10. Globale Gesundheit

Durch die Globalisierung werden wir zunehmend mit Problemen konfrontiert, welche Landesgrenzen überschreiten. Auch viele gesundheitspolitische Entscheidungen werden heute auf europäischer Ebene oder unter der Mitarbeit internationaler Organisationen getroffen. In diesem Kapitel betrachten wir Gesundheitsindikatoren sowie Krankheits- und Todesursachen im Hinblick auf das Bevölkerungseinkommen und die Entwicklung in verschiedenen Ländern. Wir analysieren die wichtigsten Faktoren, die die Gesundheit der Menschen in Industrie- und Entwicklungsländern beeinflussen und beschäftigen uns schließlich mit den Strategien und Akteuren, welche die Globale Gesundheit heute prägen

Effect of the COPE Program on Self-Efficacy in Mothers of Preterm Infants

The birth of a premature infant and its subsequent hospitalization in the neonatal intensive care unit are stressful experiences for mothers. Because of uncertainty concerning interactions with a premature baby, mothers often feel helpless and only hesitantly assume their maternal role. This may have a negative impact on the mother-child interaction and prevents mothers from taking an active part in the care for their child. “Creating Opportunities for Parent Empowerment” (COPE) is a 4-phase educational intervention program aiming to systematically involve parents into caring for their premature infant. In this pretest-posttest quasi-experimental study in 2 Swiss university hospitals, we focused on maternal self-efficacy. We compared self-efficacy in mothers receiving the COPE program or standard care alone at baseline and 3 months after estimated delivery date. To measure maternal self-efficacy, we used the “Tool to measure Parenting Self-Efficacy” (TOPSE). While scores for “Emotion and Affection,” “Empathy and Understanding,” as well as “Learning and Knowledge” increased in both groups, only “Learning and Knowledge” scores were significantly higher in the intervention group. Given the intention of improving learning and knowledge, the COPE program might be a promising intervention contributing to enhanced maternal self-efficacy

Algérie : sortie(s) de guerre

Souvent prisonnier de « mémoires affrontées », le traitement historique de la guerre d'Algérie a eu peine à sortir de tels horizons. Qu'il s'agisse des mémoires combattantes (surtout françaises), de celles des victimes de toutes natures, de leurs collatéraux, voire des États, la liste est longue des travaux portés par le besoin – plus ou moins conscient – de faire le deuil, sans qu'on sache toujours ce qui relève de la mise à jour objectivée ou de l'enfouissement. En la matière, la période postérieure au 19 mars 1962 est souvent absorbée, dans les images mentales des métropolitains, par un besoin de passer à autre chose, qu'exprime bien l'idée de liquidation du passé colonial. Il y a là, au cœur de l'événementialité, une asymétrie voisine et violente, rappelant celle vécue après septembre et surtout décembre 1944. L'oblitération métropolitaine des violences, qui de militaires deviennent au printemps et à l'été 1962 désormais civiles (dans leur immense majorité), doit donc être évaluée. La compréhension de ce hiatus est en effet centrale pour saisir les mécanismes de sorties de guerre. Il y a d'abord celles des hommes (supplétifs, soldats perdus de l'OAS, militants anticolonialistes, prêtres) dont les destins basculent entre la fuite éperdue et l'espoir bientôt démenti de pouvoir « faire société » en Algérie. Il y a ensuite celles de l'État qui génère des temporalités différentes allant de l'urgence du rapatriement et de l'insertion (pour les Français) en métropole aux illusions de maintien d'une présence militaire ou industrielle en Algérie. Enfin, il y a les échos régionaux de la guerre. À cet égard, l'intégration économique voire sociale des rapatriés n'exclue ni des conflits d'identités individuelles, ni de profonds clivages politiques dont les effets se font encore sentir : le combat anticolonial étant la matrice d'une génération

Severe Traumatic Brain Injury in a High-Income Country: An Epidemiological Study

This adult cohort determined the incidence and patients' short-term outcomes of severe traumatic brain injury (sTBI) in Switzerland and age-related differences. A prospective cohort study with a follow-up at 14 days was performed. Patients ≥16 years of age sustaining sTBI and admitted to 1 of 11 trauma centers were included. sTBI was defined by an Abbreviated Injury Scale of the head (HAIS) score >3. The centers participated from 6 months to 3 years. The results are presented as percentages, medians, and interquartile ranges (IQRs). Subgroup analyses were performed for patients ≤65 years (younger) and >65 (elderly). sTBI was observed in 921 patients (median age, 55 years; IQR, 33–71); 683 (74.2%) were male. Females were older (median age, 67 years; IQR, 42–80) than males (52; IQR, 31–67; p<0.00001). The estimated incidence was 10.58 per 100,000 inhabitants per year. Blunt trauma was observed in 879 patients (95.4%) and multiple trauma in 283 (30.7%). Median Glasgow Coma Score (GCS) on the scene was 9 (IQR 4–14; 8 in younger, 12 in elderly) and in emergency departments 5 (IQR, 3–14; 3 in younger, 8 in elderly). Trauma mechanisms included the following: 484 patients with falls (52.6%; younger, 242 patients [50.0%]; elderly, 242 [50.0%]), 291 with road traffic accidents (31.6%; younger, 237 patients [81.4%]; elderly, 54 [18.6%]), and 146 with others (15.8%). Mortality was 30.2% (24.5% in younger, 40.9% in elderly). Median GCS at 14 days was 15 (IQR, 14–15) without differences among subgroups. Estimated incidence of sTBI in Switzerland was low, age was high, and mortality considerable. The elderly had higher initial GCS and a higher death rate, but high GCS at 14 days

Stewards of Integrity: Institutional Approaches to Promote and Safeguard Good Research Practice in Europe

56 pages.In December 2000, the European Science Foundation published a Science Policy Briefing entitled Good Scientific Practice in Research and Scholarship. The time was not coincidental. During the 1990s, there were many major cases of research misconduct that were widely publicised in both the scientific and general media.As research organisations in various countries were undertaking efforts to tackle the problem, there was a need to learn from each other’s experiences and with the idea of the European Research Area (ERA) then burgeoning, discussions began on whether there should be coordinated efforts at the European level.The ESF Science Policy Briefing No. 10 surveyed the then existing policies and practices in Europe and discussed the responsibilities of researchers and research organisations. It called upon ESF Member Organisations, to act, in their diverse roles, as stewards of research integrity.To this end, the European Science Foundation collected information from its Member Organisations and other relevant bodies, and this resulting report presents the policies, approaches and practices to foster good scientific practice found in several European countries.Although the report is not exhaustive both in terms of countries and institutions covered, it provides a basis for an overview of mechanisms to promote good research practice and to handle cases of alleged research misconduct that exist in different European countries.This work and publication was part-funded by the European Commission (Contract No GNBL-2007-00002).Peer reviewe