Els Plans locals de joventut: una forma de participació juvenil

Aquest treball neix de l’interès per conèixer quin és el funcionament dels Plans Locals de Joventut (PLJ), com a instrument per treballar les polítiques de joventut, i el paper de la participació juvenil entorn aquest context. La temàtica principal és els PLJ però en relació amb la participació, el jovent i les polítiques de joventut actuals

Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery.

BACKGROUND: Enhanced recovery protocols may reduce postoperative complications and length of hospital stay. However, the implementation of these protocols requires time and financial investment. This study evaluated the cost-effectiveness of enhanced recovery implementation. METHODS: The first 50 consecutive patients treated during implementation of an enhanced recovery programme were compared with 50 consecutive patients treated in the year before its introduction. The enhanced recovery protocol principally implemented preoperative counselling, reduced preoperative fasting, preoperative carbohydrate loading, avoidance of premedication, optimized fluid balance, standardized postoperative analgesia, use of a no-drain policy, as well as early nutrition and mobilization. Length of stay, readmissions and complications within 30 days were compared. A cost-minimization analysis was performed. RESULTS: Hospital stay was significantly shorter in the enhanced recovery group: median 7 (interquartile range 5-12) versus 10 (7-18) days (P = 0·003); two patients were readmitted in each group. The rate of severe complications was lower in the enhanced recovery group (12 versus 20 per cent), but there was no difference in overall morbidity. The mean saving per patient in the enhanced recovery group was euro1651. CONCLUSION: Enhanced recovery is cost-effective, with savings evident even in the initial implementation period.

Projecte educatiu de ciutat de Girona

El treball que es presenta a continuació és una descripció del procés que ha seguit el Projecte Educatiu de Ciutat de Girona per elaborar-ne el propi disseny. Es defineix el PEC com a eina participativa de planificació municipal per a la concreció de les línies prioritàries de l’educació d’un territori i com a tal ha comptat d’un procés marcat principalment per la implicació ciutadana. Aquest procés ha tingut una durada de 17 mesos però en el present treball es desenvolupen, específicament, els últims mesos on hi ha hagut una participació més directe i vinculant

Rab18 dynamics in adipocytes in relation to lipogenesis, lipolysis and obesity.

Lipid droplets (LDs) are organelles that coordinate lipid storage and mobilization, both processes being especially important in cells specialized in managing fat, the adipocytes. Proteomic analyses of LDs have consistently identified the small GTPase Rab18 as a component of the LD coat. However, the specific contribution of Rab18 to adipocyte function remains to be elucidated. Herein, we have analyzed Rab18 expression, intracellular localization and function in relation to the metabolic status of adipocytes. We show that Rab18 production increases during adipogenic differentiation of 3T3-L1 cells. In addition, our data show that insulin induces, via phosphatidylinositol 3-kinase (PI3K), the recruitment of Rab18 to the surface of LDs. Furthermore, Rab18 overexpression increased basal lipogenesis and Rab18 silencing impaired the lipogenic response to insulin, thereby suggesting that this GTPase promotes fat accumulation in adipocytes. On the other hand, studies of the β-adrenergic receptor agonist isoproterenol confirmed and extended previous evidence for the participation of Rab18 in lipolysis. Together, our data support the view that Rab18 is a common mediator of lipolysis and lipogenesis and suggests that the endoplasmic reticulum (ER) is the link that enables Rab18 action on these two processes. Finally, we describe, for the first time, the presence of Rab18 in human adipose tissue, wherein the expression of this GTPase exhibits sex- and depot-specific differences and is correlated to obesity. Taken together, these findings indicate that Rab18 is involved in insulin-mediated lipogenesis, as well as in β-adrenergic-induced lipolysis, likely facilitating interaction of LDs with ER membranes and the exchange of lipids between these compartments. A role for Rab18 in the regulation of adipocyte biology under both normal and pathological conditions is proposed.

Long gamma nail in the treatment of subtrochanteric fractures.

INTRODUCTION: The purpose of our study was to retrospectively evaluate the clinical and radiological results of subtrochanteric fractures treated with a long gamma nail (LGN). The LGN has been the implant of choice at our level-1 trauma center since 1992. MATERIALS AND METHODS: Over a period of 7 years, we have treated 90 consecutive patients with subtrochanteric fractures. In order to evaluate the clinical and radiological outcomes, we reviewed the clinical and radiographic charts of these patients followed for a mean time of 2 years (range 13-36 months). RESULTS: We found no intra- or perioperative complications nor early or late infection. Clinical and radiological union was achieved at a mean of 4.3 months in all of the patients (range 3-9 months); in 24 cases (30%) the distal locking bolts were retrieved in order to enhance callus formation and remodeling as a planned secondary surgery. Three patients (3.3%) needed unplanned secondary surgery for problems related to the nailing technique. Two mechanical failures with breakage of the nail were encountered due to proximal varus malalignment, of which one was treated with exchange nailing and grafting and the other one by removal of the broken hardware, blade-plating, and bone grafting. One fracture below a short LGN was treated by exchange nailing. CONCLUSIONS: The minimally invasive technique and simple application of the LGN lead to a low percentage of complications in these difficult fractures after a relatively short learning curve. The biomechanical properties of this implant allow early mobilization and partial weight-bearing even in patients with advanced osteoporosis.

Anti-impérialisme et nouvelle gauche radicale dans la Suisse des années 68

Cette thèse entend apporter un éclairage sur l'histoire politique et sociale de la Suisse des années 68, en étudiant l'articulation entre les mouvements anti-impérialistes et la nouvelle gauche radicale, alors foisonnante. Il s'agit d'analyser cette période de contestation au prisme de l'anti-impérialisme révolutionnaire, lequel, dans le contexte de l'opposition à la guerre du Vietnam, a fortement imprégné le mouvement protestataire, en assignant notamment au tiers-monde le rôle de sujet de l'émancipation mondiale. Combinant une triple approche - chronologique, thématique et biographique - ce travail est structuré en quatre parties. La première partie esquisse un panorama des mouvements anti-impérialistes des années 1960 et 1970 en Suisse, avec une focalisation sur les «années anti-imp», entre 1968 et 1975. La deuxième interroge le rapport entre anti¬impérialisme et nouvelle gauche radicale, en proposant une typologie des principaux courants. La troisième partie s'attache à examiner le système de représentations du monde et de la Suisse véhiculé par le discours de l'extrême gauche. Prenant pour objet le militantisme, la dernière partie esquisse un portrait de groupe de la « génération anti-imp », fondé sur une enquête prosopographique et sur un corpus d'entretiens réalisés avec des militants de l'époque. L'étude révèle que l'anti-impérialisme a fourni à la contestation soixante-huitarde un cadre conceptuel et analytique, un facteur de structuration, ainsi qu'un vecteur de mobilisation. Il a en particulier permis à la gauche radicale suisse d'inscrire sa lutte anticapitaliste locale dans un horizon global d'émancipation. L'analyse de l'anti-impérialisme révolutionnaire, qui a connu son apogée dans les années 68 avant de connaître un déclin rapide et presque total, invite à appréhender cette « décennie mouvementée » comme la fin d'un long cycle politique. -- This thesis aims to shed light on the social and political history of Switzerland in the 1960s and 1970s by studying the relationship between anti-imperialist movements and the emerging new radical left. It analyses this time of rebellion through the prism of revolutionary anti-imperialism. In the context of opposition to the Vietnam War, anti-imperialism strongly influenced protest movements, notably by assigning to the Third World the role of main actor in the fight for global emancipation. Combining a threefold approach - chronological, thematic and biographical - this work is structured in four parts. The first part provides a panorama of the anti-imperialist movements of the long 1960s in Switzerland with a focus on the « anti-imp years » between 1968 and 1975. The second part questions the relationship between anti-imperialism and the new radical left and proposes a typology of its main currents. The third part examines how the radical left's discourse represented the world, and Switzerland in particular. The last part addresses the question of activism and outlines a group portrait of the « anti-imp generation » based on a prosopographical study and on a body of interviews with former activists. This study reveals that anti-imperialism, besides serving as an agent of mobilization, provided a conceptual and ideological framework, as well as a structuring factor, to the protest movements. In particular, it enabled the Swiss radical left to fit its local anti-capitalist struggle into a global horizon of emancipation. This analysis of revolutionary anti- imperialism, which had its heyday in the 1960s and 1970s before experiencing a rapid and almost total decline, thus invites us to see this « turbulent decade » as the end of a long political cycle.

Respiratory responses during affective picture viewing

Previous research has demonstrated covariation of physiological responding with judgments of valence and arousal. However, until now links between these affective dimensions and respiratory measures have not been extensively investigated. In this study, eight picture series of different affective valence and arousal level were shown to 30 subjects, while respiration, skin conductance level (SCL), heart rate (HR) and affective judgments were measured. With increasing pleasantness, inspiratory time lengthened, mean inspiratory flow decreased and thoracic breathing increased. With increasing arousal, inspiratory time and total breath duration shortened and mean inspiratory flow, minute ventilation, thoracic breathing and electrodermal activity increased. These findings confirm the importance of arousal in respiratory responding, but also indicate a modulatory role of affective valence.We propose that the arousal effects reflect energy mobilization in preparation to act, and thatthe valence effects might be a manifestation of an attention bias toward negative stimuli. [Authors]

Tot el poder als joves! : els consells de joves com a instruments de participació ciutadana en temps de crisi globalitzada i d'exclusió social de la joventut

En una època de transformacions vertiginoses que han situat les generacions joves en una situació d'exclusió social, política, econòmica i simbòlica, les polítiques de joventut han d'esdevenir un revulsiu per a l'aprenentatge i la normalització de la ciutadania activa, dins un ampli programa de reforma social orientat a la recuperació de l'Estat del benestar i de la iniciativa política per part d'unes institucions refundades sobre nocions de democràcia participativa. En aquest context, el moviment associatiu juvenil és una expressió genuïna d'apoderament, participació autònoma i capacitat d'anàlisi que pot tenir un paper protagonista, amb l'extensió del model de consells de joves arreu del territori com a espais de deliberació, decisió i participació democràtica

Aproximació i proposta a un pla de desenvolupament comunitari

El present treball duu a terme una aproximació a diferents Plans de Desenvolupament Comunitari (PDC) per mitjà de tres experiències concretes. La finalitat es centra en conèixer quines són les característiques, elements i principis bàsics per a la creació d’un marc de referència previ que permeti elaborar una proposta concreta de PDC en el marc del municipi de Banyoles. La proposta de PDC es planteja en termes generals i se’n concreta la seva fase prèvia, d’anàlisi de la realitat, des d’una vessant tècnica

Ex-post survey on the consequences and perceptions about amalgamation : The case of two Swiss municipalities

In 2006, two municipalities located in the canton of Fribourg (Switzerland), La Tour-de-Trême and Bulle, amalgamated. In this study, we report on the evolution of citizen perceptions as well as try to better understand the reasons behind the respondents various positions concerning this new political and territorial entity. Five-hundred individuals were surveyed almost four years after the amalgamation came into effect. Our results show that if the amalgamation was voted again, it would be necessary to be particularly attentive to citizen access to municipal offices and to local service provisions, to citizen identification to their municipality as well as to the life of the local associations. Indeed, these are clearly important issues for small localities. Furthermore, citizens of the newly amalgamated municipality are mostly sensitive to access to municipal offices and to contact with local representatives. Improving the population's perceptions of these particular issues could lead to a 12 percentage point increase in support for the amalgamation.

A fast-track program reduces complications and length of hospital stay after open colonic surgery.

BACKGROUND & AIMS: A fast-track program is a multimodal approach for patients undergoing colonic surgery that combines stringent regimens of perioperative care (fluid restriction, optimized analgesia, forced mobilization, and early oral feeding) to reduce perioperative morbidity, hospital stay, and cost. We investigated the impact of a fast-track protocol on postoperative morbidity in patients after open colonic surgery. METHODS: A randomized trial of patients in 4 teaching hospitals in Switzerland included 156 patients undergoing elective open colonic surgery who were assigned to either a fast-track program or standard care. The primary end point was the 30-day complication rate. Secondary end points were severity of complications, hospital stay, and compliance with the fast-track protocol. RESULTS: The fast-track protocol significantly decreased the number of complications (16 of 76 in the fast-track group vs 37 of 75 in the standard care group; P = .0014), resulting in shorter hospital stays (median, 5 days; range, 2-30 vs 9 days, respectively; range, 6-30; P < .0001). There was a trend toward less severe complications in the fast-track group. A multiple logistic regression analysis revealed fluid administration greater than the restriction limits (odds ratio, 4.198; 95% confidence interval, 1.7-10.366; P = .002) and a nonfunctioning epidural analgesia (odds ratio, 3.365; 95% confidence interval, 1.367-8.283; P = .008) as independent predictors of postoperative complications. CONCLUSIONS: The fast-track program reduces the rate of postoperative complications and length of hospital stay and should be considered as standard care. Fluid restriction and an effective epidural analgesia are the key factors that determine outcome of the fast-track program.

The efficiency of antigen recognition by CD8+ CTL clones is determined by the frequency of serial TCR engagement.

Using H-2Kd-restricted CTL clones, which are specific for a photoreactive derivative of the Plasmodium berghei circumsporozoite peptide PbCS(252-260) (SYIPSAEKI) and permit assessment of TCR-ligand interactions by TCR photoaffinity labeling, we have previously identified several peptide derivative variants for which TCR-ligand binding and the efficiency of Ag recognition deviated by fivefold or more. Here we report that the functional CTL response (cytotoxicity and IFN-gamma production) correlated with the rate of TCR-ligand complex dissociation, but not the avidity of TCR-ligand binding. While peptide antagonists exhibited very rapid TCR-ligand complex dissociation, slightly slower dissociation was observed for strong agonists. Conversely and surprisingly, weak agonists typically displayed slower dissociation than the wild-type agonists. Acceleration of TCR-ligand complex dissociation by blocking CD8 participation in TCR-ligand binding increased the efficiency of Ag recognition in cases where dissociation was slow. In addition, permanent TCR engagement by TCR-ligand photocross-linking completely abolished sustained intracellular calcium mobilization, which is required for T cell activation. These results indicate that the functional CTL response depends on the frequency of serial TCR engagement, which, in turn, is determined by the rate of TCR-ligand complex dissociation.

Are the Policy Preferences of Relatively Poor Citizens Under-represented in the Swiss Parliament?

The principle of equal political representation can be undermined by differences in economic resources among citizens. Poor citizens are likely to hold policy preferences that differ from those of richer citizens. At the same time, their lack of resources can have as a consequence that these preferences are not taken into consideration by their representatives. Focusing on the case of the Swiss Parliament and using survey data on the opinions of citizens and MPs in the 2007-2011 legislature, this study investigates whether the income of citizens systematically affects the proximity of their policy preferences with stances of their representatives. It demonstrates that on economic issues MPs hold preferences that are generally less in favour of the state's intervention in the economy than the median citizen and that relatively poor citizens are less well represented as compared to citizens with high incomes. This remains true when taking into account only the opinions of the most knowledgeable citizens among these groups as well as when the focus is only on those who turned out to vote.

On Strong Citizens: A Sociological View on Cognitions and Contentious Participation

The present thesis is about cognitions of left-wing activists and the role they play to better understand contentious participation. It compares activists of three post-industrial social movement organizations in Switzerland, i.e. Solidarity across Borders defending migrant's rights, the Society of Threatened People promoting collective human rights and Greenpeace protecting the environment. It makes use of an innovative mixed methods design combining survey and interview data. The main theoretical contribution is to conceptualize an analytical tool enabling to grasp the cognitive map of these activists by putting forward the concept of strong citizen, summing up their relation to society and politics. The relation to society consists of an extensive relation to others and an interconnected vision of society. Consequently, their primary concerns include the handing of common goods and the equal treatment of individuals with regard to common goods. The relation to politics incorporates a critical and vigilant citizen. They are critical towards political authorities and they appreciate political action by organized groups of the civil society. The thesis states that only by having such worldviews activists are able to construct an injustice, agency and identity frame for the claims of their organizations. Thus, the present work delivers a parsimonious answer to the question of where an injustice, agency and identity frame comes from. It does so by a systematic analysis of four specific arguments. First, it empirically demonstrates that these activists have - at the aggregate level - specific cognitive resources compared to the general population. Second, it describes the content of this specific cognitive outlook by evaluating the appropriateness of the strong citizen concept. Third, it looks at variations between activist's communities and shows that activists of more challenging protest issues are stronger citizens than activists of more mainstream protests. Finally, cognitions are not the only part of the story if one looks at contentious participation. Other factors, i.e. social networks and biographical availability, matter too. Therefore, I test if cognitions are able to contribute in explaining differences between activists' communities if one controls for other factors. In sum, this thesis is thus a first step to demonstrate why one should be concerned about activists' cognitions. - Cette thèse s'intéresse aux cognitions des activistes de gauche et à leur rôle dans le phénomène de la participation contestataire. Des activistes de trois organisations post- industrielles en Suisse sont comparé, à savoir Solidarité sans Frontières qui défend les droits des migrants, la Société des Peuples menacés qui promeut les droits des collectivités minoritaires et Greenpeace qui oeuvre pour la protection de l'environnement. Cette recherche utilise un « mixed methods design » en combinant de manière innovant des données de sondage et d'entretiens. Ma principale contribution théorique réside dans la conceptualisation d'un outil analytique qui permet de saisir la « carte cognitive » des activistes, à travers le concept de « strong citizen » qui se réfère à la relation spécifique qu'entretiennent certains individus avec la société et la politique. Ces individus sont caractérisés par une vision inclusive et interconnectée de la société, ainsi que par une conception politique du citoyen comme critique et vigilant. Mon argument principal est celui selon lequel seuls les individus possédant ce type particulier de cognitions sont capable de construire un cadre d'injustice, d'« agency » et d'identité. Cette thèse apporte donc quelques éléments de réponse à la question de l'origine de ces cadres cognitifs qui sont cruciales pour la participation. Pour ce faire, quatre aspects spécifiques sont analysés de manière systématique. Premièrement, je démontre empiriquement, au niveau agrégé, que ces activistes possèdent effectivement des ressources cognitives spécifiques - en comparaison avec la population générale. Deuxièmement, j'analyse le contenu de ces cognitions, ce qui me permet notamment d'évaluer la pertinence et l'adéquation du concept de « strong citizen ». Troisièmement, en m'intéressant cette fois aux variations entre communautés d'activistes, je démontre que ceux réunis autour d'enjeux protestataires très revendicatifs sont, d'un point de vue cognitif, plus proches de la figure du « strong citizen » que ceux mobilisés sur des enjeux plus consensuels. Finalement, d'autres facteurs, à savoir les réseaux sociaux et la disponibilité biographique, sont intégrés à l'analyse afin de mesurer le réel pouvoir explicatif des cognitions dans l'explication des différences observées entre communautés d'activistes. A travers ces analyses, cette thèse met en avant l'importance du rôle des cognitions dans l'étude de la participation contestataire.