146 resultados para Complementary and alternative medicine, hospital, use, epidemiology, Switzerland
Resumo:
Temperate C3-grasslands are of high agricultural and ecological importance in Central Europe. Plant growth and consequently grassland yields depend strongly on water supply during the growing season, which is projected to change in the future. We therefore investigated the effect of summer drought on the water uptake of an intensively managed lowland and an extensively managed sub-alpine grassland in Switzerland. Summer drought was simulated by using transparent shelters. Standing above- and belowground biomass was sampled during three growing seasons. Soil and plant xylem waters were analyzed for oxygen (and hydrogen) stable isotope ratios, and the depths of plant water uptake were estimated by two different approaches: (1) linear interpolation method and (2) Bayesian calibrated mixing model. Relative to the control, aboveground biomass was reduced under drought conditions. In contrast to our expectations, lowland grassland plants subjected to summer drought were more likely (43–68 %) to rely on water in the topsoil (0–10 cm), whereas control plants relied less on the topsoil (4–37 %) and shifted to deeper soil layers (20–35 cm) during the drought period (29–48 %). Sub-alpine grassland plants did not differ significantly in uptake depth between drought and control plots during the drought period. Both approaches yielded similar results and showed that the drought treatment in the two grasslands did not induce a shift to deeper uptake depths, but rather continued or shifted water uptake to even more shallower soil depths. These findings illustrate the importance of shallow soil depths for plant performance under drought conditions.
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Linear- and unimodal-based inference models for mean summer temperatures (partial least squares, weighted averaging, and weighted averaging partial least squares models) were applied to a high-resolution pollen and cladoceran stratigraphy from Gerzensee, Switzerland. The time-window of investigation included the Allerød, the Younger Dryas, and the Preboreal. Characteristic major and minor oscillations in the oxygen-isotope stratigraphy, such as the Gerzensee oscillation, the onset and end of the Younger Dryas stadial, and the Preboreal oscillation, were identified by isotope analysis of bulk-sediment carbonates of the same core and were used as independent indicators for hemispheric or global scale climatic change. In general, the pollen-inferred mean summer temperature reconstruction using all three inference models follows the oxygen-isotope curve more closely than the cladoceran curve. The cladoceran-inferred reconstruction suggests generally warmer summers than the pollen-based reconstructions, which may be an effect of terrestrial vegetation not being in equilibrium with climate due to migrational lags during the Late Glacial and early Holocene. Allerød summer temperatures range between 11 and 12°C based on pollen, whereas the cladoceran-inferred temperatures lie between 11 and 13°C. Pollen and cladocera-inferred reconstructions both suggest a drop to 9–10°C at the beginning of the Younger Dryas. Although the Allerød–Younger Dryas transition lasted 150–160 years in the oxygen-isotope stratigraphy, the pollen-inferred cooling took 180–190 years and the cladoceran-inferred cooling lasted 250–260 years. The pollen-inferred summer temperature rise to 11.5–12°C at the transition from the Younger Dryas to the Preboreal preceded the oxygen-isotope signal by several decades, whereas the cladoceran-inferred warming lagged. Major discrepancies between the pollen- and cladoceran-inference models are observed for the Preboreal, where the cladoceran-inference model suggests mean summer temperatures of up to 14–15°C. Both pollen- and cladoceran-inferred reconstructions suggest a cooling that may be related to the Gerzensee oscillation, but there is no evidence for a cooling synchronous with the Preboreal oscillation as recorded in the oxygen-isotope record. For the Gerzensee oscillation the inferred cooling was ca. 1 and 0.5°C based on pollen and cladocera, respectively, which lies well within the inherent prediction errors of the inference models.
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The tension between openness and closedness is one of the most important cleavages in Swiss political debates. In the present article, we study the psychological foundations of attitudes regarding this issue. More precisely, we examine the link between personality and attitudes toward the degree of openness of Switzerland as a general stance toward the cultural, economic and political alignment of the country. Personality is understood as a complex and multifaceted concept that forms the basis for consistent patterns of attitudes and behavior. We build on the Five-Factor Theory to explain the link between personality traits, contextual factors and political attitudes. Analyzing survey data from a random sample of Swiss citizens, we find clear evidence that personality traits affect political attitudes. Furthermore, we are able to demonstrate that the relationship between personality and attitudes toward the degree of openness of Switzerland is moderated by perceived ethnic diversity in the neighborhood.
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Oxygen- and carbon-isotope ratios in the carbonate of benthic ostracodes (Pseudocandona marchica) and molluscs (Pisidium ssp.) were measured across the transitions bordering the Younger Dryas chronozone in littoral lacustrine cores from Gerzensee (Switzerland). The specific biogenic carbonate records confirm the major shifts already visible in the continuous bulk-carbonate oxygen-isotope record (δ18OCc). If corrected for their vital offsets, oxygen-isotope ratios of Pisidium and juvenile P. marchica, both formed in summer, are almost identical to δ18OCc. This bulk carbonate is mainly composed of encrustations of benthic macrophythes (Chara ssp.), also mainly produced during summer. Adult P. marchica, which calcify in winter, show consistently higher δ18O, larger shifts across both transitions, and short positive excursions compared with the summer forms, especially during early Preboreal. Despite such complexity, the δ18O of adult P. marchica probably reflects more accurately the variations of the δ18O of former lake water because, during winter, calcification temperatures are less variable and the water column isotopically uniform. The difference between normalised δ18O of calcite precipitated in winter to that formed in summer can be used to estimate the minimum difference between summer and winter water temperatures. In general, the results indicate warmer summers during the late Allerød and early Preboreal compared with the Younger Dryas. Altogether, the isotopic composition of lake water (δ18OL) and of the dissolved inorganic carbonate (δ13CDIC) reconstructed from adult Pseudocandona marchica, as well as the seasonal water temperature contrasts, indicate that the major shifts in the δ18O of local precipitation at Gerzensee were augmented by changes of the lake's water balance, with relatively higher evaporative loss occurring during the Allerød compared with the Younger Dryas. It is possible that during the early Preboreal the lake might even have been hydrologically closed for a short period. We speculate that such hydrologic changes reflect a combination of varying evapotranspiration and a rearrangement of groundwater recharge during those climatic shifts.
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South Africa is one of the countries most affected by HIV/AIDS: According to 2014 UNAIDS data 6.8 million South Africans live with HIV/AIDS, which means a 18.9% prevalence rate among adults (15-49 years old). Despite this strong presence of HIV/AIDS in South African society it remains relatively stigmatized and is not openly talked about. The silence about HIV/AIDS maintained in everyday conversations and the superstitions associated with this illness have led to the creation of a taboo language. This study aims at shedding light on how South African users resort to specific emoticons and graphic signs to talk about HIV/AIDS online. For this purpose 368 Facebook status updates and comments concerning HIV/AIDS and its side effects were analysed. All participants, aged 14-48, lived at the moment of data collection in Cape Town, in the Cape Flats area. The online conversations investigated are mainly in English mixed with Afrikaans and/or Xhosa. The emoticons and graphic signs in most cases display a graphic depiction of the physical (and mental) effects of the illness. These linguistic and semiotic practices employed on Facebook provide insight into how Capetonian users, on the one hand, express solidarity and sympathy with people suffering from HIV/AIDS. On the other hand, the emoticons and graphic signs are used to label and position people affected by HIV/AIDS. Thus, in the South African context social network sites have become an important space and means for communicating HIV/AIDS issues.
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Background Complementary medicine (CM) is popular in Switzerland. Several CM methods (traditional Chinese medicine/acupuncture, homeopathy, anthroposophic medicine, neural therapy, and herbal medicine) are currently covered by the mandatory basic health insurance when performed by a certified physician. Treatments by non-medical therapists are partially covered by a supplemental and optional health insurance. In this study, we investigated the frequency of CM use including the evolvement over time, the most popular methods, and the user profile. Methods Data of the Swiss Health Surveys 2007 and 2012 were used. In 2007 and 2012, a population of 14,432 and 18,357, respectively, aged 15 years or older answered the written questionnaire. A set of questions queried about the frequency of use of various CM methods within the last 12 months before the survey. Proportions of usage and 95% confidence intervals were calculated for these methods and CM in general. Users and non-users of CM were compared using logistic regression models. Results The most popular methods in 2012 were homeopathy, naturopathy, osteopathy, herbal medicine, and acupuncture. The average number of treatments within the 12 months preceding the survey ranged from 3 for homeopathy to 6 for acupuncture. 25.0% of the population at the age of 15 and older had used at least one CM method in the previous 12 months. People with a chronic illness or a poor self-perceived health status were more likely to use CM. Similar to other countries, women, people of middle age, and those with higher education were more likely to use CM. 59.9% of the adult population had a supplemental health insurance that partly covered CM treatments. Conclusions Usage of CM in Switzerland remained unchanged between 2007 and 2012. The user profile in Switzerland was similar to other countries, such as Germany, United Kingdom, United States or Australia.
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BACKGROUND: Scientific progress in the biology of hematopoietic stem cells (HSCs) provides opportunities for advances in therapy for different diseases. While stem cell sources such as umbilical cord blood (UCB) are unproblematic, other sources such as human embryonic stem cells (hESCs) raise ethical concerns. STUDY DESIGN AND METHODS: In a prospective survey we established the ethical acceptability of collection, research, and therapy with UCB HSCs versus hESCs among health care professionals, pregnant women, patients undergoing in vitro fertilization therapy, parents, and HSC donors and recipients in Switzerland. RESULTS: There was overall agreement about an ethical justification for the collection of UCB for research and therapy in the majority of participants (82%). In contrast, research and therapy with hESCs was acceptable only by a minority (38% of all responders). The collection of hESCs solely created for HSC collection purposes met overall with the lowest approval rates. Hematologists displayed among the participants the highest acceptance rates for the use of hESCs with 55% for collection, 63% for research, and 73% for therapy. CONCLUSIONS: This is the first study assessing the perception of hESCs for research and therapy in comparison with UCB HSCs in different target groups that are exposed directly, indirectly, or not at all to stem cell-based medicine. Our study shows that the debate over the legitimacy of embryo-destructive transplantation medicine is far from over as particularly hESC research continues to present an ethical problem to an overwhelming majority among laypersons and even among health care professionals.
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The objective of the present study was to measure the occurrence of orofacial and cerebral injuries in different sports and to survey the awareness of athletes and officials concerning the use of mouthguards during sport activities. Two hundred and sixty-seven professional athletes and 63 officials participating in soccer, handball, basketball and ice hockey were interviewed. The frequency of orofacial and cerebral trauma during sport practice was recorded and the reason for using and not using mouthguards was assessed. A great difference in orofacial and cerebral injuries was found when comparing the different kinds of sports and comparing athletes with or without mouthguards. 45% of the players had suffered injuries when not wearing mouthguards. Most injuries were found in ice hockey, (59%), whereas only 24% of the soccer players suffered injuries when not wearing mouthguards. Sixty-eight percentage of the players wearing mouthguards had never suffered any orofacial and cerebral injuries. Two hundred and twenty-four athletes (84%) did not use a mouthguard despite general acceptance by 150 athletes (56%). Although the awareness of mouthguards among officials was very high (59%), only 25% of them would support the funding of mouthguards and 5% would enforce regulations. Athletes as well as coaches should be informed about the high risk of oral injuries when performing contact sports. Doctors and dentists need to recommend a more intensive education of students in sports medicine and sports dentistry, and to increase their willingness to become a team dentist.
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BACKGROUND Avoidable hospitalizations (AH) are hospital admissions for diseases and conditions that could have been prevented by appropriate ambulatory care. We examine regional variation of AH in Switzerland and the factors that determine AH. METHODS We used hospital service areas, and data from 2008-2010 hospital discharges in Switzerland to examine regional variation in AH. Age and sex standardized AH were the outcome variable, and year of admission, primary care physician density, medical specialist density, rurality, hospital bed density and type of hospital reimbursement system were explanatory variables in our multilevel poisson regression. RESULTS Regional differences in AH were as high as 12-fold. Poisson regression showed significant increase of all AH over time. There was a significantly lower rate of all AH in areas with more primary care physicians. Rates increased in areas with more specialists. Rates of all AH also increased where the proportion of residences in rural communities increased. Regional hospital capacity and type of hospital reimbursement did not have significant associations. Inconsistent patterns of significant determinants were found for disease specific analyses. CONCLUSION The identification of regions with high and low AH rates is a starting point for future studies on unwarranted medical procedures, and may help to reduce their incidence. AH have complex multifactorial origins and this study demonstrates that rurality and physician density are relevant determinants. The results are helpful to improve the performance of the outpatient sector with emphasis on local context. Rural and urban differences in health care delivery remain a cause of concern in Switzerland.
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The intensive and inappropriate use of antibiotics in both medicine and agriculture has selected for antibiotic resistant bacteria that cause severe problems in antibiotic therapy. In animal husbandry, antibiotics are used for therapeutic and preventive treatments of infectious diseases and as growth promoters. In Europe, many antibiotics used as growth promoters were of the same classes as important antibiotics used in human medicine. The European Union withdrew the authorization for the use of the major antimicrobial growth promoters between 1996 and 1999. In 1999 Switzerland decided to ban the use of all antimicrobials as growthpromoting feed additives. The regulations concerning antibiotic use in animal husbandry and the chronological reasons for the ban of antimicrobial growth promoters are described. This ban led to a decrease of the antibiotic volume deployed in agriculture. This measure helps to reduce the amount of antibiotic resistant bacteria in food-producing animals. However, the use of medicated feed is still a common practice to prevent and to remedy bacterial infections and thus still leads to resistant pathogens. Surveillance programs, single animal treatment, good manufacturing practices and vaccinations are additional measures to be taken to keep the level of resistances in bacteria low.
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Meta-analysis of predictive values is usually discouraged because these values are directly affected by disease prevalence, but sensitivity and specificity sometimes show substantial heterogeneity as well. We propose a bivariate random-effects logitnormal model for the meta-analysis of the positive predictive value (PPV) and negative predictive value (NPV) of diagnostic tests.
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In this study, we aimed to evaluate the relationship between the rates of resistance of Pseudomonas aeruginosa to carbapenems and the levels and diversity of antibiotic consumption. Data were retrospectively collected from 20 acute care hospitals across 3 regions of Switzerland between 2006 and 2010. The main outcome of the present study was the rate of resistance to carbapenems among P. aeruginosa. Putative predictors included the total antibiotic consumption and carbapenem consumption in defined daily doses per 100 bed days, the proportion of very broad-spectrum antibiotics used, and the Peterson index. The present study confirmed a correlation between carbapenem use and carbapenem resistance rates at the hospital and regional levels. The impact of diversifying the range of antibiotics used against P. aeruginosa resistance was suggested by (i) a positive correlation in multivariate analysis between the above-mentioned resistance and the proportion of consumed antibiotics having a very broad spectrum of activity (coefficient = 1.77; 95% confidence interval, 0.58 to 2.96; P < 0.01) and (ii) a negative correlation between the resistance and diversity of antibiotic use as measured by the Peterson homogeneity index (coefficient = -0.52; P < 0.05). We conclude that promoting heterogeneity plus parsimony in the use of antibiotics appears to be a valuable strategy for minimizing the spread of carbapenem resistance in P. aeruginosa in hospitals.