Shared Rule in Federal Political Systems: Conceptual Lessons from Subnational Switzerland

This article reconceptualizes shared rule and uses novel data to measure it, thus addressing two shortcomings of federal literature. First, while most studies focus on self-rule, one question that is largely neglected is how lower-level governments can influence politics at a higher level in the absence of “second” chambers. The answer is through shared rule. A second shortcoming is that even when addressing this question, scholars concentrate on constitutional-administrative aspects of vertical intergovernmentalism, neglecting more informal, “political” dynamics. Comparing the twenty-six Swiss cantons allows drawing two lessons for federal studies: That shared rule is multifaceted and complex, and that to study informal territorial actors as well as direct political processes is indispensable to understand how power is actually distributed in federal political systems.

Conflicting Cantonalisms: Disputed Sub-national Territorial Identities in Switzerland

The importance of constituent units for democratic federations, in general, and of the Swiss cantons for the Swiss Confederation, in particular, is beyond doubt. What is less clear, however, is how to solve conflicting views on the number and type of such units. The Swiss case offers two highly topical examples in this regard: the merger of the two ‘half-cantons’ Basel-City and Basel-Country, on the one hand, and the creation of a new canton encompassing canton Jura and the French-speaking area of canton Berne, on the other. In comparing different sub-national political identities at play in these two cases, the strength of ‘cantonalism’—understood as attachment to and identification with a canton—in Switzerland in the 21st century is shown. Second, different manifestations of cantonalism are compared: centre-periphery in Basel, linguistic vs. religious in Jura. Finally, the similar direct-democratic pathways chosen to solve both conflicting understandings of cantonalism testify to the Swiss commitment to peaceful, negotiated and popularly sanctioned settlements.

Populism and Liberal Democracy: Populists in Government in Austria, Italy, Poland and Switzerland

The enduring electoral success of populist parties across Europe and the increasing opportunities they have gained to access government in recent years bring once more into relief the question of whether populism and democracy are fully compatible. In this article we show how, despite playing different roles in government within very different political systems, and despite the numerous constraints placed upon them (for instance, EU membership, international law and domestic checks and balances), populist parties consistently pursued policies that clashed with fundamental tenets of liberal democracy. In particular, the idea that the power of the majority must be limited and restrained, the sanctity of individual rights and the principle of the division of powers have all come under threat in contemporary Europe. This has contributed to the continuing erosion of the liberal consensus, which has provided one of the fundamental foundations of the European project from its start.

The Politics of Local Autonomy: Measuring Cantonal (De)Centralisation in Switzerland

In Switzerland, there are 26 systems of cantonal decentralisation because regulating municipal autonomy is an exclusively cantonal competency. Existing measures of local autonomy/cantonal decentralisation are confined to measuring the real or perceived distribution of functions. Alternatively, they weigh expenditures (Dafflon 1992) or tax revenues (Dlabac and Schaub forthcoming) of municipalities against those of the canton. Complementing these indices, this paper additionally measures the politics dimension of cantonal decentralisation. Seven aspects are measured: intra-cantonal regionalism, cumuldesmandats (double tenure of cantonal MP and mayoral office), territorial quotas for legislative and executive elections, direct local representation and lobbying, party decentralisation, the number and size of constituencies, and direct democracy (communal referendum and initiative). This results in a ranking of all 26 cantons as regards the politics of local autonomy within their political systems. The measure will help scholars to test assumptions held for decentralisation in general, be it as a dependent (explaining decentralisation) or as an independent variable (decentralisation—so what?), within but also beyond the Swiss context.

Who Supports Minority Rights in Popular Votes? Empirical Evidence from Switzerland

Recent research shows that well-educated citizens are more supportive of minority rights in direct democratic votes than people with less education. This article however suggests that educational effects on minority rights only emerge under certain conditions. A Bayesian multilevel analysis of 39 referendums and initiatives on minority rights in Switzerland (1981–2009) shows that educational effects are particularly strong when the rights of lesser-known cultural minorities are to be extended. They are entirely absent, however, when referenda address the curtailment of rights for well-known minority groups.

Sexually transmitted infections in HIV-infected people in Switzerland: cross-sectional study.

Sexually transmitted infections (STI) in HIV-infected people are of increasing concern. We estimated STI prevalence and sexual healthcare seeking behaviour in 224 sexually active HIV-infected people, including men who have sex with men (MSM, n = 112), heterosexual men (n = 65) and women (n = 47). Laboratory-diagnosed bacterial STI were more common in MSM (Chlamydia trachomatis 10.7%; 95% CI 6.2, 18.0%, lymphogranuloma venereum 0.9%; 95% CI 0.1, 6.2%, Neisseria gonorrhoeae 2.7%; 95% CI 0.9, 8.0%, syphilis seroconversion 5.4%; 95% CI 2.0, 11.3%) than heterosexual men (gonorrhoea 1.5%; 95% CI 0.2, 10.3%) or women (no acute infections). Combined rates of laboratory-diagnosed and self-reported bacterial STI in the year before the study were: MSM (27.7%; 95% CI 21.1, 36.7%); heterosexual men (1.5%; 95% CI 0.2, 10.3%); and women (6.4%; 95% CI 2.1, 21.0%). Antibodies to hepatitis C virus were least common in MSM. Antibodies to herpes simplex type 2 virus were least common in heterosexual men. Most MSM, but not heterosexual men or women, agreed that STI testing should be offered every year. In this study, combined rates of bacterial STI in MSM were high; a regular assessment of sexual health would allow those at risk of STI to be offered testing, treatment and partner management.

A catalog of high-impact windstorms in Switzerland since 1859

In recent decades, extremely hazardous windstorms have caused enormous losses to buildings, infrastructure and forests in Switzerland. This has increased societal and scientific interest in the intensity and frequency of historical high-impact storms. However, high-resolution wind data and damage statistics mostly span recent decades only. For this study, we collected quantitative (e.g., volumes of windfall timber, losses relating to buildings) and descriptive (e.g., forestry or insurance reports) information on the impact of historical windstorms. To define windstorm severity, normalized and declustered quantitative data were processed by extreme value statistics. Descriptive information was classified using a conceptual guideline. Validation with independent damage information, as well as comparison with wind measurements and a reanalysis, indicates that the most hazardous winter storms are captured, while too few moderate windstorms are detected. Strong storms in the wind measurements and reanalysis are thus added to the catalog. The final catalog encompasses approximately 240 high-impact windstorms in Switzerland since 1859. It features three robust severity classes and contains eight extreme windstorms. Evidence of high winter storm activity in the early and late 20th century compared to the mid-20th century in both damage and wind data indicates a co-variability of hazard and related damage on decadal timescales.

In vitro activity of clinically implemented β-lactams against Aerococcus urinae: presence of non-susceptible isolates in Switzerland.

We analyzed the in vitro susceptibility to several ?-lactams and vancomycin of 80 Aerococcus urinae isolates col- lected during 2011-2012 in Switzerland. MICs were determined by Etest (bioMérieux) on Müller-Hinton agar with 5% sheep blood and interpreted according to the CLSI and EUCAST criteria set for viridans streptococci. MIC50/90 for penicillin, amoxicillin, ceftriaxone and vancomycin were 0.016/0.064 mg/l, 0.032/0.064 mg/l, 0.125/0.5 mg/l and 0.38/0.5 mg/l, respectively. Three (3.8%) isolates were resistant to ceftriaxone regardless of the criteria used (MICs ?2 mg/l); one of them was also non-susceptible to penicillin (MIC of 0.25 mg/l) according to CLSI. ?-lactam resis- tance in A. urinae is a concern and suggests that more studies are needed to determine the molecular mechanisms of such resistance.

Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland.

OBJECTIVES: Inequalities and inequities in health are an important public health concern. In Switzerland, mortality in the general population varies according to the socio-economic position (SEP) of neighbourhoods. We examined the influence of neighbourhood SEP on presentation and outcomes in HIV-positive individuals in the era of combination antiretroviral therapy (cART). METHODS: The neighbourhood SEP of patients followed in the Swiss HIV Cohort Study (SHCS) 2000-2013 was obtained on the basis of 2000 census data on the 50 nearest households (education and occupation of household head, rent, mean number of persons per room). We used Cox and logistic regression models to examine the probability of late presentation, virologic response to cART, loss to follow-up and death across quintiles of neighbourhood SEP. RESULTS: A total of 4489 SHCS participants were included. Presentation with advanced disease [CD4 cell count <200 cells/μl or AIDS] and with AIDS was less common in neighbourhoods of higher SEP: the age and sex-adjusted odds ratio (OR) comparing the highest with the lowest quintile of SEP was 0.71 [95% confidence interval (95% CI) 0.58-0.87] and 0.59 (95% CI 0.45-0.77), respectively. An undetectable viral load at 6 months of cART was more common in the highest than in the lowest quintile (OR 1.52; 95% CI 1.14-2.04). Loss to follow-up, mortality and causes of death were not associated with neighbourhood SEP. CONCLUSION: Late presentation was more common and virologic response to cART less common in HIV-positive individuals living in neighbourhoods of lower SEP, but in contrast to the general population, there was no clear trend for mortality.

Orthodontic retention procedures in Switzerland.

OBJECTIVE To survey retention procedures used in orthodontic practices in Switzerland. MATERIAL AND METHODS A questionnaire previously developed by Renkema et al. (2009) was sent to 223 Swiss orthodontists. The questionnaire comprised six parts, mainly containing multiple-choice questions. Information as to background education of the individual orthodontist, retention in general, frequency of different types of removable or bonded retainers that were used, retention pro- tocol, and the type and size of the wire used for bonded retainers was assessed. RESULTS The overall response rate was 65 percent. Most orthodontists placed a bonded retainer in the upper and lower arch, except when the upper arch was expanded during treatment or when extractions were performed in the upper arch, in which case they placed a combination of fixed and removable retainers. Opinions varied with regard to how many hours the removable retainers should be worn and the duration of the retention phase. As far as bonded retainers were concerned, 87 percent of the orthodontists preferred life-long retention. Ninety-three percent of the orthodontists considered that the development of a guide- line on retention procedures would be useful. CONCLUSIONS The choice of retention procedures is mostly based on orthodontists personal preference. A further research into the long-term effectiveness of individual retention protocols is needed.

Urgent consultations at the dermatology department of Basel University Hospital, Switzerland: characterisation of patients and setting - a 12-month study with 2,222 patients data and review of the literature.

BACKGROUND Urgent consultations for skin disorders are commonly done in different settings. Scarce data exist about the characteristics of these patients. OBJECTIVE The aim of this study was to analyse specific characteristics of patients receiving an urgent consultation at a dermatology department in a university hospital. METHODS We prospectively recorded the data of all patients having had an urgent consultation during a period of 12 months. RESULTS We registered 2,222 urgent consultations. The most frequent diagnoses were eczemas (24.8%), dermatomycoses (5.1%) and dermatitis not otherwise specified (4.8%). The most frequent treatments were topical steroids, emollients, topical antibiotics, systemic antihistamines, antibiotics and virostatics. 2.2% of patients were hospitalized, 78.8% asked for a consultation for a disease lasting less than 4 weeks, and 6.9% presented the same day as the skin disease appeared. CONCLUSIONS This study shows the characteristics of patients receiving an urgent dermatologic consultation. It underlines the need for collaboration between dermatologists, other physicians, general practitioners and nurses.

Factors influencing fixed retention practices in German-speaking Switzerland : A survey.

AIM Several surveys evaluate different retention approaches among orthodontists, but none exist for general dentists. The primary aim of this survey was to record the preferred fixed retainer designs and retention protocols amongst general dentists and orthodontists in Switzerland. A secondary aim was to investigate whether retention patterns were associated with parameters such as gender, university of graduation, time in practice, and specialist status. METHODS An anonymized questionnaire was distributed to general dentists (n = 401) and orthodontists (n = 398) practicing in the German-speaking part of Switzerland. A total of 768 questionnaires could be delivered, 562 (73.2 %) were returned and evaluated. Descriptive statistics were performed and responses to questions of interest were converted to binary outcomes and analyzed using multiple logistic regression. Any associations between the answers and gender, university of graduation (Swiss or foreign), years in practice, and specialist status (orthodontist/general dentist) were assessed. RESULTS Almost all responding orthodontists (98.0 %) and nearly a third of general dentists (29.6 %) reported bonding fixed retainers regularly. The answers were not associated with the practitioner's gender. The university of graduation and number of years in practice had a moderate impact on the responses. The answers were mostly influenced by specialist status. CONCLUSION Graduation school, years in practice, and specialist status influence retention protocol, and evidence-based guidelines for fixed retention should be issued to minimize these effects. Based on the observation that bonding and maintenance of retainers are also performed by general dentists, these guidelines should be taught in dental school and not during post-graduate training.

Scales of justice in water governance: hydropower controversies in Switzerland

One significant challenge for the operationalization of water justice arises from the many dynamic scales involved. In this paper we explore the scalar dimension of justice in water governance through the insights derived from empirical research on hydropower production in the Swiss Alps and the application of the geographical concept of politics of scale. More specifically, we investigate how different actors frame the justice problem, the scales that they invoke and which actors consequently get included or excluded in their justice assessments. This study shows that there is no ideal scale for justice evaluations; whichever scale is used, some actors and justice claims are included whereas others are excluded. This is particularly true when using Fraser’s trivalent concept of justice, taking into account issues of distribution, recognition and participation where each calls for its own set of scales. Moreover, focusing on the politics of scale framing, our study reveals that the justice claim itself can become a power element. Consequently, to achieve more just water governance, there is not only a need for debate and negotiations about the conceptions and meanings of justice in a specific context, there is also a need for debate about the relevance and implications of divergent scales involved in justice claims.