No temporal association between influenza outbreaks and invasive pneumococcal infections

Objective: To assess whether the influenza peak in populations precedes the annual peak for invasive pneumococcal infections (IPI) in winter.Design: Ecological study. Active surveillance data on influenza A and IPI in children up to 16 years of age collected from 1997 to 2003 were analysed.Setting: Paediatric hospitals in Germany.Patients: Children under 16 years of age.Results: In all years under study, the influenza A season did not appear to affect the IPI season (p = 0.49). Specifically, the influenza peak never preceded the IPI peak.Conclusion: On a population level there was no indication that the annual influenza epidemic triggered the winter increase in the IPI rate or the peak of the IPI distribution in children

Is resistance to ischaemia of motor axons in diabetic subjects due to membrane depolarization?

The reasons for the resistance to ischaemia of peripheral nerves in diabetics are not well understood. We have now explored whether axonal depolarization underlies this phenomenon, as has previously been proposed. Resistance to ischaemia was determined by the new method of “threshold tracking”. This method revealed an increase in excitability of the peroneal nerve at the popliteal fossa during ischaemia, and a decrease in excitability in the post-ischaemic period. The extent of these alterations in 28 type 1 diabetics without peripheral neuropathy showed a strong correlation with the mean blood glucose concentrations during the last 24 h before examination. To test whether the ischaemic resistance was related to membrane potential, we also measured axonal superexcitability in 11 selected diabetics, since it has been shown that post-spike changes in excitability depend on membrane potential. Changes in excitability of the peroneal nerve were measured in the period between 10 and 30 msec following a conditioning supramaximal compound action potential. Under resting conditions, no differences in the post-spike superexcitability were found between controls and diabetics, despite striking differences in their responses to a 10-min pressure cuff. These observations indicate that membrane depolarization is not involved in the resistance to ischaemia of motor axons in diabetic subjects

Key factors for sustainable working conditions in emergency departments : An EUSEM-initiated, Europe-wide consensus survey

Background and importance Modern emergency medicine (EM) is a complex, demanding, and occasionally stressful field of work. Working conditions, provider well-being, and associated health and performance outcomes are key factors influencing the establishment of a sustainable emergency department (ED) working environment. Objectives This multinational European Delphi survey aimed to identify unequivocal major factors for good and poor ED working conditions and their possible effects on health care provider well-being. Design/setting and participants A total of 18 experts from six European countries (Belgium, Finland, Germany, Italy, Romania, and the UK) covering three different hospital sizes (small, medium, and large) in their respective countries participated in the two-round Delphi survey. All panelists held leadership roles in EM. Outcome measures and analysis The first step involved conducting an extensive literature search on ED working conditions. The second step involved the first Delphi round, which consisted of structured interviews with the panelists. The survey was designed to obtain information concerning important working conditions, comments regarding work-life factors identified from the literature, and ratings of their importance. Interviews were transcribed and analyzed following a standardized protocol. In the second Delphi round, experts rated the relevance of items consolidated from the first Delphi round (classified into ED work system factors, provider health outcomes, and ED work-life intervention approaches). Results A nearly unequivocal consensus was obtained in four ED work condition categories, including positive (e.g. job challenges, personal motivation, and case complexities) and negative (e.g. overcrowding, workflow interruptions/multitasking, medical errors) ED work conditions. The highly relevant adverse personal health events identified included physical fatigue, exhaustion, and burnout. Concerning intervention practices, the panelists offered a wide spectrum of opportunities with less consensus. Conclusion Work system conditions exert positive and negative effects on the work life of ED providers across Europe. Although most European countries have varying health care systems, the expert-based survey results presented herein strongly suggest that improvement strategies should focus on system-related external stressors common in various countries. Our findings lay the scientific groundwork for future intervention studies at the local and systemic levels to improve ED provider work life

No evidence for auditory N1 dishabituation in healthy adults after presentation of rare novel distractors

Previous studies were not able to show that presentation of change stimuli leads to dishabituation of the auditory evoked potential (AEP) component N1 for repeated stimuli. However, these change stimuli were usually themselves repeatedly presented. Here, we tested whether the presentation of non-repeating distractor stimuli (‘novels’) would lead to N1 dishabituation. The study sample consisted of 18 healthy participants who had to identify auditory target stimuli (´targets´) among repeated standard stimuli and rare novels. AEPs to standards were separately averaged, depending on the preceding stimulus (standards after standards, standards after targets, and standards after novels) and were compared by F statistics and Bayesian t-test. Moreover, N1 repetition effects within recording blocks were analyzed in single trial analyses. The analyses showed that targets elicited significantly larger N1 amplitudes than standards and standards elicited larger N1 amplitudes than novels. In contrast, the N1 amplitude to standards did not vary with the preceding stimulus. The single trial analyses revealed significant, but similar N1 amplitude decreases within the recording blocks for all standards. The current study revealed no evidence for N1 dishabituation, as the N1 amplitude for standards after novels was not increased as compared to the N1 for standards after standards. Thus, stimulus variation had no impact on the N1 of repeated standards, as also suggested by the single trial analyses. The lack of N1 dishabituation is at odds with the assumption that the N1 amplitude decrease after repeated stimulation results from habituation

Abschied vom Mythos: Die CSU auf dem Weg zu einer "fast normalen Partei"

Der greifbare Wandel der CSU-Machtarchitektur drängt die Frage nach den Ursachen und den Konsequenzen dieser Entwicklung auf. Argumentiert wird, dass die Neuaufstellung der Partei dem zugespitzten Dualismus von Modernität und Konservativismus geschuldet ist, eine Auflösung dieses Spannungsfeldes aber noch aussteht

The effect of shared distinctiveness on source memory: An event-related potential study

An illusory correlation (IC) is the erroneous perception that two actually uncorrelated categories are correlated. The Shared Distinctiveness Approach (SDA) explains ICs with heightened accessibility of distinctive category combinations in episodic memory. However, empirical evidence for this approach is heterogeneous. In the present event-related potential (ERP) study, we exploited the fact that more distinctive items elicit larger P300 responses than less distinctive items, which potentially predict subsequent memory performance differences for such items. Distinctiveness at encoding was created by presenting words that differed from frequently presented, positive words in valence, font color, or both. We hypothesized that shared distinctiveness (deviation in both color and valence) would lead to an enhanced P300 subsequent memory effect (SME), better source memory performance, and an overestimation of the frequency of shared distinctive items. Behavioral results indicated the presence of shared distinctiveness effects on source memory and frequency estimation. Unexpectedly, memory also was enhanced for positive items in the frequent color. This pattern also was reflected in the P300 for highly positive and negative items. However, shared distinctiveness did not modulate the P300 SME, indicating that the processing of distinctive features might only indirectly contribute to better encoding. This study shows that shared distinctiveness indeed is associated with better source memory and ICs. Because effects were observed for the most frequent and the least frequent category combination, our results imply that the processing of distinctiveness might involve attention allocation to diametrical category combinations, thereby accentuating the differences between the categories