Colorectal Cancer Screening in Switzerland: Cross-Sectional Trends (2007-2012) in Socioeconomic Disparities.

BACKGROUND: Despite universal health care coverage, disparities in colorectal cancer (CRC) screening by income in Switzerland have been reported. However, it is not known if these disparities have changed over time. This study examines the association between socioeconomic position and CRC screening in Switzerland between 2007 and 2012. METHODS: Data from the 2007 (n = 5,946) and 2012 (n = 7,224) population-based Swiss Health Interview Survey data (SHIS) were used to evaluate the association between monthly household income, education, and employment with CRC screening, defined as endoscopy in the past 10 years or fecal occult blood test (FOBT) in the past 2 years. Multivariable Poisson regression was used to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and health utilization. RESULTS: CRC screening increased from 18.9% in 2007 to 22.2% in 2012 (padjusted: = 0.036). During the corresponding time period, endoscopy increased (8.2% vs. 15.0%, padjusted:<0.001) and FOBT decreased (13.0% vs. 9.8%, padjusted:0.002). CRC screening prevalence was greater in the highest income (>$6,000) vs. lowest income (≤$2,000) group in 2007 (24.5% vs. 10.5%, PR:1.37, 95%CI: 0.96-1.96) and in 2012 (28.6% vs. 16.0%, PR:1.45, 95%CI: 1.09-1.92); this disparity did not significantly change over time. CONCLUSIONS: While CRC screening prevalence in Switzerland increased from 2007 to 2012, CRC screening coverage remains low and disparities in CRC screening by income persisted over time. These findings highlight the need for increased access to CRC screening as well as enhanced awareness of the benefits of CRC screening in the Swiss population, particularly among low-income residents.

Publication trends of shared decision making in 15 high impact medical journals: a full-text review with bibliometric analysis.

BACKGROUND: Shared Decision Making (SDM) is increasingly advocated as a model for medical decision making. However, there is still low use of SDM in clinical practice. High impact factor journals might represent an efficient way for its dissemination. We aimed to identify and characterize publication trends of SDM in 15 high impact medical journals. METHODS: We selected the 15 general and internal medicine journals with the highest impact factor publishing original articles, letters and editorials. We retrieved publications from 1996 to 2011 through the full-text search function on each journal website and abstracted bibliometric data. We included publications of any type containing the phrase "shared decision making" or five other variants in their abstract or full text. These were referred to as SDM publications. A polynomial Poisson regression model with logarithmic link function was used to assess the evolution across the period of the number of SDM publications according to publication characteristics. RESULTS: We identified 1285 SDM publications out of 229,179 publications in 15 journals from 1996 to 2011. The absolute number of SDM publications by journal ranged from 2 to 273 over 16 years. SDM publications increased both in absolute and relative numbers per year, from 46 (0.32% relative to all publications from the 15 journals) in 1996 to 165 (1.17%) in 2011. This growth was exponential (P < 0.01). We found fewer research publications (465, 36.2% of all SDM publications) than non-research publications, which included non-systematic reviews, letters, and editorials. The increase of research publications across time was linear. Full-text search retrieved ten times more SDM publications than a similar PubMed search (1285 vs. 119 respectively). CONCLUSION: This review in full-text showed that SDM publications increased exponentially in major medical journals from 1996 to 2011. This growth might reflect an increased dissemination of the SDM concept to the medical community.

Five year trends in dyslipidaemia prevalence and management in Switzerland: The CoLaus study.

BACKGROUND AND AIMS: Data from prospective cohorts describing dyslipidaemia prevalence and treatment trends are lacking. Using data from the prospective CoLaus study, we aimed to examine changes in serum lipid levels, dyslipidaemia prevalence and management in a population-based sample of Swiss adults. METHODS AND RESULTS: Cardiovascular risk was assessed using PROCAM. Dyslipidaemia and low-density lipoprotein cholesterol (LDL-C) target levels were defined according to the Swiss Group for Lipids and Atherosclerosis. Complete baseline and follow up (FU) data were available for n = 4863 subjects during mean FU time of 5.6 years. Overall, 32.1% of participants were dyslipidaemic at baseline vs 46.3% at FU (p < 0.001). During this time, lipid lowering medication (LLM) rates among dyslipidaemic subjects increased from 34.0% to 39.2% (p < 0.001). In secondary prevention, LLM rates were 42.7% at baseline and 53.2% at FU (p = 0.004). In multivariate analysis, LLM use among dyslipidaemic subjects, between baseline and FU, was positively associated with personal history of CVD, older age, hypertension, higher BMI and diabetes, while negatively associated with higher educational level. Among treated subjects, LDL-C target achievement was positively associated with diabetes and negatively associated with personal history of CVD and higher BMI. Among subjects treated at baseline, LLM discontinuation was negatively associated with older age, male sex, smoking, hypertension and parental history of CVD. CONCLUSIONS: In Switzerland, the increase over time in dyslipidaemia prevalence was not paralleled by a similar increase in LLM. In a real-life setting, dyslipidaemia management remains far from optimal, both in primary and secondary prevention.

Prostate cancer screening in Switzerland: 20-year trends and socioeconomic disparities.

BACKGROUND: Despite important controversy in its efficacy, prostate cancer (PCa) screening has become widespread. Important socioeconomic screening disparities have been reported. However, trends in PCa screening and social disparities have not been investigated in Switzerland, a high risk country for PCa. We used data from five waves (from 1992-2012) of the population-based Swiss Health Interview Survey to evaluate trends in PCa screening and its association with socioeconomic indicators. METHODS: We used multivariable Poisson regression to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and use of healthcare. RESULTS: The study included 12,034 men aged ≥50 years (mean age: 63.9). Between 1992 and 2012, ever use of PCa screening increased from 55.3% to 70.0% and its use within the last two years from 32.6% to 42.4% (p-value <0.05). Income, education, and occupational class were independently associated with PCa screening. PCa screening within the last two years was greater in men with the highest (>$6,000/month) vs. lowest income (≤$2,000) (46.5% vs. 38.7% in 2012, PR for overall period =1.29, 95%CI: 1.13-1.48). These socioeconomic disparities did not significantly change over time. CONCLUSIONS: This study shows that about half of Swiss men had performed at least one PCa screening. Men belonging to high socioeconomic status are clearly more frequently screened than those less favored. Given the uncertainty of the usefulness of PCa screening, men, including those with high socioeconomic status, should be clearly informed about benefits and harms of PCa screening, in particular, the adverse effect of over-diagnosis and of associated over-treatment.

Characterizing major avalanche episodes in space and time in the twentieth and early twentyfirst centuries in the Catalan Pyrenees

With the aim of better understanding avalanche risk in the Catalan Pyrenees, the present work focuses on the analysis of major (or destructive) avalanches. For such purpose major avalanche cartography was made by an exhaustive photointerpretation of several flights, winter and summer field surveys and inquiries to local population. Major avalanche events were used to quantify the magnitude of the episodes during which they occurred, and a Major Avalanche Activity Magnitude Index (MAAMI) was developed. This index is based on the number of major avalanches registered and its estimated frequency in a given time period, hence it quantifies the magnitude of a major avalanche episode or winter. Furthermore, it permits a comparison of the magnitude between major avalanche episodes in a given mountain range, or between mountain ranges, and for a long enough period, it should allow analysis of temporal trends. Major episodes from winter 1995/96 to 2013/14 were reconstructed. Their magnitude, frequency and extent were also assessed. During the last 19 winters, the episodes of January 22-23 and February 6-8 in 1996 were those with highest MAAMI values,followed by January 30-31, 2003, January 29, 2006, and January 24-25, 2014. To analyze the whole twentieth century, a simplified MAAMI was defined in order to attain the same purpose with a less complete dataset. With less accuracy, the same parameters were obtained at winter time resolution throughout the twentieth century. Again, 1995/96 winter had the highest MAAMI value followed by 1971/72, 1974/75 and 1937/38 winter seasons. The analysis of the spatial extent of the different episodes allowed refining the demarcation of nivological regions, and improving our knowledge about the atmospheric patterns that cause major episodes and their climatic interpretation. In some cases, the importance of considering a major avalanche episode as the result of a previous preparatory period, followed by a triggering one was revealed.

Climate trends in the municipality of Pelotas, state of Rio Grande do Sul, Brazil

ABSTRACTChanges in the frequency of occurrence of extreme weather events have been pointed out as a likely impact of global warming. In this context, this study aimed to detect climate change in series of extreme minimum and maximum air temperature of Pelotas, State of Rio Grande do Sul, (1896 - 2011) and its influence on the probability of occurrence of these variables. We used the general extreme value distribution (GEV) in its stationary and non-stationary forms. In the latter case, GEV parameters are variable over time. On the basis of goodness-of-fit tests and of the maximum likelihood method, the GEV model in which the location parameter increases over time presents the best fit of the daily minimum air temperature series. Such result describes a significant increase in the mean values of this variable, which indicates a potential reduction in the frequency of frosts. The daily maximum air temperature series is also described by a non-stationary model, whose location parameter decreases over time, and the scale parameter related to sample variance rises between the beginning and end of the series. This result indicates a drop in the mean of daily maximum air temperature values and increased dispersion of the sample data.

Trends in fish prey capture by common terns following zebra mussel invasion : do terns track fish species abundance? /

The Common Tern (Sterna hirundo) is a ground nesting colonial seabird. Terns rely primarily on small prey fishes which they obtain through plunge diving for their survival as well as the survival of their offspring during the breeding season. The zebra mussel (Dreissena polymorpha) is a small bivalve mollusk that invaded North American waters in the late 1980's. Through its suspension feeding, the zebra mussel has the ability to alter the entire aquatic ecosystem, ultimately leading to a reduction in pelagic organisms including small prey fish. The objective of the study was to determine what (if any) indirect effects the invasion of the zebra mussel has had on fish prey captured by terns. The study took place in two separate two-year periods, 1990-91 and 1995-96 on a concrete breakwall off the north shore of Lake Erie near Port Colborne, Ontario. Daily nest checks revealed clutch initiation dates, egg-laying chronology, hatching success and morphological egg characteristics (length and breadth). Behavioural observations included time each sex spent in attendance with its brood, the frequency of feeding chicks and the prey species composition and size fed to chicks as well as to females (courtship feeding). Egg sizes did not differ between study periods, nor did feeding rates to chicks, suggesting that food was not a limiting resource. Terns spent less time with their broods (more time foraging) in the 1995-96 period. However, they also had significantly larger broods and fledged more offspring. The time of each individual foraging trip decreased, suggesting that fish were easier to obtain in 1995 and 1996. Lastly, kleptoparasitism rates decreased, suggesting that the costs of foraging (time, energy) actually decreased as fewer birds adopted this strategy to compensate for what I assumed to be a lack of available food (fish). The only significant difference between the periods of 1990, 1991 and 1995, 1996 was a change in diet. Terns delivered significantly fewer rainbow smelt and more emerald shiner in 1995 and 1996. However, the average size of fish delivered did not change. Thus, there was little impact on prey captured by Common Terns in Lake Erie since the invasion of the zebra mussel.

Inter- State Variations in Productivity trends and Technological Change in Indian industry

The present study entitled ‘Inter-State Variations in Manufacturing Productivity and Technological Changes in India’ covers a period of 38 years from l960 tol998-99. The study is mainly based on ASI data. The study starts with a discussion of the major facilitating factors of industrialization, namely, historical forces, public policy and infrastructure facilities. These are discussed in greater details in the context of our discussion on Perrox’s (1998) ‘growth pole’ and ‘development pole’, Hirschman’s (1958) ‘industrial centers’ and Myrdal’s ‘spread effect’ Most of the existing literature more or less agrees that the process of industrialization has not been unifonn in all Indian states. There has been a decline in inter-state industrial disparities over time. This aspect is dealt at some length in the third chapter. An important element that deserves detailed attention is the intra-regional differences in industrialisation. Regional industrialisation implies the emergence of a few focal points and industrial regions. Calcutta, Bombay and Madras were the initial focal points. Later other centers like Bangalore, Amritsar, Ahemedabad etc. emerged as nodal points in other states. All major states account for focal points. The analysis made in the third chapter shows that industrial activities generally converge to one or two focal points and industrial regions have emerged out of the focal points in almost all states. One of the general features of these complexes and regions is that they approximately accommodate 50 to 75 percent of the total industrial units and workers in the state. Such convergence is seen hands in glow with urbanization. It was further seen that intra-regional industrial disparity comes down in industrial states like Maharashtra, Gujarat and Uttar Pradesh.

Reintroduction of the Eurasian otter (Lutra lutra) in Muga and Fluvià basins (north-eastern Spain): viability, development, monitoring and trends of the new population

Aquesta tesi es basa en el programa de reintroducció de la llúdriga eurasiàtica (Lutra lutra) a les conques dels rius Muga i Fluvià (Catalunya) durant la segona meitat dels 1990s. Els objectius de la tesi foren demostrar la viabilitat de la reintroducció, demostrar l'èxit de la mateixa, estudiar aspectes ecològics i etològics de l'espècie, aprofitant l'oportunitat única de gaudir d'una població "de disseny" i determinar les probabilitats de supervivència de la població a llarg termini. La reintroducció de la llúdriga a les conques dels rius Muga i Fluvià va reeixir, doncs l'àrea geogràfica ocupada efectivament es va incrementar fins a un 64% d'estacions positives a l'hivern 2001-02. La troballa de tres exemplars adults nascuts a l'àrea de reintroducció és una altra prova que valida l'èxit del programa. La densitat d'exemplars calculada a través dels censos visuals ha resultat baixa (0.04-0.11 llúdrigues/km), però s'aproxima al que hom pot esperar en els primers estadis d'una població reintroduïda, encara poc nombrosa però distribuïda en una gran àrea. La mortalitat post-alliberament va ser del 22% un any després de l'alliberament, similar o inferior a la d'altres programes de reintroducció de llúdrigues reeixits. La mortalitat va ser deguda principalment a atropellaments (56%). El patró d'activitat de les llúdrigues reintroduïdes va esdevenir principalment nocturn i crepuscular, amb una escassa activitat diürna. Les seves àrees vitals van ser del mateix ordre (34,2 km) que les calculades en d'altres estudis realitzats a Europa. La longitud mitjana de riu recorreguda per una llúdriga durant 24 hores va ser de 4,2 km per les femelles i 7,6 km pels mascles. Durant el període de radioseguiment dues femelles van criar i els seus moviments van poder ser estudiats amb deteniment. La resposta de la nova població de llúdrigues a les fluctuacions estacionals en la disponibilitat d'aigua, habitual a les regions mediterrànies, va consistir en la concentració en una àrea menor durant el període de sequera estival, a causa de l'increment de trams secs, inhabitables per la llúdriga per la manca d'aliment, fet que va provocar expansions i contraccions periòdiques en l'àrea de distribució. La persistència a llarg termini de la població reintroduïda va ser estudiada mitjançant una Anàlisi de Viabilitat Poblacional (PVA). El resultat va ser un baix risc d'extinció de la població en els propers 100 anys i la majoria dels escenaris simulats (65%) van assolir el criteri d'un mínim de 90% de probabilitat de supervivència. Del model poblacional construït es dedueix que un punt clau per assegurar la viabilitat de la població reintroduïda és la reducció de la mortalitat accidental. A l'àrea d'estudi, els atropellaments causen més del 50% de la mortalitat i aquesta pot ser reduïda mitjançant la construcció de passos de fauna, el tancament lateral d'alguns trams de carretera perillosos i el control de la velocitat en algunes vies. El projecte de reintroducció ha posat a punt un protocol per a la captura, maneig i alliberament de llúdrigues salvatges, que pot contenir informació útil per a programes similars. També ha suposat una oportunitat única d'estudiar una població dissenyada artificialment i poder comparar diversos mètodes per estimar la distribució i la densitat de poblacions de llúdrigues. Per últim, la reintroducció portada a terme a les conques dels rius Muga i Fluvià ha aconseguit crear una nova població de llúdrigues, que persisteix en el temps, que es reprodueix regularment i que es dispersa progressivament, fins i tot a noves conques fluvials.

Stratospheric temperature trends: impact of ozone variability and the QBO

In most climate simulations used by the Intergovernmental Panel on Climate Change 2007 fourth assessment report, stratospheric processes are only poorly represented. For example, climatological or simple specifications of time-varying ozone concentrations are imposed and the quasi-biennial oscillation (QBO) of equatorial stratospheric zonal wind is absent. Here we investigate the impact of an improved stratospheric representation using two sets of perturbed simulations with the Hadley Centre coupled ocean atmosphere model HadGEM1 with natural and anthropogenic forcings for the 1979–2003 period. In the first set of simulations, the usual zonal mean ozone climatology with superimposed trends is replaced with a time series of observed zonal mean ozone distributions that includes interannual variability associated with the solar cycle, QBO and volcanic eruptions. In addition to this, the second set of perturbed simulations includes a scheme in which the stratospheric zonal wind in the tropics is relaxed to appropriate zonal mean values obtained from the ERA-40 re-analysis, thus forcing a QBO. Both of these changes are applied strictly to the stratosphere only. The improved ozone field results in an improved simulation of the stepwise temperature transitions observed in the lower stratosphere in the aftermath of the two major recent volcanic eruptions. The contribution of the solar cycle signal in the ozone field to this improved representation of the stepwise cooling is discussed. The improved ozone field and also the QBO result in an improved simulation of observed trends, both globally and at tropical latitudes. The Eulerian upwelling in the lower stratosphere in the equatorial region is enhanced by the improved ozone field and is affected by the QBO relaxation, yet neither induces a significant change in the upwelling trend.

Evidence of trends in daily climate extremes over southern and west Africa

[ 1] There has been a paucity of information on trends in daily climate and climate extremes, especially from developing countries. We report the results of the analysis of daily temperature ( maximum and minimum) and precipitation data from 14 south and west African countries over the period 1961 - 2000. Data were subject to quality control and processing into indices of climate extremes for release to the global community. Temperature extremes show patterns consistent with warming over most of the regions analyzed, with a large proportion of stations showing statistically significant trends for all temperature indices. Over 1961 to 2000, the regionally averaged occurrence of extreme cold ( fifth percentile) days and nights has decreased by - 3.7 and - 6.0 days/decade, respectively. Over the same period, the occurrence of extreme hot (95th percentile) days and nights has increased by 8.2 and 8.6 days/decade, respectively. The average duration of warm ( cold) has increased ( decreased) by 2.4 (0.5) days/decade and warm spells. Overall, it appears that the hot tails of the distributions of daily maximum temperature have changed more than the cold tails; for minimum temperatures, hot tails show greater changes in the NW of the region, while cold tails have changed more in the SE and east. The diurnal temperature range (DTR) does not exhibit a consistent trend across the region, with many neighboring stations showing opposite trends. However, the DTR shows consistent increases in a zone across Namibia, Botswana, Zambia, and Mozambique, coinciding with more rapid increases in maximum temperature than minimum temperature extremes. Most precipitation indices do not exhibit consistent or statistically significant trends across the region. Regionally averaged total precipitation has decreased but is not statistically significant. At the same time, there has been a statistically significant increase in regionally averaged daily rainfall intensity and dry spell duration. While the majority of stations also show increasing trends for these two indices, only a few of these are statistically significant. There are increasing trends in regionally averaged rainfall on extreme precipitation days and in maximum annual 5-day and 1-day rainfall, but only trends for the latter are statistically significant.

Describing long-term trends in precipitation using generalized additive models

With the current concern over climate change, descriptions of how rainfall patterns are changing over time can be useful. Observations of daily rainfall data over the last few decades provide information on these trends. Generalized linear models are typically used to model patterns in the occurrence and intensity of rainfall. These models describe rainfall patterns for an average year but are more limited when describing long-term trends, particularly when these are potentially non-linear. Generalized additive models (GAMS) provide a framework for modelling non-linear relationships by fitting smooth functions to the data. This paper describes how GAMS can extend the flexibility of models to describe seasonal patterns and long-term trends in the occurrence and intensity of daily rainfall using data from Mauritius from 1962 to 2001. Smoothed estimates from the models provide useful graphical descriptions of changing rainfall patterns over the last 40 years at this location. GAMS are particularly helpful when exploring non-linear relationships in the data. Care is needed to ensure the choice of smooth functions is appropriate for the data and modelling objectives. (c) 2008 Elsevier B.V. All rights reserved.

A pressure-jump time-resolved x-ray diffraction study of cubic-cubic transition kinetics in monoolein

In the past two decades, the geometric pathways involved in the transformations between inverse bicontinuous cubic phases in amphiphilic systems have been extensively theoretically modeled. However, little experimental data exists on the cubic-cubic transformation in pure lipid systems. We have used pressure-jump time-resolved X-ray diffraction to investigate the transition between the gyroid Q(II)(G) and double-diamond Q(II)(D) phases in mixtures of 1-monoolein in 30 wt% water. We find for this system that the cubic-cubic transition occurs without any detectable intermediate structures. In addition, we have determined the kinetics of the transition, in both the forward and reverse directions, as a function of pressure-jump amplitude, temperature, and water content. A recently developed model allows (at least in principle) the calculation of the activation energy for lipid phase transitions from such data. The analysis is applicable only if kinetic reproducibility is achieved, at least within one sample, and achievement of such kinetic reproducibility is shown here, by carrying out prolonged pressure-cycling. The rate of transformation shows clear and consistent trends with pressure-jump amplitude, temperature, and water content, all of which are shown to be in agreement with the effect of the shift in the position of the cubic-cubic phase boundary following a change in the thermodynamic parameters.

The effect of vessel diameter on time dependent gas hold-up variations in highly viscous impeller agitated liquids

Time dependent gas hold-up generated in the 0.3 and 0.6 m diameter vessels using high viscosity castor oil and carboxy methyl cellulose (CMC) solution was compared on the basis of impeller speed (N) and gas velocity (V-G). Two types of hold-up were distinguished-the hold-up due to tiny bubbles (epsilon(ft)) and total hold-up (epsilon(f)), which included large and tiny bubbles. It was noted that vessel diameter (i.e. the scale of operation) significantly influences (i) the trends and the values of epsilon(f) and epsilon(ft), and (ii) the values of tau (a constant reflecting the time dependency of hold-up). The results showed that a scale independent correlation for gas hold-up of the form epsilon(f) or epsilon(ft) = A(N or P-G/V)(a) (V-G)(b), where "a" and "b" are positive constants is not appropriate for viscous liquids. This warrants further investigations into the effect of vessel diameter on gas hold-up in impeller agitated high viscosity liquids (mu or mu(a) > 0.4 Pa s). (C) 2003 Elsevier B.V. All rights reserved.

Tropospheric temperature trends: history of an ongoing controversy

Changes in atmospheric temperature have a particular importance in climate research because climate models consistently predict a distinctive vertical profile of trends. With increasing greenhouse gas concentrations, the surface and troposphere are consistently projected to warm, with an enhancement of that warming in the tropical upper troposphere. Hence, attempts to detect this distinct ‘fingerprint’ have been a focus for observational studies. The topic acquired heightened importance following the 1990 publication of an analysis of satellite data which challenged the reality of the projected tropospheric warming. This review documents the evolution over the last four decades of understanding of tropospheric temperature trends and their likely causes. Particular focus is given to the difficulty of producing homogenized datasets, with which to derive trends, from both radiosonde and satellite observing systems, because of the many systematic changes over time. The value of multiple independent analyses is demonstrated. Paralleling developments in observational datasets, increased computer power and improved understanding of climate forcing mechanisms have led to refined estimates of temperature trends from a wide range of climate models and a better understanding of internal variability. It is concluded that there is no reasonable evidence of a fundamental disagreement between tropospheric temperature trends from models and observations when uncertainties in both are treated comprehensively