PubMed Health⌕ Search

Biomedical subjects

D Hausser

Publications and source records attributed to D Hausser.

At least 19 recordsLinked to original sources
PubMed1996

[Exchange of syringes or apprenticeship? The buses of Bienne and Geneva].

In Switzerland, the health ministry (Office Fédéral de la Santé Publique) has systematically encouraged the evaluation of low threshold services. In this article, we discuss the evaluation of two of these: the buses for syringes exchange in Geneva and Bienne, the implementation of these two services, the success obtained and the contacts established. Even if the design of such an evaluation was relatively complicated, with one monitoring and two specific surveys, the principal aim of this article is not to measure the efficacy as such but to show how an learning process has occurred between the actors: government, administration, police, service's team, drug's users and neighbourhood's inhabitants. The efficacy for a long period of time and the implementation's success are largely linked to such learning processes.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Drug users outside medical treatment: methodological and practical aspects].

A legal context that classifies the consumption of heroin and cocaine as an illegal act, poses a considerable methodological challenge to research on users of these substances. This is in particular the case for research on those users who are not in treatment and, therefore, cannot be recruited through treatment settings. In a research project on heroin and/or cocaine users outside treatment settings, a sample of 917 individuals was recruited through "Privileged Access Interviewers" in the whole of Switzerland. In the first part of this article, we discuss matters of reliability as well as of validity concerning this method of data collection. In the second part of the article, we discuss the use of low threshold syringe exchange schemes by the user groups represented in the sample. Only intravenous drug users frequent those services - they are however a minority in the sample (n = 238). In several regions of Switzerland syringe exchange schemes do not exist. Where they do exist, they appear to correspond to a need which they are able to cover largely. In the regions without such services, intravenous drug users get their supply of syringes more frequently from pharmacies. However, pharmacies do not compensate the absence of specific syringe exchange schemes. In regions without such schemes, injections with used syringes are more frequent. Thus, regarding Aids-Prevention, there is an urgent need to develop syringe exchange schemes in all parts of the country.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Assessing HIV prevention among injecting drug users in European Community countries: a review.

By September 30th 1991, 19,579 cases of AIDS among injecting drug users had been reported in Europe. HIV seroprevalence rates among drug injectors vary from less than 5% in some cities, to over 50% in others. Since the estimated number of drug injectors in Europe is between 750,000 and 1,000,000, HIV is a considerable threat to drug injectors, their sex partners and their off-spring, affecting large numbers of citizens in the European region. This paper gives an overview of the magnitude of the drugs/AIDS problem in the European region, and the concrete measures that have been taken to prevent HIV infection among drug users. Data from the evaluation of methadone programmes, needle and syringe exchange schemes and data on sexual behaviour change of drug users are critically reviewed. Limitations of the methods used for the evaluation of prevention activities are also discussed. Based on all the material reviewed, the main conclusions are the following: AIDS is a greater threat to public health than problem drug use, more accurate and reliable evaluation methods need to be utilized at European Community level, a combination of prevention measures should be used in order to reduce the further spread of HIV infection among injecting drug users.

AIDS Serodiagnosis↗
PubMed1994

Does a condom-promoting strategy (the Swiss STOP-AIDS campaign) modify sexual behavior among adolescents?

OBJECTIVE: To measure sexual behavior changes (especially the use of condoms) among adolescents after 5 years of a population-based acquired immunodeficiency syndrome prevention strategy at the national and regional level. DESIGN: Two comparative cross-sectional surveys by self-administered questionnaires were conducted in 1987 and 1990. SETTING: Two similar samples of 16- to 19-year-old apprentices. The two samples, 1987 (n = 1359) and 1990 (n = 817), are comparable in terms of sex, age, profession, and location. RESULTS: The percentage of boys who say they are sexually active has remained the same (75%) and has slightly increased among younger girls (65% to 75%, NS). The average number of partners has remained steady for boys and girls. Regular use of any contraceptive device has remained steady among girls (75%) and increased among boys (1987, 38%; 1990, 54%; P < .001). In 1987 as well as in 1990, the condom was the most widely used method (> 90%), followed by the pill (50%), withdrawal (20%), and chemicals (5%). Rates were about the same for both sexes. Rates of irregular use of condoms increased among boys and girls (P < .01); regular use of condoms increased among boys (22% to 34%, P < .01) and girls (10% to 27%, P < .001); use of the pill has slightly decreased. CONCLUSIONS: During a 5-year period, the Swiss "STOP-AIDS" campaign and local interventions had had no real effect on the rate of sexual activity of apprentices but had had a positive effect on the use of contraception and condoms. The prevention strategy should (and will) be maintained in the future.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Evaluation of AIDS prevention among homosexual and bisexual men in Switzerland.

Attitudinal and behavioural change among gay men in Switzerland was measured between 1987 and 1990 to evaluate the effectiveness of AIDS prevention activities. The methodology used included a self-administered questionnaire published in Swiss gay magazines and distributed by gay organizations (N = 795 in 1987, N = 720 in 1990) and in-depth interviews with men recruited through advertisements and through the questionnaire (N = 42 in 1987, N = 24 in 1990). The two independent sampling procedures yielded similar samples with regard to socio-demographic characteristics, allowing comparisons to be made between the 1987 and 1990 data. Personal confrontation with AIDS (knowing someone who is HIV-positive, or who is ill or dead from AIDS) increased significantly during the period but more adequate ways of coping developed. Behavioural change towards safer sex began well before the first study. The majority of responding homosexuals have adapted their sexual behaviour to the new situation created by AIDS and generally maintain a protective behaviour. However, "exceptions" (condom rupture or episodes of non-protection) are not infrequent and should deserve more attention. Three indicators of sexual behaviour (number of sexual partners, anal sex and use of condom and oral sex with ejaculation), reported for the last 3 months before each study, exhibit few changes between 1987 and 1990: number of partners remained stable, unprotected oral sex decreased. Anal sex slightly increased, the use of condoms remaining stable. Sixty-seven percent of the sample knew their serostatus in 1990 (57% in 1987), and 13% of these stated that they were HIV+ (14% in 1987).

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Patient compliance in ambulatory medical care].

During February and March 1987, 313 private practitioners and 35 outpatients clinics in the cantons of Vaud et Fribourg participated in the study "Ambulatory medical practice". A representative sample of more than 17,800 records was collected and analysed from the 110,000 weekly consultations. In this paper we discuss the patient flow in ambulatory medical care. Overall, patient flows appear to be influenced more by practitioner and patient characteristics than by contextual factors such as medical density. In private practice the proportion of patients who are appointed and indeed attend the consultation is 50%; in outpatient clinics only 30%. The patient's compliance (probability of keeping an appointment) depends on one hand of the physicians' specialty and, on the other hand, it decreases when the appointment rate increases.

Ambulatory Care↗
PubMed1990

[The attitude of hospital personnel to AIDS].

Caregivers of 13 hospital services in Switzerland--confronted at various degrees with the aids problem--have been interviewed. The study indicates that hospital caregivers still strongly fear an HIV infection through professional contacts. At the same time they have difficulties to balance correctly risks at work against risks in their private lives. The attitudes of caregivers might negatively influence patient care. They could, however, be modified by a better management of aids related information in hospitals.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Patients in ambulatory care].

A study on ambulatory medical care has been conducted in the cantons of Vaud and Fribourg in february-march 1987. The characteristics of patients visiting a private doctor and those of outpatients in hospitals are described. At private offices women older than 15 years consult more often than men; children (0-4 years) and elderly are the groups of population who consult most. In ambulatory services of hospitals, men are more present than women; children aged 0 to 4 years and adults aged 15 to 39 years use most these services. Use of ambulatory care varies with regions and days of the week. In urban regions, people have more medical visits. On Thursdays and weekends, there are less consultations but they are more often urgent.

Adolescent↗
PubMed1990

Ambulatory medical care for the elderly in Switzerland.

Data from a study on ambulatory medical care in two Swiss cantons are used to describe the characteristics of consultations delivered to patients 65 years old and over. The differences with younger patients are presented. The elderly generally suffer from different diseases, and their problems are often chronic. Primary care concerns three-quarters of visits. Medical problems are very frequent and important among this population. It is important to know their specific needs in order to adapt medical practice to them and to be aware of the complexity of the aging process in industrialized societies.

Aged↗
PubMed1990

[Prevention in general practice--results of a study of ambulatory health care in the Waadt and Freiburg cantons].

Data on medical consultations were collected from a representative sample of self-employed physicians showing that prevention activities comprised only a small proportion of ambulatory medical care. Preventive acts are more frequent among pediatricians and gynecologists, however. The current health system favours therapeutic aspects of medicine over preventive aspects: Lack of adequate training of physicians and modes of payment for medical acts tend to discourage prevention by doctors.

Adolescent↗
PubMed1989

[Evaluation of campaigns for the prevention of AIDS in Switzerland in 1987].

Since 1985 the Swiss Federal Office of Public Health and the Swiss AIDS Foundation have been promoting AIDS prevention campaigns. A multi-media information campaign with the main slogan "STOP-AIDS" began in February 1987 and is still underway. Multiplying effects are stimulated. The evaluation of that strategy, based on 13 complementary studies, confirms its efficiency and feasibility. The evaluation process will continue in 1988. The campaign and its objectives reached the general population and the target groups. Noticeable changes in attitudes and behaviours are taking place in the way of better protection in various observed groups, moderately or strongly exposed to HIV infection. Condom sales have increased by nearly 60% in 1987 compared with 1986.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Total plasma cholesterol and HDL in a Swiss population: what attitude and norms should be adopted?].

The reports on the effectiveness of blood lipid lowering in the primary prevention of ischaemic heart disease have promoted the development of statements and strategies for decreasing plasma cholesterol levels. As the risk of ischaemic heart disease gradually increases with the serum cholesterol level, a shift of the whole cholesterol distribution curve towards lower cholesterol values not exceeding 5.2 mmol/l is found to be desirable. The population survey conducted in the cantons of Vaud and Fribourg, as part of the MONICA-project, has yielded the data about the distribution of serum total and HDL-cholesterol for a representative sample of the population. 34% of men and 30% of women aged 25 to 74 have a blood cholesterol value exceeding 6.7 mmol/l, the percentage of people with high cholesterol levels increasing with age, especially in women. HDL-cholesterol levels, higher in women than in men, remain fairly constant according to the particular age group concerned. On application of the norms proposed by the US Consensus Conference on blood cholesterol, one finds that 32% of women and 37% of men have to be considered as 'high risk' and 18% of both sexes at 'moderate risk' concerning the development of coronary heart disease. The consequences of the application of such norms in Switzerland, as well as the current cholesterol values of the Swiss population as compared to those obtained earlier on in Switzerland and the USA have to be considered on a large scale in order to draw up a global strategy for health promotion and the prevention of cardiovascular disease.

Adult↗
PubMed1988

[Continuous evaluation of the general effect of the campaign against AIDS in Switzerland].

Since 1985 the Swiss Federal Office of Public Health and the Swiss AIDS Foundation are promoting AIDS prevention campaigns. A multimedia information campaign with the main slogan "STOP-AIDS" began in Feb. 1987 and is still under way. Multiplying effects are stimulated. An evaluation program is following continuously these campaigns, examines knowledge, attitude and behaviour changes in several groups of the population and analyses the conditions of these changes. The evaluation shows that the campaign and its objectives reached the general population and the target groups. Noticeable changes in attitudes and behaviors are taking place in the way of better protection in various observed groups, moderately or strongly exposed to HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Combining repeated blood pressure measurements to obtain prevalences of high blood pressure.

Blood pressure (BP) levels may be classified as normal, borderline, or high with respect to the World Health Organization (WHO) criteria, but most studies like the MONICA project require at least two BP measurements and must tackle the problem of combining the results of the different readings into a single value for classification. The Swiss MONICA project measured the blood pressure of 1872 individuals in the areas of Vaud and Fribourg. Second BP readings were, on average, lower than the first by 3.2 mmHg for systolic and 1.1 mmHg for diastolic BP. These differences, while trivial at the individual level, nevertheless generate significant effects on prevalences of high BP. The first reading, the second, the mean, and the lowest yield prevalences of 14%, 10%, 11% and 9% respectively. Therefore, any published prevalence of high blood pressure should specify the method of measurement, the number of readings taken, and the way results were combined.

Adult↗