The Grandchildren of Immigrants in Western Europe: Patterns of Assimilation Among the Emerging Third Generation.

Migration scholars have long regarded the trajectory of the third generation as a critical test of assimilation; however, scholarship to date has been limited and largely focused on socioeconomic attainment. In this article, we rely on a large dataset of adolescent respondents in England, Germany, and the Netherlands to compare the second and third generations in terms of their social networks and cultural identities. The third generation shows stronger ties to the native fourth-plus generation alongside weaker ties to coethnics. We document comparable, albeit more moderate, dynamics of assimilation over generations in regard to national and ethnic identification, along with substantial variation by country of destination and ethnic origin group. Our results point to a dominant trend of assimilation at the third generation and suggest future challenges to provide a more durable assessment of postwar migration waves two generations after settlement.

Epidemiology and demographic patterns of cardiovascular diseases and neoplasms deaths in Western Europe: a 1990-2019 analysis.

OBJECTIVES: Cardiovascular diseases (CVDs) and neoplasms have been considered as public health concerns worldwide. This study aimed to estimate the epidemiological patterns of death burden on CVDs and neoplasms and its attributable risk factors in Western Europe from 1990 to 2019 to discuss the potential causes of the disparities. STUDY DESIGN AND METHODS: We collected data on CVDs and neoplasms deaths in 24 Western European countries from the Global Burden of Disease Study. We analyzed patterns by age, sex, country, and associated risk factors. The results include percentages of total deaths, age-standardized death rates per 100,000 population, and uncertainty intervals (UIs). Time trends were assessed using annual percent change. RESULTS: In 2019, CVDs and neoplasms accounted for 33.54% and 30.15% of Western Europe's total deaths, with age-standardized death rates of 128.05 (95% UI: 135.37, 113.02) and 137.51 (95% UI: 142.54, 128.01) per 100,000. Over 1990-2019, CVDs rates decreased by 54.97%, and neoplasms rates decreased by 19.54%. Top CVDs subtypes were ischemic heart disease and stroke; top cancers for neoplasms were lung and colorectal. Highest CVD death burdens were in Finland, Greece, Austria; neoplasm burdens in Monaco, San Marino, Andorra. The major risk factors were metabolic (CVDs) and behavioral (neoplasms). Gender differences revealed higher CVDs death burden in males, while neoplasms burden varied by risk factors and age groups. CONCLUSION: In 2019, CVDs and neoplasms posed significant health risks in Western Europe, with variations in death burdens and risk factors across genders, age groups, and countries. Future interventions should target vulnerable groups to lessen the impact of CVDs and neoplasms in the region.

Analysis of variation characteristics, transport paths, and influencing factors of atmospheric NO2 pollution in Western Europe.

Climate change and air pollution are one of the global environmental problems. It is significant to grasp the air pollution situation of Western Europe in recent 10 years for its or the global pollution control. Based on the OMI tropospheric nitrogen dioxide (NO2) column density data, the spatial and temporal distribution characteristics, variation trend, transmission path, and influencing factors of NO2 in 15 countries in Western Europe from 2011 to 2022 are discussed in this paper. Meanwhile, the annual average spatial and temporal distribution in 2023 is predicted by the random forest (RF) model. The results showed that (1) the 12-year spatial distribution map showed an increasing trend from southwest to northeast, with the border area of the Netherlands and Germany and Milan as two high-value areas, and the overall trend over time was that the high-concentration area gradually shrank, the low-concentration area gradually expanded, and the annual average concentration gradually decreased. (2) The inter-month trend presents a "U" shape, with the mean NO2 pollution ranking in winter > autumn > spring > summer. (3) Natural factors are one of the reasons affecting NO2; for instance, NO2 pollution has a strong positive correlation with the lifted index, relative humidity, and wind speed and a moderately strong negative correlation with precipitable water and air temperature. (4) Exogenous atmospheric transport is another important factor affecting the change of NO2 pollution in Western Europe. The HYSPLIT model is used to analyze the backward trajectory of Milan, Italy, and Nijmegen, Netherlands, in the four seasons of 2022. Both are mainly influenced by westerly airflows, and therefore, the transport effect in the atmosphere brings air pollutants from westerly regions in the atmosphere.

Healthcare delivery for HIV-positive people with tuberculosis in Europe.

BACKGROUND: In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). OBJECTIVES: To verify the differences in TB and HIV services in EE vs. WE. METHODS: Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. RESULTS: Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. CONCLUSION: Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.

Qualitative Evaluation of the Implementation of a Care Pathway for Colorectal Cancer Surgery.

Colorectal cancer care can be standardized by using enhanced recovery protocols. However, adherence to these protocols varies. Using Medical Research Council (MRC) guidance on process evaluations, we examined the experience of health care professionals in the implementation of a care pathway for colorectal surgery, by describing the intervention, context, implementation, mechanisms, and outcomes. Based on data from semi-structured interviews, we divided respondents into two groups: those who perceived positive outcomes of the implementation and those who perceived no effect. Respondents who perceived positive outcomes reported clinical leadership, use of feedback, positive effects of standardization, and teamwork as factors contributing to positive perceived outcomes. Respondents who perceived no effect reported a lack of organizational support, as well as challenging collaboration and standardization as mechanisms potentially explaining the poorer perception of outcomes. Multiple implementation activities were used, focusing on competence, behavior, or workplace. Our findings suggest that feedback is an important implementation activity.

"You Can't Ignore a Number This Big": Gender, Risk, and Responsibility in Online Advocacy for Women's Brain Health.

Alzheimer's disease affects more women than men and has therefore been highlighted as a women's issue. However, there is much debate regarding the nature of this gap, with some studies pointing to sex/gender differences in longevity to explain the disparity. Against this background of empirical uncertainty, we ask how online women's brain health campaigns position women as specifically at risk of developing the disease. Using a multimodal approach, we examine how these platforms relate womanhood to risk, prevention, and responsibility. Four main themes emerged: risk quantification, risk management, risk dispersion, and the gendering of risk. We confirm previous studies that identified a dual discourse in which Alzheimer's is represented as both a catastrophic threat and as a fate that individuals can and must prevent. We find that both constructions are intensified on women-oriented platforms compared with nonspecific websites. Ethical implications of the individualization and gendering of risk and responsibility are discussed.

Service User Experiences of Integrating a Mobile Solution (IMPACHS) Into Clinical Treatment for Psychosis.

Innovative technological solutions are increasingly being introduced into psychotherapy. Understanding service user perspectives is a key aspect in adapting this technology to treatment. This study investigated service users' personal experience of the utility, challenges, and rewards of using an mHealth solution in cognitive behavioral therapy for psychosis (CBTp). People participating in an early intervention program for psychosis (n = 16) utilized the mHealth solution for up to 6 months. Semi-structured qualitative interviews were conducted to capture participant experiences, and quantitative data were collected on psychopathology, usage, and quality of the solution. The solution was widely accepted and utilized in treatment. Four dominant themes were constructed from the interviews: (a) Accessibility and supporting recall, (b) Promotion of dialogue with the therapist, (c) Encouraging reflection, and (d) Factors that affected engagement with the solution. The mHealth solution was perceived as facilitating psychotherapeutic processes and supported underlying CBTp treatment principles.

Early Levallois core technology between Marine Isotope Stage 12 and 9 in Western Europe.

Early Levallois core technology is usually dated in Europe to the end of Marine Isotope Stage (MIS) 9 and particularly from the beginning of MIS 8 to MIS 6. This technology is considered as one of the markers of the transition from lower to Middle Paleolithic or from Mode 2 to Mode 3. Recent discoveries show that some lithic innovations actually appeared earlier in western Europe, from MIS 12 to MIS 9, contemporaneous with changes in subsistence strategies and the first appearance of early Neanderthal anatomical features. Among these discoveries, there is the iconic Levallois core technology. A selection of well-dated assemblages in the United Kingdom, France, and Italy dated from MIS 12 to 9, which include both cores and flakes with Levallois features, has been described and compared with the aim of characterizing this technology. The conclusion supports the interpretation that several technical features may be attributed to a Levallois technology similar to those observed in younger Middle Paleolithic sites, distinct from the main associated core technologies in each level. Some features in the sample of sites suggest a gradual transformation of existing core technologies. The small evidence of Levallois could indicate occasional local innovations from different technological backgrounds and would explain the diversity of Levallois methods that is observed from MIS 12. The technological roots of Levallois technology in the Middle Pleistocene would suggest a multiregional origin and diffusion in Europe and early evidence of regionalization of local traditions through Europe from MIS 12 to 9. The relationships of Levallois technology with new needs and behaviors are discussed, such as flake preference, functional reasons related to hunting and hafting, an increase in the use of mental templates in European populations, and changes in the structure of hominin groups adapting to climatic and environmental changes.

Molecular diagnosis of autochthonous human anaplasmosis in Austria - an infectious diseases case report.

BACKGROUND: The diagnosis of human anaplasmosis remains elusive and is probably often missed. This case report highlights the efficacy of molecular diagnostic techniques. CASE PRESENTATION: We would like to report the case of a 74-year-old man who was admitted to hospital because of a high fever, marked chills, transient diplopic images and vertigo, 6 weeks after multiple tick bites. The laboratory results showed mild anemia, marked thrombocytopenia and leukopenia and a moderately elevated C-reactive protein. The initial serology seemed to indicate an active infection with Borrelia spp., and Anaplasma phagocytophilum was detected in peripheral blood by polymerase chain reaction (PCR) and subsequent sequencing. The patient received intravenous ceftriaxone for 14 days and oral doxycycline for 4 weeks and made a fast and complete recovery. CONCLUSIONS: While human anaplasmosis has been reported very rarely in Austria, it should be considered as a differential diagnosis in febrile patients with low leukocyte and platelet counts with elevated levels of C-reactive protein after exposure to tick bites. Molecular detection of A. phagocytophilum is the technique of choice allowing rapid and reliable diagnosis.

Integrated management of blood-feeding arthropods in veterinary teaching facilities - Part 1: overview of haematophagous arthropods of interest in North-western Europe.

Numerous arthropod species negatively affect animal and human health through physical attacks, by generating allergic reactions and as potential vectors of pathogens. Their control is essential to prevent vector-borne diseases and reduce their negative direct effect. Climate change militates for appropriate preparedness towards invasive species, their establishment and their involvement in new potential vector-pathogen-host cycles. This paper reviews the main blood-feeding arthropods of veterinary/zoonotic interest and their role in the transmission of infections in North-western Europe. It is the first part of an approach aimed at proposing a coherent and affordable vector control programme for facilities housing healthy and sick animals in a veterinary faculty, from a global health point of view. It is the first review focusing on this topic in such a specific and at-risk environment. Indeed, considering its multi-disciplinary and multi-species context and the importance of animal welfare, a veterinary faculty should attach great importance to vector control.

Nombre d'espèces d'arthropodes ont un impact négatif sur la santé animale et humaine, soit lors d'attaques directes, soit en déclenchant des réactions allergiques ou encore en tant que vecteurs potentiels d'agents pathogènes. Il est essentiel de contrôler ces espèces afin de prévenir les maladies à transmission vectorielle et de réduire leurs effets négatifs directs. Le changement climatique intensifie le problème des espèces envahissantes, ce qui milite en faveur d'une préparation appropriée face à leur introduction, leur installation et leur probable participation à des cycles vecteur-pathogène-hôte inédits. Les auteurs font le point sur les principales espèces d'arthropodes hématophages d'intérêt vétérinaire et/ou zoonotique ainsi que sur leur rôle dans la transmission de maladies infectieuses dans le nord de l'Europe occidentale. Il s'agit du premier volet d'une approche visant à proposer un programme cohérent et peu coüteux de lutte anti-vectorielle afin de faciliter le maintien dans les installations des établissements d'enseignement vétérinaire d'animaux en bonne santé mais aussi d'animaux malades, dans une perspective sanitaire globale. Il s'agit de la première étude d'ensemble traitant de ce sujet dans un environnement aussi spécifique et à risque. En effet, compte tenu de la nature pluridisciplinaire des établissements d'enseignement vétérinaire, de leur axe pluri-espèces et de l'importance qu'y revêt le bien-être animal, ces institutions devraient attacher une importance majeure à la lutte anti-vectorielle.

Hay numerosas especies de artrópodo que perjudican la salud de personas y animales por las reacciones alérgicas que provoca su ataque físico o porque pueden actuar como vectores de patógenos. La lucha contra esas especies es básica para prevenir enfermedades de transmisión vectorial y reducir sus efectos perjudiciales directos. El cambio climático aconseja una adecuada preparación para hacer frente a las especies invasoras, su implantación y su intervención en eventuales nuevos ciclos vector-patógeno-hospedador. Los autores pasan revista a los principales artrópodos hematófagos de interés veterinario y/o zoonótico y exponen su función en la transmisión de infecciones en el noroeste de Europa. Se trata del primer capítulo de una reflexión encaminada a proponer, desde el punto de vista de la salud mundial, un programa coherente y asequible de lucha antivectorial que se aplique a las instalaciones de las facultades de veterinaria que alojan a animales sanos o enfermos. Se trata del primer trabajo en la materia que se centra específicamente en este tipo de entorno, tan particular como expuesto a riesgo. Toda facultad de veterinaria, en efecto, teniendo en cuenta su contexto pluridisciplinar y multiespecífico y lo importante que es el bienestar animal, debería otorgar suma importancia a la lucha contra los vectores.

Integrated management of blood-feeding arthropods in veterinary teaching facilities - Part 2: overview of control methods against adults and immature stages.

Numerous arthropod species are involved in the vector-borne transmission of pathogens either to animals and/or to humans. Part 1 of this paper was dedicated to a review of these species, and their role in the transmission of pathogens in North-western Europe. This part will discuss the different anti-arthropod control methods, which are either general, used as good management practices, or arthropod-specific. The majority of these measures are efficient against several arthropod groups. Management of the environment is crucial for controlling the immature stages of winged arthropods, fleas and lice, but also ticks. Spraying pesticides should be considered carefully, because of the risk of emergence of resistance and the negative impact on the environment and non-targeted insects. Monitoring of haematophagous arthropods is useful when considering its use in the validation of control measures, the follow-up of endemic populations, vigilance for emergence of new species, and the detection of pathogens and, indirectly, resistance to chemicals. Monitoring also helps to determine the most appropriate timing and location for implementing control measures. It is strongly advised to combine control methods targeting adults and others addressing immature stages. Even if challenging, their combination under an integrated pest management programme should be preferred. Indeed, integrated vector management aims at making vector control more efficient, cost-effective, ecologically sound and sustainable.

Nombre d'espèces d'arthropodes participent à la transmission vectorielle d'agents pathogènes aux animaux et/ou aux humains. Dans une première partie de leur étude, les auteurs ont donné une vue d'ensemble de ces espèces et expliqué le rôle qu'elles jouent dans la transmission d'agents pathogènes dans le nord de l'Europe occidentale. Cette deuxième partie est consacrée aux différentes méthodes de contrôle des arthropodes ; elles se répartissent entre d'une part, des méthodes générales qui correspondent aux bonnes pratiques de gestion, et d'autre part, des méthodes ciblant spécifiquement les arthropodes. La plupart de ces mesures sont efficaces contre plusieurs groupes d'arthropodes. Il est essentiel de respecter les principes de bonne gestion de l'environnement afin de parvenir à contrôler les stades immatures des arthropodes ailés tels que les puces et les poux, mais aussi les tiques. L'utilisation de pesticides par aérosols devrait être envisagée avec prudence en raison du risque d'émergence de résistances et de l'impact négatif de ces produits sur l'environnement et sur les insectes non-cibles. La surveillance des arthropodes hématophages présente un intérêt lorsqu'on l'applique pour la validation des mesures de contrôle, le suivi des populations endémiques, la veille face à l'émergence d'espèces nouvelles et la détection d'agents pathogènes, ainsi qu'indirectement pour détecter les résistances aux agents chimiques. La surveillance permet également de déterminer quand et où mettre en oeuvre les mesures de contrôle pour plus de résultats. Il est conseillé d'associer les méthodes ciblant les adultes et celles ciblant les stades immatures. Malgré les difficultés d'une telle association, il conviendra de la privilégier dans le cadre d'un programme intégré de gestion des nuisibles. En effet, la gestion intégrée des vecteurs vise à rendre la lutte anti-vectorielle à la fois plus efficace, plus rentable, plus rationnelle au plan écologique et plus durable.

Numerosas especies de artrópodo participan en la transmisión vectorial de patógenos a animales o personas. En la primera parte de esta serie de artículos se hace un repaso de estas especies y se explica el papel que cumplen en la transmisión de patógenos en el noroeste de Europa. En esta segunda parte se examinan los diferentes métodos de lucha contra los artrópodos, que pueden ser genéricos, esto es, utilizados como buena práctica de gestión, o ir dirigidos selectivamente contra artrópodos. La mayoría de estas medidas son eficaces contra varios grupos de artrópodos. La gestión de las condiciones del entorno es crucial para combatir a las fases inmaduras de artrópodos alados, pulgas y piojos, así como a las garrapatas. El rociado con plaguicidas es un recurso que conviene estudiar con detenimiento, dado el riesgo de que surjan resistencias y su negativo impacto en el medio ambiente y en otros insectos que no se pretende dañar. La vigilancia de las poblaciones de artrópodos hematófagos resulta útil cuando se contempla su uso para la validación de medidas de lucha, el seguimiento de poblaciones endémicas, la vigilancia de la aparición de nuevas especies o la detección de patógenos e, indirectamente, la resistencia a productos químicos. La vigilancia también ayuda a determinar el momento y lugar idóneos para aplicar medidas de lucha. Se aconseja vivamente combinar métodos de lucha dirigidos contra los adultos con otros que combatan a las fases inmaduras. La aplicación de este tipo de planteamiento combinado, por dificultosa que resulte, será siempre la opción preferible para formar parte de un programa de gestión integrada de plagas. La lucha integrada contra los vectores, en efecto, tiene por objetivo hacer más eficaz, rentable, ecológicamente sensata y sostenible la lucha contra los vectores.

Approaches to Photoprotection and Normalization in Highly Adherent Families of Children With Xeroderma Pigmentosum in the United Kingdom.

In this study, we examine photoprotection for children with Xeroderma pigmentosum (XP), a rare genetic skin disease requiring rigorous photoprotection, to reduce risks of severe burning and skin cancers from exposure to ultraviolet radiation (UVR). We elicit the views and experiences of both children and their parents to inform the care and support provided. Qualitative semistructured interviews were undertaken with 12 child-parent dyads recruited from the National XP Specialist service in London. We employed a framework approach to analysis. This identified a high level of photoprotection based either on "protection" to facilitate normal activities or "avoidance" of outdoor activity with priority given to normality in the future. These approaches were shaped by perceptions of clinical risk, the emphasis given to a normal family life and families' circumstances and resources. The findings contribute to notions of normalization and coping with demanding care regimens and inform approaches to working with families.

[The St. Petersburg medicine of the late 1820s as seen by London physician].

The article considers the condition of medicine in St. Petersburg in 1827-1828 as presented in memoirs of English physician A. B. Granville about his visiting the capital of Russia. The prominent physician and naturalist, familiar with condition of medicine in main countries of Europe, he provided substantial and objective characteristic of condition of medicine and health care in Russia. This characteristic, coming from independent and competent observer, permits to correct conceptions about condition of Russian medicine during the period when the results of modernization of the Russian Empire of XVIII-early XIX centuries manifested in full measure effecting becoming of Russian school of medicine.

One size does not fit all: Group size and the late middle Pleistocene prehistoric archive.

The role of demography is often suggested to be a key factor in both biological and cultural evolution. Recent research has shown that the linkage between population size and cultural evolution is not straightforward and emerges from the interplay of many demographic, economic, social and ecological variables. Formal modelling has yielded interesting insights into the complex relationship between population structure, intergroup connectedness, and magnitude and extent of population extinctions. Such studies have highlighted the importance of effective (as opposed to census) population size in transmission processes. At the same time, it remained unclear how such insights can be applied to material culture phenomena in the prehistoric record, especially for deeper prehistory. In this paper we approach the issue of population sizes during the time of the Lower to Middle Paleolithic transition through the proxy of regional trajectories of lithic technological change, identified in the archaeological records from Africa, the Levant, Southwestern and Northwestern Europe. Our discussion of the results takes into consideration the constraints inherent to the archaeological record of deep time - e.g., preservation bias, time-averaging and the incomplete nature of the archaeological record - and of extrapolation from discrete archaeological case studies to an evolutionary time scale. We suggest that technological trajectories of change over this transitional period reflect the robustness of transmission networks. Our results show differences in the pattern and rate of cultural transmission in these regions, from which we infer that information networks, and their underlying effective population sizes, also differed.

New bracketing luminescence ages constrain the Sima de los Huesos hominin fossils (Atapuerca, Spain) to MIS 12.

Recent chronological studies of the Sima de los Huesos (SH) hominin fossil site, Atapuerca, Spain, have established a close minimum age of at least 430 ka for sedimentary material immediately overlying the human remains. However, a firm maximum age limit still needs to be established for the SH fossils in order to better constrain the timing for the onset of Neandertal speciation. In the present study, we address this important chronological gap at SH by providing direct ages for the sediment deposits that host, and immediately underlie, the hominin fossils. Depositional ages were obtained using single-grain thermally-transferred optically stimulated luminescence (TT-OSL), a technique that has yielded reliable 'extended-range' luminescence chronologies at several independently dated Atapuerca sites. Four single-grain TT-OSL depositional ages of 453 ± 56 ka, 437 ± 38 ka, 457 ± 41 ka and 460 ± 39 ka were obtained for the red clay lithostratigraphic units (LU-5 and LU-6) found underlying and encasing the SH hominin bones. A Bayesian age-depth model was constructed using previously published chronologies, as well as the new single-grain TT-OSL ages for LU-5 and LU-6, in order to derive combined age estimates for individual lithostratigraphic units preserved at SH. The combined modeled ranges reveal that the hominin-bearing layer (LU-6) was deposited between 455 ± 17 ka and 440 ± 15 ka (mean lower and upper boundary 68.2% probability range ± 1σ uncertainty, respectively), with a mean age of 448 ± 15 ka. These new bracketing ages suggest that the hominin fossils at SH were most likely deposited within Marine Isotope Stage (MIS) 12, enabling more precise temporal constraint on the early evolution of the Neandertal lineage. The SH fossils represent the oldest reliably dated hominin remains displaying Neandertal features across Eurasia. These Neandertal features are first observed in the facial skeleton, including the mandible and teeth, as well as the temporomandibular joint, and appear consistently across the SH collection. Our chronological findings suggest that the appearance of these Neandertal traits may have been associated with the climatic demise of MIS 12 and the ecological changes that occurred in Iberia during this period. Other Middle Pleistocene hominin fossils from Europe dated to MIS 12-11, or later, show different morphological trends, with some lacking Neandertal specializations. The latest SH dating results enable improved temporal correlations with these contrasting hominin records from Europe, and suggest a complex picture for hominin evolution during the Middle Pleistocene.

Micro-CT assessment of dental mineralization defects indicative of vitamin D deficiency in two 17th-19th century Dutch communities.

OBJECTIVES: This study investigates vitamin D deficiency patterns in individuals from birth to the beginning of adolescence. Microscopic computed tomography (micro-CT) evaluation of interglobular dentine (IGD) in teeth provides information on the age of disease onset and the number of deficient periods per individual, which will increase our understanding of factors influencing vitamin D deficiency prevalence, including sociocultural practices and latitude. MATERIALS AND METHODS: Beemster and Hattem, two Dutch 17th-19th century communities, yielded relatively high prevalences of rickets (15-24%) and residual rickets (15-24%). From the affected individuals, a subsample of 20 teeth were selected for micro-CT scanning. Thin sections were made of 17 teeth, consisting of 6 teeth with and 11 teeth without observable IGD on micro-CT that were included for method comparison. RESULTS: About 19 out of 29 (65.5%) individuals (one tooth was deemed unobservable) presented with IGD on micro-CT. Eight of the 11 (72.7%) individuals without IGD on micro-CT demonstrated histologically visible IGD. In 40.7% (11/27) of the affected individuals (combined micro-CT and histology results), vitamin D deficiency was recurrent, and in four individuals, some episodes occurred at approximately annual intervals suggesting vitamin D deficiency was seasonal. In three individuals, IGD occurred in the dentine formed around birth, suggesting maternal vitamin D deficiency. DISCUSSION: Micro-CT analysis of IGD is found to be a valuable non-destructive method that can improve our understanding of the influence of sociocultural practices and latitude on disease development within age and sex groups in past communities.

Low to medium-low risk perception for dengue, chikungunya and Zika outbreaks by infectious diseases physicians in France, Western Europe.

BACKGROUND: Many tropical countries are currently experiencing dengue (DEN), chikungunya (CHIK) and also more recently Zika (ZIKA) epidemics (particularly in Latin America). Although the risk of transmission and spread of these infections in temperate regions remains a controversial issue, vector-borne diseases have been widely reported in the media and have been the focus of preventive strategies by national and international policy-makers and public health authorities. In this context, we wanted to determine the extent of risk perception in infectious diseases (ID) physicians of the current and future risk of arboviral disease introduction, autochthonous case development and epidemic scenarios in France, Western Europe. METHODS: To this aim, we developed an original standardized questionnaire survey which was disseminated by the French Infectious Diseases Society to ID physician members. RESULTS: We found that ID physicians perceived the risk of introduction and outbreak development of DEN, CHIK and ZIKA in France to be low to medium-low. Generalized Linear Model(s) identified medical school training, the extent of professional experience, and awareness of the French national plan regarding arboviral infections as significant predictors for lower risk perception among respondents. CONCLUSION: Despite the fact that arboviral diseases are increasingly being imported into France, sometimes resulting in sporadic autochtonous transmission, French ID physicians do not perceive the risk as high. Better communication and education targeting health professionals and citizens will be needed to enhance the effectiveness of the French national plan to prepare against arboviral diseases.

Can Pallars i Llobateres: A new hominoid-bearing locality from the late Miocene of the Vallès-Penedès Basin (NE Iberian Peninsula).

In the Iberian Peninsula, Miocene apes (Hominoidea) are generally rare and mostly restricted to the Vallès-Penedès Basin. Here we report a new hominoid maxillary fragment with M2 from this basin. It was surface-collected in March 2017 from the site of Can Pallars i Llobateres (CPL, Sant Quirze del Vallès), where fossil apes had not been previously recorded. The locality of provenance (CPL-M), which has delivered no further fossil remains, is located very close (ca. 50 m) to previously known CPL outcrops, and not very far (ca. 500 m in NW direction) from the classical hominoid-bearing locality of Can Poncic 1. Here we describe the new fossil and, based on the size and proportions of the M2, justify its taxonomic attribution to Hispanopithecus cf. laietanus, a species previously recorded from several Vallesian sites of the Vallès-Penedès Basin. Based on the associated mammalian fauna from CPL, we also provide a biochronological dating and a paleoenvironmental reconstruction for the site. The associated fauna enables an unambiguous correlation to the Cricetulodon hartenbergeri - Progonomys hispanicus interval local subzone, with an estimated age of 9.98-9.73 Ma (late Vallesian, MN10). Therefore, CPL-M is roughly coeval with the Hispanopithecus laietanus-bearing localities of Can Llobateres 1 and Can Feu 1, and minimally older than those of La Tarumba 1 and Can Llobateres 2. In contrast, CPL-M is younger than the early Vallesian (MN9) localities of Can Poncic 1 (the type locality of Hispanopithecus crusafonti) as well as Polinyà 2 (Gabarró) and Estació Depuradora d'Aigües Residuals-Riu Ripoll 13, where Hispanopithecus sp. is recorded. The associated fauna from CPL indicates a densely forested and humid paleoenvironment with nearby freshwater. This supports the view that Hispanopithecus might have been restricted to dense wetland forests soon before its extinction during the late Vallesian, due to progressive climatic deterioration. Coupled with the existence of other fossiliferous outcrops in the area, this find is most promising for the prospect of discovering additional fossil hominoid remains in the future.

Parents' Perspectives of Changes Within the Family Functioning After a Pediatric Cancer Diagnosis: A Multi Family Member Interview Analysis.

Pediatric cancer is a life-threatening disease that challenges the life of the diagnosed child, the parents, and possible siblings. Moreover, it also places considerable demands on family life. The aim of this study was to explore changes in the family functioning after a pediatric cancer diagnosis. Ten couples who had a child with leukemia or non-Hodgkin lymphoma were interviewed individually about their experiences. Interviews were semistructured, and the data were analyzed using Multi Family Member Interview Analysis. Three themes emerged from the data: (a) Family Cohesion: Strengthened Versus Fragmented; (b) Educational Norms and Values: Overindulgence Versus Being Stricter, and (c) Normality: Loss Versus Preservation. The conflicting dynamics present in these emerging themes exemplify the complexity of this process of family adaptation. This study illustrates the need to take into account the family level, as well as the conflicting feelings parents may experience after a pediatric cancer diagnosis.

Reaching Independence Through Forced Learning: Learning Processes and Illness Management in Parents of Children Affected by Hemophilia.

Hemophilia is a complex condition to manage, especially for parents to newly diagnosed children. This grounded theory study explores parents' learning processes and illness management in daily life during the first year after the start of their child's treatment. Using a longitudinal qualitative design, eight parents of four children were interviewed repeatedly during 12 to 14 months. The core category, reaching independence through forced learning, reflected the parents' learning process and their experiences of the challenges during the first year after start of treatment. Incentives for learning were characterized by a longing to reach independence and regain control of one's life situation. The emerging key incentive for learning was a desire to become independent of health care professionals. Early home treatment reduced the impact of the illness, and by supporting parents in different ways during the learning process, health care professionals can promote the parents' trajectory toward independency.