Centres du sein: caprice ou nécessité [Breast Centers: whim or necessity?].

In order to prevent disparities in the management of breast cancer having a direct impact on the prognosis of patients, to promote early detection and optimal treatment while considering the quality of life of patients, Breast Centers are being set up in Switzerland on the basis of existing models in Europe. The centers provide also follow-up of patients and are submitted to certification criteria established by the Swiss Society of Senology and the Swiss Cancer League. These criteria include in particular the expertise of specialists based on a sufficient volume of activity and training, compliance with recommendations of clinical practice, integration of supportive care and timeliness of care. The certification process is voluntary. A database enables the regular assessment of the provided care and of the compliance with standards. The aim and the modalities of the creation of the Breast Centers are discussed.

The "Solmobile" prevention campaigns (2001-5): synthesis and prospects

The 5-year "Solmobile" skin prevention campaigns carried out between 2001 and 2005 by the Swiss League against Cancer met their objectives. About 21'000 visits were recorded throughout Switzerland and 10'000 clinical skin examinations performed. This report briefly summarises the main results of the epidemiological evaluation of these campaigns.

La importància de les accions a pilota aturada en el futbol professional

L’objectiu del present estudi va consistir en estudiar el percentatge de gols a pilota aturada de la Lliga BBVA i la Premier League, establint el percentatge d’efectivitat de cadascuna d’elles. A més, es volia analitzar la freqüència de les diferents tipus d’accions a pilota aturada i substituir el terme estratègia per accions a pilota aturada. Amb aquest objectiu es van analitzar 80 partits disputats per equips de futbol professional en la temporada 2012-13 de la Lliga BBVA i la Premier League mitjançant l’anàlisi de vídeos. Les variable dependent era la consecució o no del gol, tenint com a variables independents 4 tipus d’accions a pilota aturada: tirs lliures directes, tirs lliures indirectes, córners i penals. Els resultats indiquen un major número de gols provinents d’accions a pilota aturada en la Lliga BBVA que en la Premier League, 29,8% per un 23,4% respectivament. Tot i això, s’ha comprovat com els percentatges d’efectivitat són pràcticament idèntics: 4,54% a la Lliga BBVA i 4,58% a la Premier League. Finalment, s’ha identificat el córner com l’acció que més es produeix en el joc, seguit de les faltes directes, els penals i les faltes indirectes.

Annual Review of the European Football Players' Labour Market / Etude annuelle du marché du travail européen des footballeurs

The key reference on the labour market and the logics of squad formation in the five main European leagues. One hundred richly coloured pages, illustrated by graphics, maps, rankings, statistical models and analysis in French and English which... - inform managers about potential strategies to put their clubs on the road to success - help managers of federations and players' unions to understand current trends and to take decisions - suggest to journalists new lines of investigation likely to interest the general public - allow researchers and students to benefit from reliable and comparable sources, developed with the greatest possible rigour - give fans the possibility to understand in detail the dynamics at work in their favourite sport and club Demographic Study of Footballers in Europe The Demographic Study of European Footballers is an annual publication destined for anyone who wishes to acquire a scientific understanding of the European football players' labour market. It presents the dynamics at work in 36 first division leagues in UEFA member countries. This edition covers our biggest ever survey comprising more than 520 clubs and 13,000 footballers. Statistical indicators relative to nine thematics (morphology, age, experience training, origin, etc.) allow the comparison of player profiles and squad compositions at league and club level. Through easily-understable regression analyses, the Study brings to light the principle differences between clubs and leagues according to economic and sporting level of championships. The final part presents the list of the most promising players under 23 years of age by league and position

Evidence-based recommendations for genetic diagnosis of familial Mediterranean fever.

Familial Mediterranean fever (FMF) is a disease of early onset which can lead to significant morbidity. In 2012, Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched with the aim of optimising and disseminating diagnostic and management regimens for children and young adults with rheumatic diseases. The objective was to establish recommendations for FMF focusing on provision of diagnostic tools for inexperienced clinicians particularly regarding interpretation of MEFV mutations. Evidence-based recommendations were developed using the European League against Rheumatism standard operating procedure. An expert committee of paediatric rheumatologists defined search terms for the systematic literature review. Two independent experts scored articles for validity and level of evidence. Recommendations derived from the literature were evaluated by an online survey and statements with less than 80% agreement were reformulated. Subsequently, all recommendations were discussed at a consensus meeting using the nominal group technique and were accepted if more than 80% agreement was reached. The literature search yielded 3386 articles, of which 25 were considered relevant and scored for validity and level of evidence. In total, 17 articles were scored valid and used to formulate the recommendations. Eight recommendations were accepted with 100% agreement after the consensus meeting. Topics covered were clinical versus genetic diagnosis of FMF, genotype-phenotype correlation, genotype-age at onset correlation, silent carriers and risk of amyloid A (AA) amyloidosis, and role of the specialist in FMF diagnosis. The SHARE initiative provides recommendations for diagnosing FMF aimed at facilitating improved and uniform care throughout Europe.

Global surveillance of cancer survival 1995-2009 : analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75 000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems. FUNDING: Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA).

El fútbol y el negocio del entretenimiento global. Los clubes como multinacionales del ocio

El artículo tiene como objetivo analizar el proceso de expansión internacional de los clubes más ricos del fútbol español durante la primera década del siglo XXI, Real Madrid y FC Barcelona. Después de que los clubes de la Premier League inglesa fueran los primeros en crear una estrategia de branding internacional, otras ligas y organizaciones deportivas han adoptado sus mismos sistemas de gestión empresarial. En España, el Real Madrid y el FC Barcelona son el ejemplo más evidente, por su número de fans en todo el mundo, por sus acuerdos internacionales en la comercialización de sus productos con otras organizaciones y por la presencia que tienen sus marcas en todo el mundo gracias a las inversiones de sus fundaciones en escuelas de fútbol en concepto de Responsabilidad Social Corporativa. Por eso, ambos clubes, Real Madrid y FC Barcelona, pueden calificarse de nuevas multinacionales del ocio.

A definition and classification of status epilepticus - Report of the ILAE Task Force on Classification of Status Epilepticus.

The Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) have charged a Task Force to revise concepts, definition, and classification of status epilepticus (SE). The proposed new definition of SE is as follows: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1 ). It is a condition, which can have long-term consequences (after time point t2 ), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures. This definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t1 ) beyond which the seizure should be regarded as "continuous seizure activity." The second time point (t2 ) is the time of ongoing seizure activity after which there is a risk of long-term consequences. In the case of convulsive (tonic-clonic) SE, both time points (t1 at 5 min and t2 at 30 min) are based on animal experiments and clinical research. This evidence is incomplete, and there is furthermore considerable variation, so these time points should be considered as the best estimates currently available. Data are not yet available for other forms of SE, but as knowledge and understanding increase, time points can be defined for specific forms of SE based on scientific evidence and incorporated into the definition, without changing the underlying concepts. A new diagnostic classification system of SE is proposed, which will provide a framework for clinical diagnosis, investigation, and therapeutic approaches for each patient. There are four axes: (1) semiology; (2) etiology; (3) electroencephalography (EEG) correlates; and (4) age. Axis 1 (semiology) lists different forms of SE divided into those with prominent motor systems, those without prominent motor systems, and currently indeterminate conditions (such as acute confusional states with epileptiform EEG patterns). Axis 2 (etiology) is divided into subcategories of known and unknown causes. Axis 3 (EEG correlates) adopts the latest recommendations by consensus panels to use the following descriptors for the EEG: name of pattern, morphology, location, time-related features, modulation, and effect of intervention. Finally, axis 4 divides age groups into neonatal, infancy, childhood, adolescent and adulthood, and elderly.

Induction chemoradiation in stage IIIA/N2 non-small-cell lung cancer: a phase 3 randomised trial.

BACKGROUND: One of the standard options in the treatment of stage IIIA/N2 non-small-cell lung cancer is neoadjuvant chemotherapy and surgery. We did a randomised trial to investigate whether the addition of neoadjuvant radiotherapy improves outcomes. METHODS: We enrolled patients in 23 centres in Switzerland, Germany and Serbia. Eligible patients had pathologically proven, stage IIIA/N2 non-small-cell lung cancer and were randomly assigned to treatment groups in a 1:1 ratio. Those in the chemoradiotherapy group received three cycles of neoadjuvant chemotherapy (100 mg/m(2) cisplatin and 85 mg/m(2) docetaxel) followed by radiotherapy with 44 Gy in 22 fractions over 3 weeks, and those in the control group received neoadjuvant chemotherapy alone. All patients were scheduled to undergo surgery. Randomisation was stratified by centre, mediastinal bulk (less than 5 cm vs 5 cm or more), and weight loss (5% or more vs less than 5% in the previous 6 months). The primary endpoint was event-free survival. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00030771. FINDINGS: From 2001 to 2012, 232 patients were enrolled, of whom 117 were allocated to the chemoradiotherapy group and 115 to the chemotherapy group. Median event-free survival was similar in the two groups at 12·8 months (95% CI 9·7-22·9) in the chemoradiotherapy group and 11·6 months (8·4-15·2) in the chemotherapy group (p=0·67). Median overall survival was 37·1 months (95% CI 22·6-50·0) with radiotherapy, compared with 26·2 months (19·9-52·1) in the control group. Chemotherapy-related toxic effects were reported in most patients, but 91% of patients completed three cycles of chemotherapy. Radiotherapy-induced grade 3 dysphagia was seen in seven (7%) patients. Three patients died in the control group within 30 days after surgery. INTERPRETATION: Radiotherapy did not add any benefit to induction chemotherapy followed by surgery. We suggest that one definitive local treatment modality combined with neoadjuvant chemotherapy is adequate to treat resectable stage IIIA/N2 non-small-cell lung cancer. FUNDING: Swiss State Secretariat for Education, Research and Innovation (SERI), Swiss Cancer League, and Sanofi.

AA amyloidosis treated with tocilizumab: case series and updated literature review.

BACKGROUND: In published case reports, tocilizumab (TCZ) has shown good efficacy for AA amyloidosis in almost all patients. We investigated the efficacy and safety of TCZ in AA amyloidosis in a multicentre study of unselected cases. METHODS: We e-mailed rheumatology and internal medicine departments in France, Switzerland and North Africa by using the Club Rhumatismes Inflammation (CRI) network and the French TCZ registry, Registry RoAcTEmra (REGATE), to gather data on consecutive patients with histologically proven AA amyloidosis who had received at least one TCZ infusion. Efficacy was defined as a sustained decrease in proteinuria level and/or stable or improved glomerular filtration rate (GFR) and by TCZ maintenance. RESULTS: We collected 12 cases of AA amyloidosis treated with TCZ as monotherapy (mean age of patients 63 ± 16.2 years, amyloidosis duration 20.6 ± 31.3 months): eight patients had rheumatoid arthritis (RA), six with previous failure of anti-tumor necrosis factor α (anti-TNF-α) therapy. In total, 11 patients had renal involvement, with two already on hemodialysis (not included in the renal efficacy assessment). For the nine other patients, baseline GFR and proteinuria level were 53.6 ± 32.8 mL/min and 5 ± 3.3 g/24 h, respectively. The mean follow-up was 13.1 ± 11 months. TCZ was effective for six of the eight RA patients (87.5%) according to European League Against Rheumatism response criteria (four good and two moderate responders). As expected, C-reactive protein (CRP) level decreased with treatment for 11 patients. Renal amyloidosis (n = 9) progressed in three patients and was stabilized in three. Overall, three patients showed improvement, with sustained decrease in proteinuria level (42%, 82% and 96%). Baseline CRP level was higher in subsequent responders to TCZ than other patients (p = 0.02). Among the six RA patients with previous anti-TNF-α therapy, amyloidosis was ameliorated in one and stabilized in three. Three serious adverse events occurred (two diverticulitis and one major calciphylaxia due to renal failure). Finally, 7 of 12 (58%) patients continued TCZ. CONCLUSIONS: The efficacy of TCZ for AA amyloidosis varies depending on the inflammatory status at treatment onset. Discrepancies between our study of unselected consecutive patients and reported cases may be due to publication bias. These results support further prospective trials of TCZ for AA amyloidosis.

Differences and similarities in rheumatology specialty training programmes across European countries.

OBJECTIVES: To analyse the similarities and discrepancies between the official rheumatology specialty training programmes across Europe. METHODS: A steering committee defined the main aspects of training to be assessed. In 2013, the rheumatology official training programmes were reviewed for each of the European League Against Rheumatism (EULAR) countries and two local physicians independently extracted data on the structure of training, included competencies and assessments performed. Analyses were descriptive. RESULTS: 41 of the 45 EULAR countries currently provide specialist training in rheumatology; in the remaining four rheumatologists are trained abroad. 36 (88%) had a single national curriculum, one country had two national curricula and four had only local or university-specific curricula. The mean length of training programmes in rheumatology was 45 (SD 19) months, ranging between 3 and 72 months. General internal medicine training was mandatory in 40 (98%) countries, and was performed prior to and/or during the rheumatology training programme (mean length: 33 (19) months). 33 (80%) countries had a formal final examination. CONCLUSIONS: Most European countries provide training in rheumatology, but the length, structure, contents and assessments of these training programmes are quite heterogeneous. In order to promote excellence in standards of care and to support physicians' mobility, a certain degree of harmonisation should be encouraged.

La construcción de la marca ‘Qatar’ a partir del deporte: ‘sports place branding’ y prensa deportiva catalana

Los grandes eventos deportivos se han utilizado con fines promocionales para los territorios desde el siglo XIX. En este sentido, la Copa del Mundo de la FIFA de 2022, que se celebrará en Qatar, deviene una excusa ideal para el gobierno de la nación para legitimar su posicionamiento internacional, así como para participar activamente en el negocio mundial del fútbol. Además, desde 2011, Qatar Foundation (QF) ejecuta un acuerdo de patrocinio con el FC Barcelona, último campeón de la UEFA Champions League (ECL) y del Mundial de Clubes de la FIFA (2011), que le permitirá desarrollar proyectos sociales vinculados a la marca Barça en todo el mundo. Este artículo tiene el objetivo de analizar el posicionamiento internacional de Qatar, canalizado mediante un proceso de construcción de marca protagonizado por el deporte y proyectado a través de los medios de comunicación qataríes (AlJazzera) y los propios de los territorios donde el gobierno qatarí invierte, como es el caso de Cataluña.

Kansainliiton tilastojulkaisut

Kansainliiton tilastojulkaisujen kokoelmaan kuuluu Kansainliiton julkaisemia tilastosarjoja ja vähäisessä määrin muita julkaisuja vuosilta 1920-1946. Tilastojen aiheina ovat mm. maailmankauppa, maksutase ja valuuttakysymykset. Kokoelmaan kuuluvia sarjoja ovat esimerkiksi Statistical year-book of the League of Nations, Review of world trade ja Memorandum on balance of payments and foreign trade balances. Kokoelmaan kuuluvat sarjat eivät ole täydellisiä. Kansainliitto (engl. League of Nations, ransk. Société des Nations) perustettiin ensimmäisen maailmansodan jälkeen tehtävänään aseistariisunta ja valtioiden välisen yhteistyön edistäminen. Kansainliitto lopetti toimintansa 1946, jolloin sen tehtävät siirtyivät juuri perustetulle YK:lle.

Käytöstä poistettujen tietokoneiden kustannusedullisin jatkokäsittely puolustusvoimissa

Puolustushallinto on suuri materiaalin käyttäjä ja hankkija, se tuottaa huomattavan määrän atk-romua, joka luokitellaan ongelmajätteeksi. Laitteiden poistaminen jää tulosyksikön vastuulle ja sen on huolehdittava niiden asianmukaisesta jatkokäsittelystä. Tietoteknisten laitteiden hävittämisestä aiheutuvat vuotuiset kulut ovat mittavia, ja tästä syystä vaihtoehtoisia tapoja hävittää materiaalia on pohdittava. Tutkielma esittelee eri jatkokäsittelyprosesseja, joilla käytöstä poistetut tietokoneet voidaan hyötykäyttää ja selvittää kustannusedullisimman vaihtoehdon. Lisäksi tutkimuksessa ilmenee kiertoprosesseista saatavat hyödyt ja haitat. Tutkimusmenetelmänä on kirjallisuustutkimus ja teemahaastattelut. Tutkimuksessa on pyritty lähdeaineiston avulla esittelemään jatkokäsittelyprosesseja yksinkertaisessa muodossa. Kirjallisuuteen ja teemahaastatteluihin perustuen on kartoitettu kustannusedullisin jatkokäsittelyprosessi. Tutkimuksessa ilmeni, kustannusedullisimmaksi vaihtoehdoksi tietokoneiden myynti uusien laitehankintojen yhteydessä. Jatkokäsittelytapa kuitenkin poikkeuksetta vaatii uusien laitteiden hankinnan yhteistyökumppanilta. Tämän vuoksi on tarkasteltava tietokonelaitteiden hintojen kilpailukykyisyys verrattuna muihin laitetoimittajiin.