Advanced trauma life support, 8th edition, the evidence for change.

The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the course content. New materials related to principles of disaster management have been added. ATLS is a common language teaching one safe way of initial trauma assessment and management.

Le rôle de la matérialité dans l'apprentissage de la lecture : aspects du curriculum enseigné, pratique enseignante et développement chez l'élève : une étude de cas à l'école primaire française

Notre étude consiste en une recherche longitudinale pour laquelle une cohorte d'élèves a été suivie depuis la Grande Section de l'école maternelle française (élèves de 5-6 ans) jusqu'au Cours Élémentaire 1re année de l'école élémentaire française (élèves de 7-8 ans) dans des situations ordinaires de classe. À ces niveaux scolaires, l'un des principaux objectifs du curriculum est l'apprentissage de la lecture. Nous considérons que l'élève construit les compétences de lecture à acquérir, i.e. les compétences caractérisant son développement potentiel, en s'appuyant sur les compétences caractérisant son développement actuel (Vygotski, 1934/1997). Lorsqu'il apprend à lire, l'élève a à sa disposition des moyens sémiotiques relatifs à la connaissance des objets et leurs usages, ainsi qu'aux gestes et leur signification (Moro & Rodriguez, 2005), ce que nous appelons globalement la matérialité. En conséquence, dans cette recherche, nous faisons l'hypothèse que ces premières habiletés relatives à la matérialité, constituent une ressource dans les situations d'enseignement- apprentissage de la lecture. Nous réalisons une étude de cas dont le recueil des données, à caractère ethnographique, est constitué de moments de classe enregistrés en vidéo, et ce, quatre fois par année scolaire. Ces douze enregistrements vidéo sont complétés par deux entretiens semi-directifs et un entretien d'auto- confrontation ; ils sont aussi mis en lien avec les Instructions officielles (programmes scolaires). L'analyse est à la fois macrogénétique et microgénétique. Pour chaque observation, concernant l'analyse macrogénétique, nous réalisons le synopsis à partir duquel nous sélectionnons des épisodes significatifs porteurs de matérialité. Les épisodes significatifs sont constitués des événements remarquables dont les analyses microgénétiques nécessitent l'utilisation d'outils, à savoir les tableaux des matérialités et les photogrammes. Notre étude montre que la matérialité permet aux élèves de devenir lecteurs et que les formes de cette matérialité changent en fonction de l'avancée des acquisitions des élèves et des dimensions de la lecture (code et compréhension) à apprendre. - Our research consists of a longitudinal study in which one group of pupils in ordinary classroom situations has been followed from the top level of French pre-elementary school (5- to 6 year-old pupils) to the second level of French primary school (7- to 8 year-old pupils). For these three school grades, one of the main objectives in the curriculum is learning to read. We consider that pupils build their new reading skills, i.e. the skills characterizing their potential development, by relying on skills characterizing their actual development (Vygotski, 1934/1997). When learning to read, pupils yet have at their disposal semiotic abilities related to knowledge both of material objects and their uses, and of basic gestures and their meaning (Moro & Rodriguez, 2005), all of this we sum up under the term of materiality. Consequently, in our research, we make the hypothesis that the children's basic abilities related to materiality constitute a resource in teaching-learning situations. We have chosen to carry out a case study. The data collected consist of videos of class sequences carried out four times a year for three years. These twelve videos are supplemented by two semi- structured interviews with the teacher, one "self-confronting" interview in which the teacher is brought to discuss her actions and by the analysis of the ministry's school curricula. Our analysis is both macrogenetic and microgenetic. For each teaching sequence, on the level of macrogenetic analysis, we have made up the synopsis from which we have selected significant episodes in terms of materiality. The significant episodes are composed of remarkable events the microgenetic analysis of which requires the use of tools such as materiality boards and photograms. Our study shows that materiality enables pupils to develop reading skills and that the forms that materiality takes on change according to the pupils' acquisition progress and the aspects of reading (code and comprehension) still to be learned.

Scenario-based assessment of future land use change on butterfly species distributions

Species distribution models (SDMs) are increasingly used to predict environmentally induced range shifts of habitats of plant and animal species. Consequently SDMs are valuable tools for scientifically based conservation decisions. The aims of this paper are (1) to identify important drivers of butterfly species persistence or extinction, and (2) to analyse the responses of endangered butterfly species of dry grasslands and wetlands to likely future landscape changes in Switzerland. Future land use was represented by four scenarios describing: (1) ongoing land use changes as observed at the end of the last century; (2) a liberalisation of the agricultural markets; (3) a slightly lowered agricultural production; and (4) a strongly lowered agricultural production. Two model approaches have been applied. The first (logistic regression with principal components) explains what environmental variables have significant impact on species presence (and absence). The second (predictive SDM) is used to project species distribution under current and likely future land uses. The results of the explanatory analyses reveal that four principal components related to urbanisation, abandonment of open land and intensive agricultural practices as well as two climate parameters are primary drivers of species occurrence (decline). The scenario analyses show that lowered agricultural production is likely to favour dry grassland species due to an increase of non-intensively used land, open canopy forests, and overgrown areas. In the liberalisation scenario dry grassland species show a decrease in abundance due to a strong increase of forested patches. Wetland butterfly species would decrease under all four scenarios as their habitats become overgrown

Age-related change in melanin-based coloration of Barn owls (Tyto alba): females that become more female-like and males that become more male-like perform better

Ornament expression fluctuates with age in many organisms. Whether these changes are adaptively plastic is poorly known. In order to understand the ultimate function of melanin-based ornaments, we studied their within-individual fluctuations and their covariation with fitness-related traits. In barn owls (Tyto alba), individuals vary from reddish-brown pheomelanic to white and from immaculate to marked with black eumelanic spots, males being less reddish and less spotted than females. During the first molt, both sexes became less pheomelanic, females displayed larger spots and males fewer spots, but the extent of these changes was not associated with reproduction. At subsequent molts, intra-individual changes in melanin-based traits covaried with simultaneous reproduction changes. Adult females bred earlier in the season and laid larger eggs when they became scattered with larger spots, while adults of both sexes produced larger broods when they became whiter. These results suggest that the production of melanin pigments and fitness-related life history traits are concomitantly regulated in a sex-specific way.

Training medical students to conduct motivational interviewing: a randomized controlled trial.

OBJECTIVE: To examine the effectiveness of motivational interviewing (MI) training among medical students. METHODS: All students (n=131) (year 5) at Lausanne Medical School, Switzerland were randomized into an experimental or a control group. After a training in basic communication skills (control condition), an 8-h MI training was completed by 84.8% students in the exprimental group. One week later, students in both groups were invited to meet with two standardized patients. MI skills were coded by blinded research assistants using the Motivational Interviewing Treatment Integrity 3.0. RESULTS: Superior MI performance was shown for trained versus control students, as demonstrated by higher scores for "Empathy" [p<0.001] and "MI Spirit" [p<0.001]. Scores were similar between groups for "Direction", indicating that students in both groups invited the patient to talk about behavior change. Behavior counts assessment demonstrated better performance in MI in trained versus untrained students regarding occurences of MI-adherent behavior [p<0.001], MI non-adherent behavior [p<0.001], Closed questions [p<0.001], Open questions [p=0.001], simple reflections [p=0.03], and Complex reflections [p<0.001]. Occurrences were similar between groups regarding "Giving information". CONCLUSION: An 8-h training workshop was associated with improved MI performance. PRACTICE IMPLICATIONS: These findings lend support for the implementation of MI training in medical schools.

The Change Questionnaire predicts change in hazardous tobacco and alcohol use.

INTRODUCTION: Assessing motivation for change is deemed an important step in the treatment process that allows further refinement of the intervention in motivational interviewing (MI) and brief MI (BMI) adaptations. During MI (and BMI) sessions, motivation for change is expressed by the client as "change talk", i.e. all statements inclined toward or away from change. We tested the predictive validity of the Change Questionnaire, a 12-item instrument assessing motivation to change, on hazardous tobacco and alcohol use. METHODS: As part of the baseline measurements for a randomized controlled trial on multi-substance BMI at the Lausanne recruitment center (army conscription is mandatory in Switzerland for males at age 20, and thus provides a unique opportunity to address a non-clinical and largely representative sample of young men), 213 participants completed the questionnaire on tobacco and 95 on alcohol and were followed-up six months later. The overall Change Questionnaire score and its six subscales (Desire, Ability, Reasons, Need, Commitment, and Taking steps) were used as predictors of hazardous tobacco use (defined as daily smoking) and hazardous alcohol use (defined as more than one occasion with six standard drinks or more per month, and/or more than 21 standard drinks per week) in bivariate logistic regression models at follow-up. RESULTS: Higher overall Change scores were significant predictors of decreased risk for hazardous tobacco (odds ratio [OR] = 0.83, p = 0.046) and alcohol (OR = 0.76, p = 0.03) use. Several sub-dimensions were associated with the outcomes in bivariate analyses. Using a principal components analysis to reduce the number of predictors for multivariate models, we obtained two components. 'Ability to change' was strongly related to change in hazardous tobacco use (OR = 0.54, p < 0.001), the second we interpreted as 'Other change language dimensions' and which was significantly related to change in hazardous alcohol use (OR = 0.81, p = 0.05). CONCLUSIONS: The present findings lend initial support for the predictive validity of the Change Questionnaire on hazardous tobacco and alcohol use, making it an interesting and potentially useful tool for assessing motivation to change among young males.

Does readiness to change predict subsequent alcohol consumption in medical inpatients with unhealthy alcohol use?

We studied whether readiness to change predicts alcohol consumption (drinks per day) 3 months later in 267 medical inpatients with unhealthy alcohol use. We used 3 readiness to change measures: a 1 to 10 visual analog scale (VAS) and two factors of the Stages of Change Readiness and Treatment Eagerness Scale: Perception of Problems (PP) and Taking Action (TA). Subjects with the highest level of VAS-measured readiness consumed significantly fewer drinks 3 months later [Incidence rate ratio (IRR) and 95% confidence interval (CI): 0.57 (0.36, 0.91) highest vs. lowest tertile]. Greater PP was associated with more drinking [IRR (95%CI): 1.94 (1.02, 3.68) third vs. lowest quartile]. Greater TA scores were associated with less drinking [IRR (95%CI): 0.42 (0.23, 0.78) highest vs. lowest quartile]. Perception of Problems' association with more drinking may reflect severity rather than an aspect of readiness associated with ability to change; high levels of Taking Action appear to predict less drinking. Although assessing readiness to change may have clinical utility, assessing the patient's planned actions may have more predictive value for future improvement in alcohol consumption.

Climate change effects on animal and plant phylogenetic diversity in southern Africa

Much attention has been paid to the effects of climate change on species' range reductions and extinctions. There is however surprisingly little information on how climate change driven threat may impact the tree of life and result in loss of phylogenetic diversity (PD). Some plant families and mammalian orders reveal nonrandom extinction patterns, but many other plant families do not. Do these discrepancies reflect different speciation histories and does climate induced extinction result in the same discrepancies among different groups? Answers to these questions require representative taxon sampling. Here, we combine phylogenetic analyses, species distribution modeling, and climate change projections on two of the largest plant families in the Cape Floristic Region (Proteaceae and Restionaceae), as well as the second most diverse mammalian order in Southern Africa (Chiroptera), and an herbivorous insect genus (Platypleura) in the family Cicadidae to answer this question. We model current and future species distributions to assess species threat levels over the next 70years, and then compare projected with random PD survival. Results for these animal and plant clades reveal congruence. PD losses are not significantly higher under predicted extinction than under random extinction simulations. So far the evidence suggests that focusing resources on climate threatened species alone may not result in disproportionate benefits for the preservation of evolutionary history.

The twist, writhe and overall shape of supercoiled DNA change during counterion-induced transition from a loosely to a tightly interwound superhelix. Possible implications for DNA structure in vivo.

A cryo-electron microscopy study of supercoiled DNA molecules freely suspended in cryo-vitrified buffer was combined with Monte Carlo simulations and gel electrophoretic analysis to investigate the role of intersegmental electrostatic repulsion in determining the shape of supercoiled DNA molecules. It is demonstrated here that a decrease of DNA-DNA repulsion by increasing concentrations of counterions causes a higher fraction of the linking number deficit to be partitioned into writhe. When counterions reach concentrations likely to be present under in vivo conditions, naturally supercoiled plasmids adopt a tightly interwound conformation. In these tightly supercoiled DNA molecules the opposing segments of interwound superhelix seem to directly contact each other. This form of supercoiling, where two DNA helices interact laterally, may represent an important functional state of DNA. In the particular case of supercoiled minicircles (178 bp) the delta Lk = -2 topoisomers undergo a sharp structural transition from almost planar circles in low salt buffers to strongly writhed "figure-eight" conformations in buffers containing neutralizing concentrations of counterions. Possible implications of this observed structural transition in DNA are discussed.

Predicting the impacts of climate change on genetic diversity in an endangered lizard species.

Many endangered species persist as a series of isolated populations, with some populations more genetically diverse than others. If climate change disproportionately threatens the most diverse populations, the species' ability to adapt (and hence its long-term viability) may be affected more severely than would be apparent by its numerical reduction. In the present study, we combine genetic data with modelling of species distributions under climate change to document this situation in an endangered lizard (Eulamprus leuraensis) from montane southeastern Australia. The species is known from only about 40 isolated swamps. Genetic diversity of lizard populations is greater in some sites than others, presumably reflecting consistently high habitat suitability over evolutionary time. Species distribution modelling suggests that the most genetically diverse populations are the ones most at risk from climate change, so that global warming will erode the species' genetic variability faster than it curtails the species' geographic distribution.