Evaluation of prenatal diagnosis of congenital heart disease in a regional controlled case study.

AIMS: This study evaluated the evolution of the prenatal diagnosis of congenital heart disease (CHD) between 2003 and 2008 and its repercussion for the CHD prevalence rate at birth in a well-defined population (Canton of Vaud, Switzerland). METHODS AND RESULTS: All 572 cases of CHD reported in the Eurocat Registry of Vaud-Switzerland between 1.5.2003 and 31.12.2008 were analysed and compared with the cases in our clinical database. CHD cases were divided into five different groups according to heart disease severity. The prenatal detection rates increased significantly between 2003 and 2008, with a mean detection rate of 25.2%. There was a significantly higher rate of prenatal diagnosis in the first four groups of CHD severity, with the highest detection rate (87.5%) found in the group with the most severe CHD (group 1). In this group, 85.7% of cases resulted in a termination of pregnancy, and there was a consequent 75% reduction in the prevalence of severe major cardiac malformation at birth. Detection rates were 66% in group 2, 68.6% in group 3, and the lowest in groups 4 and 5, with rates of 25.9% and 12.9%, respectively. CONCLUSION: This study shows that the prenatal detection rate for CHD increased in a well-defined population over the study period. Prenatal diagnosis thus has had a major impact on patients with the most severe types of CHD and has resulted in a significant reduction in severe CHD at birth.

La religion comme facteur de réhabilitation sociale. Réflexions sur les acteurs autorisés de l'islam dans les prisons suisses

L'accompagnement spirituel dans les prisons suisses est dominé par un modèle mono-culturel chrétienne. Or, la présence importante de détenus de confession musulmane dans les établissements pénitentiaires incite ceux-ci à organiser un soutien spirituel adapté à cette catégorie de leur population. Dans quel cadre légal cet accompagnement spirituel se déroule-t-il? Quelle forme prend-il ? Quels sont ceux (et plus rarement celles) qui assistent spirituellement les détenus musulmans ? Cet article propose de répondre à ces questions en énonçant les principes juridiques relatifs à l'exercice de la religion en contexte carcéral et en présentant des profils d'intervenants musulmans de prison.

Krisen - Ursachen, Deutungen und Folgen / Crises - Causes, interprétations et conséquences

L'effondrement inattendu de l'économie mondiale en 2009 a suscité un intérêt nouveau pour l'étude historique des crises. Dans ce contexte incertain, l'étude du passé a regagné en attractivité. L'ouvrage fait certaines propositions théoriques et offre une vision d'ensemble des différents types de crises du Haut Moyen-Age jusqu'à nos jours. La principale conclusion qui ressort de ces contributions est qu'il n'y a pas de réponse objective à une situation de crise. Les interprétations et les attentes ne sont certes pas complètement aléatoires, dans la mesure où elles s'inspirent des expériences du passé. Elles sont cependant soumises à de fortes variations, car les périodes de forte incertitude engendrent certains doutes vis-à-vis des enseignements du passé. Dans cette perspective, les auteurs.es parviennent, à partir de leurs études de cas historiques, à stimuler la réflexion sur la crise actuelle.

Croire ensemble. Analyse institutionnelle du paysage religieux en Suisse

L'étude présentée dans cet ouvrage offre pour la première fois en Suisse une perspective sociologique empirique et générale sur les organisations religieuses locales. Vu sous cet angle, le fait religieux se manifeste d'abord, comme le précisaient déjà Weber ou Durkheim, par l'existence de communautés de tailles et de profils divers, tant dans l'espace rural qu'urbain. En Suisse, 5'734 paroisses et groupes religieux ont pu être dénombrés en 2008. Ce recensement permet de souligner la prégnance institutionnelle des Eglises historiques, mais également l'émergence d'une plus forte pluralité religieuse, particulièrement en milieu urbain. La sociologie des organisations que propose cette étude permet de jeter un éclairage nouveau sur les effets de la sécularisation (baisse des membres et de la pratique) et de la pluralisation (diversification des confessions et traditions religieuses). L'analyse des différences et des similitudes organisationnelles selon les traditions religieuses fait apparaître un positionnement social des groupes en fonction de statuts acquis au cours de l'histoire. Les théories classiques - par exemple à pro- pos des relations entre statuts sociaux des membres et groupes d'appartenance, des types d'autorités religieuses ou encore des différences entre Eglise et Secte - sont revisitées, précisées ou reformulées grâce à des données quantitatives originales et représentatives du champ religieux suisse. -- The study presented in this book for the first time in Switzerland offers a broad empirical and sociological perspective on local religious organizations. From this perspective, religion appears first, as already observed by Weber and Durkheim, through communities regardless of their various profiles. In Switzerland, 5,734 parishes and religious groups have been identified by a national census in 2008. The book underlines the institutional salience of historical churches (Reformed and Roman Catholic) but also the emerging religious plurality, particularly in urban areas. This study sheds a new light upon the effects of secularization (lower limbs and practice) and pluralisation (diversification of religious denominations and traditions) in the organizational field. The analysis of differences and similarities between religious traditions shows a social positioning of the local groups according to the statutes acquired in history. The classical theories − e.g. about the relationship between social status of members and membership groups, types of religious authorities or differences between Church and Sect − are revisited, clarified or reformulated based on an original and representative quantitative data of the Swiss religious field.

Contribution of fine particulate matter sources to indoor exposure in bars, restaurants, and cafes

This study investigated the contribution of sources and establishment characteristics, on the exposure to fine particulate matter (PM(2.5)) in the non-smoking sections of bars, cafes, and restaurants in central Zurich. PM(2.5)-exposure was determined with a nephelometer. A random sample of hospitality establishments was investigated on all weekdays, from morning until midnight. Each visit lasted 30 min. Numbers of smokers and other sources, such as candles and cooking processes, were recorded, as were seats, open windows, and open doors. Ambient air pollution data were obtained from public authorities. Data were analysed using robust MM regression. Over 14 warm, sunny days, 102 establishments were measured. Average establishment PM(2.5) concentrations were 64.7 microg/m(3) (s.d. = 73.2 microg/m(3), 30-min maximum 452.2 microg/m(3)). PM(2.5) was significantly associated with the number of smokers, percentage of seats occupied by smokers, and outdoor PM. Each smoker increased PM(2.5) on average by 15 microg/m(3). No associations were found with other sources, open doors or open windows. Bars had more smoking guests and showed significantly higher concentrations than restaurants and cafes. Smokers were the most important PM(2.5)-source in hospitality establishments, while outdoor PM defined the baseline. Concentrations are expected to be even higher during colder, unpleasant times of the year. PRACTICAL IMPLICATIONS: Smokers and ambient air pollution are the most important sources of fine airborne particulate matter (PM(2.5)) in the non-smoking sections of bars, restaurants, and cafes. Other sources do not significantly contribute to PM(2.5)-levels, while opening doors and windows is not an efficient means of removing pollutants. First, this demonstrates the impact that even a few smokers can have in affecting particle levels. Second, it implies that creating non-smoking sections, and using natural ventilation, is not sufficient to bring PM(2.5) to levels that imply no harm for employees and non-smoking clients. [Authors]

High constant incidence rates of second primary neoplasms

The incidence of contralateral breast cancer is high and constant with age, around five per 1000 women who had a primary breast cancer. For other neoplasms, the pattern of incidence of second primary neoplasms with age is less known, particularly as for only a few neoplasms the site of origin is not totally removed, and hence remains at risk of a second primary. Using the dataset from the Cancer Registry of the Swiss Canton of Vaud, we show that the incidence of second neoplasms is constant with age also after oral and pharyngeal, colorectal cancers, cutaneous malignant melanoma (CMM) and basal cell carcinoma. The incidence of first primary oral and pharyngeal cancer increased 20-fold between age 30-39 and 70-89 years, whereas the incidence of second neoplasms did not increase with age. Rates of second colorectal cancer remained relatively constant with age, between 2.5 per 1000 at age 40-59 years and 3.8 per 1000 at 70 years and above. Likewise, for CMM, the age-specific incidence rates of second primary CMM did not vary, ranging between 1 and 2.5 per 1000 in various subsequent age groups. The pattern of incidence for second basal cell carcinoma was similar, with no clear rise with age. These patterns are compatible with the occurrence of a single mutational event in a population of susceptible individuals. A possible implication of these observations is that a variable, but potentially large, proportion of cancers arise in very high-risk individuals and the incidence, on average, increases at a high constant level at a predetermined age.

Il voto ticinese sull'iniziativa 'contro l'immigrazione di massa' del 9 febbraio 2014

Riassunto Il presente studio verte sull'analisi del voto relativo all'iniziativa popolare 'contro l'immigrazione di massa' del 9 febbraio 2014. In particolare, l'analisi si concentra sul voto avvenuto nel Ticino, il cantone svizzero in cui l'iniziativa ha avuto maggiore sostegno. Lo studio si è avvalso di un'inchiesta d'opinione rappresentativa realizzata dall'Osservatorio della vita politica regionale dell'Università di Losanna presso 1.429 cittadini ticinesi nei giorni successivi allo scrutinio. Dopo una contestualizzazione del voto del 9 febbraio rispetto alla storia delle votazioni sui temi di politica estera e migratoria, l'analisi si è concentrata sulla partecipazione al voto. Il ricorso a tre modelli interpretativi (delle risorse, della competenza e della mobilitazione) ha permesso di mostrare come il voto del 9 febbraio sia caratterizzato in particolare modo dal senso del dovere, dall'interesse per la politica e dal legame di partito. L'analisi dell'orientamento di voto evidenzia l'influenza delle dimensioni economiche, politiche, identitarie, e soprattutto, alla stregua di altri voti nel passato recente di questo cantone, una forte tensione tra centro e periferia. Dall'analisi del voto del 9 febbraio emerge un forte timore che vede nel Ticino una 'doppia periferia', verso Berna e in relazione alla vicina Lombardia. Parole chiave: iniziativa popolare, partecipazione, orientamento di voto, centro-periferia. Résumé Cette étude porte sur l'analyse du vote sur l'initiative populaire 'contre l'immigration de masse' du 9 février 2014 et, plus précisément, sur le vote qui s'est déroulé au Tessin, canton suisse dans lequel l'initiative a obtenu le plus large soutien. L'étude a été menée à l'aide d'une enquête d'opinion représentative réalisée par l'Observatoire de la vie politique régionale de l'Université de Lausanne auprès de 1.429 citoyens tessinois dans les jours suivant le scrutin. Après une contextualisation du vote du 9 février par rapport à l'histoire des votations sur les thèmes de la politique étrangère et de l'immigration, l'analyse a porté sur la participation au vote. À ce propos, l'utilisation de trois modèles explicatifs (des ressources, de la compétence et de la mobilisation) a permis de dévoiler que le vote a été caractérisé plus particulièrement par le sens du devoir (habitus du vote), par l'intérêt pour la politique et par le lien avec un parti. L'analyse de l'orientation du vote montre l'influence des aspects économiques, politiques et identitaire ainsi que, à l'instar d'autres votations récemment passées dans le canton italophone, des raisons qui mettent en évidence une vision contrastée du Tessin et notamment le risque de devenir une 'double périphérie' par rapport à Berne et à la Lombardie. Mots-clés: initiative populaire, participation, choix du vote, centre-périphérie. Zusammenfassung Die vorliegende Studie analysiert das Abstimmungsverhalten anlässlich der eidgenössischen Volksinitiative 'Gegen Masseneinwanderung' vom 9. Februar 2014. Die Analyse beschränkt sich auf die Abstimmung im Kanton Tessin, wo die Initiative am stärksten unterstützt wurde. Die Studie wurde vom Observatorium des regionalen politischen Lebens der Universität Lausanne durchgeführt und basiert auf einer repräsentativen Umfrage, bei welcher 1429 Bürger des Kantons Tessin in den Tagen nach der Abstimmung teilnahmen. Zunächst wird die Abstimmung vom 9. Februar in Bezug auf die Geschichte verschiedener anderer Abstimmungen zum Thema Aussen- und Immigrationspolitik kontextualisiert. Die Analyse analysiert dann als erstes die Wahlbeteiligung: Der Gebrauch von drei Erklärungsmodellen (Ressourcen, Kompetenz und Mobilisierung) zeigt auf, dass der Entscheid, an der Abstimmung vom 9. Februar überhaupt teilzunehmen, vor allem von Pflichtbewusstsein, politischem Interesse und Parteibindung geprägt war. Das Abstimmungsverhalten selber war dann von ökonomischen und politischen Faktoren, von der eigenen Identität sowie insbesondere - und wie auch schon andere Abstimmungen in der jüngsten Vergangenheit des italienisch-sprechenden Kantons -von einer grossen Angst geprägt, dass das Tessin eine 'doppelte Peripherie' zwischen Bern und der Lombardei werden könnte. Stichwörter: Volksinitiative, Teilnahme, Abstimmungsverhalten, Zentrum-Peripherie Abstract This study focuses on the analysis of the federal vote on the popular initiative 'against mass immigration' of 9 February 2014. More precisely, the analysis focuses on the vote that took place in Ticino, the Swiss canton in which the popular initiative has received the widest support. The study was carried out by the Research Observatory for Regional Politics at the University of Lausanne using a representative survey among 1.429 citizens of Ticino during the days following the vote. After a contextualization of the vote of 9 February with respect to the history of referenda about foreign policy and immigration issues, the analysis first discusses voter turnout. In this regard, the use of three explanatory models (resources, expertise and mobilisation) reveals that participation in the vote of 9 February was especially characterized by one's sense of duty, political interest, and links with a political party. The decision how to vote was then influenced by economic, political and identity factors as well as - like other votes in the recent past in the Italian-speaking canton - the particular fear that Ticino would become a 'double periphery' vis-à-vis both Berne and Lombardy. Keywords: popular initiative, participation, vote, centre-periphery.

Comparison of two strategies to prevent varicella outbreaks in housing facilities for asylum seekers.

BACKGROUND: The proportion of adults with positive varicella serology is lower in populations from tropical countries. Therefore immigrants to countries with a temperate climate are at risk of acquiring varicella infection during adulthood. METHODS: We tested two different strategies to prevent varicella outbreaks in housing facilities for asylum seekers arriving in the Canton of Vaud, Switzerland. The first strategy consisted of a rapid response with isolation of the affected individuals and vaccination of the susceptible contacts. The second strategy consisted of a general vaccination upon arrival of all asylum seekers aged 15-39 years with no history of chickenpox. RESULTS: From May 2008 to January 2009 we applied the rapid response strategy. Eight hundred and fifty-eight asylum seekers arrived in the Canton and an attack rate of 2.8% (seven cases among 248 exposed asylum seekers) was observed. The mean cost was US$ 31.35 per asylum seeker. The general vaccination strategy was applied from February 2009 to May 2010, a period during which 966 asylum seekers were registered. This second strategy completely prevented any outbreak at a mean cost of US$ 83.85 per asylum seeker. CONCLUSIONS: Of the two analyzed interventions to prevent varicella outbreaks in housing facilities for asylum seekers, the general vaccination strategy was more effective, more sustainable, and ethically preferable, although more costly.

Infections and functionnal impairment in nursing home residents : a reciprocal relationship

RESUME: Contexte : l'objectif de cette étude de cohorte prospective était de déterminer la relation entre la survenue d'infections et la dépendance fonctionnelle chez des résidents d'établissements de long séjour durant une période de 6 mois. Population et méthode : les patients inclus (1324 résidents) étaient âgés de 65 ans et plus (âge moyen 85.7 ans, 76.6% de femmes), étaient des résidents de 39 EMS du canton de Vaud. Au baseline, des données démographiques, médicales, concernant les facteurs de risque et protecteurs des infections ont été récoltées. Au cours du suivi de 6 mois, les infirmières des EMS ont documenté la survenue de symptômes et signes d'infection en utilisant les critères développés spécifiquement par l'APIC pour les établissements de long séjour. Les mesures du status fonctionnel ont été évaluées au baseline, à 3 mois et à 6 mois. Deux outcomes différents ont été utilisés : a) le déclin fonctionnel défini comme le décès ou une diminution des capacités fonctionnelles au suivi, b) le status fonctionnel mesuré par une échelle standardisée. Résultats : à la fin du suivi, la mortalité était de 14.6%, similaire pour les résidents avec et sans infection (16.2% versus 13.1%, P .11). Durant les 2 périodes de suivi de 3 mois, les sujets ayant présenté une ou plusieurs infections avaient des odds de déclin fonctionnel plus élevés, y compris après ajustement pour les caractéristiques démographiques, médicales et fonctionnelles du baseline, ainsi que la survenue de nouvelles maladies (odds ratio ajustés (OR) = 1.6, intervalle de confiance à 95% (IC) = 1.2-2.2, P = .002 et OR = 1.5, 95% IC= 1.1-2.0, P= .008, respectivement). Comparés aux résidents non infectés, les odds de déclin fonctionnel augmentaient significativement et graduellement chez ceux ayant eu une, respectivement 2 infections ou plus. L'analyse prédisant le score fonctionnel (restreinte aux sujets ayant survécu) a donné des résultats similaires. Finalement, une analyse de survie prédisant le temps jusqu'à la première infection a confirmé une augmentation progressive de la probabilité d'infection chez les sujets avec dépendance fonctionnelle modérée, respectivement sévère, comparés aux sujets indépendants à la ligne de base. Conclusion : chez les résidents de long séjour, les infections sont à la fois cause et conséquence de la dépendance fonctionnelle. Des études futures devraient être entreprises pour investiguer si des programmes de prévention des infections peuvent également contribuer à prévenir le déclin fonctionnel, un facteur important pour la qualité de vie de ces résidents. ABSTRACT: Objectives: To determine the relationship between infections and functional impairment in nursing home residents. Design: Prospective cohort study (follow-up period, 6 months). Setting: Thirty-nine nursing homes in western Switzerland. Participants: A total of 1,324 residents aged 65 and older (mean age 85.7; 76.6% female) who agreed to participate, or their proxies, by oral informed consent. Measurements: Functional status measured every 3 months. Two different outcomes were used: (a) functional decline defined as death or decreased function at follow-up and (b) functional status score using a standardized measure. Results: At the end of follow-up, mortality was 14.6%, not different for those with and without infection (16.2% vs 13.1%, P= .11) During both 3-month periods, subjects with infection had higher odds of functional decline, even after adjustment for baseline characteristics and occurrence of a new illness (adjusted odds ratio (AOR) = 1.6, 95% confidence interval (CI) = 1.2-2.2, P = .002, and AOR 1.5, 95% CI 1.1-2.0, P .008, respectively). The odds of decline increased in a stepwise fashion in patients with zero, one, and two or more infections. The analyses predicting functional status score (restricted to subjects who survived) gave similar results. A survival analysis predicting time to first infection confirmed a stepwise greater likelihood of infection in subjects -with moderate and severe impairment at baseline than in subjects with no or mild functional impairment at baseline. Conclusion: Infections appear to be both a cause and a consequence of functional impairment in nursing home residents. Further studies should be undertaken to investigate whether effective infection control programs can also contribute to preventing functional decline, an important component of these residents' quality of life.

Kinship, ritual kinship and political milieus in an alpine Valley in 19th century

In my paper I will present some results about ritual kinship and political mobilization of popular groups in an alpine Valley: the Val de Bagnes, in the Swiss canton of Valais. There are two major reasons to choose the Val de Bagnes for our inquiry about social networks: the existence of sharp political and social conflicts during the 18th and the 19th century and the availability of almost systematic genealogical data between 1700 and 1900. The starting point of my research focuses on this question: what role did kinship and ritual kinship play in the political mobilization of popular groups and in the organization of competing factions? This question allows us to shed light on some other uses and meanings of ritual kinship in the local society. Was ritual kinship a significant instrument for economic cooperation? Or was it a channel for patronage or for privileged social contacts? The analysis highlights the importance of kinship and godparentage for the building of homogeneous social and political networks. If we consider transactions between individuals, the analysis of 19th century Val de Bagnes gives the impression of quite open networks. Men and women tried to diversify their relations in order to avoid strong dependency from powerful patrons. Nevertheless, when we consider the family networks, we can notice that most relations took place in a structured social space or a specific "milieu", were intense contacts enhanced trust, although political allegiances and social choices were not fully predictable on the basis of such preferential patterns. In a politically conflictual society, like 19th century Bagnes, ritual kinship interacted with kinship solidarities and ideological factors shaping dense social networks mostly based on a common political orientation. Such milieus sustained the building of political factions, which show surprising stability over time. In this sense, milieus are important factors to understand political and religious polarization in 19th century Switzerland.