H1N1 outbreak in a Swiss military boot camp--observations and suggestions

The A(H1N1)pdm09 influenza virus is a highly contagious pathogen which caused the 2009 influenza pandemic. The virus is known to affect mainly younger people and may be a problem in crowded living conditions. The aim of the study was to describe a major A(H1N1)pdm09 outbreak in a Swiss military boot camp and to develop suggestions for similar future situations.

Quality of life in high-risk patients: comparison of transcatheter aortic valve implantation with surgical aortic valve replacement

OBJECTIVES To compare health-related quality of life (QoL) in patients undergoing transcatheter aortic valve implantation via transapical access (TA TAVI) with patients undergoing surgical aortic valve replacement (SAVR). METHODS One hundred and forty-four high-risk patients referred for aortic valve replacement underwent TAVI screening and were assigned to either TA TAVI (n = 51, age 79.7 ± 9.2 years, logistic EuroSCORE 26.5 ± 16.1%, 51% males) or SAVR (n = 93, age 81.1 ± 5.3 years, logistic EuroSCORE 12.1 ± 9.3%, 42% males) by the interdisciplinary heart team. QoL was assessed using the Short Form 36 (SF-36) Health Survey Questionnaire and the Hospital Anxiety and Depression Scale. Furthermore, current living conditions and the degree of independence at home were evaluated. RESULTS Patients undergoing TA TAVI were at higher risk as assessed by EuroSCORE (26.5 ± 16 vs. 12.1 ± 9, P < 0.001) and STS score (6.7 ± 4 vs. 4.4 ± 3, P < 0.001) compared with SAVR patients. At the 30-day follow-up, the rate of mortality was similar and amounted to 7.8% for TA TAVI and 7.5% for SAVR patients and raised to 25.5% in TA TAVI and 18.3% in SAVR patients after a follow-up period of 15 ± 10 months. Assessment of QoL revealed no differences in terms of anxiety and depression between TA TAVI and SAVR patients. The SF-36 mental health metascore was similar in both groups (65.6 ± 19 vs. 68.8 ± 22, P = 0.29), while a significant difference was observed in the physical health metascore (49.7 ± 21 vs. 62.0 ± 21, P = 0.015). After adjustment for baseline characteristics, this difference disappeared. However, every added point in the preoperative risk assessment with the STS score decreased the SF-36 physical health dimension by two raw points at the follow-up assessment. CONCLUSIONS Selected high-risk patients undergoing TAVI by using a transapical access achieve similar clinical outcomes and QoL compared with patients undergoing SAVR. Increased STS scores predict worse QoL outcomes.

Cellular and immunological basis of the host-parasite relationship during infection with Neospora caninum

Neospora caninum is an apicomplexan parasite that is closely related to Toxoplasma gondii, the causative agent of toxoplasmosis in humans and domestic animals. However, in contrast to T. gondii, N. caninum represents a major cause of abortion in cattle, pointing towards distinct differences in the biology of these two species. There are 3 distinct key features that represent potential targets for prevention of infection or intervention against disease caused by N. caninum. Firstly, tachyzoites are capable of infecting a large variety of host cells in vitro and in vivo. Secondly, the parasite exploits its ability to respond to alterations in living conditions by converting into another stage (tachyzoite-to-bradyzoite or vice versa). Thirdly, by analogy with T. gondii, this parasite has evolved mechanisms that modulate its host cells according to its own requirements, and these must, especially in the case of the bradyzoite stage, involve mechanisms that ensure long-term survival of not only the parasite but also of the host cell. In order to elucidate the molecular and cellular bases of these important features of N. caninum, cell culture-based approaches and laboratory animal models are being exploited. In this review, we will summarize the current achievements related to host cell and parasite cell biology, and will discuss potential applications for prevention of infection and/or disease by reviewing corresponding work performed in murine laboratory infection models and in cattle.

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.

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).

Incidence and risk factors of homicide-suicide in Swiss households: National Cohort study

BACKGROUND Homicide-suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland. METHODS The study identified homicide-suicide events 1991-2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide-suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI). RESULTS The study identified 158 deaths from homicide-suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56-8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52-10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14-4.36) and higher in crowded households (HR 4.85; 1.72-13.6 comparing ≥2 with <1 persons/room). There was no association with education, occupation or nationality, the number of children, the language region or degree of urbanicity. Associations were similar for female victims. CONCLUSIONS This national longitudinal study shows that living conditions associated with psychological stress and lower levels of social support are associated with homicide-suicide events in Switzerland.

Patient satisfaction and nursing staff work satisfaction in an urban public teaching hospital

This study examined the level of patient satisfaction and nursing staff work satisfaction at an urban public hospital in the Southwestern United States. The primary objectives of this study were to determine: (1) the level of overall patient satisfaction and satisfaction with specific dimensions of hospital care; (2) the differences in patient satisfaction according to demographic characteristics (age, gender, ethnicity, and education completed) and predispositional factors (perceived health status, perceived level of pain, prior contact with the hospital, and hospital image) and the relative importance of each variable on patient satisfaction; (3) the level of overall work satisfaction and satisfaction with specific dimensions of work experienced by the medical/surgical nursing staff; (4) the differences in work satisfaction experienced by the nursing staff based on demographic variables (age, gender, ethnicity, and marital status) and professional factors (education completed, staff position, the number of years employed with the hospital, and number of years employed in nursing) and the relative importance of each variable on work satisfaction; and (5) to determine the effect of the nursing work milieu on patient and staff satisfaction.^ The study findings showed that patients experienced a moderate to low level of satisfaction with the dimensions of hospital care (admission process, daily care, information, nursing care, physician care, other hospital staff, living arrangements, and overall care). Of the eight dimensions of care, patients reported a relatively positive level of satisfaction (75 percent or better) with only one dimension: physician care. Ethnicity, perceived health status, and hospital image were significantly related to patient satisfaction. Hispanic patients, those who were in good health, and those who felt the hospital had a good image in their community were most satisfied with hospital care. Patients also reported areas of hospital care that needed the most improvement. Responses included: rude staff, better nursing care, and better communication.^ Findings from the nursing satisfaction survey indicated a low level of satisfaction with the dimensions of work (autonomy, pay, professional status, interaction, task requirements, and organizational policies). Only one dimension of work, professional status, received a mean satisfaction score in the positive range. Additionally, staff members were unanimously dissatisfied with their salaries. Frequently mentioned work-related problems reported by the staff included: staffing shortages, heavy patient loads. and excessive paperwork.^ The nursing milieu appeared to have had a significant effect on the satisfaction levels of patients nursing staff employees. The nursing staff were often short staffed, which increased the patient-to-nurse ratio. Consequently, patients did not receive the amount of attention and care they expected from the nursing staff. Crowded patient rooms allowed for little personal space and privacy. Dissatisfaction with living conditions served to influence patients' attitudes and satisfaction levels. These frustrations were often directed toward their primary caregivers, the nursing staff. Consequently, the nursing milieu appeared to directly affect and influence the satisfaction levels of both patients and staff. (Abstract shortened by UMI). ^

Twenty-three per cent of the Swiss adult population are using complementary medicine

Aim of the study: This study investigated the use among the Swiss adult population and the regional dissemination in Switzerland of various methods of complementary medicine (CM). It focused on CM methods that required visiting a physician or therapist and excluded e.g. over-the-counter drugs. Data and Methods: Data of the Swiss Health Survey 2007 were obtained from the Swiss Federal Statistical Office. This survey is performed every 5 years in a sample and is representative of the Swiss resident population from the age of 15 on. It consists of a telephone interview followed by a written questionnaire (2007: 18'760 and 14'432 respondents, respectively) and includes questions about people's state of health, general living conditions, lifestyle, health insurance and usage of health services. Users and non-users of CM were compared using logistic regression models. Results: 23.0 % of the Swiss adult population (women: 30.5 %, men: 15.2 %) used CM during the 12 months before the survey. Homeopathy (6.4 %), osteopathy (5.4 %) and acupuncture (4.9 %) were the most popular methods. The average number of treatments within 12 months for these three methods was 3.1 ± 3.6, 3.5 ± 3.3 and 6.6 ± 5.8, respectively. For treatments with homeopathy and acupuncture, medical practitioners were more commonly consulted than non-medical practitioners, for treatments with osteopathy no difference was found. By means of logistic regression, CM users and non-users were compared. There were significant differences in the use of CM between genders, age groups, levels of education and areas of living. Women, people aged 25 to 64 years, and people with higher levels of education used CM more commonly than men, people below 25 or above 64 years of age, or those with poorer education. Lake Geneva region and central Switzerland had a higher proportion of CM users than the other regions. Discussion: Almost one fourth of the Swiss adult population had used CM within 12 months before the survey. User profiles were comparable to those in other countries. Despite a generally lower self-perceived health status, elderly people were less likely to use CM. Reference: Klein SD, Frei-Erb M, Wolf U. Usage of complementary medicine across Switzerland. Results of the Swiss Health Survey 2007. Swiss Med Wkly. 2012;142:w13666.

Twenty-three per cent of the Swiss adult population are using complementary medicine

Aim of the study Various forms of complementary medicine (CM) play an important role in the Swiss health care system, they are appreciated by a majority of the population and mostly used complementarily rather than alternatively to conventional medicine. This study investigates, how many people in Switzerland are actually being treated with CM, and what the most popular methods of CM are. Data Data of the Swiss Health Survey 2007 were obtained from the Swiss Federal Statistical Office. This survey is performed every 5 years amongst a sample of the Swiss resident population above 15 years of age. It consists of a telephone interview followed by a written questionnaire (2007: 18'760 and 14'432 respondents, respectively) and includes questions about people's state of health, general living conditions, lifestyle, health insurance and usage of health services. Results 23.0% of the Swiss adult population (women: 30.5%, men: 15.2%) used CM during the 12 months before the survey. Homeopathy (6.4%), osteopathy (5.4%) and acupuncture (4.9%) were the most popular methods. The average number of treatments within 12 months for these three methods was 3.1, 3.5 and 6.6, respectively. For treatments with homeopathy and acupuncture, medical practitioners were more commonly consulted than non-medical practitioners, for treatments with osteopathy no difference was found. By means of logistic regression, CM users and non-users were compared. There were significant differences in the use of CM between genders, age groups, levels of education and areas of living. Women, people aged 25 to 64 years, and people with higher education used CM more commonly than men, people below 25 or above 64 years of age, or those with poorer education. Lake Geneva region and central Switzerland had a higher proportion of CM users than the other regions. Discussion While 2 years ago, 67.0% of the Swiss population approved a referendum in favour of CM, we find that 23.0% are in fact using it. Current political discussions focus on effectiveness, cost effectiveness and suitability of CM to decide which methods should be permanently covered by the basic health insurance.

Evaluation of the diagnostic value of the ELISA tests developed by using EgHF, Em2 and EmII/3-10 antigens in the serological diagnosis of alveolar echinococcosis

Alveolar echinococcosis (AE), caused by larva stage of Echinococcus multilocularis, is one of the lethal parasitic diseases of man and a major public health problem in many countries in the northern hemisphere. When the living conditions and habits in Turkey were considered in terms of relation with the life cycle of the parasite, it was suggested that AE has been much more common than reported mainly from the Eastern Anatolia region of Turkey. Since in vitro serologic diagnosis tests with high specificity for AE have not been used in our country, most of the cases with liver lesions were misdiagnosed by radiological investigations as malignancies. The aim of this study was to evaluate the diagnostic value of the in-house ELISA methods developed by using three different antigens (EgHF, Em2, EmII/3-10) in the serological diagnosis of AE. The study samples included a total of 100 sera provided by Bern University Parasitology Institute where samples were obtained from patients with helminthiasis and all were confirmed by clinical, parasitological and/or histopathological means. Ten samples from each of the cases infected by E.multilocularis, E.granulosus, Taenia solium, Wuchereria bancrofti, Strongyloides stercolaris, Ascaris lumbricoides, Toxocara canis, Trichinella spiralis, Fasciola hepatica and Schistosoma haematobium were studied. In the study, EgHF (E.granulosus hydatid fluid) antigens were prepared in our laboratory from the liver cyst fluids of sheeps with cystic echinococcosis, however Em2 (E.multilocularis metacestode-purified laminated layer) and EmII/3-10 (E.multilocularis recombinant protoscolex tegument) antigens were provided by Bern University Parasitology Institute. Flat bottom ELISA plates were covered with EgHF, Em2 and EmII/3-10 antigens in the concentrations of 2.5 µg, 1 µg and 0.18 µg per well, respectively, and all sera were tested by EgHF-ELISA, Em2-ELISA and EmII/3-10-ELISA methods. For each tests, the samples which were reactive above the cut-off value (mean OD of negative controls+2 SD) were accepted as positive. The sensitivity of the ELISA tests performed with EgHF, Em2 and Em2II/3-10 antigens were estimated as 100%, 90% and 90%, respectively, whereas the specificity were 63%, 91% and 91%, respectively. When Em2-ELISA and EmII/3-10-ELISA tests were evaluated together, the specificity increased to 96%. Our data indicated that the highest sensitivity (100% with EgHF-ELISA) and specificity (96% with Em2-ELISA + EmII/3-10-ELISA) for the serodiagnosis of AE can be achieved by the combined use of the ELISA tests with three different antigens. It was concluded that the early and accurate diagnosis of AE in our country which is endemic for that disease, could be supported by the use of highly specific serological tests such as Em2-ELISA ve EmII/3-10-ELISA contributing radiological data.

Möller-Barlow disease in archaeology: Preliminary study of biochemical detection

Human bone is the most direct source for reconstructing health and living conditions of ancient populations. However, many diseases remain undetected in palaeopathology. Möller-Barlow disease (scurvy) is a historically well-documented metabolic disease and must have been common in clinical and sub-clinical severity. Due to long incubation periods and the subtle nature of bone changes osteological evidence is relatively rare (Brickley & Ives 2008). Möller-Barlow disease is caused by deficiency of dietary vitamin C (ascorbic acid) and evokes symptoms like fatigue, haemorrhage, inflammations, delayed wound healing and pain. Vitamin C is a cofactor for the hydroxylation of the amino acids proline and lysine which are essential for the production of intact connective tissue by cross-linking the propeptides in collagen. In a preliminary study we tested the detectability of Möller-Barlow disease by analysis of relative quantitative variability of hydroxylated amino acids in collagen (Pendery & Koon 2013). Samples (N=9) were taken from children with (n=3, cranium, femur, tibia) and without (n=4, cranium, femur, tibia) apparent bone reactions indicative of Möller-Barlow disease, as well as from adults with lethal traumata (n=2; negative controls). The skeletal remains originated from two early medieval cemeteries from Switzerland. Gas chromatographic (GC) analysis revealed minor differences between the samples. So far children with no pathologic alterations had fairly same values as negative controls while children with bone reactions paradoxically exhibited even slightly higher values of hydroxyproline and hydroxylysine. Future research demands for larger sample size and has to discuss sampling strategies. Beside possible misdiagnosis of Möller-Barlow disease it is arguable if only the newly built bone should be analysed even though this could lead to problems related to small sample quantity. It also remains to be seen to which extent varying turnover rates of different skeletal elements, especially in children, must be taken into account.

Sustainable Pasture Management : LforS learning and simulation game

Three teams consisting of 2 to 5 persons each play the game. Each team represents a farm. Each team decides jointly on its strategy. In annual meetings in winter, the farm teams jointly discuss, evaluate and decide on how to proceed and actions to be taken. The farms make use of three different pasture areas (village pasture, intensive pasture and summer pasture) for grazing their livestock. The carrying capacity of each pasture area is different and varies according to the season. In each season, the farms have to decide on how many livestock units to graze on which pasture. Overgrazing and pasture degradation occur if the total number of livestock units exceeds the carrying capacity of a specific pasture area. Overgrazing results in a reduction of pasture productivity. To diversify and improve their livelihood strategy farms can make individual investments to increase productivity at the farm level, eg. in fodder production or in income generating activities. At the community level, collective investments can be made which may influence livestock and household economy, e.g. rehabilitate and improve pasture productivity, improve living conditions on remote pastures etc. Events occurring in the course of the game represent different types of (risk) factors such as meteorology, market, politics etc. that may positively or negatively influence livestock production and household economy. A sustainable management of pastures requires that farms actively regulate the development of their herds, that they take measures to prevent pasture degradation and to improve pasture productivity, and that they find a balance between livestock economy and other productive activities. The game has a double aim: a) each farm aims at its economic success and prosperity, and b) the three farm teams jointly have to find and implement strategies for a sustainable use of pasture areas.

Coping with drought

People in arid and semi-arid regions face difficult living conditions, increasingly aggravated by extended periods of drought and advancing desertification. However, the populations of arid and semi-arid regions can also rely on the great potential for innovation and adaptation that they have developed over centuries of living in these environments. This brochure presents the reality of people living in the world’s arid and semi-arid regions, and shows how SDC supports them in developing innovations and improving their livelihoods.

Socioeconomic atlas of Vietnam: A depiction of the 1999 population and housing census

This atlas presents a comprehensive set of maps depicting a wide range of socioeconomic aspects of the population of Vietnam. All the maps based on sensus statistics included in this atlas are available at the commune level, which gives a very detailed picture of spatial patterns in population, education, and living conditions.

Die Prekarisierungsgesellschaft. Prekäre Proteste. Politik und Ökonomie im Zeichen der Prekarisierung

Gesellschaft erscheint uns heute im flackernden Licht der Verunsicherung. Nicht erst seit der Finanzkrise erweisen sich stabil geglaubte Arbeits- und Lebensverhältnisse als prekär. Der Autor stellt die wichtigsten ökonomischen und soziologischen Theorien der Prekarisierung vor und zeigt: Prekarität hat die Gesellschaft in ihrer Gesamtheit erfasst. Wir leben in der Prekarisierungsgesellschaft. Aber was ist daraus zu schließen? Marchart beschreibt die gegenwärtigen Sozialproteste und ihre Forderungen. Er untersucht ihre demokratiepolitischen Implikationen und führt hin zu einer Gesellschaftstheorie des Konflikts und der Kontingenz.