Tind Technologies (Norway)
Hes-so: ArODES Open Archive (University of Applied Sciences and Arts Western Switzerland / Haute école spécialisée de Suisse occidentale / FH Westschweiz)Not a member yet
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Wie ist die Pflegekinderhilfe in der Schweiz organisiert? ::Rechtsgrundlagen, Organisationsmodelle und Zuständigkeiten
No full textGeneral practitioners’ management of occupational diseases ::a qualitative study in French-speaking Switzerland
No full textBackground: Work-related health problems are a frequent reason for consultation with primary care physicians; however, few studies report on the way general practitioners’ (GPs) approach work-related health issues with their patients. Aim: To investigate the practices of Swiss GPs in regarding work-related health issues presented by their patients, and to identify the resources and difficulties they faced. Methods: Semi-structured interviews were conducted with 12 GPs, transcribed, and analyzed thematically. Results: GPs do explore their patients' occupational field. However, the data collected are limited, even though doctors recognize that a high proportion of mental and musculoskeletal disorders may be work-related. Work-related disease insurance issues are a frequent concern in GPs everyday practice, often causing a discomfort regarding these issues. Exchanges between GPs and employers regarding work-related health issues are relatively uncommon but can yield positive outcomes when they occur. Occupational risk prevention is confined to certain high-risk exposures. When asked to express their difficulties in dealing with work-related issues, GPs mention the lack of dedicated time, insurance issues, contact with employers or the lack of it and lack of training. As for resources, GPs mainly identify specialist doctors, but still, only few of them mention occupational physicians. Conclusions: Some work-related pathologies, whether frequent or serious, are not systematically investigated by GPs. This raises the question of their detection and probable under-reporting. To improve anamnesis, identification, and referral practices for occupational health issues, we suggest a targeted training for GPs, strengthened networking among stakeholders—such as occupational physicians, employers and insurers- and a revision of medical billing structures to better support the management of work-related diseases for both GPs and occupational physicians
Recommandations relatives aux traitements physiothérapiques des prolapsus gynécologiques
No full textAcromioclavicular fixation Bbfore coracoclavicular tunnel placement and acromioclavicular construct design improved reduction and stability in a whole-shoulder girdle model::a pilot study
No full textBackground: Reconstruction of the acromioclavicular (AC) ligament after an acute AC dislocation as the first surgical step before coracoclavicular (CC) tunnel placement has been proposed to reduce the risk of postoperative loss of reduction. Additional reconstruction of AC ligamentous complex lesions with different types of bracing constructs has also been described to improve outcomes. Still, the effect of the sequence of surgical steps and the AC bracing construct design on the AC kinematics in a whole-shoulder girdle model has not been reported. Hypothesis: The primary hypothesis was that postoperative AC joint reduction would improve when the AC joint was reconstructed before CC tunnel placement. The secondary hypothesis was that different AC bracing construct designs affect joint kinematics during physiological motion in a whole-shoulder girdle model. Study design: Controlled laboratory study. Methods: Five cadaveric specimens (10 shoulders) were prepared for whole-shoulder mobilization with a robotic manipulator. Joint kinematics was acquired during physiological motions using an optical motion capture system. Recorded parameters were (1) the joint reduction in a resting position, expressed as joint displacements and rotations compared with an intact AC joint, and (2) the joint stability during all tested motions, expressed as joint displacements and rotations. The tested joint conditions were intact AC joint, induced Rockwood type 5 lesion, isolated CC reconstruction, and 4 AC joint bracing construct designs. AC reconstruction was performed before (AC-first technique) and after (CC-first technique) CC tunnel placement in 5 shoulders each. Results: The AC-first surgical step improved the AC joint reduction in anterior-posterior tilt compared with CC-first (median difference, -9.4°; P < .001). The AC-first surgical step also demonstrated an increased superior-inferior joint reduction with hyperreduction (median difference, 1.6 mm; P = .041) compared with CC-first. Dispersion of joint reduction values was reduced with the AC-first step and particularly for anterior-posterior tilt (IQR difference, -4.8°) and lateral-medial displacement (IQR difference, -3.4 mm). The double vertical bracing construct design increased the AC joint stability compared with other constructs and reached a statistical significance in all rotational displacement (P < .001 to P = .041) as well as in lateral-medial displacement (P = .001 to P = .015). Conclusion: The AC-first surgical step sequence improved AC joint alignment in the scapular sagittal plane and increased joint hyperreduction. The double vertical bracing construct design achieved the highest joint stability over other tested designs during passive motion. Clinical relevance: The restoration of the preinjury joint alignment and the optimization of the joint stability may improve outcomes and reduce the risk of construct de-tensioning during the rehabilitation phase
Personzentrierte Wundversorgung
No full textHintergrund : Internationale Vereinigungen fordern mit „Personzentrierter Versorgung (PZV)“ ein statt auf Krankheitsbilder auf „Menschen mit“ chronischen Krankheiten ausgerichtetes Versorgungskonzept. Fragestellung : Darstellung des Konzeptes und seiner Legitimation, bezogen auf die Versorgung von Menschen mit chronischen Wunden. Material und Methode : Narratives Review, Identifikation und Analyse von Übersichtsarbeiten sowie konzeptuellen Grundlagen, Praxisbeispiele, Diskussion einer Umsetzung. Ergebnisse : Eine PZV orientiert sich an den gesundheitlichen Bedürfnissen und Erwartungen sowie Werten und Überzeugungen der Menschen und nicht an Krankheiten, Symptomen und klinischen Daten. Inhalte sind u. a., dass die betroffenen Menschen die Unterstützung und Ausbildung erhalten, um Entscheidungen zu treffen und an ihrer eigenen Versorgung mitzuwirken. Für Evaluationen zur Umsetzung der PZV werden v. a. Teilkomponenten wie Kommunikation oder gemeinsame Entscheidungsfindung gemessen und patientenbezogene Ergebnismessungen (PROM) und Erfahrungsmessungen (PREM) genutzt. Größte Barrieren für die Umsetzung des Konzeptes sind ein auf die Akutversorgung ausgerichtetes Gesundheitssystem, mangelnder Einbezug der Patienten in Entscheidungen sowie unzureichende kommunikative Kompetenzen und krankheitsbezogene Haltungen. Eine erfolgreiche Umsetzung bedarf kultureller, struktureller und organisatorischer Maßnahmen. Schlussfolgerungen : Es braucht Überzeugung und langen Atem, um eine PZV im klinischen Alltag umzusetzen. Organisationen müssen sich darauf einlassen wollen. Die Deutsch-Österreichisch-Schweizerische Wundheilungsorganisation (WundD.A.CH) hat die Förderung der Umsetzung als einen Schwerpunkt identifiziert
Verschuldung ::die gesundheitlichen und sozialen Folgen
No full textVerschuldung ist in der Schweiz ein weitverbreitetes Phänomen. Eine Studie der Hochschule für Soziale Arbeit und Gesundheit in Lausanne zeigt auf, dass Zahlungsrückstände die psychische und physische Gesundheit der Betroffenen stark beeinträchtigen. Die Studie zeigt zudem einen geschlechtsspezifischen Umgang mit Schulden und schlägt Massnahmen auf mehreren Ebenen vor
Influence of graft type on muscle contractile dynamics after ACL reconstruction: A 9-month tensiomyographic follow-up
No full textBackground: Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) are frequently attributed to arthrogenic muscle inhibition (AMI). The type
of autologous graft used may influence the trajectory of neuromuscular recovery. Objective:
To investigate the influence of graft type—bone–patellar tendon–bone (BPTB), hamstring
tendon (HT), and quadriceps tendon (QT)—on the contractile properties of periarticular
knee muscles over a 9-month post-operative period. Hypothesis: Each graft type would
result in distinct recovery patterns of muscle contractility, as measured by tensiomyography
(TMG). Methods: Thirty-one patients undergoing ACLR with BPTB (n = 8), HT (n = 12), or
QT (n = 11) autografts were evaluated at 3, 6, and 9 months post-operatively. TMG was used
to measure contraction time (Tc) and maximal displacement (Dm) in the rectus femoris,
vastus medialis, vastus lateralis, and biceps femoris. Results: Significant within-group
improvements in Tc and Dm were observed across all graft types from 3 to 9 months (Tc:
p < 0.001 to p = 0.02; Dm: p < 0.001 to p = 0.01). The QT group showed the most pronounced Tc reduction in RF (from 30.16 ± 2.4 ms to 15.44 ± 1.6 ms, p < 0.001) and VM (from
31.05 ± 2.6 ms to 18.65 ± 1.8 ms, p = 0.004). In contrast, HT grafts demonstrated limited Tc
recovery in BF between 6 and 9 months compared to BPTB and QT (p < 0.001), indicating a
stagnation phase. BPTB exhibited persistent bilateral deficits in both quadriceps and BF at
9 months. Conclusions: Autograft type significantly influences neuromuscular recovery
patterns after ACLR. TMG enables objective, muscle-specific monitoring of contractile
dynamics and may support future individualized rehabilitation strategie
Rifampicin exposure in tuberculosis patients with comorbidities in Sub-Saharan Africa ::prioritising populations for treatment — a systematic review and meta-analysis
No full textBackground and Objectives : Emerging evidence suggests that comorbidities like human immunodeficiency virus (HIV) infection, diabetes mellitus (DM), and malnutrition in tuberculosis (TB) patients can alter drug concentrations, thereby affecting the treatment outcomes. For these populations, personalised strategies such as therapeutic drug monitoring (TDM) may be essential. We investigated the variations of drug levels within comorbid populations and analysed the differences in patterns observed between sub-Saharan Africa (SSA) and non-SSA regions. Methods : We performed a systematic review and meta-analysis of rifampicin drug pharmacokinetics (PK) through searches of major databases from 1980 to December 2023. A random-effects meta-analysis model using R-studio version 4.3.2 was conducted to estimate pooled serum rifampicin exposure (area under the concentration-time curve [AUC], and peak maximum concentration [Cmax]) between patients with TB-HIV infection, and TB-DM. Results : From 3300 articles screened, 24 studies met inclusion criteria, contributing 33 comorbidity subgroups for meta-analysis. In SSA, 14 subgroups assessed rifampicin PK in TB-HIV, 1 in TB-DM, and none in TB-malnutrition. The pooled mean Cmax was below the recommended range (8–24 mg/L) for all subgroups. For TB-HIV, the pooled Cmax was 5.59 mg/L, 95% CI (4.59–6.59), I2 = 97% for SSA populations and 5.59 mg/L, 95% CI (3.65; 6.59) for non-SSA populations. The Cmax for TB-DM in SSA (9.60 ± 4.4 mg/L) exceeded non-SSA (4.27 mg/L, 95% CI [2.77–5.76]). The lowest AUC was in TB-HIV (SSA, 29.09 mg/L h, 95% CI [21.06; 37.13, I2 = 91%]). High variability and heterogeneity (I2 >90%) were observed, with most studies (20/23) showing low bias. Conclusion : Our results emphasise the need for individualised dosing and targeted TDM implementation among TB-HIV and TB-DM populations on rifampicin in SSA. Although all populations exhibited low Cmax levels, TB-HIV populations may be prioritised as AUC levels were lowest. In clinical settings in SSA, Cmax-based TDM is more practical, but AUC can be used in treatment where feasible
Speech-to-speech translation pipelines for conversations in low-resource languages
No full textThe popularity of automatic speech-to-speech translation for human conversations is growing, but the quality varies significantly depending on the language pair. In a context of community interpreting for low-resource languages, namely Turkish and Pashto to/from French, we collected fine-tuning and testing data, and compared systems using several automatic metrics (BLEU, COMET, and BLASER) and human assessments. The pipelines consist of automatic speech recognition, machine translation, and speech synthesis, with local models and cloud-based commercial ones. Some components have been fine-tuned on our data. We evaluated over 60 pipelines and determined the best one for each direction. We also found that the ranks of components are generally independent of the rest of the pipeline
3D modular construction made of precast SFRC-stiffened panels
No full textA new concept of a 3D volumetric module, made up of six plane stiffened self-compacting fiber-reinforced concrete (SFRC) panels, is here studied. Experimental campaigns are carried out on SFRC material and on the thin-slab structures used for this modular concept. The high volume of steel fibers (80 kg/m3) used in the formulation of this concrete allow a positive strain hardening to be obtained in the post-cracking regime observed on the bending characterization tests. The high mechanical material characteristics, obtained both in tension and compression, allow a significant decrease in the module slabs’ thickness. The tests carried out on the 7 cm thick slab demonstrate a high load-bearing capacity and ductility under bending loading; this is also the case for shear loading configuration, although without any shear reinforcements. Numerical simulations of the material mechanical tests were conducted using Abaqus code; the results corroborate the experimental findings. Then, simulations were also conducted at the structural level, mainly to evaluate the behavior and the bearing capacity of the thin 3D module stiffened slabs. Finally, knowing that the concrete module truck transport can be a weak point, the decelerations induced during transportation were characterized and the integrity of the largest 3D module was demonstrated