The international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: evidentiary tables : a statement for healthcare professionals from the neurocritical care society and the European society of intensive care medicine.

A variety of technologies have been developed to assist decision-making during the management of patients with acute brain injury who require intensive care. A large body of research has been generated describing these various technologies. The Neurocritical Care Society (NCS) in collaboration with the European Society of Intensive Care Medicine (ESICM), the Society for Critical Care Medicine (SCCM), and the Latin America Brain Injury Consortium (LABIC) organized an international, multidisciplinary consensus conference to perform a systematic review of the published literature to help develop evidence-based practice recommendations on bedside physiologic monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews on physiologic processes important in the care of acute brain injury. In this article we provide the evidentiary tables for select topics including systemic hemodynamics, intracranial pressure, brain and systemic oxygenation, EEG, brain metabolism, biomarkers, processes of care and monitoring in emerging economies to provide the clinician ready access to evidence that supports recommendations about neuromonitoring.

The international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: a list of recommendations and additional conclusions : a statement for healthcare professionals from the neurocritical care society and the European society of intensive care medicine.

Careful patient monitoring using a variety of techniques including clinical and laboratory evaluation, bedside physiological monitoring with continuous or non-continuous techniques and imaging is fundamental to the care of patients who require neurocritical care. How best to perform and use bedside monitoring is still being elucidated. To create a basic platform for care and a foundation for further research the Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to develop recommendations about physiologic bedside monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews as a background to the recommendations. In this article, we highlight the recommendations and provide additional conclusions as an aid to the reader and to facilitate bedside care.

Newly described human polyomaviruses Merkel Cell, KI and WU are present in urban sewage and may represent potential environmental contaminants

Recently, three new polyomaviruses (KI, WU and Merkel cell polyomavirus) have been reported to infect humans. It has also been suggested that lymphotropic polyomavirus, a virus of simian origin, infects humans. KI and WU polyomaviruses have been detected mainly in specimens from the respiratory tract while Merkel cell polyomavirus has been described in a very high percentage of Merkel cell carcinomas. The distribution, excretion level and transmission routes of these viruses remain unknown. Here we analyzed the presence and characteristics of newly described human polyomaviruses in urban sewage and river water in order to assess the excretion level and the potential role of water as a route of transmission of these viruses. Nested-PCR assays were designed for the sensitive detection of the viruses studied and the amplicons obtained were confirmed by sequencing analysis. The viruses were concentrated following a methodology previously developed for the detection of JC and BK human polyomaviruses in environmental samples. JC polyomavirus and human adenoviruses were used as markers of human contamination in the samples. Merkel cell polyomavirus was detected in 7/8 urban sewage samples collected and in 2/7 river water samples. Also one urine sample from a pregnant woman, out of 4 samples analyzed, was positive for this virus. KI and WU polyomaviruses were identified in 1/8 and 2/8 sewage samples respectively. The viral strains detected were highly homologous with other strains reported from several other geographical areas. Lymphotropic polyomavirus was not detected in any of the 13 sewage neither in 9 biosolid/sludge samples analyzed. This is the first description of a virus isolated from sewage and river water with a strong association with cancer. Our data indicate that the Merkel cell polyomavirus is prevalent in the population and that it may be disseminated through the fecal/urine contamination of water. The procedure developed may constitute a useful tool for studying the excreted strains, prevalence and transmission of these recently described polyomaviruses.

The Future of Mobile Services and Wireless Applications in the Finnish Healthcare Sector

Työn päätavoitteena oli tutkia mobiilipalveluita ja langattomia sovelluksia Suomen terveydenhuollon sektorilla. Tutkimus havainnollistaa avain-alueita, missä mobiilipalvelut ja langattomat sovellukset voivat antaa lisäarvoa perinteiseen lääketieteen harjoittamiseen, ja selvittää, mitkä ovat tähän kehitykseen liittyvät suurimmat ongelmat ja uhkat sekä tutkimustuloksiin pohjautuvat mahdolliset palvelut ja sovellukset 5-10 vuoden kuluttua. Tutkimus oli luonteeltaan kvalitatiivinen ja tutkimuksen toteuttamiseen valittiin tulevaisuudentutkimus ja erityisesti yksi sen menetelmistä, delfoi-menetelmä. Tutkimuksen aineisto kerättiin kahdelta puolistrukturoidulta haastattelukierrokselta. Työn empiirinen osuus keskittyi kuvailemaan Suomen terveydenhuollon sektoria, siinä meneillään olevia projekteja sekä teknisiä esteitä. Lisäksi pyrittiin vastaamaan tutkimuksen pääkysymykseen. Tutkimustulokset osoittivat, että tärkeät alueet, joihin langaton kommunikaatio tulisi vaikuttamaan merkittävästi, ovat ensiaputoiminta, kroonisten potilaiden etämonitorointi, välineiden kehittäminen langattomaan kommunikaatioon kotihoidon parantamiseksi ja uusien toimintamallien luomiseksi sekä lääketieteellinen yhteistyö jakamalla terveydenhuoltoon liittyvät informaation lähteet. Työn tulosten perusteellavoitiin antaa myös muutamia toimenpide-ehdotuksia jatkotutkimuksia varten.

Inclusion and empowerment in public art and urban design

To involve citizens in developing the processes of city making is an objective that occupies part of the agenda of political parties in the context of the necessary renewal in representative democracy. This paper aims to provide some answers to the following questions: Is it possible to overcome the participatory processes based exclusively on the consultation? Is it possible to"train" residents to take an active role in decision-making? How can we manage, proactively, the relationship between public actors, technicians and politicians, in a participatory process? We analyse the process development for creating the Wall of Remembrance in the Barcelona neighbourhood of Baró de Viver, a work of public art, created and produced by its neighbours, in the context of a long participatory process focused on changing the image of the neighbourhood and the improvement of public space. This result and this process have been possible in a given context of cooperation among neighbours, local government and the research team (CR-Polis, Art, City, Society at the University of Barcelona). The development of a creative process of citizen participation between 2004 and 2011 made possible the direct management of decision making by the residents on the field of the design of public space in the neighbourhood. However, the material results of the process does not overshadow the great achievement of the project: the inclusion of a neighbourhood in taking informed decisions because of their empowerment in public space design and management of their remembrances.

Poverty and marginalisation : challenges to poor women's leadership in urban India

This article examines the women's quota at the local governance level in urban India, using several case studies of women municipal councillors, to question the evidently low numbers of poor and marginalised women amongst them. It examines issues of class, caste, and religion that have a direct impact on the access of poor women to quotas reserved for them at the local government level. The objective of this work is to draw attention to the specific ways in which women are constrained at the pre-election stage, resulting in an elite capture of the women's quota in India, indicating the need for further research and study on this issue.

Tales of the City. Storytelling as a contemporary tool of urban planning and design

Almost thirty years ago, as the social sciences underwent their 'discursive turn', Bernardo Secchi (1984) drew, in what he called the 'urban planning narrative', the attention of planners to the production of myths, turning an activity often seen as primarily technical into one centred around the production of images and ideas. This conception of planning practice gave rise to a powerful current of research in English-speaking countries. Efforts were made to both combine the urban planning narrative with storytelling and to establish storytelling as a prescriptive or descriptive model for planning practice. Thus, just as storytelling is supposed to have led democratic communication off track through a pronounced concern for a good story, storytelling applied to the field of urban production may have led to an increasing preoccupation with staging and showmanship for projects to the detriment of their real inclusion in political debate. It is this possible transformation of the territorial action that will be the focus of the articles collected in this special issue of Articulo - Journal of urban research.

Use and perception of urban green spaces in Barcelona

Background: Although the mechanisms are not well understood yet, evidence exists of the benefits of urban green spaces for human health. As a consequence, one of the concerns of public health interventions must be to promote the use of urban green spaces within cities. Aims: This study aims to explore the citizens’ purposes of use of urban green spaces as well as the elements related to the characteristics of these places that condition their use. Methods: In-depth interviews were conducted with non-hospitalised people living in different areas of Barcelona, with different socioeconomic status and different residential distance to urban green spaces (n = 20). Thematic content analysis of the qualitative data was performed. Results: Physical pursuits and attention restoration were identified as prominent purposes of use of urban green spaces. The natural features of urban green spaces were identified as the most relevant determiners for the use of these places. Conclusions: To promote the use of urban green spaces, qualitative findings from this study suggest that purpose-built places should be provided. Moreover, natural features of urban green spaces must be particularly taken into account when designing and maintaining them.

Animals in an Urban Context. A Zooarchaeological study of the Medieval and Post-Medieval town of Turku

The aim of this study is to explore the role and importance of different animal species in Turku through an analysis of osteological data and documentary evidence. The osteological material used in this study is derived from two town plots in Turku dating from the 13th century to the 19th century. The osteological material deposited in Turku represents animals bred both in the town and in the surrounding landscape. Animal husbandry in SW-Finland can also be examined through a number of historical documents. The importance of animals in Turku and its hinterland are closely connected and therefore the roles of the animals in both urban and rural settings are examined. The study has revealed the complexity of the depositional patterns in medieval and post-medieval Turku. In the different areas of Turku, characteristic patterns in the osteological material and different deposit types were evident. These patterns are reflections of the activities and therefore of the lifestyles practiced in Turku. The results emphasise the importance of context- awareness in the study of material culture from archaeological sites. Both the zooarchaeological and historical sources indicate that cattle were important in animal husbandry in Turku from the Middle Ages up to the 19th century. Sheep were the second most common species. When taking into consideration the larger size of cattle, the dominance of these animals when it come to meat consumption seems clear even in those phases where sheep bones are more abundant. Pig is less abundant in the material than either cattle or sheep and their importance for subsistence was probably fairly modest, albeit constant. Goats were not abundant in the material. Most of the identified goat bones came from low utility body parts (e.g. skulls and lower extremities), but some amount of goat meat was also consumed. Wild species were of minor importance when it came to consumption practices in Turku. The changes in Turku’s animal husbandry patterns between the medieval and post medieval periods is reflected in the change in age of the animals slaughtered, which was part of a wider pattern seen in North- and Central Europe. More mature animals are also present in the assemblages. This pattern is related to the more pronounced importance of cattle as a manure producer and a draught animal as a result of the intensification of crop cultivation. This change seems to occur later in Finland than in the more Southerly regions, and indeed it did not necessarily take hold in all parts of the country.

The consequences of burnout syndrome among healthcare professionals in Spain ans Spanish speaking Latin American countrie

Objectives: Identify the frequency and intensity of the perception of adverse professional consequences and their association with burnout syndrome and occupational variables. Methods: Cross-sectional sample of 11,530 healthcare professionals resident in Spain and Latin America. The association of negative work-related consequences on burnout, as measured by the MBI and work-related variables was analysed by multiple logistic regression. Results: The emotional exhaustion was the first variable associated with absenteeism, with intention of giving up profession, personal deterioration, and family deterioration. Depersonalization was most associated with the perception of having made mistakes. Conclusions: The findings indicate a considerable prevalence of adverse work-related consequences

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 2: How is healthcare perceived?

Medically unexplained symptoms (MUS) are common among adolescents and an important cause of clinical visits. This study sought to understand the experiences with, and perceptions of, the healthcare of adolescents who have MUS and their parents. Using a qualitative approach, six focus groups and two individual interviews were conducted with a total of ten adolescents and sixteen parents. The participants were recruited in a university hospital in Switzerland. A thematic analysis was conducted in accordance with the Grounded Theory. Six main themes emerged: needing a label for the symptoms, seeking an etiology to explain the symptoms, negotiating the medical system, medication and treatments, interactions with doctors, and the inclusion of parents during consultations. Transcending these themes, however, was the need for good communication between the adolescents, their parents and the clinicians. When explaining the symptoms, clinicians should make sure to discuss the results, investigations and lack of organic origin.

Social insurances system's shortcomings : the example of the low-income young retirees' access to healthcare [Imperfections du système d'assurances sociales : l'exemple de l'accès aux soins des jeunes retraité(e)s à revenu modeste]

This article presents the results of a study involving 2445 recently retired persons from the Canton of Vaud in Switzerland who choose to forego health care. These persons of modest means barely qualify for government assistance programs and do not benefit from the social safety net that is provided to the truly destitute. 17.9% of the respondents to the questionnaire said that they forego health care for financial reasons. Interviews reveal the complex reasons that lie behind such a choice, as well as the compensation strategies that are sometimes used to get medical treatment. These strategies show that the people are able to act when the circumstances require them to do so. Despite that, their situation remains insecure. Cet article analyse les résultats d'une étude sur le renoncement aux soins menée auprès de 2445 Vaudois∙e∙s récemment retraité∙e∙s. Ces personnes de situation modeste sont proches des limites d'accès aux aides étatiques et ne bénéficient pas du même filet de protection sociale que d'autres plus démunies. 17.9% des répondant∙e∙s au questionnaire déclarent renoncer à des soins pour raisons financières. Des entretiens mettent en évidence la complexité du renoncement, ainsi que les stratégies compensatoires que les personnes adoptent pour accéder à certains soins. Ces dernières démontrent une capacité d'agir en situation qui reste toutefois précaire.

Geospatial approach for defining the Wildland-Urban Interface in the Alpine environment

Problems related to fire hazard and fire management have become in recent decades one of the most relevant issues in the Wildland-Urban Interface (WUI), that is the area where human infrastructures meet or intermingle with natural vegetation. In this paper we develop a robust geospatial method for defining and mapping the WUI in the Alpine environment, where most interactions between infrastructures and wildland vegetation concern the fire ignition through human activities, whereas no significant threats exist for infrastructures due to contact with burning vegetation. We used the three Alpine Swiss cantons of Ticino, Valais and Grisons as the study area. The features representing anthropogenic infrastructures (urban or infrastructural components of the WUI) as well as forest cover related features (wildland component of the WUI) were selected from the Swiss Topographic Landscape Model (TLM3D). Georeferenced forest fire occurrences derived from the WSL Swissfire database were used to define suitable WUI interface distances. The Random Forest algorithm was applied to estimate the importance of predictor variables to fire ignition occurrence. This revealed that buildings and drivable roads are the most relevant anthropogenic components with respect to fire ignition. We consequently defined the combination of drivable roads and easily accessible (i.e. 100 m from the next drivable road) buildings as the WUI-relevant infrastructural component. For the definition of the interface (buffer) distance between WUI infrastructural and wildland components, we computed the empirical cumulative distribution functions (ECDF) of the percentage of ignition points (observed and simulated) arising at increasing distances from the selected infrastructures. The ECDF facilitates the calculation of both the distance at which a given percentage of ignition points occurred and, in turn, the amount of forest area covered at a given distance. Finally, we developed a GIS ModelBuilder routine to map the WUI for the selected buffer distance. The approach was found to be reproducible, robust (based on statistical analyses for evaluating parameters) and flexible (buffer distances depending on the targeted final area covered) so that fire managers may use it to detect WUI according to their specific priorities.