The evolution of income-related inequalities in health care utilization in Switzerland over time

This study investigates equity in access to health care in Switzerland over time, using nationwide representative survey data from 1982, 1992, 1997 and 2002. Both simple quintile distributions and concentration indices are used to assess horizontal equity, i.e. the extent to which adults in equal need for medical care appear to have equal rates of medical care utilization. Looking at each of the four survey years separately the results indicate that by and large, there is little or no inequity in use except with respect to specialist visits which are clearly pro rich distributed as in most other OECD countries. We neither find much significant variation over time despite the fact that the share of health care has grown from close to 8% to more than 11% over this period and that a major reform of the health care system has taken place in 1996health care utilization; inequality

The evolution of income-related health inequalities in Switzerland over time

This paper presents new evidence on income-related health inequality and its development over time in Switzerland. We employ the methods lined out in van Doorslaer and Jones (2003) and van Doorslaer and Koolman (2004) measuring health using an interval regression approach to compute concentration indices and decomposing inequality into its determining factors. Nationally representative survey data for 1982, 1992, 1997 and 2002 are used to carry out the analysis. Looking at each of the four years separately the results indicates the usual positive relationship between income and health, but the distribution is among the least unequal in Europe. No clear trend emerges in the evolution of the inequality indices over the two decades. Inequality is somewhat lower in 1982 and 1992 as compared to 1997 and 2002 but the differences are not significant. The most important contributors to health inequality are income, education and activity status, in particular retirement. Regional differences including the widely varying health care supply, by contrast, do not exert any systematic influenceInequalities in health; concentration index; decomposition analysis

The evolution of income-related inequalities in health care utilization in Switzerland over time

This study investigates equity in access to health care in Switzerland over time, using nationwide representative survey data from 1982, 1992, 1997 and 2002. Both simple quintile distributions and concentration indices are used to assess horizontal equity, i.e. the extent to which adults in equal need for medical care appear to have equal rates of medical care utilization. Looking at each of the four survey years separately the results indicate that by and large, there is little or no inequity in use except with respect to specialist visits which are clearly pro rich distributed as in most other OECD countries. We neither find much significant variation over time despite the fact that the share of health care has grown from close to 8% to more than 11% over this period and that a major reform of the health care system has taken place in 1996

Comparing the effects of COX and non-COX-inhibiting NSAIDs on enhancement of apoptosis and inhibition of aberrant crypt foci formation in a rat colorectal cancer model

The protection against colorectal cancer (CRC) by non-steroidal anti-inflammatory drugs (NSAIDs) is in part dependent on inhibition of cyclooxygenase (COX). We compared the efficacy of the non-COX-inhibiting R flurbiprofen (R-FB) with COX-inhibiting sulindac and racemic flurbiprofen (Rac-FB), and determined their effects on apoptosis, in an azoxymethane (AOM)-induced rat CRC model. In experiment 1, groups of rats were given daily drug gavage (R-FB 30 mg/kg, Rac-FB 10 mg/kg and Sulindac 20 mg/kg) for one week, followed by AOM treatment and were killed eight hours later, colons were examined for apoptosis and cell proliferation. In experiment 2, groups of rats were given two AOM treatments, followed by daily drug gavage until they were killed ten weeks later, colons were examined for aberrant crypt foci (ACF) and prostaglandin E 2 production. All drugs significantly enhanced apoptosis and inhibited ACF, irrespective of their COX-inhibiting potency (p<0.01), but sulindac was more potent in inhibition of large ACF, p<0.05. COX-inhibiting sulindac achieved the greatest protective effect. The greater safety profile of Rac-FB should provide an advantage for chemoprevention.This work was supported by the National Health and Medical Research Council (NHMRC) and Cancer Council of South Australia (CCSA) (project no: 1007501 and 525925)

A (too) bright future? Arctic diatoms under radiation stress

Decreasing Arctic sea ice cover and increasing stratification of ocean surface waters make the exposure of pelagic microalgae to high irradiances more likely. Apart from light being a necessary prerequisite for photosynthesis, rapidly changing and/or high irradiances are potentially detrimental. An in situ study was performed in the high Arctic (79°N) to determine the effect of high irradiances in general, and ultraviolet radiation (UVR, 280–400 nm) in particular, on cell concentrations, fatty acid composition, and hotoprotective pigments of three diatom species isolated from seawater around Svalbard. Unialgal cultures were exposed in situ at 0.5- and 8 m-depth. After 40 h, cell concentrations of Synedropsis hyperborea and Thalassiosira sp., ere lower at 0.5 than at 8 m, and the content of the photoprotective xanthophyll-cycle pigment iatoxanthin in all species (S. hyperborea, Thalassiosira sp.,Porosira glacialis) was higher in the 0.5 m exposure compared to 8 m. In S. hyperborea, growth was addition-ally inhibited by UVR at 0.5-m depth. In situ radiation conditions led, furthermore, to a significant decrease in polyunsaturated fatty acids (PUFAs) in all three species, but UVR had no additional effect. Hence, we conclude that natural radiation conditions close to the surface could reduce growth and PUFA concentrations, but the effects are species specific. The diatoms’ potential to acclimate to these conditions over time has to be evaluated

Quantitative Vibrational Dynamics of the Metal Site in a Tin Porphyrin: An IR, NRVS, and DFT Study

We used a newer, synchrotron-based, spectroscopic technique (nuclear resonance vibrational spectroscopy, NRVS) in combination with a more traditional one (infrared absorption, IR) to obtain a complete, quantitative picture of the metal center vibrational dynamics in a six-coordinated tin porphyrin. From the NRVS 119Sn site-selectivity and the sensitivity of the IR signal to 112Sn/119Sn isotope substitution, we identified the frequency of the antisymmetric stretching of the axial bonds (290 cm–1) and all the other vibrations involving Sn. Experimentally authenticated density functional theory (DFT) calculations aid the data interpretation by providing detailed normal mode descriptions for each observed vibration. These results may represent a starting point toward the characterization of the local vibrational dynamics of the metallic site in tin porphyrins and compounds with related structures. The quantitative complementariness between IR, NRVS, and DFT is emphasized

Role of cancer stem cell markers ALDH1, BCL11B, BMI-1, and CD44 in the prognosis of advanced HNSCC

PURPOSE Cancer stem cells (CSCs) are held accountable for the progress of head and neck squamous cell carcinoma (HNSCC). In the presented study, the authors evaluated the prognostic value of CSC markers in two particular HNSCC cohorts. METHODS This two cohort study consisted of 85~patients with advanced stage HNSCC, treated with primary radio(chemo)therapy (pRCT), and 95~patients with HNSCC, treated with surgery and partially adjuvant radio(chemo)therapy. Overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were assessed. Samples were assessed for the expression of different molecular stem cell markers (ALDH1, BCL11B, BMI\hbox-1, and CD44). RESULTS In the pRCT cohort, none of the baseline patient and tumor features exhibited a~statistically significant relation with survival in either the cohort or the human papillomavirus (HPV)-stratified subcohorts. High expression of BMI\hbox-1 significantly decreased OS and DFS, while high expression of CD44 decreased all modes of survival. Multivariate analysis showed significant prognostic influence for all tested CSC markers, with high BMI\hbox-1 and CD44 decreasing survival (BMI-1: OS, DFS, DSS; CD44: OS, DFS) and high ALDH1 and BCL11B showing a~beneficial effect on survival (ALDH1: OS, DFS; BCL11B: OS, DSS). In the surgical cohort, classical prognosticators such as HPV status, R1 resection, and nodal status in HPV-negative HNSCC played a~significant role, but the tested CSC markers showed no significant effect on prognosis. CONCLUSION Although validation in independent cohorts is still needed, testing for CSC markers in patients with advanced or late stage HNSCC might be beneficial, especially if many comorbidities exist or disease is irresectable. The findings might guide the development and earlier use of targeted therapies in the future

Particle Migration in Large Cross-Section Ceramic On-Demand Extrusion Components

Ceramic On-Demand Extrusion (CODE) is a direct ink writing process which allows for the creation of near theoretically dense ceramic components with large cross-sections due to oil-assisted drying. Yttria-stabilized zirconia (YSZ) colloidal pastes (∼d50 ≲ 1 µm) were used in CODE to produce dense (multi-road infill and ≳ 98% relative density), large continuous volume (\u3e 1 cm3), and high fidelity (nozzle diameters ≲ 1 mm) structural ceramic components. However, many of these printed components underwent significant particle migration after forming. The reason for this particle migration defect was investigated using the coffee-ring effect for dilute solutions and rheological methods for dense suspensions. Modifications to the colloidal paste, such as changes in solids loading, pH, or surfactant concentration were explored as to their effectiveness to mitigate the defect. Ultimately, paste formulation and printing trade-offs are discussed with respect to the post-printing defect and as to general direct-write patterning

Study protocol: young carers and young adult carers in Switzerland

Background: In Switzerland, the issue of young carers and young adult carers - young people under the age of 18 and 24 respectively, who take on significant or substantial caring tasks and levels of responsibility that would usually be associated with an adult - has not been researched before. The number of these younger carers is unknown, as is the extent and kind of their caring activities and the outcomes for their health, well-being, psycho-social development, education, transitions to adulthood, future employability and economic participation. Methods: The project is comprised of three stages: 1. A national Swiss-wide online survey to examine awareness of the issue of younger carers amongst professional populations in the education, health and social services sectors; 2. An online survey of 4800 Swiss pupils in schools using standardised instruments to identify the proportion and characteristics of pupils who are carers; and 3. Semi-structured interviews with 20 families comprising family members with care needs and younger carers, to consolidate and validate the other stages of the study; and to hear directly from care-dependent family members and younger carers about their experiences of the issues identified in the surveys and in previous published research. Discussion: The needs of younger carers and their ill and disabled family members in Switzerland have not been systematically investigated. This will be the first study in the country to investigate these issues and to develop evidence-based recommendations for policy and practice, drawing also on international research. The present study therefore fills an important national and international research gap. It will collect important data on the awareness, extent, kind and impact of caring amongst children and young people in Switzerland, and cross-link these findings with robust evidence from other countries. The study will reveal (a) the extent of awareness of the issue of young carers amongst medical, social, health, educational, and other groups in Switzerland; (b) the proportion and number of young carers amongst a normative child population, and what these young carers ‘do’ in terms of their caring roles; and (c) direct accounts by families of their care-giving and receiving experiences

Fabricating Functionally Graded Materials by Ceramic On-Demand Extrusion with Dynamic Mixing

Ceramic On-Demand Extrusion (CODE) is an extrusion-based additive manufacturing process recently developed for fabricating dense, functional ceramic components. Presented in this paper is a further development of this process focusing on fabrication of functionally graded materials (FGM). A dynamic mixing mechanism was developed for mixing constituent ceramic pastes, and an extrusion control scheme was developed for fabricating specimens with desired material compositions graded in real time. FGM specimens with compositions graded between Al2O3 and ZrO2 were fabricated and ultimately densified by sintering to validate the effectiveness of the CODE process for FGM fabrication. Energy dispersive spectroscopy (EDS) was used to compare final compositions to the original material designs. The specimen’s hardness at different locations along the gradients was examined by micro-indentation tests. The dimensions of sintered specimens were measured, and the effects of material composition gradients on the distortions of sintered FGM specimens were analyze