Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches

Analyses topographiques et chimiques des pigments des œuvres peintes

Problématique de l’analyse La détermination de la nature des pigments, des charges de la préparation et leurs successions dans les couches picturales apporte un enseignement fondamental sur la technologie, la provenance géographique et la datation des œuvres peintes. Cependant, la petitesse des prélèvements, leur complexité nécessitent l’utilisation de techniques d’observation et d’analyse de petites surfaces telle que la microsonde électronique de Castaing. Méthodologie analytique Une œuvre ..

L'informatique scientifique dans l'enseignement de la biologie et de la géologie au lycée

Nous essayons de montrer comment l'utilisation des principes de la modélisation évènementielle peuvent être utilisés pour une introduction pédagogique à l'utilisation de concepts statistiques en biologie. Nous traitons du cas de la circulation des microfilaires chez l'hôte vertébré, et de leur absorption par leurs vecteurs (moustiques) ; mais les résultats obtenus nous permettent, à notre avis, en considérant l'hôte comme le siège d'un flux parasitaire, de donner une approche globale des caractéristiques quantitatives du parasitisme. (Résumé d'auteur

The Ghassanian Techno-Complex: Late/Final PPNB Lithic Assemblages from Desert Kite-Associated Occupation Sites in Jibal al-Khashabiyeh, South-Eastern Jordan

International audienceA series of eight dwelling sites were discovered recently in south-eastern Jordan, directly associated with eight mass-hunting structures: desert kites. These associated sites also share a clear chronological framework, as they are all dated to the end of the Pre-Pottery Neolithic B. The archaeological material, mostly made up of abundant lithic industries, is extremely homogenous and coherent at all the sites. The excavated lithic industries from three of the eight dwelling sites are studied here. They show similarities and consist of a blade and a bifacial component of small to large-sized artefacts, in association with a large assemblage of small arrowheads of various types. On the basis of the specific characteristics of the whole lithic assemblage, a new regional techno-complex, called the “Ghassanian”, is defined for these desert margins of the Fertile Crescent

Organic-rich biolaminated facies from a Kimmeridgian lagoonal environment in the French southern Jura mountains: a way of estimating accumulation rate variations

During Kimmeridgian times, the present-day Southern Jura was a carbonate platform. In the palaeolagoon at the village of Orbagnoux, organic matter was deposited, giving birth to calcareous laminites, with organic carbon reaching 12%. Three facies may be distinguished; two types of laminites are encountered: one made of parallel laminae and the other made of undulating laminae. The laminites alternate with massive limestone beds, in which no internal structure may be seen. The lithology, sedimentology and the faunal, floral and organic content of laminites and of massive limestones was thoroughly investigated at different scales using various methods: field observation, transmitted-light and scanning electron microscopy, Rock Eval pyrolysis, biomarkers, infrared study of kerogen, palynofacies observation. It is suggested that the different types of laminites (parallel or undulating) may reflect variations in the accumulation rates, linked with the carbonate and organic matter productions. Undulating laminae would correspond to periods of lack of sedimentation whereas parallel laminae would reflect alternations of periods of sedimentation and periods of non-sedimentation. These variations might in turn reflect climatic changes affecting the emerged lands supplying the lagoon with detrital products (organic or inorganic). The accumulation and preservation of organic matter were made possible by the development of microbial mats, building “oxygen-tight” barriers at the water-sediment interface. These barriers separated overlying, oxygenated water from anaerobic sediments. These phenomena may explain one way in which potential hydrocarbon source-rocks can form under a (poorly ?) oxygenated water column.</p

A Late PPNB lithic assemblage associated to kite hunters from Jibal al-Khashabiyeh, southeastern Jordan

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Chemical and Mechanical Characterisation of White Earthenware Glazes from the Johnston‐Vieillard Manufactory (France, 19th Century)

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Industrial production of white earthenware in the Johnston-Vieillard manufactory (19th century): recipes evolution and production strategies

International audienceThe aim of this paper is to present research conducted on the ceramic productions of a French ceramic manufactory in Bordeaux. The Johnston-Vieillard manufactory produced, between 1845 and 1895, a special type of ceramic called “white earthenware”. Although general documents remain (such as ceramic treatises, World Exhibition's catalogues, lawsuits, correspondences), factory archives (that were either lost or destroyed) are severely lacking in order to document the production techniques (choice of raw materials, recipes, firing conditions, division of labor and life in the manufactory, …). Recently, a lot of pieces and remains of white earthenware (wasted materials and elements used at the different stages of the chaîne opératoire) were discovered during an excavation performed in the ancient factory area. In the present study, we focused specifically on the modifications over time of white earthenware production.We examined six groups of sherds representative of different production periods of the factory. These sherds came from the available and abundant wastes found during the excavation located in the ancient waste dumps of the manufactory. A total of 150 fragments – 70 biscuits and 80 glazed white earthenwares – were selected for analysis. As a matter of fact, composition of bodies and glazes were investigated using a combination of analytical techniques that included Scanning Electron Microscopy-Energy Dispersive X-ray Spectroscopy (SEM-EDS), Particle Induced X-Ray and Gamma Emission (PIXE-PIGE) and X-Ray Diffraction (XRD).Analyses showed significant differences on chemical composition of glazes and bodies during the different stages of the factory life. Thus, it is possible to make assumptions concerning the recipes used for paste and glaze during the different chronological periods. Of course, these recipes are compared to those available in the literature of the 19th century. Finally, hypothesis about adaptability of the glaze to the paste are discussed. The correlation between the modifications of glazes and bodies composition with the variations of the coefficient of thermal expansion.The aim of this work is to contribute to document an industrial production of white earthenware throughout the 19th century. Results obtained on the characterization of the ceramic production technologies and on the modification over time of the recipes (glazes and bodies) will be presented

Inside an industrial manufactory of ceramic: recipes evolution and production strategies

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