The Rise and Fall of the Doctor-Patient Relationship

This talk will outline the history of the doctor-patient relationship in the West. It will touch briefly on medicine in Greek and Roman antiquity, using key texts from Hippocrates and Galen. It will also sketch the changing balance of the religious and the secular in medieval medicine. Finally, it will outline the rise of the modern personal doctor-patient relationship in the 18th century and analyze the chronic dissatisfaction that settled over relations between doctors and patients in the last quarter of the 20th century.

Accumulation rate and stable oxygen isotope ratios of the ice cores from the North Greenland Traverse

We present for the first time all 12 d18O records obtained from ice cores drilled in the framework of the North Greenland Traverse (NGT) between 1993 and 1995 in northern Greenland. The cores cover an area of 680 km × 317 km, 10 % of the Greenland ice sheet. Depending on core length (100-175 m) and accumulation rate (90-200 kg/m**2/a) the single records reflect an isotope-temperature history over the last 500-1100 years. Lowest d18O mean values occur north of the summit and east of the main divide as a consequence of Greenland's topography. In general, ice cores drilled on the main ice divide show different results than those drilled east of the main ice divide that might be influenced by secondary regional moisture sources. A stack of all NGT records and the NGRIP record is presented with improved signal-to-noise ratio. Compared to single records, this stack represents the mean d18O signal for northern Greenland that is interpreted as proxy for temperature. Our northern Greenland d18O stack indicates distinctly enriched d18O values during medieval times, about AD 1420 ± 20 and from AD 1870 onwards. The period between AD 1420 and AD 1850 has depleted d18O values compared to the average for the entire millennium and represents the Little Ice Age. The d18O values of the 20th century are comparable to the medieval period but are lower than that about AD 1420.

Improved ore processing assessed by digital image análisis of the ores: a key to the sustainable development of the Iberian Pyrite Belt

Mining in the Iberian Pyrite Belt (IPB), the biggest VMS metallogenetic province known in the world to date, has to face a deep crisis in spite of the huge reserves still known after ≈5 000 years of production. This is due to several factors, as the difficult processing of complex Cu-Pb-Zn-Ag- Au ores, the exhaustion of the oxidation zone orebodies (the richest for gold, in gossan), the scarce demand for sulphuric acid in the world market, and harder environmental regulations. Of these factors, only the first and the last mentioned can be addressed by local ore geologists. A reactivation of mining can therefore only be achieved by an improved and more efficient ore processing, under the constraint of strict environmental controls. Digital image analysis of the ores, coupled to reflected light microscopy, provides a quantified and reliable mineralogical and textural characterization of the ores. The automation of the procedure for the first time furnishes the process engineers with real-time information, to improve the process and to preclude or control pollution; it can be applied to metallurgical tailings as well. This is shown by some examples of the IPB.

A review of the potential of renewable energy sources for the State of Jammu and Kashmir (India)

The future economic development trajectory for India is likely to result in rapid and accelerated growth in energy demand, with expected shortages. Many of its current policies and strategies are aimed at the improvement and possible maximization of energy production from the renewable sector. It is also clear that while energy-conservation and energy-efficiency can make an important contribution in the national energy strategy, renewable energies will be essential to the solution and are likely to play an increasingly important role for the growth of grid power, providing energy access, reducing consumption of fossil fuels, and helping India pursue its low carbon progressive pathway. However, most of the states in India, like the northernmost State of Jammu and Kashmir (J&K), have experienced an energy crisis over a sustained period of time. As India intends to be one of the emerging powers of the 21st century, it has to embark upon with these pressing issues in a more sustainable manner and accordingly initiate various renewable energy projects within these states. This paper will provide a broad-spectrum view about the energy situation within J&K and will highlight the current policies along with future strategies for the optimal utilization of renewable energy resources.

Extreme pointer years in tree-ring records of central Spain as evidence of climatic events and the eruption of the Huaynaputina Volcano (Peru, 1600 AD)

The study of pointer years of numerous tree-ring chronologies of the central Iberian Peninsula (Sierra de Guadarrama) could provide complementary information about climate variability over the last 405 yr. In total, 64 pointer years have been identified: 30 negative (representing minimum growths) and 34 positive (representing maximum growths), the most significant of these being 1601, 1963 and 1996 for the negative ones, and 1734 and 1737 for the positive ones. Given that summer precipitation was found to be the most limiting factor for the growth of Pinus in the Sierra de Guadarrama in the second half of the 20th century, it is also an explanatory factor in almost 50% of the extreme growths. Furthermore, these pointer years and intervals are not evenly distributed throughout time. Both in the first half of the 17th and in the second half of 20th, they were more frequent and more extreme and these periods are the most notable for the frequency of negative pointer years in Central Spain. The interval 1600–1602 is of special significance, being one of the most unfavourable for tree growth in the centre of Spain, with 1601 representing the minimum index in the regional chronology. We infer that this special minimum annual increase was the effect of the eruption of Huaynaputina, which occurred in Peru at the beginning of 1600 AD. This is the first time that the effects of this eruption in the tree-ring records of Southern Europe have been demonstrated.

Reuse of vacant agro-industrial buildings. The case of the public slaughterhouses in Spain

Nearly 3000 slaughterhouses (74% of them public facilities) were built in Spain during the last decades of the nineteenth century and the first half of the twentieth century. The need to comply with new technical requirements and regulations on the hygiene of the meat passed in the 70s and the gradual replacement of public facilities by larger and more modern private slaughterhouses have subsequently led to the closure and abandonment of many of these buildings. Public slaughterhouses generally consisted of several single-storey and open-plan buildings located around a courtyard. Although originally they were preferably located on the outskirts of the towns, many slaughterhouses are now placed inside the built up areas, due to the urban development. The present work aims to contribute to a better understanding of these agro-industrial buildings and to provide ideas for their conservation and reuse. A review on the historical evolution and the architectural features of the public slaughterhouses in Spain is presented and different examples of old vacant slaughterhouses reused to accommodate libraries, offices, community centres, exhibition halls or sports centres, among others, are shown in the paper.

Technical evolution of 3d modular construction from the nineteenth century to world war II

3D Modular construction is poorly known and scarcely published in technical literature. In spite of that there are an increasing number of manufacturers offering their products in different countries. This method has largely evolved from early examples such as the American Gold Rush prefabrication in the nineteenth century, the Sears precut homes or Voisin´s prototypes for modular homes, to the end of the first half of the twentieth century. In this period a non negligible number of attempts in 3D modular construction have been carried out, ranging from theoretical proposals to several hundred or thousand units produced. Selected examples of modular architecture will be analyses in order to illustrate its technical evolution, concerning materials, structure, transportation and on site assembly. Success and failure factors of the different systems will be discussed. Conclusions about building criteria shown in them and their applicability in current architecture will be drawn.

Initializing the DSSAT-Century model: inverse calibration of carbon pools from apparent soil N mineralization

The CENTURY soil organic matter model was adapted for the DSSAT (Decision Support System for Agrotechnology Transfer), modular format in order to better simulate the dynamics of soil organic nutrient processes (Gijsman et al., 2002). The CENTURY model divides the soil organic carbon (SOC) into three hypothetical pools: microbial or active material (SOC1), intermediate (SOC2) and the largely inert and stable material (SOC3) (Jones et al., 2003). At the beginning of the simulation, CENTURY model needs a value of SOC3 per soil layer which can be estimated by the model (based on soil texture and management history) or given as an input. Then, the model assigns about 5% and 95% of the remaining SOC to SOC1 and SOC2, respectively. The model performance when simulating SOC and nitrogen (N) dynamics strongly depends on the initialization process. The common methods (e.g. Basso et al., 2011) to initialize SOC pools deal mostly with carbon (C) mineralization processes and less with N. Dynamics of SOM, SOC, and soil organic N are linked in the CENTURY-DSSAT model through the C/N ratio of decomposing material that determines either mineralization or immobilization of N (Gijsman et al., 2002). The aim of this study was to evaluate an alternative method to initialize the SOC pools in the DSSAT-CENTURY model from apparent soil N mineralization (Napmin) field measurements by using automatic inverse calibration (simulated annealing). The results were compared with the ones obtained by the iterative initialization procedure developed by Basso et al., 2011.

Lipid biomarkers in the Enol Lake (Asturias, Northern Spain): coupled natural and human induced environmental history

The lipid content of three cores from Lake Enol (Picos de Europa National Park, Asturias, Northern Spain) was studied. The n-alkane profiles indicated a major input from terrigenous plants [predominance of high molecular weight (HMW) alkanes] since ca. 1695 AD to the water body, although the uppermost cm revealed a predominance of organic matter (OM) derived from algae, as the most abundant alkane was C17. Three units revealing different environmental conditions were defined. Unit A (ca. 1695–1860 AD) in the lowermost parts of ENO13-10 (< 12 cm) and ENO13-15 (< 28 cm) was identified and was characterized by higher OM input and evidence of minimal degradation (high CPI values, predominance of HMW n-alkanoic acids and good correspondence between the predominant n-alkane and n-alkanoic acid chains). These findings could be linked to the Little Ice Age, when cold and humid conditions may have favored an increase in total organic carbon (TOC) and n-alkane and n-alkanoic acid content (greater terrigenous OM in-wash), and may have also reduced bacterial activity. In Unit B (ca. 1860–1980 AD) the lack of correspondence between the n-alkane and n-alkanoic acid profiles of ENO13-10 (12–4 cm) and ENO13-15 (28–8 cm) suggested a certain preferential microbial synthesis of long chain saturated fatty acids from primary OM and/or bacterial activity, coinciding with a decrease in OM input, which could be linked to the global warming that started in the second half of the 19th century. In ENO13-7 the low OM input (low TOC) was accompanied by some bacterial degradation (predominance ofHMWn-alkanoic acids but with a bimodal distribution) in the lowermost 16–5 cm. Evidence of considerable phytoplankton productivity and microbial activity was especially significant in Unit C (ca. 1980–2013 AD) identified in the uppermost part of all three cores (5 cm in ENO13-7, 4 cm in ENO13-10 and 8 cm in ENO13-15), coinciding with higher concentrations of n-alkanes and n-alkanoic acids, which were considered to be linked to warmer and drier conditions, as well as to greater anthropogenic influence in modern times. Plant sterols, such as b-sitosterol, campesterol and stigmasterol, were significantly present in the cores. In addition, fecal stanols, such as 24-ethylcoprostanol from herbivores, were present, thereby indicating a continuous and significant pollution input derived from these animals since the 17th century, being more important in the last 20 years.

Molecular and genealogical evidence for a founder effect in Fanconi anemia families of the Afrikaner population of South Africa

Fanconi anemia (FA) is a rare, genetically heterogeneous autosomal recessive disorder associated with progressive aplastic anemia, congenital abnormalities, and cancer. FA has a very high incidence in the Afrikaner population of South Africa, possibly due to a founder effect. Previously we observed allelic association between polymorphic markers flanking the FA group A gene (FANCA) and disease chromosomes in Afrikaners. We genotyped 26 FA families with microsatellite and single nucleotide polymorphic markers and detected five FANCA haplotypes. Mutation scanning of the FANCA gene revealed association of these haplotypes with four different mutations. The most common was an intragenic deletion of exons 12–31, accounting for 60% of FA chromosomes in 46 unrelated Afrikaner FA patients, while two other mutations accounted for an additional 20%. Screening for these mutations in the European populations ancestral to the Afrikaners detected one patient from the Western Ruhr region of Germany who was heterozygous for the major deletion. The mutation was associated with the same unique FANCA haplotype as in Afrikaner patients. Genealogical investigation of 12 Afrikaner families with FA revealed that all were descended from a French Huguenot couple who arrived at the Cape on June 5, 1688, whereas mutation analysis showed that the carriers of the major mutation were descendants of this same couple. The molecular and genealogical evidence is consistent with transmission of the major mutation to Western Germany and the Cape near the end of the 17th century, confirming the existence of a founder effect for FA in South Africa.

Solution to Darwin's dilemma: Discovery of the missing Precambrian record of life

In 1859, in On the Origin of Species, Darwin broached what he regarded to be the most vexing problem facing his theory of evolution—the lack of a rich fossil record predating the rise of shelly invertebrates that marks the beginning of the Cambrian Period of geologic time (≈550 million years ago), an “inexplicable” absence that could be “truly urged as a valid argument” against his all embracing synthesis. For more than 100 years, the “missing Precambrian history of life” stood out as one of the greatest unsolved mysteries in natural science. But in recent decades, understanding of life's history has changed markedly as the documented fossil record has been extended seven-fold to some 3,500 million years ago, an age more than three-quarters that of the planet itself. This long-sought solution to Darwin's dilemma was set in motion by a small vanguard of workers who blazed the trail in the 1950s and 1960s, just as their course was charted by a few pioneering pathfinders of the previous century, a history of bold pronouncements, dashed dreams, search, and final discovery.

The Significance of the Disputed Territory in Bechuanaland 1887-1893

British Imperial policy in Southern Africa in the last three decades of the nineteenth century oscillated between two extremes. It began in the early 1870's with Lord Kimberley's attempt to effect confederation as a means of devolving Imperial responsibility and expenditure. It ended in 1899 with Britain's active intervention against the Boers. For most of the remaining years of those decades a middle course was adopted while the British Government struggled to reconcile its diverse political interests. Strategy, supremacy, economy, humanitarianism, and recognition of colonial aspirations were all at one time or another, in varying degrees, motivating forces behind Imperial policy. Many historians have pointed out how incompatible many of these ends were and how the attempt to pursue them all at once almost inevitably ended in at least one of them being sacrificed on the way. This study focusses on a relatively minor problem over a period of about seven years. It attempts to show how the British Government tried to reconcile, in this case, the predominant motives of economy and supremacy. The problem of the Disputed Territory now seems like a small fish in a big ocean because non the great hopes and fears that it raised were ever realized. But the anticlimactic nature of the outcome of events should not be allowed to conceal two important points: first, that the problem loomed large at the time in the eyes of the Imperial Government; and second, that in the case of its policy towards the Disputed Territory, the Government gained a greater degree of success in trying to reconcile seemingly incompatible ends than it did in many other instances.

The autonomy of the EU legal order and the law-making activities of international organizations. Some examples regarding the Council most recent practice. Research Papers in Law 03/2012

[Introduction.] It is generally believed that while the principle of the autonomy of the EU legal order, in the sense of constitutional and institutional autonomy that is to say what concerns the autonomous decision-making of the EU, has been clearly strengthened by the most recent jurisprudence of the Court of Justice (eg. Moxplant3, Intertanko or the Kadi/Al Baraakat judgements or the Opinion 1/2009 of the CJEU etc.) as well as, in my opinion, in many aspects by the Treaty of Lisbon, it is still valid to add that the principle of a favourable approach, stemming from the Court jurisprudence, for the enhanced openness of the EU legal order to international law has remained equally important for the EU4. On the other hand, it should be also seen that in a globalized world, and following the increased role of the EU as an international actor, its indispensable and crucial role concerning the creation of world (legal) order in many policy fields ( for example let's think about the G20 issues, the global economic and financial crisis, the role of the EU in promoting and protecting human rights worldwide, the implementation of the multilateral or regional conventional law, developed in the framework the UN (e.g. in the field of agriculture or environment etc) or what concerns the Kyoto process on climate change or the conservation of marine biological resources at international level etc), it seems reasonable and justified to submit that the influence, for example, of the law-making activities of the main stakeholder international organizations in the mentioned policy-areas on the EU (especially on the development of its constantly evolving legal order) or vice-versa the influence of the EU law-making practice on these international organizations is significant, in many aspects mutually interdependent and more and more remarkable. This tendency of the 21st century doesn't mean, however, in my view, that the notion of the autonomy of the EU legal order would have been weakened by this increasing interaction between international law and EU law over the passed years. This contribution is going to demonstrate and prove these departuring points by giving some concrete examples from the most recent practice of the Council (all occuring either in the second half of 2009 or after the entry into force of the Lisbon Treaty), and which relate to two very important policy areas in the EU, namely the protection of human rights and the Common Fishery Policy.

Iceland’s contested European Policy: The Footprint of the Past - A Small and Insular Society. Jean Monnet Occasional Paper 01/2013

Introduction. Iceland’s domestic politics and foreign affairs are undergoing drastic changes. After an economic crash, violent protests on the streets of Reykjavik for the first time in Iceland’s history contributed to the defeat of the government. The party system has been altered. A turn has been taken towards Europe after the United States left the island, first by closing its military base in 2006 and then by its clear stance not to assist the country in its economic difficulties. The former close relations with the superpower are unlikely ever to be restored. The EU membership application is placing severe constraints on political parties which are split on the issue and has put in jeopardy the unity of the first left majority in the Icelandic parliament, the Althingi. Society is in a state of flux after an unprecedented economic downscaling and the collapse of almost its entire financial sector – which had boomed rapidly beginning in the mid-1990s. The credibility of politicians, the parliament and the media is in ruins. Iceland’s smallness and its location on the geographical map – one could also say the geopolitical map – has had a profound influence on its domestic and foreign affairs. Iceland is closely associated with the other Nordic states and has adopted many of their domestic characteristics, with important exceptions. On the other hand, the country has come under American influence – geographically, it straddles the Mid-Atlantic rift – and has limited its participation in the European project. Its geographical location in the middle of the North Atlantic has led to a notion that the country’s culture is unique and should be protected by all available means. Politicians continue to play the ‘nationalistic uniqueness’ card with considerable success even though the country has been swept by globalization. Rapid modernization (which only really began in the Second World War with British and American occupations) and sudden engagement with the outside world (which only extended to the general public in the last quarter of the twentieth century) are still slowly but steadily making their mark on the country’s foreign policy. The country’s political discourse and foreign policy still bear the hallmark of the past, i.e. of a small and insular society This paper will address the political developments in Iceland since the 2008 economic crash and place it in a historical context. The aim is to understand Iceland’s present foreign policy and, in particular, the highly contested decision by its government in 2009 to apply for membership of the European Union. The paper is divided into five sections in addition to this introduction and the concluding remarks. First, it starts by explaining the importance in Iceland of a political discourse based on the concept of independence which dates back to the historical narrative of the settlement period. This section will also examine Iceland’s close relations with the other Nordic states – despite important differences between it and the others. Second, the paper will analyse the importance of the party system, i.e. the dominance of the centre-right in Icelandic politics, and the changed nature of the system. Third, it examines how Iceland further distinguishes itself from the other Nordic states in many important features. Fourthly, the paper analyses the country’s three main foreign policy priorities in the post-war period, i.e. extensions of the Exclusive Economic Zone, firm defence arrangements with the US and membership of NATO, and the drive for better market access for marine products – including a partial engagement in the European project. Fifthly, the paper examines how the country’s smallness, in terms of its central administrative capacity, has affected its domestic and foreign policy-making. The concluding section summarizes the main findings concerning the political and historical obstacles that the Social Democratic Alliance faces in its hard-fought battle to change the country’s European Policy.

Future of the EU27: What to expect from this summer’s period of reflection. CEPS Commentary, 18 July 2016

As the UK’s brutal political fallout of Brexit continues to astound the world, leaders in the other member states are wrestling with the EU’s new reality. They deemed it too early to draw conclusions at the June European Council. Instead, the heads of state and government declared a period of political reflection on the future of an EU with 27 member states. They will meet again informally on September 16th in Bratislava. The question is: What impetus can they give to reforms to remain united and deal with the challenges of the 21st century?