"A renewed sense of purpose": Mothers' and fathers' experience of having a child following a recent stillbirth.

Background Most research has focused on mothers¿ experiences of perinatal loss itself or on the subsequent pregnancy, whereas little attention has been paid to both parents¿ experiences of having a child following late perinatal loss and the experience of parenting this child. The current study therefore explored mothers¿ and fathers' experiences of becoming a parent to a child born after a recent stillbirth, covering the period of the second pregnancy and up to two years after the birth of the next baby.MethodIn depth interviews were conducted with 7 couples (14 participants). Couples were eligible if they previously had a stillbirth (after 24 weeks of gestation) and subsequently had another child (their first live baby) who was now under the age of 2 years. Couples who had more than one child after experiencing a stillbirth and those who were not fluent in English were excluded. Qualitative analysis of the interview data was conducted using Interpretive Phenomenological Analysis.ResultsFive superordinate themes emerged from the data: Living with uncertainty; Coping with uncertainty; Relationship with the next child; The continuing grief process; Identity as a parent. Overall, fathers' experiences were similar to those of mothers', including high levels of anxiety and guilt during the subsequent pregnancy and after the child was born. Coping strategies to address these were identified. Differences between mothers and fathers regarding the grief process during the subsequent pregnancy and after their second child was born were identified. Despite difficulties with bonding during pregnancy and at the time when the baby was born, parents' perceptions of their relationship with their subsequent child were positive.ConclusionsFindings highlight the importance of tailoring support systems not only according to mothers' but also to fathers' needs. Parents¿, and particularly fathers', reported lack of opportunities for grieving as well as the high level of anxiety of both parents about their baby's wellbeing during pregnancy and after birth implies a need for structured support. Difficulties experienced in bonding with the subsequent child during pregnancy and once the child is born need to be normalised.

Immersion communautaire à Lausanne : une autre façon d'enseigner la santé publique [Community immersion in Lausanne: a different approach to teaching public health?].

Teaching community medicine represents a significant challenge for medical schools, which tend to struggle to promote interest in the issue among students. In 2009, the Lausanne medical school introduced a "community immersion" module specifically designed to address the issue. The new module requires students working in small groups under the supervision of a tutor to investigate a health question of their choice. The investigation involves conducting interviews with stakeholders (health professionals, patients, politicians, etc.), carrying out a survey, and presenting the results of the investigation in a "congress". An external evaluation showed that the objectives of the initiative had been largely achieved, with an increase of interest in community medicine for over 50% of students (based on a total cohort of 150 students) and a high level of satisfaction for over 90% of students and tutors. This paper presents the results of the initiative and its use for promoting community-oriented medicine.

A Small World Perspective on Urban Systems

The theory of small-world networks as initiated by Watts and Strogatz (1998) has drawn new insights in spatial analysis as well as systems theory. The theoryâeuro?s concepts and methods are particularly relevant to geography, where spatial interaction is mainstream and where interactions can be described and studied using large numbers of exchanges or similarity matrices. Networks are organized through direct links or by indirect paths, inducing topological proximities that simultaneously involve spatial, social, cultural or organizational dimensions. Network synergies build over similarities and are fed by complementarities between or inside cities, with the two effects potentially amplifying each other according to the âeurooepreferential attachmentâeuro hypothesis that has been explored in a number of different scientific fields (Barabási, Albert 1999; Barabási A-L 2002; Newman M, Watts D, Barabàsi A-L). In fact, according to Barabási and Albert (1999), the high level of hierarchy observed in âeurooescale-free networksâeuro results from âeurooepreferential attachmentâeuro, which characterizes the development of networks: new connections appear preferentially close to nodes that already have the largest number of connections because in this way, the improvement in the network accessibility of the new connection will likely be greater. However, at the same time, network regions gathering dense and numerous weak links (Granovetter, 1985) or network entities acting as bridges between several components (Burt 2005) offer a higher capacity for urban communities to benefit from opportunities and create future synergies. Several methodologies have been suggested to identify such denser and more coherent regions (also called communities or clusters) in terms of links (Watts, Strogatz 1998; Watts 1999; Barabási, Albert 1999; Barabási 2002; Auber 2003; Newman 2006). These communities not only possess a high level of dependency among their member entities but also show a low level of âeurooevulnerabilityâeuro, allowing for numerous redundancies (Burt 2000; Burt 2005). The SPANGEO project 2005âeuro"2008 (SPAtial Networks in GEOgraphy), gathering a team of geographers and computer scientists, has included empirical studies to survey concepts and measures developed in other related fields, such as physics, sociology and communication science. The relevancy and potential interpretation of weighted or non-weighted measures on edges and nodes were examined and analyzed at different scales (intra-urban, inter-urban or both). New classification and clustering schemes based on the relative local density of subgraphs were developed. The present article describes how these notions and methods contribute on a conceptual level, in terms of measures, delineations, explanatory analyses and visualization of geographical phenomena.

Association of working conditions with self-reported work-related symptoms: results from the Swiss dataset of the European Working Conditions Survey

Working conditions are important determinants of health. The aims of this article are to 1) identify working conditions and work characteristics that are associated with workers' perceptions that their work is harmful to their health and 2) identify with what symptoms these working conditions are associated.We used the Swiss dataset from the 2005 edition of the European Working Conditions Survey. The dependent variable was based on the question "Does your work affect your health?". Logistic regression was used to identify a set of variables collectively associated with self-reported work-related adverse health effects.A total of 330 (32%) participants reported having their health affected by work. The most frequent symptoms included backache (17.1%), muscular pains (13.1%), stress (18.3%) and overall fatigue (11.7%). Scores for self-reported exposure to physicochemical risks, postural and physical risks, high work demand, and low social support were all significantly associated with workers' perceptions that their work is harmful to their health, regardless of gender or age. A high level of education was associated with stress symptoms, and reports that health was affected by work was associated with low job satisfaction.Many workers believe that their work affects their health. Health specialists should pay attention to the potential association between work and their patients' health complaints. This is particularly relevant when patients mention symptoms such as muscular pains, backache, overall fatigue, and stress. Specific attention should be given to complaints of stress in highly educated workers.

Iowa Motorcycle Ride Meter, HR-1019, 1980

The Iowa Department of Transportation (Iowa DOT) through the Highway Division is responsible for the design, construction and maintenance of roadways that will provide a high level of serviceability to the motorist. First, the motorist expects to be able to get where he wants to go, but now he also demands a minimum level of comfort. In the construction of new roadways, the public is quick to express dissatisfaction with rough pavements. The Highway Division of the Iowa DOT (formerly Iowa State Highway Commission) has a specification which requires a "smooth-riding surface". For over 40 years, new portland cement concrete (pcc) pavement has been checked with a 10-foot rolling straightedge. The contractor is required to grind, saw or mill off all high spots that deviate more than 1/8" from the 10-foot straight line. Unfortunately, there are instances where a roadway that will meet the above criteria does not provide a "smooth-riding surface". The roadway may have monger undulations (swales) that result in an undesirable ride. The objective of this project was to develop a repeatable, reliable time stable, lightweight test unit to measure the riding quality of pcc pavement at normal highway speed the day after construction.

Molecular biology of baculovirus and its use in biological control in Brazil

Baculoviruses are insect viruses found mainly in Lepidoptera. The family Baculoviridae is taxonomically divided in two genera, Nucleopolyhedrovirus and Granulovirus, which differ by occlusion body morphology. NPVs (Nucleopolyhedroviruses) have polyhedrical inclusion bodies (PIBs) containing multiple viral particles, while GVs (Granuloviruses) appear to be generally single particles occluded in oval shaped occlusion bodies. During the life cycle, two different viral progenies are produced: BV (Budded Virus) and PDV (Polyhedra Derived Virus), which are essential for the infectious process and virus propagation in host cells. Baculoviruses are being used for pest control and they are especially safe due to their specificity and invertebrate-restricted host range. Baculoviruses have been used as vectors for high level protein expression ofheterologous genes from prokaryotic and eukaryotic organisms. Also, recombinant DNA techniques have allowed the production of genetically modified viral insecticides. This study is a review on the taxonomy, structure, replication and molecular biology of baculoviruses, as well as their use as bioinsecticides in Brazil.

Psychosocial analysis of ETA's violence legitimation discourse

This study analyses the fundamental components shaping the violence legitimation discourse of ETA (Euskadi Ta Askasuna). With this aim, a category system has been built, which organizes the psychosocial processes identified in previous studies related to violence legitimation. Based on the proposed category system, a content analysis was conducted on 21 statements of ETA, released between 1998 and 2011. An intraobserver and inter-observer reliability analysis reveals high level stability and replicability of the categorization. The results show, firstly, that outgroup components have a predominant presence over ingroup components. Secondly, in the components hierarchy, we observe that elements referring to identity come in first place, followed in similar frequencies by those related to violence representation and the definition of the situation.

Being Female: a handicap for researchers in the competion for NCCR.

The Swiss National Science Foundation made a call for National Centers fo Competence in Research (NCCR) for the first time in 1999 and 2004. Together, these announcements concerned all disciplines and led to 126 preproposals, which were put forward by 2134 men and women researchers. It can be assumed that this operation mobilised Swiss researchers who regarded themselves as particularly well qualified to conduct high-level research in their field. The article uses network analysis and regression analysis methods to examine to what extend women had a lower success rate than men in the two selection rounds because of their sex. On the whole, the findings attest the gender neutrality of the National Science Foundation's selection procedures. However, they also confirm the well-known fact that women scientists are less represented in the higher echelons of academia and concentrated in the social sciences and humanities, as well as showing that this concentration reduces women's chances of success in scientific competition. The article shows that unequal gender-specific success rates prior to the NCCR funding contest play a fairly significant role.

Do seismic waves sense fracture connectivity?

A defining characteristic of fractured rocks is their very high level of seismic attenuation, which so far has been assumed to be mainly due to wave-induced fluid flow (WIFF) between the fractures and the pore space of the embedding matrix. Using oscillatory compressibility simulations based on the quasi-static poroelastic equations, we show that another important, and as of yet undocumented, manifestation of WIFF is at play in the presence of fracture connectivity. This additional energy loss is predominantly due to fluid flow within the connected fractures and is sensitive to their lengths, permeabilities, and intersection angles. Correspondingly, it contains key information on the governing hydraulic properties of fractured rock masses and hence should be accounted for whenever realistic seismic models of such media are needed.

Psychosocial analysis of ETA's violence legitimation discourse

This study analyses the fundamental components shaping the violence legitimation discourse of ETA (Euskadi Ta Askasuna). With this aim, a category system has been built, which organizes the psychosocial processes identified in previous studies related to violence legitimation. Based on the proposed category system, a content analysis was conducted on 21 statements of ETA, released between 1998 and 2011. An intraobserver and inter-observer reliability analysis reveals high level stability and replicability of the categorization. The results show, firstly, that outgroup components have a predominant presence over ingroup components. Secondly, in the components hierarchy, we observe that elements referring to identity come in first place, followed in similar frequencies by those related to violence representation and the definition of the situation.

In vitro emergence of rifampicin resistance in Propionibacterium acnes and molecular characterization of mutations in the rpoB gene.

OBJECTIVES: Activity of rifampicin against Propionibacterium acnes biofilms was recently demonstrated, but rifampicin resistance has not yet been described in this organism. We investigated the in vitro emergence of rifampicin resistance in P. acnes and characterized its molecular background. METHODS: P. acnes ATCC 11827 was used (MIC 0.007 mg/L). The mutation rate was determined by inoculation of 10(9) cfu of P. acnes on rifampicin-containing agar plates incubated anaerobically for 7 days. Progressive emergence of resistance was studied by serial exposure to increasing concentrations of rifampicin in 72 h cycles using a low (10(6) cfu/mL) and high (10(8) cfu/mL) inoculum. The stability of resistance was determined after three subcultures of rifampicin-resistant isolates on rifampicin-free agar. For resistant mutants, the whole rpoB gene was amplified, sequenced and compared with a P. acnes reference sequence (NC006085). RESULTS: P. acnes growth was observed on rifampicin-containing plates with mutation rates of 2 ± 1 cfu  ×  10(-9) (4096× MIC) and 12 ± 5 cfu  ×  10(-9) (4 × MIC). High-level rifampicin resistance emerged progressively after 4 (high inoculum) and 13 (low inoculum) cycles. In rifampicin-resistant isolates, the MIC remained >32 mg/L after three subcultures. Mutations were detected in clusters I (amino acids 418-444) and II (amino acids 471-486) of the rpoB gene after sequence alignment with a Staphylococcus aureus reference sequence (CAA45512). The five following substitutions were found: His-437 → Tyr, Ser-442 → Leu, Leu-444 → Ser, Ile-483 → Val and Ser-485 → Leu. CONCLUSION: The rifampicin MIC increased from highly susceptible to highly resistant values. The resistance remained stable and was associated with mutations in the rpoB gene. To our knowledge, this is the first report of the emergence of rifampicin resistance in P. acnes.

Variations of Tine Texturing of PCC Pavement, MLR-93-4, 1996

Seven experimental texture sections were constructed on the Polk-Jasper RP-163-1(50)--16--77 project just east of Des Moines. The experimental sections included two groove depths for a longitudinal tine texture and 13 mm (1/2 in.), 19 mm (1 in.) and variable spaced transverse tine textures. An artificial turf textured section was also included. Friction values and a rating of objectionable noise were determined for all sections. All transverse tine textures generated a high level of objectionable noise. The longitudinal tine texture was rated very good in regard to objectionable noise. At this time, all tined textures are providing satisfactory friction values.

Epilepsy surgery in children and adults.

SUMMARY: Epilepsy surgery is the most effective way to control seizures in patients with drug-resistant focal epilepsy, often leading to improvements in cognition, behaviour, and quality of life. Risks of serious adverse events and deterioration of clinical status can be minimised in carefully selected patients. Accordingly, guidelines recommend earlier and more systematic assessment of patients' eligibility for surgery than is seen at present. The effectiveness of surgical treatment depends on epilepsy type, underlying pathology, and accurate localisation of the epileptogenic brain region by various clinical, neuroimaging, and neurophysiological investigations. Substantial progress has been made in the methods of presurgical assessment, particularly in patients with normal features on MRI, but evidence is scarce for the indication and effect of most presurgical investigations, with no biomarker precisely delineating the epileptogenic zone. A priority for the development of epilepsy surgery is the generation of high-level evidence to promote the harmonisation and dissemination of best practices.

Parental monitoring: a way to decrease substance use among Swiss adolescents?

The objective of this research was to determine whether the level of parental monitoring is associated with substance use among adolescents in Switzerland, and to assess whether this effect remains when these adolescents have consuming peers. For this purpose, we used a nationally representative sample from the Swiss participation in the 2007 European School Project on Alcohol and Other Drugs survey, which included 7,611 adolescents in public schools (8th-10th grades). Four levels of parental control were created and four substances (tobacco, alcohol, cannabis, and ecstasy) were analyzed. All significant variables at the bivariate level were included in the multivariate analysis. Most adolescents had a high level of parental monitoring and that was associated with younger age, females, high socioeconomic status, intact family structure, and satisfactory relationships with mother, father, and peers. Overall, substance use decreased as parental monitoring increased and high parental monitoring decreased as having consuming peers increased. Results remained essentially the same when the variable "having consuming peers" was added to the analysis. Conclusion: parental monitoring is associated to positive effects on adolescent substance use with a reduction of consumption and a lower probability of having consuming peers, which seems to protect adolescents against potentially negative peer influence. Encouraging parents to monitor their adolescents' activities and friendships by establishing rules about what is allowed or not is a way to limit the negative influence of consuming peers on adolescent substance use.

Etat confusionnel avec pneumencéphale: quel est votre diagnostic [A patient with confusion and pneumocephalus: what is your diagnosis?]

We report the case of a 58 year old male who presented with acute meningoencephalitis and pneumocephalus (intracranial air) visualized on head CT scan. Despite the lack of typical clinical signs such as retroauricular tenderness, red tympanic membrane or otorrhea, mastoiditis was suggested by head CT scan. The patient made a full recovery after mastoidectomy and six weeks of antibiotic therapy. Streptococcus pneumoniae grew from a surgical purulent mastoid tissue sample. Mastoiditis and its complications are rare in adults. A high level of clinical suspicion is needed when a patient presents with encephalitis of unclear origin.