Comment tes médecins de famille prennent-ils en charge l'hypothyroïdie infraclinique [How do Swiss family physicians treat subclinical hypothyroidism?].

L'hypothyroïdie infraclinique est fréquemment rencontrée et sa prévalence augmente avec l'âge. Les recommandations relatives au dépistage et au traitement de l'hypothyroïdie infraclinique sont controversées. Une enquête internationale auprès des médecins de famille, à laquelle la Suisse a participé, a mis en évidence de fortes variations dans la prise en charge de l'hypothyroïdie infraclinique entre les pays. Ces différences de traitement traduisent avant tout le manque de données fiables quant à la prise en charge de cette condition. L'essai clinique randomisé européen TRUST devrait permettre de clarifier les indications pour le dépistage et la substitution par thyroxine. Une collaboration avec les médecins de famille et le soutien des Instituts universitaires de médecine générale à Lausanne et à Berne pour le recrutement des patients devraient permettre d'obtenir des données directement applicables à une population représentative de la médecine ambulatoire. Subclinical hypothyroidism is a common condition, and its prevalence increases with age. Currently, guidelines regarding the screening and treatment of subclinical hypothyroidism are controversial. An international survey of general practitioners (GPs), to which Swiss GPs also contributed, showed large inter-country variations in treatment strategies for subclinical hypothyroidism. These differences are mainly explained by the lack of strong evidence for the management of this condition. The European randomized-controlled clinical trial TRUST should help clarify recommendations for screening and thyroxin replacement for the elderly with subclinical hypothyroidism. Working in close collaboration with GPs in Switzerland for the recruitment of patients will ensure that the findings from this study will be applicable to primary care settings.

Der Anpassungsprozess von Ost an West - schnell aber nicht homogen. Teil 2 der Serie : Entwicklung der Mobilität im vereinten Deutschland

The article investigates the question, whether and in how far the travel behaviour of the former GDR inhabitants and the former FRG inhabitants has equalled since the years after the German reunification. A person-group specific analysis shows that the major differences still consist only in the elderly of age 60 and above. This is mainly due to the much slower process of motorization within this age group in the former GDR. In the younger age groups the adaption of the travel behaviour has almost been achieved; mainly as a consequence of the fast motorization process since 1990 in these age groups. Where differences are still valid, this stems firstly from worse supply conditions, especially with public transport, but also with road infrastructure, as can be seen by an overall lower system speed in the former GDR. A panel analysis shows, that the dynamics in terms of transport specific life style changes is far more relevant in the former GDR than former FRC. This is linked with higher mobility in the persons with such changes. These changes will probably come to an end once the economic development will have stabilised and the cohort with the biggest behavioural differences will gradually decrease.

CH‚́ emissions from a West Siberian mire

Tiivistelmä: Metaanivuo länsi-siperialaiselta suolta

Self-reported smoking cessation activities among Swiss primary care physicians.

ABSTRACT: BACKGROUND: Individual counselling, pharmacotherapy, and group therapy are evidence-based interventions that help patients stop smoking. Acupuncture, hypnosis, and relaxation have no demonstrated efficacy on smoking cessation, whereas self-help material may only have a small benefit. The purpose of this study is to assess physicians' current clinical practice regarding smokers motivated to stop smoking. METHODS: The survey included 3385 Swiss primary care physicians. Self-reported use of nine smoking cessation interventions was scored. One point was given for each positive answer about practicing interventions with demonstrated efficacy, i.e. nicotine replacement therapy, bupropion, counselling, group therapy, and smoking cessation specialist. No points were given for the recommendation of acupuncture, hypnosis, relaxation, and self-help material. Multivariable logistic analysis was performed to identify factors associated with a good practice score, defined as >1. RESULTS: The response rate was 55%. Respondents were predominately over the age of 40 years (88%), male (79%), and resided in urban areas (74%). Seventeen percent reported being smokers. Most of the physicians prescribed nicotine replacement therapy (84%), bupropion (65%), or provided counselling (70%). A minority of physicians recommended acupuncture (26%), hypnosis (8%), relaxation (7%), or self-help material (24%). A good practice score was obtained by 85% of respondents. Having attended a smoking cessation training program was the only significant predictor of a good practice score (odds ratio: 6.24 , 95% CI 1.95-20.04). CONCLUSION: The majority of respondents practice recommended smoking cessation interventions. However, there is room for improvement and implementing an evidence-based smoking cessation-training program could provide additional benefit.

Floods of 1986 and 1990 in the Raccoon River Basin, West-Central Iowa, HR-140, 1992

Water-surface-elevation profiles and peak discharges for the floods of 1973 and 1979 are compared to those of 1986 and 1990 in the Raccoon River basin, west-central Iowa. The profiles illustrate the 1979 and 1986 floods on the Raccoon, South Raccoon, and Middle Raccoon Rivers, the 1973 and 1986 floods on Walnut Creek, and the 1986 flood on Willow Creek and Mosquito Creek. The 1986 flood is the largest on record at U.S. Geological Survey streamflowgaging stations on the Middle Raccoon River tributary at Carroll, Middle Raccoon River near Bayard, Middle Raccoon River at Panora, and Walnut Creek at Des Moines. The 1990 flood discharge is the largest on record at U.S. Geological Survey crest-stage gaging stations on Hardin Creek near Farlin and on East Fork Hardin Creek near Churdan. The flood history given in this report describes rainfall conditions for floods that occurred during 1986 and 1990. Discharge for the 1990 flood on East Fork Hardin Creek near Churdan was 1.01 times larger than the 100-year recurrence-interval discharge.

Audit report on the City of West Union, Iowa for the year ended June 30, 2013

Audit report on the City of West Union, Iowa for the year ended June 30, 2013

Thin Bonded Concrete Resurfacing U.S. 34 West Burlington, Iowa, HR-34

The Experimental Project was designated as Research Project No. HR-34, sponsored by the Iowa Highway Research Board and constructed by the Iowa Highway Commission. Construction was supervised cooperatively by Engineers of the Iowa Highway Commission and the Portland Cement Association. The objective of the experiment is to study the behavior of relatively thin portland cement concrete resurfacing courses placed with bond on old concrete pavements. The phase of the problem being studied now, involves only pavements in which the old concrete is structurally sound.

The Arts (Music, Arts&Crafts and Drama) as a procedure for learning pre-school content: Grupo Edebé Project

There is nothing as amazing and fascinating as children learning process. Between 0 and 6 years old, a child brain develops in a waythat will never be repeated. At this age, children are eager to discover and they have great potential of active and affective life.Because of this, their learning capacity in this period is incalculable. (Jordan-Decarbo y Nelson, 2002; Wild, 1999).Pre-school Education is a unique and special stage, with self identity, which aims are:attending children as a whole,motivate them to learn,give them an affective and stable environment in which they can grow up and get to be balanced and confident people and inwhich they can relate to others, learn, enjoy and be happy.Arts, Music, Visual Arts and Drama (Gardner, 1994) can provide a framework of special, even unique, personal expression.With the aim of introducing qualitative improvements in the education of children and to ensure their emotional wellbeing, and havingnoticed that teachers had important needs and concerns as regards to diversity in their student groups, we developed a programbased on the detection of needs and concerns explained by professionals in education.This program of Grupo edebé, object of our research, is a multicultural, interdisciplinary and globalizing project the aims of which are:developing children's talent and personality,keeping their imagination and creativity and using these as a learning resource,promoting reasoning, favouring expression and communication,providing children with the tools to manage their emotions,and especially, introducing Arts as a procedure to increase learning.We wanted to start the research by studying the impact (Brice, 2003) that this last point had on the learning of five-year-old childrenschooled in multicultural environments.Therefore, the main goal of the research was the assessment of the implementation of a child education programme attending todiversity in a population of five-year-old children, specifically in the practice of procedures based on the use of Arts (music, arts andcrafts and theatre) as a vehicle or procedure for learning contents in Pre-school stage.Because children emotional welfare was a subject of our concern, and bearing in mind that the affective aspects are of vitalimportance for learning and child development (Parke and Gauvain, 2009), Grupo Edebé has also evaluated the starting, evolving andfinal impact in five-year-old children given that they finish Pre-school education at that age.