Population based screening - the difficulty of how to do more good than harm and how to achieve it

Screening people without symptoms of disease is an attractive idea. Screening allows early detection of disease or elevated risk of disease, and has the potential for improved treatment and reduction of mortality. The list of future screening opportunities is set to grow because of the refinement of screening techniques, the increasing frequency of degenerative and chronic diseases, and the steadily growing body of evidence on genetic predispositions for various diseases. But how should we decide on the diseases for which screening should be done and on recommendations for how it should be implemented? We use the examples of prostate cancer and genetic screening to show the importance of considering screening as an ongoing population-based intervention with beneficial and harmful effects, and not simply the use of a test. Assessing whether screening should be recommended and implemented for any named disease is therefore a multi-dimensional task in health technology assessment. There are several countries that already use established processes and criteria to assess the appropriateness of screening. We argue that the Swiss healthcare system needs a nationwide screening commission mandated to conduct appropriate evidence-based evaluation of the impact of proposed screening interventions, to issue evidence-based recommendations, and to monitor the performance of screening programmes introduced. Without explicit processes there is a danger that beneficial screening programmes could be neglected and that ineffective, and potentially harmful, screening procedures could be introduced.

[Gingival retraction methods. A literature review]

The exposure of the preparation margin and the control of the hemorrhage in the gingival sulcus are prerequisites for precise impressions and thereby improving the quality of indirectly fabricated restorations. The purpose of this review article is to summarize available evidence with respect to current methods of gingival retraction and to provide the clinician with practical tips.

Relaxation of species-specific neighborhood effects in Bornean rain forest under climatic perturbation

Evidence of negative conspecific density dependence (NDD) operating on seedling survival and sapling recruitment has accumulated recently. In contrast, evidence of NDD operating on growth of trees has been circumstantial at best. Whether or not local NDD at the level of individual trees leads to NDD at the level of the community is still an open question. Moreover, whether and how perturbations interfere with these processes have rarely been investigated. We applied neighborhood models to permanent plot data from a Bornean dipterocarp forest censused over two 10-11 year periods. Although the first period was only lightly perturbed, a moderately strong El Nino event causing severe drought occurred in the first half of the second period. Such events are an important component of the environmental stochasticity affecting the region. We show that local NDD on growth of small-to-medium-sized trees may indeed translate to NDD at the level of the community. This interpretation is based on increasingly negative effects of bigger conspecific neighbors on absolute growth rates of individual trees with increasing basal area across the 18 most abundant overstory species in the first period. However, this relationship was much weaker in the second period. We interpreted this relaxation of local and community-level NDD as a consequence of increased light levels at the forest floor due to temporary leaf and twig loss of large trees in response to the drought event. Mitigation of NDD under climatic perturbation acts to decrease species richness, especially in forest overstory and therefore has an important role in determining species relative abundances at the site.

Advances in Kartvelian Morphology and Syntax. Contributions to the festival of languages Bremen, 17 Sep to 7 Oct, 2009

Within the scope of Festival of Languages took place in 2009 the Conference Advances in Kartvelian Morphology and Syntax. Selected presentations are presented in this publication. The authors discuss topics such as anaphora in Svan, intonation in Georgien, pragmatics of subordinating clauses in Georgian, but also research on modern developments as SMS-communication in Georgian language area etc. DEUTSCH: Im Rahmen des Festivals der Sprachen fand im Jahre 2009 an der Universität Bremen die Tagung Advances in Kartvelian Morphology and Syntax statt. Ausgewählte Vorträge werden mit dieser Publikation vorgestellt. Die Autoren behandeln unter anderem Themen wie Ana-pher im Svanischen, Intonation im Georgischen, Pragmatik von Nebensätzen des Georgi-schen, aber auch Forschungen über moderne Entwicklungen wie die SMS-Kommunikation im georgischsprachigen Sprachraum usw. CONTENTS: NINO AMIRIDZE, TAMAR RESECK & MANANA TOPADZE GÄUMANN: Preface; KEVIN TUITE: The Kartvelian suffixal intransitive; MANANA KOBAIDZE: Towards the morphological and syntactical classification of Georgian verbs; RENÉ LACROIX: Origin of Sets I–II suffixes in South Caucasian through reanalysis; STAVROS SKOPETEAS & CAROLINE FÉRY: Prosodic cues for exhaustive interpretations: a production study on Georgian intonation; WINFRIED BOEDER: Anaphora in Svan; YASUHIRO KOJIMA : The position of rom and the pragmatics of subordinate clauses in Georgian; NATIA AMAGHLOBELI : Morphological aspects of Georgian SMS language.