Stochastic Population Projection for Germany - based on the Quadratic Spline approach to modelling age specific fertility rates

This contribution builds upon a former paper by the authors (Lipps and Betz 2004), in which a stochastic population projection for East- and West Germany is performed. Aim was to forecast relevant population parameters and their distribution in a consistent way. We now present some modifications, which have been modelled since. First, population parameters for the entire German population are modelled. In order to overcome the modelling problem of the structural break in the East during reunification, we show that the adaptation process of the relevant figures by the East can be considered to be completed by now. As a consequence, German parameters can be modelled just by using the West German historic patterns, with the start-off population of entire Germany. Second, a new model to simulate age specific fertility rates is presented, based on a quadratic spline approach. This offers a higher flexibility to model various age specific fertility curves. The simulation results are compared with the scenario based official forecasts for Germany in 2050. Exemplary for some population parameters (e.g. dependency ratio), it can be shown that the range spanned by the medium and extreme variants correspond to the s-intervals in the stochastic framework. It seems therefore more appropriate to treat this range as a s-interval covering about two thirds of the true distribution.

Errors in palliative care: kinds, causes, and consequences: a pilot survey of experiences and attitudes of palliative care professionals.

Abstract Background: Medical errors have recently been recognized as a relevant concern in public health, and increasing research efforts have been made to find ways of improving patient safety. In palliative care, however, studies on errors are scant. Objective: Our aim was to gather pilot data concerning experiences and attitudes of palliative care professionals on this topic. Methods: We developed a questionnaire, which consists of questions on relevance, estimated frequency, kinds and severity of errors, their causes and consequences, and the way palliative care professionals handle them. The questionnaire was sent to all specialist palliative care institutions in the region of Bavaria, Germany (n=168; inhabitants 12.5 million) reaching a response rate of 42% (n=70). Results: Errors in palliative care were regarded as a highly relevant problem (median 8 on a 10-point numeric rating scale). Most respondents experienced a moderate frequency of errors (1-10 per 100 patients). Errors in communication were estimated to be more common than those in symptom control. The causes most often mentioned were deficits in communication or organization. Moral and psychological problems for the person committing the error were seen as more frequent than consequences for the patient. Ninety percent of respondents declared that they disclose errors to the harmed patient. For 78% of the professionals, the issue was not a part of their professional training. Conclusion: Professionals acknowledge errors-in particular errors in communication-to be a common and relevant problem in palliative care, one that has, however, been neglected in training and research.

Fate of clinical research studies after ethical approval--follow-up of study protocols until publication.

BACKGROUND: Many clinical studies are ultimately not fully published in peer-reviewed journals. Underreporting of clinical research is wasteful and can result in biased estimates of treatment effect or harm, leading to recommendations that are inappropriate or even dangerous. METHODS: We assembled a cohort of clinical studies approved 2000-2002 by the Research Ethics Committee of the University of Freiburg, Germany. Published full articles were searched in electronic databases and investigators contacted. Data on study characteristics were extracted from protocols and corresponding publications. We characterized the cohort, quantified its publication outcome and compared protocols and publications for selected aspects. RESULTS: Of 917 approved studies, 807 were started and 110 were not, either locally or as a whole. Of the started studies, 576 (71%) were completed according to protocol, 128 (16%) discontinued and 42 (5%) are still ongoing; for 61 (8%) there was no information about their course. We identified 782 full publications corresponding to 419 of the 807 initiated studies; the publication proportion was 52% (95% CI: 0.48-0.55). Study design was not significantly associated with subsequent publication. Multicentre status, international collaboration, large sample size and commercial or non-commercial funding were positively associated with subsequent publication. Commercial funding was mentioned in 203 (48%) protocols and in 205 (49%) of the publications. In most published studies (339; 81%) this information corresponded between protocol and publication. Most studies were published in English (367; 88%); some in German (25; 6%) or both languages (27; 6%). The local investigators were listed as (co-)authors in the publications corresponding to 259 (62%) studies. CONCLUSION: Half of the clinical research conducted at a large German university medical centre remains unpublished; future research is built on an incomplete database. Research resources are likely wasted as neither health care professionals nor patients nor policy makers can use the results when making decisions.

Management of Pharyngeal Fistulas After Anterior Cervical Spine Surgery: A Treatment Algorithm for Severe Complications.

STUDY DESIGN:: Retrospective database- query to identify all anterior spinal approaches. OBJECTIVES:: To assess all patients with pharyngo-cutaneous fistulas after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA:: Patients treated in University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011 with the diagnosis of pharyngo-cutaneous fistulas. METHODS:: We conducted a retrospective study on 5 patients between 2005 and 2011 with PCF after ACSS, their therapy management and outcome according to radiologic data and patient charts. RESULTS:: Upon presentation 4 patients were paraplegic. 2 had PCF arising from one piriform sinus, two patients from the posterior pharyngeal wall and piriform sinus combined and one patient only from the posterior pharyngeal wall. 2 had previous unsuccessful surgical repair elsewhere and 1 had prior radiation therapy. In 3 patients speech and swallowing could be completely restored, 2 patients died. Both were paraplegic. The patients needed an average of 2-3 procedures for complete functional recovery consisting of primary closure with various vascularised regional flaps and refining laser procedures supplemented with negative pressure wound therapy where needed. CONCLUSION:: Based on our experience we are able to provide a treatment algorithm that indicates that chronic as opposed to acute fistulas require a primary surgical closure combined with a vascularised flap that should be accompanied by the immediate application of a negative pressure wound therapy. We also conclude that particularly in paraplegic patients suffering this complication the risk for a fatal outcome is substantial.

Conversioni al cattolicesimo a Roma tra Sei e Settecento. La presenza degli scandinavi nell’Ospizio dei Convertendi.

In my PhD dissertation, I have examined a group of people of Scandinavian origin received by Ospizio dei Convertendi. This group has been hitherto largely unknown to historical research. The Ospizio was an institute founded by the Oratorian Congregation in Rome in 1673 to provide religious instruction and material aid to both recent and aspirant converts to Roman Catholicism. My research traces the profile of converts and a typology of motives, examining different factors which influenced the conversion process. I show that the key factors were often of a social rather than a religious nature. Moreover, I have analyzed the hospice in the context of Counter-Reformation charity as well. In terms of numbers, the Scandinavians formed a somewhat marginal yet not insignificant group within the Roman hospice. Out of a total of 2203 guests received between 1673 and 1706, 4.6 % were Scandinavians: 74 Swedes (including Finland and Livonia) and 27 Danes (including Norway). They came from a rigorously Protestant region which reacted to Catholicism with severe legislative measures. Converts to Catholicism risked confiscation of their goods, expulsion or even capital punishment. Since both Sweden and Denmark were practically impenetrable to Catholicism at the time and clandestine missionary attempts often failed before they had even properly started, the Roman Catholic Church shifted its interest towards Northerners arriving in Rome, a preferred destination for young noblemen, artists and migrant craftsmen. The material related to Ospizio dei Convertendi, conserved in the Vatican archives, is a scarcely known yet unusually rich source, not only for the religious history of our continent, but also for social history and the study of migration in early modern Europe. It contains a wealth of information about members of the subordinate classes, of their travels and lives in Europe. The profile delineated in these documents is of individuals who had a wide range of different professions and different aspirations. These documents encompass a vast social spectrum that was highly mobile on a continent which by that time had become pluriconfessional. Therefore, these migrants faced the complex religious reality in their everyday life. The principal corpus of my research consists of two types of manuscript sources created for administrative and in a way also for apologetic purposes of the Roman Catholic Church. My starting point is the Primo registro generale of Ospizio dei Convertendi. This is a volume in which the following information about each guest was registered: name, nationality, city of origin, age, sex, profession, confession professed before converting, date of arrival, departure, abjuration and baptism. Typically, the convert was male, originating from Stockholm or Copenhagen, from 21 to 30 years of age. The biggest occupational groups in descending order were soldiers, noblemen, craftsmen and sailors. Thus the data reflects a multiform reality of interurban and long distance migration, ideals regarding the education of young noblemen and gentry as well as the need of European armies to hire foreign mercenaries in their various campaigns. Against this background the almost total absence of women is hardly surprising: there is only one woman in the material I have studied. The second main source, Nota degl’ospiti ricevuti e spese fatte per essi, sheds more light on the choices of the converts, their motivations and their lives outside Scandinavia before reaching Rome. This narrative material permits an analysis which completes but also goes far beyond the columns of the Institute’s general register. This material consists of reports written by Catholic priests based on an interview conducted upon each guest’s arrival. The material frequently includes information on what the converts would do following their departure from the Institute as well. These sources have a specific narrative form and contain short biographies, list reasons for converting and information about the journey from the North to the Mediterranean - a journey which in many cases took several years. Moreover, they show that certain unorthodox practices such as calling on the saints and pleading for help from them were not uncommon in the Protestant popular religion. The recording of information on conversions from Protestantism to Catholicism reflects both religious and social interest on the part of the receiving institute. The information obtained was used for the purposes of religious teaching, for finding adequate ways of inserting the convert into Italian society so that he could earn a living, and to find effective methods to convert others with a similar cultural and geographical background. The stories recorded were based on interviews with the newly-arrived, information obtained from a travel companion or fellow countrymen, or from written documents the aspirant converts carried with them. These sources illustrate, although sometimes in rather simplified ways, the circumstances and motivations which were relevant to the choice of changing one’s confession. In addition, I have examined petitions addressed to the hospice and other Roman authorities in order to get financial aid. These petitions were written by Italian scrittori, and they contain certain conventions and topoi of presenting the conversion with the purpose of improving the chances of obtaining financial aid. It is through these filters, which may seem initially almost invisible, that the remote voice of the converts reaches us. The results of the analysis are particularly interesting because they disagree with some of the principal conclusions of previous work on the subject. First, earlier research has focused almost exclusively on the conversions of noblemen, and has argued, second, that the Queen Christina of Sweden was the driving force behind their change of confession. The sources examined for this dissertation present a profile of long-distance migrants, many of them members of the subordinate classes, who were looking for ways to make their living in Europe. These people had in many cases left their country of origin several years earlier and not for religious reasons, so, crucially, we are not dealing with confessional migration in these cases. Rather, conversion was a complex process, intricately tied up with strategies of survival, integration and upward social mobility. At the same time, while these components are significant on their own right, they do not necessarily point to the absence of motivations of a more clearly religious nature.

‘Just how (re)usable is Research Data? A legal perspective’ - A poster summarizing the recommendations of the OpenAIRE legal and licensing study.

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Hesperian College, showing south view of the building remodeled 1881-1882

Hesperian College with students and faculty, showing south view of the building remodeled 1881-1882. [Chapman University was founded by members of the Christian Church (Disciples of Christ) as Hesperian College in Woodland, Calif., on March 4, 1861. In 1920, the assets of Hesperian College were absorbed by California Christian College, which held classes in downtown Los Angeles. In 1934, the school was renamed after the chairman of its board of trustees (and primary benefactor), C.C. Chapman.]

Niagara Postcards, 1902, 1908, 1910, undated.

Consists of 33 postcards featuring various scenes and landmarks in the Niagara region. The postcards feature the Great Gorge Route, the Niagara River and Falls, Queenston Heights, Ridley College, military camps in Niagara-on-the-Lake, and a Catholic Church in Port Colborne. Most of the postcards are blank, but four have been postmarked. One of these is addressed to Miss Ada Misner, Espanola, Ont., from M.G. and is postmarked August 18, 1908. Another postcard is addressed to Mr. Alfred H. Smith, Stamford Hill, London N., from Hedley Smith, France and is postmarked 1902. Another is addressed to Miss Annabel Bishop, Buffalo, N.Y. from Irene Lalour(?), and is postmarked April 30, 1908. The last postcard is addressed to Miss Edna Lackie, Toronto, from R.M. and is postmarked August 1, 1910.

Artists Rendering of Isobel Price

Artist’s rendering in colour of Isobel Price in an oval frame with a hook at the top and a section at the back which contains a lock of hair. This painting was done by Gerald Sinclair Hayward who was a renowned artist whose work was displayed at an exhibition in New York in 1899. He painted Theodore Roosevelt, William K. Vanderbilt and members of the ruling families of Britain, Germany and Russia. The frame is enclosed in a folding case lined with velvet and silk. The silk is quite worn. The outside of the case appears to be leather and has a stand for setting it upright. It closes with a metal latch. This is accompanied by a note by R. Band.

List of Records of Deeds for Graves, St. Catharines

1 handwritten list of records of deeds for graves in the public cemetery of St. Catharines including: Deed no.133 between the Rector of St. George’s Church in St. Catharines and Samuel DeVeaux Woodruff for 480 square feet in section P. Deed no. 134 between the Rector and church wardens of St. George’s Church and Anne S. Sanderson for 208 square feet in section P and Deed no. 1235 between the City Council of St. Catharines and Samuel D. Woodruff for 336 square feet in section P, 1861, 1883.

La Guerre civile espagnole : l'influence du Québec sur les politiques du gouvernement fédéral

La politique extérieure canadienne en regard de la Guerre civile espagnole fut adoptée en juillet 1937. Le gouvernement canadien adopta une politique de neutralité analogue à celle pilotée par la Grande-Bretagne à travers le Comité de non-intevention. Il promulgua un embargo sur l’exportation d’armes de toutes sortes sur le territoire espagnol, et ce, aux deux belligérants. De plus, avec la Loi sur l’enrôlement à l’étranger, Ottawa criminalisa l’engagement volontaire sur toutes ses formes, plus particulièrement le Bataillon Mackenzie – Papineau, ramification canadienne des Brigades Internationales. Au Québec, cette guerre fut fortement ressentie. Les élites traditionnelles et le clergé catholique anathématisent le Front Populaire espagnol en l’assimilant au communisme soviétique, et se solidarisent avec leurs coreligionnaires espagnols. Selon Ernest Lapointe, bras droit de Mackenzie King au Québec, Ottawa doit tenir compte du courant conservateur chez les Québécois francophones afin de prévenir une crise domestique pouvant avoir des conséquences sur l’unité nationale. Mais la politique étrangère du Canada à l’égard du gouvernement républicain espagnol n’a que partiellement été influencée par la réaction clérico-nationaliste au Québec. Elle est bien davantage le résultat de l’alignement du Canada sur la politique étrangère britannique.

L'hagiographie pataphysique : enjeux de l'ethos dans les Vies de Saints du Calendrier

RÉSUMÉ Forme littéraire développée dès les débuts du IVe siècle, l’hagiographie, plus tard sanctionnée par l’Église catholique romaine, se déploie avec tout le rituel et le décorum requis par le genre institué, dévoilant les modalités du savoir et du croire qui la distingue. Cette forme fixe fut réactivée, contre toute attente, dans une somme étoffée durant la seconde moitié du XXe siècle par le Collège de ‘Pataphysique, aréopage de philosophes, littérateurs et plasticiens, qui n’est pas un conclave d’excentriques, pas davantage qu’un nouvel « isme », mais une institution qui résolument emblématise la Science. Ce réemploi générique de l’hagiographie est caractérisé par une hétérogénéité bien peu canonique s’inscrivant dans une continuité problématique par rapport au sous-texte. Une première traversée du Calendrier inviterait à croire à une entreprise parodique et iconoclaste. La parodie, qui est aussi une imitation, pose un problème de visée. Le second degré de Gérard Genette implique deux grands régimes discursifs : le sérieux (le sérieux proprement dit et le satirique) et le ludique. Ces régimes nous ont été utiles pour arrimer la question de l’humour. Il y a là en somme deux possibilités, soit la parodie sérieuse conduisant à ridiculiser l’hagiographie et le Calendrier des Saints qui seraient sérieusement visés, néantisés, tournés en dérision; soit la parodie ludique, à portée nulle, simple jeu, farce farfelue, « pour rire ». Or, nous avons tenté de démontrer dans ce mémoire que, même s’il y a lieu d’avancer des arguments en faveur de l’un et de l’autre type de parodie, le partage ne fonctionne pas, précisément peut-être parce qu’il est possible de montrer à la fois que c’est sérieux et pas sérieux. Dans un troisième temps, on peut aussi faire la démonstration que le pas-sérieux est sérieux. Les jeux de mots, d’homophonie n’engagent-ils pas le Verbe? L’imitation impossible ne réfléchit-elle pas les imitabile de la Sainte Église? La situation énonciatrice tributaire de l’hagiographie pataphysique est non différentiable d’un souci de didactisme qui place la composante moralisatrice au centre des enjeux discursifs. Elle induit de ce fait des attentes en matière d’ethos consistant à mettre au même diapason une représentation sociale de l’énonciateur et une représentation intradiscursive au ton didactique. Elle adjoint un autre ton, savant celui-là, érudit, qui vient défaire la belle convergence et fait disjoncter la rhétorique du genre. Cette rhétoricité problématique de l’hagiographie pataphysique a été abordée sous l’angle de l’ethos. L’ethos est l’instance de validation par laquelle nous renvoyons non pas au caractère de l’orateur, mais, suivant en cela Dominique Maingueneau, au type de parole engendrée par le discours et qui, en retour, rend ce discours crédible. Que devient cette instance lorsque la visée persuasive du discours est remise en question, que l’ethos se démultiplie de façon hétérogène sans véritablement assurer la cohésion du propos ni garantir sa portée? La parodie posant incidemment un problème de visée, est-ce du côté d’un ethos parodique que se trouve la réponse? Il nous a convenu de mesurer, d’articuler, de déplacer cette postulation. Nous nous sommes saisi, pour les besoins de notre argumentation, d’une discipline historiquement lourde d’investissement théorique, soit la rhétorique. Celle-ci constitue à la fois une méthode de composition d’un discours reposant sur des lieux susceptibles de susciter l’adhésion et l’émulation de l’énonciataire et une méthode d’analyse. Guidé par une définition étendue du texte, traversant les littératures non narrative et narrative, il nous a importé enfin de restituer la pratique cymbaliste à partir d’un corpus qui est resté l’apanage du « seul » pataphysicien. Nous nous sommes ainsi situé dans l’horizon plus global de la réceptivité d’un discours qui évacue l’idéologique, qui jamais ne se laisse saisir tout à fait, ni enferrer par le fétiche du sens au profit des potentialités qu’il recèle, et cela à partir d’axiomes arbitraires soumis à l’unique exigence de cohérence interne.

Systématisation du contenu théologique de l’expression « nouvelle évangélisation » à la lumière de la théologie pastorale de Jean-Paul II

Polarisé par l’événement du jubilé de l’an 2000, Jean-Paul II, tout au long de son pontificat, achemine l’Église catholique dans un long pèlerinage vers le IIIe millénaire de l’humanité. À l’aube du XXIe siècle, avec le contenu théologique du concile Vatican II pour boussole fiable, le pape polonais arbore une vision pastorale originale marquée par l’expression « nouvelle évangélisation ». Reprise de l’épiscopat d’Amérique latine, cette expression devient ainsi son emblème et son fer de lance durant les quelque 27 années de son pontificat. Largement récupérée par maints milieux ecclésiaux, l’expression méritait qu’on en produise une étude systématique à la lumière de la théologie pastorale de celui qui en a été le divulgateur privilégié. Pour ce faire, nous avons choisi comme texte fondateur à notre étude sa lettre apostolique Tertio Millennio Adveniente publiée en 1994, en raison de la vision pastorale qui s’en dégage à l’aube de l’an 2000. Ce texte, qui couvre la période du concile Vatican II jusqu’à l’entrée de l’Église catholique dans le IIIe millénaire, définit le cadre temporel de notre recherche. Par ailleurs, il nous permet de retenir trois référents théologiques pour conduire notre étude. Nous les analysons et nous en conduisons une synthèse théologique à travers trois regards synoptiques qui acheminent progressivement la thèse vers sa conclusion. Le premier référent théologique retenu est l’exhortation apostolique Evangelii Nuntiandi du pape Paul VI ; le deuxième référent est l’ouvrage de Karol Wojtyla Aux sources du renouveau ; le troisième référent est l’exhortation postsynodale Ecclesia in America. Avec une démarche herméneutique justifiée, et par la synthèse de ces référents théologiques, trois aboutissants voient le jour. Le premier regarde l’application pastorale du concile Vatican II : dans un regard pastoral justifié par une anthropologie définie, le pasteur articule les constitutions Lumen Gentium et Gaudium et Spes pour proposer une praxis pastorale. Le second aboutissant parle alors de la notion de la créativité de la foi. Cette créativité de la foi se décline, elle, dans les médiations culturelles – troisième aboutissant – qui s’articulent elles-mêmes autour des concepts d’attitudes et de dialogue wojtylien. La critique proposée en conclusion de thèse porte directement sur l’anthropologie proposée par Jean-Paul II sous-jacente à chacun de ces trois aboutissants.

Subversión discursiva y sexual en La Virgen de los sicarios de Fernando Vallejo

Il existe en Colombie un réseau de discours qui cherche à contrôler la production discursive sur le sexe et à brider la sexualité des Colombiens. La Virgen de los sicarios de Fernando Vallejo (1994), répond de manière subversive à un tel conditionnement discursif et sexuel. La production discursive sur la sexualité en Colombie a été construite, principalement, à partir de la tradition catholique, des discours de l’État et de textes scientifiques. Par conséquent, les comportements sexuels que le discours institutionnel ne considère pas comme des comportements normaux sont soumis à un pouvoir qui leur confère une place abominable dans l’ordre sexuel en Colombie. La Virgen de los sicarios émerge de la production littéraire queer colombienne et propose une histoire subversive sur le plan discursif autant que sexuel. Ce mémoire décrit d'abord la présence inévitable du discours religieux en Colombie et sa forte relation avec l'État pour démontrer l'existence d'une norme discursive. Ensuite, l’analyse du roman de Vallejo permet d’observer comment cette norme est bouleversée en utilisant ses propres linéaments pour l'affaiblir. Finalement, à partir de concepts développés par Michel Foucault et Judith Butler, ce travail met en évidence l'existence d'une norme sexuelle en Colombie qui part des discours et qui se déploie vers les corps – norme qui est contestée à travers un processus selon lequel l'auteur libère la sexualité des personnages du pouvoir qui domine leurs corps.