Twenty years' experience with the Swiss data registry for assisted reproductive medicine: outcomes, key trends and recommendations for improved practice.

QUESTIONS UNDER STUDY The impact of assisted reproductive technology (ART) on Swiss demography was quantified. From 1993 to 2012 the number of deliveries, including multiples, generated by ART was compared with overall delivery numbers. Swiss experts in ART collaborated in a consensus to increase successful outcomes, to reduce the incidence of complications of ART and to validate recommendations through statistical review of available data. METHODS Data generated between 1993 and 2012 and published by the Federal Office of Statistics (BfS) were compared with the Swiss database on ART (FIVNAT-CH) as organised by the Swiss Society of Reproductive Medicine (SGRM). From these analyses a panel of Swiss experts in ART extracted recommendations to improve current practice, to prevent complications related to ART and to recommend changes in current Swiss legislation dealing with ART. RESULTS Since 1993 the age of women giving birth rose together with the number of women asking for ART. This demographic trend was reflected in a rise in the number of deliveries generated by ART (in 2012: 2.2%) and the proportion of multiple births (in 2012: 17.6%). The outcome of ART was most negatively influenced by the age of the treated patient. The number of retrieved oocytes decisively impacted the likelihood of delivery, the risk of multiple births and the incidence of ovarian hyperstimulation syndrome. CONCLUSIONS Optimal ovarian stimulation should be designed for the retrieval of 10 to 15 oocytes per treatment. Swiss legislation should enable and stimulate a policy of elective single embryo transfer to avoid multiple births.

Resuming motor vehicle driving following orthopaedic surgery or limb trauma.

Following elective orthopaedic surgery or the treatment of a fracture, patients are temporarily unable to drive. This loss of independence may have serious social and economic consequences for the patient. It is therefore essential to know when it is safe to permit such patients to return to driving. This article, based upon a review of the current literature, proposes recommendations of the time period after which patients may safely return to driving. Practical decisions are made based upon the type of surgical intervention or fracture. Swiss legislation is equally approached so as to better define the decision.

Expert Opinion on the Perceived Effectiveness and Importance of On-Farm Biosecurity Measures for Cattle and Swine Farms in Switzerland.

Biosecurity is crucial for safeguarding livestock from infectious diseases. Despite the plethora of biosecurity recommendations, published scientific evidence on the effectiveness of individual biosecurity measures is limited. The objective of this study was to assess the perception of Swiss experts about the effectiveness and importance of individual on-farm biosecurity measures for cattle and swine farms (31 and 30 measures, respectively). Using a modified Delphi method, 16 Swiss livestock disease specialists (8 for each species) were interviewed. The experts were asked to rank biosecurity measures that were written on cards, by allocating a score from 0 (lowest) to 5 (highest). Experts ranked biosecurity measures based on their importance related to Swiss legislation, feasibility, as well as the effort required for implementation and the benefit of each biosecurity measure. The experts also ranked biosecurity measures based on their effectiveness in preventing an infectious agent from entering and spreading on a farm, solely based on transmission characteristics of specific pathogens. The pathogens considered by cattle experts were those causing Bluetongue (BT), Bovine Viral Diarrhea (BVD), Foot and Mouth Disease (FMD) and Infectious Bovine Rhinotracheitis (IBR). Swine experts expressed their opinion on the pathogens causing African Swine Fever (ASF), Enzootic Pneumonia (EP), Porcine Reproductive and Respiratory Syndrome (PRRS), as well as FMD. For cattle farms, biosecurity measures that improve disease awareness of farmers were ranked as both most important and most effective. For swine farms, the most important and effective measures identified were those related to animal movements. Among all single measures evaluated, education of farmers was perceived by the experts to be the most important and effective for protecting both Swiss cattle and swine farms from disease. The findings of this study provide an important basis for recommendation to farmers and policy makers.

La protection des données personnelles en droit international privé

Les nouvelles technologies et l’arrivée de l’Internet ont considérablement facilité les échanges transnationaux de données entre les entreprises publiques et/ou privées et également entre les personnes elles-mêmes. Cependant cette révolution numérique n’a pas été sans conséquences sur l’utilisation de nos données personnelles puisque cette abondance de données à la portée de tiers peut conduire à des atteintes : la commercialisation des données personnelles sans le consentement de l’intéressé par des entreprises ou encore la diffusion de sa photographie, de son nom, de son prénom à son insu en sont des exemples. La question qui vient alors se poser est en cas de litige, c’est-à-dire en cas d’atteintes au droit à la protection de nos données personnelles, présentant un ou des éléments d’extranéité, quels tribunaux pouvons-nous saisir ? Et quelle est la loi qui sera applicable ? Les droits québécois, de l’Union européenne, et suisse présentent différents critères de rattachement intéressants et adaptés à des situations prenant place hors et sur internet. Le droit commun de chacun de ces systèmes est envisagé, puis appliqué aux données personnelles dans le cadre d’une situation normale, et ensuite à internet si la situation diffère. La doctrine est également analysée dans la mesure où certaines solutions sont tout à fait intéressantes, et cela notamment sur internet. Un premier chapitre est consacré à la compétence internationale des tribunaux et aux critères de rattachement envisageables en droit commun à savoir notamment : le tribunal de l’État de survenance du préjudice, le tribunal de l’État de la faute ou encore le tribunal du domicile de la victime. Et ceux prévus ou non par la doctrine tels que l’accessibilité et le ciblage par exemple. Les conflits de lois sont étudiés dans un deuxième chapitre avec également l’énumération les différents facteurs de rattachement envisageables en droit commun comme la loi de l’État du préjudice, la loi de l’État de la faute ou encore la loi de l’État favorisant la victime. Et également ceux prévus par la doctrine : la loi de l’État « offrant la meilleure protection des données à caractère personnel » ou encore la loi de l’État où est établi le « maître du fichier ». Le tribunal le plus compétent au regard des principes généraux de droit international privé en cas d’atteintes au droit de la protection des données personnelles hors et sur internet est le tribunal de l’État du domicile de la victime. Et la meilleure loi applicable est la loi de l’État du domicile ou de la résidence principale du demandeur et du défendeur à l’instance, et dans le cas où la situation ne présente pas d’éléments d’extranéité, la meilleure loi est la loi favorisant la victime.

La protection des données personnelles en droit international privé

Les nouvelles technologies et l’arrivée de l’Internet ont considérablement facilité les échanges transnationaux de données entre les entreprises publiques et/ou privées et également entre les personnes elles-mêmes. Cependant cette révolution numérique n’a pas été sans conséquences sur l’utilisation de nos données personnelles puisque cette abondance de données à la portée de tiers peut conduire à des atteintes : la commercialisation des données personnelles sans le consentement de l’intéressé par des entreprises ou encore la diffusion de sa photographie, de son nom, de son prénom à son insu en sont des exemples. La question qui vient alors se poser est en cas de litige, c’est-à-dire en cas d’atteintes au droit à la protection de nos données personnelles, présentant un ou des éléments d’extranéité, quels tribunaux pouvons-nous saisir ? Et quelle est la loi qui sera applicable ? Les droits québécois, de l’Union européenne, et suisse présentent différents critères de rattachement intéressants et adaptés à des situations prenant place hors et sur internet. Le droit commun de chacun de ces systèmes est envisagé, puis appliqué aux données personnelles dans le cadre d’une situation normale, et ensuite à internet si la situation diffère. La doctrine est également analysée dans la mesure où certaines solutions sont tout à fait intéressantes, et cela notamment sur internet. Un premier chapitre est consacré à la compétence internationale des tribunaux et aux critères de rattachement envisageables en droit commun à savoir notamment : le tribunal de l’État de survenance du préjudice, le tribunal de l’État de la faute ou encore le tribunal du domicile de la victime. Et ceux prévus ou non par la doctrine tels que l’accessibilité et le ciblage par exemple. Les conflits de lois sont étudiés dans un deuxième chapitre avec également l’énumération les différents facteurs de rattachement envisageables en droit commun comme la loi de l’État du préjudice, la loi de l’État de la faute ou encore la loi de l’État favorisant la victime. Et également ceux prévus par la doctrine : la loi de l’État « offrant la meilleure protection des données à caractère personnel » ou encore la loi de l’État où est établi le « maître du fichier ». Le tribunal le plus compétent au regard des principes généraux de droit international privé en cas d’atteintes au droit de la protection des données personnelles hors et sur internet est le tribunal de l’État du domicile de la victime. Et la meilleure loi applicable est la loi de l’État du domicile ou de la résidence principale du demandeur et du défendeur à l’instance, et dans le cas où la situation ne présente pas d’éléments d’extranéité, la meilleure loi est la loi favorisant la victime.

A Legislator under Surveillance: The Creation and Implementation of Swiss Banking Legislation 1910-1934

This paper analyses how banking regulation was introduced in Switzerland - one of the world's most prominent financial centres - which remained in place until the beginning of the twenty-first century. It shows that the law adopted on 8 November 1934 is a perfect example of capture of the regulator by the regulated. Essentially a political response in the context of the economic crisis of the 1930s, it largely reflected the interests of banking circles by limiting the intervention of the State as much as possible. The introduction of the new legislation was facilitated by the temporary weakness of Swiss banking circles, as they depended on the State to delay or prevent the collapse of many major credit institutions. They did not manage to derail the law as they had two decades earlier when they scuppered the federal bill on banks drawn up between 1914 and 1916. But this time they were better organized and more united, and intervened all the more effectively in the legislative process itself. The 1934 law is thus distinctive in that it made no structural changes to the architecture of the financial centre but merely codified its practices through flexible legislation meant to reassure the public. The law was aimed less at controlling banking activity than at keeping - thanks to skilfully calibrated political concessions - the State from having to intervene more directly in the internal management of banks or in the fixing of interest rates and the export of capital.

Record keeping by Swiss physiotherapists--a national survey of knowledge regarding legal requirements.

A national survey conducted in Switzerland aimed to evaluate the knowledge of physiotherapists regarding the legal requirements for record keeping and to collect their feedback about record keeping in general. Three physiotherapists from various professional practice groups and a lawyer specialised in health law developed a questionnaire that was sent to the 7,753 members of two existing national associations of physiotherapists. The questionnaire evaluated the participants' knowledge by calculating a score of legal knowledge, which had a maximum of 30 points. We included 825 questionnaires in the analysis. The large majority (83.4%) of participants confessed an ignorance of the legal requirements concerning record keeping prior to the survey. The average score of legal compatibility was 8 points. The younger age of the physiotherapists was a significant predictor of having knowledge of the legal requirements for record keeping (p <0.001). The participants had an appreciation of the value of records, but they did not have the relevant knowledge regarding the legal requirements for keeping records. The participants blamed a lack of time and remuneration for their failure to keep records according to known requirements. All practising allied health professionals should keep up-to-date and accurate records that conform to active legal requirements and existing international guidelines. In addition to the existing legal requirements, the emergence of e-health and the electronic era will trigger major changes in patient record management by physiotherapists.

Why did Swiss citizens refuse a comprehensive second-hand smoke ban?

The ill effects of second-hand smoke are now well documented. To protect the population from exposure to tobacco smoke, comprehensive smoking bans are necessary as expressed in the WHO Framework Convention on Tobacco Control and its guidelines. Switzerland has only a partial smoking ban full of exceptions which has been in effect since 2010, which reproduces the so-called Spanish model. In September 2012, the Swiss citizens refused a proposal for a more comprehensive ban. This case study examines the reasons behind this rejection and draws some lessons that can be learnt from it.

Effects of the two production programs 'Naturafarm' and 'conventional' on the prevalence of non-perforating abomasal lesions in Swiss veal calves at slaughter

Non-perforating abomasal lesions are a considerable problem affecting more than half the population of veal calves. The objective of the present study was to assess the prevalence of pyloric and fundic abomasal lesions in Swiss veal calves at slaughter and to compare the occurrence of non-perforating abomasal lesions between two different production programs ('Naturafarm' and 'conventional'). 'Conventional'-production settings met the minimal standards as defined by the Swiss animal welfare legislation, whereas 'Naturafarm' production complied with increased animal welfare requirements. In order to identify risk factors for the development of abomasal lesions, information on management, housing, and feeding was obtained by a questionnaire. A total of 125 abomasa were randomly selected in one large abattoir. They were examined macroscopically, and the occurence of lesions in either the fundic or pyloric region of the abomasum was recorded separately. Animals raised in the 'conventional'-production setting revealed a significantly higher prevalence of lesions in the fundic part. Factors significantly affecting the prevalence of non-perforating lesions in the fundic part were the 'conventional'-production environment, including missing access to an outside pen, missing access to water and straw as the only roughage, feeding by bucket and the liquid milk by-product Protofit in combination with the powder Sprayfit.

Antimicrobial resistance in Swiss laying hens, prevalence and risk factors

Antimicrobial resistance is an emerging concern to public health, and food-producing animals are known to be a potential source for transmission of resistant bacteria to humans. As legislation of the European Union requires to ban conventional cages for the housing of laying hens on the one hand, and a high food safety standard for eggs on the other hand, further investigations about the occurrence of antimicrobial resistance in alternative housing types are required. In this study, we determined antimicrobial resistance in indicator bacteria from 396 cloacal swabs from 99 Swiss laying hen farms among four alternative housing types during a cross-sectional study. On each farm, four hens were sampled and exposure to potential risk factors was identified with a questionnaire. The minimal inhibitory concentration was determined using broth microdilution in Escherichia coli (n=371) for 18 antimicrobials and in Enterococcus faecalis (n=138) and Enterococcus faecium (n=153) for 16 antimicrobials. All antimicrobial classes recommended by the European Food Safety Authority for E. coli and enterococci were included in the resistance profile. Sixty per cent of the E. coli isolates were susceptible to all of the considered antimicrobials and 30% were resistant to at least two antimicrobials. In E. faecalis, 33% of the strains were susceptible to all tested antimicrobials and 40% were resistant to two or more antimicrobials, whereas in E. faecium these figures were 14% and 39% respectively. Risk factor analyses were carried out for bacteria species and antimicrobials with a prevalence of resistance between 15% and 85%. In these analyses, none of the considered housing and management factors showed a consistent association with the prevalence of resistance for more than two combinations of bacteria and antimicrobial. Therefore we conclude that the impact of the considered housing and management practices on the egg producing farms on resistance in laying hens is low.

Surplus embryos in Switzerland in 2003: legislation and availability of human embryos for research

Legislation influences the availability of embryos for research. The law in Switzerland, and in some other European countries, is restrictive concerning medically assisted reproduction and stem cell research. Swiss law prohibits the creation of embryos for research purposes. It permits the derivation of human embryonic stem cells for research from surplus embryos but prohibits research with intact surplus embryos and embryo donation to other couples. Swiss law defines all embryos generated during a reproductive cycle and not used for reproduction as surplus embryos. The aim of this study was to evaluate the surplus embryos generated in Switzerland in 2003. A detailed questionnaire was sent to all registered IVF units in Switzerland (n = 22). 11727 embryos were generated during 2003. Of these, 93.5% were transferred into the uterus and 0.4% were cryopreserved. The remaining 6.1% (n = 711) became surplus. Of these, 2.7% were transferred intravaginally and the rest discarded due to poor quality (1.6%), development arrest (1.5%), renunciation by the couple (0.2%) or for other reasons (0.1%). The number of surplus embryos in Switzerland in 2003 was evaluated. Most surplus embryos became so during a therapeutic cycle. The restrictive legal regulation decreases the availability of human embryos for research.

Occurrence of congenital disorders in Swiss sheep.

BACKGROUND The rates of congenital disorders in Swiss sheep were determined by a questionnaire which was sent to 3,183 members of the Swiss Sheep Breeders' Association. FINDINGS A total of 993 questionnaires were returned, giving a response rate of 31.2%. Of these, 862 questionnaires originated from farms keeping one of the predominant Swiss sheep breeds: Swiss White Alpine sheep, Brown-Headed Meat sheep, Swiss Black Brown Mountain sheep and Valais Blacknose sheep. During a 10-year-period, entropion was reported in 33.6% of the farms, brachygnathia inferior in 29.5%, abdominal/umbilical hernia in 15.9%, cryptorchidism in 10.5% and torticollis in 10.5%. The most significant difference between the four breeds (P<0.001) occurred for entropion in Swiss White Alpine sheep and Brown-Headed Meat sheep, brachygnathia inferior in Swiss Black Brown Mountain sheep, and scrotal/inguinal hernia in Valais Blacknose sheep. The Swiss White Alpine breed showed a significantly higher animal prevalence of entropion (6.2% in 2011 and 5.5% in 2012) than other breeds (P<0.001). CONCLUSIONS These findings indicate a breed-specific necessity for action, particularly regarding Swiss animal welfare legislation, especially entropion in Swiss White Alpine sheep is concerned. In general, careful selection of breeding stock is to be recommended.

Suicide tourism: a pilot study on the swiss phenomenon

While assisted suicide (AS) is strictly restricted in many countries, it is not clearly regulated by law in Switzerland. This imbalance leads to an influx of people —‘suicide tourists’—coming to Switzerland, mainly to the Canton of Zurich, for the sole purpose of committing suicide. Political debate regarding ‘suicide tourism’ is taking place in many countries. Swiss medicolegal experts are confronted with these cases almost daily, which prompted our scientific investigation of the phenomenon. The present study has three aims: (1) to determine selected details about AS in the study group (age, gender and country of residence of the suicide tourists, the organisation involved, the ingested substance leading to death and any diseases that were the main reason for AS); (2) to find out the countries from which suicide tourists come and to review existing laws in the top three in order to test the hypothesis that suicide tourism leads to the amendment of existing regulations in foreign countries; and (3) to compare our results with those of earlier studies in Zurich. We did a retrospective data analysis of the Zurich Institute of Legal Medicine database on AS of on-Swiss residents in the last 5 years (2008–2012), and internet research for current legislation and political debate in the three foreign countries most concerned. We analysed 611 cases from 31 countries all over the world. Non-terminal conditions such as neurological and rheumatic diseases are increasing among suicide tourists. The unique phenomenon of suicide tourism in Switzerland may indeed result in the amendment or supplementary guidelines to existing regulations in foreign countries.

North Atlantic coast fisheries arbitration : coastal waters : English translations of extracts from works of French, German, Austrian, Argentinian, Spanish, Swiss, Russian, Italian, and Belgian publicists /

Short biographical notices at the beginning of each extract.