Resident work hour restrictions do not improve patient safety in surgery: a critical appraisal based on 7 years of experience in Switzerland

In 2005 the Swiss government implemented new work-hour limitations for all residency programs in Switzerland, including a 50-hour weekly limit. The reduction in the working hours of doctors in training implicate an increase in their rest time and suggest an amelioration of doctors' clinical performance and consequently in patients' outcomes and safety - which was not detectable in a preliminary study at a large referral center in Switzerland. It remains elusive why work-hour restrictions did not improve patient safety. We are well advised to thoroughly examine and eliminate the known adverse effects of reduced work-hours to improve our patients' safety.

“Beneath the Starry Flag”: the Flags and Songs of the 1913-14 Michigan Copper Strike as Image-making in the American Labor Movement

The 1913-14 Michigan copper strike is unlike many American labor actions of the period in that it did not include red flags or socialist anthems. Many of the most familiar photographs of the strike involve American flags, not red ones. Similarly, the songs mentioned in journalistic accounts of the strikers are American Civil War songs, not popular labor songs of the period. The few newly-written songs about the strike, published in the local newspapers, seem cautiously polite and espouse values such as patriotism, liberty and human rights. During a time when sections of the "friendly" press were concerned with labor presenting the correct image and avoiding unfavorable associations, the Copper Country strikers, and the W.F.M., seem to have been attempting to create a fresh narrative regarding what this strike was (and what it was not). This paper will consider elements of the Copper Country strike in the light of media coverage, prior to July 1913, of several American labor topics that might have influenced the way the strike was presented. Particular attention will be given to photographs, songs, and accounts from the 1912 Lawrence textile strike, as well as contemporaneous critiques of labor song lyrics. Most of this commentary will be drawn from the labor and socialist press, demonstrating that the 1913-14 Michigan copper strike occurred during a period in which the labor movement was struggling to craft and image that would display it as it wished to be seen. This paper has not yet been submitted.

Determinants of Experience of Discrimination in Minorities in Germany

This study examines perceived ethnic discrimination (as opposed to “objective” discrimination). It includes a discussion of definitions of discrimination and attempts to measure it, and a review of findings on the distribution of discrimination experiences among minorities. The aim of the study is to determine the influence of factors that increase the risk of exposure to situations in which discrimination can take place (exposure hypothesis), and those that sensitize perceptions and give rise to different frequencies of subjective feelings of discrimination (sensitization hypothesis). A standardized questionnaire was administered to a random sample of German-born persons of Turkish and Greek origin and Aussiedler (ethnic Germans born in the former Soviet Union) (total N = 301). Minorities of non-German, especially of Turkish origin reported significantly more discrimination than Aussiedler in a set of nineteen everyday situations. A bivariate correlation was found between number of incidents reported and employment status with homemakers reporting the fewest incidents. However, multiple regression analysis yielded no significant effect, thus lending no clear support to the exposure hypothesis. Frequency of contacts with German friends has no effect and seems not to entail an increase in exposure opportunities, but may lead to a desensitization to discrimination due to the erosion of the relevance of ethnic categories. On the other hand, an influence through intra-ethnic contacts clearly occurs, as frequency of contact with co-ethnic friends exerts a strong positive effect on experienced discrimination. A similar effect was found for ethnic self-awareness. The latter finding confirms the sensitization hypothesis.

Cross-Layer Optimizations for Multimedia Distribution over Wireless Multimedia Sensor Networks and Flying Ad-Hoc Networks with Quality of Experience Support

The proliferation of multimedia content and the demand for new audio or video services have fostered the development of a new era based on multimedia information, which allowed the evolution of Wireless Multimedia Sensor Networks (WMSNs) and also Flying Ad-Hoc Networks (FANETs). In this way, live multimedia services require real-time video transmissions with a low frame loss rate, tolerable end-to-end delay, and jitter to support video dissemination with Quality of Experience (QoE) support. Hence, a key principle in a QoE-aware approach is the transmission of high priority frames (protect them) with a minimum packet loss ratio, as well as network overhead. Moreover, multimedia content must be transmitted from a given source to the destination via intermediate nodes with high reliability in a large scale scenario. The routing service must cope with dynamic topologies caused by node failure or mobility, as well as wireless channel changes, in order to continue to operate despite dynamic topologies during multimedia transmission. Finally, understanding user satisfaction on watching a video sequence is becoming a key requirement for delivery of multimedia content with QoE support. With this goal in mind, solutions involving multimedia transmissions must take into account the video characteristics to improve video quality delivery. The main research contributions of this thesis are driven by the research question how to provide multimedia distribution with high energy-efficiency, reliability, robustness, scalability, and QoE support over wireless ad hoc networks. The thesis addresses several problem domains with contributions on different layers of the communication stack. At the application layer, we introduce a QoE-aware packet redundancy mechanism to reduce the impact of the unreliable and lossy nature of wireless environment to disseminate live multimedia content. At the network layer, we introduce two routing protocols, namely video-aware Multi-hop and multi-path hierarchical routing protocol for Efficient VIdeo transmission for static WMSN scenarios (MEVI), and cross-layer link quality and geographical-aware beaconless OR protocol for multimedia FANET scenarios (XLinGO). Both protocols enable multimedia dissemination with energy-efficiency, reliability and QoE support. This is achieved by combining multiple cross-layer metrics for routing decision in order to establish reliable routes.

Taking the Shilling: Songs of and about World War 1

A performance lecture exploring a) contemporary music hall songs as a means of propaganda, recruitment and later criticism, b) the folk songs originating from among the soldiers, based on music hall, hymn and children's song tunes, and c) songs written about World War 1 by songwriters of the sixties and seventies in the critical vein inspired amongst others by the Vietnam War.

Selected songs of Eliakum Zunser

arr. for voice with piano accompaniment by William Fichandler ...

Repatriations and 28-day mortality of ill and injured travellers: 12 years of experience in a Swiss emergency department

QUESTIONS UNDER STUDY Many persons are travelling all over the world; the elderly with pre-existing diseases also travel to places with less developed health systems. Reportedly, fewer than 0.5% of all travellers need repatriation. We aimed to analyse and examine people who are injured or ill while abroad, where they travelled to and by what means they were repatriated. METHODS Retrospective cross-sectional study with adult patients repatriated to a single level 1 trauma centre in Switzerland (2000-2011). RESULTS A total of 372 patients were repatriated, with an increasing trend per year. Of these, 67% were male; the median age was 56 years. Forty-nine percent sustained an injury, and 13% had surgical and 38% medical pathologies. Patients with medical conditions were older than those with injuries or surgical emergencies (p <0.001). Seventy-three percent were repatriated from Europe. For repatriation from Africa trauma was slightly more frequent (53%, n = 17) than illnesses, whereas for most other countries illnesses and trauma were equally distributed. Injured patients had a median Injury Severity Score of 8. The majority of illnesses involved the nervous system (38%), mainly stroke. Forty-five percent were repatriated by Swiss Air Ambulance, 26% by ground ambulance, 18% by scheduled flights with or without medical assistance and two patients injured near the Swiss boarder by helicopter. The 28-day mortality was 4%. CONCLUSIONS The numbers of travellers repatriated increased from 2000 to 2011. About half were due to illnesses and half due to injuries. The largest group were elderly Swiss nationals repatriated from European countries. As mortality is relatively high, special consideration to this group of patients is warranted.

ACGT: advancing clinico-genomic trials on cancer - four years of experience.

The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obtained.

Qualitative Monitoring of Video Quality of Experience

Real-time monitoring of multimedia Quality of Experience is a critical task for the providers of multimedia delivery services: from television broadcasters to IP content delivery networks or IPTV. For such scenarios, meaningful metrics are required which can generate useful information to the service providers that overcome the limitations of pure Quality of Service monitoring probes. However, most of objective multimedia quality estimators, aimed at modeling the Mean Opinion Score, are difficult to apply to massive quality monitoring. Thus we propose a lightweight and scalable monitoring architecture called Qualitative Experience Monitoring (QuEM), based on detecting identifiable impairment events such as the ones reported by the customers of those services. We also carried out a subjective assessment test to validate the approach and calibrate the metrics. Preliminary results of this test set support our approach.

Information as a Key Tool for Rural Development. 25 Years of Experience in Spain

The lack of useful information has become a major obstacle that hinders the participation of the members of the community in the development process because they can not accurately perceive how their individual and/or collective action can influence their environment, and because of the lack of elements that support the decision-making processes. This article addresses these issues from the work carried out by the Association Instituto de Desarrollo Comunitario de Cuenca (IDC Cuenca) in the rural areas of this province of Spain for 25 years. The results show how the application of methodologies for the transmission of information tailored to each group of recipients in some aspects, enhances the participation of individuals.