Abortion trends 1990-1999 in a Swiss region and determinants of abortion recurrence.

OBJECTIVE: To assess age- and nationality-specific trends in abortion rates over the last decade, and to describe women's characteristics, identifying risk factors for repeated abortion. METHODS: From 1990-1999, the Health Department of Canton Vaud (Switzerland) received 13'857 abortion requests from residents aged 14-49. Population data were obtained to compute rates. RESULTS: Both the number of abortions (1400 annually) as well as their rate (8.9 per thousand women [95% confidence interval (CI) 7.3-10.5]) were stable over the decade in question. The rate of abortion for foreign women, especially from ex-Yugoslavia and Africa, was twice that for Swiss women. Half of the requests came from single women, 43% had a low education level, and half were childless. The main reason for requesting termination of pregnancy was psychosocial (93%). The mean gestational age was 7.7 weeks (SD +/- 2.3), but 96% of requests were submitted before 12 weeks. Sixty-three percent of women reported that they had used no contraception, 36% the condom and 17% the pill. Among requests, the adjusted risk of repeated abortion (22% of abortion candidates) was greater among divorced/separated/widowed women (odds ratio [OR] 1.9 [95% CI 1.5-2.4]), unemployed women (OR 1.8 [95% CI 1.5-2.1]), and those who had not attended university (OR 1.6 [95% CI 1.1-2.2]). CONCLUSIONS: Although Swiss law only permitted abortion under strict conditions, this procedure was widely available in Vaud, which nevertheless has one of the lowest rates worldwide. Efforts must be intensified to ensure universal access to family planning services, especially for foreign women and adolescents. Professionals should also target "repeaters" to provide personalised counselling.

Propranolol in infantile haemangioma: simplifying pretreatment monitoring.

BACKGROUND: Infantile haemangiomas (IHs) are very common vascular tumours. Propranolol is at present the first-line treatment for problematic and complicated haemangioma. In accordance with a Swiss protocol, children are monitored for 2 days at the start of the treatment to detect possible side effects of this drug. Our study advocates a simplification of the pretreatment monitoring process. METHODS: All children with a problematic and complicated haemangioma treated with propranolol between September 2009 and September 2012 were included in the study. All patients were hospitalised under constant nurse supervision for 48 hours at the start of the treatment and subjected to cardiac and blood measurements. The dosage of propranolol was 1 mg/kg/day on the first day and 2 mg/kg/day from the second day. Demographic data, clinical features, treatment outcome and complications were analysed. RESULTS: Twenty-nine infants were included in our study. Of these, 86.2% responded immediately to the treatment. There were no severe adverse reactions. Six patients presented transient side effects such as bradycardia, hypotension after the first dose and hypoglycaemia later. No side effects occurred after the second dose. Treatment was never interrupted. CONCLUSION: Propranolol (a β-blocker) is a safe treatment for problematic IH. Side effects may occur after the first dose. A strict 48 hour monitoring in hospital is expensive and may be unnecessary as long as the contraindications for the drug are respected.

La communication médicale avec les patients migrants allophones : difficultés de compréhension dans les consultations spécialisées centrées sur les douleurs musculo-squelettiques chroniques

Les suivis spécialisés de douleurs chroniques comportent des enjeux communicationnels sensibles liés notamment à la subjectivité des ressentis douloureux et aux fréquentes divergences de vue entre médecins et patients quant à l'origine du problème de santé et à son traitement. Centré sur ces suivis, ce travail de thèse a cherché à appréhender comment les situations sociolinguistiques des patients migrants allophones se répercutent sur la communication médicale et, plus particulièrement, sur la compréhension mutuelle dans les consultations. Il a emprunté une approche discursive s'appuyant sur l'analyse interactionnelle de consultations filmées et sur un riche corpus de données contextuelles recueillies dans des interviews de patients et de cliniciens. Les analyses réalisées ont, entre autres, mis en évidence que les difficultés de compréhension non résolues se concentrent dans les consultations des patients les moins à l'aise en français et que ces difficultés renferment pour la plupart une charge problématique certaine en termes de qualité des soins. Il apparaît également que lorsque des malentendus ou incompréhensions cliniquement pertinents ne peuvent être résolus, le caractère limité des compétences de français de base des patients migrants n'est jamais seul en cause. Des facteurs de complexité médicaux (ex. surestimations des connaissances médicales de base des patients), relationnels (ex. non-signalement de malentendus par les patients pour éviter de faire perdre la face au médecin) et discursifs (ex. nécessité de traiter de discours ou « voix » venant de l'extérieur de la consultation dans le cadre d'une polyphonie particulièrement marquée) jouent également des rôles de premier plan dans les difficultés non résolues les plus problématiques au plan clinique et sont généralement étroitement intriqués avec le langagier au sens strict. En termes pratiques, les résultats soulignent le rôle décisif de l'autoréflexivité chez les médecins, ainsi que de leur capacité à ajuster de manière flexible leurs styles communicationnels afin, par exemple, d'éviter le cumul de facteurs de complexités favorisant des malentendus ou incompréhensions problématiques. Les observations effectuées rappellent également l'importance du recours à des ressources d'interprétariat.

Antibiotic susceptibility of Neochlamydia hartmanellae and Parachlamydia acanthamoebae in amoebae.

Parachlamydia acanthamoebae and Neochlamydia hartmanellae are Chlamydia-related bacteria naturally infecting free-living amoebae. These strict intracellular bacteria might represent emerging pathogens. Recent studies report an association with lower respiratory tract infections, especially with pneumonia where they have been identified as a potential causative agent in 1-2% of cases. In this study, we defined the antibiotic susceptibility of N. hartmanellae, two strains of P. acanthamoebae and two yet unclassified Parachlamydiaceae strains using a quantitative approach. We confirmed the results obtained earlier for P. acanthamoebae strain Bn9 in an observational study. Macrolides (MICs < 0.06-0.5 μg/ml), rifampicin (MICs 0.25-2) and doxycycline (2-4 μg/ml) were active against P. acanthamoebae strains and Neochlamydia. All strains were resistant to amoxicillin, ceftriaxone and imipenem (MIC ≥32 μg/ml). Similarly to other Chlamydia-related bacteria, all investigated Parachlamydiaceae were resistant to quinolones (MICs ≥ 16 μg/ml). Therefore, we recommend a treatment with macrolides for Parachlamydia-associated pneumonia.

Institutional legacies, employment and professional integration of non EU/EEA doctors in France

Internationally, policies for attracting highly-skilled migrants have become the guidelines mainly used by the Organisation for Economic Co-operation and Development (OECD) countries. Governments are implementing specific procedures to capture and facilitate their mobility. However, all professions are not equal when it comes to welcoming highly-skilled migrants. The medical profession, as a protective market, is one of these. Taking the case of non-EU/EEA doctors in France, this paper shows that the medical profession defined as the closed labour market, remains the most controversial in terms of professional integration of migrants, protectionist barriers to migrant competition and challenge of medical shortage. Based on the path-dependency approach, this paper argues that non-EU/EEA doctors' issues in France derive from a complex historical process of interaction between standards settled in the past, particularly the historical power of medical corporatism, the unexpected long-term effects of French hospital reforms of 1958, and budgetary pressures. Theoretically, this paper shows two significant findings. Firstly, the French medical system has undergone a series of transformations unthinkable in the strict sense of a path-dependence approach: an opening of the medical profession to foreign physicians in the context of the Europeanisation of public policy, acceptance of non-EU/EEA doctors in a context of medical shortage and budgetary pressures. Secondly, there is no change of the overall paradigm: significantly, the recruitment policies of non-EU/EEA doctors continue to highlight the imprint of the past and reveal a significant persistence of prejudices. Non-EU/EEA doctors are not considered legitimate doctors even if they have the qualifications of physicians which are legitimate in their country and which can be recognised in other receiving countries.

Osakeyhtiölain maksukykytesti pienissä osakeyhtiöissä - tilitoimiston rooli neuvonantajana

Osakeyhtiölakiin on vuodesta 2006 asti sisältynyt maksukykytesti (OYL 13:2), jonka tulkinnallinen epäselvyys on motivoinut useita tutkimuksia ja melko kriittistäkin kirjoittelua. Säännöksen tarkoituksena on ehkäistä osakeyhtiön velkojia uhkaava varojenjako velvoittamalla yhtiön johto huolellisuusvelvoitteensa nojalla arvioimaan varojenjaon vaikutukset yhtiön maksukyvyn säilymiseen. Oikeuskäytännön puuttuessa maksukykytestin toteuttamistapaan liittyy kuitenkin edelleenkin merkittävää epävarmuutta. Tämän tutkimuksen tavoitteena on pyrkiä selvittämään, miten osakeyhtiölain mukainen maksukykytesti pitäisi toteuttaa pienissä osakeyhtiöissä, joiden taloushallinto on kokonaan tai osittain ulkoistettu tilitoimistolle. Olennainen osa tutkimuksen tavoitetta on ottaa kantaa tilitoimiston rooliin maksukykytestin toteuttamisessa. Tutkimuksen johtopäätöksenä voidaan todeta, että yksityiskohtaisten tilinpäätöksen tunnuslukuihin perustuvien maksukykyarvioiden laatiminen maksukykytestin toteuttamiseksi on pienissä osakeyhtiöissä pääsääntöisesti tarpeetonta. Merkitystä tulisi sen sijaan antaa yhtiön johdolla olevalle hiljaiselle tiedolle, sillä yhtiön johto tuntee yrityksen tilanteen parhaiten ja kykenee siten myös arvioimaan tuleva kehitystä. Tilitoimiston rooliksi jää tällöin varmistaa, että asiakasyrityksen johto tuntee oman vastuuasemansa. Tutkimuksen perusteella tilitoimistot voisivat myös hyödyntää omaa asemaansa pienten yhtiöiden neuvonantajina nykyistä paremmin ohjeistamalla asiakasyrityksiään dokumentoimaan maksukykytestin hallituksen kokouspöytäkirjaan esimerkiksi osana hallituksen osingonjakoehdotusta.

Kierkegaard : the temporality of becoming a self

Introduction In Difference and Repetition, Deleuze compares and contrasts Kierkegaard's and Nietzsche's ideas of repetition. He argues that neither of them really give a representation of repetition. Repetition for them is a sort of selective task: the way in which they determine what is ethical and eternal. With Nietzsche, it is a theater of un belie f. ..... Nietzsche's leading idea is to found the repetition in the etemal return at once on the death of God and the dissolution of the self But it is a quite different alliance in the theater of faith: Kierkegaard dreams of alliance between a God and a self rediscovered. I Repetition plays a theatrical role in their thinking. It allows them to dramatically stage the interplay of various personnae. Deleuze does give a positive account ofKierkegaard's "repetition"; however, he does not think that Kierkegaard works out a philosophical model, or a representation of what repetition is. It is true that in the book Repetition, Constantin Constantius does not clearly and fully work out the concept of repetition, but in Sickness Unto Death, Kierkegaard gives a full explanation of the self and its temporality which can be connected with repetition. When Sickness Unto Death is interpreted according to key passages from Repetition and The Concept of Anxiety, a clear philosophical concept of repetition can be established. In my opinion, Kierkegaard's philosophy is about the task of becoming a self, and I will be attempting to show that he does have a model of the temporality of self-becoming. In Sickness Unto Death, Kierkegaard explains his notions of despair with reference to sin, self, self-becoming, faith, and repetition. Despair is a sickness of the spirit, of the self, and accordingly can take three forms: in despair not to be conscious of having a self (not despair in the strict sense); in despair not to will to be oneself; in despair to will to be oneself2 In relation to this definition, he defines a self as "a relation that relates itself to itself and in relating itself to itself relates to another.''3 Thus, a person is a threefold relationship, and any break in that relationship is despair. Despair takes three forms corresponding to the three aspects of a self s relation to itself Kierkegaard says that a selfis like a house with a basement, a first floor, and a second floor.4 This model of the house, and the concept of the stages on life's way that it illustrates, is central to Kierkegaard's philosophy. This thesis will show how he unpacks this model in many of his writings with different concepts being developed in different texts. His method is to work with the same model in different ways throughout his authorship. He assigns many of the texts to different pseudonyms, but in this thesis we will treat the model and the related concepts as being Kierkegaard's and not only the pseudonyms. This is justified as our thesis will show this modelremains the same throughout Kierkegaard's work, though it is treated in different ways by different pseudonyms. According to Kierkegaard, many people live in only the basement for their entire lives, that is, as aesthetes ("in despair not to be conscious of having a self'). They live in despair of not being conscious of having a self They live in a merely horizontal relation. They want to get what they desire. When they go to the first floor, so to speak, they reflect on themselves and only then do they begin to get a self In this stage, one acquires an ideology of the required and overcomes the strict commands of the desired. The ethical is primarily an obedience to the required whereas the aesthetic is an obedience to desire. In his work Fear and Trembling (Copenhagen: 1843), Johannes de Silentio makes several observations concerning this point. In this book, the author several times allows the desired ideality of esthetics to be shipwrecked on the required ideality of ethics, in order through these collisions to bring to light the religious ideality as the ideality that precisely is the ideality of actuality, and therefore just as desirable as that of esthetics and not as impossible as the ideality of ethics. This is accomplished in such a way that the religious ideality breaks forth in the dialectical leap and in the positive mood - "Behold all things have become new" as well as in the negative mood that is the passion of the absurd to which the concept "repetition" corresponds.s Here one begins to become responsible because one seeks the required ideality; however, the required ideality and the desired ideality become inadequate to the ethical individual. Neither of them satisfy him ("in despair not to will to be oneself'). Then he moves up to the second floor: that is, the mystical region, or the sphere of religiousness (A) ("despair to will to be oneself). Kiericegaard's model of a house, which is connected with the above definition ofdespair, shows us how the self arises through these various stages, and shows the stages of despair as well. On the second floor, we become mystics, or Knights of Infinite Resignation. We are still in despair because we despair ofthe basement and the first floor, however, we can be fiill, free persons only ifwe live on all the floors at the same time. This is a sort of paradoxical fourth stage consisting of all three floors; this is the sphere of true religiousness (religiousness (B)). It is distinguished from religiousness (A) because we can go back and live on all the floors. It is not that there are four floors, but in the fourth stage, we live paradoxically on three at once. Kierkegaard uses this house analogy in order to explain how we become a self through these stages, and to show the various stages of despair. Consequently, I will be explaining self-becoming in relation to despair. It will also be necessary to explain it in relation to faith, for faith is precisely the overcoming of despair. After explaining the becoming of the self in relation to despair and faith, I will then explain its temporality and thereby its repetition. What Kierkegaard calls a formula, Deleuze calls a representation. Unfortunately, Deleuze does not acknowledge Kierkegaard's formula for repetition. As we shall see, Kierkegaard clearly gives a formula for despair, faith, and selfbecoming. When viewed properly, these formulae yield a formula for repetition because when one hasfaith, the basement, firstfloor, and secondfloor become new as one becomes oneself The self is not bound in the eternity ofthe first floor (ethical) or the temporality of the basement (aesthete). I shall now examine the two forms of conscious despair in such a way as to point out also a rise in the consciousness of the nature of despair and in the consciousness that one's state is despair, or, what amounts to the same thing and is the salient point, a rise in the consciousness of the self The opposite to being in despair is to have faith. Therefore, the formula set forth above, which describes a state in which there is not despair at all, is entirely correct, and this formula is also the formula for faMi in ^elating itself to itself and in willing to be itself, the self rests transparently in the power that established it.

Coevolution of Heliconius spp. and Passiflora spp. : a phylogenetic comparison

Although a substantial amount of research has been done on all aspects ofHeliconius biology and their ecological interactions with Passiflora, there has not hitherto been a phylogenetic examination of this association for coevolution. To test the HeliconiuslPassilfora association for coevolutionary congruence, phylogenies for each group were established and compared. The phylogeny for 14 species ofHeliconiinae from Costa Rica was based on combined sequence data from rRNA ITS 2 and partial EF-1a gene regions. For the Passifloraceae, 17 host plant species were utilized to establish a phylogeny based on tRNALeucine and ITS 1/5.8S1 ITS 2 sequence data. The phylogenies for both groups were largely in agreement with current classification (for Passifloraceae) and previously established phylogenies. Associations with the large subgenera Passiflora and Decaloba correspond with the two major Advanced Radiation groups in Heliconius. Although strict congruence above subgenus level was not observed, broad scale congruence was evident. One main host shift as well as other possible explanations for lack of strict congruence are suggested.

Automatic Structure Generation using Genetic Programming and Fractal Geometry

Three dimensional model design is a well-known and studied field, with numerous real-world applications. However, the manual construction of these models can often be time-consuming to the average user, despite the advantages o ffered through computational advances. This thesis presents an approach to the design of 3D structures using evolutionary computation and L-systems, which involves the automated production of such designs using a strict set of fitness functions. These functions focus on the geometric properties of the models produced, as well as their quantifiable aesthetic value - a topic which has not been widely investigated with respect to 3D models. New extensions to existing aesthetic measures are discussed and implemented in the presented system in order to produce designs which are visually pleasing. The system itself facilitates the construction of models requiring minimal user initialization and no user-based feedback throughout the evolutionary cycle. The genetic programming evolved models are shown to satisfy multiple criteria, conveying a relationship between their assigned aesthetic value and their perceived aesthetic value. Exploration into the applicability and e ffectiveness of a multi-objective approach to the problem is also presented, with a focus on both performance and visual results. Although subjective, these results o er insight into future applications and study in the fi eld of computational aesthetics and automated structure design.

Application of thermal ion-molecule reactions in tackling spectroscopic inferences in inductively coupled plasma mass spectrometry

Part I: Ultra-trace determination of vanadium in lake sediments: a performance comparison using O2, N20, and NH3 as reaction gases in ICP-DRC-MS Thermal ion-molecule reactions, targeting removal of specific spectroscopic interference problems, have become a powerful tool for method development in quadrupole based inductively coupled plasma mass spectrometry (ICP-MS) applications. A study was conducted to develop an accurate method for the determination of vanadium in lake sediment samples by ICP-MS, coupled with a dynamic reaction cell (DRC), using two differenvchemical resolution strategies: a) direct removal of interfering C10+ and b) vanadium oxidation to VO+. The performance of three reaction gases that are suitable for handling vanadium interference in the dynamic reaction cell was systematically studied and evaluated: ammonia for C10+ removal and oxygen and nitrous oxide for oxidation. Although it was able to produce comparable results for vanadium to those using oxygen and nitrous oxide, NH3 did not completely eliminate a matrix effect, caused by the presence of chloride, and required large scale dilutions (and a concomitant increase in variance) when the sample and/or the digestion medium contained large amounts of chloride. Among the three candidate reaction gases at their optimized Eonditions, creation of VO+ with oxygen gas delivered the best analyte sensitivity and the lowest detection limit (2.7 ng L-1). Vanadium results obtained from fourteen lake sediment samples and a certified reference material (CRM031-040-1), using two different analytelinterference separation strategies, suggested that the vanadium mono-oxidation offers advantageous performance over the conventional method using NH3 for ultra-trace vanadium determination by ICP-DRC-MS and can be readily employed in relevant environmental chemistry applications that deal with ultra-trace contaminants.Part II: Validation of a modified oxidation approach for the quantification of total arsenic and selenium in complex environmental matrices Spectroscopic interference problems of arsenic and selenium in ICP-MS practices were investigated in detail. Preliminary literature review suggested that oxygen could serve as an effective candidate reaction gas for analysis of the two elements in dynamic reaction cell coupled ICP-MS. An accurate method was developed for the determination of As and Se in complex environmental samples, based on a series of modifications on an oxidation approach for As and Se previously reported. Rhodium was used as internal standard in this study to help minimize non-spectral interferences such as instrumental drift. Using an oxygen gas flow slightly higher than 0.5 mL min-I, arsenic is converted to 75 AS160+ ion in an efficient manner whereas a potentially interfering ion, 91Zr+, is completely removed. Instead of using the most abundant Se isotope, 80Se, selenium was determined by a second most abundant isotope, 78Se, in the form of 78Se160. Upon careful selection of oxygen gas flow rate and optimization ofRPq value, previous isobaric threats caused by Zr and Mo were reduced to background levels whereas another potential atomic isobar, 96Ru+, became completely harmless to the new selenium analyte. The new method underwent a strict validation procedure where the recovery of a suitable certified reference material was examined and the obtained sample data were compared with those produced by a credible external laboratory who analyzed the same set of samples using a standardized HG-ICP-AES method. The validation results were satisfactory. The resultant limits of detection for arsenic and selenium were 5 ng L-1 and 60 ng L-1, respectively.

Comitum princeps tu mihi eris: Rape and the Distribution of Auctoritas in Ovid's Fasti

In Ovid’s Fasti, the rape narratives of Callisto, Lara, Flora, and Carna contain the common themes of the distribution of auctoritas and/or the subversion of auctoritas. While all four characters are victims of rape, Callisto loses auctoritas as a result of her rape by Jupiter, whereas Flora and Carna gain auctoritas from their rapes by Zephyrus and Janus respectively. Since Ovid associated Augustus with Jupiter on more than one occasion in the poem, it appears that readers were meant to see a parallel between Jupiter’s dealings with auctoritas in these narratives and Augustus’ exercise of his auctoritas over Rome. Zephyrus’ and Janus’ bestowal of auctoritas upon their victims was intended to be a foil for Jupiter’s denial of auctoritas to Callisto and strict regulation of his own auctoritas, which Lara’s narrative exemplifies, in order for Ovid to criticize the overwhelming nature of Augustus’ auctoritas, as well as specific Augustan policies.

Report of Directors to the Shareholders, 1970

The report reads: "The year 1970 saw many significant changes in our Company. Sales were higher than in any previous year showing an increase in gallons of 8.8% and in dollar volume of 9.7%. The new offices and warehouse are fully operational, the fermenters installed prior to vintage assisted in holding our labour costs to a reasonable level, and the use of liquid sugar proved very successful. We added two representatives to our sales staff during the year and direct contact with our customers will be intensified. Product development is continuing and the addition of new lines and better distribution will be receiving priority. Our venture in the product supply for Valley Rouge Wines of Manitoba will, we trust, increase our sales volume and assist in lowering our fixed overhead. Capital expenses in 1971 will continue at a high level. Our co-operation with the various Government departments in respect to pollution, will obligate our Company to install facilities to satisfy the strict requirements in this regard. Preparations must be made now to handle bulk harvested grapes, the addition of storage and fermenting capacity and the replacement of production equipment, will be under constant review, thus enabling us to maintain production and efficiency. With the continued dedicated service of our personnel and the support of all our Shareholders, we are confident the challenge will be met in 1971."

Opinion Regarding the Estate of S.D. Woodruff

An opinion regarding the estate of S.D. Woodruff. This is in regard to the liability of the estate to pay succession duties in Ontario upon certain American bonds and securities in the City of New York. This is a 6 page printed document prepared by Dewart, Young and Maw - February 7, 1905.

Letter to Gordon Pringle Dallas of Edinburgh ensuring him that Conklin, Jarvis and Co.

Letter to Gordon Pringle Dallas of Edinburgh ensuring him that Conklin, Jarvis and Co. “act under strict business principles”. The letter is signed S.D. Woodruff, Sept. 20, 1884.