Use it or lose it! Cognitive activity as a protec-tive factor for cognitive decline associated with Alzheimer's disease.

Because of the worldwide aging of populations, Alzheimer's disease and other dementias constitute a devastating experience for patients and families as well as a major social and economic burden for both healthcare systems and society. Multiple potentially modifiable cardiovascular and lifestyle risk factors have been associated with this disease. Thus, modifying these risk factors and identifying protective factors represent important strategies to prevent and delay disease onset and to decrease the social burden. Based on the cognitive reserve hypothesis, evidence from epidemiological studies shows that low education and cognitive inactivity constitute major risk factors for dementia. This indicates that a cognitively active lifestyle may protect against cognitive decline or delay the onset of dementia. We describe a newly developed preventive programme, based on this evidence, to stimulate and increase cognitive activity in older adults at risk for cognitive decline. This programme, called "BrainCoach", includes the technique of "motivational interviewing" to foster behaviour change. If the planned feasibility study is successful, we propose to add BrainCoach as a module to the already existing "Health Coaching" programme, a Swiss preventive programme to address multiple risk factors in primary care

Electroosmotically generated disinfectant from urine as a by-product of electricity in microbial fuel cell for the inactivation of pathogenic species

This work presents a small scale and low cost ceramic based microbial fuel cell, utilising human urine into electricity, while producing clean catholyte into an initially empty cathode chamber through the process of electro-osmostic drag. It is the first time that the catholyte obtained as a by-product of electricity generation from urine was transparent in colour and reached pH>13 with high ionic conductivity values. The catholyte was collected and used ex situ as a killing agent for the inactivation of a pathogenic species such as Salmonella typhimurium, using a luminometer assay. Results showed that the catholyte solutions were efficacious in the inactivation of the pathogen organism even when diluted up to 1:10, resulting in more than 5 log-fold reduction in 4 min. Long-term impact of the catholyte on the pathogen killing was evaluated by plating Salmonella typhimurium on agar plates and showed that the catholyte possesses a long-term killing efficacy and continued to inhibit pathogen growth for 10 days

Anamnèse professionnelle en médecine de premier recours: présentation d'un questionnaire de dépistage des problèmes de santé liés au travail

A brief screening questionnaire has been administered to 791 patients consulting a primary health care physician, to discover job-related health problems. Among the 791 patients, 43 percent estimate subjectively that their job has an unfavorable influence on their health. The study participants were patients from the general consultation of the outpatient department of the medical universitary policlinic of Lausanne and from 10 private medical practices in the french part of Switzerland. Among the 791 patients, 401 were interviewed seconderly in a more detailed questionnaire. These questionnaires were evaluated by 3 reviewers of the Institute of Occupational Health Sciences. 25 percent (one of four patient) was identified for having a job-related health problem. For the primary health care physician, the question is: how to manage such job-related problems and how to orient patient to use the adequate services and institutions

Conflit éthique en médecine ambulatoire : quelles sont les valeurs en jeu ?

Nous présentons «l'analyse éthique» d'une situation clinique : un jeune homme qui souffre d'un cancer colique débutant refuse catégoriquement une prise en charge chirurgicale. Le médecin se trouve confronté à un conflit éthique. Les différentes options éthiques ainsi que leurs justifications respectives sont exposées. Les éléments constitutifs du jugement clinique sont mis en évidente. La méthodologie pour tenter de résoudre ce « conflit éthique» est présentée, telle qu'elle est mise en pratique régulièrement à la Policlinique médicale universitaire

Towards sustainable sanitation: Mitigating microbial health risks in the production of urine-derived fertilizers

To identify and address health and safety challenges, first, I conducted a screening of fecal pathogens in source-separated urine. The pathogen inactivation performance of two innovative fertilizer production technologies was then evaluated in laboratory and field conditions. An in-depth assessment of the main mechanisms leading to pathogen inactivation during fertilizer production suggested nuanced adjustments in the treatment to yield more hygienic outcomes. Finally, occupational exposure and risks of infection during fertilizer production were evaluated using innovative exposure analysis techniques and modeling. Quantitatively identifying risks in this way will allow development of strategies to promote innovation and overcome barriers to safe and sustainable sanitation