Red meat and cancer risk in a network of case-control studies focusing on cooking practices.

BACKGROUND: Consumption of red meat has been related to increased risk of several cancers. Cooking methods could modify the magnitude of this association, as production of chemicals depends on the temperature and duration of cooking. METHODS: We analyzed data from a network of case-control studies conducted in Italy and Switzerland between 1991 and 2009. The studies included 1465 oral and pharyngeal, 198 nasopharyngeal, 851 laryngeal, 505 esophageal, 230 stomach, 1463 colon, 927 rectal, 326 pancreatic, 3034 breast, 454 endometrial, 1031 ovarian, 1294 prostate and 767 renal cancer cases. Controls included 11 656 patients admitted for acute, non-neoplastic conditions. Odds ratios (ORs) and confidence intervals (CIs) were estimated by multiple logistic regression models, adjusted for known confounding factors. RESULTS: Daily intake of red meat was significantly associated with the risk of cancer of the oral cavity and pharynx (OR for increase of 50 g/day = 1.38; 95% CI: 1.26-1.52), nasopharynx (OR = 1.29; 95% CI: 1.04-1.60), larynx (OR = 1.46; 95% CI: 1.30-1.64), esophagus (OR = 1.46; 95% CI: 1.23-1.72), colon (OR = 1.17; 95% CI: 1.08-1.26), rectum (OR = 1.22; 95% CI:1.11-1.33), pancreas (OR = 1.51; 95% CI: 1.25-1.82), breast (OR = 1.12; 95% CI: 1.04-1.19), endometrium (OR = 1.30; 95% CI: 1.10-1.55) and ovary (OR = 1.29; 95% CI: 1.16-1.43). Fried meat was associated with a higher risk of cancer of oral cavity and pharynx (OR = 2.80; 95% CI: 2.02-3.89) and esophagus (OR = 4.52; 95% CI: 2.50-8.18). Risk of prostate cancer increased for meat cooked by roasting/grilling (OR = 1.31; 95% CI: 1.12-1.54). No heterogeneity according to cooking methods emerged for other cancers. Nonetheless, significant associations with boiled/stewed meat also emerged for cancer of the nasopharynx (OR = 1.97; 95% CI: 1.30-3.00) and stomach (OR = 1.86; 95% CI: 1.20-2.87). CONCLUSIONS: Our analysis confirmed red meat consumption as a risk factor for several cancer sites, with a limited impact of cooking methods. These findings, thus, call for a limitation of its consumption in populations of Western countries.

Of housing and politics : mapping political opportunities for mobilising in Bangalore, India

Quelles sont les conditions pour l'émergence d'une mobilisation sociale en faveur du logement convenable dans la métropole de Bangalore (Inde)? Cette question, qui est au coeur de cette thèse, est particulièrement pertinente dans le contexte d'une ville où 1,7 million de personnes, soit un cinquième de la population, vit dans des bidonvilles. L'absence d'un mouvement mettant en cause l'échec des politiques publiques du logement est intéressante dans la mesure où l'Inde a hérité un système de gouvernance colonial et d'une tradition de mouvements sociaux. Pour répondre à ce questionnement, un cadre théorique issu de la littérature sur les mouvements sociaux est développé. Il s'articule autour des liens entre les opportunités politiques au niveau macro et les répertoires d'action des organisations de mouvement social (OMS) au niveau méso, de la tension entre la formalité de la loi et des politiques publiques et l'informalité des circuits d'échange, de la corruption et du clientélisme, et enfin, se focalise sur les systèmes de discours de caste et de la citoyenneté et de leur concrétisation dans des systèmes d'organisations et de réseaux sociaux. Ce cadre théorique permet d'étudier empiriquement la question à travers quatre OMS dans la ville de Bangalore. Les résultats mettent en avant l'existence de mécanismes complexes. Les opportunités politiques formelles n'étant ouvertes que sur le plan rhétorique, elles ne peuvent être véritablement utilisées que par des moyens légaux ou contentieux, ce qui nécessite des compétences sociales dont la plupart des habitants des bidonvilles sont dépourvus. L'inadéquation entre les ressources à disposition pour les logements sociaux et les besoins très importants des pauvres, donne un poids politique considérable aux acteurs en charge de l'attribution de ces ressources rares. Cet état de fait a des répercussions sur la politique électorale. Les habitants des bidonvilles représentant un poids électoral important, ils sont mobilisés à travers de pratiques clientélistes. La corruption et le clientélisme se nourrissent mutuellement pour maintenir une certaine dépendance des habitants. Les OMS qui développent un répertoire discursif remettant en cause le système de caste et qui encouragent une conscience citoyenne, se sont avérées les plus durables pour résister à la cooptation des forces politiques. Cette recherche empirique met en lumière l'inadéquation entre les prescriptions formelles dans le domaine de la gouvernance des besoins humains, tels que le logement, et les pratiques réelles sur le terrain. Cette recherche appelle à réfléchir au-delà de la diffusion du discours sur la « bonne gouvernance » vers des formes de « gouvernance vernaculaire » qui prendrait au sérieux l'informalité en développant une compréhension des avantages à court terme pour les personnes marginalisées dans la ville et les effets à long terme sur la pratique démocratique. - What are the conditions for the emergence of a social movement on the issue of adequate housing in the metropolitan city of Bangalore (India)? This question is at the heart of this dissertation and is particularly pertinent against the background that an estimated 1.7 million or about 20% of the city's population lives in slums. The absence of a movement addressing the failure of public housing policy despite India having inherited colonial systems of governance and traditions of movement is noteworthy. Answers are sought within a theoretical framework stemming from social movement theories that incorporates three linkages articulating around: Macro-level political opportunities and meso-level action repertoires of social movement organisations (SMOs), tensions between the formality of law, policy and the informality of exchange circuits of corruption and clientelism and finally around systems of discourses of caste and citizenship and their instantiation in concrete systems of social organisations and networks. This thesis is empirically investigated through a qualitative case study research design involving four sampled social movement organisations. The results bring complex mechanisms to the fore. Formal political opportunities are only rhetorically open and have to be cracked through legal weaponry or contentious escalation, which requires considerable social skills that slum-dwellers often lack. The inadequacy between the few housing resources and the vast number of slum-dwellers transform housing benefits and urban service provisions into political currency. Such a state of affairs has serious repercussions on conditions for mobilisation. They become imbricated with electoral logic, in which slum-dwellers represent large vote-banks and where corruption and clientelism feed each other to maintain a certain dependency of the poor. SMOs deploying a discursive repertoire that questioned the caste system and encouraged a pursuit of citizenship proved to be the most sustainable to resist co-option from political forces. This empirical investigation brings to light the mismatch between the formal prescriptions in the domain of the governance of basic human needs such as housing and the real practices on the ground. This research calls to reflect beyond the inadequacy of the diffused « good governance » discourse towards forms of « vernacular governance » that take informality seriously in understanding the short-term benefits for the marginalised in the city and the long-term effects on democratic practice.

Patients with AIDS-defining cancers are not universally screened for HIV: a 10-year retrospective analysis of HIV-testing practices in a Swiss university hospital.

OBJECTIVES: Kaposi's sarcoma (KS), invasive cervical carcinoma (ICC) and non-Hodgkin lymphoma (NHL) have been listed as AIDS-defining cancers (ADCs) by the Centers for Disease Control and Prevention since 1993. Despite this, HIV screening is not universally mentioned in ADC treatment guidelines. We examined screening practices at a tertiary centre serving a population where HIV seroprevalence is 0.4%. METHODS: Patients with KS, ICC, NHL and Hodgkin lymphoma (HL), treated at Lausanne University Hospital between January 2002 and July 2012, were studied retrospectively. HIV testing was considered part of the oncology work-up if performed between 90 days before and 90 days after the cancer diagnosis date. RESULTS: A total of 880 patients were examined: 10 with KS, 58 with ICC, 672 with NHL and 140 with HL. HIV testing rates were 100, 11, 60 and 59%, and HIV seroprevalence was 60, 1.7, 3.4 and 5%, respectively. Thirty-seven patients (4.2%) were HIV-positive, of whom eight (22%) were diagnosed at oncology work-up. All newly diagnosed patients had CD4 counts < 200 cells/μL and six (75%) had presented to a physician 12-236 weeks previously with conditions warranting HIV testing. CONCLUSIONS: In our institution, only patients with KS were universally screened. Screening rates for other cancers ranged from 11 to 60%. HIV seroprevalence was at least fourfold higher than the population average. As HIV-positive status impacts on cancer patient medical management, HIV screening should be included in oncology guidelines. Further, we recommend that opt-out screening should be adopted in all patients with ADCs and HL.

Dealing with clients' diversity in test situations: Client categorisations in psychologists' accounts of their practices

Reducing a test administration to standardised procedures reflects the test designers' standpoint. However, from the practitioners' standpoint, each client is unique. How do psychologists deal with both standardised test administration and clients' diversity? To answer this question, we interviewed 17 psychologists working in three public services for children and adolescents about their assessment practices. We analysed the numerous "client categorisations" they produced in their accounts. We found that they had shared perceptions about their clients' diversity, and reported various non-standard practices that complemented standardised test administration, but also differed from them or were even forbidden. They seem to experience a dilemma between: (a) prescribed and situated practices; (b) scientific and situated reliability; (c) commutative and distributive justice. For practitioners, dealing with clients' diversity this is a practical problem, halfway between a problem-solving task and a moral dilemma.

Variations in fathers' discourse on fatherhood and in family alliances during infancy

The aim of this pilot study is to analyse the discourse of fathers of toddlers concerning fatherhood and the link between some particularities in the discourse and family alliance. The sample consists of 13 Swiss first time fathers (5 fathers of girls and 8 of boys). In order to evaluate the paternal discourse, the fathers were given a semi-structured interview, which was later analysed using the research package Alceste. The family alliance, i.e., the degree of coordination among the partners when executing a task together, was assessed through the Lausanne Trilogue Play (Fivaz-Depeursinge & Corboz-Warnery, 1999). The main results indicated an interesting link between classes of paternal discourse grouped around the following themes "affective relationship", "daily routine" and "educational goals", and the family alliance (defined in two major categories; functional and problematic alliances). Finally, clinical perspectives on links between paternal representations and family functioning at an interactive level are discussed

Daily smoking as a marker of weight control practices among female adolescents

Purpose: There is evidence indicating that adolescent females smoke as a way to control weight. The aim of our research is to assess whether daily smoking is a marker for weight control practices among adolescent females. Methods: Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health (SMASH02) data base, a survey including 7,548 [3,838 females] in-school adolescents aged 16-20 years in Switzerland. Among females self-reporting BMI (N _ 3,761), two groups were drawn: daily smokers (DS, N _ 1,273) included all those smoking at least 1 cigarette/day and never smokers (NS, N _ 1,888) included all those having never smoked. Former (N _ 177) and occasional (N _ 423) smokers were not included. Groups were compared on weight control practices (being on a diet, self-induced vomiting, use of doctor-prescribed or over-the-counter appetite suppressors) controlling for possible confounding variables (age, BMI, feeling fat, body image, use of other substances, depression, sport practice, academic track and perceived advanced puberty). Analyses were performed with STATA 9. Bivariate analyses are presented as point-prevalence and multivariate analysis (using logistic regression) are presented as adjusted odds ratio (AOR) and [95% confidence interval]. Results: In the bivariate analysis, DS females were significantly more likely (p _ 0.001) than NS to be on a diet (DS: 33.2%, NS: 22.2%), to self-induce vomiting (DS: 9.0%, NS: 3.3%), and to use doctor prescribed (DS: 2.3%, NS: 0.9%) or over-the-counter (DS: 3.2%, NS: 1.2%) appetite suppressors. In the multivariate analysis, DS females were more likely than NS to be on a diet (AOR: 1.40 [1.17/1.68]), to self-induce vomiting (AOR: 2.07 [1.45/2.97]), and to use doctor-prescribed appetite suppressors (AOR: 1.99 [1.00/ 3.96]). Conclusions: Weight control practices are more frequent among female daily smokers than among never smokers. This finding seems to confirm cigarette smoking as a way to control weight among adolescent females. Health professionals should inquire adolescent female smokers about weight control practices, and this association must be kept in mind when discussing tobacco cessation options with adolescent females. Sources of Support: The SMASH02 survey was funded by the Swiss Federal Office of Public Health and the participating cantons.

Patients with AIDS-defining cancers are not universally screened for HIV: a 10-year retrospective analysis of HIV-testing practices in a Swiss university hospital.

OBJECTIVES: Kaposi's sarcoma (KS), invasive cervical carcinoma (ICC) and non-Hodgkin lymphoma (NHL) have been listed as AIDS-defining cancers (ADCs) by the Centers for Disease Control and Prevention since 1993. Despite this, HIV screening is not universally mentioned in ADC treatment guidelines. We examined screening practices at a tertiary centre serving a population where HIV seroprevalence is 0.4%. METHODS: Patients with KS, ICC, NHL and Hodgkin lymphoma (HL), treated at Lausanne University Hospital between January 2002 and July 2012, were studied retrospectively. HIV testing was considered part of the oncology work-up if performed between 90 days before and 90 days after the cancer diagnosis date. RESULTS: A total of 880 patients were examined: 10 with KS, 58 with ICC, 672 with NHL and 140 with HL. HIV testing rates were 100, 11, 60 and 59%, and HIV seroprevalence was 60, 1.7, 3.4 and 5%, respectively. Thirty-seven patients (4.2%) were HIV-positive, of whom eight (22%) were diagnosed at oncology work-up. All newly diagnosed patients had CD4 counts < 200 cells/μL and six (75%) had presented to a physician 12-236 weeks previously with conditions warranting HIV testing. CONCLUSIONS: In our institution, only patients with KS were universally screened. Screening rates for other cancers ranged from 11 to 60%. HIV seroprevalence was at least fourfold higher than the population average. As HIV-positive status impacts on cancer patient medical management, HIV screening should be included in oncology guidelines. Further, we recommend that opt-out screening should be adopted in all patients with ADCs and HL.

New vineyard cultivation practices create patchy ground vegetation, favouring Woodlarks

Intensive agriculture, in which detrimental farming practices lessen food abundance and/or reduce food accessibility for many animal species, has led to a widespread collapse of farmland biodiversity. Vineyards in central and southern Europe are intensively cultivated; though they may still harbour several rare plant and animal species, they remain little studied. Over the past decades, there has been a considerable reduction in the application of insecticides in wine production, with a progressive shift to biological control (integrated production) and, to a lesser extent, organic production. Spraying of herbicides has also diminished, which has led to more vegetation cover on the ground, although most vineyards remain bare, especially in southern Europe. The effects of these potentially positive environmental trends upon biodiversity remain mostly unknown as regards vertebrates. The Woodlark (Lullula arborea) is an endangered, short-distance migratory bird that forages and breeds on the ground. In southern Switzerland (Valais), it occurs mostly in vineyards. We used radiotracking and mixed effects logistic regression models to assess Woodlark response to modern vineyard farming practices, study factors driving foraging micro-habitat selection, and determine optimal habitat profile to inform management. The presence of ground vegetation cover was the main factor dictating the selection of foraging locations, with an optimum around 55% at the foraging patch scale. These conditions are met in integrated production vineyards, but only when grass is tolerated on part of the ground surface, which is the case on ca. 5% of the total Valais vineyard area. In contrast, conventionally managed vineyards covering a parts per thousand yen95% of the vineyard area are too bare because of systematic application of herbicides all over the ground, whilst the rare organic vineyards usually have a too-dense sward. The optimal mosaic with ca. 50% ground vegetation cover is currently achieved in integrated production vineyards where herbicide is applied every second row. In organic production, ca. 50% ground vegetation cover should be promoted, which requires regular mechanical removal of ground vegetation. These measures are likely to benefit general biodiversity in vineyards.

Statistical discrimination and employers' recruitment : Practices for low-skilled workers

This paper deals with the recruitment strategies of employers in the low-skilled segment of the labour market. We focus on low-skilled workers because they are overrepresented among jobless people and constitute the bulk of the clientele included in various activation and labour market programmes. A better understanding of the constraints and opportunities of interventions in this labour market segment may help improve their quality and effectiveness. On the basis of qualitative interviews with 41 employers in six European countries, we find that the traditional signals known to be used as statistical discrimination devices (old age, immigrant status and unemployment) play a somewhat reduced role, since these profiles are overrepresented among applicants for low skill positions. However, we find that other signals, mostly considered to be indicators of motivation, have a bigger impact in the selection process. These tend to concern the channel through which the contact with a prospective candidate is made. Unsolicited applications and recommendations from already employed workers emit a positive signal, whereas the fact of being referred by the public employment office is associated with the likelihood of lower motivation.