Education for specialization in prosthodontics in Switzerland and the role of EPA.

Advertisement for any dental treatment was rare in Switzerland. Then the use of digital media became popular, particularly in the field of implant- and esthetic-dentistry. In parallel to the dental schools of public universities, private universities and companies built up centers for continuing education that issue specialists diplomas and M.Sc. degrees. Prosthodontics itself is characterized by many sub-disciplines that incorporated their own associations. These also offer graduate training curricula which diminish the significance of specialization in prosthodontics. Specialized prosthodontists do not have a financial benefit in Switzerland where dentistry is not supported by any insurance. In other European countries funding of prosthodontic treatment depends on their healthcare systems. There are four specialties in Dentistry recognized by the European Union (EU). Specialization in prosthodontics was introduced in Sweden already in 1982 and today it is declared in about 20 European countries, while for others no recognized program exists. Thus there are great variations with more recognized specialists in former east European countries. In Switzerland the prosthodontic specialization curriculum was developed and guided by the Swiss Society for Reconstructive Dentistry, and only in 2001 it became fully acknowledged by the Federal Department of Health. The four Swiss Universities offer the 3-year program under the supervision of the society, while the government remains the executive body. In 2003 EPA tried to set up guidelines and quality standards for an EPA recognized specialization. In spite of these attempts and the Bologna Reform in Europe, it appears that the quality standards and the level of education still may differ significantly among European countries.

Performing AIDS. The Film-maker Rosa von Praunheim between HIV/AIDS-Communities in Germany and the USA

This paper explores the works of German film-maker Rosa von Praunheim during the AIDS crisis. In the 1980ies and 1990ies he produced several films portraying the gay communities in Germany and the USA in the face of AIDS. First, this paper analyses the cinematic techniques von Praunheim uses to criticise the German gay community and present the American practices of performing community as a role model for AIDS-activism. In a second step, the focus is put on von Praunheim’s autobiography and the rhetoric strategies he uses to participate in New York’s HIV-community, while being HIV-negative himself.

Performing AIDS. The Film-maker Rosa von Praunheim between HIV/AIDS-Communities in Germany and the USA

The paper explores the works of German film-maker Rosa von Praunheim during the AIDS crisis, who worked in Germany and the USA in the 1980ies and 1990ies and produced several films portraying the gay communities in both countries in the face of AIDS. The first part of the paper analyses how von Praunheim’s films show different forms of performing community in the two countries. It discusses the filmic techniques utilized to criticize the reaction of the German gay community to the appearance of AIDS and to present Amercian traditions of forming and performing a community as a role model for AIDS-activism. The second part focuses on von Praunheim’s autobiography „40 Years of Perversity. The Sentimental Memoirs of Rosa von Raunheim“ (1993) and the rhetoric strategies he – being HIV-negative himself – uses to become part of New York’s HIV-community. The paper examines the hypothesis that von Praunheim’s rhetoric is constructing and performing a „participative identity“ (Alois Hahn). The paper finally discusses the use and adaption of terms and symbols originating from the context of German National Socialism (e.g. the pink triangle) within the process of forming and performing New York’s AIDS-Community and how they are reused and readapted by Rosa von Praunheim.

Unaccompanied Refugee Youth in Switzerland and the 'Refugee Crisis': The Emergence of the Child Asylum Seeker

In this paper I will reflect on the emergence of the distinct figure of the child asylum seeker which has entered public and political debates in Switzerland within the last 2 years. It is a figure that is identified through certain attributes such as youth, trauma, lostness or need for protection, and it is a figure that is imbued with certain rights (namely children’s rights). While this has helped young people to receive special treatment, the question arises what the repercussions are for those who do not fit within these categories. What, for example, happens, when different notions of youth, childhood and adolescence clash and disrupt ideals of innocence and childhood? And given that negative public discourses are largely focussed on the apparent danger and uncontrollability of male, single asylum seekers, what happens when categories mix and mingle? In this paper I will shed light on the interplay of institutional expectations of what constitutes a 'proper' child refugee and the ways young people themselves play with, test and contest these norms.

Methodological Report on Kaul and Wolf's Working Papers on the Effect of Plain Packaging on Smoking Prevalence in Australia and the Criticism Raised by OxyRomandie

This report contains a methodological assessment of two working papers by Ashok Kaul and Michael Wolf on the effect of plain packaging on smoking prevalence in Australia and the criticism raised against these working papers by OxyRomandie. First, the potential of the data used by Kaul and Wolf for identifying causal effects is discussed. Second, a reanalysis of the data is provided. Third, the criticism raised by OxyRomandie is commented.

Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

INTRODUCTION HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. METHODS Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. RESULTS Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. CONCLUSIONS This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

Peroxisome proliferator-activated receptor {gamma} coactivator 1{alpha} (PGC-1{alpha}) promotes skeletal muscle lipid refueling in vivo by activating de novo lipogenesis and the pentose phosphate pathway

Exercise induces a pleiotropic adaptive response in skeletal muscle, largely through peroxisome proliferator-activated receptor coactivator 1 (PGC-1 ). PGC-1 enhances lipid oxidation and thereby provides energy for sustained muscle contraction. Its potential implication in promoting muscle refueling remains unresolved, however. Here, we investigated a possible role of elevated PGC-1 levels in skeletal muscle lipogenesis in vivo and the molecular mechanisms that underlie PGC-1 -mediated de novo lipogenesis. To this end, we studied transgenic mice with physiological overexpression of PGC-1 and human muscle biopsies pre- and post-exercise. We demonstrate that PGC-1 enhances lipogenesis in skeletal muscle through liver X receptor -dependent activation of the fatty acid synthase (FAS) promoter and by increasing FAS activity. Using chromatin immunoprecipitation, we establish a direct interaction between PGC-1 and the liver X receptor-responsive element in the FAS promoter. Moreover, we show for the first time that increased glucose uptake and activation of the pentose phosphate pathway provide substrates for RNA synthesis and cofactors for de novo lipogenesis. Similarly, we observed increased lipogenesis and lipid levels in human muscle biopsies that were obtained post-exercise. Our findings suggest that PGC-1 coordinates lipogenesis, intramyocellular lipid accumulation, and substrate oxidation in exercised skeletal muscle in vivo.

Metabolomics reveals the metabolic map of procainamide in humans and mice

Procainamide, a type I antiarrhythmic agent, is used to treat a variety of atrial and ventricular dysrhythmias. It was reported that long-term therapy with procainamide may cause lupus erythematosus in 25-30% of patients. Interestingly, procainamide does not induce lupus erythematosus in mouse models. To explore the differences in this side-effect of procainamide between humans and mouse models, metabolomic analysis using ultra-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-QTOFMS) was conducted on urine samples from procainamide-treated humans, CYP2D6-humanized mice, and wild-type mice. Thirteen urinary procainamide metabolites, including nine novel metabolites, derived from P450-dependent, FMO-dependent oxidations and acylation reactions, were identified and structurally elucidated. In vivo metabolism of procainamide in CYP2D6-humanized mice as well as in vitro incubations with microsomes and recombinant P450s suggested that human CYP2D6 plays a major role in procainamide metabolism. Significant differences in N-acylation and N-oxidation of the drug between humans and mice largely account for the interspecies differences in procainamide metabolism. Significant levels of the novel N-oxide metabolites produced by FMO1 and FMO3 in humans might be associated with the development of procainamide-induced systemic lupus erythematosus. Observations based on this metabolomic study offer clues to understanding procainamide-induced lupus in humans and the effect of P450s and FMOs on procainamide N-oxidation.

Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years

BACKGROUND/AIMS: Alveolar echinococcosis (AE) is a serious liver disease. The aim of this study was to explore the long-term prognosis of AE patients, the burden of this disease in Switzerland and the cost-effectiveness of treatment. METHODS: Relative survival analysis was undertaken using a national database with 329 patient records. 155 representative cases had sufficient details regarding treatment costs and patient outcome to estimate the financial implications and treatment costs of AE. RESULTS: For an average 54-year-old patient diagnosed with AE in 1970 the life expectancy was estimated to be reduced by 18.2 and 21.3 years for men and women, respectively. By 2005 this was reduced to approximately 3.5 and 2.6 years, respectively. Patients undergoing radical surgery had a better outcome, whereas the older patients had a poorer prognosis than the younger patients. Costs amount to approximately Euro108,762 per patient. Assuming the improved life expectancy of AE patients is due to modern treatment the cost per disability-adjusted life years (DALY) saved is approximately Euro6,032. CONCLUSIONS: Current treatments have substantially improved the prognosis of AE patients compared to the 1970s. The cost per DALY saved is low compared to the average national annual income. Hence, AE treatment is highly cost-effective in Switzerland.

Life partnerships in childhood cancer survivors, their siblings, and the general population

Background: Life partnerships other than marriage are rarely studied in childhood cancer survivors (CCS). We aimed (1) to describe life partnership and marriage in CCS and compare them to life partnerships in siblings and the general population; and (2) to identify socio-demographic and cancer-related factors associated with life partnership and marriage. Methods: As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to all CCS (aged 20–40 years) registered in the Swiss Childhood Cancer Registry (SCCR), aged <16 years at diagnosis, who had survived ≥5 years. The proportion with life partner or married was compared between CSS and siblings and participants in the Swiss Health Survey (SHS). Multivariable logistic regression was used to identify factors associated with life partnership or marriage. Results: We included 1,096 CCS of the SCCSS, 500 siblings and 5,593 participants of the SHS. Fewer CCS (47%) than siblings (61%, P < 0.001) had life partners, and fewer CCS were married (16%) than among the SHS population (26%, P > 0.001). Older (OR = 1.14, P < 0.001) and female CCS (OR = 1.85, <0.001) were more likely to have life partners. CCS who had undergone radiotherapy, bone marrow transplants (global PTreatment = 0.018) or who had a CNS diagnosis (global PDiagnosis < 0.001) were less likely to have life partners. Conclusion: CCS are less likely to have life partners than their peers. Most CCS with a life partner were not married. Future research should focus on the effect of these disparities on the quality of life of CCS.

Total acetabular retroversion following pelvic osteotomy: presentation, management, and outcome

Acetabular retroversion following acetabular osteotomy in hips with dysplasia can negatively effect the outcome. Total retroversion, where the entire anterior rim is lateral to the posterior rim, is rare and can easily be missed on pelvic radiographs due to the lack of a crossover sign. We evaluated the clinical and radiographic presentation, the surgical management, and the outcome of hips with total acetabular retroversion. We retrospectively reviewed 26 patients (26 hips) with total retroversion following 15 periacetabular osteotomies (PAO), 10 triple type, and one Salter osteotomy. We obtained range of motion (ROM), anterior impingement test, Drehmann's sign, Merle d’Aubigné-Postel score, and Tönnis score for osteoarthrosis. Corrective surgery included 19 revision PAOs and seven total hip arthroplasties (THA). The mean follow-up was 4.7 ± 4.2 (range 0.5-13.8) years. Patients presented with a restricted ROM (flexion and internal rotation), a positive anterior impingement test, a positive Drehmann's sign, and a decreased Merle d'Aubigné-Postel score due to pain. Corrective surgery was performed after mean of 7 ± 5 (1-15) years. Complications for revision PAO and THA occurred in 37% and 29%, respectively. At follow-up, the Merle d'Aubigné-Postel score improved for both revision PAOs and THAs. The prevalence of a positive anterior impingement test and Drehmann's sign decreased for revision PAOs. There was a tendency for progression of OA in hips with revision PAO. Iatrogenic total acetabular retroversion following reorientation is a disabling condition for the patients. Corrective surgery including revision PAO and THA results in improved clinical outcome. However, these procedures are technically challenging and associated with high complication rates.