Development, implementation, and evaluation of a structured reporting web tool for abdominal aortic aneurysms

BACKGROUND The majority of radiological reports are lacking a standard structure. Even within a specialized area of radiology, each report has its individual structure with regards to details and order, often containing too much of non-relevant information the referring physician is not interested in. For gathering relevant clinical key parameters in an efficient way or to support long-term therapy monitoring, structured reporting might be advantageous. OBJECTIVE Despite of new technologies in medical information systems, medical reporting is still not dynamic. To improve the quality of communication in radiology reports, a new structured reporting system was developed for abdominal aortic aneurysms (AAA), intended to enhance professional communication by providing the pertinent clinical information in a predefined standard. METHODS Actual state analysis was performed within the departments of radiology and vascular surgery by developing a Technology Acceptance Model. The SWOT (strengths, weaknesses, opportunities, and threats) analysis focused on optimization of the radiology reporting of patients with AAA. Definition of clinical parameters was achieved by interviewing experienced clinicians in radiology and vascular surgery. For evaluation, a focus group (4 radiologists) looked at the reports of 16 patients. The usability and reliability of the method was validated in a real-world test environment in the field of radiology. RESULTS A Web-based application for radiological "structured reporting" (SR) was successfully standardized for AAA. Its organization comprises three main categories: characteristics of pathology and adjacent anatomy, measurements, and additional findings. Using different graphical widgets (eg, drop-down menus) in each category facilitate predefined data entries. Measurement parameters shown in a diagram can be defined for clinical monitoring and be adducted for quick adjudications. Figures for optional use to guide and standardize the reporting are embedded. Analysis of variance shows decreased average time required with SR to obtain a radiological report compared to free-text reporting (P=.0001). Questionnaire responses confirm a high acceptance rate by the user. CONCLUSIONS The new SR system may support efficient radiological reporting for initial diagnosis and follow-up for AAA. Perceived advantages of our SR platform are ease of use, which may lead to more accurate decision support. The new system is open to communicate not only with clinical partners but also with Radiology Information and Hospital Information Systems.

New Law against an Old State: Land Restitution as a Transition to Justice in Post-Apartheid South Africa?

The research on which this text is based has been financially supported by the Berne University Research Foundation (2009–2011) as well as by an Ambizione Research Fellowship of the Swiss National Science Foundation (2012–2014). During my stays in South Africa, the Departments of Anthropology at the University of the Witwatersrand, Johannesburg, and the University of South Africa (UNISA), Pretoria, provided me with welcoming and inspiring research environments. This article benefitted greatly from engaged discussions around its presentation at various occasions, notably our ECAS 2011 panel Transition and Justice: Negotiating the Terms of New Beginnings in Africa, held in Uppsala. I am particularly grateful to my co-convener and co-editor Gerhard Anders as well as Laurens Bakker, Keebet von Benda-Beckmann, Ben Cousins, Julia Eckert, Marion Fresia, Vinodh Jaichand, Steffen Jensen, Tim Kelsall, Hanri Mostert, Johanna Mugler, David O'Kane, Julia Pauli, Mats Utas, Julia Zenker and the anonymous referees of Development and Change for their critical engagements.

When the systems fail to communicate. Cerebral resting state networks in schizophrenia spectrum disorders.

There have been numerous attempts to reveal the neurobiological basis of schizophrenia spectrum disorders. Results however, remain as heterogeneous as the schizophrenia spectrum disorders itself. Therefore, one aim of this thesis was to divide patients affected by this disorder into subgroups in order to homogenize the results of future studies. In a first study it is suggested that psychopathological rating scales should focus on symptoms-clusters that may have a common neurophysiological background. The here presented Bern Psychopathology Scale (BPS) proposes that alterations in three wellknown brain systems (motor, language, and affective) are largely leading to the communication failures observable on a behavioral level, but also - as repeatedly hypothesized - to dysconnectivity within and between brain systems in schizophrenia spectrum disorders. The external validity of the motor domain in the BPS was tested against the objective measure of 24 hours wrist actigraphy, in a second study. The subjective, the quantitative, as well as the global rating of the degree of motor disorders in this patient group showed significant correlations to the acquired motor activity. This result confirmed in a first step the practicability of the motor domain of the BPS, but needs further validation regarding pathological brain alterations. Finally, in a third study (independent from the two other studies), two cerebral Resting State Networks frequently altered in schizophrenia were investigated for the first time using simultaneous EEG/fMRI: The well-known default mode network and the left working memory network. Besides the changes in these fMRI-based networks, there are well-documented findings that patients exhibit alterations in EEG spectra compared to healthy controls. However, only through the multimodal approach it was possible to discover that patients with schizophrenia spectrum disorders have a slower driving frequency of the Resting State Networks compared to the matched healthy controls. Such a dysfunctional coupling between neuronal frequency and functional brain organization could explain in a uni- or multifactorial way (dysfunctional cross-frequency coupling, maturational effects, vigilance fluctuations, task-related suppression), how the typical psychotic symptoms might occur. To conclude, the major contributions presented in this thesis were on one hand the development of a psychopathology rating scale that is based on the assumption of dysfunctional brain networks, as well as the new evidence of a dysfunctional triggering frequency of Resting State Networks from the simultaneous EEG/fMRI study in patients affected by a schizophrenia spectrum disorder.

Germania: l’indomabile trading state

Basato su interviste con i principali attori tedeschi e su un’analisi della letteratura, l’articolo analizza lo sviluppo recente dell’economia tedesca e la strategia tedesca nell’affrontare la crisi dell’eurozona. La Germania è uno stato commerciale (trading state), la cui crescita è fortemente trainata dalle esportazioni. Fino agli anni novanta, rigidità istituzionali forti, nel sistema di relazioni industriali e nel sistema di protezione sociale, contribuivano a conciliare lo sviluppo delle esportazioni con una crescita armonica dei consumi interni, contribuendo cosi a ingabbiare la «tigre» tedesca. A partire dagli anni novanta, sia le relazioni industriali sia la protezione sociale sono state fortemente liberalizzate, stimolando ulteriormente la competitività estera e indebolendo i consumi interni. Il modello economico tedesco, cosi come è venuto profilandosi negli ultimi dieci anni, è alla base delle politiche di austerità che la Germania impone all’Europa. Tali politiche sono fortemente condivise dai partiti politici, dagli attori sociali e dall’opinione pubblica, e le probabilità che la strategia tedesca cambi sono minime.

Vocational identity trajectories: Differences in personality and development of well-being

This person-centred study investigated the longitudinal patterns of vocational identity development in relation to personality, the development of well-being, gender, nationality and the attended school track among two cohorts of Swiss adolescents in 8th or 9th grade (N = 269) and in 11th or 12th grade (N = 230). The results confirmed the existence of four identity statuses, namely, achievement, foreclosure, moratorium and diffusion. Forty-two per cent of students showed progressive patterns of identity development, while 37% remained in their identity status over time. Students with different statuses and status change patterns differed significantly in their personality traits. Higher neuroticism related to the emergence of identity exploration over time, while conscientiousness related to maintaining or achieving a sense of identity commitment in terms of achievement or foreclosure. Controlling for the effects of socio-demographics and personality traits, students who reached or maintained a state characterized by identity clarity and commitment showed a relative increase in life satisfaction, while those entering a state of identity crisis or exploration showed a decrease in life satisfaction. Copyright © 2011 John Wiley & Sons, Ltd.

Development and Criterion Validity of Differentiated and Elevated Vocational Interests in Adolescence

Interest differentiation and elevation are supposed to provide important information about a person’s state of interest development, yet little is known about their development and criterion validity. The present study explored these constructs among a group of Swiss adolescents. Study 1 applied a cross-sectional design with 210 students in 11th grade. Study 2 applied a 1-year longitudinal design with 289 students in 7th to 8th grade. gender, personality traits, and career exploration were significant predictors of state and development of differentiation and elevation. Increase in differentiation predicted increase in career decidedness above traits. elevation could not predict increase in exploration behavior over traits. The results provide support for differentiation and elevation as important aspects of adolescents’ vocational interests.

The role of the state in investor-state arbitration

The Role of the State in Investor-State Arbitration is a collection of contributions from lawyers, arbitrators and political scientists on the development of the concept of the “State” in a field that currently presents an increasing number of controversial disputes: Investor-State Arbitration. The book analyzes the limits of the host State as a regulator, studying issues such as attribution and the role of State-Owned Enterprises and sub-State entities; the changing role of the home State in Investor-State disputes, including its direct participation in Investor-State arbitration and State to State dispute settlement; and the overall role that both home and host States can play in the improvement of Investor-State Dispute Settlement.

Towards a spatial understanding of trade-offs in sustainable development: A meso-scale analysis of the nexus between land use, poverty, and environment in the Lao PDR

In land systems, equitably managing trade-offs between planetary boundaries and human development needs represents a grand challenge in sustainability oriented initiatives. Informing such initiatives requires knowledge about the nexus between land use, poverty, and environment. This paper presents results from Lao PDR, where we combined nationwide spatial data on land use types and the environmental state of landscapes with village-level poverty indicators. Our analysis reveals two general but contrasting trends. First, landscapes with paddy or permanent agriculture allow a greater number of people to live in less poverty but come at the price of a decrease in natural vegetation cover. Second, people practising extensive swidden agriculture and living in intact environments are often better off than people in degraded paddy or permanent agriculture. As poverty rates within different landscape types vary more than between landscape types, we cannot stipulate a land use–poverty–environment nexus. However, the distinct spatial patterns or configurations of these rates point to other important factors at play. Drawing on ethnicity as a proximate factor for endogenous development potentials and accessibility as a proximate factor for external influences, we further explore these linkages. Ethnicity is strongly related to poverty in all land use types almost independently of accessibility, implying that social distance outweighs geographic or physical distance. In turn, accessibility, almost a precondition for poverty alleviation, is mainly beneficial to ethnic majority groups and people living in paddy or permanent agriculture. These groups are able to translate improved accessibility into poverty alleviation. Our results show that the concurrence of external influences with local—highly contextual—development potentials is key to shaping outcomes of the land use–poverty–environment nexus. By addressing such leverage points, these findings help guide more effective development interventions. At the same time, they point to the need in land change science to better integrate the understanding of place-based land indicators with process-based drivers of land use change.

Central Equatoria State

The present map sheet is composed of field maps (1:250'000) and is one of nine maps of the Southern Sudan State Map Series (1:500'000). The maps and the Geodatabase were prepared by the Centre for Development and Environment of the University of Berne, with funding from the Swiss Federal Department of Foreign Affairs. The map is being released as a technical contribution to support the humanitarian, peace-keeping and reconstruction efforts in Southern Sudan.

Eastern Equatoria State

The present map sheet is composed of field maps (1:250'000) and is one of nine maps of the Southern Sudan State Map Series (1:500'000). The maps and the Geodatabase were prepared by the Centre for Development and Environment of the University of Berne, with funding from the Swiss Federal Department of Foreign Affairs. The map is being released as a technical contribution to support the humanitarian, peace-keeping and reconstruction efforts in Southern Sudan.

Jonglei State

The present map sheet is composed of field maps (1:250'000) and is one of nine maps of the Southern Sudan State Map Series (1:500'000). The maps and the Geodatabase were prepared by the Centre for Development and Environment of the University of Berne, with funding from the Swiss Federal Department of Foreign Affairs. The map is being released as a technical contribution to support the humanitarian, peace-keeping and reconstruction efforts in Southern Sudan.