Improving Breast Cancer Education: The Case of an Evolving Multidisciplinary Module for Undergraduate Medical Students (Lausanne Medical School, 1993-2008)

Breast cancer is a public health issue in numerous countries. Multidisciplinary collaboration is required for patient care, research, and also education of future physicians. This paper uses Kern's framework for curriculum design to demonstrate how a breast diseases module for undergraduate medical students created in 1993 evolved over 15years. The main outcomes of program refinements were better integrated course content, the development of electronic course documents, and implementation of computer-aided small group learning. A main future challenge is to further develop efficient instructional strategies in line with well-defined learning needs for undergraduate student

The Reasons for Discrepancies in TargetVolume Delineation: A SASRO Study on Head-and-Neck and Prostate Cancers

Purpose: : To understand the reasons for differences in the delineation of target volumes between physicians. Material and Methods: : 18 Swiss radiooncology centers were invited to delineate volumes for one prostate and one head-and-neck case. In addition, a questionnaire was sent to evaluate the differences in the volume definition (GTV [gross tumor volume], CTV [clinical target volume], PTV [planning target volume]), the various estimated margins, and the nodes at risk. Coherence between drawn and stated margins by centers was calculated. The questionnaire also included a nonspecific series of questions regarding planning methods in each institution. Results: : Fairly large differences in the drawn volumes were seen between the centers in both cases and also in the definition of volumes. Correlation between drawn and stated margins was fair in the prostate case and poor in the head-and-neck case. The questionnaire revealed important differences in the planning methods between centers. Conclusion: : These large differences could be explained by (1) a variable knowledge/interpretation of ICRU definitions, (2) variable interpretations of the potential microscopic extent, (3) difficulties in GTV identification, (4) differences in the concept, and (5) incoherence between theory (i.e., stated margins) and practice (i.e., drawn margins

Primary breast lymphoma: patient profile, outcome and prognostic factors. A multicentre rare cancer network study

Background: To asses the clinical profile, treatment outcome and prognostic factors in primary breast lymphoma (PBL). Methods: Between 1970 and 2000, 84 consecutive patients with PBL were treated in 20 institutions of the Rare Cancer Network. Forty-six patients had Ann Arbor stage IE, 33 stage IIE, 1 stage IIIE, 2 stage IVE and 2 an unknown stage. Twenty-one underwent a mastectomy, 39 conservative surgery and 23 biopsy; 51 received radiotherapy (RT) with (n = 37) or without (n = 14) chemotherapy. Median RT dose was 40 Gy (range 12-55 Gy). Results: Ten (12%) patients progressed locally and 43 (55%) had a systemic relapse. Central nervous system (CNS) was the site of relapse in 12 (14%) cases. The 5-yr overall survival, lymphoma-specific survival, disease-free survival and local control rates were 53%, 59%, 41% and 87% respectively. In the univariate analyses, favorable prognostic factors were early stage, conservative surgery, RT administration and combined modality treatment. Multivariate analysis showed that early stage and the use of RT were favorable prognostic factors. Conclusion: The outcome of PBL is fair. Local control is excellent with RT or combined modality treatment but systemic relapses, including that in the CNS, occurs frequentl

Indicators for the on-farm assessment of crop cultivar and livestock breed diversity: a survey-based participatory approach

International audienceAgrobiodiversity plays a fundamental role in guaranteeing food security. However, still little is known about the diversity within crop and livestock species: the genetic diversity. In this paper we present a set of indicators of crop accession and breed diversity for different farm types at farm-level, which may potentially supply a useful tool to assess and monitor farming system agrobiodiversity in a feasible and relatively affordable way. A generic questionnaire was developed to capture the information on crops and livestock in 12 European case study regions and in Uganda by 203 on-farm interviews. Through a participatory approach, which involved a number of stakeholders, eight potential indicators were selected and tested. Five of them are recommended as potentially useful indicators for agrobiodiversity monitoring per farm: (1) crop-species richness (up to 16 crop species), (2) crop-cultivar diversity (up to 15 crop cultivars, 1-2 on average), (3) type of crop accessions (landraces accounted for 3 % of all crop cultivars in Europe, 31 % in Uganda), (4) livestock-species diversity (up to 5 livestock species), and (5) breed diversity (up to five cattle and eight sheep breeds, on average 1-2).We demonstrated that the selected indicators are able to detect differences between farms, regions and dominant farm types. Given the present rate of agrobiodiversity loss and the dramatic effects that this may have on food production and food security, extensive monitoring is urgent. A consistent survey of crop cultivars and livestock breeds on-farm will detect losses and help to improve strategies for the management and conservation of on-farm genetic resources

Indikatoren zur Erfassung genetischer Vielfalt in biologischen und nicht-biologischen Landwirtschaftssystemen

Genetic variability is the fundament of life. Large genetic variability within species is the basis for adaptation to changing environmental conditions. Farmers and breeders have developed a multitude of crop cultivars and animal breeds to stabilize and increase quality and productivity. This study evaluated genetic diversity within different organic and non-organic farming systems using crop-cultivar and livestock-breed information as simple indicators. Data was collected using on-farm surveys in 15 case study regions in Europe and beyond. Selected indicators revealed strong differences of cultivar diversity between different countries and farming systems across Europe. No or only small differences were detectable between organic and non-organic farming systems. Landraces, as on-farm genetic resources, were under-represented in European case study regions

Strikingly high effects of geographic location on fauna and flora of European agricultural grasslands

International audienceWild bees, spiders, earthworms and plants contribute considerably to biodiversity in grasslands and fulfil vital ecological functions. They also provide valuable services to agriculture, such as pollination, pest control and maintenance of soil quality. We investigated the responses of wild bees, spiders, earthworms and plants to geographic location, agricultural management and surrounding landscape variables using a dataset of grassland fields within 88 farms in six European regions. Regions and taxonomic groups were selected to have contrasting properties, in order to capture the multiple facets of European grasslands. Geographic location alone had a dominant effect on the fauna and flora communities. Depending on the taxonomic group, various agricultural management and surrounding landscape variables alone had an additional significant effect on observed species richness, rarefied species richness and/or abundance, but it was always small. Bee species richness and abundance decreased with increasing number of mechanical operations (e.g. cutting). Observed spider species richness and abundance were unrelated to measured aspects of agricultural management or to surrounding landscape variables, whereas rarefied species richness showed significant relations to nitrogen input, habitat diversity and amount of grassland habitats in the surroundings. Earthworm abundance increased with increasing nitrogen input but earthworm species richness did not. Observed plant species richness decreased with increasing nitrogen input and increased when there were woody habitats in the surroundings. Rarefied plant species richness decreased with mechanical operations. Investigating multiple regions, taxonomic groups and aspects of fauna and flora communities allowed identifying the main factors structuring communities, which is necessary for designing appropriate conservation measures and ensuring continued supply of services

BIOBIO – Indikatoren für Biodiversität in ökologischen und ex-tensiven Anbausystemen

Organic and low-input farming systems provide habitats for wildlife on farmland. The EU FP7 project BIOBIO has identified a core set of 23 indicators relating to the diversity of habitats, of species, of crops and of livestock. Management indicators capturing the pressure on biodiversity are also proposed. The indicators were identified in an iterative process between scientists and stake-holders to make sure that they are not only scientifically sound but also practicable and attractive. They were tested in 12 case study regions on four major farm types. Allocating 0.25 % of the CAP budget to a farm scale biodiversity monitoring would allow to measure and analyse the indicators on 50,000 farms across Europe

Indicateurs de biodiversité dans les exploitations agricoles biologiques et conventionnelles des Vallées et Coteaux de Gascogne, cas d’étude français du projet européen BIOBIO

Dans le cadre du projet européen BIOBIO, nous avons comparé entre pays les richesses en habitats et richesses spécifiques cumulées de quatre groupes taxonomiques (plantes, abeilles sauvages, araignées, vers de terre), de 169 exploitations biologiques ou conventionnelles appartenant à 10 pays. Pour le cas d’étude français, Vallées et Coteaux de Gascogne, les corrélations entre indicateurs directs (richesses spécifiques des taxons et habitats) et indirects (pratiques agricoles) de biodiversité, relevés dans 8 exploitations conventionnelles et 8 biologiques, ont été recherchées. Les résultats montrent que le nombre d’habitats cultivés et surtout semi-naturels par exploitation est le principal facteur déterminant le niveau de biodiversité à cette échelle, pour le cas d’étude français comme pour les autres cas d’étude. Ce facteur explique en partie le plus haut niveau de biodiversité observé pour le cas d’étude français. Néanmoins, les pratiques, spécifiques ou non des modes de production biologique et conventionnelle, gouvernent généralement les paramètres de biodiversité à l’échelle de l’habitat. In fine, le projet propose la méthode BIOBIO de suivi de la biodiversité dans les exploitations agricoles

Artenvielfalt auf biologischen und nicht-biologischen Landwirtschaftsbetrieben in zehn europäischen Regionen

One of the aims of organic farming is the protection of biodiversity. In the EU FP7 project BioBio, we studied the effect of organic farming on species numbers at farm level on 169 randomly selected organic and non-organic farms with mostly low to medium intensity in ten European regions. Using a preferential sampling scheme based on habitat mapping, numbers of plants, earthworms, spiders and bees were assessed at farm level. A global analysis across the ten regions shows that organic farms have significantly higher numbers of plant and bee species than non-organic farms. The effect of organic farming on earthworm and spider species numbers are also positive but insignificant. The effects in absolute terms are small and much smaller than the variation between individual farms. Currently ongoing analyses aim at identifying the important driving factors for farmland biodiversity