Improved health of hospitality workers after a Swiss cantonal smoking ban.

QUESTIONS UNDER STUDY: Hospitality workers are a population particularly at risk from the noxious effects of environmental tobacco smoke (ETS). The Canton of Vaud, Switzerland banned smoking in public places in September 2009. This prospective study addresses the impact of the ban on the health of hospitality workers. METHODS: ETS exposure was evaluated using a passive sampling device that measures airborne nicotine; lung function was assessed by spirometry; health-related quality of life, ETS exposure symptoms and satisfaction were measured by questionnaire. RESULTS: 105 participants (smokers and non-smokers) were recruited initially and 66 were followed up after one year. ETS exposure was significantly lower after the ban. Hospitality workers had lower pre-ban forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values than expected. FEV1 remained stable after the ban, with a near-significant increase in the subgroup of asthmatics only. FVC increased at one year follow-up from 90.42% to 93.05% (p = 0.02) in the entire cohort; women, non-smokers and older participants gained the greatest benefit. The health survey showed an increase in physical wellbeing after the ban, the greatest benefit being observed in non-smokers. ETS exposure symptoms were less frequent after the ban, especially red and irritated eyes and sneezing. The new law was judged useful and satisfactory by the vast majority of employees, including smokers. CONCLUSION: The recent cantonal ban on smoking in public places brought about an improvement in lung function, physical well-being and ETS symptoms of hospitality workers, including smokers.

L'insertion sociale plurielle des femmes cadres supérieurs en Suisse : contribution à l'étude du bien-être subjectif au quotidien : approche qualitative intégrative

RESUME« L'insertion sociale plurielle des femmes cadres supérieurs en Suisse. Contribution à l'étude du bien-être subjectif au quotidien. Approche intégrative qualitative. »Depuis une quarantaine d'années, nombreux sont les travaux qui étudient les relations entre les différents milieux de vie au quotidien et, plus particulièrement, l'impact de leurs articulations singulières sur la santé. Nous y identifions deux axes principaux : l'un aborde ce phénomène selon une perspective de « conflit travail-famille » en termes de « stress », l'autre se focalise davantage sur la promotion du « bien-être » au travers d'une approche d'« équilibre travail-vie ». Or, l'ensemble de ces recherches considère comme «pathogènes» les désajustements, les contradictions et les tensions vécus au quotidien. Selon cette tendance, le « bien-être » apparaît comme un état d'équilibre ultime indépendant du contexte de vie du sujet. Toutefois, peu de recherches portent sur la dimension située du bien-être dans son rapport à l'activité concrète au sein des milieux deNotre étude s'intéresse à cette question auprès des femmes cadres supérieurs, selon une perspective critique et développementale en psychologie de la santé (Lyons & Chamberlain, 2006 ; Santiago-Delefosse, 2002,2011 ; Malrieu, 1989 ; Vygotski, 1985). En effet, cette population constitue un terrain privilégié pour comprendre le sens donné à l'activité à partir des contraintes, responsabilités et demandes perçues dans des contextes parfois contradictoires, et pour analyser le rôle de ces derniers dans un bien-être subjectif.En cohérence avec notre positionnement théorique, nous avons mené des entretiens qualitatifs focalisés sur l'activité quotidienne auprès de 20 femmes, et ceci en deux temps (T1-T2) (40 entretiens). Les résultats issus des analyses du contenu des discours permettent de définir le vécu de l'articulation des milieux de vie chez nos participantes, selon trois axes à la fois interdépendants et autonomes. Chaque axe se définit par une série de supports spécifiques jouant un rôle structurant dans leur bien-être subjectif. Ainsi, le premier axe se caractérise par des supports de maîtrise subjective, ainsi que par l'appropriation de contraintes sociales et corporelles, selon un rythme de l'activité soutenu. Le deuxième s'accompagne de supports qui favorisent la prise de distance au travers du relâchement du rythme et du lâcher prise de la maîtrise, par la création d'espaces personnels et sociaux « pour soi ». Enfin, le troisième porte sur le positionnement de soi par rapport à autrui en termes de « personnalisation ».Construits en rapport à la corporéité et à autrui au sein de contextes spécifiques, ces différents supports prennent leur sens au sein d'un système de pratiques global, unique pour chaque femme. Selon cette conception critique, le bien-être subjectif chez les femmes cadres se définit comme le fruit d'un processus mouvant issu des tensions vécues entre les trois axes de l'articulation des milieux de vie. Il est par conséquent social, corporel et psychologique.Nos résultats ouvrent des perspectives de recherche et d'intervention, notamment en santé et travail. Ces ouvertures sont orientées vers une approche intégrative en psychologie de la santé, c'est-à-dire, de la prise en compte dans des questions de santé et de bien-être du processus de construction du sujet en relation à son insertion sociale plurielle.ABSTRACT« Plural social participation among women senior managers in Switzerland. Contribution to the study of subjective well-being in everyday life. An integrative and qualitativeapproach.»For the last forty years, a large body of literature has studied the relationships between different social realms in everyday life and, more particularly, the impact of their singular intertwinements with health. We identify two main trends : The first one focuses on this phenomenon through the « work-family conflict » perspective in terms of « stress » whilst the second one is more concerned by the promotion of « well-being » through a « work-life balance » approach. However, both of these trends consider disadjustments, contradictions and tensions in everyday life as « pathogenic ». According to this conception, « well- being » appears as an ultimate state of balance which is indépendant from the subject's life context. Nevertheless, few studies have examined the situated dimension of well-being in its link to concrete activity in social realms.Our research is concerned with this issue among women senior managers from a critical and developmental perspective in Health Psychology (Lyons & Chamberlain, 2006 ; Santiago-Delefosse, 2002, 2011 ; Malrieu, 1989 ; Vygotski, 1985). In fact, this population represents a favourable field so as to study : how the meaning of daily activity is constructed accross different and often conflictive social realms ; to understand the many ways in which this population deals with perceived constraints, responsibilities and requests, and to analyse the role of situated plural activity in subjective well-being.Consitent with our theoretical framework, we have designed a qualitative method. We have conducted two-time (T1-T2) interviews with 20 women by focusing on their daily activity (40 interviews). The Thematic Content Analysis reveals that four different social realms are articulated among our participants through three main axes, which are at the same time interdependent and autonomous. Each one of these axis is defined by a certain number of specific supports that play an important role in these women's subjective well- being. The first axis is concerned by several supports that signify a « feeling of control » along with the appropriation of social and body constraints by means of a rapid pace of activity. The second one regards the use of supports that contribute to « put things into perspective » by means of the slowing down of the pace of activity and through letting go of the feeling of control. This mechanism includes the creation of personal and social spaces of « one's own ». The third axis is defined by the positioning of the self in regard to others through a process of « personnalization ».Developed in specific contexts through the intertwinnements between the body and social others, supports belonging to these axes acquire significance and meaning on the basis of their relationship to a global system of activities of which they are part. However, this articulation is uniquely defined for each participant. According to this critical approach, subjective well-being among women senior managers emerges as a meaningful and changing process, situated in a plural social context. This is, it appears as the result of conflictual interactions defining the three different axis that we have identified. Subjective well-being is hence a social, embodied and psychological phenomena that is closely linked to the articulation of different social realms. Our findings open new research and practice perspectives, especially concerning health and work issues. These perspectives convey an integrative approach in Health Psychology by considering health and well-being by taking into account the process of construction of the subject in regard to his or her plural social participation.

Statewide Assessment Instrument, June 15, 2010

The Iowa Department of Human Services (IDHS) has responsibility for Iowa’s child welfare system. Iowa’s child welfare system focuses on children that have been or are at risk of being abused or neglected, as well as children that are determined by the Juvenile Court to be a child in need of assistance (CINA). The child welfare system is focused on three major results that are safety, permanency, and child and family well-being.

Persistent hyperglycemia at 24-48 h in acute hyperglycemic stroke patients is not associated with a worse functional outcome.

BACKGROUND: Recently, it was shown that the relation between admission glucose and functional outcome after ischemic stroke is described by a J-shaped curve, with a glucose range of 3.7-7.3 mmol/l associated with a favorable outcome. We tested the hypothesis that persistence of hyperglycemia above this threshold at 24-48 h after stroke onset impairs 3-month functional outcome. METHODS: We analyzed all patients with glucose >7.3 mmol/l on admission from the Acute STroke Registry and Analysis of Lausanne (ASTRAL). Patients were divided into two groups according to their subacute glucose level at 24-48 h after last well-being time (group 1: ≤7.3 mmol/l, group 2: >7.3 mmol/l). A favorable functional outcome was defined as a modified Rankin Score (mRS) ≤2 at 3 months. A multiple logistic regression analysis of multiple demographic, clinical, laboratory and neuroimaging covariates was performed to assess predictors of an unfavorable outcome. RESULTS: A total of 1,984 patients with ischemic stroke were admitted between January 1, 2003 and October 20, 2009, within 24 h after last well-being time. In the 421 patients (21.2%) with admission glucose >7.3 mmol/l, the proportion of patients with a favorable outcome was not statistically significantly different between the two groups (59.2 vs. 48.7%, respectively). In multiple logistic regression analysis, unfavorable outcome was significantly associated with age (odds ratio, OR: 1.06, 95% confidence interval, 95% CI: 1.03-1.08 for every 10-year increase), National Institute of Health Stroke Score, NIHSS score, on admission (OR: 1.16, 95% CI: 1.11-1.21), prehospital mRS (OR: 12.63, 95% CI: 2.61-61.10 for patients with score >0), antidiabetic drug usage (OR: 0.36, 95% CI: 0.15-0.86) and glucose on admission (OR: 1.16, 95% CI: 1.02-1.31 for every 1 mmol/l increase). No association was found between persistent hyperglycemia at 24-28 h and outcome in either diabetics or nondiabetics. CONCLUSIONS: In ischemic stroke patients with acute hyperglycemia, persistent hyperglycemia (>7.3 mmol/l) at 24-48 h after stroke onset is not associated with a worse functional outcome at 3 months whether the patient was previously diabetic or not.

Rapid Improvement In Health-Related Quality Of Life In Gouty Arthritis Patients Treated With Canakinumab (Acz885) Compared To Triamcinolone Acetonide

Background : Canakinumab, a fully human anti-IL-1b antibody has been shown to control inflammation in gouty arthritis. This study evaluated changes in health-related quality of life (HRQoL) in patients treated with canakinumab or triamcinolone acetonide (TA).Methods : An 8-wk, dose-ranging, active controlled, single-blind study in patients (_18 to _80 years) with acute gouty arthritis flare, refractory to or contraindicated to NSAlDs and/or colchicine, were randomized to canakinumab 10, 25, 50, 90, 150mg sc or TA 40mg im. HRQoL was assessed using patient reported outcomes evaluating PCS and MCS, and subscale scores of SF-36_ [acute version 2]) and functional disability (HAQ-DI_).Results : In canakinumab 150mg group, the most severe impairment at baseline was reported for physical functioning and bodily pain; levels of 41.5 and 36.0, respectively, which improved in 7 days to 80.0 and 72.2 (mean increases of 39.0 and 35.6) and at 8 wks improved to 86.1 and 86.6 (mean increases of 44.6 and 50.6); these were higher than levels seen in the general US population. TA group, showed less improvement in 7 days (mean increases of 23.3 and 21.3 for physical function and bodily pain). Functional disability scores, measured by the HAQ-DI_ decreased in both treatment groups (Table 1).Conclusions : Gouty arthritis patients treated with canakinumab showed a rapid improvement in physical and mental well-being based on SF-36_ scores. In contrast to the TA group, patients treated with canakinumab showed improvement in 7 days in physical function and bodily pain approaching levels of the general population.Disclosure statement : U.A., A.F., V.M., D.R., P.S. and K.S. are employees and shareholders of Novartis Pharma AG. A.P. has received research support from Novartis Pharma AG. N.S. has received research support and consultancy fees from Novartis Pharmaceuticals Corporation, has served on advisory boards for Novartis, Takeda, Savient, URL Pharma and EnzymeRx, and is/has been a member of a speakers' bureau for Takeda. A.S. has received consultation fees from Novartis Pharma AG, Abbott, Bristol-Myers Squibb, Essex, Pfizer, MSD, Roche, UCB and Wyeth. All other authors have declared no conflicts of interest.

Resiliència i èxit escolar en l’alumnat de secundària de procedència estrangera. Diagnòstic i línies d’intervenció

L’estudi realitzat aborda i caracteritza des de l’enfocament de la resiliència com l’alumnat de procedència estrangera s’enfronta a una etapa d’alt risc d’abandonament escolar com és l’Educació Secundària Obligatòria (ESO) –especialment en el segon cicle– i el moment de transició acadèmica cap a la Postobligatòria (PO). En altres paraules, s’analitzen i valoren els mecanismes resilients desplegats per l’alumnat immigrant que donen llum sobre com aconseguir que processos, a priori, qualificats com a problemàtics o dificultosos per aquests grups degut a la seva situació de major vulnerabilitat esdevinguin una xarxa protectora que afavoreixi trajectòries d’èxit escolar. L’emmarcament conceptual des de la resiliència educativa, en general, ha centrat la seva atenció en la capacitat de l’individu per “compensar” certes limitacions amb altres habilitats. Tanmateix, la definició de resiliència a la qual ens hem aferrat té un caire més ecològic i culturalment sensible. És la definició proposada pel Resilience Research Centre (RRC) i encunyada pel seu co-director Michael Ungar: In the context of exposure to significant adversity, resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided in culturally meaningful ways (Ungar, 2012). Entesa d’aquesta manera, la resiliència és un constructe social que identifica els processos i resultats relacionats amb allò que la gent conceptualitza com a “benestar”. Així, es més probable que la resiliència aparegui quan es proporcionin els serveis, suports i recursos que garanteixen el benestar de tots els nens/es des d’una perspectiva que sigui significativa tant per a l’individu, com per la seva família i comunitat...

IRENE newsletter. Volume 1, number 1 (Spring/Summer 2007)

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 1, number 2 (Fall/Winter 2007). University of Iowa

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 2, number 1 (Spring/Summer 2008). University of Iowa

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 4, number 1 (Spring/Summer 2010)

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 4, number 2 (Fall/Winter 2010)

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 1, number 2 (Fall/Winter 2007)

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 2, number 1 (Spring/Summer 2008)

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.

IRENE newsletter. Volume 2, number 2 (Fall/Winter 2008)

IRENE’s mission is to improve the health and well-being of Iowans through collaboration in practice-based research on questions important to primary care physicians and their patients. IRENE’s purpose is to create and foster a network of research collaboration between the academic medical center and primary care physicians through out the state of Iowa with a particular focus on improving rural health.