1000 resultados para Dominikanerinnenkloster Töss (Töss, Switzerland).


Relevância:

20.00% 20.00%

Publicador:

Resumo:

In cases of highly inflammatory dermatophytosis in humans, it is important to identify the possible source of animal transmission in order to prevent recurrence, family outbreaks or rapidly progressing epidemics. A survey of dermatophytes in pets during a 14-month period in Switzerland revealed, in addition to Microsporum canis, two different species of the Trichophyton mentagrophytes complex, Arthroderma benhamiae and Arthroderma vanbreuseghemii, all causing inflammatory dermatophytoses. Arthroderma benhamiae was only and frequently isolated from guinea pigs. Arthroderma vanbreuseghemii was isolated mainly from European short hair cats, but also from dogs and in one case from a pure-bred cat. Ninety-three percent of the cats carrying A. vanbreuseghemii were hunters and all had skin lesions. In contrast, cats with skin lesions that were strictly indoors were found to be almost exclusively infected by M. canis. Therefore, it can be suspected that infection with A. vanbreuseghemii occurred during hunting and that the natural source of this dermatophyte is either soil or an animal other than the cat, most probably a rodent.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Elevated plasma cholesterol, high blood pressure and cigarette smoking are three major risk factors for coronary heart disease. Within the framework of Switzerland's participation in the multicenter study MONICA (MONItoring of trends and determinants in CArdiovascular disease), proposed by the WHO, a first risk factor survey was conducted in a representative sample of the population (25-74 years) of two reporting units (cantons of Vaud and Fribourg, canton of Tessin). A high blood cholesterol level (>6,7 mmol/l) is the most common risk factor for coronary heart disease among the studied population. Among men, about 13% have elevated blood pressure, the proportion being about one in ten among women; these proportions increase with age and are slightly above these values in Tessin. Cigarette smoking is still a common behavior; between 25 and 45 years one third of the population (male and female) regularly smoke cigarettes.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Perinatal care of pregnant women at high risk for preterm delivery and of preterm infants born at the limit of viability (22-26 completed weeks of gestation) requires a multidisciplinary approach by an experienced perinatal team. Limited precision in the determination of both gestational age and foetal weight, as well as biological variability may significantly affect the course of action chosen in individual cases. The decisions that must be taken with the pregnant women and on behalf of the preterm infant in this context are complex and have far-reaching consequences. When counselling pregnant women and their partners, neonatologists and obstetricians should provide them with comprehensive information in a sensitive and supportive way to build a basis of trust. The decisions are developed in a continuing dialogue between all parties involved (physicians, midwives, nursing staff and parents) with the principal aim to find solutions that are in the infant's and pregnant woman's best interest. Knowledge of current gestational age-specific mortality and morbidity rates and how they are modified by prenatally known prognostic factors (estimated foetal weight, sex, exposure or nonexposure to antenatal corticosteroids, single or multiple births) as well as the application of accepted ethical principles form the basis for responsible decision-making. Communication between all parties involved plays a central role. The members of the interdisciplinary working group suggest that the care of preterm infants with a gestational age between 22 0/7 and 23 6/7 weeks should generally be limited to palliative care. Obstetric interventions for foetal indications such as Caesarean section delivery are usually not indicated. In selected cases, for example, after 23 weeks of pregnancy have been completed and several of the above mentioned prenatally known prognostic factors are favourable or well informed parents insist on the initiation of life-sustaining therapies, active obstetric interventions for foetal indications and provisional intensive care of the neonate may be reasonable. In preterm infants with a gestational age between 24 0/7 and 24 6/7 weeks, it can be difficult to determine whether the burden of obstetric interventions and neonatal intensive care is justified given the limited chances of success of such a therapy. In such cases, the individual constellation of prenatally known factors which impact on prognosis can be helpful in the decision making process with the parents. In preterm infants with a gestational age between 25 0/7 and 25 6/7 weeks, foetal surveillance, obstetric interventions for foetal indications and neonatal intensive care measures are generally indicated. However, if several prenatally known prognostic factors are unfavourable and the parents agree, primary non-intervention and neonatal palliative care can be considered. All pregnant women with threatening preterm delivery or premature rupture of membranes at the limit of viability must be transferred to a perinatal centre with a level III neonatal intensive care unit no later than 23 0/7 weeks of gestation, unless emergency delivery is indicated. An experienced neonatology team should be involved in all deliveries that take place after 23 0/7 weeks of gestation to help to decide together with the parents if the initiation of intensive care measures appears to be appropriate or if preference should be given to palliative care (i.e., primary non-intervention). In doubtful situations, it can be reasonable to initiate intensive care and to admit the preterm infant to a neonatal intensive care unit (i.e., provisional intensive care). The infant's clinical evolution and additional discussions with the parents will help to clarify whether the life-sustaining therapies should be continued or withdrawn. Life support is continued as long as there is reasonable hope for survival and the infant's burden of intensive care is acceptable. If, on the other hand, the health care team and the parents have to recognise that in the light of a very poor prognosis the burden of the currently used therapies has become disproportionate, intensive care measures are no longer justified and other aspects of care (e.g., relief of pain and suffering) are the new priorities (i.e., redirection of care). If a decision is made to withhold or withdraw life-sustaining therapies, the health care team should focus on comfort care for the dying infant and support for the parents.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Due to population aging, by 2030 Switzerland may face a demand of 24 million family practitioner visits, a growth of 13 percent from the 2005 level. This result is based on the assumption that the per capita demand for doctor visits remains what was observed in 2005 by age groups and sex. During the same period, the total number of practitioners may decrease by 14 percent whereas the female proportion of such practitioners may double. These changes may cause a 33 percent decrease in the supply of physician visits to reach only 14 millions. The comparison of the demand and supply of family doctor visits reveals that by 2030, 10 million visits may be unmet which represents 40 percent of the demand. On the supply side, a full scale implementation of task delegation may partially reduce that gap (minus 2 millions). On the demand side, improved health status may bring in a larger decrease in the needs for visits (minus 4 million).

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Among the various work stress models, one of the most popular to date is the job demands-­‐control (JDC) model developed by Karasek (1979), which postulates that work-­‐related strain will be the highest under work conditions characterized by high demands and low autonomy. The absence of social support at work will further increase negative outcomes. However, this model does not apply equally to all individuals and to all cultures. In the following studies, we assessed work characteristics, personality traits, culture-­‐driven individual attributes, and work-­‐related health outcomes, through the administration of questionnaires. The samples consist of Swiss (n = 622) and South African (n = 879) service-­‐oriented employees (from health, finance, education and commerce sectors) and aged from 18 to 65 years old. Results generally confirm the universal contribution of high psychological demands, low decision latitude and low supervisor support at work, as well as high neuroticism predict the worse health outcomes among employees in both countries. Furthermore, low neuroticism plays a moderating role between psychological demands and burnout, while high openness and high conscientiousness each play a moderating role between decision latitude and burnout in South Africa. Results also reveal that culture-­‐driven individual attributes play a role in both countries, but in a unique manner and according to the ethnic group of belonging. Given that organizations are increasingly characterized with multicultural employees as well as increasingly adverse and complex job conditions, our results help in identifying more updated and refined dynamics that are key between the employee and the work environment in today's context. -- L'un des modèles sur le stress au travail des plus répandus est celui développé par Karasek (1979), qui postule qu'une mauvaise santé chez les employés résulte d'une combinaison de demandes psychologiques élevées, d'une latitude décisionnelle faible et de l'absence de soutien social au travail. Néanmoins, ce modèle ne s'applique pas de façon équivalente chez tous les individus et dans toutes les cultures. Dans les études présentées, nous avons mesuré les caractéristiques de travail, les traits de personnalité, les traits culturels et les effets lies à la santé à l'aide de questionnaires. L'échantillon provient de la Suisse (n = 622) et de l'Afrique du Sud (n = 879) et comprend des employés de domaines divers en lien avec le service (notamment des secteurs de la santé, finance, éducation et commerce) tous âgés entre 18 et 65 ans. Les résultats confirment l'universalité des effets directs des demandes au travail, la latitude décisionnelle faible, le soutien social faible provenant du supérieur hiérarchique, ainsi que le névrosisme élevé qui contribuent à un niveau de santé faible au travail, et ce, dans les deux pays. De plus, un niveau faible de névrosisme a un effet de modération entre les demandes au travail et l'épuisement professionnel, alors que l'ouverture élevée et le caractère consciencieux élevé modèrent la relation entre la latitude décisionnelle et l'épuisement professionnel en Afrique du Sud. Nous avons aussi trouvé que les traits culturels jouent un rôle dans les deux pays, mais de façon unique et en fonction du groupe ethnique d'appartenance. Sachant que les organisations sont de plus en plus caractérisées par des employés d'origine ethnique variées, et que les conditions de travail se complexifient, nos résultats contribuent à mieux comprendre les dynamiques entre l'employé et l'environnement de travail contemporain. personnalité, différences individuelles, comparaisons culturelles, culture, stress au travail, épuisement professionnel, santé des employés.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

OBJECTIVE: To assess the molecular epidemiology and risk factors of predominant clones and sporadic strains of methicillin-resistant Staphylococcus aureus (MRSA) in Swiss hospitals and to compare them with European strains of epidemic clones. MATERIAL AND METHODS: One-year national survey of MRSA cases. Analysis of epidemiological and molecular typing data (PFGE) of MRSA strains. RESULTS: In 1997, 385 cases of MRSA were recorded in the five Swiss university hospitals and in 47 community hospitals. Half of the cases were found in Geneva hospitals where MRSA was already known to be endemic. Molecular typing of 288 isolates (one per case) showed that 186 (65%) belong to four predominant clones, three of which were mostly present in Geneva hospitals. In contrast, the fourth clone (85 cases) was found in 23 hospitals (in one to 16 cases per hospital). The remaining 35% of the strains were clustered into 62 pulsed field gel electrophoresis types. They accounted for one to five patients per hospital and were defined as sporadic. Multivariate analysis revealed no independent risk factors for harboring a predominant versus a sporadic strain, except that transfer from a foreign hospital increases the risk of harboring a sporadic strain (OR, 42; 95% CI, 5-360). CONCLUSION: While cases with predominant clones were due to the local spread of these clones, most sporadic cases appear to be due to the continuous introduction of new strains into the country. With the exception of a transfer from a hospital outside Switzerland, no difference in the clinical or epidemiological characteristics was observed between patients harboring a predominant clone and those with a sporadic strain.