Recent excavations carried out in the Iberian Peninsula have revealed some skeletons with arrow wounds at sites dating from the neolithic to the Bronze Age. The discovery of burials in which the human remains have not been moved and the methodical nature of the excavation have made an in situ examination possible, and have confirmed this evidence as testimony of violent action, of which there are many other examples all over Europe. Four cases of silex arrowheads found in different human bones from the excavation of the hypogeum of Longar (Navarra, Spain), carried out between 1991 and 1993, are described.

Background Daily attending rounds (AR) are a cornerstone of teaching and patient care in academic health centers. Interruptions in health care are common and can cause increased risk of errors, incomplete work, and decreased decision-making accuracy. Interruptions to AR may diminish a trainee's capacity to learn and retain information. Objective We characterized and quantified interruptions that occur during AR. Methods We used a mixed-methods design combining a prospective observational study with a qualitative study. AR were observed January to March 2020 to characterize interruptions, followed by semi-structured interviews with the observed physicians to elucidate the effect of interruptions on workflow and the educational value of rounds. Results There were 378 observed interruptions over the course of 30 AR sessions, averaging 12.6 (range 1–22, median 13) interruptions per rounding session. Bedside nursing staff was the most common source of interruptions (25%) and consultant recommendations was the most common topic of interruption (21%). Most interruptions occurred during patient presentations (76%), and the most common method of interaction was text message (24%). Most team members described negative effects of interruptions, including loss of focus and missing critical clinical information; some also reported that certain interruptions had positive effects on education and clinical care. Interns were more likely to report negative emotional reactions to interruptions. Conclusions AR are frequently interrupted for non-urgent topics by a variety of methods and sources. Negative effects included loss of focus, missed information, and increased stress. Proactive communication, particularly between physicians and nurses, was suggested to reduce interruptions.