El català i els immigrants del primer món

Motius dels immigrants del primer món per a triar el català o el castellà en el moment de triar la seva opció lingüística quan arriben a Catalunya. El treball intenta respondre mitjançant l'entrevista sociològica dues hipòtesis: aquests immigrants consideren més important el castellà que no pas el català a Catalunya? Consideren que no és imprescindible aprendre català per a viure a Catalunya?

Ionotropic and metabotropic mechanisms in chemoreception: 'chance or design'?

Chemosensory receptors convert an enormous diversity of chemical signals from the external world into a common language of electrical activity in the brain. Mammals and insects use several families of transmembrane receptor proteins to recognize distinct classes of volatile and non-volatile chemicals that are produced by conspecifics or other environmental sources. A comparison of the signalling mechanisms of mammalian and insect receptors has revealed an unexpected functional distinction: mammals rely almost exclusively on metabotropic ligand-binding receptors, which use second messenger signalling cascades to indirectly activate ion channels, whereas insects use ionotropic receptors, which are gated directly by chemical stimuli, thereby leading to neuronal depolarization. In this review, we consider possible reasons for this dichotomy, taking into account biophysical, cell biological, ecological and evolutionary influences on how information is extracted from chemosensory cues by these animal classes.

Neonatal Minimally Invasive Surgery for Congenital Diaphragmatic Hernias: a multicenter study using thoracoscopy or laparoscopy.

BACKGROUND: Minimally invasive surgery (MIS) for late-presenting congenital diaphragmatic hernia (CDH) has been described previously, but few neonatal cases of CDH have been reported. This study aimed to report the multicenter experience of these rare cases and to compare the laparoscopic and thoracoscopic approaches. METHODS: Using MIS procedures, 30 patients (16 boys and 14 girls) from nine centers underwent surgery for CDH within the first month of life, 26 before day 5. Only one patient had associated malformations. There were 10 preterm patients (32-36 weeks of gestational age). Their weight at birth ranged from 1,800 to 3,800 g, with three patients weighing less than 2,600 g. Of the 30 patients, 18 were intubated at birth. RESULTS: The MIS procedures were performed in 18 cases by a thoracoscopic approach and in 12 cases by a laparoscopic approach. No severe complication was observed. For 20 patients, reduction of the intrathoracic contents was achieved easily with 15 thoracoscopies and 5 laparoscopies. In six cases, the reduction was difficult, proving to be impossible for the four remaining patients: one treated with thoracoscopy and three with laparoscopy. The reasons for the inability to reduce the thoracic contents were difficulty of liver mobilization (1 left CDH and 2 right CDH) and the presence of a dilated stomach in the thorax. Reductions were easier for cases of wide diaphragmatic defects using thoracoscopy. There were 10 conversions (5 laparoscopies and 5 thoracoscopies). The reported reasons for conversion were inability to reduce (n = 4), need for a patch (n = 5), lack of adequate vision (n = 4), narrow working space (n = 1), associated bowel malrotation (n = 1), and an anesthetic problem (n = 1). Five defects were too large for direct closure and had to be closed with a patch. Four required conversion, with one performed through video-assisted thoracic surgery. The recurrences were detected after two primer thoracoscopic closures, one of which was managed by successful reoperation using thoracoscopy. CONCLUSIONS: In the neonatal period, CDH can be safely closed using MIS procedures. The overall success rate in this study was 67%. The indication for MIS is not related to weeks of gestational age, to weight at birth (if >2,600 g), or to the extent of the immediate neonatal care. Patients with no associated anomaly who are hemodynamically stabilized can benefit from MIS procedures. Reduction of the herniated organs is easier using thoracoscopy. Right CDH, liver lobe herniation, and the need for a patch closure are the most frequent reasons for conversion.

Reasons and meanings attributed by women who experienced induced abortion: an integrative review

OBJECTIVE Identifying the contribution of developed research on what motivates women to induce an abortion and the meaning attributed to these experiences in their lives. METHOD An integrative review conducted in MEDLINE/PubMed, LILACS, BDENF, CINAHL and SciELO databases, covering the periods from 2001 to 2011. RESULTS We selected and analyzed 11 studies with selection criteria being reasons given by women for inducing abortion and/or the meaning attributed to this experience in their lives, including social, religious, ethical and moral aspects related to this practice, as well as the suffering experienced from the experience. The illegality of abortion is identified as a risk factor for unsafe abortions, reaffirming this issue as a public health and social justice problem. CONCLUSION Results evidence aspects that can contribute to improving health quality and ratify the importance of research to support nursing practices.

Rational reasoning or adaptive behavior? Evidence from two-person beauty contest games

Many experiments have shown that human subjects do not necessarily behave in line with game theoretic assumptions and solution concepts. The reasons for this non-conformity are multiple. In this paper we study the argument whether a deviation from game theory is because subjects are rational, but doubt that others are rational as well, compared to the argument that subjects, in general, are boundedly rational themselves. To distinguish these two hypotheses, we study behavior in repeated 2-person and many-person Beauty-Contest-Games which are strategically different from one another. We analyze four different treatments and observe that convergence toward equilibrium is driven by learning through the information about the other player s choice and adaptation rather than self-initiated rational reasoning.

Prevalence rate and reasons for refusals of influenza vaccine in elderly.

More knowledge on the reasons for refusal of the influenza vaccine in elderly patients is essential to target groups for additional information, and hence improve coverage rate. The objective of the present study was to describe precisely the true motives for refusal. All patients aged over 64 who attended the Medical Outpatient Clinic, University of Lausanne, or their private practitioner's office during the 1999 and 2000 vaccination periods were included. Each patient was informed on influenza and its complications, as well as on the need for vaccination, its efficacy and adverse events. The vaccination was then proposed. In case of refusal, the reasons were investigated with an open question. Out of 1398 patients, 148 (12%) refused the vaccination. The main reasons for refusal were the perception of being in good health (16%), of not being susceptible to influenza (15%), of not having had the influenza vaccine in the past (15%), of having had a bad experience either personally or a relative (15%), and the uselessness of the vaccine (10%). Seventeen percent gave miscellaneous reasons and 12% no reason at all for refusal. Little epidemiological knowledge and resistance to change appear to be the major obstacles for wide acceptance of the vaccine by the elderly.

To say or not to say: a qualitative study on the disclosure of their condition by human immunodeficiency virus-positive adolescents.

PURPOSE: Human immunodeficiency virus (HIV)-positive adolescents face a number of challenges in dealing with their disease, treatment, and developmental tasks. This qualitative study describes some of the reasons why, and the extent to which, adolescents may or may not disclose their condition to others. METHODS: A semistructured interview lasting 40-110 minutes was conducted with each of 29 adolescents 12-20 years old, 22 female and seven male) living in Switzerland. Interviews were tape recorded and transcribed verbatim. The analysis of the content of interviews allowed us to identify salient topics (e.g., disclosure), which were then explored in detail. RESULTS: Of 29 participants, eight had not disclosed their condition to anyone outside the family, 19 had disclosed it to good friends, and 16 had disclosed it to some teachers. Four participants had engaged in public disclosure, and six of 10 sexually active teenagers disclosed their status to their partners. The attitudes toward disclosure among younger adolescents were mostly related to those of the parents, particularly the mother. Older adolescents, engaged in their search for autonomy, tended to decide independently what to say and to whom. Although foster/adoptive parents would often encourage disclosure, biological parents, especially HIV-positive mothers, insisted on not disclosing the adolescent's status for fear of stigma. CONCLUSION: The health care team should systematically address the issue of disclosure with the adolescent and his family (or foster parents), the aim being to balance the right of the adolescent and that adolescent's family to maintain privacy against the concerns of sexual partners, as well as the adolescent's interest in divulging HIV status to relatives, school staff, and friends.

Thomas Mann's Death in Venice or Plutarch's way towards Eros

In Death in Venice Thomas Mann refers explicitly to Plato's Symposium and Phaedrus in order to explain the relationship between Gustav von Aschenbach and Tadzio but he hides that his novel also depends on Plutarch's Eroticus. Why? The aim of this article is precisely to reveal the different reasons for such an attitude. Indeed, Plutarch speaks highly of conjugal love in his Eroticus and this way is not followed by Mann in Death in Venice but, at the same, the German writer finds in this Plutarch's philosophical dialogue all the necessary elements to build his story of masculine love and decides not to manage without it.

Health care renunciation for economic reasons in Switzerland.

BACKGROUND: Most societies elaborate ways to contain increasing health care expenditures. In Switzerland out of pocket payments and cuts in the catalogue of reimbursed services are used as cost-containment measures. The aims of the study were to estimate the extent of health care renunciation for economic reasons and to identify associated factors. METHODS: A population-based cross-sectional survey (2008-2009) of a representative sample in the Canton of Geneva, Switzerland. Health care underuse, income level categories (<CHF 3000/month, 3000-4999, 5000-6999, 7000-9499, 9500-13 000, >13 000), education, occupation, insurance status and cardiovascular comorbidities were collected using self-rated questionnaires. RESULTS: 765 men and 814 women aged 35-74 years participated. 14.5% (229/1579) (95%CI 12.7-16.2) renounced health care for economic reasons. Among those who renounced (N = 229), 74% renounced dental care, 37% physician consultation (22% specialist, 15% general practitioner), 26% health devices, 13% medication, and 5% surgery. Income was negatively correlated with renouncement (r = -0.18, p <.0001). Each decrease in income level category provided a 48% increased risk of renouncing health care for economic reasons (OR 1.48, 1.31-1.65). This association remained when dental care was excluded from the definition of health care renunciation. CONCLUSIONS: In a region of Switzerland with a high cost of living, such as Geneva, socioeconomic status may influence the use of the health care system, and renunciation for economic reasons was not uncommon. More than 30% of the lowest income group renounced health care for economical reasons in the previous year. Health care underuse and renunciation may worsen the health status of a substantial part of society.

Prevalence rate and reasons for refusals of influenza vaccine in the elderly

RESUME Peu d'informations sont disponibles concernant la prévalence et les motifs de refus de la vaccination contre la grippe dans la population âgée. Le but de notre recherche était d'investiguer les vrais motifs de refus de la vaccination (c'est-à-dire pas uniquement les raisons de non-vaccination parfois indépendantes du patient lui- même) chez les personnes âgées. Tous les patients ambulatoires de plus de 65 ans consultant la Policlinique Médicale Universitaire (PMU) de Lausanne ou leur médecin traitant durant les périodes de vaccination contre la grippe 1999-2000 et 2000-2001 ont été inclus. Chaque patient recevait une information sur la grippe et ses complications, de même que sur la nécessité de la vaccination, son efficacité et ses effets seconda ires éventuels. En l'absence de contre-indication, la vaccination était proposée. En cas de refus, les motifs étaient investigués par une question ouverte. Sur 1398 sujets inclus, 148 (12%) ont refusé la vaccination. Les raisons principales de refus étaient la perception d'être en bonne santé (16%), de ne pas être susceptible à la grippe (15%) ou le fait de ne jamais avoir été vacciné contre la grippe dans le passé (15%). On retrouvait également la mauvaise expérience personnelle ou d'un proche lors d'une vaccination (15%) et l'impression d'inutilité du vaccin (10%). 17% des personnes interrogées ont donné des motifs autres et 12% n'ont pas explicité leur non-acceptation. Les refus de vaccination contre la grippe dans la population âgée sont essentiellement liés aux convictions intimes du patient quant à son état de santé et à sa susceptibilité à la grippe, de même qu'à l'efficacité supposée de la vaccination. La résistance au changement semble être un obstacle majeur à l'introduction de la vaccination chez les personnes de plus de 65 ans. SUMMARY More knowledge on the reasons for refusal of the influenza vaccine in elderly patients is essential to target groups for additional information, and hence improve coverage rate. The objective of the present study was to describe precisely the true motives for refusal. All patients aged over 64 who attended the Medical Outpatient Clinic, University of Lausanne, or their private practitioner's office during the 1999 and 2000 vaccination periods were included. Each patient was informed on influenza and its complications, as well as on the need for vaccination, its efficacy and adverse events. The vaccination was then proposed. In case of refusal, the reasons were investigated with an open question. Out of 1398 patients, 148 (12%) refused the vaccination. The main reasons for refusal were the perception of being in good health (16%), of not being susceptible to influenza (15%), of not having had the influenza vaccine in the past (15%), of having had a bad experience either personally or a relative (15%), and the uselessness of the vaccine (10%). Seventeen percent gave miscellaneous reasons and 12% no reason at all for refusal. Little epidemiological knowledge and resistance to change appear to be the major obstacles for wide acceptance of the vaccine by the elderly.

Quality of life, happiness and satisfaction with life of individuals 75 years old or older cared for by a home health care program

This case study identifies the elements that compose the Quality of Life (QofL) of individuals who were 75 years old or older and receive care at home. The study's sample was composed of individuals 75 years or older cared for by a home health care service in the primary health care unit in Vilafranca del Penedès, Spain (n=26). The variables included: a) socio-demographic data; b) concept of QofL; c) perception of QofL; d) reasons for their perception; d) satisfaction with life and related aspects; and f) feeling of happiness. Face to face interviews were conducted. A total of 76.9% of the individuals reported a good perception of QofL and the main reasons related to it were: health, family and social relationships, and the ability to adapt. Role Theory and Disengagement Theory explain the adaptation process of these individuals at this point in life.

Quality of life, happiness and satisfaction with life of individuals 75 years old or older cared for by a home health care program

This case study identifies the elements that compose the Quality of Life (QofL) of individuals who were 75 years old or older and receive care at home. The study's sample was composed of individuals 75 years or older cared for by a home health care service in the primary health care unit in Vilafranca del Penedès, Spain (n=26). The variables included: a) socio-demographic data; b) concept of QofL; c) perception of QofL; d) reasons for their perception; d) satisfaction with life and related aspects; and f) feeling of happiness. Face to face interviews were conducted. A total of 76.9% of the individuals reported a good perception of QofL and the main reasons related to it were: health, family and social relationships, and the ability to adapt. Role Theory and Disengagement Theory explain the adaptation process of these individuals at this point in life.

Quality of life, happiness and satisfaction with life of individuals 75 years old or older cared for by a home health care program

This case study identifies the elements that compose the Quality of Life (QofL) of individuals who were 75 years old or older and receive care at home. The study's sample was composed of individuals 75 years or older cared for by a home health care service in the primary health care unit in Vilafranca del Penedès, Spain (n=26). The variables included: a) socio-demographic data; b) concept of QofL; c) perception of QofL; d) reasons for their perception; d) satisfaction with life and related aspects; and f) feeling of happiness. Face to face interviews were conducted. A total of 76.9% of the individuals reported a good perception of QofL and the main reasons related to it were: health, family and social relationships, and the ability to adapt. Role Theory and Disengagement Theory explain the adaptation process of these individuals at this point in life.

Combination of lentivector immunization and low-dose chemotherapy or PD-1/PD-L1 blocking primes self-reactive T cells and induces anti-tumor immunity.

In the last two decades, anti-cancer vaccines have yielded disappointing clinical results despite the fact that high numbers of self/tumor-specific T cells can be elicited in immunized patients. Understanding the reasons behind this lack of efficacy is critical in order to design better treatment regimes. Recombinant lentivectors (rLVs) have been successfully used to induce antigen-specific T cells to foreign or mutated tumor antigens. Here, we show that rLV expressing a murine nonmutated self/tumor antigen efficiently primes large numbers of self/tumor-specific CD8(+) T cells. In spite of the large number of tumor-specific T cells, however, no anti-tumor activity could be measured in a therapeutic setting, in mice vaccinated with rLV. Accumulating evidence shows that, in the presence of malignancies, inhibition of T-cell activity may predominate overstimulation. Analysis of tumor-infiltrating lymphocytes revealed that specific anti-tumor CD8(+) T cells fail to produce cytokines and express high levels of inhibitory receptors such as programmed death (PD)-1. Association of active immunization with chemotherapy or antibodies that block inhibitory pathways often leads to better anti-tumor effects. We show here that combining rLV vaccination with either cyclophosphamide or PD-1 and PD-L1 blocking antibodies enhances rLV vaccination efficacy and improves anti-tumor immunity.

Renoncement aux soins: comment appréhender cette réalité en médecine de premier recours [Patients forgoing health care for economic reasons: how to identify this in a primary care setting?].

Although the performance of the Swiss health system is high, one out of ten patients in general practitioner's (GP) office declares having foregone care in the previous twelve months for economic reasons. Reasons for foregoing care are several and include a lack of knowledge of existing social aids in getting health insurance, unavailability of GPs and long waiting lists for various types of care. Although long term knowledge of patients or a psychosocial history of deprivation or poverty may help identify individuals at risk of foregoing care, many may remain undetected. We propose then a few instruments to help GPs to identify, in a simple and structured approach, patients at risk of forgoing care for economic reasons; these patients are frequently deprived and sometimes poor.