Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study.

BACKGROUND: The quality of colon cleansing is a major determinant of quality of colonoscopy. To our knowledge, the impact of bowel preparation on the quality of colonoscopy has not been assessed prospectively in a large multicenter study. Therefore, this study assessed the factors that determine colon-cleansing quality and the impact of cleansing quality on the technical performance and diagnostic yield of colonoscopy. METHODS: Twenty-one centers from 11 countries participated in this prospective observational study. Colon-cleansing quality was assessed on a 5-point scale and was categorized on 3 levels. The clinical indication for colonoscopy, diagnoses, and technical parameters related to colonoscopy were recorded. RESULTS: A total of 5832 patients were included in the study (48.7% men, mean age 57.6 [15.9] years). Cleansing quality was lower in elderly patients and in patients in the hospital. Procedures in poorly prepared patients were longer, more difficult, and more often incomplete. The detection of polyps of any size depended on cleansing quality: odds ratio (OR) 1.73: 95% confidence interval (CI)[1.28, 2.36] for intermediate-quality compared with low-quality preparation; and OR 1.46: 95% CI[1.11, 1.93] for high-quality compared with low-quality preparation. For polyps >10 mm in size, corresponding ORs were 1.0 for low-quality cleansing, OR 1.83: 95% CI[1.11, 3.05] for intermediate-quality cleansing, and OR 1.72: 95% CI[1.11, 2.67] for high-quality cleansing. Cancers were not detected less frequently in the case of poor preparation. CONCLUSIONS: Cleansing quality critically determines quality, difficulty, speed, and completeness of colonoscopy, and is lower in hospitalized patients and patients with higher levels of comorbid conditions. The proportion of patients who undergo polypectomy increases with higher cleansing quality, whereas colon cancer detection does not seem to critically depend on the quality of bowel preparation.

Causes of subcontracting: Evidence from panel data on construction firms

This paper examines factors explaining subcontracting decisions in the construction industry. Rather than the more common cross-sectional analyses, we use panel data to evaluate the influence of all relevant variables. We design and use a new index of the closeness to small numbers situations to estimate the extent of hold-up problems. Results show that as specificity grows, firms tend to subcontract less. The opposite happens when output heterogeneity and the use of intangible assets and capabilities increase. Neither temporary shortage of capacity nor geographical dispersion of activities seem to affect the extent of subcontracting. Finally, proxies for uncertainty do not show any clear effect.

Informe sobre la segunda reunión del panel de expertos de dinámica de población de la anchoveta peruana

La segunda reunión del panel de expertos continua sus estudios sobre recursos pesqueros tomando como tema principal la anchoveta peruana. Esta investigación considera el trabajo realizado el año anterior en su primera reunión.

Tercera sesión del panel de expertos sobre la dinámica de la población de anchoveta peruana, julio de 1972

La tercera sesión del panel de expertos hace un reencuentro de las condiciones oceanográficas entre el año 1971 y 1972 respecto a la pesquería de la anchoveta.

Informe de la Cuarta sesión del panel de expertos de la evaluación del stock de anchoveta peruana

Se presenta una revisión de los sucesos de las pesquerías en el lapso desde la anterior reunión del Panel en Julio, 1972 y de lo que se piensa ha tenido lugar en el recurso y en su medio ambiente; se indican diversas líneas de investigación del stock. Se resume la evidencia colateral acerca de los stocks y de su medio ambiente; ésta se relaciona con el fenómeno de El Niño, con las aves guaneras, el aumento de las capturas de sardinas, el contenido graso de la anchoveta y los estadios de maduración de la misma. Cada una de estas entidades indican que recientemente han prevalecido condiciones especiales en el ambiente de la anchoveta, en la biota asociada y en ciertos aspectos de su fisiología. Se ha hecho una detallada revisión de varios tipos de investigación de las poblaciones de anchoveta y de las evidencias que, acerca del estado del recurso, pueden derivarse de tales investigaciones. Se examinó la evidencia obtenida del uso de equipo acústico en el estudio de la distribución de stocks y en la estimación de su abundancia; el trabajo se realizó mediante exploraciones de varias embarcaciones (exploraciones Eureka) y de exploraciones especiales con el barco de investigación SNP-1; también se hizo uso de equipo eco-integrador. Se discuten las fuentes de errores sistemáticos existentes en ese trabajo. Se llega a la conclusión que lo que ese trabajo indicó fue que en Febrero de 1973 existía alrededor de 4 millones de toneladas de anchoveta.

Segundo panel de expertos:informe sobre los efectos económicos de diferentes medidas regulatorias de la pesquería de la Anchoveta peruana

En el informe de su cuarta reunión el Panel de Expertos en Dinámica revisó los datos proporcionados por el Instituto del Mar del Perú sobre el presente estado del stock de la anchoveta. Estos datos mostraron, evidentemente, que el stock de ancho veta se encontraba en una crítica situación a comienzos de 1973. Los mejores cálculos indicaban que la mayor captura que podría obtenerse en 1973 sería alrededor de a millones de toneladas pero que sería conveniente mantencrla muy por debajo de este nivel, especialmente antes de la mayor temporada de desove en Agosto-Setiembre. En 1974 el reclutamiento podía ser muy bajo especialmente si el stock desovante seguía siendo agotado por la pesca, de modo que las capturas en 1974 podrían ser mucho más bajas del promedio aún en el caso de que no hubiera restricciones para la pesca.

Informe de la primera sesión del panel internacional de expertos para evaluación de la población de la merluza peruana. Marzo 2003

Presentan los resultados del trabajo del panel siguiendo la secuencia establecida en los términos de referencia: estimar el estatus del stock de la merluza peruana, Proveer proyecciones del rendimiento y desarrollo del stock, bajo un escenario pesquero apropiado para el stock de la merluza peruana, comentar sobre medidas administrativas apropiadas de corto y mediano plazo, para la merluza peruana.

Informe de la segunda sesión del panel internacional de expertos para evaluación de la población de la merluza peruana. Marzo 2004

Evalua los resultados del trabajo del Panel de acuerdo con los términos de referencia: actualizar la evaluación y estimar el estatus del stock de la merluza peruana, evaluar el stock desovante y la ojiva de madurez, proponer una cuota para el año 2004, revisar los datos de los cruceros para determinar si existe merluza fuera del área geográfica muestreada, proveer proyecciones del rendimiento y desarrollo del stock bajo esquemas pesqueros apropiados para la merluza peruana.

V panel internacional de expertos en evaluación de la Anchoveta Peruana (Engraulis ringens Jenyns)

Estudia la información sobre los procesos biológicos de la anchoveta y su dinámica poblacional frente a la variabilidad ambiental, en el marco de un enfoque ecosistémico, que permita caracterizar el rol actual de la anchoveta en el Ecosistema de Afloramiento frente al Perú, proporcionando mayores elementos para el desarrollo sustentable de su pesquería.

Convergence in panel data: Evidence from the skipping estimation

This paper demonstrates that, unlike what the conventional wisdom says, measurement error biases in panel data estimation of convergence using OLS with fixed effects are huge, not trivial. It does so by way of the "skipping estimation"': taking data from every m years of the sample (where m is an integer greater than or equal to 2), as opposed to every single year. It is shown that the estimated speed of convergence from the OLS with fixed effects is biased upwards by as much as 7 to 15%.

Notas sobre el estado actual del stock de anchoveta a base del informe del panel de expertos realizado en julio de 1972 y de los últimos estudios y prospecciones bio-oceanológicas efectuados por el Instituto del Mar

Revisa los acontecimientos recientes de la pesquería de anchoveta a la luz de las investigaciones contínuas realizadas y de las conclusiones del terce informe del Panel de Expertos en dinámica de poblaciones.

The policy relevance of wear emissions from road transport, now and in the future : an international workshop report and consensus statement

Road transport emissions are a major contributor to ambient particulate matter concentrations and have been associated with adverse health effects. Therefore, these emissions are targeted through increasingly stringent European emission standards. These policies succeed in reducing exhaust emissions, but do not address "nonexhaust" emissions from brake wear, tire wear, road wear, and suspension in air of road dust. Is this a problem? To what extent do nonexhaust emissions contribute to ambient concentrations of PM10 or PM2.5? In the near future, wear emissions may dominate the remaining traffic-related PM10 emissions in Europe, mostly due to the steep decrease in PM exhaust emissions. This underlines the need to determine the relevance of the wear emissions as a contribution to the existing ambient PM concentrations, and the need to assess the health risks related to wear particles, which has not yet received much attention. During a workshop in 2011, available knowledge was reported and evaluated so as to draw conclusions on the relevance of traffic-related wear emissions for air quality policy development. On the basis of available evidence, which is briefly presented in this paper, it was concluded that nonexhaust emissions and in particular suspension in air of road dust are major contributors to exceedances at street locations of the PM10 air quality standards in various European cities. Furthermore, wear-related PM emissions that contain high concentrations of metals may (despite their limited contribution to the mass of nonexhaust emissions) cause significant health risks for the population, especially those living near intensely trafficked locations. To quantify the existing health risks, targeted research is required on wear emissions, their dispersion in urban areas, population exposure, and its effects on health. Such information will be crucial for environmental policymakers as an input for discussions on the need to develop control strategies.

Comparison of organ doses and image quality between CT and flat panel XperCT scans in wrist and inner ear examinations.

The aim of this study was to evaluate and compare organ doses delivered to patients in wrist and petrous bone examinations using a multislice spiral computed tomography (CT) and a C-arm cone-beam CT equipped with a flat-panel detector (XperCT). For this purpose, doses to the target organ, i.e. wrist or petrous bone, together with those to the most radiosensitive nearby organs, i.e. thyroid and eye lens, were measured and compared. Furthermore, image quality was compared for both imaging systems and different acquisition modes using a Catphan phantom. Results show that both systems guarantee adequate accuracy for diagnostic purposes for wrist and petrous bone examinations. Compared with the CT scanner, the XperCT system slightly reduces the dose to target organs and shortens the overall duration of the wrist examination. In addition, using the XperCT enables a reduction of the dose to the eye lens during head scans (skull base and ear examinations).

Consensus interdisciplinaire CHUV-HUG sur la prise en charge des douleurs du dos. Son application lausannoise dans la filière du dos [Inter-hospital CHUV-HUG medical consensus of back pain management. Its application in care pathways within CHUV of Lausanne].

Back pain is a considerable economical burden in industrialised countries. Its management varies widely across countries, including Switzerland. Thus, the University Hospital and University of Lausanne (CHUV) recently improved intern processes of back pain care. In an already existing collaborative context, the two university hospitals in French-speaking Switzerland (CHUV, University Hospital of Geneva), felt the need of a medical consensus, based on a common concept. This inter-hospital consensus produced three decisional algorithms that bear on recent concepts of back pain found in literature. Eventually, a fast track was created at CHUV, to which extern physicians will have an organised and rapid access. This fast track aims to reduce chronic back pain conditions and provides specialised education for general practitioners-in-training.