La démocratie directe et le droit international : prise en compte des obligations internationales de la Confédération et participation populaire à la politique extérieure

Le droit international connaît une évolution quantitative et qualitative qui entraîne des répercussions sur les institutions de l'initiative populaire et du référendum. Ce phénomène laisse apparaître deux problématiques principales - la prise en compte du droit international dans l'exercice des droits populaires et la participation des citoyens à la politique extérieure - dont certaines facettes sont aujourd'hui abondamment discutées. La présente étude a pour but d'examiner les droits d'initiative populaire et de référendum, tels que reconnus sur le plan fédéral, à l'aune de ces deux problématiques. Pour chacun d'entre eux, l'auteur procède à un état des lieux, sur la base duquel il explore certaines pistes afin de proposer un aménagement optimal des institutions de démocratie directe, compte tenu de leur environnement juridique actuel.

Participation rates for organized colorectal cancer screening programmes: an international comparison.

OBJECTIVE: Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates. METHODS: Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round. RESULTS: Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation. CONCLUSION: Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.