Appropriateness of colonoscopy in Europe (EPAGE II). Surveillance after polypectomy and after resection of colorectal cancer.

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for surveillance after polypectomy and after curative-intent resection of colorectal cancer (CRC), and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of surveillance colonoscopy after polypectomy and after resection of CRC was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: Most CRCs arise from adenomatous polyps. The characteristics of removed polyps, especially the distinction between low-risk adenomas (1 or 2, small [< 1 cm], tubular, no high-grade dysplasia) vs. high-risk adenomas (large [> or = 1 cm], multiple [> 3], high-grade dysplasia or villous features), have an impact on advanced adenoma recurrence. Most guidelines recommend a 3-year follow-up colonoscopy for high-risk adenomas and a 5-year colonoscopy for low-risk adenomas. Despite the lack of evidence to support or refute any survival benefit for follow-up colonoscopy after curative-intent CRC resection, surveillance colonoscopy is recommended by most guidelines. The timing of the first surveillance colonoscopy differs. The expert panel considered that 56 % of the clinical indications for colonoscopy for surveillance after polypectomy were appropriate. For surveillance after CRC resection, it considered colonoscopy appropriate 1 year after resection. CONCLUSIONS: Colonoscopy is recommended as a first-choice procedure for surveillance after polypectomy by all published guidelines and by the EPAGE II criteria. Despite the limitations of the published studies, colonoscopy is also recommended by most of the guidelines and by EPAGE II criteria for surveillance after curative-intent CRC resection.

Being Recognizable in Order to Overcome the Crisis: The Ambivalence of Islamis Actor's Struggle for Visibility in France and Switzerland

Since the 1990s, and especially since the early 2000s, passionate controversies (Göle 2014) have emerged around the new visibility of Islam in the public sphere across Europe. These controversies, which crystallized in the headscarf debate, seem even more disturbing given that women who wear it are often young, urban and educated: that is to say, "modern" (Göle 1997, 2011). Indeed, these young women wearing the hijab seem to disrupt the narrative of Western modernity, including the decline in religious practice (Hervieu-Léger 2006) or the narration of the process of secularization in Europe. It is in the context of these controversies that Islam is built imaginatively as a "public problem" that has to be "solved" (Behloul 2012). Thus, this social construction of the Muslim other has nurtured an assessment of the failure of multiculturalism in some European countries and a process of convergence around a single model of civic integration in Europe (Behloul 2012, Joppke 2004, 2010).

General and Abdominal Adiposity and Risk of Death in Europe

Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. This study examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). A Cox regression analysis was used, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

The Role of Parliaments in European foreign policy

This book addresses the debate on the democratic deficit of European foreign and defence policies. This debate revolves around two dimensions. The first one has to do with the accountability of CFSP institutions. Is the current degree of parliamentary oversight of these policies the most appropriate? Has the disengagement of national parliaments regarding European foreign policy been counterbalanced by giving sufficient powers to the European Parliament? And, regarding the European Security and Defence Policy (ESDP), are national parliaments effectively controlling it? The second dimension of the debate is related to the wider question of whether the European Parliament is capable of legitimising EU policy outcomes. In the absence of a Europe-wide demos and of a true party system, what interests do Members of the European Parliament (MEPs) represent when dealing with foreign policy issues? Are there transnational cleavages in foreign policy or are they mainly national? Furthermore, is the European Parliament developing a transnational, autonomous stance on foreign policy issues, different from that of the Council or the Commission? The present volume is the result of the 2nd Meeting of the FORNET Working Group on “Evolution and Accountability of CFSP Institutions” organised by the Observatory of European Foreign Policy (Research line of the Institut Universitari d’Estudis Europeus), which took place in Barcelona, the 4 and 5 March 2005.

Reaction-diffusion waves of advance in the transition to agricultural economics

In a previous paper [J.Fort and V.Méndez, Phys. Rev. Lett. 82, 867 (1999)], the possible importance of higher-order terms in a human population wave of advance has been studied. However, only a few such terms were considered. Here we develop a theory including all higher-order terms. Results are in good agreement with the experimental evidence involving the expansion of agriculture in Europe

Appropriateness of colonoscopy in Europe (EPAGE II): presentation of methodology, general results, and analysis of complications.

BACKGROUND AND STUDY AIMS: Appropriate use of colonoscopy is a key component of quality management in gastrointestinal endoscopy. In an update of a 1998 publication, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE II) defined appropriateness criteria for various colonoscopy indications. This introductory paper therefore deals with methodology, general appropriateness, and a review of colonoscopy complications. METHODS:The RAND/UCLA Appropriateness Method was used to evaluate the appropriateness of various diagnostic colonoscopy indications, with 14 multidisciplinary experts using a scale from 1 (extremely inappropriate) to 9 (extremely appropriate). Evidence reported in a comprehensive updated literature review was used for these decisions. Consolidation of the ratings into three appropriateness categories (appropriate, uncertain, inappropriate) was based on the median and the heterogeneity of the votes. The experts then met to discuss areas of disagreement in the light of existing evidence, followed by a second rating round, with a subsequent third voting round on necessity criteria, using much more stringent criteria (i. e. colonoscopy is deemed mandatory). RESULTS: Overall, 463 indications were rated, with 55 %, 16 % and 29 % of them being judged appropriate, uncertain and inappropriate, respectively. Perforation and hemorrhage rates, as reported in 39 studies, were in general < 0.1 % and < 0.3 %, respectively CONCLUSIONS: The updated EPAGE II criteria constitute an aid to clinical decision-making but should in no way replace individual judgment. Detailed panel results are freely available on the internet (www.epage.ch) and will thus constitute a reference source of information for clinicians.

Increasing prevalence of gastroschisis in Europe 1980-2002: a phenomenon restricted to younger mothers?

Gastroschisis is an abdominal wall defect more prevalent in offspring of young mothers. It is known to be increasing in prevalence despite the general decrease in the proportion of births to young European women. We investigated whether the increase in prevalence was restricted to the high-risk younger mothers. We analysed 936 cases of gastroschisis from 25 population-based registries in 15 European countries, 1980-2002. We fitted a Bayesian Hierarchical Model which allowed us to estimate trend, to estimate which registries were significantly different from the common distribution, and to adjust simultaneously for maternal age, time (in grouped years) and the random variation between registries. The maternal age-standardised prevalence (standardised to the year 2000 European maternal age structure) increased almost fourfold from 0.54 [95% Credible Interval (CrI) 0.37, 0.75] per 10,000 births in 1980-84 to 2.12 [95% CrI 1.85, 2.40] per 10,000 births in 2000-02. The relative risk of gastroschisis for mothers <20 years of age in 1995-2002 was 7.0 [95% CrI 5.6, 8.7]. There were geographical differences within Europe, with higher rates of gastroschisis in the UK, and lower rates in Italy after adjusting for maternal age. After standardising for regional variation, our results showed that the increase in risk over time was the same for mothers of all ages--the increase for mothers <20 years was 3.96-fold compared with an increase of 3.95-fold for mothers in the other age groups. These findings indicate that the phenomenon of increasing gastroschisis prevalence is not restricted to younger mothers only.

Habitudes alimentaires et image corporelle chez des étudiants de deuxième année de gymnase à Lausanne [Food habits and body image of students in Lausanne]

During adolescence, nutrition needs are high; however the literature shows that few adolescents are following standardized nutritional requirements. A few weeks before an intervention about nutrition to high school adolescents in Lausanne, they were invited to fill in a self-reported questionnaire about their nutrition modes and habits, and their self-image satisfaction (N = 198). Results show that only 5% of youth are eating 5 fruits and vegetables per day and only 29% 3 to 5 dairy products. 21% of female and 6% of boys are not satisfied about their self-image, and those exhibiting a poor self-image tend to adopt health compromising eating patterns in a higher proportion. During adolescence it is important not only to investigate the nutritional habits but also one's self image.

Appropriateness of colonoscopy in Europe (EPAGE II). Chronic diarrhea and known inflammatory bowel disease.

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for investigation of chronic diarrhea, management of patients with known inflammatory bowel disease (IBD), and for colorectal cancer (CRC) surveillance in such patients, and to report report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding the evaluation of chronic diarrhea, the management of IBD, and colorectal cancer surveillance in IBD was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: According to the literature, colonoscopic evaluation may be justified for patients aged > 50 years with recent-onset chronic diarrhea or with alarm symptoms. Surveillance colonoscopy for CRC should be offered to all patients with extensive ulcerative colitis or colonic Crohn's disease of 8 years' duration, and to all patients with less extensive disease of 15 years' duration. Intervals for surveillance colonoscopy depend on duration of evolution, initial diagnosis, and histological findings. The EPAGE II criteria also confirmed the appropriateness of diagnostic colonoscopy for diarrhea of > 4 weeks' duration. They also suggest that, in addition to assessing extent of IBD by colonoscopy, further colonoscopic examination is appropriate in the face of persistent or worsening symptoms. Surveillance colonoscopy in IBD patients was generally appropriate after a lapse of 2 years. In the presence of dysplasia at previous colonoscopy, it was not only appropriate but necessary. CONCLUSIONS: Despite or perhaps because of the limitations of the available published studies, the panel-based EPAGE II (http://www.epage.ch) criteria can help guide appropriate colonoscopy use in the absence of strong evidence from the literature.

Demographic Study of Footballers in Europe / Etude démographique des footballeurs en Europe

The Demographic Study of European Footballers is an annual publication destined for anyone who wishes to acquire a scientific understanding of the European football players' labour market. It presents the dynamics at work in 36 first division leagues in UEFA member countries. This edition covers our biggest ever survey comprising 528 clubs and 12,524 footballers. Statistical indicators relative to nine thematics (morphology, age, experience training, origin, etc.) allow the comparison of player profiles and squad compositions at league and club level. Through easily-understable regression analyses, the Study brings to light the principle differences between clubs and leagues according to economic and sporting level of championships. The final part presents the list of the most promising players under 23 years of age by league and position.

The "image" of the cave and the constant temptation to correct Plato: Benjamin Jowettt as an example

Translations of the first chapters of Book VII of Plato's Republic, in which he introduces the well-known image of the cave, eikón, reveals an astonishing and intriguing variety of interpretations of this image: "allegory", "myth", "fable", "parable", "simile" and "comparison", to cite but a few. Taking as an example the work by Benjamin Jowett, the Victorian translator of Plato, remarkable for its textual accuracy and by means of a close analysis of the terms related to the image, this paper insists on the need to neither interpret nor correct the great ideal philosopher, in this case revealing some evident contradictions that arise when this advice is not followed and pointing out the occasional use of terms extraneous to the Platonic lexicon such as "allegory".

Science in Western Islam. The circulation of knowledge in Mediterranean region

La Mediterrània ha estat gresol de la circulació d¿idees i persones des de fa mil·lennis. Durant l¿edat mitjana, però, el moviment més rellevant va ser, tal vegada, el que es va produirentre l¿Orient (Maixriq) i l¿Occident (Magrib) islàmics. Els viatges d¿estudis, íntimament units a les prescripcions religioses,varen convertir els científics musulmans en membres especialment actius en la difusió dels coneixements i dels avenços ques¿anaven adquirint a la capital de l¿imperi, Bagdad. Lluny de ser mers «transportistes» de la ciència, el nivell cultural assolit durantl'edat d'or abbassí els va convertir en un dels clímaxs intel·lectuals de la història. Al principi, tot i restar en un discret segonpla, els científics del nord d¿Àfrica i, especialment, els científicsd'al-Andalus varen tenir un paper essencial en la transmissióde la ciència oriental cap a una Europa que en va recollir el testimoni.Per això l¿aportació de la cultura araboislàmica és un esglaó sense el qual és impossible entendre la ciència posterior.Els camps conreats foren diversos: medicina, agronomia,òptica... però l¿àmbit que presidí la ciència fou, sens dubte,l¿astronomia (relacionada, al seu torn, amb les matemàtiques i la geografia). Els noms dels astrònoms més rellevants (desd¿al-Khwarizmi fins a Azarquiel) i les fites que varen assolir justifiquen que fossin coneguts per un públic ampli. Malgrat tot, continuen essent uns grans desconeguts.

Appropriateness of colonoscopy in Europe (EPAGE II). Functional bowel disorders: pain, constipation and bloating.

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for the investigation of functional bowel symptoms, and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of functional bowel symptoms was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: Much of the evidence for use of colonoscopy in evaluation of chronic abdominal pain, and/or constipation and/or abdominal bloating is modest. Major limitations include small numbers of patients and lack of adequate characterization of these patients. Large community-based follow-up studies are needed to enable better definition of the natural history of patients with functional bowel disorders. Guidelines stress that alarm features ("red flags"), such as rectal bleeding, anemia, weight loss, nocturnal symptoms, family history of colon cancer, age of onset > 50 years, and recent onset of symptoms should all lead to careful evaluation before a diagnosis of functional bowel disorder is made. EPAGE II assessed these symptoms by means of 12 clinical scenarios, rating colonoscopy as appropriate, uncertain and inappropriate in 42 % (5/12), 25 % (3/12), and 33 % (4/12) of these, respectively. CONCLUSIONS: Evidence to support the use of colonoscopy in the evaluation of patients with functional bowel disorders and no alarm features is lacking. These patients have no increased risk of colon cancer and thus advice on screening for this is not different from that for the general population. EPAGE II criteria, available online (http://www.epage.ch), consider colonoscopy appropriate in patients of > 50 years with chronic or new-onset bowel disturbances, but not in patients with isolated chronic abdominal pain.

A forensic science perspective on the role of images in crime investigation and reconstruction

This article presents a global vision of images in forensic science. The proliferation of perspectives on the use of images throughout criminal investigations and the increasing demand for research on this topic seem to demand a forensic science-based analysis. In this study, the definitions of and concepts related to material traces are revisited and applied to images, and a structured approach is used to persuade the scientific community to extend and improve the use of images as traces in criminal investigations. Current research efforts focus on technical issues and evidence assessment. This article provides a sound foundation for rationalising and explaining the processes involved in the production of clues from trace images. For example, the mechanisms through which these visual traces become clues of presence or action are described. An extensive literature review of forensic image analysis emphasises the existing guidelines and knowledge available for answering investigative questions (who, what, where, when and how). However, complementary developments are still necessary to demystify many aspects of image analysis in forensic science, including how to review and select images or use them to reconstruct an event or assist intelligence efforts. The hypothetico-deductive reasoning pathway used to discover unknown elements of an event or crime can also help scientists understand the underlying processes involved in their decision making. An analysis of a single image in an investigative or probative context is used to demonstrate the highly informative potential of images as traces and/or clues. Research efforts should be directed toward formalising the extraction and combination of clues from images. An appropriate methodology is key to expanding the use of images in forensic science.