Perspective of asylum-seeking caregivers on the quality of care provided by a Swiss paediatric hospital : a qualitative study

This study investigated the perspective of asylum-seeking caregivers on the quality of healthcare delivered to their children in a qualitative in-depth interview study. The health of asylum-seeking children is of key interest for healthcare providers, yet knowledge of the perspective of asylum-seeking caregivers when accessing healthcare is limited.; The study took place in a paediatric tertiary care hospital in Basel, Switzerland.; Interviews were done with 13 asylum-seeking caregivers who had presented with their children at the paediatric tertiary care hospital. Nine female and four male caregivers from Tibet, Eritrea, Afghanistan, Syria, Iraq, Albania and Macedonia were included. A diverse sample was chosen regarding cultural and social background, years of residence in Switzerland and reasons for seeking care. A previously developed and pilot-tested interview guide was used for semistructured in-depth interviews between 36 and 92 min in duration. Data analysis and reporting was done according to Consolidated Criteria for Reporting Qualitative Research. The number of interviews was determined by saturation of data.; The interviewees described a mismatch of personal competencies and external challenges. Communication barriers and unfamiliarity with new health concepts were reported as challenges. These were aggravated by isolation and concerns about their child's health. The following factors were reported to strongly contribute to satisfaction of healthcare delivery: a respectful and trusting caregiver-provider relationship, the presence of interpreters and immediate availability of treatment.; A mismatch of personal competencies and external challenges importantly influences the caregiver-provider relationship. To overcome this mismatch establishment of confidence was identified as a key factor. This can be achieved by availability of interpreter services, sufficient consultation time and transcultural trainings for healthcare workers. Coordination between the family, the government's asylum system and the medical system is required to facilitate this process

Consensus recommendations of the german consortium for hereditary breast and ovarian cancer

BACKGROUND: The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has established a multigene panel (TruRisk®) for the analysis of risk genes for familial breast and ovarian cancer. SUMMARY: An interdisciplinary team of experts from the GC-HBOC has evaluated the available data on risk modification in the presence of pathogenic mutations in these genes based on a structured literature search and through a formal consensus process. KEY MESSAGES: The goal of this work is to better assess individual disease risk and, on this basis, to derive clinical recommendations for patient counseling and care at the centers of the GC-HBOC from the initial consultation prior to genetic testing to the use of individual risk-adapted preventive/therapeutic measures

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

One health, une seule santé

One Health, « Une seule santé », est une stratégie mondiale visant à développer les collaborations interdisciplinaires pour la santé humaine, animale et environnementale. Elle promeut une approche intégrée, systémique et unifiée de la santé aux échelles locale, nationale et mondiale, afin de mieux affronter les maladies émergentes à risque pandémique, mais aussi s'adapter aux impacts environnementaux présents et futurs. Bien que ce mouvement s’étende, la littérature en français reste rare. Traduit de l’anglais, coordonné par d’éminents épidémiologistes et s'appuyant sur un large panel d' approches scientifiques rarement réunies autour de la santé, cet ouvrage retrace les origines du concept et présente un contenu pratique sur les outils méthodologiques, la collecte de données, les techniques de surveillance et les plans d’étude. Il combine recherche et pratique en un seul volume et constitue un ouvrage de référence unique pour la santé mondiale

Wear and the Transition from Static to Mixed Lubricated Friction of Sorption or Spreading Dominated Metal-Thermoplastic Contacts

Stiction, run-in wear and friction of lubricated polyoxymethylene homopolymer (POM)- and aliphatic polyamide (PA46)-steel tribosystems were investigated for mild-loaded mixed lubrication conditions with and without thermal conditioning of the polymers in the lubricant prior to testing. Macroscopic oscillatory tribometry and standard gliding experiments were carried out. The hypothesis that sorption of a lubricant into a thermoplastic polymer and partial solving of the surface by the lubricant can change wear rate and friction was tested. It was found that for POM-lubricant-pairings, the tribological behavior is dominated by the sorption of the lubricant into the polymer; it is not influenced by the spreading energy. For the PA46-lubricant pairings, no mass uptake by sorption was measured, and the tribological behavior is influenced by spreading and changes in hardness due to thermal aging. For mild loading in mixed lubricated conditions, friction and wear properties seem to be primarily determined by the hardness-dependence of abrasive contact and less by adhesion or hysteretic mechanisms

Wear and the Transition from Static to Mixed Lubricated Friction of Sorption or Spreading Dominated Metal-Thermoplastic Contacts

Stiction, run-in wear and friction of lubricated polyoxymethylene homopolymer (POM)- and aliphatic polyamide (PA46)-steel tribosystems were investigated for mild-loaded mixed lubrication conditions with and without thermal conditioning of the polymers in the lubricant prior to testing. Macroscopic oscillatory tribometry and standard gliding experiments were carried out. The hypothesis that sorption of a lubricant into a thermoplastic polymer and partial solving of the surface by the lubricant can change wear rate and friction was tested. It was found that for POM-lubricant-pairings, the tribological behavior is dominated by the sorption of the lubricant into the polymer; it is not influenced by the spreading energy. For the PA46-lubricant pairings, no mass uptake by sorption was measured, and the tribological behavior is influenced by spreading and changes in hardness due to thermal aging. For mild loading in mixed lubricated conditions, friction and wear properties seem to be primarily determined by the hardness-dependence of abrasive contact and less by adhesion or hysteretic mechanisms

Perspective of asylum-seeking caregivers on the quality of care provided by a Swiss paediatric hospital : a qualitative study

This study investigated the perspective of asylum-seeking caregivers on the quality of healthcare delivered to their children in a qualitative in-depth interview study. The health of asylum-seeking children is of key interest for healthcare providers, yet knowledge of the perspective of asylum-seeking caregivers when accessing healthcare is limited.; The study took place in a paediatric tertiary care hospital in Basel, Switzerland.; Interviews were done with 13 asylum-seeking caregivers who had presented with their children at the paediatric tertiary care hospital. Nine female and four male caregivers from Tibet, Eritrea, Afghanistan, Syria, Iraq, Albania and Macedonia were included. A diverse sample was chosen regarding cultural and social background, years of residence in Switzerland and reasons for seeking care. A previously developed and pilot-tested interview guide was used for semistructured in-depth interviews between 36 and 92 min in duration. Data analysis and reporting was done according to Consolidated Criteria for Reporting Qualitative Research. The number of interviews was determined by saturation of data.; The interviewees described a mismatch of personal competencies and external challenges. Communication barriers and unfamiliarity with new health concepts were reported as challenges. These were aggravated by isolation and concerns about their child's health. The following factors were reported to strongly contribute to satisfaction of healthcare delivery: a respectful and trusting caregiver-provider relationship, the presence of interpreters and immediate availability of treatment.; A mismatch of personal competencies and external challenges importantly influences the caregiver-provider relationship. To overcome this mismatch establishment of confidence was identified as a key factor. This can be achieved by availability of interpreter services, sufficient consultation time and transcultural trainings for healthcare workers. Coordination between the family, the government's asylum system and the medical system is required to facilitate this process

Preventing Chronic Pain: A Human Systems Approach—Results from a Massive Open Online Course

Chronic pain conditions are the top reason patients seek care, the most common reason for disability and addiction, and the biggest driver of healthcare costs; their treatment costs more than cancer, heart disease, dementia, and diabetes care. The personal impact in terms of suffering, disability, depression, suicide, and other problems is incalculable. There has been much effort to prevent many medical and dental conditions, but little effort has been directed toward preventing chronic pain. To address this deficit, a massive open online course (MOOC) was developed for students and healthcare professionals. “Preventing Chronic Pain: A Human Systems Approach” was offered by the University of Minnesota through the online platform Coursera. The first offering of this free open course was in the spring of 2014 and had 23 650 participants; 53% were patients or consumers interested in pain. This article describes the course concepts in preventing chronic pain, the analytic data from course participants, and post course evaluation forms