Critical incidence reporting systems - an option in equine anaesthesia? Results from a panel meeting.

OBJECTIVE To provide a brief introduction into Critical Incident Reporting Systems (CIRS) as used in human medicine, and to report the discussion from a recent panel meeting discussion with 23 equine anaesthetists in preparation for a new CEPEF-4 (Confidential Enquiry into Perioperative Equine Fatalities) study. STUDY DESIGN Moderated group discussions, and review of literature. METHODS The first group discussion focused on the definition of 'preventable critical incidents' and/or 'near misses' in the context of equine anaesthesia. The second group discussion focused on categorizing critical incidents according to an established framework for analysing risk and safety in clinical medicine. RESULTS While critical incidents do occur in equine anaesthesia, no critical incident reporting system including systematic collection and analysis of critical incidents is in place. CONCLUSIONS AND CLINICAL RELEVANCE Critical incident reporting systems could be used to improve safety in equine anaesthesia - in addition to other study types such as mortality studies.

Characterization of Neisseria gonorrhoeae isolates detected in Switzerland (1998–2012): emergence of multidrug-resistant clones less susceptible to cephalosporins

Background: The spread of Neisseria gonorrhoeae (Ng) isolates resistant to the clinically implemented antibiotics is challenging the efficacy of treatments. Unfortunately, phenotypic and molecular data regarding Ng detected in Switzerland are scarce. Methods: We compared the characteristics of Ng detected during 1998–2001 (n = 26) to those detected during 2009–2012 (n = 34). MICs were obtained with the Etest and interpreted as non-susceptible (non-S) according to EUCAST criteria. Sequence type (ST) was achieved implementing the NG-MAST. BlaTEM, ponA, penA, mtrR, penB, tet (M), gyrA, parC, mefA, ermA/B/C/F, rplD, rplV, and 23S rRNA genes were analyzed. Results: The following susceptibility results were obtained (period: % of non-S, MIC90 in mg/L): penicillin (1998–2001: 42.3%, 3; 2009–2012: 85.3%, 16), cefixime (1998–2001: 0%, ≤0.016; 2009–2012: 8.8%, 0.125), ceftriaxone (1998–2001: 0%, 0.004; 2009–2012: 0%, 0.047), ciprofloxacin (1998–2001: 7.7%, 0.006; 2009–2012: 73.5%, ≥32), azithromycin (1998–2001: 11.5%, 0.25; 2009–2012: 23.6%, 0.38), tetracycline (1998–2001: 65.4%, 12; 2009–2012: 88.2%, 24), spectinomycin (1998–2001: 0%, 12; 2009–2012: 0%, 8). The prevalence of multidrug-resistant (MDR) isolates increased from 7.7% in 1998–2001 to 70.6% in 2009–2012. International STs and genogroups (G) emerged during 2009–2012 (G1407, 29.4%; G2992, 11.7%; G225, 8.8%). These isolates possessed distinctive mechanisms of resistance (e.g., G1407: PBP1 with L421, PBP2 pattern XXXIV, GyrA with S91F and D95G, ParC with S87R, PorB with G120K and A121N, mtrR promoter with A deletion). Conclusions: The prevalence of penicillin- ciprofloxacin- and tetracycline-resistant Ng has reached dramatic levels, whereas cefixime and ceftriaxone show MICs that tend to increase during time. International MDR clones less susceptible to cephalosporins are rapidly emerging indicating that the era of untreatable gonococcal infections is close.

Stellt ein niedriges Selbstkonzept einen Risikofaktor für Anpassungsprobleme nach dem Schuleintritt dar?

Im Rahmen einer prospektiven Längsschnittstudie wurde überprüft, ob ein niedriges Selbstkonzept einen Risikofaktor für Anpassungsprobleme unmittelbar nach dem Schuleintritt darstellt. Dazu wurden die Entwicklungsverläufe von 31 Kindern mit niedrigem Selbstkonzept und 72 Kindern mit hohem Selbstkonzept miteinander verglichen. Im Kindergarten unterschieden sich die beiden Gruppen weder in soziodemographischen noch in kognitiven Merkmalen. Nach dem Schuleintritt waren Kinder mit niedrigem Selbstkonzept in der Schule jedoch sowohl sozial als auch in Bezug auf ihre Leistung weniger angepasst als Kinder mit hohem Selbstkonzept. Die Ergebnisse werden hinsichtlich ihrer praktischen Bedeutsamkeit diskutiert.

Entwicklung von Handkoordination, exekutiven Funktionen und Schulleistungen bei Kindern mit Auffälligkeiten in der Handgeschicklichkeit

ABSTRACT In der vorliegenden Studie wurden die Handgeschicklichkeit, exekutive Funktionen und Schulleistungen bei Vorschulkindern mit und ohne Problemen in der Handgeschicklichkeit über einen 3-Jahres-Zeitraum untersucht. Insgesamt wurden N=94 Kinder, die zu Beginn 5- oder 6-jährig waren, untersucht, davon 47 Risikokinder mit sehr niedrigen Leistungen in der Handgeschicklichkeit und 47 Vergleichskinder. Diese wurden anhand der Variablen Alter, sozioökonomischer Status und nonverbale Intelligenz bestimmt. Die Risikokinder zeigten persistierende Defizite in der Handkoordination über den gesamten Untersuchungszeitraum hinweg. Obwohl sich alle Kinder insgesamt deutlich in den exekutiven Funktionen verbesserten, zeigten die Risikokinder ferner eine bedeutsam schlechtere Interferenzkontrolle und kognitive Flexibilität als die Vergleichskinder. Auch die schulischen Leistungen in den Bereichen Lesen, Schreiben und Mathematik zu Beginn der Beschulung waren bei den Risikokindern niedriger als bei den Vergleichskindern. Diese Befunde deuten auf domänübergreifende Probleme bei inhibitorischen und/oder Automatisierungsprozessen bei Kindern mit Auffälligkeiten in der Handgeschicklichkeit hin und geben wichtige Hinweise auf notwendige Interventionsmaßnahmen.

Personality factors in elementary school children: Contributions to academic performance over and above executive functions?

Unique contributions of Big Five personality factors to academic performance in young elementary school children were explored. Extraversion and Openness (labeled “Culture” in our study) uniquely contributed to academic performance, over and above the contribution of executive functions in first and second grade children (N = 446). Well established associations between Conscientiousness and academic performance, however, could only be replicated with regard to zero-order correlations. Executive functions (inhibition, updating, and shifting), for their part, proved to be powerful predictors of academic performance. Results were to some extent dependent on the criterion with which academic performance was measured: Both personality factors had stronger effects on grades than on standardized achievement tests, whereas the opposite was true for executive functions. Finally, analyses on gender differences revealed that Extraversion and Openness/Culture played a more dominant role in girls than in boys, but only regarding grades.

Executive functions in 5- to 8-year olds: Developmental changes and relationship to academic achievement

Pronounced improvements in executive functions (EF) during preschool years have been documented in cross-sectional studies. However, longitudinal evidence on EF development during the transition to school and predictive associations between early EF and later school achievement are still scarce. This study examined developmental changes in EF across three time-points, the predictive value of EF for mathematical, reading and spelling skills and explored children's specific academic attainment as a function of early EF. Participants were 323 children following regular education; 160 children were enrolled in prekindergarten (younger cohort: 69 months) and 163 children in kindergarten (older cohort: 78.4 months) at the first assessment. Various tasks of EF were administered three times with an interval of one year each. Mathematical, reading and spelling skills were measured at the last assessment. Individual background characteristics such as vocabulary, non-verbal intelligence and socioeconomic status were included as control variables. In both cohorts, changes in EF were substantial; improvements in EF, however, were larger in preschoolers than school-aged children. EF assessed in preschool accounted for substantial variability in mathematical, reading and spelling achievement two years later, with low EF being especially associated with significant academic disadvantages in early school years. Given that EF continue to develop from preschool into primary school years and that starting with low EF is associated with lower school achievement, EF may be considered as a marker or risk for academic disabilities.

International horse movements and spread of equine diseases: Equine Infectious Anaemia and Glanders - two examples

International trade with horses is important and continuously increasing. Therefore the risk of spread of infectious diseases is permanently present. Within this context the worldwide situation of equine vector-borne diseases and of other diseases which are notifiable to the World Organisation of Animal Health (OIE), is described. Furthermore it provides estimates of the numbers of horse movements between these countries, as well as information on import requirements and preventive measures for reducing the risk of disease spread. According to TRACES (Trade Control and Expert System of the European Union) data from 2009 and 2010 81 horses per week were imported from North America into Europe, 42 horses per week from South America, 11 horses per week from the North of Africa and the African horse sichness free-zone of South Africa, 28 per week from the Middle East and the rest of Asia and approximately 4 horses per week from Australia / Oceania. Trade within the European Union resulted amongst others in the introduction of Equine Infectious Anaemia (EIA) from Roma- nia into other European countries. Another example is the suspected case of glanders which occurred after importation of horses from Leb- anon via France and Germany into Switzerland in July 2011.

The course of radiographic loosening, pain and functional outcome around the first revision of a total hip arthroplasty

Background: The published data on pain and physical function before and after revision of total hip arthroplasty (THA) is scarce. The study reports the course and interrelationships of radiographic loosening, pain and physical function 5 year before and after a first revision THA. Methods: The study was based on the IDES-THA database. All patients with their first THA revision for aseptic loosening and a documented index surgery on the same side and at least one pre-revision and one post-revision follow-up were selected. Only patients with an intact contralateral hip joint (Charnley class-A) were included. Follow-ups within ±5.5 years around the revision time point were analyzed. Annual prevalences of radiographic component loosening and the non-desired outcomes (moderate/severe/intolerable pain, walking <30 minutes, hip flexion range <90°) were calculated. Results: Signs of radiographic component loosening started to increase about 4 years before revision surgery. Two years later, a sharp increase of painful hips from 15% to 80% in the revision year was observed. In the year after revision surgery, this rate dropped back to below 10%. Walking capacity started to noticeably deteriorate 3 years before revision and in the revision year about 65% of patients could not walk longer than 30 minutes. As opposed to pain, walking capacity did not recover to pre-revision levels and the best outcome was only reached two years post-revision. Hip flexion range had the slowest and least extent of deterioration (≈45% flexed <70° in the revision year) but with the best outcomes at only three years after revision surgery it took the longest to recover. Conclusion: Prevalence of radiological loosening signs and/or pain intensity follow an almost parallel course around the first revision of a THA for aseptic component loosening. This process begins about 4 years (radiographic loosening) before the actual revision surgery and intensifies about 2 years later (pain). It also involves walking capacity and hip range of motion. While pain levels go back to levels similar to those after primary surgery, range of motion and even more walking capacity remain moderately compromised.

Der Weg des Landes Appenzell in die Eidgenossenschaft: Das Bündnis von 1513 und seine Vorgeschichte. CD-ROM mit interaktiven Leseübungen und Kommentaren zu Schriftdokumenten im Zusammenhang mit der Aufnahme des Landes Appenzell in die Eidgenossenschaft vor 500 Jahren

Die CD bietet als erste Publikation überhaupt die Möglichkeit, anhand wichtiger Quellen den Weg des Landes Appenzell in die Eidgenossenschaft nachzuvollziehen. Die Dokumente zeigen die Vorgeschichte des Bündnisses vom 17. Dezember 1513, mit welchem Appenzell als 13. Ort in die Eidgenossenschaft aufgenommen wurde. Zudem kann mit der CD ROM das Lesen alter Handschriften erlernt werden. Das bietet die CD ROM nicht nur das Bild und den gesamten Wortlaut der Urkunde von 1513, sondern auch eine Audio-Datei des Dokuments und erstmals auch eine Übertragung des Urkundentexts in modernes Deutsch.

Kriegs- und Krisenzeiten. Zürich zur Zeit des Ersten Weltkriegs

Die 18 Beiträge werfen einen regionalgeschichtlichen Blick auf Wirtschaft, Alltag, Militär, Kultur zur Zeit des Ersten Weltkriegs in Stadt und Kanton Zürich und thematisieren das Gedenken daran. Sie schlagen eine Brücke von der europäischen Kriegs- zur Krisengeschichte im Raum Zürich.