Migration et violence

Les migrants et les requérants s'asile qui ont survécu à des violences ou à des tortures ont expérimenté des traumatismes physiques et psychologiques qui ont laissé des traces, des plaies béantes. Une fois arrivés dans le pays d'accueil, la violence dont ils ont été l'objet ne s'arrête pas nécessairement, car l'immigration peut générer elle-même de nouvelles formes de violence qui s'adressent à des sujets rendus au départ vulnérables par leurs expériences. En effet, quand les migrants et les requérants d'asile arrivent dans le pays d'accueil, ils se heurtent souvent à une très faible tolérance de la part des population autochtones, à des contrôles policiers et administratifs, à une incertitude permanente quant au bon droit de trouver chez nous protection et sécurité. Le soignant, lorsqu'il prend en charge ces victimes de violence dans un réseau multidisciplinaire de soins, peut panser, en partie, ces plaies et ainsi leur redonner une certaine dignité. [Auteurs]]]> Emigration and Immigration ; Transients and Migrants ; Violence fre oai:serval.unil.ch:BIB_562D08AFA101 2022-05-07T01:18:12Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_562D08AFA101 Das „Gesicht der Zeit“ und seine feuilletonistischen Facetten : Zur Physiognomik der „kleinen Form“ nach 1900 https://www.rombach-verlag.de/buecher/wissenschaft/rombach/buch/details/physiognomisches-schreiben.html Utz, Peter info:eu-repo/semantics/bookPart incollection 2016 Physiognomisches Schreiben : Stilistik, Rhetorik und Poetik einer gestaltdeutenden Kulturtechnik, pp. 47-66 von Arburg, Hans-Georg (ed.) Tremp, Benedikt (ed.) Zimmermann, Elias (ed.) info:eu-repo/semantics/altIdentifier/isbn/978-3-7930-9856-0 ger oai:serval.unil.ch:BIB_562D42148454 2022-05-07T01:18:12Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_562D42148454 Getting Nervous: An Evolutionary Overhaul for Communication. info:doi:10.1146/annurev-genet-120116-024648 info:eu-repo/semantics/altIdentifier/doi/10.1146/annurev-genet-120116-024648 info:eu-repo/semantics/altIdentifier/pmid/28934592 Varoqueaux, F. Fasshauer, D. info:eu-repo/semantics/review article 2017-11-27 Annual review of genetics, vol. 51, pp. 455-476 info:eu-repo/semantics/altIdentifier/eissn/1545-2948 urn:issn:0066-4197 <![CDATA[The evolution of a nervous system as a control system of the body's functions is a key innovation of animals. Its fundamental units are neurons, highly specialized cells dedicated to fast cell-cell communication. Neurons pass signals to other neurons, muscle cells, or gland cells at specialized junctions, the synapses, where transmitters are released from vesicles in a Ca &lt;sup&gt;2+&lt;/sup&gt; -dependent fashion to activate receptors in the membrane of the target cell. Reconstructing the origins of neuronal communication out of a more simple process remains a central challenge in biology. Recent genomic comparisons have revealed that all animals, including the nerveless poriferans and placozoans, share a basic set of genes for neuronal communication. This suggests that the first animal, the Urmetazoan, was already endowed with neurosecretory cells that probably started to connect into neuronal networks soon afterward. Here, we discuss scenarios for this pivotal transition in animal evolution

Care and cost trajectories of asylum seekers in a nurse-led, patient centered, care network in Switzerland.

Switzerland, with its decentralized health system, has seen the emergence of a variety of care models to meet the complex needs of asylum seekers. A network of public and private providers was designed in the canton Vaud, in which a nurse-led team acts as a first contact point to the health system and provides health checks, preventive care, and health education to this population. In addition, the service plays a case management role for more complex and vulnerable patients. While the network has been examined from a clinical angle, we provide the first descriptive evidence on the care and cost trajectories of asylum seekers in the canton. We used routinely collected administrative, patient-level data in a Swiss region responsible for 10% of the asylum seekers in the country. We extracted data on all asylum seekers aged 18 or older who entered the network between 2012 and 2015. The data covered all healthcare costs during the period until they left the network, either because they were granted residence, they left the country, or until 31 December 2018. We estimated random effects regression models for costs and consultations within and outside the network for each month of stay in the network. We investigated language barriers in access to care by stratifying the analysis between patients who spoke one of the official Swiss languages or English and patients who did not speak any of these languages. We found that both overall health care costs and contacts with the nurse-led team were relatively high during the first year of stay. Asylum seekers then progressively integrated into the regular health system. Individuals who did not speak the language generally had more contacts with the network and fewer contacts outside. In this exploratory study, we observe a transition from nurse-led specific care with frequent contacts to care in the regular health system. This leads us to generate the hypothesis that a nurse-led, patient-centered care network for asylum seekers can play an important role in providing primary care during the first year after their arrival and can subsequently help them navigate autonomously within the conventional healthcare system

Douleur irradiant dans l'hypochondre gauche?. [Pain irritating in the left hypochondre?]

We report the case of a 43-year-old man with subacute epigastric pain and left hypochondriac irradiation. The final diagnosis is a splenic infarction. A typical manifestation of this disease is a sudden diffuse pain in the left hypochondrium, accompanied by nausea and early satiety. Etiology is usually hematologic for patients under 40 years old and embolic for patients over 40. Abdominal scanner can be used to confirm the diagnosis, the treatment is conservative. Splenic infarction is rare, and therefore not often included in the differential diagnosis. More than 20% of the cases can lead to complications such as an abscess or rupture. Therefore splenic infarction should be included in the differential diagnosis in the situation of left hypochondriac pain

Early childhood caries in Switzerland: a marker of social inequalities

BACKGROUND: Early childhood caries (ECC) is a marker of social inequalities worldwide because disadvantaged children are more likely to develop caries than their peers. This study aimed to define the ECC prevalence among children living in French-speaking Switzerland, where data on this topic were scarce, and to assess whether ECC was an early marker of social inequalities in this country. METHODS: The study took place between 2010 and 2012 in the primary care facility of Lausanne Children's Hospital. We clinically screened 856 children from 36 to 71 months old for ECC, and their caregivers (parents or legal guardians) filled in a questionnaire including items on socioeconomic background (education, occupation, income, literacy and immigration status), dental care and dietary habits. Prevalence rates, prevalence ratios and logistic regressions were calculated. RESULTS: The overall ECC prevalence was 24.8 %. ECC was less frequent among children from higher socioeconomic backgrounds than children from lower ones (prevalence ratios ≤ 0.58). CONCLUSIONS: This study reported a worrying prevalence rate of ECC among children from 36 to 71 months old, living in French-speaking Switzerland. ECC appears to be a good marker of social inequalities as disadvantaged children, whether from Swiss or immigrant backgrounds, were more likely to have caries than their less disadvantaged peers. Specific preventive interventions regarding ECC are needed for all disadvantaged children, whether immigrants or Swiss

General practitioners can evaluate the material, social and health dimensions of patient social status

OBJECTIVE: To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.DESIGN: Cross-sectional ulticentric survey. SETTING: Fourty-seven primary care private offices in Western Switzerland. PARTICIPANTS: Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011. MAIN MEASURES: PRIMARY OUTCOME: patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care. RESULTS: To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p&lt;0.0001). CONCLUSIONS: GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status

Forgoing dental care for economic reasons in Switzerland: a six-year cross-sectional population-based study

BACKGROUND: While oral health is part of general health and well-being, oral health disparities nevertheless persist. Potential mechanisms include socioeconomic factors that may influence access to dental care in the absence of universal dental care insurance coverage. We investigated the evolution, prevalence and determinants (including socioeconomic) of forgoing of dental care for economic reasons in a Swiss region, over the course of six years. METHODS: Repeated population-based surveys (2007-2012) of a representative sample of the adult population of the Canton of Geneva, Switzerland. Forgone dental care, socioeconomic and insurance status, marital status, and presence of dependent children were assessed using standardized methods. RESULTS: A total of 4313 subjects were included, 10.6% (457/4313) of whom reported having forgone dental care for economic reasons in the previous 12 months. The crude percentage varied from 2.4% in the wealthiest group (monthly income ≥ 13,000 CHF, 1 CHF ≈ 1$) to 23.5% among participants with the lowest income (&lt;3,000 CHF). Since 2007/8, forgoing dental care remained stable overall, but in subjects with a monthly income of &lt;3,000 CHF, the adjusted percentage increased from 16.3% in 2007/8 to 20.6% in 2012 (P trend = 0.002). Forgoing dental care for economic reasons was independently associated with lower income, younger age, female gender, current smoking, having dependent children, divorced status and not living with a partner, not having a supplementary health insurance, and receipt of a health insurance premium cost-subsidy. CONCLUSIONS: In a Swiss region without universal dental care insurance coverage, prevalence of forgoing dental care for economic reasons was high and highly dependent on income. Efforts should be made to prevent high-risk populations from forgoing dental care

Primary Care-Led Transition Clinics Hold Promise in Improving Care Transitions for Cancer Patients Facing Social Disparities: A Commentary.

Transitions in care are key junctions during which care coordination, communication, and individualized support are required to ensure optimal health outcomes for patients. This is particularly true for patients who face social disparities, such as poverty, limited health literacy, or belonging to a racial or ethnic minority, who are particularly at risk for experiencing poor care transitions. Interdisciplinary primary care-led transition clinics are an intervention that have shown promise in improving care transitions for diverse patient populations, including those that face social disparities, but their role in improving transitions in cancer care remains largely untapped. In this commentary we highlight why the time-limited support of an interdisciplinary primary care-led transition clinic that targets socially vulnerable cancer patients holds the promise of achieving more equitable healthcare access, healthcare quality, and ultimately more equitable health outcomes for cancer patients

Grands consommateurs des services d'urgence, un défi pour le système de santé : une mise au point

Dans de nombreux pays, on assiste à une augmentation importante de la fréquentation des services d’urgences des hôpitaux, entraînant un risque accru d’encombrement de ces services et, potentiellement, un risque pour la santé des patients consultants. Les causes possibles de tels encombrements sont multiples : fréquemment mentionnés sont les patients consultant plusieurs fois par année, les grands consommateurs des services d’urgence. Selon la littérature, ils représentent 3,5 % à 7,7 % des patients et 12 % à 18 % des consultations. Ils correspondent, comparativement aux patients usagers occasionnels de services d’urgence, plus fréquemment à des personnes souffrant de troubles psychiques, présentant des maladies chroniques multiples, dépendantes à une substance ou de conditions socioéconomique modestes. Les raisons les plus fréquemment citées par les grands consommateurs, comme motifs de consultation, sont la gravité perçue de leur maladie et l’offre limitée d’alternatives à une consultation d’urgence. Ils se sentent, par ailleurs, régulièrement discriminés et stigmatisés lors de leur prise en charge. Plusieurs types d’interventions, rapportées dans la littérature, permettent soit de réduire le nombre de consultations par des grands consommateurs, soit de mieux prendre en charge ces patients. Citons les interventions portant sur l’amélioration de la littératie de santé des grands consommateurs ; celles axées sur leur réorientation préhospitalière par du personnel soignant ; celles visant une limitation de l’accès aux services d’urgences par un système de gate-keeper ou par des incitatifs économiques ; celles assurant un accès à des soins communautaires facilités, par exemple par la mise en place de structures de soins de bas-seuil ; celles enfin, particulièrement efficaces, mettant l’accent sur la coordination des soins entre prise en charge hospitalière et communautaire, telle que le case-management

Les comportements face au VIH/sida parmi les migrants originaires d'Afrique subsaharienne en Suisse : Enquête ANSWER 2013-2014

L'enquête Internet ANSWER (African Net Survey WE Respond!) auprès des migrants provenant d'Afrique subsaharienne (ASS) a été menée entre septembre 2013 et février 2014, sur mandat de l'OFSP et avec la collaboration de l'ASS. Cette enquête s'inscrit dans le cadre du mandat de surveillance épidémiologique de deuxième génération du VIH et des autres IST auquel l'IUMSP participe activement. Le but de cette enquête a été de décrire dans cette population les connaissances, attitudes et comportements (en particulier, les comportements sexuels, l'usage de préservatifs et la réalisation de tests de dépistage du VIH) en lien avec la prévention du VIH et des autres infections sexuellement transmissibles. Une analyse exploratoire de facteurs associés à certains comportements (partenaires multiples, utilisation de préservatifs, réalisation de tests) a également été menée. Il s'agissait d'une enquête par Internet auto-administrée disponible en 7 langues, à laquelle les personnes originaires d'Afrique subsaharienne étaient invitées à participer. Un groupe d'accompagnement composé de professionnels de la prévention du VIH et de médiateurs culturels de différents pays africains a participé activement à toutes les étapes du projet (conception du questionnaire, traductions, cognitive testing, promotion de l'enquête, mobilisation communautaire)