Gemeinschaft in der zweiten Generation: Religiöses Deutungssystem und geteilte Lebenspraxis in Auroville

Vor dem Hintergrund von Deinstitutionalisierungsprozessen Neuer religiöser Gemeinschaften tritt die Gemeinschaft Auroville als bemerkenswertes Kontrastbeispiel auf, besteht sie nämlich seit ihrer Gründung 1968 in der gemeinschaftlichen Form. Von dieser Beobachtung ausgehend steht die Frage nach den Bedingungen zur Konstitution und Aufrechterhaltung der Gemeinschaft im Zentrum dieses Aufsatzes. Mit Blick auf das Erklärungsmuster aus der Durkheim-Parsons-Tradition zur Konstitution religiöser Gemeinschaften, welches über das Konzept der Wertintegration verläuft, wird die Frage diskutiert, welche Rolle dem religiösen Symbolsystem Aurovilles in der Aufrechterhaltung der Gemeinschaft zukommt. Anhand des Freiheits- respektive Individualisierungsnarratives, das sich bei der zweiten Generation als identifikatorisches Moment durchgesetzt hat, lässt sich zeigen, dass nicht die gemeinschaftlichen Werte, sondern der lebenspraktische Bedingungsrahmen die Individuen in die Gemeinschaft einbindet

Predictors of state-of-the-art management of early breast cancer in Switzerland

Background: The aim of this study was to investigate predictors of state-of-the-art management of early breast cancer in Switzerland. Patients and methods: The study included 3499 women aged 25-79 years diagnosed with invasive breast cancer stages I-IIIA in 2003-2005. Patients were identified through population-based cancer registries and treated in all kinds of settings. Concordance with national and international recommendations was assessed for 10 items covering surgery, radiotherapy, systemic adjuvant therapy and histopathology reporting. We used multivariate logistic regression to identify independent predictors of high (10 points) and low (≤7 points) concordance. Results: In one-third of the patients, management met guidelines in all items, whereas in about one-fifth, three or more items did not comply. Treatment by a surgeon with caseload in the upper tercile and team involved in clinical research were independent predictors of a high score, whereas treatment by a surgeon with a caseload in the lower tercile was associated with a low score. Socioeconomic characteristics such as income and education were not independent predictors, but patient's place of residence and age independently predicted management according to recommendations. Conclusion: Specialization and involvement in clinical research seem to be key elements for enhancing the quality of early breast cancer management at population leve

Pathological Processing Techniques and Final Diagnosis of Breast Cancer Sentinel Lymph Nodes

Background: Recommendations for intraoperative and postoperative breast sentinel lymph node (SLN) processing differ widely. Micrometastases and isolated tumor cells (ITC) have recently been proposed as prognostically and therapeutically relevant. We compared 3 SLN protocols with regard to intraoperative and postoperative diagnosis. Materials and Methods: SLN in cohort I (270 patients) were intraoperatively assessed by stereomicroscopy. Intraoperative frozen section (IFS) was used only in stereomicroscopically suspicious SLN. In cohort II (197 patients), all SLN were examined with only 1 IFS. Final SLN workup in cohorts I and II consisted of complete step sectioning with immunohistochemistry. In cohort III (268 patients) 2 or more IFS were performed followed by 3 step sections and immunohistochemistry. Results: pN1 stages were significantly higher in cohorts I and II (33.3% and 34.0% respectively) than in cohort III (24.6%). Intraoperative false negativity for the detection of metastases (pN1) ranged from 54.4% (cohort I) and 35.8% (cohort II) to 21.2% (cohort III). In contrast, ITC were detected significantly more frequently in cohort I (9.3%) and cohort II (14.7%) than in cohort III (1.9%). Conclusions: Higher rates of SLN metastases and ITC in cohort I/II compared to cohort III suggest that IFS may result in tissue loss thus increasing the risk of missing metastases. Sparse IFS but complete postoperative SLN workup with step sectioning and immunohistochemistry provides more accurate information regarding minimal disease in SLN, but often results in delayed axillary lymph node dissection. This is important for preoperative patient information and recommendations in SLN processing protocol

Assessment of the extent of microcalcifications to predict the size of a ductal carcinoma in situ: comparison between tomosynthesis and conventional mammography

OBJECTIVES The objective was to determine if digital tomosynthesis of the breast (DBT) assesses the extension of ductal carcinoma in situ (DCIS) with higher precision than mammography (MG). MATERIAL AND METHODS The local ethics committee approved this retrospective study including 26 patients with DCIS, which were rated by three radiologists. Statistics were performed using intraclass correlation (ICC) for interreader agreement and the Pearson correlation for correlation of MG and DBT. Standard of reference was the histologic extension. RESULTS The ICC was excellent. Correlation between MG and histology was 0.879 (P<.01) and for DBT and histology was 0.914 (P<.01). CONCLUSION DBT provides a slightly better estimation of the size of a DCIS than MG

First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions).

The purpose of this study is to obtain a consensus for the therapy of B3 lesions. The first International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL), benign phyllodes tumors (PT), and radial scars (RS) took place in January 2016 in Zurich, Switzerland organized by the International Breast Ultrasound School and the Swiss Minimally Invasive Breast Biopsy group-a subgroup of the Swiss Society of Senology. Consensus recommendations for the management and follow-up surveillance of these B3 lesions were developed and areas of research priorities were identified. The consensus recommendation for FEA, LN, PL, and RS diagnosed on core needle biopsy or vacuum-assisted biopsy (VAB) is to therapeutically excise the lesion seen on imaging by VAB and no longer by open surgery, with follow-up surveillance imaging for 5 years. The consensus recommendation for ADH and PT is, with some exceptions, therapeutic first-line open surgical excision. Minimally invasive management of selected B3 lesions with therapeutic VAB is acceptable as an alternative to first-line surgical excision

Late-Holocene climatic variability south of the Alps as recorded by lake-level fluctuations at Lake Ledro, Trentino, Italy

International audienceA lake-level record for the late Holocene at Lake Ledro (Trentino, northeastern Italy) is presented. It is based on the sediment and pollen analysis of a 1.75 m high stratigraphic section observed on the southern shore (site Ledro I) and a 3.2 m long sediment core taken from a littoral mire on the southeastern shore (site Ledro II). The chronology is derived from 15 radiocarbon dates and pollen stratigraphy. The late-Holocene composite record established from these two sediment sequences gives evidence of centennial-scale fluctuations with highstands at c. 3400, 2600, 1700, 1200 and 400 cal. BP, in agreement with various palaeohydro-logical records established in central and northern Italy, as well as north of the Alps. In addition, high lake-level conditions at c. 2000 cal. BP may be the equivalent of stronger river discharge observed at the same time in Central Italy's rivers. In agreement with the lake-level record of Accesa (Tuscany), the Ledro record also suggests a relatively complex palaeohydrological pattern for the period around 4000 cal. BP. On a millennial scale, sediment hiatuses observed in the lower part of the Ledro I sediment sequence indicate that, except for a high-stand occurring just after 7500 cal. BP, lower lake levels generally prevailed rather before c. 4000 cal. BP than afterwards. Finally, the lake-level data obtained at Lake Ledro indicate that the relative continuity of settlements in humid areas of northern Italy during the Bronze Age (in contrast to their general abandonment north of the Alps between c. 3450 and 3150 cal. BP), does not reflect different regional patterns of climatic and palaeohy-drological conditions. In contrast, the rise in lake level dated to c. 3400 cal. BP at Ledro appears to coincide with a worldwide climate reversal, observed in both the hemispheres, while palaeoenvironmental and archaeological data collected at Lake Ledro may suggest, as a working hypothesis, a relative emancipation of proto-historic societies from climatic conditions