Level In Switzerland Research Articles

Fiscal institutions at the cantonal level in Switzerland

SummaryIn this paper, institutions are described which are designed to reach sustainability of public finances in the Swiss cantons. These are on the one hand direct popular rights, the fiscal referendum in particular, which allow citizens to express their fiscal preferences. These are on the other hand debt breaks, i.e. institutions, which prevent expenditure and revenue from drifting apart too much in order to limit possible deficits. Both together, fiscal referenda and debt breaks, allow cantons to perform a sustainable fiscal policy. This also holds — and is particularly important — for those cantons that are financially weak. That these institutions are successful is not only demonstrated by descriptive analysis but also supported by econometric analyses. Moreover, they also reduce interest payments cantons have to bear for investment expenditure. Thus, with well-designed institutions federal states might even be able to better follow a sustainable fiscal policy than unitary ones.

Learning from the chaos: Heterogeneous age limits of bans on tobacco sales to young people in Switzerland

Aims: Underage sales bans aiming to reduce young people access to tobacco were implemented in most Western countries, yet not everywhere, if at all, in Switzerland. The effect of different age limits on commercial access to tobacco is investigated using data from a naturalistic field study assessing retailers’ compliance with bans forbidding the sale of tobacco to people under the age of 16 and 18 in two Swiss cantons.Method: Applying stratified random sampling procedures, 1823 test purchases with underage ‘mystery clients’ were conducted in 2007, 2009 and 2011.Findings: Age-specific analysis revealed differences in direct retail accessibility of youth under the age of 16, considering age limits and the time since ban implementation. The implementation of more restrictive age limits resulted in a lower overall compliance and slower decrease in violation rates. It is nonetheless expected that in the long term, the level of direct accessibility of people aged less than 16 will be markedly reduced in the more restrictive legal context.Conclusions: Despite poor overall results, longitudinal analysis show potential for real improvement. These findings should be considered in future debates on more ‘pragmatic’ measures at regional or national levels in Switzerland and elsewhere.

Changes in the Use of the Methylprednisolone Protocol for Traumatic Spinal Cord Injury in Switzerland

A retrospective cohort study. To examine the differences in the use of the methylprednisolone protocol for traumatic spinal cord injury before and after the publication of new guidelines in Switzerland. The use of the methylprednisolone protocol for traumatic spinal cord injury changed after the publication of new guidelines. The rate of physicians prescribing high-dose methylprednisolone for patients with acute spinal cord injury was studied. Two intervals, each comprising 24 months before and after the publication of the consensus article in Switzerland, were compared. As a secondary parameter, the neurological development during the rehabilitation period was compared. The charts of all adult patients who were referred for treatment of a spine or spinal cord injury during the periods from April 2001 to March 2003 and from April 2008 to March 2010 were retrospectively reviewed for demographic and medical details, the application of methylprednisolone within the first 48 hours after the injury, the diagnoses at the time of their referral, and the diagnosis at the time of hospital discharge. Classification of traumatic spinal cord injury was made according to the guidelines of the American Spinal Injury Association. Neurological improvement concerning the level of injury was defined as a change of this segment to a more caudal one or a complete normalization of sensory and motor function. During the 2 study periods, 110 patients (2001-2003) and 116 patients (2008-2010) were included. Between 2001 and 2003, 96% of patients with a neurological deficit after spinal cord injury were treated with high-dose methylprednisolone, whereas this rate dropped to 23% during the second time interval. In both treatment periods, neurological improvement during the rehabilitation period (mean: 6 mo) did not differ significantly. Pooled data of all patients with a neurological deficit in both study periods (n = 159) showed improved neurological levels in 32% of patients treated with methylprednisolone and 28% of patients without this therapy, without a statistical difference between the groups. In Switzerland, the acceptance of the guidelines for treating traumatic spinal cord injury with high-dose methylprednisolone has been extremely high in the past. The use of high-dose methylprednisolone has decreased to a much lower level in Switzerland after the publication of new guidelines, which is comparable to various other countries. Despite these changes, no differences in the neurological outcome were detected between the observed patient populations.

Fondaparinux versus enoxaprin in the management of acute coronary syndromes in Switzerland: A cost comparison analysis

Anticoagulation therapy is routinely used in cases of non ST-segment elevation acute coronary syndromes (NSTE-ACS). The most commonly used drug in such events is enoxaparin, a low molecular weight heparin. Fondaparinux, a synthetic pentasaccharide, is as effective as enoxaparin in terms of survival or residual angina pectoris and significantly reduces bleeding complications. The purpose of this study was to assess the magnitude of cost reductions if enoxaparin were replaced by fondaparinux in Switzerland. Costs of hospital stay for NSTE-ACS with or without bleeding complications at the Geneva University Hospitals were determined for patients admitted between July 1st, 2007 and June 30th, 2008. These costs were applied to subjects recruited in the AMIS Plus registry, which gathers information on ACS in Swiss hospitals, using three scenarios. Firstly, using the baseline incidence of bleeding episodes observed in the AMIS plus registry. Secondly, using the baseline incidence of haemorrhagic episodes observed in the Geneva University Hospitals sample and thirdly, using the incidence of haemorrhagic episodes observed in the OASIS-5 study. These results and costs were then extrapolated to the national level. At the Swiss national level, replacement of enoxaparin by fondaparinux would generate annual savings ranging from 854,000 Swiss Francs (scenario 1) to 3,400,000 Swiss Francs (scenario 2) and 2,845,000 Swiss Francs (scenario 3). Estimated savings accounted for 55 to 63% of total hospital costs. Use of fondaparinux instead of enoxaparin in patients with NSTE-ACS could yield substantial savings at the local as well as the national level in Switzerland.

RESIGNED BUT SATISFIED: THE NEGATIVE IMPACT OF PUBLIC SERVICE MOTIVATION AND RED TAPE ON WORK SATISFACTION

This article examines the relationship between red tape, Public Service Motivation (PSM) and a particular work outcome labelled ‘resigned satisfaction’. Using data from a national survey of over 3754 public servants working at the municipal level in Switzerland, this study shows the importance of looking more closely at the concept of work satisfaction and, furthermore, of thoroughly investigating the impact of the different PSM dimensions on work outcomes. Unsurprisingly, research findings show that red tape is the most important predictor of resignation. Nevertheless, when PSM dimensions are analysed separately, results demonstrate that ‘commitment to public interest/civic duty’ and, to a lesser extent, ‘attraction to policy‐making’ decrease resignation, whereas ‘compassion’ and ‘self‐sacrifice’ increase it. This study thus highlights some of the negative (or undesirable) effects of PSM that have not been previously addressed in PSM literature.

Revising Swiss Policies

Evidence-based policy-making and other recent reforms in public steering emphasize the role systematic evidence can play in improving decision making and public policies. Increasing deficits heighten the pressure on public authorities to legitimate public spending and to find savings. Existing studies show that the influence of research-based information on decision making is shaped by several factors, but they typically do not distinguish between different types of information. Our contribution aims to compare the influence of efficiency analysis to information about performance effectiveness. We do so by looking at 10 cases in which public policies are being revised at the federal level in Switzerland, and do so by tracing the entire policy reform process. This qualitative analysis sheds light on which actors use efficiency information, how and under which conditions, and highlights the contribution of efficiency analysis for evidence-based policy-making.

Impacts of climate change on Swiss biodiversity: An indicator taxa approach

We present a new indicator taxa approach to the prediction of climate change effects on biodiversity at the national level in Switzerland. As indicators, we select a set of the most widely distributed species that account for 95% of geographical variation in sampled species richness of birds, butterflies, and vascular plants. Species data come from a national program designed to monitor spatial and temporal trends in species richness. We examine some opportunities and limitations in using these data. We develop ecological niche models for the species as functions of both climate and land cover variables. We project these models to the future using climate predictions that correspond to two IPCC 3rd assessment scenarios for the development of ‘greenhouse’ gas emissions. We find that models that are calibrated with Swiss national monitoring data perform well in 10-fold cross-validation, but can fail to capture the hot-dry end of environmental gradients that constrain some species distributions. Models for indicator species in all three higher taxa predict that climate change will result in turnover in species composition even where there is little net change in predicted species richness. Indicator species from high elevations lose most areas of suitable climate even under the relatively mild B2 scenario. We project some areas to increase in the number of species for which climate conditions are suitable early in the current century, but these areas become less suitable for a majority of species by the end of the century. Selection of indicator species based on rank prevalence results in a set of models that predict observed species richness better than a similar set of species selected based on high rank of model AUC values. An indicator species approach based on selected species that are relatively common may facilitate the use of national monitoring data for predicting climate change effects on the distribution of biodiversity.

Alcohol Dependence Figures in the Swiss General Population: A Sisyphean Challenge for Epidemiologists

Background: Research in Switzerland and elsewhere calls for valid estimations of alcohol dependence figures at the population level. As none of the methodologies developed for this purpose has proven to possess higher validity over others, this study follows the idea of methodological triangulation and compares estimates to assess their convergence. Methods: This study considers 6 standard methodological approaches to derive 17 estimates for alcohol dependence in the Swiss general population. Results: Estimates from statistics on cirrhosis mortality and from the application of external pool estimates agree with the central tendency of adjusted estimates derived using standard alcohol-related screening tools in population surveys. The number of alcohol-dependent individuals living in Switzerland is expected to be close to 250,000 (i.e. approximately 3.9% of the population aged 15 or older). Conclusion: Due to variations in estimates, it is difficult to report consistent figures for alcohol dependence at the general population level in Switzerland. Nonetheless, observation of an unambiguous central tendency and the convergence of estimates support their validity.

Low occurrence of Clostridium difficile in fecal samples of healthy calves and pigs at slaughter and in minced meat in Switzerland.

Clostridium difficile is a cause of diarrhea and colitis in humans. The increase of incidence and severity of C. difficile infections in humans in past years is due, at least in part, to the emergence of more virulent strains (PCR ribotypes 027 and 078). Recent studies describe the occurrence of hypervirulent strains in ground meat products. Therefore, food animals and food need to be assessed for their possible role as vectors of C. difficile to humans. In this pilot study, fecal samples of 204 calves and 165 pigs, as well as 46 minced meat products were investigated to determine the occurrence of C. difficile in farm animals at slaughter and in ground meat products at the retail level in Switzerland. C. difficile was isolated from only one fecal sample of a calf. All samples from pigs and ground meat were negative. Further characterization revealed that the isolated strain harbored genes for toxins A and B as well as binary toxin, and belonged to the ribotype 078. Based on these results, low occurrence of C. difficile in farm animals at slaughter and retail ground meat in Switzerland is postulated. However, further studies are necessary to confirm these preliminary data and to assess future trends.

Changes of overweight and obesity in the adult Swiss population according to educational level, from 1992 to 2007

BackgroundIn many high income developed countries, obesity is inversely associated with educational level. In some countries, a widening gap of obesity between educational groups has been reported. The aim of this study was to assess trends in body mass index (BMI) and in prevalence of overweight and obesity and their association with educational level in the adult Swiss population.MethodsFour cross-sectional National health interview surveys conducted in 1992/93 (n = 14,521), 1997 (n = 12,474), 2002 (n = 18,908) and 2007 (n = 17,879) using representative samples of the Swiss population (age range 18-102 years). BMI was derived from self-reported data. Overweight was defined as BMI ≥ 25 and <30 kg/m2, and obesity as BMI ≥ 30 kg/m2.ResultsMean (± standard deviation) BMI increased from 24.7 ± 3.6 in 1992/3 to 25.4 ± 3.6 kg/m2 in 2007 in men and 22.8 ± 3.8 to 23.7 ± 4.3 kg/m2 in women. Between 1992/3 and 2007, the prevalence of overweight + obesity increased from 40.4% to 49.5% in men and from 22.3% to 31.3% in women, while the prevalence of obesity increased from 6.3% to 9.4% in men and from 4.9% to 8.5% in women. The rate of increase in the prevalence of obesity was greater between 1992/3 and 2002 (men: +0.26%/year; women: +0.31%/year) than between 2002 and 2007 (men: +0.10%/year; women: +0.10%/year). A sizable fraction (~25%) of the increasing mean BMI was due to increasing age of the participants over time. The increase was larger in low than high education strata of the population. BMI was strongly associated with low educational level among women and this gradient remained fairly constant over time. A weaker similar gradient by educational level was apparent in men, but it tended to increase over time.ConclusionIn Switzerland, overweight and obesity increased between 1992 and 2007 and was associated with low education status in both men and women. A trend towards a stabilization of mean BMI levels was noted in most age categories since 2002. The increase in the prevalence of obesity was larger in low education strata of the population. These findings suggest that obesity preventive measures should be targeted according to educational level in Switzerland.

Biogeochemistry of particulate organic matter from lakes of different trophic levels in Switzerland

Biomarker compositions of particulate organic matter (POM) from the oligotrophic Lake Brienz and the eutrophic Lake Lugano (both Switzerland) are compared, in order to obtain information about organic matter (OM) production and transformation processes in relation to water column stratification. Eutrophic conditions in Lake Lugano are reflected by enhanced alkalinity, elevated total organic carbon (TOC) and chlorin contents compared with Lake Brienz. Lower δ 13C values of dissolved inorganic carbon (DIC) in Lake Lugano reflect enhanced OM respiration in the water column. Differences in OM dynamics between both lakes, as well as seasonal variations, are evidenced by TOC-normalised concentration profiles of total fatty acids (FAs) and total neutrals. In Lake Brienz, the results reflect the relative contributions of primary productivity and refractory, allochthonous OM to POM, governed by particle load and interflows due to density stratification. The depth trends at Lake Lugano are a result of high primary productivity, water column stratification and associated particle load in the upper layers, as well as microbially induced degradation close to the chemocline and greater preservation under anoxic conditions. Minor differences exist with regard to the OM composition. In both lakes, FA distributions and the composition of n-alkanols indicate a predominant autochthonous OM source (algae, zooplankton, bacteria). Inputs of OM from diatoms are reflected in highly-branched isoprenoid (HBI) alkenes, 16:1 n-FAs and 24-methylcholesta-5,22-dien-3β-ol (either epibrassicasterol or brassicasterol). Differences in relative proportions of n-C 16 vs. n-C 18 FAs and alkanols, respectively, as well as in the percentages of C 27, C 28 and C 29 sterols relative to the sum of sterols are related to differences in the abundances of chrysophytes, diatoms and green algae within the euphotic zone of both lakes as well as in bacterial activity and soil in-wash. High relative proportions of cholesterol in the autumn samples, most pronounced at Lake Lugano, were attributed to an increased input from zooplankton grazing in the water column. Differences in OM degradation processes are reflected in slightly higher chlorin index values and higher relative proportions of saturated vs. unsaturated n-FAs in Lake Lugano. Higher contents of branched chain FAs, 16:1ω7 n-FA, and enhanced 18:1ω7/18:1ω9 n-FA ratios suggest enhanced bacterial biomass in the water column of Lake Lugano close to the chemocline. Increasing proportions of saturated n-FAs and n-alkanols with increasing water depth, most distinct in the autumn for both lakes, argue for intensified bacterial activity and degradation of OM during autumn. High relative contents of sterols and low n-alkanol concentrations in POM close to the chemocline at Lake Lugano during spring are interpreted to reflect higher primary productivity in the photic zone, OM export to the deeper parts and enhanced degradation rates of more labile constituents (i.e. C 13–C 20 n-alkanols), as compared to Lake Brienz.

Improvements in PM10 Exposure and Reduced Rates of Respiratory Symptoms in a Cohort of Swiss Adults (SAPALDIA)

Reductions in mortality following improvements in air quality were documented by several studies, and our group found, in an earlier analysis, that decreasing particulate levels attenuate lung function decline in adults. We investigated whether decreases in particulates with an aerodynamic diameter of less than 10 microm (PM10) were associated with lower rates of reporting respiratory symptoms (i.e., decreased morbidity) on follow-up. The present analysis includes 7,019 subjects who underwent detailed baseline examinations in 1991 and a follow-up interview in 2002. Each subject was assigned model-based estimates of average PM10 during the 12 months preceding each health assessment and the difference was used as the exposure variable of interest (DeltaPM10). Analyses were stratified by symptom status at baseline and associations between DeltaPM10 and change in symptom status during follow-up were adjusted for important baseline characteristics, smoking status at follow-up, and season. We then estimated adjusted odds ratios for symptoms at follow-up and numbers of symptomatic cases prevented due to the observed reductions in PM10. Residential exposure to PM10 was lower in 2002 than in 1991 (mean decline 6.2 microg/m3; SD = 3.9 microg/m3). Estimated benefits (per 10,000 persons) attributable to the observed changes in PM10-levels were: 259 (95% confidence interval [CI]: 102-416) fewer subjects with regular cough, 179 (95% CI, 30-328) fewer subjects with chronic cough or phlegm and 137 (95% CI, 9-266) fewer subjects with wheezing and breathlessness. Reductions in particle levels in Switzerland over the 11-year follow-up period had a beneficial effect on respiratory symptoms among adults.

Preparations for the European football championship (EURO 2008) in Switzerland

The European football championship (EURO 2008) is taking place in Austria and Switzerland between 7 and 29 June 2008. From a public health point of view, such a mass gathering requires attention with regard to infectious disease prevention because of (i) a potential increased risk for disease transmission (ii) increased media attention and (iii) its potential as a target for actions of a bioterrorist nature [2,6,8,9]. This article gives an overview of the preparations for Euro 2008 on the national level in Switzerland with regards to infectious diseases.

CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland

This work aimed at assessing the doses delivered in Switzerland to paediatric patients during computed tomography (CT) examinations of the brain, chest and abdomen, and at establishing diagnostic reference levels (DRLs) for various age groups. Forms were sent to the ten centres performing CT on children, addressing the demographics, the indication and the scanning parameters: number of series, kilovoltage, tube current, rotation time, reconstruction slice thickness and pitch, volume CT dose index (CTDI(vol)) and dose length product (DLP). Per age group, the proposed DRLs for brain, chest and abdomen are, respectively, in terms of CTDI(vol): 20, 30, 40, 60 mGy; 5, 8, 10, 12 mGy; 7, 9, 13, 16 mGy; and in terms of DLP: 270, 420, 560, 1,000 mGy cm; 110, 200, 220, 460 mGy cm; 130, 300, 380, 500 mGy cm. An optimisation process should be initiated to reduce the spread in dose recorded in this study. A major element of this process should be the use of DRLs.

Financing a competitive recycling initiative in Switzerland

The purpose of the paper is to enhance the understanding of different pricing systems within the real world of solid waste management: first the effect on recycling behaviour of citizens, and second the effect on the budget goals, and third the operational logic of different economic measures will be analyzed. Hence it helps practitioners understand and cope with the challenge of meeting the zero profit budget goal in public solid waste management while inducing behaviour change in the regional solid waste system. The question “How can robust recycling strategies be financed?” is addressed. The analysis draws on a system dynamics model for solid waste management that is based on a model framework on human behaviour and public policy that embraces an evolutionary feedback perspective. The model structure was deduced from an ex-post analysis of observed phenomena in solid waste management such as recurring budget deficits at the local level in Switzerland. The paper illustrates how the model was used as a policy lab in which various pricing and incentive strategies were tested that allowed addressing “what-if-questions” under controlled conditions. The various policy-experiments illustrated crucial trade offs between zero profit budget goals at the local level and the administration of a successful recycling initiative. Different scenario-experiments show that under worst-case conditions economic instrument are not sufficient in order to yield a robust policy outcome.

Metals, non-metals and PCB in electrical and electronic waste – Actual levels in Switzerland

The chemical composition of waste of small electrical and electronic equipment (s-WEEE), a rapidly growing waste stream, was determined for selected metals (Cu, Sb, Hg etc.) and non-metals (Cl, Br, P) and PCBs. During a 3-day experiment, all output products and the s-WEEE input mass flows in a WEEE recycling plant were measured. Only output products were sampled and analyzed. Material balances were established, applying substance flow analysis (SFA). Transfer coefficients for the selected substances were also determined. The results demonstrate the capability of SFA to determine the composition of the highly heterogeneous WEEE for most substances with rather low uncertainty (2 σ ⩽ ± 30%). The results confirm the growing importance of s-WEEE regarding secondary resource metals and potential toxic substances. Nowadays, the thirty times smaller s-WEEE turns over larger flows for many substances, compared to municipal solid waste. Transfer coefficient results serve to evaluate the separation efficiency of the recycling process and confirm – with the exception of PCB and Hg – the limitation of hand-sorting and mechanical processing to separate pollutants (Cd, Pb, etc.) out of reusable fractions. Regularly applied SFA would serve to assess the efficacy of legislative, organizational and technical measures on the WEEE.

Functions of scenarios in transition processes

Given the interplaying tendencies of economic decline, social instability, and environmental depletion, any transition towards sustainable development faces a challenging task. To successfully cope with this complexity requires transition management. Integrated approaches for supporting sustainability transitions have been elaborated in the last years. Future studies and scenario construction are regarded as essential components in these approaches. However, the related studies in this field have focused either on a specific type of transition process, or on decision support in a different contextual process, or on a specific function of scenarios. Thus, an evaluation of the wide range of viewpoints on the functions of scenarios with respect to the requirements for transition management is still missing. In this paper, we systematically elaborate upon the functions for transition management that scenarios can fulfil. The developed concept is applied to five empirical scenario studies supporting transition processes on the national, regional and local level in Switzerland. The paper contributes to the development of a functional methodology of transition support, providing initial guidelines for answering the question of which method is appropriate for what type and phase of a transition process.

Genetic Alterations in Primary Glioblastomas in Japan

Current knowledge of genetic alterations in glioblastomas is based largely on genetic analyses of tumors from mainly caucasian patients in the United States and Europe. In the present study, screening for several key genetic alterations was performed on 77 primary (de novo) glioblastomas in Japanese patients. SSCP followed by DNA sequencing revealed TP53 mutations in 16 of 73 (22%) glioblastomas and PTEN mutations in 13 of 63 (21%) cases analyzed. Polymerase chain reaction (PCR) showed EGFR amplification in 25 of 77 (32%) cases and p16 homozygous deletion in 32 of 77 (42%) cases. Quantitative microsatellite analysis revealed LOH 10q in 41 of 59 (69%) glioblastomas. The frequencies of these genetic alterations were similar to those reported for primary glioblastomas at the population level in Switzerland. As previously observed for glioblastomas in Europe, there was a positive association between EGFR amplification and p16 deletion (p=0.009), whereas there was an inverse association between TP53 mutations and p16 deletion (p=0.049) in glioblastomas in Japan. Multivariate analyses showed that radiotherapy was significantly predictive for longer survival of glioblastoma patients (p=0.002). SSCP followed by DNA sequencing of the kinase domain (exons 18-21) of the EGFR gene revealed mutations in 2 ou of 69 (3%) glioblastomas in Japan and in 4 of 81 (5%) glioblastomas in Switzerland. The allele frequencies of polymorphisms at codon 787 CAG/CAA (Gln/Gln) in glioblastomas in Japan were G/G (82.4%), G/A (10.8%), A/A (6.8%), corresponding to G 0.878 versus A 0.122, significantly different from those in glioblastomas in Switzerland: G/G (27.2%), G/A (28.4%), A/A (44.4%), corresponding to G 0.414 versus A 0.586 (p < 0.0001). These results suggest that primary glioblastomas in Japan show genetic alterations similar to those in Switzerland, suggesting a similar molecular basis in caucasians and Asians, despite different genetic backgrounds, including different status of a polymorphism in the EGFR gene.

Decline of Ambient Air Pollution Levels and Improved Respiratory Health in Swiss Children

The causality of observed associations between air pollution and respiratory health in children is still subject to debate. If reduced air pollution exposure resulted in improved respiratory health of children, this would argue in favor of a causal relation. We investigated whether a rather moderate decline of air pollution levels in the 1990s in Switzerland was associated with a reduction in respiratory symptoms and diseases in school children. In nine Swiss communities, 9,591 children participated in cross-sectional health assessments between 1992 and 2001. Their parents completed identical questionnaires on health status and covariates. We assigned to each child an estimate of regional particles with an aerodynamic diameter < 10 μg/m3 (PM10) and determined change in PM10 since the first survey. Adjusted for socioeconomic, health-related, and indoor factors, declining PM10 was associated in logistic regression models with declining prevalence of chronic cough [odds ratio (OR) per 10-μg/m3 decline = 0.65, 95% confidence interval (CI), 0.54–0.79], bronchitis (OR = 0.66; 95% CI, 0.55–0.80), common cold (OR = 0.78; 95% CI, 0.68–0.89), nocturnal dry cough (OR = 0.70; 95% CI, 0.60–0.83), and conjunctivitis symptoms (OR = 0.81; 95% CI, 0.70–0.95). Changes in prevalence of sneezing during pollen season, asthma, and hay fever were not associated with the PM10 reduction. Our findings show that the reduction of air pollution exposures contributes to improved respiratory health in children. No threshold of adverse effects of PM10 was apparent because we observed the beneficial effects for relatively small changes of rather moderate air pollution levels. Current air pollution levels in Switzerland still exceed limit values of the Swiss Clean Air Act; thus, children’s health can be improved further.

Reform der Gewerbesteuer: Wie es Euch gefallt?- Eine Nachlese

: One of the most pertinent reform discussions in Germany is found in the debate on the local business tax. During the last year, two basic reform proposals, a revitalisation of the current local business tax and its replacement by a surcharge on personal and corporate income taxes, intensively competed. Finally, none of these alternatives was realised. The federal parliament and government could only agree to introduce temporary financial relief for local jurisdictions. In this article, the continuous need for a fundamental reform of local government finances is emphasised. After a discussion of the basic alternative reform models against the background of characteristics of economically reasonable local government finances, the simulated impact of a local surcharge on income taxes is compared to the tax rate differences at the local level in Switzerland. The surcharge model would lead to smaller tax rate differentials than currently exist at the Swiss local level. The resistance against such a reform is explained by the fact that political actors at the local level oppose the implied higher political responsibility when citizens face local income tax rates as prices for local public services.