Changes of overweight and obesity in the adult Swiss population according to educational level, from 1992 to 2007.

In many high income developed countries, obesity is inversely associated with educational level. In some countries, a widening gap of obesity between educational groups has been reported. The aim of this study was to assess trends in body mass index (BMI) and in prevalence of overweight and obesity and their association with educational level in the adult Swiss population. Four cross-sectional National health interview surveys conducted in 1992/93 (n = 14,521), 1997 (n = 12,474), 2002 (n = 18,908) and 2007 (n = 17,879) using representative samples of the Swiss population (age range 18-102 years). BMI was derived from self-reported data. Overweight was defined as BMI > or = 25 and <30 kg/m(2), and obesity as BMI > or = 30 kg/m(2). Mean (+/- standard deviation) BMI increased from 24.7 +/- 3.6 in 1992/3 to 25.4 +/- 3.6 kg/m2 in 2007 in men and 22.8 +/- 3.8 to 23.7 +/- 4.3 kg/m(2) in women. Between 1992/3 and 2007, the prevalence of overweight + obesity increased from 40.4% to 49.5% in men and from 22.3% to 31.3% in women, while the prevalence of obesity increased from 6.3% to 9.4% in men and from 4.9% to 8.5% in women. The rate of increase in the prevalence of obesity was greater between 1992/3 and 2002 (men: +0.26%/year; women: +0.31%/year) than between 2002 and 2007 (men: +0.10%/year; women: +0.10%/year). A sizable fraction (approximately 25%) of the increasing mean BMI was due to increasing age of the participants over time. The increase was larger in low than high education strata of the population. BMI was strongly associated with low educational level among women and this gradient remained fairly constant over time. A weaker similar gradient by educational level was apparent in men, but it tended to increase over time. In Switzerland, overweight and obesity increased between 1992 and 2007 and was associated with low education status in both men and women. A trend towards a stabilization of mean BMI levels was noted in most age categories since 2002. The increase in the prevalence of obesity was larger in low education strata of the population. These findings suggest that obesity preventive measures should be targeted according to educational level in Switzerland.

Prévention des maladies et promotion de la santé: propositions pour une stratégie vaudoise : stratégie dans quelques régions : complément au rapport de mars 2007

[Table des matières] Introduction. 2 Stratégies de prévention dans d'autres régions. 3. Australie (Australian Better Health Initiative 2006-2010). 4. Royaume-Uni. 5. Suisse. 5.1 En résumé ... 5.2 Vers une loi fédérale (?) 5.3 Suisse : synopsis. 6. Saint-Gall. 6.1 Poids corporel sain pour les enfants. 6.2 Santé au travail. 6.3 Dépendances. 6.4 Prévention et promotion de la santé dans les communes. 6.5 Saint-Gall : synopsis. 7. Valais. 8. Tessin. 8.1 Canton du Tessin : Synopsis I (programme général). 8.2 Canton du Tessin : Synopsis II (activités en cours). Annexe 1 : 21 buts de santé pour la Suisse (Santé Publique Suisse). Annexe 2 : 7 thèses sur la nouvelle réglementation de la prévention et de la promotion de la santé en Suisse (Office fédéral de la santé publique).

Evaluation épidémiologique du programme genevois de dépistage du cancer du sein : 2007-2011

A l'instar de nombreux pays industrialisés, le cancer du sein est à Genève le cancer le plus fréquent (environ 460 cas par an) et la première cause de décès chez les femmes entre 45 et 55 ans. Depuis mars 1999, le Programme genevois de dépistage du cancer du sein a pour missions de promouvoir, d'organiser et de mener une action de prévention auprès de la population féminine du canton âgée de 50 à 69 ans. Ce rapport décrit l'évolution de 15 ans d'activité de dépistage (chapitre 2) et analyse l'utilisation (chapitre 3), la qualité (chapitre 4) et l'efficacité (chapitre 5) du programme genevois entre 2007 et 2011. Couvrant 86'720 mammographies et près de 37'000 femmes, ce rapport s'intéresse aussi, au-delà des indicateurs usuels de performance, à mieux estimer certains effets indésirables comme les résultats faussement positifs ou les cancers survenant entre 2 examens de dépistage (dits cancers d'intervalle).

Fingermarks and Other Impressions Left by the Human Body - A Review (August 2007-July 2010)

The purpose of this paper is to review the scientific literature from August 2007 to July 2010. The review is focused on more than 420 published papers. The review will not cover information coming from international meetings available only in abstract form. Fingermarks constitute an important chapter with coverage of the identification process as well as detection techniques on various surfaces. We note that the research has been very dense both at exploring and understanding current detection methods as well as bringing groundbreaking techniques to increase the number of marks detected from various objects. The recent report from the US National Research Council (NRC) is a milestone that has promoted a critical discussion on the state of forensic science and its associated research. We can expect a surge of interest in research in relation to cognitive aspect of mark and print comparison, establishment of relevant forensic error rates and statistical modelling of the selectivity of marks' attributes. Other biometric means of forensic identification such as footmarks or earmarks are also covered in the report. Compared to previous years, we noted a decrease in the number of submission in these areas. No doubt that the NRC report has set the seed for further investigation of these fields as well.

Please die during office hours : periodicity of cardiovascular events in switzerland between 1969 and 2007

Purpose: to evaluate and compare the periodical patterns of death from cardiovascular disease (CVD), including acute myocardial infarction (AMI) and stroke in the Swiss population between the years 1969 and 2007.¦Methods: Swiss mortality database for the period of 1969- 2007 (2'362'430 deaths overall). The number of deaths due to CVD, AMI and stroke according to the time of day, day of the week and month were assessed, overall and after dividing the events according to gender and age (< 65 or ≥65 years old).¦Results: In general and for all four subgroups according to age and sex, there is a daily variation in the number of deaths with a first peak in the morning (8h00 -12h00) and a smaller second peak in the late afternoon (14h - 18h). Both males and females have similar hourly patterns, although the magnitude of the difference diminishes in older patients particularly for people who die from stroke. For the weekly variation, there seems to be a significant trend only in the younger population with the lowest mortality rates on Sunday and the highest on Mondays for all diseases. When it comes to seasonal variation according to month, the trend is more significant in the elder patients with the highest death rates during the winter months (+31%) and the lowest in the summer (July/August).¦Conclusion: There is a timely pattern for CVD, AMI and stroke deaths in Switzerland. This pattern changes according to the age and sex of the patients. Knowing this trend, its triggering factors and consequences, perhaps there could be measures put in place to prevent, diagnose and treat the population which is the most vulnerable at certain times.

Trends in self-reported prevalence and management of hypertension, hypercholesterolemia and diabetes in Swiss adults, 1997-2007.

Switzerland has a low mortality rate from cardiovascular diseases, but little is known regarding prevalence and management of cardiovascular risk factors (CV RFs: hypertension, hypercholesterolemia and diabetes) in the general population. In this study, we assessed 10-year trends in self-reported prevalence and management of cardiovascular risk factors in Switzerland. data from three national health interview surveys conducted between 1997 and 2007 in representative samples of the Swiss adult population (49,261 subjects overall). Self-reported CV RFs prevalence, treatment and control levels were computed. The sample was weighted to match the sex - and age distribution, geographical location and nationality of the entire adult population of Switzerland. self-reported prevalence of hypertension, hypercholesterolemia and diabetes increased from 22.1%, 11.9% and 3.3% in 1997 to 24.1%, 17.4% and 4.8% in 2007, respectively. Prevalence of self-reported treatment among subjects with CV RFs also increased from 52.1%, 18.5% and 50.0% in 1997 to 60.4%, 38.8% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Self-reported control levels increased from 56.4%, 52.9% and 50.0% in 1997 to 80.6%, 75.1% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Finally, screening during the last 12 months increased from 84.5%, 86.5% and 87.4% in 1997 to 94.0%, 94.6% and 94.1% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. in Switzerland, the prevalences of self-reported hypertension, hypercholesterolemia and diabetes have increased between 1997 and 2007. Management and screening have improved, but further improvements can still be achieved as over one third of subjects with reported CV RFs are not treated.

Differences in self-reported prevalence and management of cardiovascular risk factors in Switzerland, 2007

Purpose: To assess the prevalence of four self-reported cardiovascular risk factors (CV RFs: smoking, hypertension, dyslipidaemia and diabetes) and their reported management in seven Swiss regions (Léman, MiUelland, Zurich, North-West Switzerland, Oriental Switzerland, Central Switzerland and Tessin). Methods: National health interview survey conducted in 2007 in a representative sample of the Swiss population (17,879 subjects). Age-adjusted data on prevalence of self-reported CV RFs, treatment among participants reporting a RF, control of RFs among treated participants and CV RF screening in the last 12 months levels were computed after weighting. Results: The prevalence of hypertension was highest in North-West Switzerland (27.3%) and lowest in Central Switzerland (21.0%, p<0.001). Antihypertensive treatment was highest in Léman region (62.7%) and lowest in Oriental Switzerland (55.2%, p<0.001). Screening was higher in Tessin (89.3%) and lowest in Léman region (81.8%, p<0.001). Prevalence of dyslipidaemia was highest in Tessin and Léman region (20.7% and 20.1 %, respectively) and lowest in Oriental Switzerland (14.5%, p<0.001). Lipid-Iowering treatment was highest in Tessin and Léman region (44.3% each) and lowest in Central Switzerland (30.7%, p<0.001). Dyslipidaemia screening was highest in Tessin (76.6%) and lowest in Central Switzerland (58.6%, p<0.001). Prevalence of diabetes was highest in North-West Switzerland (5.4%) and lowest in Central Switzerland (3.3%, p<0.05). Diabetes screening was highest in Tessin (78.1%) and lowest in Oriental Switzerland (64.0%, p<0.001). Conversely, no between-region differences were found for hypertension or dyslipidaemia control (see table). Conclusion: there are significant differences between the Swiss regions in self-reported prevalence and management of CV RFs. Screening is beUer in Tessin than in the other regions.

Withdrawal, "serosorting" and "strategic positioning": use of risk reduction strategies with casual sex partners in men who have sex with men (MSM) in Switzerland, 2007

Introduction: 1) Withdrawal before ejaculation, "serosorting" (to choose a partner of same serostatus) and "strategic positioning" (only insertive vs. only receptive role in anal sex according to serostatus) are known to be used by MSM as alternatives to condom use. 2) Despite their questionable levels of effectiveness they are collectively labelled as "risk reduction strategies" (RRS). Objectives: The aim of this study is to estimate the prevalence and factors related to RRS in men who report unprotected anal intercourse (UAI) with occasional partners in the last 12 months. Methods: 1) In 2007, a module on RRS was included in a repeated national survey conducted among readers of gay newspapers, members of gay organizations and visitors of gay websites (N=2953). 2) Using an anonymous self-completed questionnaire, participants were asked whether, with the aim of avoiding HIV infection, RRS were used with occasional partners. Analysis: 1) Prevalences were calculated in participants who reported UAI with occasional partners in the last 12 months (n=416). 2) A logistic regression was performed, using "at least one RRS" as dependent variable. Number of partners in the last 12 months, HIV-status and usual socio-demographic characteristics were used as independent factors. Result : 1) 70% (292/416) of the participants reporting UAI used at least one RRS when they had unprotected sex with casual partners in the last 12 months (Table 1). 2) Withrawal before ejaculation was the most frequently reported strategy, followed by serosorting and strategic positioning (Table 1). 3) Participants who reported at least one RRS were more likely to be over 30 years and to belong to a gay organisation. HIV-positive and non-tested participants were less likely to report RRS than HIV-negative participants (Table 2). Conclusions: 1) The majority of MSM who reported UAI in the last 12 months tried to reduce risk of HIV transmission by using specific strategies (withdrawal, serosorting, strategic positioning). It is not known, however, to what extent the use of these strategies was systematic. 2) It is necessary to provide MSM with balanced information on these strategies and their respective level of effectiveness. 3) It is important to monitor the use of RRS in HIV behavioural surveillance surveys in MSM.

Stability analysis of the 2007 Chehalis lake landslide based on long-range terrestrial photogrammetry and airborne LIDAR data

On December 4th 2007, a 3-Mm3 landslide occurred along the northwestern shore of Chehalis Lake. The initiation zone is located at the intersection of the main valley slope and the northern sidewall of a prominent gully. The slope failure caused a displacement wave that ran up to 38 m on the opposite shore of the lake. The landslide is temporally associated with a rain-on-snow meteorological event which is thought to have triggered it. This paper describes the Chehalis Lake landslide and presents a comparison of discontinuity orientation datasets obtained using three techniques: field measurements, terrestrial photogrammetric 3D models and an airborne LiDAR digital elevation model to describe the orientation and characteristics of the five discontinuity sets present. The discontinuity orientation data are used to perform kinematic, surface wedge limit equilibrium and three-dimensional distinct element analyses. The kinematic and surface wedge analyses suggest that the location of the slope failure (intersection of the valley slope and a gully wall) has facilitated the development of the unstable rock mass which initiated as a planar sliding failure. Results from the three-dimensional distinct element analyses suggest that the presence, orientation and high persistence of a discontinuity set dipping obliquely to the slope were critical to the development of the landslide and led to a failure mechanism dominated by planar sliding. The three-dimensional distinct element modelling also suggests that the presence of a steeply dipping discontinuity set striking perpendicular to the slope and associated with a fault exerted a significant control on the volume and extent of the failed rock mass but not on the overall stability of the slope.

Rhumatologie. Polyarthrite rhumatoide et spondylarthrite ankylosante [Rheumatoid arthritis and ankylosing spondylitis: rheumatologic highlights 2007]

L'utilisation des traitements biologiques est maintenant solidement ancrée dans la prise en charge des rhumatismes inflammatoires. Les anti-TNFa sont à juste titre devenus des agents de choix ces dix dernières années, et la littérature récente nous rappelle leurs places et indications dans la spondylarthrite ankylosante. Toutefois, tous les patients n'y répondent pas et la disponibilité de nouveaux traitements est certainement une addition bienvenue. L'abatacept est un nouveau traitement de la polyarthrite rhumatoïde avec un mode d’action innovateur, qui paraît efficace et adéquatement sûr et pour lequel quelques données et aspects pratiques d'utilisation sont présentés. Nous devons néanmoins encore apprendre à l'intégrer dans des stratégies thérapeutiques, comme nous sommes en train de le faire avec le rituximab. The use of biological therapy is now firmly established in the management of inflammatory rheumatism. The anti-TNFalpha have rightly become agents of choice over the last 10 years, and the recent literature reminds us of their places and indications in ankylosing spondylitis. However, not all patients respond, and the availability of new treatments is certainly a welcome addition. Abatacept is a new treatment for rheumatoid arthritis with an innovative mode of action. It appears effective and safe, and some data as well as practical aspects on its use are presented. Nevertheless, we must still learn to integrate it into our therapeutic strategies, as we are presently doing with rituximab

Les comportements face au VIH/sida des hommes qui ont des relations sexuelles avec des hommes: résultats de Gaysurvey 2007

Gaysurvey est une enquête menée périodiquement en Suisse parmi les hommes qui ont des relations sexuelles avec des hommes (HSH). Elle s'inscrit dans le dispositif de surveillance du VIH, établi par l'Office fédéral de la santé publique, en tant qu'instrument de suivi des comportements face au VIH/sida dans ce groupe-cible. Elle a déjà été réalisée à huit reprises : en 1987, 1990, 1992, 1994, 1997, 2000, 2004, 2007. [...] Elle permet d'établir des tendances temporelles au niveau des pratiques sexuelles et des expositions au risque d'infection par le VIH. Elle permet, en outre, d'approfondir certaines thématiques pertinentes pour le travail de prévention (gestion du risque au sein d'une relation stable, entrée dans la sexualité, etc.). Ce document a pour objectif de faire la synthèse des tendances mises au jour lors de la dernière vague d'enquête, réalisée en 2007. [Introduction p. 4]