269 research outputs found
Banking Transactions in Switzerland and China
Traditional banking service providers in Switzerland are facing competition. Smartphone applications open up new possibilities. Will we pay our bills, open an account, or take out a loan directly with a smartphone app in future? Does this make postal services, traditional banks, and credit card companies redundant for banking services? This question cannot be answered with a clear yes or no. A glance in the direction of China might reveal where developments could lead in Switzerland. It can be assumed that the banking business will change and that the competitive pressure on traditional providers will increas
Schlussbericht Finanzdienstleistungsbranche Schweiz : Herausforderungen fĂŒr Unternehmen, Mitarbeitende und Bildungsinstitutionen
Die Finanzdienstleistungsbranche Schweiz befindet sich im Umbruch. Die Finanz- und Wirtschaftskrise, der Steuerstreit mit anderen LĂ€ndern und die verschĂ€rften regulatorischen Rahmenbedingungen stellen sowohl Banken wie auch Versicherungen vor neue Herausforderungen. Um die WettbewerbsfĂ€higkeit des schweizerischen Finanzplatzes zu stĂ€rken, muss frĂŒhzeitig auf die VerĂ€nderungen reagiert werden. Herausgefordert sind Arbeitgebende und Arbeitnehmende. Die vorliegende Studie soll aufzeigen, welche Kompetenzen bei ausgesuchten Jobfamilien in Zukunft gefragt sind
Die Neupositionierung des Wealth Management in der Schweiz : Entwicklungen und ihre Auswirkungen auf die Soll-Kompetenzen in der Kundenberatung
StudieDie vorliegende Studie zeichnet ein umfassendes Bild zur Neupositionierung des Wealth Management in der Schweiz. Sie stĂŒtzt sich dabei namentlich auf eine Online-Befragung von in der Kundenberatung tĂ€tigen Personen und auf persönliche
Interviews mit FĂŒhrungskrĂ€ften von Schweizer Banken ab. Dabei stand insgesamt die Frage im Zentrum, wie sich die Rahmenbedingungen fĂŒr die Beratung von Privatkunden im Wealth Management verĂ€ndern werden und was dies fĂŒr die zukĂŒnftigen
Soll-Kompetenzen von Kundenberatern und den Aus- und Weiterbildungsbedarf bedeutet
Patient and professional experiences of palliative care referral discussions from cancer services : a qualitative interview study
Objectives The aim of this paper was to identify current barriers, facilitators and experiences of raising and discussing palliative care with people with advanced cancer. Methods Semiâstructured interviews were conducted with patients with advanced cancer and healthcare professionals (HCPs). Patients were included who had and had not been referred to palliative care. Transcripts were analysed using framework analysis. Results Twentyâfour patients and eight HCPs participated. Two overarching themes and five subâthemes emerged: Theme oneâreferral process: timing and triggers, responsibility. Theme twoâengagement: perception of treatment, prognosis and palliative care, psychological and emotional preparedness for discussion, and understanding how palliative care could benefit present and future care. Conclusion There is a need to identify suitable patients earlier in their cancer trajectory, address misconceptions about palliative care, treatment and prognosis, and better prepare patients and HCPs to have meaningful conversations about palliative care. Patients and HCPs need to establish and communicate the relevance of palliative care to the patient's current and future care, and be clear about the referral process
Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis
<p>Abstract</p> <p>Background</p> <p>Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and neutrophils. Thus, the relationship between vitamin D status and LL-37 production may be of importance for host immunity, but little data is available on this subject, especially in the setting of human sepsis syndrome and other critical illness.</p> <p>Methods</p> <p>Plasma concentrations of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP) and LL-37 in critically ill adult subjects admitted to intensive care units (ICUs) with sepsis and without sepsis were compared to healthy controls.</p> <p>Results</p> <p>Critically ill subjects had significantly lower plasma 25(OH)D concentrations compared to healthy controls. Mean plasma LL-37 levels were significantly lower in critically ill subjects compared to healthy controls. Vitamin D binding protein levels in plasma were significantly lower in critically ill subjects with sepsis compared to critically ill subjects without sepsis. There was a significant positive association between circulating 25(OH)D and LL-37 levels.</p> <p>Conclusion</p> <p>This study demonstrates an association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls. It also establishes a positive association between vitamin D status and plasma LL-37, which suggests that systemic LL-37 levels may be regulated by vitamin D status. Optimal vitamin D status may be important for innate immunity especially in the setting of sepsis. Further invention studies to examine this association are warranted.</p
Thymic stromal lymphopoietin is released by human epithelial cells in response to microbes, trauma, or inflammation and potently activates mast cells
Compelling evidence suggests that the epithelial cellâderived cytokine thymic stromal lymphopoietin (TSLP) may initiate asthma or atopic dermatitis through a dendritic cellâmediated T helper (Th)2 response. Here, we describe how TSLP might initiate and aggravate allergic inflammation in the absence of T lymphocytes and immunoglobulin E antibodies via the innate immune system. We show that TSLP, synergistically with interleukin 1 and tumor necrosis factor, stimulates the production of high levels of Th2 cytokines by human mast cells (MCs). We next report that TSLP is released by primary epithelial cells in response to certain microbial products, physical injury, or inflammatory cytokines. Direct epithelial cellâmediated, TSLP-dependent activation of MCs may play a central role in âintrinsicâ forms of atopic diseases and explain the aggravating role of infection and scratching in these diseases
Developing a complex intervention to support timely engagement with palliative care for patients with advanced cancer in primary and secondary care in the UK : a study protocol
Introduction: For patients with advanced cancer, timely access to palliative care can improve quality of life and enable patients to participate in decisions about their end-of-life care. However, in a UK population of 2500 patients who died from cancer, one-third did not receive specialist palliative care, and of those who did, the duration of involvement was too short to maximise the benefits. Initiating a conversation about palliative care is challenging for some health professionals and patients often have unmet information needs and misconceptions about palliative care. We will work closely with patients and health professionals to develop a patient decision aid and health professional training module designed to facilitate a timely and informed conversation about palliative care. Methods and analysis: This study is being conducted over 24 months from November 2017 to October 2019 and follows the UK Medical Research Council framework for developing complex interventions and the International Patient Decision Aids Guideline. The Ottawa Decision Support Framework underpins the study. The Supporting Timely Engagement with Palliative care (STEP) intervention will be developed though an iterative process informed by interviews and focus groups with patients with advanced cancer, oncologists, general practitioners and palliative care doctors. An expert panel will also review each iteration. The expert panel will consist of a patient representative with experience of palliative care, health professionals who are involved in advanced cancer care decision-making, a medical education expert and the National Council for Palliative Care director of transformation. The feasibility and acceptability of the decision aid and doctor training will be tested in oncology and general practice settings. Ethics and dissemination: Ethical approval for the study has been granted by the Office for Research Ethics Committees Northern Ireland (ORECNI), approval reference 17/NI/0249. Dissemination and knowledge transfer will be conducted via publications, national bodies and networks, and patient and family groups
Metabolite-related dietary patterns and the development of islet autoimmunity
The role of diet in type 1 diabetes development is poorly understood. Metabolites, which reflect dietary response, may help elucidate this role. We explored metabolomics and lipidomics differences between 352 cases of islet autoimmunity (IA) and controls in the TEDDY (The Environmental Determinants of Diabetes in theYoung) study. We created dietary patterns reflecting pre-IA metabolite differences between groups and examined their association with IA. Secondary outcomes included IA cases positive for multiple autoantibodies (mAb+). The association of 853 plasma metabolites with outcomes was tested at seroconversion to IA, just prior to seroconversion, and during infancy. Key compounds in enriched metabolite sets were used to create dietary patterns reflecting metabolite composition, which were then tested for association with outcomes in the nested case-control subset and the full TEDDY cohort. Unsaturated phosphatidylcholines, sphingomyelins, phosphatidylethanolamines, glucosylceramides, and phospholipid ethers in infancy were inversely associated with mAb+ risk, while dicarboxylic acids were associated with an increased risk. An infancy dietary pattern representing higher levels of unsaturated phosphatidylcholines and phospholipid ethers, and lower sphingomyelins was protective for mAb+ in the nested case-control study only. Characterization of this high-risk infant metabolomics profile may help shape the future of early diagnosis or prevention efforts
- âŠ