La fonction publique en Suisse : analyse géopolitique d'un fédéralisme à géométrie variable

Bien que présenté comme un modèle de stabilité, le fédéralisme est constamment remis en question. Le but de l'article est de présenter quelques-unes de ses caractéristiques lues à travers les effectifs de la fonction publique en Suisse. Pour ce faire, nous distinguerons quatre types d'employeurs : Confédération, cantons, communes et corporations de droit public, lesquels représentent 10,5 % du total des actifs en Suisse. Nous analyserons la densité administrative, la variation des emplois et le degré de décentralisation selon la culture, le territoire et la religion. Il ressort que la fonction publique intermédiaire, c'est-à-dire les cantons, joue le premier rôle avec ses 140'000 emplois en équivalents plein temps (EPT) sur un total de 328'000, en hausse de 10,3 % par rapport à 2001. Les communes comptent 38 % des agents publics (+3,6 % par rapport à 2001), loin devant la Confédération, 11 % du total (en perte de vitesse : -1,2 %) et les corporations de droit public, 9 % du total (+14,5 %). Le taux d'administration est plus élevé dans la partie francophone que dans la partie germanophone, ainsi que dans les centres économiques et les zones frontières. Les écarts entre les cantons peuvent varier du simple au triple. En fait, deux modèles politico-administratifs transparaissent : le premier « cantonaliste » et davantage étatiste dans la partie latine, l'autre « communaliste » et décentralisé, dominant dans la partie germanophone. Le quotient de décentralisation administrative montre de grandes différences entre l'est et l'ouest, qui s'estompent toutefois avec la modernisation des institutions et le repositionnement de la Suisse face à l'Europe.

Increased risks of early sexual initiators: time makes a difference

BACKGROUND: Years since onset of sexual intercourse (YSSI) is a rarely used variable when studying adolescents- sexual outcomes. The aim of this study is to evaluate the influence of YSSI on the adverse sexual outcomes of early sexual initiators. METHODS: Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health database, a nationally representative cross-sectional survey including 7429 adolescents in post mandatory school aged 16-20 years. Only adolescents reporting sexual intercourse (SI) were included (N=4388; 45% females) and divided by age of onset of SI (early initiators, age<16: N=1469, 44% females; and late initiators, age≥16: N=2919, 46% females). Analyses were done separately by gender. Groups were compared for personal characteristics at the bivariate level. We analyzed three sexual outcomes (≥4 sexual partners, pregnancy and non-use of condom at last SI) controlling for all significant personal variables with two logistic regressions first using age, then YSSI as one of the confounding variables. Results are given as adjusted odds ratios (aOR) using lSI as the reference category. RESULTS: After adjusting for YSSI instead of age, negative sexual outcomes among early initiators were no longer significant, except for multiple sexual partners among females, although at a much lower level. Early initiators were less likely to report non-use of condom at last SI when adjusting for YSSI (females: aOR=0.59 [0.44-0.79]; p<0.001; males aOR=0.71 [0.50-1.00]; p=0.053). CONCLUSION: YSSI is an important explanatory variable when studying adolescents- sexuality and needs to be included in future research on adolescents- sexual health.

Relationship between obesity and the risk of clinically significant depression: Mendelian randomisation study.

BACKGROUND: Obesity has been shown to be associated with depression and it has been suggested that higher body mass index (BMI) increases the risk of depression and other common mental disorders. However, the causal relationship remains unclear and Mendelian randomisation, a form of instrumental variable analysis, has recently been employed to attempt to resolve this issue. AIMS: To investigate whether higher BMI increases the risk of major depression. METHOD: Two instrumental variable analyses were conducted to test the causal relationship between obesity and major depression in RADIANT, a large case-control study of major depression. We used a single nucleotide polymorphism (SNP) in FTO and a genetic risk score (GRS) based on 32 SNPs with well-established associations with BMI. RESULTS: Linear regression analysis, as expected, showed that individuals carrying more risk alleles of FTO or having higher score of GRS had a higher BMI. Probit regression suggested that higher BMI is associated with increased risk of major depression. However, our two instrumental variable analyses did not support a causal relationship between higher BMI and major depression (FTO genotype: coefficient -0.03, 95% CI -0.18 to 0.13, P = 0.73; GRS: coefficient -0.02, 95% CI -0.11 to 0.07, P = 0.62). CONCLUSIONS: Our instrumental variable analyses did not support a causal relationship between higher BMI and major depression. The positive associations of higher BMI with major depression in probit regression analyses might be explained by reverse causality and/or residual confounding.

Progressive multifocal leukoencephalopathy in common variable immunodeficiency: mitigated course under mirtazapine and mefloquine.

Demonstration of survival and outcome of progressive multifocal leukoencephalopathy (PML) in a 56-year-old patient with common variable immunodeficiency, consisting of severe hypogammaglobulinemia and CD4+ T lymphocytopenia, during continuous treatment with mirtazapine (30 mg/day) and mefloquine (250 mg/week) over 23 months. Regular clinical examinations including Rankin scale and Barthel index, nine-hole peg and box and block tests, Berg balance, 10-m walking tests, and Montreal Cognitive Assessment (MoCA) were done. Laboratory diagnostics included complete blood count and JC virus (JCV) concentration in cerebrospinal fluid (CSF). The noncoding control region (NCCR) of JCV, important for neurotropism and neurovirulence, was sequenced. Repetitive MRI investigated the course of brain lesions. JCV was detected in increasing concentrations (peak 2568 copies/ml CSF), and its NCCR was genetically rearranged. Under treatment, the rearrangement changed toward the archetype sequence, and later JCV DNA became undetectable. Total brain lesion volume decreased (8.54 to 3.97 cm(3)) and atrophy increased. Barthel (60 to 100 to 80 points) and Rankin (4 to 2 to 3) scores, gait stability, and box and block (7, 35, 25 pieces) and nine-hole peg (300, 50, 300 s) test performances first improved but subsequently worsened. Cognition and walking speed remained stable. Despite initial rapid deterioration, the patient survived under continuous treatment with mirtazapine and mefloquine even though he belongs to a PML subgroup that is usually fatal within a few months. This course was paralleled by JCV clones with presumably lower replication capability before JCV became undetectable. Neurological deficits were due to PML lesions and progressive brain atrophy.

Combining conservative and variable markers to inferthe evolutionary history of Prunus subgen. Amygdalus s.l.under domestication

The genus Prunus L. is large and economically important. However, phylogenetic relationships within Prunus at low taxonomic level, particularly in the subgenus Amygdalus L. s.l., remain poorly investigated. This paper attempts to document the evolutionary history of Amygdalus s.l. and establishes a temporal framework, by assembling molecular data from conservative and variable molecular markers. The nuclear s6pdh gene in combination with the plastid trnSG spacer are analyzed with bayesian and maximum likelihood methods. Since previous phylogenetic analysis with these markers lacked resolution, we additionally analyzed 13 nuclear SSR loci with the δµ2 distance, followed by an unweighted pair group method using arithmetic averages algorithm. Our phylogenetic analysis with both sequence and SSR loci confirms the split between sections Amygdalus and Persica, comprising almonds and peaches, respectively. This result is in agreement with biogeographic data showing that each of the two sections is naturally distributed on each side of the Central Asian Massif chain. Using coalescent based estimations, divergence times between the two sections strongly varied when considering sequence data only or combined with SSR. The sequence-only based estimate (5 million years ago) was congruent with the Central Asian Massif orogeny and subsequent climate change. Given the low level of differentiation within the two sections using both marker types, the utility of combining microsatellites and data sequences to address phylogenetic relationships at low taxonomic level within Amygdalus is discussed. The recent evolutionary histories of almond and peach are discussed in view of the domestication processes that arose in these two phenotypically-diverging gene pools: almonds and peaches were domesticated from the Amygdalus s.s. and Persica sections, respectively. Such economically important crops may serve as good model to study divergent domestication process in close genetic pool.

Tissue-specific regulatory circuits reveal variable modular perturbations across complex diseases.

Mapping perturbed molecular circuits that underlie complex diseases remains a great challenge. We developed a comprehensive resource of 394 cell type- and tissue-specific gene regulatory networks for human, each specifying the genome-wide connectivity among transcription factors, enhancers, promoters and genes. Integration with 37 genome-wide association studies (GWASs) showed that disease-associated genetic variants-including variants that do not reach genome-wide significance-often perturb regulatory modules that are highly specific to disease-relevant cell types or tissues. Our resource opens the door to systematic analysis of regulatory programs across hundreds of human cell types and tissues (http://regulatorycircuits.org).