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Objectives: Vaccination against human papillomaviruses (HPV) prevents over 70% of precancerous lesions leading to cervical cancer. In 2016 in France, 19.5% of girls aged 16 benefited from a comprehensive immunisation strategy, contrarily to countries like Sweden and Great-Britain where that rate nears 80%. The study aim was to evaluate the impact on HPV vaccination of information given to parents of girls aged 11 to 14.Study design: A descriptive study used questionnaires to evaluate parents’ knowledge and opinion on HPV vaccination before and after reading an information leaflet. It included parents of girls aged 11 to 14 not previously vaccinated against HPV. Results: There were 106 questionnaires analysed. The initial level of information was poor: 10 of 11 questions assessing knowledge scored below 50% of correct answers. After reading the leaflet, knowledge increased significantly while adherence rose by 74%. Among the 51% initially undecided, 20% intended on vaccinating their daughter after being informed. Conclusion: The leaflet enhanced knowledge and strengthened intention to vaccinate. However, parents’ adherence to vaccination remained moderate. Digital information must be provided alongside communication campaigns by healthcare professionals. This requires identifying levers and barriers and adapting vaccination strategies.

Year-to-year extreme alterations in California (CA) precipitation, denoted here as flips, present significant challenges to resource managers, emergency management officials, and the state’s economy and ecosystems generally. We evaluate regional (north, central, and south) and statewide flip behavior since 1571 CE utilizing instrumental data and paleoclimate reconstructions. Flips, defined as dry-to-wet and wet-to-dry consecutive alterations between the tailward 30th percentiles of the precipitation distribution, have occurred throughout this period without indication of systematic change through the recent time of modern anthropogenic forcing. Statewide “grand flips” are notably absent between 1892 and 1957; bootstrap Monte Carlo analysis indicates that this feature is consistent with random behavior. Composites for northeastern Pacific Ocean winter sea level pressure and jet-stream winds associated with flip events indicate anomalous high or low pressure during the core precipitation delivery season for dry or wet flip years, respectively, and jet-stream conditions that are also like those associated with individual dry or wet years. Equatorial Pacific sea surface temperatures play a partial role in both dry-to-wet and wet-to-dry events in central and southern CA in the longer-period reconstruction data, with response restricted primarily to southern CA in the smaller sample-size instrumental data. Knowledge of a prior year extreme, potentially representing initiation of a flip, provides no enhancement of prediction quality for the second year beyond that achievable from skillful seasonal prediction of equatorial Pacific sea surface temperatures. Overall, results indicate that the first-order nature of flip behavior from the later 1500s reflects the quasi–white noise nature of precipitation variability in CA, influenced secondarily by equatorial Pacific sea surface conditions, particularly in southern CA.

The spatial context is critical when assessing present-day climate anomalies, attributing them to potential forcings and making statements regarding their frequency and severity in a long-term perspective. Recent international initiatives have expanded the number of high-quality proxy-records and developed new statistical reconstruction methods. These advances allow more rigorous regional past temperature reconstructions and, in turn, the possibility of evaluating climate models on policy-relevant, spatio-temporal scales. Here we provide a new proxy-based, annually-resolved, spatial reconstruction of the European summer (June–August) temperature fields back to 755 CE based on Bayesian hierarchical modelling (BHM), together with estimates of the European mean temperature variation since 138 BCE based on BHM and composite-plus-scaling (CPS). Our reconstructions compare well with independent instrumental and proxy-based temperature estimates, but suggest a larger amplitude in summer temperature variability than previously reported. Both CPS and BHM reconstructions indicate that the mean 20th century European summer temperature was not significantly different from some earlier centuries, including the 1st, 2nd, 8th and 10th centuries CE. The 1st century (in BHM also the 10th century) may even have been slightly warmer than the 20th century, but the difference is not statistically significant. Comparing each 50 yr period with the 1951–2000 period reveals a similar pattern. Recent summers, however, have been unusually warm in the context of the last two millennia and there are no 30 yr periods in either reconstruction that exceed the mean average European summer temperature of the last 3 decades (1986–2015 CE). A comparison with an ensemble of climate model simulations suggests that the reconstructed European summer temperature variability over the period 850–2000 CE reflects changes in both internal variability and external forcing on multi-decadal time-scales. For pan-European temperatures we find slightly better agreement between the reconstruction and the model simulations with high-end estimates for total solar irradiance. Temperature differences between the medieval period, the recent period and the Little Ice Age are larger in the reconstructions than the simulations. This may indicate inflated variability of the reconstructions, a lack of sensitivity and processes to changes in external forcing on the simulated European climate and/or an underestimation of internal variability on centennial and longer time scales., Support for PAGES 2k activities is provided by the US and Swiss National Science Foundations, US National Oceanographic and Atmospheric Administration and by the International Geosphere-Biosphere Programme. JPWacknowledges support from the Centre of Climate Dynamics (SKD), Bergen. The work of OB, SW and EZ is part of CLISAP. JL, SW, EZ, JPW, JGN, OB also acknowledge support by the German Science Foundation Project ‘Precipitation in the past millennia in Europe–Extensionback toRoman times’.MBacknowledges the Catalan Meteorological Survey (SMC), National Programme I+D, Project CGL2011-28255. PD and RB acknowledge support from the Czech Science Foundation project no. GA13-04291S. VK was supported by Russian Science Foundation (grant 14- 19-00765) and the Russian Foundation for Humanities (grants 15-07-00012, 15-37-11129). GH and AS are supported by the ERC funded project TITAN (EC- 320691). GH was further funded by the Wolfson Foundation and the Royal Society as a Royal Society Wolfson Research Merit Award (WM130060) holder. NY is funded by the LOEWEexcellence cluster FACE2- FACE of the Hessen State Ministry of Higher Education, Research and the Arts; HZ acknowledge support from the DFG project AFICHE. Lamont contribution #7961. The reconstructions can be downloaded from the NOAA paleoclimate homepage: www.ncdc.noaa. gov/paleo/study/19600. LFD, EGB and JFGR were supported by grants CGL2011-29677-c02-02 and CGL2014-599644-R. All authors are part of the Euro- Med 2kConsortium.

The thermometer-based global surface temperature time series (GST) commands a prominent role in the evidence for global warming, yet this record has considerable uncertainty. An independent record with better geographic coverage would be valuable in understanding recent change in the context of natural variability. We compiled the Paleo Index (PI) from 173 temperature-sensitive proxy time series (corals, ice cores, speleothems, lake and ocean sediments, historical documents). Each series was normalized to produce index values of change relative to a 1901–2000 base period; the index values were then averaged. From 1880 to 1995, the index trends significantly upward, similar to the GST. Smaller-scale aspects of the GST including two warming trends and a warm interval during the 1940s are also observed in the PI. The PI extends to 1730 with 67 records. The upward trend appears to begin in the early 19th century but the year-to-year variability is large and the 1730–1929 trend is small.

Introduction: Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Besides esthetic impairments, patients suffer loss of tissue functionality. Although biodegradable surgical sutures present an excellent opportunity to locally deliver bioactive[for full text, please go to the a.m. URL], 130. Kongress der Deutschen Gesellschaft für Chirurgie

Årsliste 2000 Problemer med høye verdier av kimtall (v/20°C, 200-300 pr. ml) i deler av vannforsyningsnettet til Trondheim kommune ble registrert i første halvår 1999. Orienterende undersøkelser for å belyse årsaker og virkninger i denne sammenheng ble utført i perioden april-juli. Begroing/beleggdannelse i vannforsyningssystemet ble analysert med biologiske og kjemiske metoder. Begroingssamfunnet var preget av jernbakterier (Leptothrix spp.), ciliater, zooflagellater og nematoder. Organismene som utviklet seg var til dels indikatorarter for rent vann. For en behandling/kontroll av den hygieniske tilstand i vannforsyningssystemet på kort og lang sikt, er det behov for å fremskaffe et praktisk egnet kunnskapsgrunnlag forankret i de stedegne forhold ved Trondheim kommunes vannforsyning. Trondheim kommune