Suicide in HIV-Infected Individuals and the General Population in Switzerland, 1988-2008

Objective High rates of suicide have been described in HIV-infected patients, but it is unclear to what extent the introduction of highly active antiretroviral therapy (HAART) has affected suicide rates. The authors examined time trends and predictors of suicide in the pre-HAART (1988—1995) and HAART (1996—2008) eras in HIV-infected patients and the general population in Switzerland. Method The authors analyzed data from the Swiss HIV Cohort Study and the Swiss National Cohort, a longitudinal study of mortality in the Swiss general population. The authors calculated standardized mortality ratios comparing HIV-infected patients with the general population and used Poisson regression to identify risk factors for suicide. Results From 1988 to 2008, 15,275 patients were followed in the Swiss HIV Cohort Study for a median duration of 4.7 years. Of these, 150 died by suicide (rate 158.4 per 100,000 person-years). In men, standardized mortality ratios declined from 13.7 (95% CI=11.0—17.0) in the pre-HAART era to 3.5 (95% CI=2.5—4.8) in the late HAART era. In women, ratios declined from 11.6 (95% CI=6.4—20.9) to 5.7 (95% CI=3.2—10.3). In both periods, suicide rates tended to be higher in older patients, in men, in injection drug users, and in patients with advanced clinical stage of HIV illness. An increase in CD4 cell counts was associated with a reduced risk of suicide. Conclusions Suicide rates decreased significantly with the introduction of HAART, but they remain above the rate observed in the general population, and risk factors for suicide remain similar. HIV-infected patients remain an important target group for suicide prevention.

Musical stem completion: Humming that note

This study looked at how people store and retrieve tonal music explicitly and implicitly using a production task. Participants completed an implicit task (tune stem completion) followed by an explicit task (cued recall). The tasks were identical except for the instructions at test time. They listened to tunes and were then presented with tune stems from previously heard tunes and novel tunes. For the implicit task, they were asked to sing a note they thought would come next musically. For the explicit task, they were asked to sing the note they remembered as coming next. Experiment 1 found that people correctly completed significantly more old stems than new stems. Experiment 2 investigated the characteristics of music that fuel retrieval by varying a surface feature of the tune (same timbre ordifferent timbre) from study to test and the encoding task (semantic or nonsemantic). Although we did not find that implicit and explicit memory for music were significantly dissociated for levels of processing, we did find that surface features of music affect semantic judgments and subsequent explicit retrieval.

Emergency department admissions to a prison hospital: a retrospective cohort study from Switzerland

There are more than 10 million prison inmates throughout the world and this number is increasing continuously. Prisoners are a particularly vulnerable minority group that has special healthcare needs and demands on healthcare services and providers. The aim of this study was to give an overview of prisoners' healthcare problems leading to emergency department admission, in order to make recommendations to help to optimise treatment of this target group.

Resocialization of the Street Children

This project studied the phenomenon of street children through various forms of action dealing with them. The target group included 100 children who frequented the Pygmalion and Open House day centres in Bucharest. On the basis of this sample it was possible to establish the main problems of the street children: reasons for appearance, age on the street, origin, family size, attitude towards parents, reasons for street life, consumption of toxic substances, reasons for detention by the police, main health problems, needs and wishes. The work in Bucharest was supplemented by visits elsewhere in Romania and abroad which provided a breadth of understanding and knowledge of the specific profile of street children, of the complexity of their problems and of their prospects. A comparison of the causes of the phenomenon, and study of some projects and intervention programmes both from Romania and abroad provided the basis for a proposed strategy for combatting the problem. The practical activities on the project included continuing counselling and informative and education activities with the children in order to motivate them to change their life. Further mediation was aimed at changing the hostile approach of the public opinion and some people in authority towards these children. The experiments with schooling and professional resocialisation of the street children provided clear evidence of the possibility of reintroducing them into the social framework but this will require systems and mechanisms specially developed to achieve this.

Opportunistic and systematic screening for chlamydia: a study of consultations by young adults in general practice

BACKGROUND: Opportunistic screening for genital chlamydia infection is being introduced in England, but evidence for the effectiveness of this approach is lacking. There are insufficient data about young peoples' use of primary care services to determine the potential coverage of opportunistic screening in comparison with a systematic population-based approach. AIM: To estimate use of primary care services by young men and women; to compare potential coverage of opportunistic chlamydia screening with a systematic postal approach. DESIGN OF STUDY: Population based cross-sectional study. SETTING: Twenty-seven general practices around Bristol and Birmingham. METHOD: A random sample of patients aged 16-24 years were posted a chlamydia screening pack. We collected details of face-to-face consultations from general practice records. Survival and person-time methods were used to estimate the cumulative probability of attending general practice in 1 year and the coverage achieved by opportunistic and systematic postal chlamydia screening. RESULTS: Of 12 973 eligible patients, an estimated 60.4% (95% confidence interval [CI] = 58.3 to 62.5%) of men and 75.3% (73.7 to 76.9%) of women aged 16-24 years attended their practice at least once in a 1-year period. During this period, an estimated 21.3% of patients would not attend their general practice but would be reached by postal screening, 9.2% would not receive a postal invitation but would attend their practice, and 11.8% would be missed by both methods. CONCLUSIONS: Opportunistic and population-based approaches to chlamydia screening would both fail to contact a substantial minority of the target group, if used alone. A pragmatic approach combining both strategies might achieve higher coverage.

A new method to monitor visual field defects caused by photoreceptor degeneration by quantitative optical coherence tomography

PURPOSE: To correlate the dimension of the visual field (VF) tested by Goldman kinetic perimetry with the extent of visibility of the highly reflective layer between inner and outer segments of photoreceptors (IOS) seen in optical coherence tomography (OCT) images in patients with retinitis pigmentosa (RP). METHODS: In a retrospectively designed cross-sectional study, 18 eyes of 18 patients with RP were examined with OCT and Goldmann perimetry using test target I4e and compared with 18 eyes of 18 control subjects. A-scans of raw scan data of Stratus OCT images (Carl Zeiss Meditec, AG, Oberkochen, Germany) were quantitatively analyzed for the presence of the signal generated by the highly reflective layer between the IOS in OCT images. Starting in the fovea, the distance to which this signal was detectable was measured. Visual fields were analyzed by measuring the distance from the center point to isopter I4e. OCT and visual field data were analyzed in a clockwise fashion every 30 degrees , and corresponding measures were correlated. RESULTS: In corresponding alignments, the distance from the center point to isopter I4e and the distance to which the highly reflective signal from the IOS can be detected correlate significantly (r = 0.75, P < 0.0001). The greater the distance in VF, the greater the distance measured in OCT. CONCLUSIONS: The authors hypothesize that the retinal structure from which the highly reflective layer between the IOS emanates is of critical importance for visual and photoreceptor function. Further research is warranted to determine whether this may be useful as an objective marker of progression of retinal degeneration in patients with RP.

The Current Discussion on Men and Masculinities

In the past gender specific problems were mainly discussed in a female perspective. In the meantime there is a rising attentiveness in the living conditions of men and their coping strategies within critical life events. In this paper an appropriate frame of reference is outlined which can be used in those areas of social work where men are already discovered as a target group with special difficulties and needs.

The Road to Negative Behavior: Discriminatory Intentions in the German Population

This study analyzes discriminatory intentions shared by members of the German majority against several outgroups in Germany. Patterns of discriminatory intentions against various minority groups were investigated for several indicators, including gender, age, and political orientation, by means of a representative survey (N = 1,778). The relationship between prejudices and discriminatory intentions against different target groups was also analyzed. Prejudice and discriminatory intentions show moderate but consistently positive correlations in relation to one and the same target group. Moreover, it was found that discriminatory intentions against one outgroup are related to hostile attitudes towards other outgroups, too. The results support the hypothesis of a syndrome of group-focused enmity.

Autorenwerkzeuge für digitale, multimediale und interaktive Lernbausteine im Web 2.0

Die vorliegende Forschungsarbeit siedelt sich im Dreieck der Erziehungswissenschaften, der Informatik und der Schulpraxis an und besitzt somit einen starken interdisziplinären Charakter. Aus Sicht der Erziehungswissenschaften handelt es sich um ein Forschungsprojekt aus den Bereichen E-Learning und Multimedia Learning und der Fragestellung nach geeigneten Informatiksystemen für die Herstellung und den Austausch von digitalen, multimedialen und interaktiven Lernbausteinen. Dazu wurden zunächst methodisch-didaktische Vorteile digitaler Lerninhalte gegenüber klassischen Medien wie Buch und Papier zusammengetragen und mögliche Potentiale im Zusammenhang mit neuen Web 2.0-Technologien aufgezeigt. Darauf aufbauend wurde für existierende Autorenwerkzeuge zur Herstellung digitaler Lernbausteine und bestehende Austauschplattformen analysiert, inwieweit diese bereits Web 2.0-Technologien unterstützen und nutzen. Aus Sicht der Informatik ergab sich aus der Analyse bestehender Systeme ein Anforderungsprofil für ein neues Autorenwerkzeug und eine neue Austauschplattform für digitale Lernbausteine. Das neue System wurde nach dem Ansatz des Design Science Research in einem iterativen Entwicklungsprozess in Form der Webapplikation LearningApps.org realisiert und stetig mit Lehrpersonen aus der Schulpraxis evaluiert. Bei der Entwicklung kamen aktuelle Web-Technologien zur Anwendung. Das Ergebnis der Forschungsarbeit ist ein produktives Informatiksystem, welches bereits von tausenden Nutzern in verschiedenen Ländern sowohl in Schulen als auch in der Wirtschaft eingesetzt wird. In einer empirischen Studie konnte das mit der Systementwicklung angestrebte Ziel, die Herstellung und den Austausch von digitalen Lernbausteinen zu vereinfachen, bestätigt werden. Aus Sicht der Schulpraxis liefert LearningApps.org einen Beitrag zur Methodenvielfalt und zur Nutzung von ICT im Unterricht. Die Ausrichtung des Werkzeugs auf mobile Endgeräte und 1:1-Computing entspricht dem allgemeinen Trend im Bildungswesen. Durch die Verknüpfung des Werkzeugs mit aktuellen Software-Entwicklungen zur Herstellung von digitalen Schulbüchern werden auch Lehrmittelverlage als Zielgruppe angesprochen.

Vergleich von Softwarelösungen für die Ökobilanzierung – eine softwareergonomische Analyse

Ökobilanzierung von Produktsystemen dient der Abschätzung ihrer Wirkung auf die Umwelt. Eine vollständige Lebenswegbetrachtung erfordert auch die Einbeziehung intralogistischer Transportprozesse bzw. -mittel. Für die Erstellung von Ökobilanzen wird i. d. R. ein Computerprogramm verwendet. Die Demoversionen dreier kommerzieller Softwarelösungen (SimaPro, GaBi und Umberto NXT LCA) und die Vollversion einer Open Source Software (openLCA) wurden aus softwareergonomischer Sicht analysiert. Hierzu erfolgte u. a. der Nachbau der bereitgestellten Tutorials bzw. die Modellierung eigener Produktsysteme. Im Rahmen der Analyse wurden die Punkte • Entstehung, Verbreitung, Zielgruppe, • Eignung der Tutorials, Erlernbarkeit, • Grafische Benutzeroberfläche, Individualisierbarkeit der Software, • Umsetzung der Anforderungen aus den Ökobilanzierungsnormen, • Notwendige Arbeitsschritte zur Erstellung einer Ökobilanz einer vergleichenden Betrachtung unterzogen. Der Beitrag beinhaltet eine Einführung in die wesentlichen Prinzipien der Ökobilanzierung und die Grundsätze der Softwareergonomie. Diese werden zu softwareergonomischen Eigenschaften für Ökobilanzsoftwarelösungen subsumiert. Anschließend werden die Ergebnisse des Softwarevergleiches dargestellt. Abschließend erfolgt eine Zusammenfassung der Erkenntnisse.

Rahmenwerk für zielgruppenorientiertes Blended E-Learning im MINT-Bereich im Kontext des Lebenslangen Lernens

Das heutige Leben der Menschen ist vom Internet durchdrungen, kaum etwas ist nicht „vernetzt“ oder „elektronisch verfügbar“. Die Welt befindet sich im Wandel, die „Informationsgesellschaft“ konsumiert in Echtzeit Informationen auf mobilen Endgeräten, unabhängig von Zeit und Ort. Dies gilt teilweise auch für den Aus- und Weiterbildungssektor: Unter „E-Learning“ versteht man die elektronische Unterstützung des Lernens. Gelernt wird „online“; Inhalte sind digital verfügbar. Zudem hat sich die Lebenssituation der sogenannten „Digital Natives“, der jungen Individuen in der Informationsgesellschaft, verändert. Sie fordern zeitlich und räumlich flexible Ausbildungssysteme, erwarten von Bildungsinstitutionen umfassende digitale Verfügbarkeit von Informationen und möchten ihr Leben nicht mehr Lehr- und Zeitplänen unterordnen – das Lernen soll zum eigenen Leben passen, lebensbegleitend stattfinden. Neue „Lernszenarien“, z.B. für alleinerziehende Teilzeitstudierende oder Berufstätige, sollen problemlos möglich werden. Dies soll ein von der europäischen Union erarbeitetes Paradigma leisten, das unter dem Terminus „Lebenslanges Lernen“ zusammengefasst ist. Sowohl E-Learning, als auch Lebenslanges Lernen gewinnen an Bedeutung, denn die (deutsche) Wirtschaft thematisiert den „Fachkräftemangel“. Die Nachfrage nach speziell ausgebildeten Ingenieuren im MINT-Bereich soll schnellstmöglich befriedigt, die „Mitarbeiterlücke“ geschlossen werden, um so weiterhin das Wachstum und den Wohlstand zu sichern. Spezielle E-Learning-Lösungen für den MINT-Bereich haben das Potential, eine schnelle sowie flexible Aus- und Weiterbildung für Ingenieure zu bieten, in der Fachwissen bezogen auf konkrete Anforderungen der Industrie vermittelt wird. Momentan gibt es solche Systeme allerdings noch nicht. Wie sehen die Anforderungen im MINT-Bereich an eine solche E-Learning-Anwendung aus? Sie muss neben neuen Technologien vor allem den funktionalen Anforderungen des MINTBereichs, den verschiedenen Zielgruppen (wie z.B. Bildungsinstitutionen, Lerner oder „Digital Natives“, Industrie) und dem Paradigma des Lebenslangen Lernens gerecht werden, d.h. technische und konzeptuelle Anforderungen zusammenführen. Vor diesem Hintergrund legt die vorliegende Arbeit ein Rahmenwerk für die Erstellung einer solchen Lösung vor. Die praktischen Ergebnisse beruhen auf dem Blended E-Learning-System des Projekts „Technische Informatik Online“ (VHN-TIO).

Street-level bureaucrats and new modes of governance - How conflicting roles affect the implementation of the Swiss Ordinance on Verterinary Drugs

Lipsky’s seminal concept of street-level bureaucrats (SLBs) focuses on their role as public servants. However, in the course of new modes of governance, private actors have gained an additional role as implementation agents. We explore the logic of private SLBs during the implementation of the Swiss Ordinance on Veterinary Medicinal Products (OVMP) where veterinarians are simultaneously implementing agents, policy addressees, and professionals with economic interests. We argue that, because of contradictory reference systems, it is problematic for the output performance if an actor is simultaneously the target group of a policy and its implementing agent.

How involved are they really? A comparative network analysis of the institutional drivers of local actor inclusion

Different socio-economic and environmental drivers lead local communities in mountain regions to adapt land use practices and engage in protection policies. The political system also has to develop new approaches to adapt to those drivers. Local actors are the target group of those policy approaches, and the question arises of if and how much those actors are consulted or even integrated into the design of local land use and protection policies. This article addresses this question by comparing seven different case studies in Swiss mountain regions. Through a formal social network analysis, the inclusion of local actors in collaborative policy networks is investigated and compared to the involvement of other stakeholders representing the next higher sub-national or national decisional levels. Results show that there is a significant difference (1) in how local actors are embedded compared to other stakeholders; and (2) between top-down versus bottom-up designed policy processes.

The impact of absolute importance and processing overlaps on prospective memory performance

Prospective memory is the ability to remember an intention at an appropriate moment in the future. Prospective memory tasks can be more or less important. Previously, importance was manipulated by emphasizing the importance of the prospective memory task relative to the ongoing task it was embedded in. This resulted in better prospective memory performance but also ongoing task costs. In the present study, we simply instructed one group of participants that the prospective memory task was important (i.e., absolute importance instruction) and compared them to a group with relative importance instructions and a control group. The results showed that absolute importance lead to an increase in prospective memory performance without enhancing ongoing task costs, whereas relative importance resulted in both increased prospective memory performance and ongoing task costs. Thus, prospective memory can be enhanced without ongoing task costs, which is particularly crucial for safety-work contexts.

The Associations Between Social, Behavioral, and Health Risk Factors on a High School Student’s Decision to Pursue Post High School Plans

Background: Due to the relationship between SES and health, pursuing post high-school plans can lead to better future health outcomes for the student. The current paper assesses how behavioral and health risk factors, and family and social support, effect a student’s decision to pursue post high school plans. Methods: Data from the Youth Behavioral Component of the 2007 Connecticut School Health Survey were analyzed. Composite measures of exposure to/participation in violent behavior, mental and physical health, family/social support and substance abuse were created. The effects of these domains on the decision to pursue post high-school plans were assessed using logistic regression. Data were stratified by socioeconomic status. Results: Low SES students were more likely than high SES students to be doubtful for post high-school plans. Cocaine abuse emerged as the risk factor that put low SES students at the highest odds of not pursuing post high-school plans, followed by involvement in violent/aggressive behavior, and receiving less family/social support than their peers. Similar findings regarding violence and family/social support were found in the high SES group. Findings regarding substance abuse in the high SES group were not statistically significant. Discussion: Prevention programs regarding violence and substance abuse may have the added benefit of increasing the likelihood that high school students will make post high school plans. Preventing cocaine use among low SES students may be of particular importance. Violence prevention measures should be tailored to the target group. Adequate family/social support emerged as an encouraging factor for post high school plans.