Swiss Canton Of Vaud Research Articles

Legume intake and cancer risk in a network of case-control studies.

Evidence on the relationship between legume consumption and risk of specific cancer sites is inconclusive. We used data from a series of case-controls studies, conducted in Italy and in the Swiss Canton of Vaud between 1991 and 2009 to quantify the association between legume consumption and several cancer sites including oral cavity, esophagus, larynx, stomach, colorectum, breast, endometrium, ovary, prostate and kidney. Multiple logistic regression models controlled for sex, age, education, smoking, alcohol, body mass index, physical activity, comorbidities, and consumption of fruit, vegetables, processed meat and total calorie intake were used to estimate the odds ratios (OR) for different cancer sites and their corresponding 95% confidence intervals(CI). For female hormone-related cancers, the models also included adjustments for age at menarche, menopausal status and parity. Although most of the estimates were below unity, suggesting a protective effect, only colorectal cancer showed a significant association. Compared to no consumption, the OR for consuming at least one portion of legumes was 0.79 (95% CI: 0.68-0.91), the OR for consuming two or more portions was 0.68 (95% CI: 0.57-0.82) and the estimate for an increment of one portion per week was 0.87 (95% CI: 0.81-0.93). The inverse association between legume consumption and colorectal cancer suggests a possible role of legumes in preventing cancer risk.

Innovative Lighting Systems: Opportunities for Energy Savings

This paper analyses, from an energy flow perspective, the implementation of smart lighting systems in street lighting, where lights are dimmed to adapt to the flow of objects passing in a street. The research focus on the sustainability perspective of implementing a transition to smart lighting systems when compared to regular LED lighting. To account for externalities, the energy flow was addressed considering the extra electronic devices used in a smart lighting system (controllers, motion sensors, radars, and computers).
 
 To compare both traditional LED street lighting and smart lighting the paper started with a model of a 2.5-kilometre street, scaling up scenarios of the commune Ecublens, in the Swiss canton of Vaud, and then to half and all residential streets of Switzerland were examined to understand if the gains in energy savings are scalable. 
 
 The research shows that, even with the additional electronic devices, the smart lighting system reduces the energy consumption of street lighting, even when considering the production of the extra components used. Financially, the extra costs of implementing smart lighting systems are offset by the savings in electricity consumption. Therefore, smart lighting systems for street lighting can be an environmentally and economically beneficial project to implement.

Coproducing value during the COVID-19 pandemic.

Service users, professionals, and civil society all contribute to public health. Inclusion of all relevant actors in a network community coproduction approach can improve public health crisis responses. Using the Swiss canton of Vaud's COVID-19 response as an example, we describe ways in which a network approach can add value to public health services.

Potentially inappropriate prescriptions: Associations with the health insurance contract and the quality of the patient–physician relationship?

ContextPotentially Inappropriate Prescriptions (PIP) are often used as an indicator of potential drug overuse or misuse to limit adverse drug events in older people. ObjectiveTo determine whether PIP exposure differs as a function of the patient's health insurance scheme and the patient–physician relationship. MethodsOur dataset was collected from two surveys delivered to two cohorts of the Swiss Lc65+ study, together with a stratified random sample of older people in the Swiss canton of Vaud. The study sample consisted of 1,595 people aged 68 years and older living in the community and reporting at least one prescription drug. Logit regression models of PIP risk were run for various categories of variables: health related, socioeconomic, health insurance scheme and patient–physician relationship. Results17% of our respondents had at least one PIP. Our results suggested that being enrolled in a health plan with restriction in the patient's choice of providers and having higher deductibles were associated with lower PIP risk. PIP risk did not differ as a function of the quality of the patient–physician relationship. ConclusionOur study helps to raise awareness about the organizational risk factors of PIP and, more specifically, how health insurance contracts could play a role in improving the management of drug consumption among community-dwelling older people.

Clinical profile and care pathways among unaccompanied minor asylum seekers in Vaud, Switzerland.

The objectives of this study were to describe the overall clinical profile (somatic and psychological health) and the care pathways of unaccompanied minor asylum seekers (UMAS) who arrived in the Swiss canton of Vaud in 2015. This was a retrospective study based on information extracted from the medical files of 109 patients over 1 year of follow-up. All the reasons for consultation and referrals as well as the diagnoses made were noted and coded using ICD-10. The healthcare providers for all diagnoses and referrals were also noted. Our sample was predominantly male (87.2%) and hailed primarily from Eritrea (39.4%) and Afghanistan (32.1%). Gatekeeping nurses at a specialized migrant care facility (MCF) referred 67.7% of the UMAS to other providers for further medical care, including 45.4% to the Interdisciplinary Division for Adolescent Health (DISA). However, 46.8% of the 109 UMAS also sought care at other structures without any referral by MCF or DISA as intended. Of the patients 39.4% were found to have at least one mental health problem, mainly functional disorders (21.1%), symptoms and episodes of depression (17.4%), symptoms of post-traumatic stress disorder (PTSD) (13.8%) and sleeping disorders (12.8%). The most common diagnoses of infectious diseases included community-acquired respiratory infections (43.1%), scabies (20.2%) and cases of skin abscesses and furuncles (13.8%). In fewer instances, cases of active tuberculosis (3.7%), chronic hepatitis B (2.8%), intestinal parasites (1.8%) and gastritis caused by Helicobacter pylori (1.8%) were also diagnosed. A significant proportion of UMAS presented traumatological (30.3%) and ophthalmological (25.7%) problems. Among the female UMAS (12.8% of the sample), evidence of genital mutilation (21.4%), pregnancy (21.4%) and abortion (14.3%) was common. An integrated approach involving efficient coordination between different providers is necessary in order to respond adequately to the major healthcare needs of UMAS. Special attention should be paid to mental health.

Towards housing sustainability: a framework for the decision-making process of tenants

The mismatch between the supply and demand of rental apartments in Switzerland represents an obstacle to the transition towards a more sustainable society. The difficulty for the housing providers to accommodate the fast societal change of the demand brings about an increase in vacancies and, to minimize investment risks, a resistance to innovation in the building sector. In this context, understanding the determinants of tenants’ residential mobility and location choice becomes key to designing and promoting sustainable housing. In this paper we present a new interdisciplinary framework for the decision-making process of tenants. To do so, we elucidate the main parameters of the decisions to move and where to move, based on literature review and a group discussion in the Swiss canton of Vaud with the tenants of the two housing providers SCHL and Swiss Mobiliar. We find that the desired housing function determines the tenants’ housing selection. We observe that this desired function changes according to the type of trigger that pushes tenants to move. Additionally, we elicit the potential sustainability implications of the housing functions in the Swiss context. We conclude that the framework can serve as a starting point for rethinking sustainable interventions in the housing sector.

The absent rewards of assimilation: how ethnic penalties persist in the Swiss labour market

We analyse whether the origin of immigrants and/or their level of assimilation to the host country (birth and naturalisation) can explain labour market trajectories. Among the manifold domains in which individuals with a migration background may face disadvantages, we focus on labour market re-integration because it has been proven to be a key factor in fostering long-term social integration into the host country. Although empirical evidence for discriminatory practices by employers is generally difficult to provide with registry data, our design minimises potential alternative explanations. Our study benefits from a unique dataset combining registry and survey data, which were collected in the Swiss Canton of Vaud among all newly unemployed individuals between February and April 2012. The findings are based on real labour market behaviour and show that when controlling for encompassing information on human and social capital and other employability criteria, individuals whose provenance is from outside the European Union face periods of unemployment that are up to 50% (or 3 months) longer than those of Swiss natives. Surprisingly, observable assimilation proofs in the form of naturalisation or birth in the host country do not improve labour market re-integration. We explain this finding by employers’ discriminatory hiring behaviour.

Legalised non-consensual sterilisation – eugenics put into practice before 1945, and the aftermath. Part 2: Europe

This article deals with the nine European nations which legalised non-consensual sterilisation during the interwar years, thus completing the review, the first part of which was published in an earlier issue of this Journal. Like we did for North America, Japan and Mexico, countries concerned are addressed in chronological order, as practices in one of these influenced policies in others, involved later. For each, we assess the continuum of events up to the present time. The Swiss canton of Vaud was the first political entity in Europe to introduce a law on compulsory sterilisation of people with intellectual disability, in 1928. Vaud’s sterilisation Act aimed at safeguarding against the abusive performance of these procedures. The purpose of the laws enforced later in eight other European countries (all five Nordic countries; Germany and, after its annexation by the latter, Austria; Estonia) was, on the contrary, to effect the sterilisation of large numbers of people considered a burden to society. Between 1933 and 1939, from 36,000 to 400,000 residents (two-thirds of whom were women) were compulsorily sterilised in Nazi Germany. In Sweden, some 32,000 sterilisations carried out between 1935 and 1975 were involuntary. It might have been expected that after the Second World War ended and Nazi legislation was suspended in Germany and Austria, including that regulating coerced sterilisation, these inhuman practices would have been discontinued in all nations concerned; but this happened only decades later. More time still went by before the authorities in certain countries officially acknowledged the human rights violations committed, issued apologies and developed reparation schemes for the victims’ benefit.

Compulsory Voting, Habit Formation, and Political Participation

Can electoral institutions induce lasting changes in citizens’ voting habits? We study the long-term and spillover effects of compulsory voting in the Swiss canton of Vaud (1900–1970) and find that this intervention increases turnout in federal referendums by 30 percentage points. However, despite its magnitude, the effect disappears quickly after voting is no longer compulsory. We find minor spillover effects on related forms of political participation that also vanish immediately after compulsory voting has been abolished. Overall, these results question habit formation arguments in the context of compulsory voting.

It's Discrimination, Stupid: Labour Market (Re-) Entry Difficulties Among Different Immigrant Groups in Switzerland 2015

We start from the empirical observation that unemployed migrants from Africa and Ex-Yugoslavia have more difficulties when trying to re-enter the labour market as compared to migrants from Portugal. Based on a unique dataset of newly unemployed individuals in the Swiss Canton of Vaud, we set out to analyse the reasons for the large difference in the length of unemployment spells by testing the most important theoretical approaches of employability proposed in the literature. First, we analyse whether differences at the level of individual resources explain differences in outcome (human capital). Second, we test how the size of the social network influences the likelihood of finding employment (social capital). Third, we account for motivation, effort and job search strategies (proactive search behaviour). Eventually, we controlled for individual wellbeing as a potential driver of unemployment duration but we found no evidence that these different factors are able to explain the underperformance of Ex-Yugoslavian and African respondents. Our conclusion is that discriminatory patterns related to nationality are at least in part responsible for the substantial disadvantage of these groups and we explain it by referring to the diffusion of negative stereotypes about specific immigrant communities in the public sphere.

Inequality in social capital and labour market re-entry among unemployed people

Research on social capital inequality has tended to emphasise the fact that the distribution of social capital follows that of other resources, with the result that it tends to amplify social inequalities. More elaborated theoretical accounts and some empirical studies suggest, however, that under some circumstances, social capital can actually compensate for disadvantage in social position. In this paper we test these competing hypotheses on a population of newly unemployed people in the Swiss canton of Vaud (N=3521). It appears that in most cases the distribution of social capital reflects that of other dimensions of stratification that are associated with labour market disadvantage, such as education, immigrant status, gender, and occupational status. On one important component of social capital, the number of work-related contacts, some immigrant groups score better than Swiss nationals. While this is an important predictor of early exit from unemployment, it fails to translate into an improvement of labour market prospects for the relevant immigrant groups, most likely because its effect is counteracted by more powerful forces such as inequality in skills and discrimination.

Availability, Cost or Culture? Obstacles to Childcare Services for Low-Income Families

AbstractRecent research has highlighted the existence of a social bias in the extent to which children have access to childcare. In general, children living in higher income households are more likely to be cared for in childcare centres. While the existence of a social bias in access to childcare services has been clearly demonstrated, we currently lack a clear explanation as to why this is the case. This paper uses a unique dataset based on survey data collected specifically to study patterns of childcare use in the Swiss canton of Vaud (N = 875). The paper exploits the variation in the way childcare is organised within the canton. Childcare is a municipal policy, as a result of which there are twenty-nine different systems in operation. Fees are progressive everywhere, but variation is substantial. Availability is also very different. This peculiar institutional setup provides an ideal situation to examine the determinants of childcare use by different income groups. Our findings suggest that differences in the fees charged to low-income households, as well as the degree of progressivity of the fee structure, are significant predictors of use, while availability seems to matter less.

Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies.

Background:Some components of the Mediterranean diet have favourable effects on endometrial cancer, and the Mediterranean diet as a whole has been shown to have a beneficial role on various neoplasms.Methods:We analysed this issue pooling data from three case-control studies carried out between 1983 and 2006 in various Italian areas and in the Swiss Canton of Vaud. Cases were 1411 women with incident, histologically confirmed endometrial cancer, and controls were 3668 patients in hospital for acute diseases. We measured the adherence to the Mediterranean diet using a Mediterranean Diet Score (MDS), based on the nine dietary components characteristics of this diet, that is, high intake of vegetables, fruits/nuts, cereals, legumes, fish; low intake of dairy products and meat; high monounsaturated to saturated fatty acid ratio; and moderate alcohol intake. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) for increasing levels of the MDS (varying from 0, no adherence, to 9, maximum adherence) using multiple logistic regression models, adjusted for major confounding factors.Results:The adjusted OR for a 6–9 components of the MDS (high adherence) compared with 0–3 (low adherence) was 0.43 (95% CI 0.34–0.56). The OR for an increment of one component of MDS diet was 0.84 (95% CI 0.80–0.88). The association was consistent in strata of various covariates, although somewhat stronger in older women, in never oral contraceptive users and in hormone-replacement therapy users.Conclusions:Our study provides evidence for a beneficial role of the Mediterranean diet on endometrial cancer risk, suggesting a favourable effect of a combination of foods rich in antioxidants, fibres, phytochemicals, and unsaturated fatty acids.

Networking the unemployed: Can policy interventions facilitate access to employment through informal channels?

AbstractIt is widely known that informal contacts and networks constitute a major advantage when searching for a job. Unemployed people are likely to benefit from such informal contacts, but building and sustaining a network can be particularly difficult when out of employment. Interventions that allow unemployed people to effectively strengthen their networking capability could as a result be promising. Against this background, this article provides some hints in relation to the direction that such interventions could take. First, on the basis of data collected on a sample of 4,600 newly‐unemployed people in the Swiss Canton of Vaud, it looks at the factors that influence jobseekers' decisions to turn to informal contacts for their job search. The article shows that many unemployed people are not making use of their network because they are unaware of the importance of this method. Second, it presents an impact analysis of an innovative intervention designed to raise awareness of the importance of networks which is tested in a randomized controlled trial setting.

Norm Internalization and Political Collective Action

Can compulsory voting induce lasting changes in citizens' voting habits? We study the long-term and spillover effects of a severely sanctioned and long-standing compulsory voting law in the Swiss canton of Vaud (1900-1970). Our findings suggest that compulsory voting strongly increases turnout in federal referendums by about 30 percentage points. However, this effect returns to zero quickly after voting is no longer compulsory. Moreover, we find only minor spillover effects on related forms of political participation. These spillover effects are limited to referendums that were concurrent with referendums for which voting was compulsory. These results question habit formation arguments in the context of compulsory voting laws. Instead, our findings are consistent with a rationalist model of political participation in which individuals quickly adapt to changes in the costs of non-voting.

Second neoplasms after invasive and borderline ovarian cancer

Excess risk of subsequent cancers has been documented in women diagnosed with ovarian cancer. We updated to 2006 data on second cancers in women diagnosed with invasive and borderline ovarian cancer in the Swiss canton of Vaud. Between 1974 and 2006, 304 borderline and 1530 invasive first ovarian tumours were abstracted from the Vaud Cancer Registry database and followed up till the end of 2006. Calculation of expected numbers of tumours in the cohorts was based on site-specific, age-specific and calendar-year-specific incidence rates. We computed the standardized incidence ratios (SIRs) of second cancers, and the corresponding 95% confidence intervals (CI). There was no change in the incidence of malignant cancers, but that of borderline tumours increased over more recent years. Overall, 110 second neoplasms were observed versus 49.7 expected after invasive ovarian cancer (SIR 2.21; 95% CI: 1.82-2.67). Significant excess risks were observed for cancers of the breast, corpus uteri and leukaemias. When synchronous cancers were excluded, the overall SIR for all sites declined to 1.05. Thirty-one second neoplasms were observed after borderline tumours compared with 21.1 expected (SIR=1.47; 95% CI: 1.00-2.09). SIRs were above unity for ovary, colorectum and uterus. After exclusion of synchronous neoplasms, SIR for all neoplasms declined to 1.09, and remained significant only for second ovarian cancers (SIR=4.93). The present record linkage cohort study shows an excess risk for selected synchronous neoplasms in women diagnosed with both borderline and invasive ovarian cancer, likely because of shared genetic and perhaps environmental factors.

Tobacco smoking and the risk of upper aero‐digestive tract cancers: A reanalysis of case–control studies using spline models

Although tobacco smoking has long been recognized as a major risk factor for cancer of the upper aero-digestive tract (UADT, i.e., oral cavity, pharynx, larynx, and oesophagus), very few studies have provided estimates of the effect of very low tobacco consumption. Step-functions have been the common statistical methods for risk estimates, but the choice of reference category and of interval cutpoints influence the results, especially when data are sparse. In the present analysis, the dose-response relationship between UADT cancers and tobacco smoking was evaluated through logistic regression spline models. We included 1,241 UADT male cases and 2,835 male controls pooled from a large series of case-control studies conducted in northern Italy and in the Swiss Canton of Vaud during the last 2 decades. For cancers of the pharynx, larynx and oesophagus, the risk steadily increased with number of cigarettes/day. The risk of oral, pharyngeal and oesophageal cancers was significantly higher in smokers than in nonsmokers beginning with as low as 2 cigarettes/day. The effect of tobacco smoking at low levels seemed less evident for laryngeal cancer since the raise in risk begun with 6 cigarettes/day. In conclusion, for all the examined UADT sites, a monotonic dose-response relationship between cancer risk and cigarette smoking emerged. The excess of risk among people smoking 2 cigarettes/day highlights the absence of any harmless level for cigarette smoking, and it further supports the need of public health programs against tobacco smoking.

Cancer epidemiology and trends in Switzerland

Trends in cancer mortality in Switzerland over the period 1980-2001 and of incidence in the Swiss Canton of Vaud (640,000 inhabitants) over the period 1974-2003 are reviewed and discussed. Steady declines in cancer mortality were observed, over the last decade, particularly from the mid-1980's, with falls in overall mortality of 11% in men and 8% in women. The fall was of 20 % in male lung, whereas lung cancer has steadily increased in women by 47 %. Substantial declines were observed for stomach and colorectum in both sexes, (cervix) uteri and breast in women. Declines were also observed for leukaemias, Hodgkin's disease and testicular cancer, namely the neoplasms most influenced by therapeutic improvements, while trends in lymphomas and myeloma showed no clear pattern. With reference to incidence in the Vaud population between 1979 and 2003, all major tobacco-related neoplasms have declined by 19% in men aged 35 to 64, but increased by 69% in all age women. In both sexes, age-adjusted incidence of all non-tobacco-related cancers has substantially increased, mostly in younger-middle age (+ 70% in men, + 33% in women). Trends are discussed in the perspective of the European Commission's target of a 15% reduction in total cancer mortality between 2000 and 2015.

Second neoplasms after oesophageal cancer

The authors considered the incidence of second neoplasms among 1,672 oesophageal cancers diagnosed between 1974 and 2004 in the Cancer Registries of the Swiss Cantons of Vaud and Neuchâtel, and followed-up to 2004. A total of 141 second neoplasms were observed versus 38.5 expected, corresponding to a standardized incidence ratio (SIR) of 3.7 (95% confidence interval: 3.1-4.3). The SIRs were statistically significant for cancers of the oral cavity and pharynx (57.3), larynx (24.3), lung (6.6) and intestines (2.6). The SIRs were higher in subjects diagnosed below age 50 and in the first year after diagnosis. The SIR of upper digestive and respiratory tract neoplasms was higher for oesophageal cancers diagnosed in the upper (87.5) and middle (68.1), as compared with the lower third (19.4). There was no rise of second oral, pharyngeal and laryngeal cancer with advancing age, and their incidence tended indeed to decline from 100/1,000 at age 40-49 to 25/1,000 at age 70-79. There was no tendency to rise with age in the incidence of first oesophageal cancer in subjects who subsequently developed another upper digestive or respiratory tract neoplasm. The excess risks of upper digestive and respiratory tract neoplasms are attributable to increased diagnosis and registration of second neoplasms following a diagnosis of oesophageal cancer, as well as to heavy tobacco and alcohol consumption in oesophageal cancer cases. The absence of rise in incidence with age is also compatible with the existence of a subset of the population of susceptible individuals.

Methadone Maintenance Treatment (MMT) in General Practice or in Specialized Centers: Profile of Patients in the Swiss Canton of Vaud

We studied profile of patients (n = 1782) treated in specialized centers and general practice (GP) enrolled in methadone maintenance treatment (MMT) programs during 2001 in the Swiss Canton of Vaud. We found that GPs treated the majority of patients (76%). Specialized centers treated a higher proportion of patients with uncontrolled intravenous use of cocaine and heroin, and prescribed neuroleptics as concomitant medication three times more frequently than GPs. Patients treated in specialized centers were more likely to undergo screening for HIV, HBV, HCV, and receive complete HBV immunization. In conclusion, specialized centers are more likely to treat severely addicted patients and patients with a poor global assessment (physical, psychiatric, and social).