Tabacologie: mise au point 2015 [Smoking cessation: update 2015].

La prévalence mondiale du tabagisme est environ cinq fois plus importante chez les hommes que chez les femmes, toutefois cet écart tend à s'égaliser. En ce qui concerne les conséquences sur la santé du tabagisme, les femmes semblent plus susceptibles que les hommes. Elles sont notamment plus à risque de présenter certains cancers pulmonaires ou de décéder de maladies cardiovasculaires. Si les hommes sont moins enclins à demander de l'aide pour arrêter de fumer, les femmes quant à elles ont moins de succès dans leurs tentatives d'arrêt et les traitements semblent moins efficaces chez ces dernières. Des interventions d'aide à l'arrêt et des mesures de prévention du tabagisme adaptées aux spécificités de genre ont le potentiel d'améliorer la prise en charge des fumeurs et de diminuer les disparités de genre en santé. Smoking remains a major public health problem in Switzerland and is responsible for about 9000 deaths annually. In 2013, a quarter of the Swiss population (15 and over) were smokers and more than half of them wanted to quit smoking. This article provides an update of Swiss clinical practice guidelines published in 2011 and covers several new features, including views regarding smoking reduction, gradual quitting, use of nicotine replacement therapy for a short period prior to quitting, nicotine mouth spray marketing and the reimbursement of varenicline and bupropion treatments (under certain conditions) by basic health insurance. An algorithm summarizes the different stages of management of patients who smoke.

Identifying Specific Cues and Contexts Related to Smoking Craving for the Development of Effective Virtual Environments

Craving is considered the main variable associated with relapse after smoking cessation. Cue Exposure Therapy (CET) consists of controlled and repeated exposure to drug-related cues with the aim of extinguishing craving responses. Some virtual reality (VR) environments, such as virtual bars or parties, have previously shown their efficacy as tools for eliciting smoking craving. However, in order to adapt this technology to smoking cessation interventions, there is a need for more diverse environments that enhance the probability of generalization of extinction in real life. The main objective of this study was to identify frequent situations that produce smoking craving, as well as detecting specific craving cues in those contexts. Participants were 154 smokers who responded to an ad hoc self-administered inventory for assessing craving level in 12 different situations. Results showed that having a drink in a bar/pub at night, after having lunch/dinner in a restaurant and having a coffee in a cafe or after lunch/dinner at home were reported as the most craving-inducing scenarios. Some differences were found with regard to participants' gender, age, and number of cigarettes smoked per day. Females, younger people, and heavier smokers reported higher levels of craving in most situations. In general, the most widely cited specific cues across the contexts were people smoking, having a coffee, being with friends, and having finished eating. These results are discussed with a view to their consideration in the design of valid and reliable VR environments that could be used in the treatment of nicotine addicts who wish to give up smoking.

Experts' consensus on use of electronic cigarettes : a Delphi survey from Switzerland

Objectifs: Dans certains pays, les cigarettes électroniques contenant de la nicotine (e-cigarettes) sont considérées comme des produits de consommation courante, sans régulation spécifique. Dans d'autres (comme en Suisse), la vente d'e-cigarettes contenant de la nicotine est interdite, malgré l'importante demande de nombreux fumeurs de pouvoir les obtenir. Au vu du manque de données scientifiques sur l'efficacité et la sécurité à long-terme de ces produits, les spécialistes de la lutte contre le tabagisme se trouvent divisés sur la question de leur régulation. Afin d'obtenir un consensus parmi ces experts que nous puissions transmettre aux autorités sanitaires, nous avons réalisé une étude d'avis d'experts sur le plan national. Méthode : Nous avons utilisé une méthodologie Delphi, à l'aide de questionnaires électroniques, afin de synthétiser l'opinion d'experts suisses sur la question de la cigarette électronique. Participants : 40 experts suisses représentant l'ensemble de la Suisse. Mesures : Nous avons mesuré le degré de consensus entre les experts au sujet de recommandations touchant à la régulation, la vente et l'utilisation de l'e-cigarette contenant de la nicotine, ainsi que leur opinion générale sur le produit. De nouvelles recommandations et déclarations ont été formulées en tenant compte des réponses et des commentaires des participants. Résultats : Un consensus entre les experts a établi que l'e-cigarette contenant de la nicotine devrait être accessible en Suisse, mais seulement dans des conditions spécifiques. La vente devrait être réservée aux adultes, en utilisant des standards de qualité, une limite de concentration maximale de nicotine, et être accompagnée d'une liste d'ingrédients autorisés. La publicité devrait être restreinte et l'utilisation de l'e- cigarette devrait être interdite dans les lieux publics. Conclusions : Ces recommandations permettent de regrouper trois principes : 1) le principe de réalité, étant donné que le produit est déjà disponible sur le marché ; 2) le principe de prévention, puisque l'e- cigarette procure une alternative au tabac pour les fumeurs actuels, et 3) le principe de précaution, afin de protéger les mineurs et les non-fumeurs, étant donné que les effets à long-terme ne sont pas encore connus. Les autorités suisses devraient mettre en place une législation spécifique afin d'autoriser l'e- cigarette contenant de la nicotine.

Construcció d'un equip per a la producció de cervesa artesana

Catalunya és un dels territoris on hi ha hagut més auge del sector de la cervesa artesana, i són molt nombroses les microcerveseries i les botigues especialitzades on es poden trobar els recursos materials necessaris, a més de ser centres difusió de coneixements relacionats. Així, doncs, aquest projecte està emmarcat en un context que permet el desenvolupament de tècniques d’elaboració de cervesa artesana. Aquest projecte es basa en la construcció d’un equip amb materials reutilitzats i amb un pressupost limitat que permet reproduir a petita escala els processos d’elaboració que es duen a terme en les microcerveseries artesanes actuals. El projecte s’ha assentat sobre la comprensió dels fonaments teòrics i pràctics del procés d’elaboració de cervesa, i amb l’experiència inicial d’elaboració de cervesa amb un equip bàsic de tipus homebrewer. Per minimintzar costos els tancs s’han construït a partir de barrils de cervesa i les parts sobrants s’han aprofitat per a altres elements. S’han emprat elements quotidians com una olla a pressió i s’ha construït un sistema regulador de pressió (per al tanc de fermentació cilindrocònic isobàric construït) en lloc d’adquirir-lo. S’ha posat l’èmfasi en minimitzar la necessitat de manipulació manual durant l’elaboració. Per tant, s’han instal·lat els components de l’equip formant un circuit tancat amb sistema de bombeig, i s’ha incorporat un sistema que permet el control i la lectura de les temperatures de cada procés. Altres elements són el sistema de filtres amb mecanisme de tub en forma d’ela (que permet l’extracció del most dels tanc de maceració i de cocció d’una manera efectiva i sense necessitat de manipulació) i el sistema de dutxa (que permet automatitzar el procés de rentat i filtrat). Un element que distingeix aquest equip d’altres equips emprats en algunes microcerveseries artesanes és el tanc de fermentació cilindrocònic isobàric amb vàlvula controladora de pressió, que permet prescindir de la doble fermentació en ampolla, ja que permet aprofitar el gas carbònic produït durant la fermentació per la carbonatació de la cervesa. Es pot concloure que gràcies a les seves característiques, l’equip permet realitzar successives elaboracions obtenint el mateix producte amb les mateixes característiques organolèptiques, principalement gràcies a la cambra de fermentació, que permet realitzar les etapes de fermentació, maduració i clarificació controlant la temperatura desitjada; al tanc de maceració amb aïllament, que permet realitzar el procés a temperatura constant sense pèrdues tèrmiques i al sistema de control de temperatura de totes les etapes. L’únic inconvenient és que, degut a la manca pressupostària, ha estat impossible l’adquisició d’un sistema d’embotellament isobàric que permeti realitzar l’embotellament sense pèrdues del gas carbònic. Per tant, el producte final pot embotellar-se amb una lleugera pèrdua de gas o es pot emmagatzemar en el mateix fermentador cilindrocònic per al seu consum directe, a l’estil d’alguns brewpubs.

Validation of French and German versions of a Perceived Neighborhood Social Cohesion questionnaire among young Swiss males, and its relationship with substance use

This study main purpose was the validation of both French and German versions of a Perceived Neighborhood Social Cohesion Questionnaire. The sample group comprised 5065 Swiss men from the "Cohort Study on Substance Use Risk Factors." Multigroup Confirmatory factor analysis showed that a three-factor model fits the data well, which substantiates the generalizability of Perceived Neighborhood Social Cohesion Questionnaire factor structure, regardless of the language. The Perceived Neighborhood Social Cohesion Questionnaire demonstrated excellent homogeneity (α = 95) and split-half reliability (r = .96). The Perceived Neighborhood Social Cohesion Questionnaire was sensitive to community size and participants' financial situation, confirming that it also measures real social conditions. Finally, weak but frequent correlations between Perceived Neighborhood Social Cohesion Questionnaire and alcohol, cigarette, and cannabis dependence were measured.

E-cigarette use in young Swiss men : is vaping an effective way of reducing or quitting smoking ?

QUESTION UNDER STUDY: To test longitudinally differences in conventional cigarette use (cigarettes smoked, cessation, quit attempts) between vapers and nonvapers. METHODS: Fifteen months follow-up of a sample of 5 128 20-year-old Swiss men. The onset of conventional cigarette (CC) use among nonsmokers, and smoking cessation, quit attempts, changes in the number of CCs smoked among smokers at baseline were compared between vapers and nonvapers at follow-up, adjusted for nicotine dependence. RESULTS: Among baseline nonsmokers, vapers were more likely to start smoking at follow-up than nonvapers (odds ratio [OR] 6.02, 95% confidence interval [CI] 2.81, 12.88 for becoming occasional smokers, and OR = 12.69, 95% CI 4.00, 40.28 for becoming daily smokers). Vapers reported lower smoking cessation rates among occasional smokers at baseline (OR = 0.43 (0.19, 0.96); daily smokers: OR = 0.42 [0.15, 1.18]). Vapers compared with nonvapers were heavier CC users (62.53 vs 18.10 cigarettes per week, p <0.001) and had higher nicotine dependence levels (2.16 vs 0.75, p <0.001) at baseline. The number of CCs smoked increased between baseline and follow-up among occasional smokers (b = 6.06, 95% CI 4.44, 7.68) and decreased among daily smokers (b = -5.03, 95% CI -8.69, -1.38), but there were no differential changes between vapers and nonvapers. Vapers showed more quit attempts at follow-up compared with nonvapers for baseline occasional smokers (incidence rate ratio [IRR] 1.81, 95% CI 1.24, 2.64; daily smokers IRR 1.28, 95% CI 0.95, 1.73). CONCLUSIONS: We found no beneficial effects of vaping at follow-up for either smoking cessation or smoking reduction.

Les Science studies : de la marginalité thématique à la refondation de la discipline

Dans cet article, nous tentons de mettre en évidence ce qui, progressivement, constitue des points de convergence relativement partagés (l'analyse des controverses, l'attention portée au contenu, la prise en compte des connaissances, des inscriptions, des objets et des instruments dans l'action) qui influent partiellement sur les problématiques et approches d'autres domaines et courants de pensée en sociologie. Des déplacements significatifs ont été opérés qui sont potentiellement porteurs d'effets profonds, encore faudrait-il qu'ils soient repris par d'autres sociologues, ce qui n'a rien d'évident tant ils posent questions. Ainsi, les Science studies (étude sociale des sciences), qui ont longtemps constitué un domaine relativement à part de la sociologie du fait de ses objets d'études, contribue au renouveau des manières de penser et de travailler dans les sciences sociales en ouvrant des champs de questionnement autour de la définition des éléments constitutifs de la société et de l'agency. n this article, we highlight what gradually becomes converging topics and issues (analyzing of controversies, consideration for the content, the objects and the instruments of the action, integration of the issues related to the knowledge) and affects the problematics and approaches into other research fields and currents of thought in sociology. Significant shifts occurred which are potential carriers of profound effects if they would be picked up by other sociologists, which is not obvious due to the profounds debates emerging from theses studies. Thus, the Science Studies, which have long been an area relatively apart from sociology because of its objects of study, participate to the renewal of ways of thinking and working in the social sciences by opening questioning around the definition of the elements of society and the agency.

Rotas de síntese e a homogeneidade dos precursores de mulita e cordierita

Multicomponent ceramics are mainly synthesized by conventional solid-state reaction route and sol-gel routes. In the sol-gel route, colloidal or polymeric gel are envolved. In this work, some principles of the chemistry of theses routes are discused and it is ilustrated a variety of strategies for obtaining a homogeneous multicomponent precursors.

Contribuição ao estudo de uma metodologia alternativa para obtenção de dioxissulfeto de terras raras

In the last decade, many method has been developed to obtain oxysufides. However, theses materials were obtained by reaction involved gaseous toxics, CO, CS2, H2S and S. In the present work, the synthesis of lanthanum oxysufides actived by europium (III) through an alternative method has been made. This method involve the rare earth sulfate reduction under an atmosphere of argon contained 10% hydrogen using the thermogravimetric technique. The results showed the formation of the phase TR2O2S (TR = La and Eu) at temperatures which depend upon the heating rate, respectively 650 - 830ºC at 5ºC min-1 and 680 - 800ºC at 10ºC min-1. The oxysufides obtained are characterized by infrared spectroscopy. The method developed is more economic than the usual industrial methods and the environmental problems during the synthesis are also better controled.

Food Safety Testing: Rapid Molecular Methods for Chemical and Biological Hazards

The central goal of food safety policy in the European Union (EU) is to protect consumer health by guaranteeing a high level of food safety throughout the food chain. This goal can in part be achieved by testing foodstuffs for the presence of various chemical and biological hazards. The aim of this study was to facilitate food safety testing by providing rapid and user-friendly methods for the detection of particular food-related hazards. Heterogeneous competitive time-resolved fluoroimmunoassays were developed for the detection of selected veterinary residues, that is coccidiostat residues, in eggs and chicken liver. After a simplified sample preparation procedure, the immunoassays were performed either in manual format with dissociation-enhanced measurement or in automated format with pre-dried assay reagents and surface measurement. Although the assays were primarily designed for screening purposes providing only qualitative results, they could also be used in a quantitative mode. All the developed assays had good performance characteristics enabling reliable screening of samples at concentration levels required by the authorities. A novel polymerase chain reaction (PCR)-based assay system was developed for the detection of Salmonella spp. in food. The sample preparation included a short non-selective pre-enrichment step, after which the target cells were collected with immunomagnetic beads and applied to PCR reaction vessels containing all the reagents required for the assay in dry form. The homogeneous PCR assay was performed with a novel instrument platform, GenomEra^™, and the qualitative assay results were automatically interpreted based on end-point time-resolved fluorescence measurements and cut-off values. The assay was validated using various food matrices spiked with sub-lethally injured Salmonella cells at levels of 1-10 colony forming units (CFU)/25 g of food. The main advantage of the system was the exceptionally short time to result; the entire process starting from the pre-enrichment and ending with the PCR result could be completed in eight hours. In conclusion, molecular methods using state-of-the-art assay techniques were developed for food safety testing. The combination of time-resolved fluorescence detection and ready-to-use reagents enabled sensitive assays easily amenable to automation. Consequently, together with the simplified sample preparation, these methods could prove to be applicable in routine testing.

Predictors of smoking craving during virtual reality exposure

Cue exposure treatment (CET) consists of controlled and repeated exposure to drugrelated stimuli in order to reduce cue-reactivity. Virtual reality (VR) has proved to be a promising tool for exposition. However, identifying the variables that can modulate the efficacy of this technique is essential for selecting the most appropriate exposure modality. The aim of this study was to determine the relation between several individual variables and self-reported craving in smokers exposed to VR environments. Fortysix smokers were exposed to seven complex virtual environments that reproduce typical situations in which people smoke. Self-reported craving was selected as the criterion variable and three types of variables were selected as the predictor variables: related to nicotine dependence, related to anxiety and impulsivity, and related to the sense of presence in the virtual environments. Sense of presence was the only predictor of self-reported craving in all the experimental virtual environments. Nicotine dependence variables added predictive power to the model only in the virtual breakfast at home. No relation was found between anxiety or impulsivity and self-reported craving. Virtual reality technology can be very helpful for improving CET for substance use disorders. However, the use of virtual environments would make sense only insofar as the sense of presence was high. Otherwise, the effectiveness of exposure might be affected. © 2012 by the Massachusetts Institute of Technology.

Análisis arqueomorfológico de la llanura litoral al Norte de Valencia. Estructuración territorial y revisión de las tramas centuriadas

This paper is the result of the archaeo-morphological analysis of an area located to the north of the city of Valencia (Spain). This research has been developed in the context of one of the author’s PhD, which aims to analyse the whole of the city’s historical territory. The morphology of Valencia’s historical landscape and its different features have been analysed with a diachronic and multidisciplinary approach, combining data obtained from different types of analysis and through methodological procedures based on archaeo-morphology, traditional archaeology and landscape archaeology. For the first time, this methodology has been used in this territory. The results obtained represent a challenge regarding traditionally defended theses.

Fate of peat utilization

Peat is an organic substance with the maintenance of a mineral part, what shows it as interesting object for studying. Both organic and mineral parts of peat find application in various fields of activity of the people. Antibacterial properties of peat are known since an antiquity. Today people have expanded a spectrum of application of peat to use of by-products of its processing for reception of rather ecologically harmless fuel. The master theses are focused on peat, as on ambiguous raw materials for processing and fuel manufacture. The purpose of theses to show how much widely applied peat, technologies on its processing and its influence on environment at all stages of its working out.

Exposure to Tobacco Smoke and Markers of Subclinical Atherosclerosis in Children and Adolescents. The STRIP Study.

Background: Measurement of serum cotinine, a major metabolite of nicotine, provides a valid marker for quantifying exposure to tobacco smoke. Exposure to tobacco smoke causes vascular damage by multiple mechanisms, and it has been acknowledged as a risk factor for atherosclerosis. Multifactorial atherosclerosis begins in childhood, but the relationship between exposure to tobacco smoke and arterial changes related to early atherosclerosis have not been studied in children. Aims: The aim of the present study was to evaluate exposure to tobacco smoke with a biomarker, serum cotinine concentration, and its associations with markers of subclinical atherosclerosis and lipid profile in school-aged children and adolescents. Subjects and Methods: Serum cotinine concentration was measured using a gas chromatographic method annually between the ages 8 and 13 years in 538-625 children participating since infancy in a randomized, prospective atherosclerosis prevention trial STRIP (Special Turku coronary Risk factor Intervention Project). Conventional atherosclerosis risk factors were measured repeatedly. Vascular ultrasound studies were performed among 402 healthy 11-year-old children and among 494 adolescents aged 13 years. Results: According to serum cotinine measurements, a notable number of the school aged children and adolescents were exposed to tobacco smoke, but the exposure levels were only moderate. Exposure to tobacco smoke was associated with decreased endothelial function as measured with flow-mediated dilation of the brachial artery, decreased elasticity of the aorta, and increased carotid and aortic intima-media thickness. Longitudinal exposure to tobacco smoke was also related with increased apolipoprotein B and triglyceride levels in 13-year-old adolescents, whose body mass index and nutrient intakes did not differ. Conclusions: These findings suggest that exposure to tobacco smoke in childhood may play a significant role in the development of early atherosclerosis. Key Words: arterial elasticity, atherosclerosis, children, cotinine, endothelial function, environmental tobacco smoke, intima-media thickness, risk factors, ultrasound

Yrityksen strategiaprosessi : Näkökulmia strategisen johtamisen kehitämiseksi konserniorganisaatiossa

Tämän tutkimuksen tavoitteena oli määritellä strategiaprosessiin liittyvät kriittiset alueet, konsernijohdon tehtävät strategiaprosessissa sekä edellisten pohjalta kehittää konsernityyppiselle yritykselle normatiivinen strategiaprosessin malli kriittisten alueiden hallitsemiseksi. Tavoitteena oli myös lisätä strategisen ajattelun ja strategiaprosessien ymmärtämistä selittämällä niiden historiallista kehittymistä sekä niiden käsitteistöä ja käsitteiden sisältöä. Probleemaa lähestyttiin sekä doktriinin kautta että tulkitsemalla strategiaprosessissa ilmeneviä ongelmia ja analysoimalla niiden syy ja seuraussuhteita. Käsillä oleva teoreettis praktinen tutkimus toteutettiin osittain toiminta-analyyttisella tutkimusotteella, osittain toiminta analyyttisella tutkimusotteella case tutkimuksen ja komparatiivisen analyysin tukemana sekä osittain päätöksentekometodologisella tutkimusotteella. Työn teoreettinen osa tehtiin kirjallisuustutkimuksena. Siinä luotiin strategiaprosessin ja konsernijohtamisen käsitteellinen perusta ja tutkimuksen viitekehys. Konsernijohtaminen laajennettiin tutkimuksessa tulosten osalta yleistäen koskemaan muitakin hajautettuja yritysorganisaatioita kuin pelkän juridiikan pohjalta muodostuneita konserneja. Tutkimuksen aluksi tarkasteltiin strategisen ajattelun koulukuntia eri näkemyksineen sekä toisaalta strategia-ajattelun kehittymistrendeja 1950 luvulta nykyhetkeen. Samoin tarkasteltiin sitä, kuinka strategiaprosessit oval kehittyneet samara ajanjaksona. Huomion painopisteen todettiin siirtyneen strategisen johtamisen inhimilliseen puoleen strategisem johtajuuden samalla korostuessa ja strategisen ajattelun laajentuessa Empiirinen osuus toteutettiin case tutkimuksena. Sen kuluessa kartoitettiin strategiaprosessin keskeiset ongelma alueet ja analysoitiin niiden takana olevat syyt, jotta voidin määritellä strategiapmsessin kehittämisen suunnat ja painopisteaiueet. Teoreettisen ja empiirisen osan penisteella määriteltiin strategiaprosessin kriittiset alueet yleisellä tasolla. Kriittisellä alueella tarkoitetaan asiakokonaisuutta tai asiaa, jonka on oltava kunaossa, jotta strategiaprosessit toimisivat. Nämä alueet liittyvat itse strategiaprosessiin suoraan tai välillisesti muun johtamistyön kautta. Strategiaprosessin kriittisten alueiden määrittelyn yhteydessä asetettiin doktriiniin tukeutuen strategiaprosessin kehittämissuunnat konsernijohdon nakäkökulmasta tarkasteltuna. Näihin kehittämissuuntiin ja edelleen doktriiniin tukeutuen määriteltiin konsernijohdon strategiaprosessin substanssitehtävät, prosessia tukevat tehtävät sekä prosessin toteuttamis- ja kehittämistehtävtä. Konsernijohdon strategiaprosessin tehtävät eivät muodosta sekventiaalista ja hierarkista järjestelmää vaan ovat joukko aktiviteetteja, joita toteutetaan tarpeen mukaan. Konsernijohdon strategiaprosessi määriteltiin ja kuvattiin tutkimuksessa johdon työskentelyprosessiksi sellaisten toimeenpanokelpoisten strategioiden tuottamiseksi ja toimeenpanemiseksi, jotka lisäävät yrityksen (konsernin) arvoa omistajan näkökulmasta mutta huomioivat myös muiden keskeisten sidosryhmien vaatimukset, tavoitteet ja rajoitteet. Konsernijohdon strategiaprosessi nähdään tässä jatkuvana konsernitasoisena päämäärä- ja keinopuolen tarkasteluna. Siinä konsernijohto tiedostaa konsernin ulkoisesta ja sisäisestä ymparistostä tulevat signaalit sekä pitää yllä näkemystä konsernin strategisesta asemasta. Tiedon massan näkemyksen saavutettua kriittisen rajansa se pakottaa konsernijohdon aivioimaan aiempia ratkaisuja uudessa valossa. Tämä validointi perustuu jatkuvasti esitettyihin neljään kysymykseen: onko ympäristö , premissi ja toimeenpanoseurannasta kertyneen tietämyksen perusteella nähtävissä vaikutuksia välittömiin toimenpiteisiin, vaikutuksia toimintasuunnitelmiin tai kriittisiin seurannan kohteisiin, vaikutuksia suunnanvalintoihin tai vaikutuksia perususkomuksiin? Konsernijohdon strategiaprosessi etenee jatkuvana prosessina päätösten ja ajan virrassa.