707 resultados para Fribourg, Canton de
Resumo:
Between 1976 and 2003, no infections with Salmonella Abortusovis had been officially recorded in Switzerland. Since then, however, several sheep flocks were infected and suffered massive fetal losses suggesting a re-emergence of the disease. Therefore, the aim of this study was to assess the epidemiological situation of S. Abortusovis infection in sheep in this country. A representative serum sample collected in 2007 in the context of certifying Brucella freedom included sera from 578 flocks with a total of 8426 sheep from all regions in Switzerland and the Principality of Liechtenstein. Sera were tested by ELISA for the presence of antibodies specific for S. Abortusovis. The cantonal seroprevalence was estimated at the sheep as well as the flock-level by taking into account (a) all flocks with one or more seropositive sheep (Flock 1+) and (b) only the flocks with two or more seropositive sheep (Flock 2+). Flocks with seropositive sheep were found throughout the country with an overall sheep-level prevalence of 1.7%. At the flock-level, overall prevalences of 16.3% and 5.0% were found for Flock 1+ and Flock 2+ definitions, respectively. Significant sheep-level clusters were located in the cantons of Bern, the Valais and Graubunden, while significant flock-level clusters (Flock 1+ and Flock 2+) were located in the canton of Graubunden only. Our results indicate that exposure of Swiss sheep flocks to S. Abortusovis is wide-spread.
Resumo:
OBJECTIVES: To validate the Probability of Repeated Admission (Pra) questionnaire, a widely used self-administered tool for predicting future healthcare use in older persons, in three European healthcare systems. DESIGN: Prospective study with 1-year follow-up. SETTING: Hamburg, Germany; London, United Kingdom; Canton of Solothurn, Switzerland. PARTICIPANTS: Nine thousand seven hundred thirteen independently living community-dwelling people aged 65 and older. MEASUREMENTS: Self-administered eight-item Pra questionnaire at baseline. Self-reported number of hospital admissions and physician visits during 1 year of follow-up. RESULTS: In the combined sample, areas under the receiver operating characteristic curves (AUCs) were 0.64 (95% confidence interval (CI)=0.62-0.66) for the prediction of one or more hospital admissions and 0.68 (95% CI=0.66-0.69) for the prediction of more than six physician visits during the following year. AUCs were similar between sites. In comparison, prediction models based on a person's age and sex alone exhibited poor predictive validity (AUC
Resumo:
BACKGROUND: In general cantons regulate and control the Swiss health service system; patient flows within and between cantons are thereby partially disregarded. This paper develops an alternative spatial model, based upon the construction of orthopedic hospital service areas (HSAOs), and introduces indices for the analysis of patient streams in order to identify areas, irrespective of canton, with diverse characteristics, importance, needs, or demands. METHODS: HSAOs were constructed using orthopedic discharge data. Patient streams between the HSAOs were analysed by calculating three indices: the localization index (% local residents discharged locally), the netindex (the ratio of discharges of nonlocal incoming residents to outgoing local residents), and the market share index (% of local resident discharges of all discharges in local hospitals). RESULTS: The 85 orthopedic HSAOs show a median localization index of 60.8%, a market share index of 75.1%, and 30% of HSAOs have a positive netindex. Insurance class of bed, admission type, and patient age are partially but significantly associated with those indicators. A trend to more centrally provided health services can be observed not only in large urban HSAOs such as Geneva, Bern, Basel, and Zurich, but also in HSAOs in mountain sport areas such as Sion, Davos, or St.Moritz. Furthermore, elderly and emergency patients are more frequently treated locally than younger people or those having elective procedures. CONCLUSION: The division of Switzerland into HSAOs provides an alternative spatial model for analysing and describing patient streams for health service utilization. Because this small area model allows more in-depth analysis of patient streams both within and between cantons, it may improve support and planning of resource allocation of in-patient care in the Swiss healthcare system.