[The importance of clinical information in diagnostic imaging in the febrile patient]

From conventional radiography to cross-sectional imaging methods, modern radiology offers a wide range of diagnostic tools for investigating patients with fever. To achieve the best results and to yield a correct diagnosis, the radiologist must tailor the diagnostic protocol individually for every patient. The decision on the most suitable imaging method, and the type and timing of contrast media strongly depends on the suspected diagnosis. Based on patient history and laboratory data, some modalities may be contraindicated or the patient may need a premedication. The authors give a short overview of diagnostic strategies in evaluating the most important causes of fever and point to the need of discussion and co-operation between clinicians and radiologists.

The PRO-AGE study: an international randomised controlled study of health risk appraisal for older persons based in general practice

BACKGROUND: This paper describes the study protocol, the recruitment, and base-line data for evaluating the success of randomisation of the PRO-AGE (PRevention in Older people-Assessment in GEneralists' practices) project. METHODS/DESIGN: A group of general practitioners (GPs) in London (U.K.), Hamburg (Germany) and Solothurn (Switzerland) were trained in risk identification, health promotion, and prevention in older people. Their non-disabled older patients were invited to participate in a randomised controlled study. Participants allocated to the intervention group were offered the Health Risk Appraisal for Older Persons (HRA-O) instrument with a site-specific method for reinforcement (London: physician reminders in electronic medical record; Hamburg: one group session or two preventive home visits; Solothurn: six-monthly preventive home visits over a two-year period). Participants allocated to the control group received usual care. At each site, an additional group of GPs did not receive the training, and their eligible patients were invited to participate in a concurrent comparison group. Primary outcomes are self-reported health behaviour and preventative care use at one-year follow-up. In Solothurn, an additional follow-up was conducted at two years. The number of older persons agreeing to participate (% of eligible persons) in the randomised controlled study was 2503 (66.0%) in London, 2580 (53.6%) in Hamburg, and 2284 (67.5%) in Solothurn. Base-line findings confirm that randomisation of participants was successful, with comparable characteristics between intervention and control groups. The number of persons (% of eligible) enrolled in the concurrent comparison group was 636 (48.8%) in London, 746 (35.7%) in Hamburg, and 1171 (63.0%) in Solothurn. DISCUSSION: PRO-AGE is the first large-scale randomised controlled trial of health risk appraisal for older people in Europe. Its results will inform about the effects of implementing HRA-O with different methods of reinforcement.

The impact of the stone age diet on gingival conditions in the absence of oral hygiene

BACKGROUND: The objective of this study was to assess the oral microbiota and clinical data in subjects without access to traditional oral hygiene methods and who ate a diet available in the Stone Age. METHODS: Ten subjects living in an environment replicating the Stone Age for 4 weeks were enrolled in this study. Bleeding on probing (BOP), gingival and plaque indices, and probing depth (PD) were assessed at baseline and at 4 weeks. Microbiologic samples were collected at the mesio-buccal subgingival aspects of all teeth and from the dorsum of the tongue and were processed by checkerboard DNA-DNA hybridization methods. RESULTS: No subject had periodontitis. Mean BOP decreased from 34.8% to 12.6% (P <0.001). Mean gingival index scores changed from 0.38 to 0.43 (not statistically significant) and mean plaque scores increased from 0.68 to 1.47 (P <0.001). PD at sites of subgingival sampling decreased (mean difference: 0.2 mm; P <0.001). At week 4, the total bacterial count was higher (P <0.001) for 24 of 74 species, including Bacteroides ureolyticus, Eikenella corrodens, Lactobacillus acidophilus, Capnocytophaga ochracea, Escherichia coli, Fusobacterium nucleatum naviforme, Haemophilus influenzae, Helicobacter pylori, Porphyromonas endodontalis, Staphylococcus aureus (two strains), Streptococcus agalactiae, Streptococcus anginosis, and Streptococcus mitis. Bacterial counts from tongue samples were higher at baseline (P <0.001) for 20 species, including Tannerella forsythia (previously T. forsythensis), Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans; serotype a), and Streptococcus spp. CONCLUSIONS: The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars. Although plaque levels increased, BOP and PD decreased. Subgingival bacterial counts increased for several species not linked to periodontitis, whereas tongue bacterial samples decreased during the study period.

History of Art in the Digital Age: Problems and Possibilities

Ziel der vorliegenden Arbeit ist, einen allgemeinen Überblick über die Wirkung von Computern auf die Kunstgeschichte zu geben. Zu Beginn der Arbeit wird der Charakter der informationstechnologischen Revolution untersucht, einschließlich seiner schon oft festgestellten Parallelen mit der "Gutenberg"- Revolution, deren Ausgangspunkt in der Entwicklung der Druckerpresse liegt. Wie auch bei Gutenberg, ist die Entwicklung der Informationstechnologie technologisch bedingt. Jedoch führt sie durch ihren Schwerpunkt auf Flexibilität und Verbreitung an ein anderes Ziel. Diese Flexibilität ist zweischneidig: während sie viele neue Möglichkeiten eröffnet, scheint sie auch einen bruchstückhafteren, iterativen Ansatz zur Untersuchung des Vorzugs von Information vor Wissen anzuregen. Es bleibt jedoch offen, ob dieser Ansatz als notwendige Konsequenz der Struktur dieser vorhandenen neuen Technologie betrachtet werden kann, oder ob er eher als Produkt eines allgemeinen intellektuellen Wandels, angeregt durch das Aufkommen des postmodernen Diskurses, beschrieben werden soll. Ich werde in dem vorliegenden Artikel für den zweitgenannten Grund argumentieren. Ich bin außerdem der Meinung, dass der in der neuen Technologie enthaltenen Tendenz zur Fragmentierung entgegengewirkt werden kann - vorausgesetzt der Wunsch besteht. Die Entwicklung des Computers hängt eng mit der Nachfrage des Konsumenten zusammen. Aus diesem Grund kann ein neuer Trend in der Nachfrage die Art der Ausweitung und Modifizierung technologischer Vorgänge mitbestimmen.Des weiteren werden in der vorliegenden Arbeit Problemstellungen diskutiert, die speziell Auswirkungen auf die Untersuchung von Bildern haben. Hierbei wird sowohl das Potential digitaler Bilder für neue Formen der Erforschung und Analyse diskutiert, als auch die vielen neuen Möglichkeiten im Zeitalter des Internets.

On the Role of Copyright Protection in the Information Society

In January 2012, Poland witnessed massive protests, both in the streets and on the Internet, opposing ratification of the Anti-Counterfeiting Trade Agreement, which triggered a wave of strong anti-ACTA movements across Europe. In Poland, these protests had further far-reaching consequences, as they not only changed the initial position of the government on the controversial treaty but also actually started a public debate on the role of copyright law in the information society. Moreover, as a result of these events the Polish Ministry for Administration and Digitisation launched a round table, gathering various stakeholders to negotiate a potential compromise with regard to copyright law that would satisfy conflicting interests of various actors. This contribution will focus on a description of this massive resentment towards ACTA and a discussion of its potential reasons. Furthermore, the mechanisms that led to the extraordinary influence of the anti-ACTA movement on the governmental decisions in Poland will be analysed through the application of models and theories stemming from the social sciences. The importance of procedural justice in the copyright legislation process, especially its influence on the image of copyright law and obedience of its norms, will also be emphasised.

Systemic Determinants of the Information Systems Outsourcing Decision: A Comparative Study of German and United States Firms

The practice of information systems (IS) outsourcing is widely established among organizations. Nonetheless, evidence suggests that organizations differ considerably in the extent to which they deploy IS outsourcing. This variation has motivated research into the determinants of the IS outsourcing decision. Most of this research is based on the assumption that a decision on the outsourcing of a particular IS function is made independently of other IS functions. This modular view ignores the systemic nature of the IS function, which posits that IS effectiveness depends on how the various IS functions work together effectively. This study proposes that systemic influences are important criteria in evaluating the outsourcing option. It further proposes that the recognition of systemic influences in outsourcing decisions is culturally sensitive. Specifically, we provide evidence that systemic effects are factored into the IS outsourcing decision differently in more individualist cultures than in collectivist ones. Our results of a survey of United States and German firms indicate that perceived in-house advantages in the systemic impact of an IS function are, indeed, a significant determinant of IS outsourcing in a moderately individualist country (i.e., Germany), whereas insignificant in a strongly individualist country (i.e., the United States). The country differences are even stronger with regard to perceived in-house advantages in the systemic view of IS professionals. In fact, the direction of this impact is reversed in the United States sample. Other IS outsourcing determinants that were included as controls, such as cost efficiency, did not show significant country differences.