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In the German-speaking part of Switzerland, people use Swiss German and High German side by side in their daily life. This situation gives rise to various attitudes towards both of these two varieties. Interestingly, some of these attitudes seem to be partly in conflict. The aim of this paper is to show that these attitudes are not necessarily conflicted but rather that such attitudes normally have a multidimensional character. Multidimensional attitudes can be traced back to multidimensional mental models on which people naturally draw. In applying Berthele's (2010) cluster model, which combines Geeraerts's (2003) rationalist and romantic models for standardization, the paper illustrates, based on a recent study, which mental models have to be operative to conceptualize the complex frames of the two varieties in use. Additionally, recent shifts in the attitudinal climate in Switzerland indicate that these cognitive cultural models are not static but are subject to dynamic processes. [ABSTRACT FROM AUTHOR]

At the scale of Switzerland, the national railway company SBB Cargo AG has to schedule its locomotives and drivers in order to be able to pull all trains. Two objective functions are considered in a two-stage lexicographic fashion: (1) the locomotive and driver costs and (2) the driver time that is spent without driving. As the problem instances tend to reach really big sizes (up to 1900 trains), we propose to schedule locomotives and drivers in a sequential way, thus having a sequence of smaller problems to solve. Moreover, for smaller instances, we also propose to schedule jointly locomotives and drivers in an integrated way, therefore increasing the search space but possibly leading to better solutions. In this paper, we present a mathematical formulation and model for the problem. We also consider the contract-related constraints of the drivers, and we propose a way to integrate some time flexibility in the schedules. Next, we propose an innovative matheuristic to solve the problem, relying on a descent local search and a rolling horizon decomposition. An important goal of this method is to explore thoroughly at which extent a general-purpose solver can be used on this problem. Finally, the benefits of each aspect of the model and of the method are analyzed in detail on the results obtained for 20 real SBB Cargo AG instances. [ABSTRACT FROM AUTHOR]

Families of persons with acquired brain injuries need to be supported from the early phase of hospitalization. To date, no known early family intervention is available for this population. Using the Medical Research Council Framework, we developed a new intervention based on the Calgary Assessment and Intervention Models that includes the family preferences, clinician's expertise, and the contextual resources. This paper aims to describe the complete development process including a scoping review, an assessment of families and clinicians' needs, an evaluation of the contextual resources, and an adaptation of the theoretical framework. Using a systemic perspective, we tailored the new intervention to involve the stakeholder's preferences. The result is an early family intervention named SAFIR©, led by a clinical nurse specialist, including five core components and structured around three phases and a follow-up. The next steps will be focused on assessment of the clinical feasibility of this new intervention. [ABSTRACT FROM AUTHOR]

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Lack of water use data at the user scale is frequently noted in integrated water management and water demand modelling studies. This situation affects particularly mountain tourist areas, where high seasonal water demand related to the variation of temporary population are rarely documented. Irrigation is also a major water use in moutain territories but is not commonly measured. This paper proposes a framework for local-scale monitoring of seasonal water use behaviours and their territorial inprint. A monitoring strategy was developed to collect water demand data at thin spatio-temporal scales which were analysed using two concepts: (i) the water use regime, describing the dynamics of water uses throughout the year using normalised values, and (ii) the water use density, expressing the territorial footprint of a water use, in terms of unit area. This strategy was applied in the alpine tourist municipality of Montana (Switzerland). A two-year monitoring campaign of irrigation and drinking water uses was carried out combining in-field measurement (water metres) with interviews of water users. The temporal resolution of the collected water use dataset (bi-weekly, daily) was sufficient to assess the specific water demand patterns and the short-term water use peaks responsible for water stress in Alpine tourist regions. It provided the first irrigation monitoring in the area and a classification of drinking water data according to their spatial distribution, the type of building and the permanency of residents. The water use density method gives a new prespective on the spatial intensity of water uses, highlighting the importance of garden irrigation in Montana. Also, the water use regime method identified July as the period of water demand peaking. The monitoring of water uses at such thin temporal scale constitutes the necessary dataset for the creation of water balance models that accurately reproduce the effective water use behaviours. [ABSTRACT FROM AUTHOR]

Trees that characterized many agricultural landscapes across Europe are declining, despite the recent revival of agroforestry research and increasing direct payments for their maintenance. Therefore, in addition to field experiments, there is a need for transdisciplinary research in close alliance with local farmers. This paper proposes a three-step participatory design and assessment approach, incorporating local innovation and scientific evidence. To our knowledge, this is the first participatory and bioeconomic analysis of farmer-designed agroforestry systems in Europe. First, an exploratory survey of farmers' innovations in Switzerland was conducted together with a literature review. Based on the survey, 14 representative agroforestry practices were defined for the bioeconomic assessment, focusing on walnut ( Juglans hybr.) and wild cherry ( Prunus avium) . The predictions of long-term yields were made with the Yield-SAFE model, and the profitability was assessed using the Farm-SAFE model. The survey results suggested a lack of local knowledge on key ecosystem services provided by agroforestry. It is therefore recommended to apply the concept of ecosystem services, in order to support the design of multifunctional agriculture and to increase the willingness to pay for its services. According to our yield predictions, mixing trees and crops was commonly more productive (12 out of the 14 options, land equivalent ratio = 0.95-1.30) than growing them in separate forestry or arable systems. This result contradicts the widespread view among modern Swiss farmers that agroforestry is unproductive. In terms of profitability, 68 % of the 56 financial scenarios for the agroforestry practices, particularly those linked to innovative marketing of fruit or receiving payments for ecosystem services, were found to be more profitable than the business as usual reference systems. These results demonstrate that there is a need and a value in bridging the gap between scientists and farmers, in order to coproduce applied knowledge for the design of productive agroforestry practices. [ABSTRACT FROM AUTHOR]

The growing challenge of digital hate speech requires an understanding of its complexity, scale, and impact. Research on experiencing digital hate speech has so far been limited to the roles of personal victim, observer, and perpetrator, with a focus on young people. However, research on hate crimes suggests that vicarious victimization may also be relevant due to its negative impacts. In addition, the lack of knowledge about the older generation neglects the fact that older people are increasingly seen as vulnerable to digital risks. Therefore, this study introduces vicarious victimization as an additional role in research on digital hate speech. Prevalence rates for the four roles are examined across the life span, using a nationally representative sample of adult Internet users in Switzerland. Additionally, all roles are correlated with life satisfaction and loneliness, two stable indicators of subjective well-being. The results show that in this national population, personal victimization and perpetration are less common (<7 percent), whereas observation and vicarious victimization are more common (>40 percent). Prevalence decreases with age in all roles. As expected, multivariate analyses show that both forms of victimization are negatively related to life satisfaction and positively related to loneliness, with these effects being stronger for personal victimization. Similarly, being an observer and being a perpetrator correlate negatively, but not significantly, with well-being. This study contributes to a theoretical and empirical distinction between personal and vicarious victims and provides insight into their effects on well-being in a population largely unexplored in terms of age and national representativeness. [ABSTRACT FROM AUTHOR]

In this article, we extend the targeted-regressor approach suggested in Bai and Ng (2008) for variables sampled at the same frequency to mixed-frequency data. Our MIDASSO approach is a combination of the unrestricted MIxed-frequency DAta-Sampling approach (U-MIDAS) (see Foroni et al. 2015; Castle et al. 2009; Bec and Mogliani 2013), and the LASSO-type penalized regression used in Bai and Ng (2008), called the elastic net (Zou and Hastie 2005). We illustrate our approach by forecasting the quarterly real GDP growth rate in Switzerland. [ABSTRACT FROM AUTHOR]

Background: Measuring work-related stress in a reliable way is important in the development of appropriate prevention and intervention strategies. Especially in multilingual studies the use of comparable and reliable instruments is crucial. Therefore, the aim of this study was to translate selected scales and single items from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) into French and Italian and psychometrically test them in a sample of health professionals.Methods: This study used cross-sectional data from health professionals at 163 randomised selected health organisations in Switzerland. Selected COPSOQ items/scales were backwards- and forwards- translated and cross-culturally adapted from German to French and Italian. Reliability was assessed with Cronbach alpha and intraclass correlation coefficients, construct validity with confirmatory factor analysis (CFA) and structural equation modelling as well as comparative fit index.Results: Responses from 12,754 health professionals were included in the analysis. Of the overall 24 scales, 20 in the German version, 19 in the French version and 17 in the Italian version attained sufficient internal consistency with a threshold of 0.7 for Cronbach's alpha. Predominantly high factor loadings on scale level are reported (> 0.35), as well as good and satisfactory fit values with RMSEA below 0.1, SRMR below 0.08 and CFI above 0.95. For 10 out of 15 scales, the test for factor invariance revealed a significant difference regarding the psychological constructs of the scales across the language versions.Conclusions: The psychometric properties verify the underlying theoretical model of the COPSOQ questionnaire, which is to some extent comparable across the three language versions. Of the 10 scales with significant factor variance, four showed large differences, implying that revision is needed for better comparability. Potential cultural issues as well as regional differences may have led to the factor variance and the different reliability scores per scale across language versions. One known influencing factor for regional differences is culture, which should be considered in scale development. Moreover, emerging topics such as digitization should be considered in further development of the questionnaire. [ABSTRACT FROM AUTHOR]

To facilitate evaluation of complex, organisational health interventions (OHIs), this paper aims at developing a context, process, and outcome (CPO) evaluation model. It builds on previous model developments in the field and advances them by clearly defining and relating generic evaluation categories for OHIs. Context is defined as the underlying frame that influences and is influenced by an OHI. It is further differentiated into the omnibus and discrete contexts. Process is differentiated into the implementation process, as the time-limited enactment of the original intervention plan, and the change process of individual and collective dynamics triggered by the implementation process. These processes lead to proximate, intermediate, and distal outcomes, as all results of the change process that are meaningful for various stakeholders. Research questions that might guide the evaluation of an OHI according to the CPO categories and a list of concrete themes/indicators and methods/sources applied within the evaluation of an OHI project at a hospital in Switzerland illustrate the model's applicability in structuring evaluations of complex OHIs. In conclusion, the model supplies a common language and a sharedmentalmodel for improving communication between researchers and companymembers and will improve the comparability and aggregation of evaluation study results. [ABSTRACT FROM AUTHOR]

Machine Learning (ML) can improve the analysis of complex and interrelated factors that place adherent people at risk of viral rebound. Our aim was to build ML model to predict RNA viral rebound from medication adherence and clinical data. Patients were followed up at the Swiss interprofessional medication adherence program (IMAP). Sociodemographic and clinical variables were retrieved from the Swiss HIV Cohort Study (SHCS). Daily electronic medication adherence between 2008–2016 were analyzed retrospectively. Predictor variables included: RNA viral load (VL), CD4 count, duration of ART, and adherence. Random Forest, was used with 10 fold cross validation to predict the RNA class for each data observation. Classification accuracy metrics were calculated for each of the 10-fold cross validation holdout datasets. The values for each range from 0 to 1 (better accuracy). 383 HIV+ patients, 56% male, 52% white, median (Q1, Q3): age 43 (36, 50), duration of electronic monitoring of adherence 564 (200, 1333) days, CD4 count 406 (209, 533) cells/mm3, time since HIV diagnosis was 8.4 (4, 13.5) years, were included. Average model classification accuracy metrics (AUC and F1) for RNA VL were 0.6465 and 0.7772, respectively. In conclusion, combining adherence with other clinical predictors improve predictions of RNA. [ABSTRACT FROM AUTHOR]

Food systems have increasingly strong impacts on the environment, and they influence our human well‐being. In Switzerland, food consumption accounts for one‐third of the environmental impact caused by total final consumption. At the same time, non‐communicable diseases have been linked to a number of dietary aspects. In Switzerland, all non‐communicable diseases together are responsible for 80% of total public health care costs annually. Current assessments that link environmental sustainability and human health‐oriented diets for Switzerland lack a transparent representation of the dynamic effects caused by large‐scale conversions of the food system. In this study, therefore, a system dynamics model is employed to investigate intended and unintended changes on the food system structure and on environmental impacts. Several human health‐oriented scenarios are implemented and tested with different production‐ and consumption‐side intervention strategies. Because all scenarios assuming an increase in the consumption of plant‐based products also involve higher consumption of dairy products, consequences for bovine meat need to be considered. The biological link between milk and bovine meat production leads to an unintended increase in bovine meat production as milk production increases. Intervention strategies at the consumption level thus need to be accompanied by intervention strategies at the agricultural production level. Similarly, intervention strategies that aim at improving health outcomes at the production level need to be accompanied by strategies that affect diets and thus consumption preferences. Avoiding instances of policy resistance requires integrated policy design and implementation across agriculture, the environment and human health. This integration is a challenge for farmers, the food industry and consumers alike. [ABSTRACT FROM AUTHOR]

Background: Mental disorders in the perinatal period (PMD) can severely harm women and their children if not detected early and treated appropriately. Even though mental health care is covered by health insurance and is used widely by women in the perinatal period in Switzerland, it is not known if the care provided is meeting the needs of the patients and is efficient in the view of health care professionals. The aim of this study is to identify strengths, gaps and requirements for adequate mental health care in the perinatal period from the perspectives of patients and care providers for a wide range of relevant mental disorders. Methods: In the qualitative study we conduct (1) semi-structured single interviews with former PMD patients to obtain narratives about their experiences and needs for health care for their condition. Women are included who have been treated for PMD but are mentally stable at the time of the interview (n = 24). We will stratify the sample by 4 clusters of relevant ICD-10 F-diagnoses, covering the most frequent and the most severe mental disorders. We will further stratify the sample based on whether the women already had experience with psychiatric or psychological health care or not before their last episode of PMD. We will also conduct (2) three interprofessional focus groups with health and social care professionals involved in perinatal care, and a health insurance representative. The focus groups will consist of 5–8 professionals. Data collection and thematic analysis will consider Levesque's et al. (2013) conceptual model on access to health care. Discussion: The study will provide fundamental data on the experiences and perspectives about perinatal mental health care from user and provider perspectives. The study will generate the evidence base needed to develop models of integrated, coordinated, patient- and family-centred care that is accessed by women with various types of PMD. Trial registration: The study was registered on ClinicalTrials.gov in November 2019 under the identifier NCT04185896. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic position (SEP) is an important contextual factor in the Stress Process Model of caregiving. However, the basic assumption that low SEP is associated with greater caregiver burden has so far lacked empirical support. The objective of this study was to investigate social inequalities in the caregiver burden among caregiving partners of persons with a physical disability, i.e., spinal cord injury (SCI), applying a dyadic approach. More specifically, we investigated 1) the association of the caregivers' SEP with caregiver burden ('actor effect'); 2) the association of the care-receivers' SEP with caregiver burden ('partner effect'), and 3) potential mediators of the association between SEP and caregiver burden. Methods: Cross-sectional survey data from 118 couples of persons with SCI and their partners living in Switzerland was used. We firstly employed logistic regression to investigate the actor and partner effects of SEP on objective (hours of caregiving) and subjective caregiver burden (Zarit Burden Interview). We additionally used structural equation modelling to explore whether unfulfilled support needs, psychosocial resources and the care-receivers health status mediated the association between SEP and caregiver burden. SEP was operationalized by household income, education, subjective social position, financial strain and home ownership. Results: We observed a consistent trend towards higher objective and subjective burden in lower SEP groups. Caregivers with higher subjective social positon and home ownership indicated lower subjective burden, and caregivers with higher education and absence of financial strain reported lower objective burden. Further evidence suggested a partner effect of SEP on caregiver burden, whereby objective caregiver burden was reduced in couples where the care-receiver had a higher educational level. The negative association between SEP and subjective burden was partially mediated by the unfulfilled support needs and deprived psychological resources of the caregiver, and the poor health status of the care-receiver. Similar mediation effects were not supported for objective burden. Conclusions: Our study, in the context of SCI, provides support for the contextual role of SEP in the Stress Process Model of caregiving. To reduce subjective caregiver burden, policy programs may target the strengthening of psychosocial resources, or the improvement of access to support services for caregivers with low SEP. [ABSTRACT FROM AUTHOR]

Fertility preservation is an increasingly important discipline. It requires close coordination between reproductive medicine specialists, reproductive biologists, and oncologists in various disciplines. In addition, it represents a particular health policy challenge, since fertility-protection measures are to be understood as a treatment for side effects of gonadotoxic treatments and would therefore normally have to be reimbursed by health insurance companies. Therefore, it is inevitable that fertility-preservation activities should organise themselves into a network structure both as a medical-logistic network and as a professional medical society. The necessary network structures can differ significantly at regional, national, and international level, as the size of the regions to be integrated and the local cultural and geographical conditions, as well as the political conditions are very different. To address these issues, the current review aims to point out the basic importance and the chances but also the difficulties of fertility-protection networks and give practical guidance for the development of such network structures. We will not only discuss network structures theoretically but also present them based on three established, different sized networks, such as the Danish Network (www.rigshospitalet.dk), representing a centralised network in a small country; the German-Austrian-Swiss network Ferti PROTEKT® (www.fertiprotekt.com), representing a centralised as well as decentralised network in a large country; and the Oncofertility® Consortium (www.oncofertility.northwestern.edu), representing a decentralised, internationally oriented network, primarily serving the transfer of knowledge among its members. [ABSTRACT FROM AUTHOR]

In multi-tiered states, subnational policymakers face a dilemma: on one hand, they must ensure the social legitimacy of their subnational unit by owning relevant policies including their potentially negative consequences; on the other, they have to manage their budget responsibly, which limits the scope of policy development. We study this dilemma in relation to social policies, by examining how the constituent units and municipalities in Germany, Italy, Spain and Switzerland deal with it, taking social assistance as an empirical example. Our analysis suggests that the combination of the federation's history and a multinational political context affects the incentives and the choices made by the policymakers regarding ownership and disownership of policy competencies in the field of social assistance. By analysing mechanisms that are likely to play out in multi-tiered welfare states, our article contributes to both the social policy and the political science literatures. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the intention to use pre-exposure prophylaxis (PrEP) when available and to identify predictors of the intention to use PrEP among men who have sex with men (MSM) living in Switzerland. The theoretical model drew on the Unified Theory of Acceptance and Use of Technology and considered additional variables related specifically to PrEP, HIV protection and the resources of MSM.Subject and methods: For data collection, we used an anonymous, standardized self-administered online questionnaire. In 2015, we gathered a convenience sample of 556 HIV-negative MSM living in Switzerland. We analyzed the data using descriptive and bivariate statistics and used structural equation modeling to test the hypothesized model.Results: Predictors of respondents’ moderate intention to use PrEP were performance expectancy, effort expectancy, perceived social influence, concerns about using PrEP, attitudes toward condom use, negative experiences of condom use and age. These variables were predicted by HIV protection-related aspects and resources.Conclusion: The findings provide insights into the complex dynamic underlying the intention to use PrEP. [ABSTRACT FROM AUTHOR]

The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals (4-12) to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework's five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. Background The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk et al. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Design Secondary analysis of a cross sectional survey. Methods Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. Results The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk et al.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk et al.'s original has only one. Conclusion The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. Relevance to clinical practice The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to evaluate the effectiveness of organisational strategies aimed at increasing professionals' confidence in Evidence-Based Practice, supporting its use and implementation. [ABSTRACT FROM AUTHOR]

Background: Prediction models in autosomal dominant polycystic kidney disease (ADPKD) are useful in clinical settings to identify patients with greater risk of a rapid disease progression in whom a treatment may have more benefits than harms. Mayo Clinic investigators developed a risk prediction tool for ADPKD patients using a single kidney value. Our aim was to perform an independent geographical and temporal external validation as well as evaluate the potential for improving the predictive performance by including additional information on total kidney volume.Methods: We used data from the on-going Swiss ADPKD study from 2006 to 2016. The main analysis included a sample size of 214 patients with Typical ADPKD (Class 1). We evaluated the Mayo Clinic model performance calibration and discrimination in our external sample and assessed whether predictive performance could be improved through the addition of subsequent kidney volume measurements beyond the baseline assessment.Results: The calibration of both versions of the Mayo Clinic prediction model using continuous Height adjusted total kidney volume (HtTKV) and using risk subclasses was good, with R2 of 78% and 70%, respectively. Accuracy was also good with 91.5% and 88.7% of the predicted within 30% of the observed, respectively. Additional information regarding kidney volume did not substantially improve the model performance.Conclusion: The Mayo Clinic prediction models are generalizable to other clinical settings and provide an accurate tool based on available predictors to identify patients at high risk for rapid disease progression. [ABSTRACT FROM AUTHOR]

We make use of both an ex post and an ex ante evaluation to analyze the Swiss payment for milk processed into cheese. This payment for each kilogram of raw milk processed into cheese is issued to milk producers through dairy processors. In the ex post evaluation, by applying a vector autoregressive model, we estimate the effects of reductions of the payment for prices of raw milk used to produce Emmentaler, Gruyère, and industrial cheese. Past declines in the payment have only been partially transmitted to raw milk prices. The rate of transmission is higher for milk used for the production of industrial cheese than for artisan cheeses. In the ex ante impact evaluation, we use a partial equilibrium model and develop a counterfactual scenario in which the payment is removed. The payment for milk processed into cheese is found to have effects on cheese production and exports but also has important indirect effects on other dairy products. Our findings suggest that about two-thirds of the payment are benefiting milk producers. At the same time, the overall welfare losses resulting from the elimination of the aid are smaller than the budget allocated to this measure, suggesting a net welfare gain from elimination. [ABSTRACT FROM AUTHOR]

Purpose: Many children are requiring tube weaning intervention as a result of increased survival rates of high risk infants and the temporary use of feeding tubes. This study aimed to describe service delivery models and treatment approaches in a variety of paediatric feeding/tube weaning programs. Method: A questionnaire on tube weaning was formulated based on a literature review. Purposive maximum variation sampling was used to include feeding/ weaning programs operating in a variety of settings and countries. Eight feeding teams in Australia, Europe and the USA agreed to participate and completed the questionnaire. Result: All teams employed sensori-motor interventions, with the majority also offering psychological interventions. Six of eight teams utilised hunger induction during the initiation of tube weaning, and in many cases this preceded eating skill development or controlled sensory modulation. Conclusion: A multi-model tube weaning approach is commonly adopted by many centres worldwide. In many cases, psychological theory and theoretical orientation is fundamental to tube weaning practice. Further investigation regarding the efficacy and effectiveness of weaning interventions is recommended to ensure clinical practice is based on sound evidence. This may present as a challenge given many interventions occur concomitantly and the psychotherapeutic experience is difficult to evaluate. [ABSTRACT FROM PUBLISHER]

Background: Land Use Regression (LUR) is a popular method to explain and predict spatial contrasts in air pollution concentrations, but LUR models for ultrafine particles, such as particle number concentration (PNC) are especially scarce. Moreover, no models have been previously presented for the lung deposited surface area (LDSA) of ultrafine particles. The additional value of ultrafine particle metrics has not been well investigated due to lack of exposure measurements and models.Methods: Air pollution measurements were performed in 2011 and 2012 in the eight areas of the Swiss SAPALDIA study at up to 40 sites per area for NO2 and at 20 sites in four areas for markers of particulate air pollution. We developed multi-area LUR models for biannual average concentrations of PM2.5, PM2.5 absorbance, PM10, PMcoarse, PNC and LDSA, as well as alpine, non-alpine and study area specific models for NO2, using predictor variables which were available at a national level. Models were validated using leave-one-out cross-validation, as well as independent external validation with routine monitoring data.Results: Model explained variance (R(2)) was moderate for the various PM mass fractions PM2.5 (0.57), PM10 (0.63) and PMcoarse (0.45), and was high for PM2.5 absorbance (0.81), PNC (0.87) and LDSA (0.91). Study-area specific LUR models for NO2 (R(2) range 0.52-0.89) outperformed combined-area alpine (R (2)  = 0.53) and non-alpine (R (2)  = 0.65) models in terms of both cross-validation and independent external validation, and were better able to account for between-area variability. Predictor variables related to traffic and national dispersion model estimates were important predictors.Conclusions: LUR models for all pollutants captured spatial variability of long-term average concentrations, performed adequately in validation, and could be successfully applied to the SAPALDIA cohort. Dispersion model predictions or area indicators served well to capture the between area variance. For NO2, applying study-area specific models was preferable over applying combined-area alpine/non-alpine models. Correlations between pollutants were higher in the model predictions than in the measurements, so it will remain challenging to disentangle their health effects. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aimed at developing and implementing evidence-based patient and family education on oral anticoagulation therapy. Background The number of persons with chronic diseases who live at home is increasing. They have to manage multiple diseases and complex treatments. One such treatment is oral anticoagulation therapy, a high risk variable dose medication. Adherence to oral anticoagulation therapy is jeopardised by limited information about the medications, their risk and complications, the impact of individual daily routine and the limited inclusion of family members in education. Hence, improved and tailored education is essential for patients and families to manage oral anticoagulation therapy at home. Design and methods A community-based participatory research design combined with the Precede-Proceed model was used including a systematic literature review, posteducation analysis, an online nurse survey, a documentation analysis and patient/family interviews. The study was conducted between April 2010-December 2012 at a department of general internal medicine in a teaching hospital in Switzerland. Participants were the department's nursing and medical professionals including the patients and their families. Results The evidence-based patient and family education on oral anticoagulation therapy emerged comprising a learning assessment, teaching units, clarification of responsibilities of nurse professionals and documentation guidelines. Conclusion and clinical relevance The inclusion of the whole department has contributed to the development and implementation of this evidence-based patient family education on oral anticoagulation therapy, which encompasses local characteristics and patient preferences. This education is now being used throughout the department. [ABSTRACT FROM AUTHOR]

Psychological characteristics are crucial to identifying talents, which is why these are being incorporated in today’s multidimensional talent models. In addition to multidimensionality, talent studies are increasingly drawing on holistic theories of development, leading to the use of person-oriented approaches. The present study adopts such an approach by looking at the influence that motivational characteristics have on the development of performance, in a person-oriented way. For this purpose, it looks at how the constructs achievement motive, achievement goal orientation and self-determination interact with one another, what patterns they form and how these patterns are linked to subsequent sports success. Ninety-seven top young football players were questioned twice. Another year later, it was enquired which of these players had been selected for the U15 national team. At both measuring points, four patterns were identified, which displayed a high degree of structural and individual stability. As expected, thehighly intrinsically achievement-oriented playerswere significantly more likely to move up into the U15 national team. The results point to the importance of favourable patterns of motivational variables in the form of specific types, for medium-term performance development among promising football talents, and thus provide valuable clues for the selection and promotion of those. [ABSTRACT FROM AUTHOR]

Introduction and Aims This study investigated the associations of alcohol outlet density with specific alcohol outcomes (consumption and consequences) among young men in Switzerland and assessed the possible geographically related variations. Design and Methods Alcohol consumption and drinking consequences were measured in a 2010-2011 study assessing substance use risk factors (Cohort Study on Substance Use Risk Factors) among 5519 young Swiss men. Outlet density was based on the number of on- and off-premise outlets in the district of residence. Linear regression models were run separately for drinking level, heavy episodic drinking ( HED) and drinking consequences. Geographically weighted regression models were estimated when variations were recorded at the district level. Results No consistent association was found between outlet density and drinking consequences. A positive association between drinking level and HED with on-premise outlet density was found. Geographically weighted regressions were run for drinking level and HED. The predicted values for HED were higher in the southwest part of Switzerland ( French-speaking part). Discussion and Conclusions Among Swiss young men, the density of outlets and, in particular, the abundance of bars, clubs and other on-premise outlets was associated with drinking level and HED, even when drinking consequences were not significantly affected. These findings support the idea that outlet density needs to be considered when developing and implementing regional-based prevention initiatives. [Astudillo M, Kuendig H, Centeno-Gil A, Wicki M, Gmel G. Regional abundance of on-premise outlets and drinking patterns among Swiss young men: District level analyses and geographic adjustments. Drug Alcohol Rev 2014;33:526-33] [ABSTRACT FROM AUTHOR]

Background: What constitutes best practice in the area of intersex, renamed Disorders/differences of sex development (DSD/dsd) or even variations of sex development (VDS) after the ‘‘Chicago consensus’’? What kind of model of care would meet the requirements of an ethical management of intersex/dsd/VDS? Methods: In 2005, we launched an interdisciplinary SHS and gender medicine project to improve the standards of care for persons with intersex/dsd/VDS. Abroad, this project, initiated in Lausanne, has sometimes been called the ‘‘Swiss Model’’. It includes the development of an interdisciplinary team, based at the University hospital CHUV, who takes care of persons born with intersex/dsd/VDS and also teaches an ethical model of care to students at the Medical School of the University of Lausanne. The ‘‘Swiss Model’’ is centered on the children’s fundamental rights to bodily integrity, self-determination and genital autonomy. We describe our 10 years’ experience, the reasons, goals and development modalities of our team and model of care. Results: We have developed a medical ethics ‘‘from below’’ to overcome the lack of ethical recommendations, as it was the case until 2012 in Switzerland. During this period of time, genital surgeries and other non-vital medical treatments have been postponed until the child could fully participate in the medical decisions and give one’s informed assent or consent. Only one family did not follow our recommendations. Conclusions: The Lausanne experience testifies to the possibility of changing the so-called Johns Hopkins paradigm in actual practice. The model of care we have implemented can define best practice as it is scientifically grounded, medically reasonable, and ethically consistent. [ABSTRACT FROM AUTHOR]

Faults in the host rock that might exist in the vicinity of deep geological repositories for radioactive waste, constitute potential enhanced pathways for radionuclide migration. Several processes might trigger pore pressure increases in the faults leading to fault failure and induced seismicity, and increase the faults' permeability. In this research, we developed a mathematical model to simulate fault activation during an experiment of controlled water injection in a fault at the Mont-Terri Underground Research Laboratory in Switzerland. The effects of in-situ stress, fault shear strength parameters and heterogeneity are assessed. It was shown that the above factors are critical and need to be adequately characterized in order to predict the faults' hydro-mechanical behaviour. [ABSTRACT FROM AUTHOR]