La mosaïque suisse : les représentations de la territorialité et du plurilinguisme dans les cantons bilingues

En se reconnaissant tous dans la nation suisse, les quatre groupes de langue officielle font de la mosaïque suisse une authentique nation politique. Pour beaucoup, le ciment de cette mosaïque est le principe de territorialité des langues (le citoyen doit utiliser la langue officielle d’un territoire), qui dispense un sentiment de sécurité culturelle. Pourtant, ce principe coexiste plus souvent qu’on ne le pense avec le principe de la liberté de la langue (le citoyen choisit sa langue de communication avec les autorités), et il ne suffit donc pas à résoudre des conflits liés au contact des langues qui, dans certains cantons, ont parfois le caractère passionnel des mouvements nationalitaires. Il s’agit donc de se pencher sur le niveau cantonal, où se règlent généralement les conflits, pour mesurer les représentations linguistiques en Suisse, en ce qui concerne la territorialité et l’homogénéité linguistique, mais aussi, plus généralement, le plurilinguisme. Ce texte propose d’examiner comment les conseillers municipaux des cantons bilingues français/allemand (Berne, Fribourg, Valais) perçoivent le fait plurilingue dans leur commune, dans leur canton ainsi qu’en Suisse. Car, en fonction des stratégies identitaires, de l’appartenance à un canton et à un groupe linguistique minoritaire ou majoritaire – au niveau cantonal ou national –, les discours varient considérablement, qu’il s’agisse de bilinguisme individuel ou institutionnel, de l’enseignement des langues ou encore du statut de la diglossie (coexistence entre une langue standard et des dialectes).By recognizing themselves in the Swiss nation, the four official language groups make of the Swiss mosaic a genuine political nation. For many, the cement of this mosaic is the “territorial principle” (a citizen must use the official language of a given territory), which is said to provide a feeling of cultural security. Yet, more often that one might think, this principle coexists with the “personal principle” (a citizen chooses the language of communication with authorities), and it cannot in itself settle conflicts related to language contact, some of which, in certain cantons, can be as passionate as nationality conflicts. Thus, we want to look into the cantonal level, where conflicts generally have to be resolved, in order to assess linguistic representations in Switzerland, in regard to territoriality and linguistic homogeneity, but also, more generally, to multilingualism. This paper proposes to study how municipal counsellors in French/German bilingual cantons (Bern, Fribourg, Valais) perceive multilingualism, in their municipality, in their canton, as well as in Switzerland. Depending on identity strategies, on the cantonal belonging and the belonging to a minority or a majority linguistic group (at the cantonal or national level), the discourses can vary considerably when one approaches certain topics—be it the individual or institutional bilingualism, language teaching, or the status of diglossia (coexistence between a standard language and dialects)

Does aspirin detract from the benefits of mineralocorticoid receptor antagonists in patients with heart failure and a reduced left ventricular ejection fraction? Probably!

No abstract available

From Little Fatherlands to Imagined Protonation: The Discourse on Francoprovençal in the Journal de Genève and the Gazette de Lausanne (1826–1998)

Francoprovençal is a Romance language originating in the sixth century and described by linguists in the nineteenth century. There are still many young native speakers in Italy (Aosta Valley), unlike France and Switzerland, where speakers can only be found in the traditionally Catholic cantons of Fribourg and Valais. However, the Protestant cantons of Geneva and Vaud also initiated a discussion about the vanishing language. The press archives illustrate the evolution of language representations, ranging from acceptance of the extinction of this patois to the insistence on preservation efforts and, more recently, hope for revitalization. The present analysis is based on texts from the Journal de Genève and the Gazette de Lausanne containing the keywords “patois” and/or “francoprovençal,” from 1826 to 1998. The corpora reflect identity construction based on language at a regional, national or transnational scale. In the nineteenth century, the imagined language community applied to little fatherlands (cantons), to French-speaking Switzerland (Romandy) or to a cross-border space around Geneva (along with Savoy). In the twentieth century, the appearance of the word “francoprovençal” led some people to broaden their interest to the entire FP area, with some manifestations of a “protonational” construction encompassing Swiss, French and Italian regions

Neither Italian nor German: From Ethnolinguistic Tensions to Intercultural Dialogue in Two Contemporary South-Tyrolean Novels

South Tyrol, an Italian autonomous province bordering Austria and Switzerland, has three official languages: Italian, German, and Ladin. Despite the picture of peaceful coexistence and Alpine idyll, significant tensions between the language groups remain. They stem from traumatic historical events, especially the Italianization policy by the fascist regime after the formerly Austrian part of Tyrol south of the Brenner pass was annexed to Italy in 1919. They are also linked to the persistence of cultural stereotypes. The essay demonstrates the ways in which literature might act as a mediator between language groups through the exploration of one German-language novel, Joseph Zoderer’s Die Walsche (‘The Italian’) (1982), and one Italian-language novel, Francesca Melandri’s Eva dorme (‘Eva sleeps’) (2010). We show how these novels can be seen as representative of a contemporary South Tyrolean literature whose authors seek to overcome stereotypical images of both German-speaking and Italian-speaking populations in order to initiate stronger intercultural relations. These new voices challenge the monolingual paradigm often promoted by local politicians and advocate for a new approach to multilingual and multiethnic society

Cardiac arrhythmias and conduction defects in systemic sclerosis

Signs and symptoms of arrhythmias or conduction defects are frequently reported in patients with SSc. These rhythm disorders may have several origins (i.e. related to primary heart involvement, pericardial disease, valvular regurgitation or pulmonary arterial hypertension) and may negatively affect the overall prognosis of these patients. It is therefore important to identify patients at high risk for cardiac arrhythmias with a complete cardiological evaluation and to identify the underlying heart disease, including SSc-related myocardial involvement. In addition, some therapeutic options in SSc patients may differ from those recommended in other population

Une législation suisse glottophile ? Entre territorialité et liberté, pragmatisme et indifférence: Un plurilinguisme à géométrie très variable

A diferència d'altres Estats oficialment multilingües, Suïssa sol considerar-se un país glotòfil, on les minories lingüístiques tenen poques queixes. El seu èxit sol atribuir-se al principi de territorialitat (una llengua oficial per territori), però el principi de personalitat (lliure elecció per la ciutadania de la llengua en les comunicacions administratives) també és important en els cantons bi/plurilingües, pel que sembla una territorialitat diferenciada. El marc jurídic es basa en la cooperació entre els cantons, que regulen les qüestions lingüístiques pròpies, i l'Estat federal. L'oficialització de les tres llengües principals (alemany, francès i italià) s'ha completat recentment amb la del romanx, una llengua vulnerable des del punt de vista demogràfic. Alhora, els dialectes suís-alemanys han estat molt vius, malgrat que són absents dels textos constitucionals. Tot i això, cal desconfiar de l'acceptació total d'aquesta imatge idealitzada de Suïssa, quan els interessos legislatius semblen indiferents a les llengües d'immigració i, a més, no atorguen reconeixement al francoprovençal. Aquesta llengua romanç que encara es parla en algunes parts de la Suïssa francòfona no està protegida per cap política destinada a garantir-ne la supervivència. Aquest article vol reflexionar sobre l'aplicabilitat de la noció de glotofília a Suïssa centrant-se en els textos que constitueixen l'arquitectura de la legislació lingüística del país.; Unlike other officially multilingual states, Switzerland is often seen as a glottophile country, where linguistic minorities have few complaints. Its success is often attributed to the principle of territoriality (one official language per territory), but the principle of personality (free choice of by citizens of the language in State-citizen communications) is also important in bi/plurilingual cantons, in what appears to be a differentiated territoriality. The legal framework is based on cooperation between the cantons, which govern their own linguistic matters, and the federal State. The officialization of the three main languages (German, French, and Italian) was recently supplemented by that of Romansh, a vulnerable language from a demographic perspective. At the same time, the Swiss-German dialects have remained very much alive, despite their absence from constitutional texts. However, one should be wary of total acceptance of this idealised image of Switzerland, when the legislator seems indifferent to languages of immigration and, moreover, does not grant recognition to Franco-Provençal. This Romance language that is still spoken in parts of Francophone Switzerland is not protected by any policies aimed at ensuring its survival. This article aims to reflect on the applicability of the notion of glottophilia to Switzerland by focusing on the texts that constitute the architecture of language legislation in the country.; Contrairement à d’autres États officiellement plurilingues, la Suisse a une image de pays « glottophile » où les minorités linguistiques ont peu de doléances. Sa réussite est souvent attribuée au principe de territorialité (une langue officielle par territoire), mais le principe de personnalité (libre choix de la langue administrative par les citoyens) a aussi son importance dans les cantons bi/plurilingues, dans une forme de « territorialité différenciée ». Le cadre juridique est fondé sur une coopération entre les cantons, souverains en matière linguistique, et l’État fédéral. L’officialisation ancienne des trois langues principales (allemand, fran.ais, italien) a été complétée par celle du romanche, langue fragilisée d’un point de vue démographique. Parallèlement, les dialectes suissesallemands sont restés très vivants, tout en étant absents des textes constitutionnels. On doit toutefois se garder de souscrire à une image trop flatteuse de la Suisse, alors que le législateur semble indifférent aux langues issues de l’immigration et, par ailleurs, n’accorde pas de reconnaissance au francoprovençal. Cette langue latine parfois encore parlée en Suisse francophone ne fait pas l’objet d’une politique visant à assurer sa survie. Le présent article vise à réfléchir à l’applicabilité de la notion de « glottophilie » à la Suisse en se concentrant sur les textes qui constituent l’armature de la législation linguistique en Suisse.; A diferencia de otros Estados oficialmente multilingües, Suiza suele considerarse un país glotófilo, donde las minorías lingüísticas tienen pocas quejas. Su éxito suele atribuirse al principio de territorialidad (una lengua oficial por territorio), pero el principio de personalidad (libre elección por la ciudadanía de la lengua en las comunicaciones administrativas) también es importante en los cantones bi/plurilingües, en lo que parece ser una territorialidad diferenciada. El marco jurídico se basa en la cooperación entre los cantones, que regulan sus propias cuestiones lingüísticas, y el Estado federal. La oficialización de las tres lenguas principales (alemán, francés e italiano) se ha completado recientemente con la del romanche, una lengua vulnerable desde el punto de vista demográfico. Al mismo tiempo, los dialectos suizo-alemanes han permanecido muy vivos, a pesar de su ausencia en los textos constitucionales. Sin embargo, hay que desconfiar de la aceptación total de esta imagen idealizada de Suiza, cuando los intereses legislativos parecen indiferentes a las lenguas de inmigración y, además, no otorgan reconocimiento al franco-provenzal. Esta lengua romance que aún se habla en algunas partes de la Suiza francófona no está protegida por ninguna política destinada a garantizar su supervivencia. Este artículo pretende reflexionar sobre la aplicabilidad de la noción de glotofilia a Suiza centrándose en los textos que constituyen la arquitectura de la legislación lingüística del país

Cardiopulmonary assessment of patients with systemic sclerosis for hematopoietic stem cell transplantation: recommendations from the European Society for Blood and Marrow Transplantation Autoimmune Diseases Working Party and collaborating partners.

Systemic sclerosis (SSc) is a rare disabling autoimmune disease with a similar mortality to many cancers. Two randomized controlled trials of autologous hematopoietic stem cell transplantation (AHSCT) for SSc have shown significant improvement in organ function, quality of life and long-term survival compared to standard therapy. However, transplant-related mortality (TRM) ranged from 3-10% in patients undergoing HSCT. In SSc, the main cause of non-transplant and TRM is cardiac related. We therefore updated the previously published guidelines for cardiac evaluation, which should be performed in dedicated centers with expertize in HSCT for SSc. The current recommendations are based on pre-transplant cardiopulmonary evaluations combining pulmonary function tests, echocardiography, cardiac magnetic resonance imaging and invasive hemodynamic testing, initiated at Northwestern University (Chicago) and subsequently discussed and endorsed within the EBMT ADWP in 2016

Future therapeutic targets in rheumatoid arthritis?

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent joint inflammation. Without adequate treatment, patients with RA will develop joint deformity and progressive functional impairment. With the implementation of treat-to-target strategies and availability of biologic therapies, the outcomes for patients with RA have significantly improved. However, the unmet need in the treatment of RA remains high as some patients do not respond sufficiently to the currently available agents, remission is not always achieved and refractory disease is not uncommon. With better understanding of the pathophysiology of RA, new therapeutic approaches are emerging. Apart from more selective Janus kinase inhibition, there is a great interest in the granulocyte macrophage-colony stimulating factor pathway, Bruton's tyrosine kinase pathway, phosphoinositide-3-kinase pathway, neural stimulation and dendritic cell-based therapeutics. In this review, we will discuss the therapeutic potential of these novel approaches

The contribution of musculoskeletal disorders in multimorbidity: Implications for practice and policy

People frequently live for many years with multiple chronic conditions (multimorbidity) that impair health outcomes and are expensive to manage. Multimorbidity has been shown to reduce quality of life and increase mortality. People with multimorbidity also rely more heavily on health and care services and have poorer work outcomes. Musculoskeletal disorders (MSDs) are ubiquitous in multimorbidity because of their high prevalence, shared risk factors, and shared pathogenic processes amongst other long-term conditions. Additionally, these conditions significantly contribute to the total impact of multimorbidity, having been shown to reduce quality of life, increase work disability, and increase treatment burden and healthcare costs. For people living with multimorbidity, MSDs could impair the ability to cope and maintain health and independence, leading to precipitous physical and social decline. Recognition, by health professionals, policymakers, non-profit organisations, and research funders, of the impact of musculoskeletal health in multimorbidity is essential when planning support for people living with multimorbidity

High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people with acute chest pain: a systematic review and cost-effectiveness analysis.

BACKGROUND: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of unnecessary hospital admissions and anxiety. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of hs-cTn assays for the early (within 4 hours of presentation) rule-out of AMI in adults with acute chest pain. METHODS: Sixteen databases, including MEDLINE and EMBASE, research registers and conference proceedings, were searched to October 2013. Study quality was assessed using QUADAS-2. The bivariate model was used to estimate summary sensitivity and specificity for meta-analyses involving four or more studies, otherwise random-effects logistic regression was used. The health-economic analysis considered the long-term costs and quality-adjusted life-years (QALYs) associated with different troponin (Tn) testing methods. The de novo model consisted of a decision tree and Markov model. A lifetime time horizon (60 years) was used. RESULTS: Eighteen studies were included in the clinical effectiveness review. The optimum strategy, based on the Roche assay, used a limit of blank (LoB) threshold in a presentation sample to rule out AMI [negative likelihood ratio (LR-) 0.10, 95% confidence interval (CI) 0.05 to 0.18]. Patients testing positive could then have a further test at 2 hours; a result above the 99th centile on either sample and a delta (Δ) of ≥ 20% has some potential for ruling in an AMI [positive likelihood ratio (LR+) 8.42, 95% CI 6.11 to 11.60], whereas a result below the 99th centile on both samples and a Δ of < 20% can be used to rule out an AMI (LR- 0.04, 95% CI 0.02 to 0.10). The optimum strategy, based on the Abbott assay, used a limit of detection (LoD) threshold in a presentation sample to rule out AMI (LR- 0.01, 95% CI 0.00 to 0.08). Patients testing positive could then have a further test at 3 hours; a result above the 99th centile on this sample has some potential for ruling in an AMI (LR+ 10.16, 95% CI 8.38 to 12.31), whereas a result below the 99th centile can be used to rule out an AMI (LR- 0.02, 95% CI 0.01 to 0.05). In the base-case analysis, standard Tn testing was both most effective and most costly. Strategies considered cost-effective depending upon incremental cost-effectiveness ratio thresholds were Abbott 99th centile (thresholds of < £6597), Beckman 99th centile (thresholds between £6597 and £30,042), Abbott optimal strategy (LoD threshold at presentation, followed by 99th centile threshold at 3 hours) (thresholds between £30,042 and £103,194) and the standard Tn test (thresholds over £103,194). The Roche 99th centile and the Roche optimal strategy [LoB threshold at presentation followed by 99th centile threshold and/or Δ20% (compared with presentation test) at 1-3 hours] were extendedly dominated in this analysis. CONCLUSIONS: There is some evidence to suggest that hs-CTn testing may provide an effective and cost-effective approach to early rule-out of AMI. Further research is needed to clarify optimal diagnostic thresholds and testing strategies. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013005939. FUNDING: The National Institute for Health Research Health Technology Assessment programme