II-dependent hypertension model) or stable atherosclerotic plaques (1-kidney, 1-clip: Ang II-independent hypertension model and normotensive shams) were used for experiments. Mice swam regularly for 5 weeks and were compared with sedentary controls. Exercised 2-kidney, 1-clip mice developed significantly more stable plaques (thinner fibrous cap, decreased media degeneration, layering, macrophage content, and increased smooth muscle cells) than sedentary controls. Exercise did not affect blood pressure. Conversely, swimming significantly reduced aortic Ang II type 1 receptor mRNA levels, whereas Ang II type 2 receptor expression remained unaffected. Sympathetic tone also significantly diminished in exercised 2-kidney, 1-clip mice compared with sedentary ones; renin and aldosterone levels tended to increase. Ang II type 1 downregulation was not accompanied by improved endothelial function, and no difference in balance among T-helper 1, T-helper 2, and T regulatory cells was observed between sedentary and exercised mice. These results show for the first time, in a mouse model of Ang II-mediated vulnerable plaques, that swimming prevents atherosclerosis progression and plaque vulnerability. This benefit is likely mediated by downregulating aortic Ang II type 1 receptor expression independent from any hemodynamic change. Ang II type 1 downregulation may protect the vessel wall from the Ang II proatherogenic effects. Moreover, data presented herein further emphasize the pivotal and blood pressure-independent role of Ang II in atherogenesis.

The role of microRNAs in the development of type 2 diabets

Pancreatic ß cells are highly specialized endocrine cells located within the islets of Langerhans in the pancreas. Their main role is to produce and secrete insulin, the hormone essential for the regulation of glucose homeostasis and body's metabolism. Diabetes mellitus develops when the amount of insulin released by ß cells is not sufficient to cover the metabolic demand. In type 1 diabetes (5-10% of diagnoses) insulin deficiency is caused by the autoimmune destruction of pancreatic ß cells. Type 2 diabetes (90% of diagnoses) results from a genetic predisposition and from the presence of adverse environmental conditions. The combination of these factors reduces insulin sensitivity of peripheral target tissues, causes impairment in ß-cell function and can lead to partial loss of ß cells. The development of novel therapeutic strategies for the treatment of diabetes necessitates the comprehension of the cellular processes involved in dysfunction and loss of ß cells. My thesis was focused on the involvement in the physiopathological processes leading to the development of diabetes of a class of small regulatory RNA molecules, called microRNAs (miRNAs) that post- transcriptionally regulate gene expression. Global miRNA profiling in pancreatic islets of two animal models of diabetes, the db/db mice and mice that were fed a high fat diet (HFD), characterized by obesity and insulin resistance, led us to identify two groups of miRNAs displaying expression changes under pre-diabetic and diabetic conditions. Among the miRNAs already upregulated in pre-diabetic db/db mice and HFD mice, miR- 132 was found to have beneficial effects on pancreatic ß cell function and survival. Indeed, mimicking the upregulation of miR-132 in primary pancreatic islet cells and ß-cell lines improved glucose- induced insulin secretion and favored survival of the cells upon exposure to pro-apoptotic stimuli such as palmitate and cytokines. MiR-132 was found to exert its action by enhancing the expression of MafA, a transcription factor essential for ß-cell function, survival and identity. On the other hand, up-regulation of miR-199a-5p and miR-199a-3p was detectable only in the islets of diabetic db/db mice and resulted in impaired insulin secretion and sensitization of the cells to apoptosis. MiR-199a- 5p was found to decrease insulin secretion by inducing the expression of granuphilin, a potent inhibitor of ß cell exocytosis. In contrast, miR-199a-3p was demonstrated to directly target and reduce the expression of two key ß-cell genes, mTOR and cMET, resulting in impaired ß-cell adaptation to metabolic demands and loss by apoptosis. Our findings suggest that miRNAs are important players in the onset of type 2 diabetes. MiRNA expression is adjusted in pancreatic ß cells exposed to a diabetogenic environment. These changes initially concern miRNAs responsible for adaptive processes aimed at compensating the onset of insulin resistance, but later such changes can be overlapped by modifications in the level of several additional miRNAs that favor ß-cell failure and the onset of type 2 diabetes.

A Three-Dimensional Framework to Analyse the Governance of Population Registers

In June 2006, the Swiss Parliament made two important decisions with regards to public registers' governance and individuals' identification. It adopted a new law on the harmonisation of population registers in order to simplify statistical data collection and data exchange from around 4'000 decentralized registers, and it also approved the introduction of a Unique Person Identifier (UPI). The law is rather vague about the implementation of this harmonisation and even though many projects are currently being undertaken in this domain, most of them are quite technical. We believe there is a need for analysis tools and therefore we propose a conceptual framework based on three pillars (Privacy, Identity and Governance) to analyse the requirements in terms of data management for population registers.

Production endogène de Nortestostérone chez l'homme et influence de l'activité physique et du régime alimentaire

RESUME Depuis les années 1980, les stéroïdes androgéniques anabolisants (SAA) sont restés les produits dopants les plus utilisés par les sportifs. Les propriétés principales attribuées à ces substances sont une augmentation de la masse et de la force musculaire ainsi qu'une agressivité supérieure pouvant s'avérer bénéfique lors des entraînements ou des compétitions. En plus de cette "tradition" liée à la consommation des SAA, une autre problématique est apparue dans le monde antidopage suite à la fulgurante expansion de l'utilisation des compléments alimentaires par les athlètes professionnels et amateurs. Dès la fin des années 1990, une recrudescence de cas positifs de dopage aux SAA a été attribuée à la contamination des compléments alimentaires par des composés anabolisants tels que la testostérone ou la nandrolone ou par des prohormones se situant en amont dans le métabolisme de certains SAA et conduisant à la présence, dans les urines, de traces de substances interdites par l'Agence Mondiale Antidopage (AMA). Afin de mettre en garde les autorités antidopage ainsi que les athlètes quant aux problèmes liés aux compléments alimentaires, le Laboratoire Suisse d'Analyse du Dopage (LAD) a décidé d'étudier de manière plus précise la composition d'une centaine de produits accessibles en Suisse par l'intermédiaire d'internet. Cette étude a permis de mettre en évidence un taux de non conformité des produits avoisinant les 20%, avec une contamination plus importante des produits contenant des hormones ou des prohormones. La consommation de doses journalières recommandées des produits contaminés a mené à la détection dans les urines de la présence de substances interdites par l'AMA. Ces résultats confirment ainsi que l'usage de compléments alimentaires peut s'avérer dangereuse dans le cadre de contrôles antidopage et que les effets sur l'état physique et mental des athlètes peuvent dépasser les effets désirés et être dramatiques pour la poursuite d'une carrière sportive. D'autre part, cela démontre que l'alimentation peut mener à la présence urinaire de substances proscrites telles que les métabolites de la nandrolone, la 19-norandrostéreone (19-NA) et la 19-norétiocholanolone (19-NE). Afin de démontrer un effet potentiel de l'exercice physique sur l'excrétion urinaire des métabolites de la nandrolone, une première étude clinique a été réalisée avec 34 volontaires. Deux doses orales de nandrolone marquée avec deux atomes de C13 ont été administrées aux sujets. Les urines ont été récoltées durant les 5 jours suivant les prises orales (études d'excrétion) ainsi qu'avant et après les 8 séances d'entraînements du protocole. Les analyses des études d'excrétion ont permis d'établir une variabilité intra- et inter-individuelle du métabolisme et de la pharmacocinétique de la 19-NA et de la 19-NE. En dépit de la rapide élimination urinaire des métabolites de la nandrolone C13, les analyses des échantillons prélevés avant et après les différents efforts n'ont pas révélé une influence nette de l'exercice physique sur les concentrations urinaires de la 19-NA et 19-NE. Une seconde étude clinique a été effectuée, avec la participation de 30 volontaires. Il s'agissait de déterminer si la consommation de multiples doses orales d'un décanoate de testostérone, de 19-norandrostenedione (un précurseur de la nandrolone) ou de placebo durant un mois, pouvait avoir des effets bénéfiques sur la récupération et la performance physique. En parallèle, les sujets étaient soumis à un entrainement d'endurance intense et individualisé. Divers paramètres physiologiques ont été étudiés dans le sérum et les urines afin de mettre en évidence une meilleure récupération de l'organisme. Aucun de ses paramètres n'a permis de conclure que la consommation orale de SAA est favorable pour optimaliser les capacités de récupération des athlètes. De plus, les performances physiques ont été évaluées avant et après l'entraînement et le traitement. Aucune différence significative n'a été démontrée entre les trois groupes de volontaires. L'état psychologique des volontaires a été évalué à l'aide de questionnaires (short Profile of Mood State, sPOMS) remplis à trois reprises au cours du protocole. De manière générale, l'évolution observée est une augmentation de la fatigue avec une diminution de la vigueur. Des analyses statistiques ont révélé que des prises orales de testostérone, et dans une moindre mesure de 19-norandrostenedione, ont une légère influence sur cette évolution générale en diminuant les effets de l'entrainement sur le profil psychologique. Les urines récoltées durant le protocole ont été analysées par GC/C/IRMS et GCMS afin de détecter les variations des concentrations des hormones liées au métabolisme de la testostérone. Les résultats ont démontré une variabilité interindividuelle du métabolisme de la testostérone qui implique que les critères de positivité imposés par l'AMA ne sont pas forcément valables pour tous les individus. La détection de la 19-NA et de la 19-NE, issus du métabolisme in vivo de la 19norandrostenedione, a confirmé les résultats obtenus sur la pharmacocinétique et le métabolisme de la nandrolone C13 obtenus lors de la première étude clinique. Ce travail a permis de clarifier certains points en lien avec l'abus de la nandrolone dans le sport et notamment par rapport à la consommation de compléments alimentaires. Les deux études cliniques n'ont pas véritablement apporté les réponses souhaitées aux hypothèses de départ. Cependant certains aspects intéressants en relation avec le métabolisme des SAA ont été découverts et pourront peut-être permettre à la lutte antidopage d'évoluer vers une meilleure efficacité. SUMMARY Since 1980's, anabolic androgenic steroids (AAS) are still the most used doping agents in sports. The main properties attributed to these substances are an increase of muscle mass and strength and also a higher aggressiveness that could be beneficial during trainings and competitions. In addition to this "tradition" linked to the AAS intake, another problematics has raised in the antidoping field. Indeed, nutritional supplements have been more and more used by professional and amateur athletes. Since the end of the 1990's, an outburst of positive doping cases with AAS has been attributed to nutritional supplements contaminations with anabolic compounds like testosterone or nandrolone or with prohormones located above in the metabolism of some AAS and prompting urinary traces of forbidden compounds by the World Antidoping Agency (WADA). In order to inform the antidoping authorities and the athletes about the problems linked to the nutritional supplements, the Swiss Laboratory for Doping Analyses (LAD) decided to investigate more precisely the composition of about hundred products accessible in Switzerland through different web sites. This study showed that about 20% of the products were not conformed to the composition announced by the manufacturers. The oral intake of daily recommended doses of the contaminated products revealed the presence in urines of forbidden substances by the WADA. Hence, these results confirm that the use of nutritional supplements can lead to adverse analytical findings in antidoping controls and that the effects on athletes' physical and mental state could be different from the ones desired and could be dramatic for the continuation of an athlete's career. Moreover, this demonstrates that the diet can lead to the presence in urines of proscribed substances like nandrolone metabolites, i.e. 19-norandrosterone (19-NA) and 19-noretiocholanolone (19-NE). To put forward a potential effect of physical exercise on urinary nandrolone metabolites excretion rate, a first clinical study was done with 34 volunteers. Two oral doses of nandrolone labelled with two C13 atoms were administered to the subjects. The urines were collected during the 5 days following the treatment (excretion studies) and before and after the 8 exercise sessions of the protocol. The analyses of excretion studies revealed an intra- and inter-individual variability of the metabolism and the pharmacokinetics of 19-NA and 19-NE. In spite of the rapid urinary elimination of the nandrolone C13 metabolites, the analyses of the urine samples gathered before and after efforts did not show a clear influence of physical exercise on the urinary 19-NA and 19-NE concentrations. A second clinical study was done with the participation of 30 volunteers. The main aim was to determine if multiple oral doses of testosterone undecanoate, 19-norandrostenedione (a nandrolone precursor) or placebo during one month, could have beneficial effects on recovery and physical performance. Meanwhile, the individuals had to follow an intense and personalized endurance training program. Several physiological parameters were investigated in serum and urines in order to demonstrate a better organism's recovery. None of these parameters lead to the conclusion that oral intake of AAS is useful to optimise the recovery capacities of athletes. In addition, physical performances were evaluated before and after the training and treatment month. No significant difference was shown between the three volunteers groups. The psychological state of the volunteers was assessed through questionnaires (short Profile of Mood State, sP4MS) filled three times during the protocol. The global evolution is an increase of fatigue with an decrease of vigour. Statistical analyses revealed that the oral intake of testosterone, and to a lesser extent of 19= norandrostenedione, have a small influence on this general evolution in decreasing the effect of training on the psychological profile. The urines collected during the protocol were analysed by GC/C/IRMS and GCMS to detect concentrations variations of hormones related to the testosterone metabolism. The results revealed an interindividual variability of testosterone metabolism which implies that the guidance concerning endogenous steroids prescribed by the WADA are not uniformly valid for all individuals. Detection of 19-NA and 19-NE, coming from the in vivo metabolism of 19norandrostenedione, confirmed the results previously obtained on the pharamcokinetics and metabolism of the nandrolone C13 in the first clinical study. This work allowed to clarify some aspects linked to nandrolone abuse in sports and noteworthy related to nutritional supplements intake. The two clinical studies did not really bring plain answers to the basal hypotheses but some interesting aspects in relation with AAS metabolism were put forth and would perhaps allow an evolution of a more effective fight against doping.

Partial cricotracheal resection in children weighing less than 10 kilograms.

OBJECTIVES: To assess the long-term outcome, safety, and efficacy of partial cricotracheal resection (PCTR) for subglottic stenosis in a group of children and infants weighing less than 10 kg at the time of the surgery. STUDY DESIGN: Historical cohort study. SETTING: Academic tertiary medical center. SUBJECTS AND METHODS: Thirty-six children weighing less than 10 kg at the time of the surgery were compared to a group of 65 children who weighed more than 10 kg. The Kaplan Meier method and Cox regression were carried out to detect differences in decannulation time and rates and to examine the influence of various parameters (i.e., comorbidities, type of surgery, and complications requiring revision surgery) at the time of decannulation. Evaluation of the long-term outcome was based on questionnaires assessing breathing, voice, and swallowing. RESULTS: Decannulation rate was 92 percent (33/36) for the group of children weighing less than 10 kg. No significant differences were found between the two body weight groups with respect to the aforementioned covariates. The median follow-up period was nine years (range, 1-23 yrs). Questionnaire responses revealed completely normal breathing and swallowing in 72 percent and 90 percent of the children, respectively. Seventy-one percent of the patients considered their voice to be rough or weak. CONCLUSION: PCTR in infants and children weighing less than 10 kg is a safe and efficient technique with similar long-term results when compared to results seen in older and heavier children.

Il voto ticinese sull'iniziativa 'contro l'immigrazione di massa' del 9 febbraio 2014

Riassunto Il presente studio verte sull'analisi del voto relativo all'iniziativa popolare 'contro l'immigrazione di massa' del 9 febbraio 2014. In particolare, l'analisi si concentra sul voto avvenuto nel Ticino, il cantone svizzero in cui l'iniziativa ha avuto maggiore sostegno. Lo studio si è avvalso di un'inchiesta d'opinione rappresentativa realizzata dall'Osservatorio della vita politica regionale dell'Università di Losanna presso 1.429 cittadini ticinesi nei giorni successivi allo scrutinio. Dopo una contestualizzazione del voto del 9 febbraio rispetto alla storia delle votazioni sui temi di politica estera e migratoria, l'analisi si è concentrata sulla partecipazione al voto. Il ricorso a tre modelli interpretativi (delle risorse, della competenza e della mobilitazione) ha permesso di mostrare come il voto del 9 febbraio sia caratterizzato in particolare modo dal senso del dovere, dall'interesse per la politica e dal legame di partito. L'analisi dell'orientamento di voto evidenzia l'influenza delle dimensioni economiche, politiche, identitarie, e soprattutto, alla stregua di altri voti nel passato recente di questo cantone, una forte tensione tra centro e periferia. Dall'analisi del voto del 9 febbraio emerge un forte timore che vede nel Ticino una 'doppia periferia', verso Berna e in relazione alla vicina Lombardia. Parole chiave: iniziativa popolare, partecipazione, orientamento di voto, centro-periferia. Résumé Cette étude porte sur l'analyse du vote sur l'initiative populaire 'contre l'immigration de masse' du 9 février 2014 et, plus précisément, sur le vote qui s'est déroulé au Tessin, canton suisse dans lequel l'initiative a obtenu le plus large soutien. L'étude a été menée à l'aide d'une enquête d'opinion représentative réalisée par l'Observatoire de la vie politique régionale de l'Université de Lausanne auprès de 1.429 citoyens tessinois dans les jours suivant le scrutin. Après une contextualisation du vote du 9 février par rapport à l'histoire des votations sur les thèmes de la politique étrangère et de l'immigration, l'analyse a porté sur la participation au vote. À ce propos, l'utilisation de trois modèles explicatifs (des ressources, de la compétence et de la mobilisation) a permis de dévoiler que le vote a été caractérisé plus particulièrement par le sens du devoir (habitus du vote), par l'intérêt pour la politique et par le lien avec un parti. L'analyse de l'orientation du vote montre l'influence des aspects économiques, politiques et identitaire ainsi que, à l'instar d'autres votations récemment passées dans le canton italophone, des raisons qui mettent en évidence une vision contrastée du Tessin et notamment le risque de devenir une 'double périphérie' par rapport à Berne et à la Lombardie. Mots-clés: initiative populaire, participation, choix du vote, centre-périphérie. Zusammenfassung Die vorliegende Studie analysiert das Abstimmungsverhalten anlässlich der eidgenössischen Volksinitiative 'Gegen Masseneinwanderung' vom 9. Februar 2014. Die Analyse beschränkt sich auf die Abstimmung im Kanton Tessin, wo die Initiative am stärksten unterstützt wurde. Die Studie wurde vom Observatorium des regionalen politischen Lebens der Universität Lausanne durchgeführt und basiert auf einer repräsentativen Umfrage, bei welcher 1429 Bürger des Kantons Tessin in den Tagen nach der Abstimmung teilnahmen. Zunächst wird die Abstimmung vom 9. Februar in Bezug auf die Geschichte verschiedener anderer Abstimmungen zum Thema Aussen- und Immigrationspolitik kontextualisiert. Die Analyse analysiert dann als erstes die Wahlbeteiligung: Der Gebrauch von drei Erklärungsmodellen (Ressourcen, Kompetenz und Mobilisierung) zeigt auf, dass der Entscheid, an der Abstimmung vom 9. Februar überhaupt teilzunehmen, vor allem von Pflichtbewusstsein, politischem Interesse und Parteibindung geprägt war. Das Abstimmungsverhalten selber war dann von ökonomischen und politischen Faktoren, von der eigenen Identität sowie insbesondere - und wie auch schon andere Abstimmungen in der jüngsten Vergangenheit des italienisch-sprechenden Kantons -von einer grossen Angst geprägt, dass das Tessin eine 'doppelte Peripherie' zwischen Bern und der Lombardei werden könnte. Stichwörter: Volksinitiative, Teilnahme, Abstimmungsverhalten, Zentrum-Peripherie Abstract This study focuses on the analysis of the federal vote on the popular initiative 'against mass immigration' of 9 February 2014. More precisely, the analysis focuses on the vote that took place in Ticino, the Swiss canton in which the popular initiative has received the widest support. The study was carried out by the Research Observatory for Regional Politics at the University of Lausanne using a representative survey among 1.429 citizens of Ticino during the days following the vote. After a contextualization of the vote of 9 February with respect to the history of referenda about foreign policy and immigration issues, the analysis first discusses voter turnout. In this regard, the use of three explanatory models (resources, expertise and mobilisation) reveals that participation in the vote of 9 February was especially characterized by one's sense of duty, political interest, and links with a political party. The decision how to vote was then influenced by economic, political and identity factors as well as - like other votes in the recent past in the Italian-speaking canton - the particular fear that Ticino would become a 'double periphery' vis-à-vis both Berne and Lombardy. Keywords: popular initiative, participation, vote, centre-periphery.

Le couple à l'épreuve du désengagement sportif : accompagnements, arrangements et tensions

At the end of a sporting career, triathletes are often living as a couple and the cessation of sport has an effect on the their relationship. While a large part of the existence and identity of the couple is dedicated to the triathlon, disengagement from sport undeniably changes the gender balance. The allocation of roles is not a linear process in a couple, and the effects of giving up sport have not really been studied. Therefore, this article focuses on how couples deal with the various ways a sporting career comes to an end, which are characterized by changes in direction and temporary or permanent cessation. Sex, roles, age, social class, respective commitments or the fact of having children are variables taken into account in this analysis. The survey is based on interviews conducted with 10 couples. The analysis suggests that the disengagement from sport depends on how compromise was established during the sporting career. Between those who support their partner's sporting career, those who share it intermittently and those who pursue their own activities even to the exclusion of the other, the way to manage disengagement can vary depending on the situation and the roles assigned to each person.

Life designing: A paradigm for career construction in the 21st century

At the beginning of the 21st century, a new social arrangement of work poses a series of questions and challenges to scholars who aim to help people develop their working lives. Given the globalization of career counseling, we decided to address these issues and then to formulate potentially innovative responses in an international forum. We used this approach to avoid the difficulties of creating models and methods in one country and then trying to export them to other countries where they would be adapted for use. This article presents the initial outcome of this collaboration, a counseling model and methods. The life-designing model for career intervention endorses five presuppositions about people and their work lives: contextual possibilities, dynamic processes, non-linear progression, multiple perspectives, and personal patterns. Thinking from these five presuppositions, we have crafted a contextualized model based on the epistemology of social constructionism, particularly recognizing that an individual's knowledge and identity are the product of social interaction and that meaning is co-constructed through discourse. The life-design framework for counseling implements the theories of self-constructing [Guichard, J. (2005). Life-long self-construction. International Journal for Educational and Vocational Guidance, 5, 111-124] and career construction [Savickas, M. L. (2005). The theory and practice of career construction. In S. D. Brown & R. W. Lent (Eds.), Career development and counselling: putting theory and research to work (pp. 42-70). Hoboken, NJ: Wiley] that describe vocational behavior and its development. Thus, the framework is structured to be life-long, holistic, contextual, and preventive.

Partial cricotracheal resection for paediatric subglottic stenosis: update of the Lausanne experience with 129 cases.

OBJECTIVES: Partial cricotracheal resection (PCTR) is widely accepted for treating severe paediatric laryngotracheal stenosis (LTS). However, it remains limited to a few experienced centres. Here we report an update of the Lausanne experience in paediatric PCTR performed or supervised by a senior surgeon (Philippe Monnier). METHODS: An ongoing database of 129 paediatric patients who underwent PCTR for benign LTS between March 1978 and July 2012 at our hospital was retrospectively reviewed. Demographic characteristics and information on preoperative status, stenosis and surgery were collected. Primary outcomes were measured as overall and operation-specific decannulation rates (ODR and OSDR, respectively), and secondary outcomes as morbidity, mortality and postoperative functional results. RESULTS: A total of 129 paediatric patients [79 males and 50 females; mean age, 4.1 years (1 month-16 years, median age of 2 years old)] underwent PCTR during the study period. ODR and OSDR were 90 and 81%, respectively. The decannulation rates were significantly superior for single-stage PCTR compared with double-stage PCTR in both ODR and OSDR. Eight patients died postoperatively for reasons unrelated to surgery. Partial anastomotic dehiscence was seen in 13 patients, 9 of whom were successfully treated by revision surgery. Respiratory, voice and swallowing functions were near normal or only minimally impaired in 86, 65 and 81% of patients, respectively. CONCLUSIONS: PCTR is effective and feasible with good ODR and OSDR for highgrade / severe LTS. Glottic involvement and the presence of comorbidities were negative predictive factors of decannulation. Early detection and reintervention of postoperative incipient dehiscence contribute to avoiding the progress to late restenosis; however, voice improvement remains a challenge.

Attitudes Toward Organizational Change among Public Middle Managers

Positive attitudes toward change (PATC) are an important current issue in public organizations facing profound financial and managerial reforms. This study aims to identify social and organizational antecedents of PATC. The investigated population is composed of middle managers working in Swiss public hospitals (N = 720), which are currently being confronted by major reforms. Partial mediation effects of organizational commitment (OC) in the relationships between independent variables and PATC are also controlled. The findings show that perceived social support (work relationships with colleagues and supervisors) as well as perceived organizational support (employee voice and participation, information and communication, work-life balance) are positively and significantly related to PATC. Stress perception is shown to have a negative impact on PATC. This article provides valuable contributions with respect to antecedents of attitudes toward change in a population of public middle managers.