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PubMed2001

Comparative soil sampling in the Dornach site (Switzerland) for soil three-dimensional pollution description.

Fifteen institutions from 13 European countries and Switzerland participated in a comparative test sampling at the Dornach site, near Basel in Switzerland. They received the site description and were asked to develop their own sampling plans, based on their national guidelines for a three-dimensional description of the Pb, Zn, Cu and Cd pollution, with a maximum of 15 samples. The comparative sampling test took place in late August 1997. The sampling plans and records, provided by the participants, were compared and evaluated in terms of sampling strategy throughout the site, the sampling strategy inside the sampling unit, strategy at the sampling point and last minute alteration of the sampling plans in the field. The object of this was to define the similarities and the differences in the sampling plans and identify the crucial steps inducing error or uncertainty which should be harmonized throughout Europe. The number of the total composite samples varied from 4 to 16, while the number of sampling points varied from 4 to 224 and the sampling density varied from 0.25 to 16 single samples per 100 m2. The number of 10 x 10 m2 quadrats from which samples were taken varied from 3 to 56, out of the total 61. The number of sampling units varied between 3 and 12. The criteria in descending order of frequency were: both land use and pedology, land use, pedology. The majority of the national participants divided the sampling units into two or three sub-units, while seven participants collected replicate composite samples from the same sampling unit. Only one sampled from the existing profiles, eight national representatives ignored the plough depth. The sampling pattern inside the sampling unit was in descending order of frequency: random, point sampling, regular, 'W' and 'X' shaped sampling. The number of single samples in the composite varied from 1 to 20. Most of the national participants sampled to pre-defined (ad-hoc) sampling depths, while others sampled soil horizons and others both. The maximum soil depth sampled also varied from 20 to 117 cm. Most participants mixed in the top organic matter horizon while others sampled it separately. Most sampled separately the top Ah horizon in the forest while the rest mixed it with the underlying soil horizon. The last-minute sampling plan alterations were in: the sampling depth (nine), the movement of sampling points (five), the reduction of sub-samples in the composite sample (four), changes in the number of sampling units (three), ignoring the bottom sample (three), not sampling the L/H layer (three) although this was planned, unplanned sampling of the L/H layer (two) and changing the number of planned samples (two). This study has highlighted the need for soil sampling harmonization throughout Europe for pollution and soil quality determination.

Environmental Monitoring↗
PubMedDate not supplied

Decision making of nurses practicing in intensive care in Canada, Finland, Northern Ireland, Switzerland, and the United States.

In this study, our intention was to describe the decision making of nurses practicing in intensive care, and the differences of nurses' decision making in Canada, Finland, Northern Ireland, Switzerland, and the United States. The instrument used in the study was a 56-item Likert-type questionnaire that has been used in previous studies and has proved to be a reliable tool. The target group comprised a nonrandom sample of nurses (N = 314) from five countries. The samples are not representative; therefore, the results in these cases cannot be generalized. The results showed that the decision making of nurses practicing in intensive care was broadly based, and that there were some country differences in data collection, problem definition, and planning. In contrast, decision making related to the implementation and evaluation of nursing is quite similar in the different countries. Canada and the United States on the one hand, and Finland, Northern Ireland, and Switzerland on the other, showed more similarities with each other in data collection, problem definition, and nursing planning related to decision making. Neither experience nor nurse's knowledge structure was associated with different decision-making approaches.

Canada↗
PubMed1997

Calf health in cow-calf herds in Switzerland.

In 1993, an observational study was initiated to provide general information on animal health in extensive beef farms, to estimate disease frequency and the economic impact of calf diseases and to identify risk factors related to health and weight gain. The longitudinal study was conducted from fall 1993 until winter 94/95 and included 100 farms in western Switzerland. The basic concept was to follow one generation of calves on these farms and record all events concerning animal health from birth to weaning. The study population included 1270 calves (most were Angus crossbreds). Farm-management data were collected with a questionnaire conducted on the farm. Birth and weaning weights were obtained from the beef cattle breeding association. Clinical diagnoses and treatment costs were provided by the farm veterinarians. Two thirds of the dead calves were submitted to a complete postmortem examination. Fifty-three percent of the farms in the study were primary type income farms while 47% were secondary type income farms. Thirty-eight percent of the farms were situated in the lower areas of Switzerland, 14% in the prealpine foothills, the remaining 48% were located in mountain areas. Preweaning calf mortality was 5%. The main causes of calf deaths were respiratory diseases and digestive disorders. Twenty-two percent of the calves were treated at least once by a veterinarian; 36% of the treatments administered by the veterinarian were applied because of diarrhea, 27% because of respiratory diseases. Disease incidence was highest during the months of November, December and January. The association of disease and potential farm-level risk factors was analysed using chi 2-statistics and multivariable regression methods including generalized estimating equations to adjusted for herd effects. Specific risk factors for disease were not identified. Treatment for disease was not associated with 250-day standardized weight gain.

Aging↗
PubMed2003

Risk adjustment in Switzerland.

In Switzerland the new law on Health Insurance, effective since 1996, introduced pro competitive changes in the market of sickness funds. The legislator expected high mobility between sickness funds of both healthy and sick insured as open enrolment was introduced with the new law. That is why the risk adjustment scheme, that was already introduced 1993, was limited until 2005. However, consumer mobility remained low and risk selection strategies are still profitable, since risk-adjustment is based only on demographic variables. This paper describes risk adjustment, consumer mobility, risk selection activities of sickness funds and the impact of imperfect risk adjustment on the development of HMO and PPO models. The paper concludes with a description of the current political and scientific discussion in Switzerland.

Capitation Fee↗
PubMed2006

[CT utilisation in Switzerland: frequency and secular trends].

PURPOSE: This study analyzes CT examinations in Switzerland. MATERIALS AND METHODS: Using different sources (administrative data on the equipment, a 1998 nationwide inquiry into practices, and data provided by the Swiss University Hospitals of Basel, Zurich, and Lausanne), we determined the frequency of CT examinations (hospitals and private radiologists) in 1998 according to different descriptive variables and studied the progression in CT use over time. RESULTS: CT scanners increased by 7% between 1998 and 2004. The average annual number of CT examinations in 1998 was 46.3/1000 population, 3.4% of all radiological examinations in Switzerland in 1997-1998. The most frequent examination was CT of the skull (24%), while private radiology institutes perform more CTs of the spine. More CT examinations were performed for men than for women (sex ratio M/F=1.17). The average annual increase in CT in Swiss hospitals varied from 8% for Basel to 18% for Lausanne. Finally, the proportion of pediatric examinations was 5%; their numbers appear to be stabilizing. CONCLUSION: There is a significant increase in CT examinations. It is hoped that our study will heighten awareness among doctors of CT examinations in order to optimize their use.

Humans↗
PubMed2003

The information network of senior citizens in Geneva, Switzerland, and progress in flu vaccination coverage between 1991 and 2000.

Switzerland has lagged behind other industrialized countries in increasing vaccination coverage against flu in the elderly population. The information campaign "United against Flu", started in Geneva in 1993, gradually extended to other French and Italian speaking cantons in Switzerland and indirectly affected German-speaking cantons. Activities developed include the production of TV spots, press conferences, information forwarded to health professionals, an Internet site and information material such as leaflets and posters to risk groups. The campaign is evaluated by repeated surveys that measure vaccination coverage as well as network of informants, knowledge and perceptions in the geriatric population. Vaccination coverage of the geriatric population in Geneva canton has increased from 29% in 1991 to 59% in the year 2000.

Aged↗
PubMed2003

Ozone air pollution and foliar injury development on native plants of Switzerland.

The objectives of this study were to examine the foliar sensitivity to ozone exposure of 12 tree, shrub, and herbaceous species native to southern Switzerland and determine the seasonal cumulative ozone exposures required to induce visible foliar injury. The study was conducted from the beginning of May through the end of August during 2000 and 2001 using an open-top chamber research facility located within the Lattecaldo Cantonal Forest Nursery in Canton Ticino, southern Switzerland (600 m asl). Plants were examined daily and dates of initial foliar injury were recorded in order to determine the cumulative AOT40 ppb h ozone exposure required to cause visible foliar injury. Plant responses to ozone varied significantly among species; 11 species exhibited visible symptoms typical of exposures to ambient ozone. The symptomatic species (from most to least sensitive) were Populus nigra, Viburnum lantana, Salix alba, Crataegus monogyna, Viburnum opulus, Tilia platyphyllos, Cornus alba, Prunus avium, Fraxinus excelsior, Ribes alpinum, and Tilia cordata; Clematis spp. did not show foliar symptoms. Of the 11 symptomatic species, five showed initial injury below the critical level AOT40 10 ppmh O3 in the 2001 season.

Air Pollutants↗
PubMed2002

Current laparoscopic practice patterns in urology: results of a survey among urologists in Germany and Switzerland.

OBJECTIVES: A survey was performed to assess the current practice patterns in laparoscopy among urologists in Germany and Switzerland. METHODS: Using the database directory of the German and Swiss Urological Association urological departments were identified. A detailed questionnaire was designed and sent by postal service. Responding questionnaires were analyzed. RESULTS: The overall response rate was 64%. Fifty-four percent of respondents in Germany and 33% in Switzerland already perform laparoscopy; another 50% and 56% are planning to introduce laparoscopy. Thirty-six percent think that laparoscopy is economical and 77% await shortening of hospital stay. Major concerns are: Economical aspects, lengthy learning curve, investment, and lack of scientific data. The number of laparoscopic procedures during 12 months was registered for 19 indications. More than 40 procedures for one indication are performed by only 6% of the departments. CONCLUSIONS: The survey reveals an increasing number of departments performing laparoscopy and broad acceptance of the technology but combined with some major concerns. Currently only a minority of the departments perform more than 40 procedures for one indication suggesting that at present laparoscopy is mainly a center-based technology.

Data Collection↗
PubMed2002

Serological cross-sectional survey of psoroptic sheep scab in Switzerland.

Sheep scab, caused by the mite Psoroptes ovis, is a notifiable disease in Switzerland. Mandatory prophylactic treatments are carried out in spring for all sheep grazing on common alpine pastures. Despite these strict control measures the number of outbreaks has been increasing in recent years, raising questions on the spread of this epizootic disease. To improve the traditional microscopic diagnosis, we developed an ELISA for the specific determination of antibodies against psoroptic antigens with sensitivity and specificity of 93.7 and 96.5%, respectively. Using this test, a serum bank, representative of the sheep population in Switzerland (approximately 15% of registered sheep flocks, randomly chosen, collected between February and May 1998), was screened. The prevalence using 16,404 sera was 10.4, and 11.9% of the 2083 flocks were diagnosed as positive. Additionally, there was a significant increase found for mean seropositivity relative to the flock size (P<0.001, linear regression). Therefore, larger flocks had a higher risk of sheep scab, which may be caused by more frequent animal movement. Spatial analysis of the results revealed a region with significantly higher risk (relative risk = 3.5, P<0.001) of seropositivity, where no cases have officially been notified in the period between 1997 and 1999. The next goal is to establish an efficient control strategy based on serological monitoring of the total sheep population.

Animals↗
PubMed1997

Epidemiological investigation of trichinellosis in Switzerland.

Domestic pigs in Switzerland have been considered Trichinella-free for decades, despite the occurrence of Trichinella in the wildlife cycle. In order to reevaluate the present epidemiological situation, tissue samples from 11226 domestic pigs, 356 wild boars and 452 foxes were examined using the standard artificial digestion method. A simultaneous serological study, extended to include 25239 sera from sows provided by a Swiss pig serum bank, was also undertaken. The results of both studies support the conclusion that Trichinella spp. do not occur within the domestic pig population in Switzerland. Among the fox population, Trichinella was detected in four (0.9%) of the animals tested using the digestion method, and Trichinella britovi was identified as the infecting species by RAPD fingerprint analyses.

Animals↗
PubMed2001

Characterization of enterotoxigenic Staphylococcus aureus strains isolated from bovine mastitis in north-east Switzerland.

Thirty-four strains of enterotoxin-producing Staphylococcus aureus obtained from milk samples of 34 dairy cows suffering from mastitis from 34 different farms in north-east Switzerland were identified and further characterized by pheno- and genotypic methods. This included the identification of staphylococcal enterotoxin (SE) types, an antibiotic resistance testing, the appraisal of hemolysis, the egg yolk reaction, the detection of the clumping factor and protein A by means of a latex agglutination, the PCR amplification of a S. aureus specific part of the gene encoding the 16S-23S rRNA "intergenic spacer" region and a species specific part of the 23S rRNA-gene, the PCR amplification of the clumping factor (clfA) gene, the X region and the IgG-binding region of the protein A (spa) gene, the coagulase (coa) gene and additionally a macrorestriction analysis of the chromosomal DNA. Within the 26 cultures which formed a single SE, there were 23 SEC- and three SED-formers. Eight cultures were SEAD formers. It was remarkable that 22 SEC formers were also positive for TSST-1. Eighteen of the 23 SEC-formers could be classified as being of the same phenotype. Most of the cultures of one enterotoxin type also showed a great uniformity in the size and number of repeats of the X region as well as in the size of the IgG-binding region of protein A gene and in the size of the coagulase gene. Macrorestriction analysis revealed 11 PFGE patterns. These were in part only different from each other in a few fragments and thus displayed close clonal relations. The results of the present investigation show that a broad distribution of identical or closely related enterotoxin-producing S. aureus clones seem to contribute to the bovine mastitis problem in north-east Switzerland.

Animals↗
PubMed2000

The challenge of identification following the tragedy of the Solar Temple (Cheiry/Salvan, Switzerland).

On October 5, 1994, 48 members of the Sect of the Solar Temple were found dead at two different locations in Switzerland: 23 victims in Cheiry and 25 victims in Salvan. Our Institute was commissioned to solve the forensic problems presented by this tragedy. Our goals were to establish the time of death, determine its causes, help elucidate the surrounding circumstances and identify the victims. This work presented us with the following challenges. This catastrophe was of an 'open' type: there was no list of 'passengers'; the victims were of five different nationalities and many had just arrived in Switzerland to participate in this event; family ties were very complex within this group; half of the victims were burned and sometimes charred; the exceptionally intense media converage of the story put a lot of pressure on the investigators and our Institute. In spite of these difficulties, all the victims were positively identified within 1 month. In the present report, we describe the steps realized to progress in our work. A special section describes our relationship with the journalists and their invaluable help in our investigations. The importance of being prepared for such an event is discussed.

Disasters↗
PubMed2001

Medical prescription of heroin to chronic heroin addicts in Switzerland - a review.

In 1994, a new project dealing with the treatment of heroin dependency was introduced in Switzerland. A group of heavy opiate addicts, who had failed in previous medical therapies, received heroin by prescription, supported by health and social services. The admission criteria to this treatment are summarized as the main results of this project: physical and mental health of the addicts improved on average during treatment, an improvement also took place in their social reintegration, a significant decrease in consumption of illegal drugs took place and illegal activities declined massively. The proportion of patients who continued the treatment in a time period of 12 months was held at 76%. Comparison of the treatment costs with the economic benefits shows that there is a total benefit per patient and per day of 26 US dollars. Further drug related political decisions in Switzerland as well as the assessments of the International Narcotics Control Board (INCB) of the United Nations to this project will be reported and discussed.

Adult↗
PubMed1997

[Intracranial pressure monitoring in France, and French-speaking Belgium and Switzerland. Retrospective and prospective survey].

OBJECTIVE: To assess the use of ICP monitoring in France and French-speaking Belgium and Switzerland. PARTICIPANTS: Neuro-intensive care unit (ICU) and neuroanaesthesia teams. METHODS: Retrospective survey (concerning the year 1995), followed by a prospective one (spread over a period of 4 months in 1996) about policy concerning: frequency, delay, duration, indications, complications and cost of ICP monitoring in their units. Other questions were: type of devices, duration of the device insertion, operators and place of operating. RESULTS: Out of the 77 units which replied, 54 regularly carried out ICP monitoring, corresponding to a total of 2,012 patients in 1995. Only 23 participated in the prospective survey (301 patients). Out of the 54 hospitals, 25 assessed the ICP in more than 50 patients per year. Head trauma was the main indication for ICP monitoring (61%), the second indication was intracranial haemorrhage (23% of patients). The most often monitored patients were young males for head trauma, whereas females were mainly monitored for intracranial haemorrhage. The delay for starting ICP monitoring was 16 hours and was maintained for 7 days in head trauma patients. Intraventricular catheter and fibreoptic devices were chosen in the same proportion, a subdural system was used in 8% of the cases. The devices were inserted by neurosurgeons in 80% of cases, anaesthetists also participated in this operation. Risk of haemorrhage was very low (0.7%), the risk of infection was 4% and always concerned intraventricular catheters. CONCLUSION: ICP monitoring is widely practised in France and French-speaking Belgium and Switzerland, especially for traumatic brain injury in young males. Anaesthetists mainly took part in the operation, especially for the fibreoptic devices.

Adult↗
PubMed2002

Rhipicephalus ticks infected with Rickettsia and Coxiella in Southern Switzerland (Canton Ticino).

Ticks of the Rhipicephalus sanguineus species complex may be vector of various pathogens including Rickettsia conorii (the etiological agent of the Mediterranean spotted fever) and Coxiella burnetii (cause of the Query (Q) fever). R. sanguineus ticks have been imported in several parts of central and northern Europe, especially in environments such as kennels and houses providing the appropriate microclimatic conditions and the blood source necessary for their survival. Since 1940 these ticks have occasionally been recorded in Switzerland. In Ticino (the southern part of Switzerland), they have been reported since 1980 and their probable establishment in this area has been suggested in the '90s. By means of PCR and direct sequencing, we tested the identity of these ticks (using 12S rDNA gene) and the occurrence of Rickettsia spp. (using 16S rDNA, gltA and OmpA genes) as well as Coxiella sp. (using 16S rDNA). The results indicated that in Ticino, two different tick species coexist, i.e. R. sanguineus sensu stricto and Rhipicephalus turanicus. A few individuals of R. sanguineus sensu stricto are infected with Rickettsia massiliae/Bar29, which are strains of unknown pathogenicity. Coxiella sp., an endosymbiont of Rhipicephalus ticks, has also been identified in both tick species. Due to climatic changes towards global warming, imported tick species may therefore adapt to new area and might be considered as epidemiological markers for a number of infectious agents transmitted by them.

Animals↗
PubMed1994

The HSR on chromosome 1 of the house mouse, Mus domesticus: distribution and frequency in Switzerland.

A total of 357 house mice (Mus domesticus) from 83 localities uniformly distributed throughout Switzerland were screened for the presence of a homogenously staining region (HSR) on chromosome 1. Altogether 47 mice from 11 localities were HSR/+ or HSR/HSR. One sample of 11 individuals all had an HSR/HSR karyotype. Almost all mice with the variant were collected from the Rhone valley (HSR frequency: 61%) and Val Bregaglia (HSR frequency: 81%). For samples from most of the area of Switzerland, the HSR was absent. There was no strong association between the geographic distribution of the HSR and the areas of occurrence of metacentrics. However, at Chiggiogna the HSR was found on Rb (1.3). Possible explanations for the HSR polymorphism are discussed.

Animals↗
PubMed2000

Health technology assessment in Switzerland.

Switzerland has a mixed public and private healthcare system. All citizens are enrolled in compulsory basic health insurance. A 1996 law allows people to choose among different sickness funds and managed care plans. The federal government is empowered to act on important health issues, but the 26 cantons have prime responsibility in health care and social welfare. They have their own laws on health care, hygiene, hospitals, and social welfare. These laws are not harmonized. The system is complex, with a mix of public (mainly hospitals) and private (mainly doctors' offices) providers. The health services are decentralized. Ambulatory care was traditionally provided in doctors' offices, but the last decade has seen the development of centers for day surgery, group practices, and managed care plans. Decisions on placement, location, and extension of services are decentralized. The payment system is very complex. Current trends include global budgets, cost analyses, and prices related to patient categories. However, coverage policy is developed centrally and includes both traditionally established services and new technologies. New technologies are added to the list only after evaluation by the Federal Coverage Committee. The coverage process integrates health technology assessment (HTA). Coverage can be granted in stages, including limited coverage and temporary coverage. Technologies and coverage can be reevaluated on the basis of registries or assessment information. The structure of the Swiss healthcare system does not lend itself to the establishment of a national HTA program. However, recent moves include the development of a coordinating mechanism for HTA in Switzerland.

Delivery of Health Care↗
PubMed2003

Genotyping of Cryptosporidium spp. isolated from human stool samples in Switzerland.

In a study to estimate the frequency of Cryptosporidium infections in Switzerland, stool samples from patients found to be positive for Cryptosporidium spp. by modified Ziehl-Neelson staining and fluorescence microscopy were used for genotyping experiments. With 9 of 12 samples, DNA extraction and subsequent genotyping was successful. All Cryptosporidium-isolates belonged to the bovine genotype. In one stool sample, two strains of Cryptosporidium were demonstrated, suggesting a mixed infection. In comparison with reference strains from calves, one of the isolates showed a full sequence identity and the other a similarity of 97.5%. The fact that only bovine genotypes were detected suggests, that cryptosporidiosis must primarily be considered as a zoonotic disease in Switzerland. This is in contrast to other countries, where the human genotype of C. parvum was shown to dominate the epidemiological situation. The results of our study are supported by the previous finding, that two of the analysed strains originated from patients who used to consume raw milk or raw cream, a known risk factor for cryptosporidiosis.

Animals↗