Discretionary medical reporting of potentially unfit drivers: a questionnaire-based survey in Southeast Switzerland

In Switzerland, every physician has the right to report a patient that is potentially unfit to drive to the licensing authority without violating medical confidentiality. Verified information regarding physicians' attitudes concerning this discretionary reporting and the frequency of such reports are not available. In order to answer these questions, 635 resident physicians were sent a questionnaire. The response rate was 52%. On average, the responding physicians--for all specialties--reported 0.31 patients (SD 0.64, 95% CI 0.24-0.38) in the year before the survey and 1.00 patient (SD 1.74, 95% CI 0.81-1.20) in the past 5 years. Seventy-nine percent of the responding physicians indicated knowing the current legal requirements for driving in Switzerland. In applied logistic regression analysis, only two factors correlate significantly with reporting: male sex (odds ratio 5.4) and the specialty "general medicine" (odds ratio 3.4). Ninety-seven percent of the physicians were against abolishing medical discretionary reporting and 29% were in favor of introducing mandatory reporting. The great majority of the questioned physicians supported the discretionary reporting of drivers that are potentially unfit to drive as currently practiced in Switzerland. The importance and the necessity of a regular traffic medicine-related continuing education for medical professionals are shown by the low number of reports per physician.

Last stop expulsion - The minority question and forced migration in East-Central Europe: 1918-49

This article deals with the European minorities in the period between the two world wars and with their final expulsion from nation-states at the end of World War II. First, the tensions which arose between the organised minorities and the successor states of the Habsburg Monarchy are accounted for primarily by the argument that the various minorities located within the successor states had already undergone a comprehensive processes of nationalisation within the Habsburg Empire. Therefore they were able to resist assimilation by the political elites of the new titular nations (Czechs, Poles, Rumanians, Serbs). A second topic is that of the use made of the minorities issue by Adolf Hitler to help achieve his expansionist aims. The minorities issue was central to the international destabilisation of interwar Europe. Finally, the mass expulsion of minorities (above all, Germans) after the end of the war is explained by strategic considerations on the part of the Allied powers as well as involving the nation-state regimes. It is argued, against a commonly held view, that German atrocities during the period of occupation had little to do with the decision to expel most ethnic Germans from their territories of settlement in Poland, Czechoslovakia and Yugoslavia. The article shows that it is necessary to treat national minorities in the first half of the twentieth century as a single phenomenon which shares similar features across the various nation-states of East-Central Europe.

Combined use of transcranial magnetic stimulation and metal electrode implants: a theoretical assessment of safety considerations

This paper provides a theoretical assessment of the safety considerations encountered in the simultaneous use of transcranial magnetic stimulation (TMS) and neurological interventions involving implanted metallic electrodes, such as electrocorticography. Metal implants are subject to magnetic forces due to fast alternating magnetic fields produced by the TMS coil. The question of whether the mechanical movement of the implants leads to irreversible damage of brain tissue is addressed by an electromagnetic simulation which quantifies the magnitude of imposed magnetic forces. The assessment is followed by a careful mechanical analysis determining the maximum tolerable force which does not cause irreversible tissue damage. Results of this investigation provide useful information on the range of TMS stimulator output powers which can be safely used in patients having metallic implants. It is shown that conventional TMS applications can be considered safe when applied on patients with typical electrode implants as the induced stress in the brain tissue remains well below the limit of tissue damage.

Intracoronary Optical Coherence Tomography and Histology of Overlapping Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model

OBJECTIVES: This study sought to assess the vascular response of overlapping Absorb stents compared with overlapping newer-generation everolimus-eluting metallic platform stents (Xience V [XV]) in a porcine coronary artery model. BACKGROUND: The everolimus-eluting bioresorbable vascular scaffold (Absorb) is a novel approach to treating coronary lesions. A persistent inflammatory response, fibrin deposition, and delayed endothelialization have been reported with overlapping first-generation drug-eluting stents. METHODS: Forty-one overlapping Absorb and overlapping Xience V (XV) devices (3.0 × 12 mm) were implanted in the main coronary arteries of 17 nonatherosclerotic pigs with 10% overstretch. Implanted coronary arteries were evaluated by optical coherence tomography (OCT) at 28 days (Absorb n = 11, XV n = 7) and 90 days (Absorb n = 11, XV n = 8), with immediate histological evaluation following euthanasia at the same time points. One animal from each time point was evaluated with scanning electron microscopy alone. A total of 1,407 cross sections were analyzed by OCT and 148 cross sections analyzed histologically. RESULTS: At 28 days in the overlap, OCT analyses indicated 80.1% of Absorb struts and 99.4% of XV struts to be covered (p < 0.0001), corresponding to histological observations of struts with cellular coverage of 75.4% and 99.6%, respectively (p < 0.001). Uncovered struts were almost exclusively related to the presence of "stacked" Absorb struts, that is, with a direct overlay configuration. At 90 days, overlapping Absorb and overlapping XV struts demonstrated >99% strut coverage by OCT and histology, with no evidence of a significant inflammatory process, and comparable % volume obstructions. CONCLUSIONS: In porcine coronary arteries implanted with overlapping Absorb or overlapping XV struts, strut coverage is delayed at 28 days in overlapping Absorb, dependent on the overlay configuration of the thicker Absorb struts. At 90 days, both overlapping Absorb and overlapping XV have comparable strut coverage. The implications of increased strut thickness may have important clinical and design considerations for bioresorbable platforms.

The Life and Times of Bills

Time is one of the scarcest resources in modern parliaments. In parliamentary systems of government the control of time in the chamber is a significant power resource enjoyed – to varying degrees – by parliamentary majorities and the governments they support. Minorities may not be able to muster enough votes to stop bills, but they may have – varying degrees of – delaying powers enabling them to extract concessions from majorities attempting to get on with their overall legislative programme. This paper provides a comparative analysis of the dynamics of the legislative process in 17 West European parliaments from the formal initiation of bills to their promulgation. The ‘biographies’ of a sample of bills are examined using techniques of event-history analysis (a) charting the dynamics of the legislative process both across the life-times of individual bills and different political systems and (b) examining whether, and to what extent, parliamentary rules and some general regime attributes influence the dynamics of this process, speeding up or delaying the passage of legislation. Using a veto-points framework and transaction cost politics as a theoretical framework, the quantitative analyses suggest a number of counter-intuitive findings (e.g., the efficiency of powerful committees) and cast doubt on some of the claims made by Tsebelis in his veto-player model.

Agents, Trustees, and International Courts: Nomination and Appointment of Judicial Candidates in the WTO Appellate Body

Scholars have increasingly theorized, and debated, the decision by states to create and delegate authority to international courts, as well as the subsequent autonomy and behavior of those courts, with principal–agent and trusteeship models disagreeing on the nature and extent of states’ influence on international judges. This article formulates and tests a set of principal–agent hypotheses about the ways in which, and the conditions under which, member states are able use their powers of judicial nomination and appointment to influence the endogenous preferences of international judges. The empirical analysis surveys the record of all judicial appointments to the Appellate Body (AB) of the World Trade Organization over a 15-year period. We present a view of an AB appointment process that, far from representing a pure search for expertise, is deeply politicized and offers member-state principals opportunities to influence AB members ex ante and possibly ex post. We further demonstrate that the AB nomination process has become progressively more politicized over time as member states, responding to earlier and controversial AB decisions, became far more concerned about judicial activism and more interested in the substantive opinions of AB candidates, systematically championing candidates whose views on key issues most closely approached their own, and opposing candidates perceived to be activist or biased against their substantive preferences. Although specific to the WTO, our theory and findings have implications for the judicial politics of a large variety of global and regional international courts and tribunals.

Trade versus Culture : The Policy of Cultural Exception and the World Trade Organization

This chapter is a contribution to the Palgrave Handbook of European Media Policy (co-edited by Pauwels, Donders & Loisen). It is the chapter’s purpose to examine the proponents of the cultural exception policy, their strategies and demands, and to explore how they came to be reflected in the law and policy of the World Trade Organization (WTO). The chapter also looks at the current state of affairs, as although WTO law has not undergone any substantial amendments since its entry into force in 1995, the media landscape has in the meantime been truly transformed, in some aspects in a revolutionary manner. The broader picture of global governance has not remained still either, with new and emergent powers, changing mechanisms of rule-making and taking.

New Philology and the Biogenetics of Texts

The discussion on the New Philology triggered by French and North American scholars in the last decade of the 20th century emphasized the material character of textual transmission inside and outside the written evidences of medieval manuscripts by downgrading the active role of the historical author. However, the reception of the ideas propagated by the New Philology adherents was rather divided. Some researchers considered it to be the result of an academic “crisis” (R.T. Pickens) or questioned its innovative status (K. Stackmann: “Neue Philologie?”); others appreciated the “new attitudes to the page” it had brought to mind (J. Bumke after R.H. and M.A, Rouse) or even saw a new era of the “powers of philology” evoked (H.-U. Gumbrecht). Besides the debates on the New Philology another concept of textual materiality strengthened in the last decade, maintaining that textual alterations somewhat relate to biogenetic mutations. In a matter of fact, phenomena such as genetic and textual variation, gene recombination and ‘contamination’ (the mixing of different exemplars in one manuscript text) share common features. The paper discusses to what extent the biogenetic concepts can be used for evaluating manifestations of textual production (as the approach of ‘critique génétique’ does) and of textual transmission (as the phylogenetic analysis of manuscript variation does). In this context yet the genealogical concept of stemmatology – the treelike representation of textual development abhorred by the New Philology adepts – might prove to be useful for describing the history of texts. The textual material to be analyzed will be drawn from the Parzival Project, which is currently preparing a new electronic edition of Wolfram von Eschenbach’s Parzival novel written shortly after 1200 and transmitted in numerous manuscripts up to the age of printing. Researches of the project have actually resulted in suggesting that the advanced knowledge of the manuscript transmission yields a more precise idea on the author’s own writing process.

Populism and Liberal Democracy: Populists in Government in Austria, Italy, Poland and Switzerland

The enduring electoral success of populist parties across Europe and the increasing opportunities they have gained to access government in recent years bring once more into relief the question of whether populism and democracy are fully compatible. In this article we show how, despite playing different roles in government within very different political systems, and despite the numerous constraints placed upon them (for instance, EU membership, international law and domestic checks and balances), populist parties consistently pursued policies that clashed with fundamental tenets of liberal democracy. In particular, the idea that the power of the majority must be limited and restrained, the sanctity of individual rights and the principle of the division of powers have all come under threat in contemporary Europe. This has contributed to the continuing erosion of the liberal consensus, which has provided one of the fundamental foundations of the European project from its start.

Contrasts, Contacts, and Interconnections — Tel Kinrot as an Early Iron Age Key Site in the Northern Jordan Rift Valley at the Dawn of the 1st Millennium BCE

Ancient Kinneret (Tēl Kinrōt [Hebrew]; Tell el-ʿOrēme [Arabic]) is located on a steep limestone hill on the northwestern shores of the Sea of Galilee (2508.7529 [NIG]). The site, whose settlement history began sometime during the Pottery-Neolithic or the early Chalcolithic period, is emerging as one of the major sites for the study of urban life in the Southern Levant during the Early Iron Age (c. 1130–950 BCE). Its size, accessibility by major trade routes, and strategic location between different spheres of cultural and political influence make Tēl Kinrōt an ideal place for studying the interaction of various cultures on urban sites, as well as to approach questions of ethnicity and regionalism during one of the most debated periods in the history of the ancient Levant. The paper will briefly discuss the settlement history of the site during the Early Iron Age. However, the main focus will lie on the material culture of the late Iron Age IB city that rapidly evolved to a regional center during the transition from the 11th to the 10th century BCE. During this period, ancient Kinneret features a multitude of cultural influences that reach from Egypt via the Central Hill Country until the Northern parts of Syria and the Amuq region. While there are indisputably close ties with the ‘Aramaean’ realm, there are also strong indications that there were – at the same time – vivid socio-economic links with the West, i.e. the Southern and Northern Mediterranean coasts and their hinterland. It will be argued that the resulting ‘cultural blend’ is a typical characteristic of the material culture of the Northern Jordan Rift Valley in the advent of the emerging regional powers of the Iron Age II.