Primary prevention of sexually transmitted infections in Switzerland: practices of family physicians and their determinants-a national cross-sectional survey.

To describe the activities of general practitioners (GPs) pertaining to primary prevention in the field of affective and sexual life, studying the advice they provide as well as their vaccination practices. Cross-sectional national survey. The study was carried out using the Swiss Primary Care Active Monitoring GPs' network, a national GP network created in 2012. One hundred and seventy Swiss GPs, from a random sample from professional lists stratified by canton, participated in the present study. Prevention practices against sexually transmitted infections (STIs) performed by GPs through advice provided as well as their vaccination practices. Predictive factor of these practices through their links with the doctors' relevant characteristics and their opinions about STI prevention. Approximately 80% consider prevention in the area of affective and sexual life to be part of their duty and discuss it easily with patients. Most of them spontaneously give advice regarding STIs during a routine consultation. Regarding human papillomavirus (HPV) immunisation in adults, almost half of GPs report never doing it, while almost 75% often or always immunise their adult patients against hepatitis B. Higher numbers of consultations per day are associated with vaccinating more adults against HPV (OR 1.13 (1.05 to 1.23)) and against hepatitis A (OR 1.17 (1.05 to 1.31)). Vaccinating children against hepatitis B is associated with practising in rural areas (OR 4.64 (1.20 to 17.98)). GPs practising in the French-speaking region of Switzerland immunise children less against HPV (OR 0.40 (0.20 to 0.80)). Longer consultations are associated with providing advice on affective and sexual life during a first consultation (OR 1.08 (1.01 to 1.14)). Swiss GPs are involved in primary prevention against STIs and consider it as their responsibility. Prevention practices are associated with GPs' favourable opinions on prevention

Hybrid Local-Order Mechanism for Inversion Symmetry Breaking

Using classical Monte Carlo simulations, we study a simple statistical mechanical model of relevance to the emergence of polarisation from local displacements on the square and cubic lattices. Our model contains two key ingredients: a Kitaev-like orientation-dependent interaction between nearest neighbours, and a steric term that acts between next-nearest neighbours. Taken by themselves, each of these two ingredients is incapable of driving long-range symmetry breaking, despite the presence of a broad feature in the corresponding heat capacity functions. Instead each component results in a "hidden" transition on cooling to a manifold of degenerate states, the two manifolds are different in the sense that they reflect distinct types of local order. Remarkably, their intersection---\emph{i.e.} the ground state when both interaction terms are included in the Hamiltonian---supports a spontaneous polarisation. In this way, our study demonstrates how local ordering mechanisms might be combined to break global inversion symmetry in a manner conceptually similar to that operating in the "hybrid" improper ferroelectrics. We discuss the relevance of our analysis to the emergence of spontaneous polarisation in well-studied ferroelectrics such as BaTiO$_3$ and KNbO$_3$.Comment: 8 pages, 8 figure

Esparsette (Onobrychis viciifolia) als mögliche Futterpflanze zur Kontrolle von Magen-Darm-Strongyliden bei Schafen

In der Schaf- und Ziegenhaltung stellt der Befall mit Magen-Darm-Strongyliden (MDS) einen wesentlichen Problemfaktor für die Tiergesundheit dar. Klinische und subklinische Erkrankungen können von erheblicher wirtschaftlicher Relevanz sein. Eine zunehmende Resistenzentwicklung gegen seit langem eingesetzte Anthelminthika hat derzeit einen intensivierten Einsatz dieser Wirkstoffe zur Folge und verschärft das Problem somit zusätzlich. Die Entwicklung und Bereitstellung komplementärer Kontrollstrategien könnte zu einer erheblichen Reduktion des Anthelminthika-Einsatzes beitragen. Eine mögliche Strategie stellt der Einsatz tanninhaltiger Futterpflanzen dar. Wir beschreiben Ergebnisse aus einem in vivo Versuch zur antiparasitischen Wirkung von Esparsettenheu und Esparsettensilage (6,2 % und 4,4 % Tannine / Trockensubstanz) gegen Haemonchus contortus und Cooperia curticei in experimentell infizierten Lämmern. Nach 16-tägiger Fütterung mit Esparsettenheu war die H. contortus Wurmbürde im Vergleich zu einer isoproteisch und isoenergetisch gefütterten Kontrollgruppe (0,1 % Tannine / Trockensubstanz) um 53 % reduziert (P < 0,05). Es konnte gezeigt werden, dass Lämmer, die mit Esparsettenheu gefüttert wurden, bereits 10 Tage nach Versuchsbeginn 44 % (P < 0,05) weniger H. contortus Eier pro Gramm Kot (EpG) ausschieden als die Kontrolltiere. Bei Versuchsende (16 Tage nach Fütterungsbeginn) war die H. contortus Eiausscheidung im Vergleich zur Kontrolle um 58 % reduziert (P < 0,01). Die Tagesgewichtszunahme der Lämmer in der Esparsettenheu-Gruppe war im Vergleich zur Kontrollgruppe tendenziell besser (163 g/Tag und 96 g/Tag; P = 0,07). Die Fütterung mit Esparsettensilage reduzierte die H. contortus Eiausscheidung verglichen mit der Kontrolle um 48 %. Dieses Resultat war allerdings nicht signifikant (P = 0,075). Im Vergleich zu den Kontrollgruppen wurde die C. curticei Eiausscheidung durch Esparsettenheu um 74 % (P < 0,001) und durch Esparsettensilage um 81 % (P < 0,001) reduziert. Es handelt sich bei dieser Studie um die erste, welche die für den Praxiseinsatz wichtige Verwendung einer konservierten, tanninhaltigen Futterpflanze gezielt gegen H. contortus und C. curticei untersucht

Understanding Variation in Sets of N-of-1 Trials.

A recent paper in this journal by Chen and Chen has used computer simulations to examine a number of approaches to analysing sets of n-of-1 trials. We have examined such designs using a more theoretical approach based on considering the purpose of analysis and the structure as regards randomisation that the design uses. We show that different purposes require different analyses and that these in turn may produce quite different results. Our approach to incorporating the randomisation employed when the purpose is to test a null hypothesis of strict equality of the treatment makes use of Nelder's theory of general balance. However, where the purpose is to make inferences about the effects for individual patients, we show that a mixed model is needed. There are strong parallels to the difference between fixed and random effects meta-analyses and these are discussed

General practitioners' views and preferences about quality improvement feedback in preventive care: a cross-sectional study in Switzerland and France.

Feedback is widely used as a strategy to improve the quality of care in primary care settings. As part of a study conducted to explore the quality of preventive care, we investigated general practitioners' (GPs) views on the usefulness of feedback and their preferences regarding how feedback is provided. This cross-sectional study was conducted in 2015 among randomly selected community-based GPs in two regions of Switzerland and France. GPs were asked to complete an anonymous questionnaire about how often they provided 12 measures of preventive care: blood pressure, weight and height measurements, screening for dyslipidemia, at-risk drinking (and advice to reduce for at-risk drinkers), smoking (and advice to stop for smokers), colon and prostate cancer, and influenza immunization for patients &gt;65 years and at-risk patients. They were also asked to estimate the usefulness of a feedback regarding their preventive care practice, reason(s) for which a feedback could be useful, and finally, to state which type of feedback they would like to receive. Chi-square tests were used to compare frequencies. Multivariate logistic regression was used to identify factors associated with GPs considering feedback as useful. Five hundred eighteen of 1100 GPs (47.1%) returned the questionnaire. They were predominantly men (62.5%) and most (40.1%) were aged between 55 and 64 years old. Overall, 44.3% stated that a feedback would be useful. Younger GPs and those carrying out more measures of preventive care were more likely to consider feedback useful. The two main reasons for being interested in feedback were to receive knowledge about the study results and to modify or improve practice. The two preferred feedback interventions were a brief report and a report with specific information regarding prevention best practice, whereas less than 1% would like to discuss the results face-to-face with the study investigators. These findings suggest that GPs have preferences regarding the types of feedback they would like to receive. Because the implementation of guidelines is highly related to the acceptance of feedback, we strongly encourage decision makers to take GPs' preferences into account when developing strategies to implement guidelines, in order to improve the quality of primary care

Charge order at the frontier between the molecular and solid states in Ba3NaRu2O9

We show that the valence electrons of Ba3NaRu2O9, which has a quasi-molecular structure, completely crystallize below 210 K. Using an extended Hubbard model, we show that the charge ordering instability results from long-range Coulomb interactions. However, orbital ordering, metal-metal bonding and formation of a partial spin gap enforce the magnitude of the charge separation. The striped charge order and frustrated hcp lattice of Ru2O9 dimers lead to competition with a quasi-degenerate charge-melted phase under photo-excitation at low temperature. Our results establish a broad class of simple metal oxides as models for emergent phenomena at the border between the molecular and solid states.Comment: Minor changes, with supporting information. To appear in Phys. Rev. Let

Rates, Delays, and Completeness of General Practitioners' Responses to a Postal Versus Web-Based Survey: A Randomized Trial.

Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs' preventive practices. This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study. Among the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P&lt;.001), but median response time was much shorter (1 day vs 1-3 weeks, P&lt;.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P&lt;.001). Web-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs' participation in surveys while reducing costs

Ecohydrology of a Floodplain Forest: Relationships Between Evapotranspiration, Vegetation, and Topography at Congaree National Park, South Carolina

Congaree National Park supports high biodiversity and provides ecosystem services for the surrounding area in the floodplain wetland system, especially in the bottomland hardwood forests which contain some of the last remaining old-growth stands in the eastern U.S. Maintaining the hydraulic functions of this ecosystem is essential not only for the conservation of biodiversity, but also for the ecosystem services it provides, such as nitrification, denitrification, decomposition, removal of organic carbon, and phosphorous uptake and sorption. Because management practices of the park depend on understanding the area‟s hydrology, past research has been performed to analyze the flooding of Congaree River. However, not much has been done to better understand groundwater movement through the floodplain sediments in the Congaree River Valley. The goal of this project is to quantify interactions between the shallow unconfined aquifer and local vegetation surrounding eight piezometers in the Congaree Observation Well Network at Congaree National Park through calculating and comparing evapotranspiration rates, specific yield, vegetation diversity and basal area, and microtopography. Data on groundwater response to storm events, diurnal signals caused by evaporation and transpiration in the forest, vegetation community structure, and local topography were compared to better understand the role of these factors on vegetation water demand in this wetland-dominated system

The Woods-Saxon Potential in the Dirac Equation

The two-component approach to the one-dimensional Dirac equation is applied to the Woods-Saxon potential. The scattering and bound state solutions are derived and the conditions for a transmission resonance (when the transmission coefficient is unity) and supercriticality (when the particle bound state is at E=-m) are then derived. The square potential limit is discussed. The recent result that a finite-range symmetric potential barrier will have a transmission resonance of zero-momentum when the corresponding well supports a half-bound state at E=-m is demonstrated.Comment: 8 pages, 4 figures. Submitted to JPhys