Algies après cure de hernie inguinale: que faire [Pain after inguinal hernia repair: what to do?]

Hernia repair one of the most frequently performed operations in general surgery. With the introduction of tension-free mesh repair, recurrence rates dropped well below 5% for open and laparoscopic procedures. However, chronic postoperative pain remains a widely neglected complication with a high socio-economic impact. It occurs in about 10-20% of patients after hernia repair. We review the different types of post-herniorrhaphy pain with the typical diagnostic features and we conclude with a pragmatic algorithm based on our clinical experience.

Heterogeneity, selection and labor market disparities

We study the incentives to acquire skill in a model where heterogeneous firmsand workers interact in a labor market characterized by matching frictions and costlyscreening. When effort in acquiring skill raises both the mean and the variance of theresulting ability distribution, multiple equilibria may arise. In the high-effort equilibrium, heterogeneity in ability is sufficiently large to induce firms to select the bestworkers, thereby confirming the belief that effort is important for finding good jobs.In the low-effort equilibrium, ability is not sufficiently dispersed to justify screening,thereby confirming the belief that effort is not so important. The model has implications for wage inequality, the distribution of firm characteristics, sorting patternsbetween firms and workers, and unemployment rates that can help explaining observedcross-country variation in socio-economic and labor market outcomes.

How the West "invented" fertility restriction

We analyze the rise of the first socio-economic institution in history that limited fertility ? long before theDemographic Transition. The "European Marriage Pattern" (EMP) raised the marriage age of women andensured that many remained celibate, thereby reducing childbirths by up to one third between the 14thand 18th century. To explain the rise of EMP we build a two-sector model of agricultural production ?grain and livestock. Women have a comparative advantage in the latter because plow agriculture requiresphysical strength. After the Black Death in 1348-50, land abundance triggered a shift towards the landintensivepastoral sector, improving female employment prospects. Because women working in animalhusbandry had to remain unmarried, more farm service spelled later marriages. The resulting reductionin fertility led to a new Malthusian steady state with lower population pressure and higher wages. Themodel can thus help to explain the divergence in income per capita between Europe and Asia long beforethe Industrial Revolution. Using detailed data from England after 1290, we provide strong evidence forour mechanism. Where pastoral agriculture dominated, more women worked as servants, and marriageoccurred markedly later. Overall, we estimate that pastoral farming raised female ages at first marriage bymore than 4 years.

Estudi de les aigües salines a la conca del riu Llobregat i Cardener : implicacions ambientals

L’increment de la salinitat a les aigües subterrànies a prop de la zones de les explotacions mineres salines representa un problema ambiental amb moltes implicacions socio-econòmiques. La part mitja de la conca del riu Llobregat i Cardener és un clar exemple d’aquesta problemàtica. En molts casos l’origen de la salinitat és dubtós, ja que pot provenir del contacte de l’aigua de l’aqüífer amb formacions geològiques salines naturals o per l’afectació de les escombreres produïdes per l’explotació minera de potasses que es troba en aquesta regió. L’objectiu d’aquest treball és demostrar que el Ra pot ser un bon traçador per determinar l’origen de la salinitat de les aigües i complementar les analítiques químiques elementals i dels isòtops del sofre i de l’oxigen del sulfat (δ34SSO4 i δ18OSO4). La presència dels diversos isòtops del Ra en les aigües subterrànies dependrà de la geologia i del temps de residència de l’aigua dins l’aqüífer. L’anàlisi de 12 mostres de la comarca indica que el 226Ra és el millor dels isòtops del Ra que permet diferenciar l’origen de les aigües subterrànies.

Secular trends in height and weight among children and adolescents of the Seychelles, 1956-2006.

BACKGROUND: Height of individuals has long been considered as a significant index of nutrition and health of a population; still, there is little information regarding the trends of height and weight among developing or transitional countries. We assessed the secular trends in height and weight in children of the Seychelles, a rapidly developing island state in the Indian Ocean (African region). METHODS: Height and weight were measured in all students of all schools in four selected school grades (kindergarten, 4th, 7th and 10th grades) for the periods 1998-9 (6391 children) and 2005-6 (8582 children). Data for 1956-7 was extracted from a previously published report. RESULTS: At age 15.5 years, boys/girls were on average 10/13 cm taller and 15/9 kg heavier in 2005-6 than in 1956-7. Height increased in boys/girls by 1.62/0.93 cm/decade between 1956-7 and 1998-9 and by 1.14/1.82 cm/decade between 1998-9 and 2005-6. For weight, the linear increase in boys/girls was 1.38/1.10 kg/decade between 1956-7 and 1998-9 and 2.21/2.50 kg/decade between 1998-9 and 2005-6. Overall, the relative increase in weight between 1956-7 and 2005-6 was 5-fold higher than the relative increase in height. CONCLUSION: Height and weight increased markedly over time in children aged <16 years in the Seychelles, consistent with large changes in socio-economic and nutritional indicators in the considered 50-year interval. The markedly steeper increase in weight than height over time is consistent with an epidemic of overweight and obesity.

Does unemployment hurt less if there is more of it around? A panel analysis of life satisfaction in Germany and Switzerland

This paper examines the existence of a habituation effect to unemployment: Do theunemployed suffer less from job loss if unemployment is more widespread, if their ownunemployment lasts longer and if unemployment is a recurrent experience? Theunderlying idea is that unemployment hysteresis may operate through a sociologicalchannel: if many people in the community lose their job and remain unemployed over anextended period, the psychological cost of being unemployed diminishes and the pressureto accept a new job declines. We analyze this question with individual-level data from theGerman Socio-Economic Panel (1984-2009) and the Swiss Household Panel (2000-2009). We find no evidence for a mitigating effect of high surrounding unemployment onunemployed individuals' subjective well-being: Becoming unemployed hurts as muchwhen regional unemployment is high as when it is low. Likewise, the strongly harmfulimpact of being unemployed on well-being does not wear off over time, nor do repeatedepisodes of unemployment make it any better. It thus appears doubtful that anunemployment shock becomes persistent because the unemployed become used to, andhence reasonably content with, being without a job.

Exercici terapèutic cognitiu en lesions cerebrals

Estudi experimental basat amb el mètode Perfetti realitzat per avaluar l’eficàcia i l’eficiència del tractament envers a les diferents afectacions cerebrals que pot tenir un pacient quan ha patit un AVC (Accident Vascular Cerebral). Farem un estudi quantitatiu, tenint en compte unes variables específiques que ens indicaran d’una forma molt més acurada l’evolució del pacient des de l’ inici fins a la fi del tractament. Hem de tenir en compte que al ser un estudi experimental ens podem trobar amb certes limitacions, implícites com trobar la idoneïtat de la mostra de pacients o que totes les afectacions cerebrals d’estudi siguin compatibles. Sempre tindrem en compte que no es seguirà un protocol sinó que és un tractament individualitzat i totalment personalitzat. La població en el nostre país cada cop envelleix més, per això millorar la qualitat de vida és imprescindible. El que volem és intentar que el pacient millori la seva qualitat de vida minvant la seva dependència i/o discapacitat, després de l’AVC. En conseqüència i ja que l’actual situació socioeconòmica no és favorable podrem afavorir la reducció de l’actual despesa sanitària,en aquest tipus de patologies en el nostre país.

Estratègies educatives a través de l'expressió corporal per a la inclusió de l'alumnat amb risc d'exclusió social

Aquest document ens explica com afecta la crisi socioeconòmica del nostre país als infants que es troben en situació de risc social. En concret, la recerca es va centrar en una escola pública de Torelló on hi ha un predomini d’infants immigrants. La majoria d’aquests infants es troben en una situació precària i, a més, tenen dificultats per entendre la llengua del centre i per comunicar-se amb la mestra tutora de l’aula. Per concloure l’estudi es va elaborar un pla d’acció on es mostra que si es porten a terme estratègies educatives inclusives, com pot ser l’expressió corporal, dins l’aula ordinària els infants amb major risc social poden aprendre més amb la interacció.

Sosioekonomisten tekijöiden yhteys terveyteen 75- ja 80-vuotiailla jyväskyläläisillä miehillä ja naisilla

Summary: Socio-economic factors and health among 75- and 80-year-old men and women

A case study of landslides and coping strategies in two villages of central-eastern Nepal

Landslides are an increasing problem in Nepal's Middle Hills due to both natural and human phenomena: mainly increasingly intense monsoon rains and a boom in rural road construction. This problem has largely been neglected due to underreporting of losses and the dispersed nature of landslides. Understanding how populations cope with landslides is a first step toward developing more effective landslide risk management programs. The present research focuses on two villages in Central-Eastern Nepal, both affected by active landslides but with different coping strategies. Research methods are interdisciplinary, based on a geological assessment of landslide risk and a socio-economic study of the villages using household questionnaires, focus group discussions and transect walks. Community risk maps are compared with geological landslide risk maps to better understand and communicate community risk perceptions, priorities and coping strategies. A modified typology of coping strategies is presented, based on previous work by Burton, Kates, and White (1993) that is useful for decision-makers for designing more effective programs for landslide mitigation. Main findings underscore that coping strategies, mainly seeking external assistance and outmigration, are closely linked to access to resources, ethnicity/social status and levels of community organization. Conclusions include the importance of investing in organizational skills, while building on local knowledge about landslide mitigation for reducing landslide risk. There is great potential to increase coping strategies by incorporating skills training on landslide mitigation in existing agricultural outreach and community forest user group training.

On Automatic Diagnosis of Alzheimer's Disease based on Spontaneous Speech Analysis and Emotional Temperature

Alzheimer's disease is the most prevalent form of progressive degenerative dementia; it has a high socio-economic impact in Western countries. Therefore it is one of the most active research areas today. Alzheimer's is sometimes diagnosed by excluding other dementias, and definitive confirmation is only obtained through a post-mortem study of the brain tissue of the patient. The work presented here is part of a larger study that aims to identify novel technologies and biomarkers for early Alzheimer's disease detection, and it focuses on evaluating the suitability of a new approach for early diagnosis of Alzheimer’s disease by non-invasive methods. The purpose is to examine, in a pilot study, the potential of applying Machine Learning algorithms to speech features obtained from suspected Alzheimer sufferers in order help diagnose this disease and determine its degree of severity. Two human capabilities relevant in communication have been analyzed for feature selection: Spontaneous Speech and Emotional Response. The experimental results obtained were very satisfactory and promising for the early diagnosis and classification of Alzheimer’s disease patients.

Alzheimer disease diagnosis based on automatic spontaneous speech analysis

Alzheimer’s disease (AD) is the most prevalent form of progressive degenerative dementia and it has a high socio-economic impact in Western countries, therefore is one of the most active research areas today. Its diagnosis is sometimes made by excluding other dementias, and definitive confirmation must be done trough a post-mortem study of the brain tissue of the patient. The purpose of this paper is to contribute to im-provement of early diagnosis of AD and its degree of severity, from an automatic analysis performed by non-invasive intelligent methods. The methods selected in this case are Automatic Spontaneous Speech Analysis (ASSA) and Emotional Temperature (ET), that have the great advantage of being non invasive, low cost and without any side effects.

Die Schweizer Gemeinden im Wandel : Konvergenz oder Divergenz?

Switzerland is currently going through a phase of political restructuring. The numerous reform activities at the beginning of the twenty-first century leave almost no area of political life untouched. The reforms are particularly abundant in the 2′867 municipalities, spanning from amalgamations, intermunicipal co-operation, New Public Management, to reforms of the political systems. Accounting for the fact that there are big socio-economic differences between the municipalities as well as their political systems, we investigate whether the municipalities are headed for divergence or convergence as a result of these reforms. The empirical results are derived from three surveys of the local authorities conducted in 1988, 1994, and 1998. The results indicate that the communes do convergence in regard to their administrative and political structure. However, the convergence appears to be limited to the single cantons and observable only among certain types of municipalities.

The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization

BACKGROUND: Non-communicable diseases (NCDs) are increasing worldwide. We hypothesize that environmental factors (including social adversity, diet, lack of physical activity and pollution) can become "embedded" in the biology of humans. We also hypothesize that the "embedding" partly occurs because of epigenetic changes, i.e., durable changes in gene expression patterns. Our concern is that once such factors have a foundation in human biology, they can affect human health (including NCDs) over a long period of time and across generations. OBJECTIVES: To analyze how worldwide changes in movements of goods, persons and lifestyles (globalization) may affect the "epigenetic landscape" of populations and through this have an impact on NCDs. We provide examples of such changes and effects by discussing the potential epigenetic impact of socio-economic status, migration, and diet, as well as the impact of environmental factors influencing trends in age at puberty. DISCUSSION: The study of durable changes in epigenetic patterns has the potential to influence policy and practice; for example, by enabling stratification of populations into those who could particularly benefit from early interventions to prevent NCDs, or by demonstrating mechanisms through which environmental factors influence disease risk, thus providing compelling evidence for policy makers, companies and the civil society at large. The current debate on the '25 × 25 strategy', a goal of 25% reduction in relative mortality from NCDs by 2025, makes the proposed approach even more timely. CONCLUSIONS: Epigenetic modifications related to globalization may crucially contribute to explain current and future patterns of NCDs, and thus deserve attention from environmental researchers, public health experts, policy makers, and concerned citizens.

Epidemiologie der chronisch venösen Insuffizienz--Schweizer Befragung liefert überraschende Ergebnisse [Epidemiology of chronic venous insufficiency--Swiss survey with surprising results]

Lower limb chronic venous insufficiency (CVI) is one of the most common diseases in western world adults with considerable socio-economic impact. Varicose veins of the legs are caused by a number of factors. Current data suggest that both lifestyle and environmental factors play a role in varicose vein occurrence. Nevertheless, environmental factors seem to play greater role than previously thought. This was also observed in a Swiss survey of 1099 participants carried out during summer 2008 in 40 different Swiss pharmacies.