Trends in self-reported prevalence and management of hypertension, hypercholesterolemia and diabetes in Swiss adults, 1997-2007.

Switzerland has a low mortality rate from cardiovascular diseases, but little is known regarding prevalence and management of cardiovascular risk factors (CV RFs: hypertension, hypercholesterolemia and diabetes) in the general population. In this study, we assessed 10-year trends in self-reported prevalence and management of cardiovascular risk factors in Switzerland. data from three national health interview surveys conducted between 1997 and 2007 in representative samples of the Swiss adult population (49,261 subjects overall). Self-reported CV RFs prevalence, treatment and control levels were computed. The sample was weighted to match the sex - and age distribution, geographical location and nationality of the entire adult population of Switzerland. self-reported prevalence of hypertension, hypercholesterolemia and diabetes increased from 22.1%, 11.9% and 3.3% in 1997 to 24.1%, 17.4% and 4.8% in 2007, respectively. Prevalence of self-reported treatment among subjects with CV RFs also increased from 52.1%, 18.5% and 50.0% in 1997 to 60.4%, 38.8% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Self-reported control levels increased from 56.4%, 52.9% and 50.0% in 1997 to 80.6%, 75.1% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Finally, screening during the last 12 months increased from 84.5%, 86.5% and 87.4% in 1997 to 94.0%, 94.6% and 94.1% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. in Switzerland, the prevalences of self-reported hypertension, hypercholesterolemia and diabetes have increased between 1997 and 2007. Management and screening have improved, but further improvements can still be achieved as over one third of subjects with reported CV RFs are not treated.

Hyperesthésie et apaisement: aspects historiques et psychologiques

L'auteur fait une synthèse des contributions, actuelles ou passées, décrivant la tendance chez un individu à exacerber ses sensations (hyperesthésie), agréables ou douloureuses, y compris les éprouvés émotionnels. Il met l'accent sur l'effet antagoniste ou inhibiteur que les sensations peuvent avoir les unes sur les autres. Puisque l'angoisse implique, elle aussi, une dimension sensorielle, il insiste sur le but paradoxal d'apaisement et donc défensif qui peut motiver la recherche de sensations, en se référant à la notion de « procédé autocalmant » développée par l'école psychosomatique de Paris.¦Ce travail se divise en deux parties consacrées respectivement à l'enfant et à l'adulte, elles-mêmes déclinées sur deux versants, l'un « normal » et l'autre pathologique. Il y est question :¦- des comportements de l'enfant susceptibles d'être produits pour les sensations apaisantes qu'ils procurent : succion, ingestion d'aliments, balancement, masturbation, etc.¦- des auto-agressions dans certains troubles du développement de l'enfant et de l'adolescent¦- de l'hypersensibilité ou émotivité dans les typologies du tempérament ou du caractère proposées dans l'histoire; de la passion également, envisagée comme un embrasement lui aussi potentiellement défensif¦- de deux parmi les troubles de l'adulte qui ont le plus été décrits en termes d'hyperesthésie, à savoir l'hystérie et la manie.¦Il s'agit d'un travail théorique, qui intègre des aspects historiques, et qui peut servir de base à des explorations cliniques ou des recherches plus spécifiques.¦The author presents a summary of past and recent publications describing the disposition in the individual to exacerbate sensations (hyperesthesia), whether pleasurable or painful, including emotional experiences. He emphasizes the possible opposing or inhibiting action these sensations can have between them.¦As anxiety also implies a sensory dimension, the author underlines the paradoxically alleviating, and hence defensive purpose driving the pursuit of sensations, by reference to the notion of self-soothing procedures (procédés auto-calmants), conceptualized by the Paris Psychosomatic School.¦This work is divided into two parts focusing on childhood and adulthood respectively, each in its turn concentrating on both the « normal » and pathological aspects. Topics covered include:¦- behaviours that children may engage in for the soothing effects they produce ; sucking, consumption of food, rocking, masturbation, etc.¦- self-harm in some cases of developmental disorders in children and adolescents¦- hypersensibility and emotivity as described in historical temperament and character types ; passion, also regarded as another defensive excitement.¦- two of the most commonly described disorders of hyperesthesia in adults, namely hysteria and mania.¦This thesis constitutes a research of a theoretical nature. It integrates historical aspects, which can be used as a basis for clinical exploration or further more specific research.

Temperature effect upon blood consumption in Triatoma infestans

Different blood consumption speed was observed in Triatoma infestans - nymphs and adults - exposed to 12 degrees C and 28 degrees C. Exposure to optimal temperature (28 degrees C) allows the insects to consume blood at a rate of 9% per day. Significative relationship between blood amount present in the promesenteron and consumed blood was found at 28 degrees. Consumption of blood was drastically reduced at the lowest temperature. Accordingly, lack of ovaric development, oviposition and mating behaviour was observed in insects kept at 12 degrees C. Relationship between laboratory and field observations are discussed.

Desconnexió de la xarxa

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit cientí­fic del Jovent l'any 2009. Aquest treball es planteja com un repte la necessitat de connexió a una xarxa de subministrament elèctric i d'aigua. L'objectiu del treball ha estat comprovar si, tan tècnicament com econòmica, es pot aconseguir l'autosuficiència d'una casa de muntanya del Vallès Oriental tot aprofitant els recursos que ens ofereix el medi, però sense haver de renunciar al nivell de vida al qual ens hem acostumat durant els darrers anys. Després d'una recollida de dades i valoració del consum energètic mínim que volem imposar, hem dissenyat una instal·lació capaç d'aprofitar les energies renovables de l'entorn i de satisfer les nostres necessitats. La instal·lació inclou plaques fotovoltaiques, col·lectors solars, cisternes per a la recollida d'aigua, bombes, etc. Finalment, s'inclou un pressupost d'aquesta instal·lació, que indica que els diners que caldria invertir són massa. Es demostra, doncs, que l'autosuficiència d'aquesta casa és tècnicament viable, però econòmicament inviable (o gens rendible).

Communication during brief intervention, intention to change, and outcome.

OBJECTIVES: To explore the relationship between patient's intention to change regarding future alcohol consumption following brief alcohol intervention (BAI) and changes in alcohol consumption 12-months later and the communication characteristics between patient and counselor during BAI. DESIGN, SETTING AND SUBJECTS: Data from 367 patients (experimental arm) of a pragmatic randomized controlled trial were used to assess the effectiveness of BAI among hazardous drinkers attending an Emergency Department (Lausanne University Hospital, Lausanne, Switzerland). Alcohol outcome measures at baseline and 12 months follow-up included usual number of drinks per week, monthly frequency of heavy episodic drinking (5 or more standard drinks for men; 4 or more for women), and the Alcohol Use Disorders Identification Test (AUDIT) score. In addition, the communication characteristics between patient and counselor were analyzed via tape recordings using the Motivational Interviewing Skill Code (MISC) from 97 participants. Patient readiness and importance to change on a 10-point Likert scale (readiness/importance to change ruler) was asked during BAI, and patient intention to change alcohol consumption (yes/no) was asked at the last step. Differences in alcohol outcome at follow-up between the 367 patients who did or did not have an intention to change consumption at baseline were compared, as were differences between these two groups in communication characteristics for the 97 who completed tape recordings. RESULTS: Patients with an intention to decrease alcohol consumption reduced alcohol use and related problems more often, and reported higher levels of importance and readiness to change than did their counterparts. Analyses of MISC-coded data showed a significantly higher use of MI-consistent skills among those with a moderation intention, but no group differences on the 8 other counselor communication skills measures were found. Analyses of patient speech during the intervention indicated that those with an intention to change their alcohol consumption significantly more often self-explored personal ambivalence towards alcohol, expressed more intensely their ability, commitment, desire, need and reason to change their alcohol use than did those in the no decrease group. CONCLUSIONS: The intention expressed by hazardous drinkers when concluding BAI is associated with both patient change talk during BAI and drinking outcome 12 months later, but is mainly independent of counselor communication skills. This intention may be an important clinical indicator of which hazardous drinkers are most likely to improve after BAI.

Could cell membranes produce acoustic streaming? Making the case for synechococcus self-propulsion

Sir James Lighthill proposed in 1992 that acoustic streaming occurs in the inner ear, as part of the cochlear amplifier mechanism. Here we hypothesize that some of the most ancient organisms use acoustic streaming not only for self-propulsion but also to enhance their nutrient uptake. We focus on a motile strain of Synechococcus, a yanobacteria whose mechanism for self-propulsion is not known. Molecular motors could work like piezoelectric transducers acting on the crystalline structure surrounding the outer cell membrane. Our calculations show that a traveling surface acoustic wave (SAW)could account for the observed velocities. These SAW waves will also produce a non-negligible Stokes layer surrounding the cell: motion within this region being essentially chaotic. Therefore, an AS mechanism would be biologically advantageous, enhancing localized diffusion processes and consequently, chemical reactions. We believe that acoustic streaming, produced by nanometer scale membrane vibrations could be widespread in cell biology. Other possible instances are yeast cells and erythrocytes. Flows generated by acoustic streaming may also be produced by silica coated diatoms along their raphe. We note that microelectromechanical (MEMS) acoustic streaming devices were first introduced in the 1990’s. Nature may have preceded this invention by 2.7 Gyr.

How are temporal and social comparisons related to appraisals of self-rated health during very old age?

This study investigated the direction of effects of temporal and downward social comparisons on self-rated health in very old age. Self-rated health can either reinforce or hinder comparison processes. In the framework of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old, individuals aged 80 to 84 at baseline were interviewed and followed longitudinally for 5 years. Multilevel analyses were used to test the relative importance of temporal and social comparisons on self-rated health evaluations synchronically and diachronically (with a time lag of 12 to 18 months) as well as the direction of these relative influences. Results indicate that (a) at the synchronic level, continuity temporal comparisons have more impact than downward social comparisons on self-rated health; (b) both types of comparison had an independent and positive effect on self-rated health at the diachronic level; (c) self-rated health has an independent synchronic effect on both types of comparison and an independent diachronic effect in temporal comparison.

Gestió dels recursos hídrics del Monestir Budista Sakya Tashi Ling

Amb la finalitat de millorar l’autosuficiència hídrica del monestir budista del Garraf Sakya Tashi Ling, es fa una avaluació de l’estat dels recursos hídrics d’aquest sistema, així com els seus usos i punts de consum. L’avaluació s’ha realitzat mitjançant la integració i ús de paràmetres mediambientals, hídrics i arquitectònics. Amb l’estimació d’entrades i consums d’aigua, juntament amb els càlculs realitzats, s’ha diagnosticat l’estat actual del sistema. Mitjançant la realització d’un inventari dels diferents equipaments i dispositius instal·lats en els punts de consum d’aigua, s’han detectat mancances en la eficiència hídrica com l’escassa implementació de dispositius d’estalvi hídric o la inexistent captació de les aigües pluvials. El diagnòstic de les mancances ha orientat les propostes de millora aplicables al sistema. Aquestes incideixen principalment en la millora de l’estalvi d’aigua amb la instal·lació de dispositius estalviadors i en la captació d’aigües pluvials mitjançant una xarxa de recollida, emmagatzematge i distribució.

Anàlisi ambiental de La Pleta: oficina tècnica del Parc del Garraf

En aquest projecte s’ha analitzat la viabilitat de l’autosuficiència de la Pleta, l’oficina tècnica del Parc del Garraf, a partir de diferents recursos renovables. S’ha realitzat un estudi del consum hídric i energètic i de la generació de residus per tal d’avaluar les deficiències de cada sistema, per poder-hi aplicar les mesures pertinents. Els resultats obtinguts mostren que un 40% de l’aigua que es consumeix a l’edifici prové dels camions cisterna que la subministren. Per tant, la principal proposta de millora va encaminada a reduir aquest volum d’aigua i per aconseguir-ho, es proposa augmentar la superfície de recollida d’aigua de pluja aprofitant la zona pavimentada del pati de magatzems. Les altres propostes intentaran reduir el volum total d’aigua consumida, com per exemple canviar el filtre actual de les aixetes per airejadors que permeten estalviar fins a un 50% d’aigua, instal·lar cisternes de volum inferior o posar en funcionament el reg per degoteig instal·lat actualment a la Pleta però que no es troba en funcionament. Pel que fa a l’energia hi ha dues fonts, el gasoil i les plaques FV. En quant al gasoil cal diferenciar entre el consum del generador per produir electricitat i el consum de la caldera per la calefacció. Un cop estudiat el sistema s’ha obtingut que les plaques solars FV aconsegueixen produir el 73% de l’electricitat demandada a la Pleta, la resta de l’electricitat la proporciona el generador. El principal problema, però és el gran consum de gasoil per la calefacció. Les millores proposades per a solucionar aquesta problemàtica pretenen millorar l’eficiència de la instal·lació de plaques solars FV col·locant més panells solars i disminuir el consum de gasoil per part de la calefacció, ja sigui millorant l’eficiència energètica i/o canviant la font d’energia per biomassa. En el cas de residus s’ha observat que es produeixen 3.283 kg/any, sent el rebuig la fracció més important. Per tal de reduir el volum de residus generats, es pretén fomentar la utilització d’estris reutlilitzables i el correcte reciclatge, substituint les papereres actuals dels despatxos per les de paper i posant cartells informatius o indicatiu en els llocs adients.

Cap a l'autosuficiència energètica: barri La Plana, Sitges

En el present estudi s’ha analitzat si és possible l’autosuficiència energètica al barri projectat de La Plana de Sitges a partir de fonts renovables d’energia. S’ha realitzat un anàlisi de l’oferta potencial del barri de La Plana, format per habitatges unifamiliars i plurifamiliars, serveis i equipaments i s’ha comparat el potencial de producció energètica dels recursos renovables locals a cada subsistema i pel sistema de La Plana. Diferenciant si són una Oferta estàndard (4.000 MWh/a) seguint la Normativa d’ecoeficiència de Sitges o bé una Oferta renovable (19.000 MWh/a) segons un Ecobarri proposat en aquest projecte a partir d’energia solar fotovoltaica i tèrmica. En l’estudi de la demanda, diferenciant entre una Demanda estàndard (39.000 MWh/a), respon al total de La Plana seguint el consum d’un habitatge tipus de la mitjana catalana (ICAEN, 2002) i una Demanda eficient (20.800 MWh/a) seguint un model de baix consum projectat en un Ecobarri de Barcelona. (Vallbona, 2009). Per analitzar de forma detallada les variables d’oferta i demanda, s’han proposat quatre escenaris diferents on es valoren l’autosuficiència energètica del sistema de la Plana i aspectes ambientals d’emissions derivades de la utilització de l’energia. El primer escenari és l’estàndard i és el resultat d’analitzar conjuntament una oferta i una demanda estàndard. Al segon escenari conflueixen una Oferta Estàndard i una Demanda Eficient. En el tercer escenari coincideixen una Oferta Renovable i una Demanda Estàndard. El quart i últim escenari respon a la proposta d’Ecobarri on l’Oferta és renovable i la Demanda eficient. Tanmateix, s’ha realitzat un estudi sobre els aspectes econòmics de La Plana que s’estimen en uns beneficis per la venda de l’energia d’uns 5 milions d’euros anuals i uns costos d’instal·lació de 80 milions d’euros. Finalment s’ha constatat que és possible assolir una autosuficiència del 90% a l’escenari Ecobarri (oferta renovable - demanda eficient). Mitjançant la instal·lació de sistemes de captació solar a les cobertes, cobrint el 100% de la demanda d’ACS, i captadors solars FV, ambdues estratègies són viables i representen beneficis econòmics i una reducció d’emissions de l’ordre de 13.700 Tn CO2 equivalents anuals que suposen un estalvi del 88% respecte un escenari d’oferta i demanda estàndard.

Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

BACKGROUND: As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. METHODS: A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. RESULTS: Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p < 0.005), and significantly higher proportion of "good/very good" responses for 4/9 items. After adjusting for explanatory variables, physicians remained more likely to have higher skillfulness (β = 0.13, p = 0.05). Among all, higher skillfulness was associated with perception/awareness of problems in the following areas: inadequate cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p < 0.005) was negatively correlated with skillfulness. CONCLUSIONS: Overall, there is much room for cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.