Determination and control of schistosomiasis

The subject of this conference reflects the scientific community's interest in seeking to understand the complex causal web whose various social, economic, and biological components interact in the production and reproduction of schistosomiasis and its control in relation to community participation. From the onset, the author stresses the impossibility of dealing separately with community participation, as if social components were just one more "weapon" in the arsenal for schistosomiasis control. This study begins with a brief historical review of the 71 years of control activities with this endemic disease, stressing the enormous efforts and huge expenditures in this field vis-à-vis the limited results, despite the extraordinary technological development of specific, classical control inputs such as new treatment drugs and molluscicides. The article then discusses the various strategies used in control programs, emphasizing ideological consistencies and contradictions. Interactions at the macro and micro levels are discussed, as are the determinants and risk factors involved in producing the disease's endemicity. Unequal occupation of space leaves the segregated portion of the population exposed to extremely favorable conditions for transmission of the disease. This raises the issue of how to control an endemic disease which is so closely linked to the way of life imposed on the population. The study challenges the classical control model and suggests an alternative model now undergoing medium-term investigation in the States of Espirito Santo, and Pernambuco, Brazil. The author concludes that we do not need new strategies, but a new control model, contrary to the prevailing classical model in both concept and practice. From the conceptual point of view, the new model mentioned above is different from others in that schistosomiasis control is seen from a social perspective stressing the population's accumulated knowledge in addition to the building of shared knowledge. The model's praxis has the following characteristics: (1) it is integrated with and financed by research agencies and health services; (2) it operates at the local health services level; (3) use of molluscicides has been eliminated; (4) emphasis is given to individual medical treatment and improvement of sanitary conditions.

Digitale politische Partizipation - Spannungsfeld zwischen MyPolitics und OurPolitics

Der Beitrag untersucht soziale und politische Aspekte digitaler politischer Partizipation. Einerseits müssen die Optionen für MyPolitics ausgeschöpft werden, indem Instrumente für elektronische Abstimmungen und Wahlen bereitgestellt werden. Andererseits sollte das Potenzial politischer Partizipation genutzt und Plattformen für OurPolitics gefördert werden. Solche Plattformen, ergänzt durch geeignete Matching-Verfahren, bringen Interessierte mit ähnlichen Anliegen zusammen und fördern politische Gestaltungskraft. Sie sind ein erster Schritt zum Public Memory einer digitalen Gesellschaft und bereichern nachfolgende Generationen mit ihrem Gedankengut.

Genomik und personalisierte Medizin [Genomics and personalized medicine].

Personalized medicine has a substantial potential to transform the way diseases will be predicted, prevented and treated. The field will greatly benefit from novel DNA sequencing technologies, in particular commoditization of individual whole genome sequencing. This evolution cannot be stopped, and the medical and scientific community, as well as the society at large, have the responsibility to anticipate the expected benefits from this revolution, but also the potential risks associated with it. Massive investments will be needed for the potential of personalized medicine to be realized, and for the field to come to maturity. In particular, a paradigm change in the way clinical research is done is needed. Switzerland and its Western part pro-actively anticipate these changes.

Topische Therapie bei Colitis ulcerosa [Topical therapy of ulcerative colitis].

The availability of new topical preparations for the treatment of left sided ulcerative colitis ulcerosa offers a therapy optimization for many patients. Rectal application of steroids and 5-aminosalicylic acid (5-ASA) is associated with fewer side effects and has a higher therapeutic efficacy in mild to moderate-active left-sided colitis as compared to a systemic therapy. Often it is argued that the patients' compliance is insufficient with a rectal therapy. However, with sufficient information on the proven advantages this is usually not the case. The rectal application of drugs in distal ulcerative colitis is suitable also for the maintenance of remission. Therefore the new therapy guidelines recommend topical therapy more than in former times. Subsequently, these manuscripts focussed specifically on the topical therapy of distal colitis, to elucidate that clear treatment advantages are present in daily practice.

Insuffisance veineuse chronique stade III: Prise en charge physio- thérapeutique [3rd degree chronic venous insufficiency: physiotherapy treatment]

A venous ulcer is the end result of a long pathological process where venous hypertension represents the principal cause of a number of complications. The physiotherapist by adapting various different therapeutic approaches improves the vascular, joint and respiratory problems of these patients.

Youth of the Eighties, Parents of 2000, Sociological Observations

(Résumé de l'ouvrage) This book is meant to honour the Belgian religious educationalist Herman Lombaerts reflecting on his legacy. He is internationally renowned as a scholar with a strong commitment to and a conceptual analysis of the social and cultural context in which people live and learn. This series of essays is build upon a thought provoking, streamlined design on the relationship between theology and education, relying on Lombaerts' societal and cultural analysis of contemporary religious education. Three key elements are at stake: the self-agency of the learner, the hermeneutic and communitive interpretation of religious traditions in the teaching of religion, and the radical re-imagination of Christian theology relying on this new model of religious educational praxis. For Lombaerts, the search processes of religious people have their own dynamic and dignity. Practical theology should listen carefully and empathetically to this quest. But he is also convinced of the need of solid fundamental research to understand critically its ambiguities and perspectives. Scholars from Europe, the United States and Australia lead the way in this process of "conceptual stretching". Issues such as happiness of children, identity formation of youth, educational and religious insecurity of parents, multi-faith education, tradition crisis of churches, theological education of lay ministers, narrativity and modern art in religious education, etc. are examined from a practical theological point of view, with a strong commitment to the philosophical, psychological, sociological, educational and political dimensions of three issues. With this book the editors hope to commemorate Lombaerts' international radiation, by building a collegial bridge between the different theoretical approaches in the German, Dutch, French, Italian and Anglo-Saxon religious educational research.

Zeitpunkt der Medikamenten-einnahme bei Hypertonie und Angina pectoris. Eine kontrollierte Uberwachungsstudie. [Time of drug intake in hypertension and angina pectoris. A controlled monitoring study]

A prospective cross-over study was performed in a general practice environment to assess and compare compliance data obtained by electronic monitoring on a BID or QD regimen in 113 patients with hypertension or angina pectoris. All patients were on a BID regimen (nifedipine SR) during the first month and switched to QD regimen (amlodipine) for another month. Taking compliance (i.e. the proportion of days with correct dosing) improved in 30% of patients (95% confidence interval 19 to 41%, p < 0.001), when switching from a BID to a QD regimen, but at the same time there was a 15% increase (95% confidence interval 5 to 25%, p < 0.02) in the number of patients with one or more no-dosing days. About 8% of patients had a low compliance rate, irrespective of the dosage regimen. Actual dosage intervals were used to estimate extent and timing of periods with unsatisfactory drug activity for various hypothetical drug durations of action, and it appears that the apparent advantage of QD regimen in terms of compliance is clinically meaningful only, when the duration of activity extents beyond the dosage interval in all patients.

Comunidad y ciudadanía activa: fenomenología de una ocupación ética en un contexto de inmigración

La teoria i la praxi de la investigació qualitativa actual és hereva de la tradició fenomenològica. L’objectiu de la investigació està relacionat amb la comprensió profunda de les dimensions de l’educació i el treball, així com la seva significació per a les dones i els homes amb històries de vida marcades per la immigració. També, el treball de la investigació actual analitza la construcció de una identitat individual i col•lectiva de les dones i els homes amb una història d’immigració i reflexiona com desenvolupen el seu compromís a través d’una ocupació ètica. Es fa èmfasi en els elements transversals de la cultura i les construccions de gènere dins del domini de treball i educació. El mètode biogràfic narratiu es va utilitzar per estudiar les qüestions plantejades per la investigació. El procés de triangulació de les veus de les dones, els homes i de l’organització participant es va duu a terme per assegurar la validesa dels resultats i es van interpretar els indicadors de la recerca des del marc teòric proposat. A mode de conclusió, el treball es refereix a la formació permanent i considera que la violació del dret a l’educació és un factor que limita les oportunitats d’experimentar aquest tipus d’ocupació i, té efectes en la integritat personal i col·lectiva. Esperem que aquesta investigació pugui contribuir a la política d’immigració de les diferents organitzacions.

Le Groupe Prévention et Traitement des Plaies des Hospices-CHUV [The Hospices-CHUV's Wound Prevention and Treatment Group]

The treatment of wounds is a challenge that caregivers of all specialities encounter daily in the care of an ageing population and chronically ill patients. An interdisciplinary group has been created in recent years within the Hospices-CHUV to assist caregivers in their care of patients with wounds. This group has developed a variety of tools to assist decision-making and offers a range of continuing education for those employees involved in wound care. The authors describe the approach of the group and the documents produced during the first two years of experience.

L'angioplastie coronaire chez le patient âgé [Coronary angioplasty in elderly patients]

Percutaneous transluminal coronary angioplasty (PTCA) is a widely accepted treatment of symptomatic coronary heart disease providing prompt and prolonged clinical, improvement in most patients. We have examined the value of this therapy in a group of 91 patients in their eighth decade treated by 133 consecutive angioplasties. Most patients had refractory or instable angor in spite of optimal pharmacotherapy. Multivessel disease was present in 67% and maintained left-ventricular function in 92% of the patients. The angiographic success rate of PTCA was 84%; technical failures occurred in 12% and adverse events in 14%. Two patients died. The rate of symptomatic restenosis was 24%. Survival and patients free of myocardial events were at 89% and 60%, respectively, estimated by Kaplan-Meier analysis. PTCA is an efficient and acceptable treatment for the elderly patient with severe and drug-resistant angina. Two years after PTCA the majority of patients was asymptomatic.