Socioeconomic status, structural and functional measures of social support, and mortality: The British Whitehall II Cohort Study, 1985-2009.

The authors examined the associations of social support with socioeconomic status (SES) and with mortality, as well as how SES differences in social support might account for SES differences in mortality. Analyses were based on 9,333 participants from the British Whitehall II Study cohort, a longitudinal cohort established in 1985 among London-based civil servants who were 35-55 years of age at baseline. SES was assessed using participant's employment grades at baseline. Social support was assessed 3 times in the 24.4-year period during which participants were monitored for death. In men, marital status, and to a lesser extent network score (but not low perceived support or high negative aspects of close relationships), predicted both all-cause and cardiovascular mortality. Measures of social support were not associated with cancer mortality. Men in the lowest SES category had an increased risk of death compared with those in the highest category (for all-cause mortality, hazard ratio = 1.59, 95% confidence interval: 1.21, 2.08; for cardiovascular mortality, hazard ratio = 2.48, 95% confidence interval: 1.55, 3.92). Network score and marital status combined explained 27% (95% confidence interval: 14, 43) and 29% (95% confidence interval: 17, 52) of the associations between SES and all-cause and cardiovascular mortality, respectively. In women, there was no consistent association between social support indicators and mortality. The present study suggests that in men, social isolation is not only an important risk factor for mortality but is also likely to contribute to differences in mortality by SES.

Tötungsstile. Ein triebpsychologischer und pathoanalytischer Beitrag zum Verständnis psychischer Begleitprozesse bei Tötungsdelikten = L'acte de tuer. Eclairage szondien et pathoanalytique sur les styles de meurtre

Zusammenfassung: Um die innerpsychischen Begleitprozesse von Tötungsdelikten aus triebpsychologischer Sicht zu verstehen, wendete ich mich an 33 Menschen, die ein Tötungsdelikt begangen oder zu begehen versucht haben. Als Methode diente mir der Szondi-Test, den ich mit den Betreffenden durchführte, die mir ausserdem von sich und ihrem Delikt erzählten. Die reguläre triebdiagnostische Analyse wie auch die Kainsyndromatik nach Szondi ergaben jedoch keine Gruppenbildungen und brachten mich in meinem Verständnis der Tötungen nicht wirklich weiter. So wendete ich mich der pathoanalytischen Betrachtungsweise zu, die mittels der vier grossen Nosographien der klassischen Psychiatrie, Gruppenvergleiche erst möglich machte und mir einen Überblick über verschiedene Grundstrukturen bot. Die Strukturdiagnostik der 33 Szondi-Tests sollte die Basis und demnach meine neue Ausgangslage bilden. Hypothesengenerierend stiess ich dann auf zwei weitere Einflussgrössen, die den Prozess einer Tötung entscheidend mitzuprägen schienen: die verschiedenen Aggressionsstile und die acting-Prozesse. Diese drei Einflussgrössen ergaben in ihrem Zusammenspiel auf der nosographischen, der anthropologischen und der metapsychologischen Ebene vier konstante Grössen mit je spezifischen Eigenschaften, die ich als Tötungsstile bezeichnete. Auf diese Weise entstand ein theoretisch-klinisches Modell zur retrospektiven Erfassung innerpsychischer Prozesse, die eine tötende Handlung aus triebpsychologischer und pathoanalytischer Sicht begleiten.

Questions et réponses sur l'utilisation du rivaroxaban (Xarelto) dans la pratique [Questions and answers regarding the use of rivaroxaban in daily practice].

Several new oral anticoagulants are now on the Swiss market and the general practitioner faces new challenges regarding the management of these new drugs. This consensus document aims to answer to the most frequently asked questions regarding rivaroxaban and covers different topics such as indications, initiation of treatment, drug-drug interactions and perioperative management.

Les proches des personnes souffrant d'une démence [Caring for the caregiver]

Les syndromes démentiels évoluent sur plusieurs années et touchent la personne dans sa globalité, altérant ses fonctions cognitives, son comportement et ses capacités relationnelles. Le patient perd peu à peu son indépendance. Les proches vont alors jouer un rôle essentiel auprès de lui et devront s'adapter à l'évolution de ses besoins, assumant progressivement surveillance, guidance et aide concrète. L'inestimable contribution des familles et les difficultés liées à l'exercice de ce rôle sont encore trop peu reconnues. De nombreuses études décrivent les conséquences négatives de l'aide naturelle. Toutefois les données sont moins riches quant aux déterminants de ces conséquences. Les proches ont souvent besoin d'information, de conseil et de soutien psychologique. Les programmes psychoéducatifs sont une des possibilités d'aide auprès de l'entourage de patients déments. Dementing disorders usually evolve over several years and alter cognitive performances, behavior and social abilities. Progressively, the patients lose their independence. Families will play a key role for the demented patient and have to adapt to the evolution of his or her needs. They will have to watch over, guide and help the demented proxy. The families' invaluable contribution and the numerous difficulties they encounter while they care for their demented proxy are insufficiently recognized. The deleterious consequences on the carers are currently better known than the determinants of these consequences. Families often need information, counselling and psychological support. Psycho-educational programs represent one of the possible strategies to help families and carers of patients with dementia

HIA Forum, HIA: A tool to support healthier communities (September 2009)

The HIA Forum provides an opportunity for those with an interest in HIA to meet, share experiences, hear about new developments and consider how to progress HIA. 2009 HIA Forum events focused on how HIA can and is being used to support healthier communties.

Traitement de la coxarthrose par des prothèses totales de hanche sur mesure [Treatment of coxarthrosis with fitted total hip prostheses replacement]

The treatment of hip osteoarthritis with total hip arthroplasty has continuously evolved since it was first introduced in the sixties. The problem of aseptic loosening of the cemented prostheses, mainly in young active patients, has stimulated two different types of research: on one side the improvement of cementing techniques and on the other side the development of cementless osteoinegrable implants. We discuss the problems of these cementless hip prostheses. Recently published anatomic and biomechanic studies have led to the development of personalized custom femoral stems for each patient. The conception technique and first clinical results are described.