The contribution of glacial archaeology to our knowledge of alpine passages - L'apport de l'archéologie des glaciers dans la connaissance des voies de passage alpins

Die europäischen Alpen sind in den Hochlagen trotz einem immensen Rückgang in den letzten Jahrzehnten immer noch stark vergletschert. Früher dachte man, dass die alpine Zone über rund 2000 m über Meer vom prähistorischen Menschen nicht begangen wurde. 1991 zeigte die Entdeckung des Mannes aus dem Eis beim Tisenjoch („Ötzi“) in über 3000 m Höhe, dass schon im Neolithikum Vorstösse bis in die vergletscherten Gebiete der Alpen stattgefunden haben. Die ältesten Spuren am Schnidejoch, einem Pass in den Berner Alpen der Schweiz, reichen bis in die Zeit zwischen 4800 und 4500 v.Chr. zurück. Der Pass wurde auch in der Frühen Bronzezeit benutzt, wie zahlreiche Objekte aus der Zeit zwischen etwa 2200 und 1600 v.Chr. belegen. Frühbronzezeitliche Funde liegen auch vom Lötschenpass, einem zweiten Passübergang in den Berner Alpen vor. Nördlich dieser Übergänge befinden sich die bekannten frühbronzezeitlichen Gräber des Berner Oberlandes (Region des unteren Thunersees), südlich davon stammen zahlreiche frühbronzezeitliche Funde aus Gräbern und Nekropolen im Rhonetal. Dank der Erhaltung von organischem Material bieten die Eisfundstellen wertvolle Einblicke zur Frequentierung der Hochalpen. Neben Bohlenwegen, Strassen und Brücken bilden Pässe wichtige Elemente des prähistorischen terrestrischen Transportsystems.

Prior knowledge of the clinical picture does not introduce bias in the histopathologic diagnosis of melanocytic skin lesions

A common debate among dermatopathologists is that prior knowledge of the clinical picture of melanocytic skin neoplasms may introduce a potential bias in the histopathologic examination. Histologic slides from 99 melanocytic skin neoplasms were circulated among 10 clinical dermatologists, all of them formally trained and board-certified dermatopathologists: 5 dermatopathologists had clinical images available after a 'blind' examination (Group 1); the other 5 had clinical images available before microscopic examination (Group 2). Data from the two groups were compared regarding 'consensus' (a diagnosis in agreement by ≥4 dermatopathologists/group), chance-corrected interobserver agreement (Fleiss' k) and level of diagnostic confidence (LDC: a 1-5 arbitrary scale indicating 'increasing reliability' of any given diagnosis). Compared with Group 1 dermatopathologists, Group 2 achieved a lower number of consensus (84 vs. 90) but a higher k value (0.74 vs. 0.69) and a greater mean LDC value (4.57 vs. 4.32). The same consensus was achieved by the two groups in 81/99 cases. Spitzoid neoplasms were most frequently controversial for both groups. The histopathologic interpretation of melanocytic neoplasms seems to be not biased by the knowledge of the clinical picture before histopathologic examination.

Repatriations and 28-day mortality of ill and injured travellers: 12 years of experience in a Swiss emergency department

QUESTIONS UNDER STUDY Many persons are travelling all over the world; the elderly with pre-existing diseases also travel to places with less developed health systems. Reportedly, fewer than 0.5% of all travellers need repatriation. We aimed to analyse and examine people who are injured or ill while abroad, where they travelled to and by what means they were repatriated. METHODS Retrospective cross-sectional study with adult patients repatriated to a single level 1 trauma centre in Switzerland (2000-2011). RESULTS A total of 372 patients were repatriated, with an increasing trend per year. Of these, 67% were male; the median age was 56 years. Forty-nine percent sustained an injury, and 13% had surgical and 38% medical pathologies. Patients with medical conditions were older than those with injuries or surgical emergencies (p <0.001). Seventy-three percent were repatriated from Europe. For repatriation from Africa trauma was slightly more frequent (53%, n = 17) than illnesses, whereas for most other countries illnesses and trauma were equally distributed. Injured patients had a median Injury Severity Score of 8. The majority of illnesses involved the nervous system (38%), mainly stroke. Forty-five percent were repatriated by Swiss Air Ambulance, 26% by ground ambulance, 18% by scheduled flights with or without medical assistance and two patients injured near the Swiss boarder by helicopter. The 28-day mortality was 4%. CONCLUSIONS The numbers of travellers repatriated increased from 2000 to 2011. About half were due to illnesses and half due to injuries. The largest group were elderly Swiss nationals repatriated from European countries. As mortality is relatively high, special consideration to this group of patients is warranted.

A manual of Judaism : detailed in a conversation between a rabbi and his pupil; being an introduction into the knowledge of the principles of the Jewish faith; for the use of the juvenile members of that persuasion

Joshua Van Oven

Survey of VFC provider knowledge of catch-up regimens and contraindications to vaccination in Houston, Texas

In 2004, Houston had one of the lowest childhood immunization levels among major metropolitan cities in the United States at 65% for the 4:3:1:3:3 vaccination series. Delays in the receipt of scheduled vaccinations may be related to missed opportunities due to health care provider lack of knowledge about catch-up regimens and contraindications for pediatric vaccination. The objectives of this study are to identify, measure, and report on VFC provider-practice characteristics, knowledge of catch-up regimens and contraindications, and use of Reminder recall (R/R) and moved or gone elsewhere (MOGE) practices among providers with high (>80%) and low (<70%) immunization coverage among 19-35 month old children. The sampling frame consists of 187 Vaccines for Children (VFC) providers with 2004 clinic assessment software application (CASA) scores. Data were collected by personal interview with each participating practice provider. Only ten VFC providers were successful at maximizing vaccinations for every vignette and no provider administered the maximum possible number of vaccinations at visit 2 for all six vignettes. Both coverage groups administered polio conjugate vaccine (PCV), haemophilus influenza type b (Hib), and diphtheria, tetanus and acellular pertussis (DTaP) most frequently and omitted most frequently varicella zoster vaccine (VZV) and measles, mumps, and rubella (MMR) vaccine. ^

Knowledge of exercise recommendations and energy intake from foods and beverages in relation to exercise behaviors within two Hispanic border communities

This research is a secondary analysis of the Qué Sabrosa Vida population-based cross-sectional study of two predominately Mexican American communities located along the Texas-Mexico border in 2000. There were two aims for this research. The first was to determine the relationship between knowledge of exercise and water recommendations, and exercise behavior and water consumption. The second was to determine the relationship between exercise behavior and percentage of energy consumption from beverages. Chi-square analysis revealed the majority of both populations had adequate knowledge about water and exercise recommendations, although significant percentages of the populations (>40%) did not consume water or exercise in adequate amounts. Knowledge was found to be a component of both behaviors, as it was more prevalent in the adults who exercised and consumed water in adequate amounts. Analysis of variance revealed no significant difference between overall beverage calorie percentage and exercise level (all p-values > 0.05); both regions and genders reported ∼18% of total caloric intake from beverages. There was no disproportionate influence of beverage calories on total caloric intake, after controlling for water consumption and independent of exercise behavior. These findings suggest that overall caloric intake, from both foods and beverages, may be the most influential factor to the energy imbalance contributing to the obesity crisis in these Hispanic border populations. ^

Contraceptive attitudes and knowledge of female adolescents

Despite the recent decline in adolescent pregnancy rates, adolescent pregnancy continues to be a significant public health issue in the United States. The United States consistently reports the highest rate of adolescent pregnancy among developed countries. Adolescent mothers are more likely to have multiple pregnancies, to access welfare and other social services, and to be unmarried. Teen mothers are less likely to complete high school, enter college, and typically command much less earning power throughout their lifetime as compared to women who delay childbirth until later. Moreover, the United States spends approximately $9.1 billion annually on teen pregnancies. ^ Additionally disconcerting is recent data which demonstrates that the decline in teen pregnancy rates is leveling off and that the rate of adolescent pregnancy has increased for the first time since 1993. Contraceptive use is a key component to the prevention of adolescent pregnancy. Contraceptive nonuse and failure result in unintended pregnancies among adolescents. This review sought to assess the levels of knowledge and attitudes toward contraception among adolescent females.^ Levels of knowledge of contraception among adolescents are tolerable; however, there is substantial room for improvement. Misperceptions about the side effects and mechanisms of action of contraception are pervasive among this population. Adolescents who have low levels of knowledge regarding contraception tend to discontinue usage or use inconsistently. Attitudes toward contraception are greatly influenced by levels of knowledge. As a result, adolescents tend to develop more positive attitudes as misperceptions are abated. Moreover, clear disparities persist among adolescents with minority and young adolescents being at increased risk of pregnancy, poor contraceptive use, and insufficient knowledge about contraception.^ Understanding the level of knowledge of and attitudes toward contraceptives among adolescents is essential to the development of effective pregnancy prevention programs. In order to effectively reduce adolescent pregnancy, prevention initiatives must target the vulnerable populations and incorporate the necessary cultural components.^

US medical students' knowledge of obstetric fistula in developing countries

Obstetric fistula is a devastating child birth injury affecting millions of women worldwide. This paper explores the knowledge and understanding of medical students at the University of Texas Health Science Center at San Antonio regarding this global public health issue. Obstetric fistula has been eradicated in most industrialized nations, and has therefore faded from view of many modern medical organizations. The United Nations Population Fund has launched a “Campaign to End Fistula” in an attempt to bring global awareness to this preventable and treatable condition. Based on a survey administered to medical students at UTHSCSA, a baseline understanding of this disorder based on current curriculum is reviewed, with the objective of improving future physicians’ awareness of obstetric fistula. Despite a low survey response rate, there was a significant association between greater knowledge about causes, treatment, and complications of obstetric fistula and advanced years in medical school. However, the fourth year medical students averaged only a 70.5 percent of correct responses on the survey, indicating room for improvement in addressing this topic during medical school. ^

Knowledge of medical abortion among Brazilian medical students

OBJECTIVE: To assess the knowledge of Brazilian medical students regarding medical abortion (MA) and the use of misoprostol for MA, and to investigate factors influencing their knowledge. METHODS: All students from 3 medical schools in São Paulo State were invited to complete a pretested structured questionnaire with precoded response categories. A set of 12 statements on the use and effects of misoprostol for MA assessed their level of knowledge. Of about 1260 students invited to participate in the study, 874 completed the questionnaire, yielding a response rate of 69%. The Ï (2) test was used for the bivariate analysis, which was followed by multiple regression analysis. RESULTS: Although all students in their final year of medical school had heard of misoprostol for termination of pregnancy, and 88% reported having heard how to use it, only 8% showed satisfactory knowledge of its use and effects. Academic level was the only factor associated with the indicators of knowledge investigated. CONCLUSION: The very poor knowledge of misoprostol use for MA demonstrated by the medical students surveyed at 3 medical schools makes the review and updating of the curriculum urgently necessary.

ACGT: advancing clinico-genomic trials on cancer - four years of experience.

The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obtained.

Qualitative Monitoring of Video Quality of Experience

Real-time monitoring of multimedia Quality of Experience is a critical task for the providers of multimedia delivery services: from television broadcasters to IP content delivery networks or IPTV. For such scenarios, meaningful metrics are required which can generate useful information to the service providers that overcome the limitations of pure Quality of Service monitoring probes. However, most of objective multimedia quality estimators, aimed at modeling the Mean Opinion Score, are difficult to apply to massive quality monitoring. Thus we propose a lightweight and scalable monitoring architecture called Qualitative Experience Monitoring (QuEM), based on detecting identifiable impairment events such as the ones reported by the customers of those services. We also carried out a subjective assessment test to validate the approach and calibrate the metrics. Preliminary results of this test set support our approach.

The Key Role Transferring Knowledge of Nuclear España, The Spanish Nuclear Society Magazine

The magazine of the Spanish Nuclear Society (SNE), “Nuclear España” is a scientific-technical publication with almost thirty years of uninterrupted edition and more than 300 numbers published. Their pages approach technical subjects related to the nuclear energy, as well as the activities developed by the SNE, especially in national and international meetings. The main part of the magazine is composed by articles written by known specialist of the energy industry. One of the top goals of the magazine is to help on transferring the knowledge from the generation that built the nuclear power plants in Spain and the new generation of professionals that have started its nuclear career in the last years. Each number is monographic, trying to cover as many aspects on an issue as it is possible, with collaborations from the companies, the research centers and universities that helps to have complementary points of view. On the other hand the articles help to deep in the issue´s topic, broadening the view of the readers about the nuclear field and helping to share knowledge across the industry. The news section of the Magazine picks up the actuality of the sector as a whole. The editorial section reflects the opinion of the SNE Governing Board and the Magazine Committee on the subjects of interest in this field. On the other hand, the monthly interview sets out the professional outstanding opinions. With a total of eleven numbers per year, three of them have a noticeable international character: the one dedicated to the operative experiences on the Spanish and European nuclear power plants, the monographic issue devoted tothe Annual Meeting of the SNE and the international issue, which covers the last activities of the Spanish industry in international projects. Both first are bilingual issues (Spanish-English), whereas the international edition is published completely in English. Besides its diffusion through all the members of the SNE, the Magazine is distributed, in the national scope, to companies and organisms related to the nuclear power, universities, research centers, representatives of the Central, Autonomic and Local Administrations, mass media and communication professionals. It is also sent to the utilities and research centers in Europe, United States, South America and Asia.

Information as a Key Tool for Rural Development. 25 Years of Experience in Spain

The lack of useful information has become a major obstacle that hinders the participation of the members of the community in the development process because they can not accurately perceive how their individual and/or collective action can influence their environment, and because of the lack of elements that support the decision-making processes. This article addresses these issues from the work carried out by the Association Instituto de Desarrollo Comunitario de Cuenca (IDC Cuenca) in the rural areas of this province of Spain for 25 years. The results show how the application of methodologies for the transmission of information tailored to each group of recipients in some aspects, enhances the participation of individuals.