Participation de la population au dépistage du cancer du sein : déterminants et enjeux

Cet article présente le résumé de l'atelier consacré au dépistage du cancer du sein organisé dans le cadre de la 70e Assemblée annuelle de la Société suisse de médecine interne qui s'est tenue à Genève du 25 au 27 avril 2002. L'objectif de cet atelier était d'identifier, sur la base des programmes pilotes conduits en Suisse ainsi que dans le Bas-Rhin (France), les modalités d'organisation les mieux adaptées au contexte sanitaire et culturel local afin d'optimiser la participation de la population aux programmes de dépistage du cancer susceptibles d'être mis en oeuvre dans les prochaines années. En effet, une participation élevée constitue, avec l'exigence de qualité, la condition nécessaire pour que ces programmes soient efficaces.

Basic indicators for better governance in international sport (BIBGIS) : an assessment tool for international sport governing bodies

This working paper presents the Basic Indicators for Better Governance in International Sport (BIBGIS) as a tool to assess and measure the state of governance of international sport governing bodies. The working paper is organised as follows. We start by presenting different definitions of governance and some examples of principles of good governance in sport and critique them. We then introduce our approach which is based on a limited number of indicators divided among seven dimensions and apply it to the International Olympic Committee (IOC) and other international sport governing bodies. Although our approach can also be used to benchmark the governance of different sport organisations, we demonstrate that it faces limitations. We conclude with suggested next steps for future BIBGIS developments.

Informal care and labour force participation among middle-aged women in Spain

Informal care is today the form of support most commonly used by those who need other peoplein order to carry out certain activities that are considered basic (eating, dressing, taking a shower,etc.), in Spain and in most other countries in the region. The possible labour opportunity costsincurred by these informal carers, the vast majority of whom are middle-aged women, have not asyet been properly quantified in Spain. It is, however, crucially important to know these quantities ata time when public authorities appear to be determined to extend the coverage offered up to nowas regards long-term care.In this context, we use the Spanish subsample of the European Community Household Panel (1994-2001) to estimate a dynamic ordered probit and so attempt to examine the effects of various typesof informal care on labour behaviour. The results obtained indicate the existence of labouropportunity costs for those women who live with the dependent person they care for, but not forthose who care for someone outside the household. Furthermore, whereas caregiving for morethan a year has negative effects on labour force participation, the same cannot be said of those who start caregiving and stop caregiving .

Human growth hormone doping in sport.

BACKGROUND AND OBJECTIVES: Recombinant human growth hormone (rhGH) has been on the list of forbidden substances since availability of its recombinant form improved in the early 1990s. Although its effectiveness in enhancing physical performance is still unproved, the compound is likely used for its potential anabolic effect on the muscle growth, and also in combination with other products (androgens, erythropoietin, etc.). The degree of similarity between the endogenous and the recombinant forms, the pulsatile secretion and marked interindividual variability makes detection of doping difficult. Two approaches proposed to overcome this problem are: the indirect method, which measures a combination of several factors in the biological cascade affected by administration of GH; and the direct method, which measures the difference between the circulating and the recombinant (represented by the unique 22 kD molecule) forms of GH. This article gives an overview of what is presently known about hGH in relation to sport. The available methods of detection are also evaluated. METHODS: Review of the literature on GH in relation to exercise, and its adverse effects and methods of detection when used for doping. RESULTS AND CONCLUSION: The main effects of exercise on hGH production and the use and effects of rhGH in athletes are discussed. Difficulties encountered by laboratories to prove misuse of this substance by both indirect and direct analyses are emphasised. The direct method currently seems to have the best reliability, even though the time window of detection is too short. hGH doping is a major challenge in the fight against doping. The effect of exercise on hGH and its short half-life are still presenting difficulties during doping analysis. To date the most promising method appears to be the direct approach utilising immunoassays.

Towards a sedentary society: trends in adolescent sport practice in Switzerland (1993-2002).

The rate of overweight and obese children and adolescents is rapidly increasing in developed countries. Although a decrease in sport practice may be one of the several factors implicated, data on recent trends are scarce. This article presents the trends in sport practice among Swiss adolescents between 1993 and 2002, comparing data from two surveys.

El Misterio de la biblioteca Mil.lènium o cómo promover relaciones colaborativas desde la participación del alumnado = The Mystery of the Mil.lènium Library: How to Promote Collaborative Relationships Through Student Participation

La pedagogía crítica acentúa la falta de neutralidad de la escuela respecto a las relaciones de poder que existen en la sociedad. Su propuesta consiste en modificar las relaciones de poder en el aula en el sentido de transformar las relaciones coercitivas –las que reproducen las relaciones existentes– en relaciones colaborativas partiendo del reconocimiento y la participación de los alumnos en las actividades escolares. Desde esta perspectiva, uno de los objetivos de las actividades es que los niños produzcan «textos identitarios», entendidos como artefactos que los alumnos se pueden apropiar para promover su desarrollo cognitivo. El artículo muestra el trabajo educativo integrado desde Educación Infantil hasta 6.º de Primaria de una escuela de la provincia de Girona en la que el 97% de los alumnos es de origen extranjero y cuyo propósito es incrementar las habilidades lingüísticas orales y escritas en la lengua escolar, así como la utilización de otros lenguajes multimedia. La unidad didáctica consiste en la elaboración de un cuento a lo largo de un curso escolar por parte de todo el alumnado con la ayuda de los profesores, de dos autores y de tres ilustradores. Cada ciclo escolar decide los personajes y el escenario y explicita textualmente el transcurso de la acción. Los ilustradores producen las imágenes y los autores posibilitan la transición de aquello que ha elaborado un ciclo al producto del siguiente. La actividad basada en la participación y la utilización de procedimientos democráticos de decisión se inserta en la propuesta educativa y lingüística de la escuela, así como en sus concreciones curriculares. Los resultados muestran que los textos construidos por los niños se apoyan en sus «fondos de conocimiento» sociales y familiares y constituyen una fuente de progreso en la consecución de las competencias básicas y en la construcción de valores democráticos

Declining labor force attachment and downward trends in unemployment and participation

The US labor market witnessed two apparently unrelated secular movements in thelast 30 years: a decline in unemployment between the early 1980s and the early 2000s,and a decline in participation since the early 2000s. Using CPS micro data and a stock-flow accounting framework, we show that a substantial, and hitherto unnoticed, factorbehind both trends is a decline in the share of nonparticipants who are at the margin ofparticipation. A lower share of marginal nonparticipants implies a lower unemploymentrate, because marginal nonparticipants enter the labor force mostly through unemployment,while other nonparticipants enter the labor force mostly through employment.

Specific Silencing of the REST Target Genes in Insulin-Secreting Cells Uncovers Their Participation in Beta Cell Survival.

The absence of the transcriptional repressor RE-1 Silencing Transcription Factor (REST) in insulin-secreting beta cells is a major cue for the specific expression of a large number of genes. These REST target genes were largely ascribed to a function of neurotransmission in a neuronal context, whereas their role in pancreatic beta cells has been poorly explored. To identify their functional significance, we have generated transgenic mice expressing REST in beta cells (RIP-REST mice), and previously discovered that REST target genes are essential to insulin exocytosis. Herein we characterized a novel line of RIP-REST mice featuring diabetes. In diabetic RIP-REST mice, high levels of REST were associated with postnatal beta cell apoptosis, which resulted in gradual beta cell loss and sustained hyperglycemia in adults. Moreover, adenoviral REST transduction in INS-1E cells led to increased cell death under control conditions, and sensitized cells to death induced by cytokines. Screening for REST target genes identified several anti-apoptotic genes bearing the binding motif RE-1 that were downregulated upon REST expression in INS-1E cells, including Gjd2, Mapk8ip1, Irs2, Ptprn, and Cdk5r2. Decreased levels of Cdk5r2 in beta cells of RIP-REST mice further confirmed that it is controlled by REST, in vivo. Using siRNA-mediated knock-down in INS-1E cells, we showed that Cdk5r2 protects beta cells against cytokines and palmitate-induced apoptosis. Together, these data document that a set of REST target genes, including Cdk5r2, is important for beta cell survival.

Determination of testosterone misuse in sport, an international comparative study

Introduction: Urinary steroid profiling is used in doping controls to detect testosterone abuse. A testosterone over epitestosterone (T/E) ratio exceeding 4.0 is considered as suspicious of testosterone administration, irrespectively of individual heterogeneous factors such as the athlete's ethnicity. A deletion polymorphism in the UGT2B17 gene was demonstrated to account for a significant part of the inter-individual variability in the T/E between Caucasians and Asians. However, the anti-doping strategy includes the determination of carbon isotope ratio on androgen metabolites which has been demonstrated to be reliable for the direct detection of testosterone misuse. Herein, we examined the profiles and the variability in the 13C/12Cratios of urinary steroids in a widely heterogeneous cohort of professional soccer players residing in different world countries (Argentina, Italy, Japan, South-Africa, Switzerland and Uganda). Aim: The determination of threshold values based on genotype information and diet specific of the ethnicity is expected to enhance significantly the detection of testosterone misuse. Methods: The steroid profile of 57 Africans, 32 Asians, 50 Caucasians and 32 Hispanics was determined by gas chromatography-mass spectrometry. The carbon isotope ratio of selected androgens in urine specimens were determined by means of gas chromatography/combustion/isotope ratio mass spectrometry (GC-C-IRMS). Results: Significant differences have been observed between all ethnic groups. After estimation of the prevalence of the UGT2B17 deletion/deletion genotype (African:22%; Asian:81%; Caucasian:10%; Hispanic:7%), ethnicspecific thresholds were developed for a specificity of 99% for the T/E (African:5.6; Asian:3.8; Caucasian:5.7; Hispanic:5.8). Italian and Swiss populations recorded an enrichment in 13C of the urinary steroids with respect to the other groups, thereby supporting consumption of a relatively larger proportion of C3 plants in their diet. Noteworthy, detection criteria based on the difference in the carbon isotope ratio of androsterone and pregnanediol for each population were well below the established threshold value for positive cases. Conclusion: These profiling results demonstrate that a unique and nonspecific threshold to evidence testosterone misuse is not fit for purpose. In addition, the carbon isotopic ratio from these different diet groups highlight the importance to adapt the criteria for increasing the sensitivity in the detection of exogenous testosterone. In conclusion, it may be emphasized that combining the use of isotope ratio mass spectrometry including refined interpretation criteria for positivity and the subject-based profiling of steroids will most probably improve the efficiency of the confirmatory test.