[Adapted and Standardised Patient Management in the Treatment of Neovascular AMD in the Outpatient Setting of a University Eye Hospital.]

Visual results in treating neovascular age-related macular degeneration (AMD) using intravitreal injected anti-VEGF (IVT) clearly depend on injection frequency. Regarding to the European approval Ranibizumab has to be used only in cases of recurrent visual loss after the loading phase. In contrast monthly treatment--as also provided in the ANCHOR and MARINA studies--is generally allowed in Switzerland. However, it is commonly tried to reduce the injection frequency because of the particular cost situation in all health systems and of cause also due to the necessary strict monitoring and reinjection regimes, which raise management problems with increasing patient numbers. In this article the special treatment regimes of our University Eye Hospital is presented, in which a reduced injection frequency basically leads to the same increased and stable visual results as in ANCHOR and MARINA; however, needing significantly more injections as generally provided in other countries of Europe. The main focus for achieving this in a large number of patients is placed on re-structuring our outpatient flow for IVT patients with particular emphasis on patient separation and standardisation of treatment steps leading to significantly reduced time consumption per patient. Measurements of timing and patient satisfaction before and after restructuring underline its importance in order to be able to treat more patients at a high quality even in the future. The exceptional importance of spectral domain OCT measurements as the most important criterium for indicating re-treatment is illustrated.

Investigation of Human-Structure Interaction Through Experimental and Analytical Studies

Vibration serviceability is a widely recognized design criterion for assembly-type structures, such as stadiums, that are likely subjected to rhythmic human-induced excitation. Human-induced excitation of a structure occurs from the movement of the occupants such as walking, running, jumping, or dancing. Vibration serviceability is based on the level of comfort that people have with the vibrations of a structure. Current design guidance uses the natural frequency of the structure to assess vibration serviceability. However, a phenomenon known as human-structure interaction suggests that there is a dynamic interaction between the structure and passive occupants, altering the natural frequency of the system. Human-structure interaction is dependent on many factors, including the dynamic properties of the structure, posture of the occupants, and relative size of the crowd. It is unknown if the shift in natural frequency due to humanstructure interaction is significant enough to warrant consideration in the design process. This study explores the interface of both structural and crowd characteristics through experimental testing to determine if human-structure interaction should be considered because of its potential impact on serviceability assessment. An experimental test structure that represents the dynamic properties of a cantilevered stadium structure was designed and constructed. Experimental modal analysis was implemented to determine the dynamic properties of the empty test structure and when occupied with up to seven people arranged in different locations and postures. Comparisons of the dynamic properties were made between the empty and occupied testing configurations and analytical results from the use of a dynamic crowd model recommended from the Joint Working Group of Europe. Data trends lead to the development of a refined dynamic crowd model. This dynamic model can be used in conjunction with a finite element model of the test structure to estimate the dynamic influence due to human-structure interaction due to occupants standing with straight knees. In the future, the crowd model will be refined and can aid in assessing the dynamic properties of in-service stadium structures.

The Retirement Behaviour of Older Workers in Transitional Economies

Research has shown that public pay-as-you-go, defined-benefit pension plans penalise those who stay at work beyond a certain age by reducing the present discounted value of future retirement benefits. In discussions on the effectiveness of policies aimed at eliminating the age-dependency factor in workers' decisions to retire, it is often assumed either that the benefits in all future periods have the same weight in the present discounted value or that the discount rate is close to unity due to low real interest rates used in this case. Galuscak first considered the U.S. pension scheme, showing that discounting plays a crucial role since the formula for the present discounted value of future retirement benefits is sensitive to the discount rate used. He then analysed the role of social security incentives and retirement provisions on older workers' behaviour in the labour markets of the Czech and Slovak Republics and the effect of the macroeconomic environment on workers' decisions to retire. He calculated the optimal parameters of the Czech and Slovak pension rules and assessed the potential effectiveness of changes to the Czech scheme introduced in January 1996.

Monument Preservation in Central Europe

Recent decades have seen both what has been referred to as an "inflation of historical monuments" and an acceleration of the process of "monumentification" affecting buildings of relatively recent date. In order to gain a better understanding of this, Kovacs looked at the experience in countries of Central Europe (Romania, Hungary, Slovenia, the Czech Lands, Slovakia), discovering a number of similarities as well as differences in detail. More important, however, was the discovery of the much wider importance of this phenomenon as a whole, which is particularly visible in this part of Europe, where "European" theory and practice of monument preservation are combined with progressivist demolitionism and traditional "natural" attitudes towards the built environment. Kovacs found that monument preservation has not only become a major occupation within building activity seen as a matter of anthropology, but also seems to be the determining feature of the contemporary cultural attitude. The scale of preservation activity has long since reached the level of urban design as an essential criterion for matters of future development, making it necessary to extend the conclusions of theoretical research down to broader generalities of the building domain. Kovacs then looked at the specific features of the countries concerned, including the survival of traditional building techniques in Romania, and the wide variety of preservationist policies in use.

The 2002 European registry of cardiac catheter interventions

OBJECTIVE: The tradition of yearly reports on cardiac catheter interventions in Europe has been initiated in 1992. This 11th report presents aggregated data on cardiac catheter procedures in 30 European countries in the year 2002. DESIGN AND SETTING: A detailed questionnaire addressing summary data of all cardiac interventions was mailed to presidents or delegates of the national societies of cardiology in Europe. The questionnaire was distributed to all institutions with cardiac catheterisation programs. All questionnaires were compiled in a national summary data sheet, then entered into a central database and subsequently analysed. MAIN OUTCOME MEASURES: Coronary angiography, PTCA, and stenting in absolute numbers and per million inhabitants in the participating countries and the whole of Europe. RESULTS: Overall, 1,901,932 coronary angiograms were reported. The population-adjusted rate of coronary angiograms amounted to an absolute mean of 3358 per 10(6) inhabitants, an increase of 7% compared with 2001. A total of 686,869 PTCA procedures were reported. The mean European number of PTCAs per 10(6) inhabitants increased by 10% from 1103 in 2001 to 1213 in 2002. Procedures with stenting increased by 17% from 508,999 to 593,906. The stenting rate was 86% compared with 82% in 2001. CONCLUSIONS: In pace with epidemiological demand and the need to catch-up from underuse in certain countries, a continuous and considerable growth of coronary interventions can be observed. It will take years to find out whether the announced change of paradigm in the treatment of multivessel disease in the wake of drug-eluting stents will come true.

Further concerns about self-assessment: are medical students aware of their progress in clinical skills during clerkship

Background: Medical students do not accurately self-assess their competence. However, little is known about the awareness of change of competence over time. The aim of this study was to evaluate if students are aware of their progress. Summary of work: Twenty-two fourth year medical students had self- and expert-assessments of their clinical skills in musculoskeletal medicine in an OSCE like station (4 point Likert scale) at the beginning (t0) and end (t1) of their eight weeks clerkship in internal medicine. Thirteen students were assigned to the intervention of a 6x1 hour practical examination course; nine took part in the regular clinical clerkship activities only and served as controls. Summary of results/Conclusions: The intervention students significantly improved their skills (from 2.78 ± 0.36 to 3.30 ± 0.36, p<0.05) in contrast to the control students (from 3.11 ± 0.58 to 2.83 ± 0.49, n.s.). At t0, 19 students, at t1 21 out of 22 students underestimated their competence. Correlations between the change of self- and expert-assessment were r=0.43, p<0.05 (all), r=0.47, n.s. (control) and r=-0.12, n.s. (intervention), respectively. Take-home message: Medical students improving their clinical skills by an interactive course in addition to their regular clerkship activities are not aware of their progress

The Postmodern ‘Turn’ in Social Work: The Challenges of Identity and Equality

Diversity and demands for equality have challenged fixed notions of identity amongst the diverse populations of Europe. This development has prompted discourses about the significance of fluidity and multiplicity in identities that have given prominence to postmodern theories in the profession of social work. A number of social work educators have contributed to the ensuing debates. Walter Lorenz’s work has contributed substantially to developments on this front by:highlighting the dangers of essentialising fixed identities in professional practice, referring to the failure of social workers to live up to professional values and ideals in the Nazi attack on Jews and others who were different from the Aryan norms that Hitler’s regime sought to impose; arguing for racial equality in multicultural Europe; and ensuring that social work theories and practice engaged with innovations in the social sciences more generally to improve the profession’s research, theoretical and practice bases. In this article, I engage with crucial debates that have shaped the profession during the post-war period, honouring Walter Lorenz’s contributions to them in the process.

Social services in accession countries

The 1st May 2004 10 new countries joined the European Union. It is one of the most impor-tant events in the history of the European Union and all of Europe. New nations are accessing the Community and so new challenges are emerging. An important challenge is the exchange of information in order to better understand each other. This article aims to outline informa-tion on the social services in selected accession countries - Poland, Czech Republic, Slovakia and Hungary (hereinafter "Visegrad countries").

The Effect of the Japan 2011 Disaster on Nuclear and Alternative Energy Stocks Worldwide: An Event Study

This event study investigates the impact of the Japanese nuclear disaster in Fukushima-Daiichi on the daily stock prices of French, German, Japanese, and U.S. nuclear utility and alternative energy firms. Hypotheses regarding the (cumulative) abnormal returns based on a three-factor model are analyzed through joint tests by multivariate regression models and bootstrapping. Our results show significant abnormal returns for Japanese nuclear utility firms during the one-week event window and the subsequent four-week post-event window. Furthermore, while French and German nuclear utility and alternative energy stocks exhibit significant abnormal returns during the event window, we cannot confirm abnormal returns for U.S. stocks.

Global biomass burning: a synthesis and review of Holocene paleofire records and their controls

We synthesize existing sedimentary charcoal records to reconstruct Holocene fire history at regional, continental and global scales. The reconstructions are compared with the two potential controls of burning at these broad scales – changes in climate and human activities – to assess their relative importance on trends in biomass burning. Here we consider several hypotheses that have been advanced to explain the Holocene record of fire, including climate, human activities and synergies between the two. Our results suggest that 1) episodes of high fire activity were relatively common in the early Holocene and were consistent with climate changes despite low global temperatures and low levels of biomass burning globally; 2) there is little evidence from the paleofire record to support the Early Anthropocene Hypothesis of human modification of the global carbon cycle; 3) there was a nearly-global increase in fire activity from 3 to 2 ka that is difficult to explain with either climate or humans, but the widespread and synchronous nature of the increase suggests at least a partial climate forcing; and 4) burning during the past century generally decreased but was spatially variable; it declined sharply in many areas, but there were also large increases (e.g., Australia and parts of Europe). Our analysis does not exclude an important role for human activities on global biomass burning during the Holocene, but instead provides evidence for a pervasive influence of climate across multiple spatial and temporal scales.

Dry grasslands of NW Bulgarian mountains: first insights into diversity, ecology and syntaxonomy

We present the data of the 3rdresearch expedition of the European Dry Grasslands Group (EDGG), which was conducted in 2011 in two contrasting areas in NW Bulgarian mountains. The aim was to collect plot data for comparing Bulgarian dry grasslands with those of other parts of Europe in terms of syntaxonomy and biodiversity. We sampled 15 nested-plot series (0.0001–100 m²) and 68 normal plots(10 m²) covering the full variety of dry grassland types occurring in the Vratsa area (Balkan Mts.) and the Koprivshtitsa area (Sredna Gora Mt.). In the plots all vascular plants, terricolous non-vascular plants and a set of soil and other environmental parameters were determined. By applying modified TWIN-SPAN, we distinguished 10 floristically well characterised vegetation types at the association level. After comparison with the regional and European literature, we propose to place them within three classes and five orders: Festuco-Brometea with the orders Stipo pulcherrimae-Festucetalia pallentis (xerophilous dry grasslands of base-rich rocks; alliance Saturejion montanae), Brachypodietalia pinnate (meso-xeric, basiphilous grasslands; alliances Cirsio-Brachypodion pinnate and Chyrsopogono grylli-Danthonion calycinae),Calluno-Ulicetea with the order Nardetalia stricae (lowland to montane Nardus swards; alliance Violion caninae), and Koelerio-Corynephoretea with the orders Sedo-Scleranthetalia (open communities of skeleton-rich, acidic soils; alliance unclear) and Trifolioarvensis-Festucetalia ovinae(closed, meso-xeric, acidophilous grasslands; alliance Armerio rumelicae-Potentillion). The Violion caninae with the association Festuco rubrae-Genistelletum sagittalisis reported from Bulgaria for the first time, while the two occurring Koelerio-Corynephoretea communities are described as new associations (Cetrario aculeatae-Plantaginetum radicatae, Plantagini radicatae-Agrostietum capillaris). According to DCA the main floristic gradient was largely determined by soil conditions, differentiating the Festuco-Brometea communities on soils with high pH and high humus content from the Koelerio-Corynephoretea communities on acidic, humus-poor soils, while the Calluno-Ulicetea stands are the connecting link. At 10 m² Festuco-Brometea and Calluno-Ulicetea stands were richer in species across all investigated taxa and in vascular plants than Koelerio-Corynephoretea stands; the latter were richest in lichen species, while bryophyte richness did not differ significantly among syntaxa. Among the Bulgarian classes, the species-area relationships tended to be steepest in the Festuco-Brometea (i.e. highest beta diversity), but both alpha and beta diversity clearly fell behind the Festuco-Brometea communities in the Transylvanian Plateau, Romania, located less than 500 km north of the study region. Overall, our study contributes to a more adequate placement of the Bulgarian dry grasslands in the European syntaxonomic system and provides valuable data for large-scale analyses of biodiversity patterns