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Medium Term (medium + term)
Selected AbstractsGoverning Emerging Stock Markets: legal vs administrative governanceCORPORATE GOVERNANCE, Issue 1 2005Katharina Pistor Transition economies face a fundamental dilemma. They need to develop financial markets, and yet they lack the ingredients it takes to do so. Recipes for legal governance mechanisms that have worked elsewhere, including reactive law enforcement by courts and proactive law enforcement by regulators, may not help in the short to medium term. Using evidence from stock market development in China and Russia, this paper suggests that at least in the short term, administrative governance may be a viable alternative to legal governance in emerging stock markets. [source] Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: a systematic and narrative review of randomized controlled trialsDIABETIC MEDICINE, Issue 6 2010K. Hawthorne Diabet. Med. 27, 613,623 (2010) Abstract To determine if culturally appropriate health education is more effective than ,usual' health education for people with diabetes from ethnic minority groups living in high- and upper-middle-income countries. A systematic review with meta-analysis, following the methodology of the Cochrane Collaboration. Electronic literature searches of nine databases were made, with hand searching of three journals and 16 author contacts. The criteria for inclusion into the analysis were randomized controlled trials of a specified diabetes health education intervention, and a named ethnic minority group with Type 2 diabetes. Data were collected on HbA1c, blood pressure, and quality-of-life measures. A narrative review was also performed. Few studies fitted the selection criteria, and were heterogeneous in methodologies and outcome measures, making meta-analysis difficult. HbA1c showed an improvement at 3 months [weighted mean difference (WMD) ,0.32%, 95% confidence interval (CI) ,0.63, ,0.01] and 6 months post intervention (WMD ,0.60%, 95% CI ,0.85, ,0.35). Knowledge scores also improved in the intervention groups at 6 months (standardized mean difference 0.46, 95% CI 0.27, 0.65). There was only one longer-term follow-up study, and one formal cost-effectiveness analysis. Culturally appropriate health education was more effective than ,usual' health education in improving HbA1c and knowledge in the short to medium term. Due to poor standardization between studies, the data did not allow determination of the key elements of interventions across countries, ethnic groups and health systems, or a broad view of their cost-effectiveness. The narrative review identifies learning points to direct future research. [source] A systematic review of the effectiveness of smoking relapse prevention interventions for abstinent smokersADDICTION, Issue 8 2010Shade Agboola ABSTRACT Aims To carry out a systematic review of the effectiveness of relapse prevention interventions (RPIs) among abstinent smokers who had completed an initial course of treatment or who had abstained unassisted, pooling only outcome data from similar follow-up time points. Methods We used the same search strategy as was used in Cochrane reviews of RPIs to identify randomized trials of behavioural and pharmacological studies of smoking RPIs published up to July 2008. Abstinence from smoking was defined as either continuous abstinence or point prevalence abstinence, measured at three follow-up time points: short term (1,3 months post randomization), medium term (6,9 months) and long term (12,18 months). Abstinence among pregnant/postpartum women was also measured at delivery or the last follow-up prior to delivery. Random effect meta-analysis was used to estimate pooled odds ratios (OR) with 95% confidence intervals (CI). Results Thirty-six studies randomizing abstainers were included. Self-help materials appeared to be effective in preventing relapse at long-term follow up in initially unaided quitters (pooled OR 1.52; 95% CI 1.15 to 2.01, I2 = 0%, NNT = 11, 3 studies). Other behavioural interventions for relapse prevention appeared effective in the short term only. There were positive results for the use of pharmacotherapies for relapse prevention. Bupropion was effective at long-term follow-up (pooled OR 1.49; 95% CI 1.10 to 2.01; I2 = 0%; NNT = 11; 4 studies). Nicotine replacement therapy (NRT) was effective at medium-term (pooled OR 1.56; 95% CI 1.16 to 2.11; I2 = 37%; NNT = 14; 4 trials) and long-term follow-ups (pooled OR 1.33; 95% CI 1.08 to 1.63; I2 = 0%; NNT = 20; 4 trials). Single trials of extended treatment of Varenicline and rimonabant were also found to be effective at short-term and medium-term follow-ups. Conclusions Self-help materials appear to prevent relapse in initially unaided quitters. Use of NRT, bupropion and varenicline appears to be effective in preventing relapse following an initial period of abstinence or an acute treatment episode. There is currently no good evidence that behavioural support prevents relapse after initial unaided abstinence or following an acute treatment period. [source] The Impact of Uncertainty ShocksECONOMETRICA, Issue 3 2009Nicholas Bloom Uncertainty appears to jump up after major shocks like the Cuban Missile crisis, the assassination of JFK, the OPEC I oil-price shock, and the 9/11 terrorist attacks. This paper offers a structural framework to analyze the impact of these uncertainty shocks. I build a model with a time-varying second moment, which is numerically solved and estimated using firm-level data. The parameterized model is then used to simulate a macro uncertainty shock, which produces a rapid drop and rebound in aggregate output and employment. This occurs because higher uncertainty causes firms to temporarily pause their investment and hiring. Productivity growth also falls because this pause in activity freezes reallocation across units. In the medium term the increased volatility from the shock induces an overshoot in output, employment, and productivity. Thus, uncertainty shocks generate short sharp recessions and recoveries. This simulated impact of an uncertainty shock is compared to vector autoregression estimations on actual data, showing a good match in both magnitude and timing. The paper also jointly estimates labor and capital adjustment costs (both convex and nonconvex). Ignoring capital adjustment costs is shown to lead to substantial bias, while ignoring labor adjustment costs does not. [source] How sustainable is the Japanese recovery?ECONOMIC OUTLOOK, Issue 4 2004Article first published online: 14 OCT 200 For nearly two years the Japanese economy has grown significantly faster than commentators expected, raising the question of whether the country has finally broken out of its long economic malaise. This article by Simon Knapp examines recent developments to see whether this recovery is sustainable. It argues that over the last year the recovery has broadened out beyond merely the export sector, although there are good reasons to believe that growth as measured by GDP has been overstated and that many serious structural problems remain. Business investment has surged on the back of rising profitability and an improved labour market has helped lift consumer confidence. At the same time the paper recognises the importance of China's boom in stimulating the Japanese economy over the last two years, and estimates that this factor may have boosted the level of GDP by between 1 to 2%. With Chinese growth now moderating to more sustainable levels, export growth will slow over the next year or so. However, domestic demand should now be strong enough, in the absence of major external shocks, to generate GDP growth of around 1.5 to 2% per annum in the medium term; a respectable figure given the country's falling population. [source] Prospects for the Euro: Why has it been so weak?ECONOMIC OUTLOOK, Issue 1 2001Stephen Hall In this article, Stephen Hall and Brian Henry consider the reasons for the Euro's weakness since its introduction and ask what are the likely prospects for a recovery to near-fundamental levels over the medium term. They conclude that the major factor leading to the currency's depreciation since 1999 has been a rise in the risk premium surrounding the Euro. A successful launch of Euro notes and coins may help to eliminate this premium. [source] What is Changing in Academic Research?EUROPEAN JOURNAL OF EDUCATION, Issue 2 2006Futures Scenarios, Trends What is changing in academic research? What has changed over the past decades and what might change in the coming ones? Could the research mission of universities be carried out in slightly or radically different ways in the medium term? This article aims to cast light on the trends and driving forces that can be observed in academic research over the past two decades in the OECD area. It gives an outlook of the main current characteristics of academic research at a macro level in terms of funding and activities in comparison with research performed by other sectors. It also highlights future challenges and sketches a few possible futures scenarios in a 20-year time frame. [source] Sequestration and turnover of plant- and microbially derived sugars in a temperate grassland soil during 7 years exposed to elevated atmospheric pCO2GLOBAL CHANGE BIOLOGY, Issue 2 2007MICHAEL BOCK Abstract Temperate grasslands contribute about 20% to the global terrestrial carbon (C) budget with sugars contributing 10,50% to this soil C pool. Whether the observed increase of the atmospheric CO2 concentration (pCO2) leads to additional C sequestration into these ecosystems or enhanced mineralization of soil organic matter (SOM) is still unclear. Therefore, the aim of the presented study was to investigate the impact of elevated atmospheric pCO2 on C sequestration and turnover of plant- (arabinose and xylose) and microbially derived (fucose, rhamnose, galactose, mannose) sugars in soil, representing a labile SOM pool. The study was carried out at the Swiss Free Air Carbon Dioxide Enrichment (FACE) experiment near Zurich. For 7 years, Lolium perenne swards were exposed to ambient and elevated pCO2 (36 and 60 Pa, respectively). The additional CO2 in the FACE plots was depleted in 13C compared with ambient plots, so that ,new' (<7 years) C inputs could be determined by means of compound-specific stable isotope analysis (13C : 12C). Samples were fractionated into clay, silt, fine sand and coarse sand, which yielded relatively stable and labile SOM pools with different turnover rates. Total sugar sequestration into bulk soil after 7 years of exposure to elevated pCO2 was about 28% compared with the control plots. In both ambient and elevated plots, total sugar concentrations in particle size fractions increased in the order sand Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapyHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2005Paula Ravasco MD Abstract Background. We aimed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer, specifically, nutritional outcome, morbidity, and quality of life (QOL), during and 3 months after radiotherapy. Methods. Seventy-five patients with head and neck cancer who were referred for radiotherapy (RT) were randomized to the following groups: group 1 (n = 25), patients who received dietary counseling with regular foods; group 2 (n = 25), patients who maintained usual diet plus supplements; and group 3 (n = 25), patients who maintained intake ad lib. Nutritional intake (determined by diet history) and status (determined by Ottery's Subjective Global Assessment), and QOL (determined by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 [EORTC QLQ-C30]) were evaluated at baseline, at the end of RT, and at 3 months. Results. Energy intake after RT increased in both groups 1 and 2 (p , .05). Protein intake also increased in both groups 1 and 2 (p , .006). Both energy and protein intake decreased significantly in group 3 (p < .01). At 3 months, group 1 maintained intakes, whereas groups 2 and 3 returned to or below baseline levels. After RT, >90% of patients experienced RT toxicity; this was not significantly different between groups, with a trend for reduced symptomatology in group 1 versus group 2/group 3 (p < .07). At 3 months, the reduction of incidence/severity of grade 1+2 anorexia, nausea/vomiting, xerostomia, and dysgeusia was different: 90% of the patients improved in group 1 versus 67% in group 2 versus 51% in group 3 (p < .0001). After RT, QOL function scores improved (p < .003) proportionally with improved nutritional intake and status in group 1/group 2 (p < .05) and worsened in group 3 (p < .05); at 3 months, patients in group 1 maintained or improved overall QOL, whereas patients in groups 2 and 3 maintained or worsened overall QOL. Conclusions. During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Agricultural land use and Skylark Alauda arvensis: a case study linking a habitat association model to spatially explicit change scenariosIBIS, Issue 1 2010NIGEL D. BOATMAN The development of forward scenarios is a useful method of envisaging the environmental implications of potential changes in land use, as a tool for policy development. In this paper, a spatially explicit case study is used to provide insight into the environmental impacts of Common Agricultural Policy reform on Skylark Alauda arvensis, a species which is widespread on arable farmland, breeds in crops and has declined in recent decades. A generalized linear mixed model was used to estimate Skylark breeding population densities in different crops, using survey data collected from farms in the east of England, supplemented by the literature. Model outputs were then used to predict Skylark densities in an East Anglian Joint Character Area dominated by arable cropping. Predicted densities were mapped at field level using GIS, based on actual cropping derived from Integrated Administration and Control System data collected for the administration of subsidy payments. Three future scenarios were then created, based on expert opinion of potential changes in cropping over the next 5 years, and potential changes in Skylark density mapped on the basis of the predicted changes in cropping patterns. Overall, Skylark densities were predicted to decrease on average by 11,14% under ,market-led' (increasing wheat and oilseed rape, reduced set-aside) and ,energy crop' (5% area under short rotation coppice) scenarios, but remained virtually unchanged under an ,environment-led' (diverse cropping) scenario. The ,market-led' scenario is closest to short-term agricultural trajectories, but wider cultivation of biomass energy crops as modelled under the ,energy crop' scenario could occur in the medium term if energy policies are favourable. Appropriate mitigation strategies therefore need to be implemented if a continued decline in the Skylark population on lowland arable farmland is to be averted. The results provide a readily accessible visualization of the potential impacts of land-use change for policy-makers; similar techniques could be applied to visualize effects of changes arising through other drivers, including climate change. [source] Cytotoxicity analysis of EDTA and citric acid applied on murine resident macrophages cultureINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2007K. F. Amaral Abstract Aim, To assess the ex vivo cytotoxicity of EDTA and citric acid solutions on macrophages. Methodology, The cytotoxicity of 17% EDTA and 15% citric acid was evaluated on murine macrophage cultures using MTT-Tetrazolium method [3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide]. A total of 5 × 105 cells were plated in medium culture with 17% EDTA or 15% citric acid. Fresh medium was used as a control. Toxicity values were analysed statistically by anova and Tukey's test (P < 0.05) at short (0, 6, 12, 24 h) and medium periods (1, 3, 5, 7 days), using ELISA absorbance. Results, On the short term, both EDTA (0.253 nm) and citric acid (0.260 nm) exhibited cytotoxic effects on macrophage cultures (P < 0.05). On the medium term, statistical differences were observed (P < 0.05) between the groups. EDTA (0.158 nm) and citric acid (0.219 nm) were cytotoxic when compared with the control group; EDTA-reduced macrophage viability significantly more than citric acid (P < 0.05). Conclusions, Both EDTA and citric acid had effects on macrophages cells ex vivo, but citric acid was less toxic in periods from 1 to 7 days of use. [source] An overview of the Turkish dairy sectorINTERNATIONAL JOURNAL OF DAIRY TECHNOLOGY, Issue 1 2008SERTAÇ GÖNENÇ The livestock sector and dairy subsector have great importance for Turkey, in terms of both nutrition and economy. The share of the livestock sector in the total agricultural production value has varied between 25% and 30% in the last three decades. Raw milk production is characterized by small-scale farms, with an average of three heads of dairy cattle per farm. Turkey's dairy industry was established and developed by the State with the opening of the Turkish Dairy Industry Institution (TSEK) in 1963 as a state-owned enterprise (SOE). TSEK facilitated modernization of the sector, created a dairy market and played a role in stabilizing the consumer and producer prices. In 1995, a liberalization movement in the agricultural sector started in Turkey and the TSEK enterprises were privatized. After privatization, producer prices decreased between 11.51% and 18.45% and consumer prices of dairy products increased in general. Today, the dairy processing sector has a dual structure that on one hand comprises many small- and medium-sized enterprises, while on the other features seven large holding companies that hold the largest market share (CR4 71). This study aims to show that the restructuring of the agricultural SOEs in the first place resulted in undesirable impacts, and thus that the planning and implementation of the privatization of the state enterprises in the dairy sector should be taken as a strategy in the medium term, using the experiences of other developing countries. [source] ,Close-to-Balance or in Surplus': A Policy-Maker's Guide to the Implementation of the Stability and Growth PactJCMS: JOURNAL OF COMMON MARKET STUDIES, Issue 4 2000Michael J. Artis Under the Stability and Growth Pact, countries are committed to achieve medium-term budget positions of ,close-to-balance or in surplus'. The rationale for this commitment is that such budgetary positions would allow for the full working of the built-in stabilizers without triggering the sanctions procedures of the Pact. This article sets out to show how quantifications of the medium-term (structural) requirement can accommodate the desired aim and suggests how fiscal measurement and forecasting errors as well as the budgetary effects of ageing may be allowed for. All in all, broadly balanced budgets in the medium term appear to be ,roughly right' for most euro-zone countries. Of course, as the cyclical behaviour of the euro-zone economy adapts to the new EMU environment, the medium-term targets will need to be addressed again. [source] Spatial relationships between intensive land cover and residual plant species diversity in temperate farmed landscapesJOURNAL OF APPLIED ECOLOGY, Issue 6 2006SIMON M. SMART Summary 1In temperate farmed landscapes conservation policies increasingly emphasize large-scale reductions in land-use intensity. Yet despite a managed reversion to more favourable abiotic conditions, depleted regional species pools may prevent the re-assembly of target communities. 2Using national-scale survey data recorded across Great Britain in 1998, we investigated the extent to which grassland indicator plant species persisted on potential refuge habitats across a spatial gradient of intensive land cover in lowland 1-km squares. These habitats comprised road verges, field boundaries, watercourse banks and small biotope fragments. Intensive land cover comprised built land, arable and improved grassland. 3The rate of reduction in indicator species richness across the intensive land cover gradient was significantly lower in all potential refuge features than in surrounding fields and larger areas of habitat. 4The best refuge locations were watercourse banks and small biotopes. In both cases, indicator species richness was higher than adjacent fields at the lowest intensive land cover and stayed higher as intensive land cover increased. 5However, as intensive land cover increased, plant traits associated with higher nutrient availability were more prominently represented among indicator species. 6Although richer assemblages of indicator species persisted on refuge features, population sizes are likely to be small, because of species,area effects, and also vulnerable to nutrient surpluses and reduced or inappropriate disturbance. 7Synthesis and applications. Across the British lowlands, linear landscape features and small habitat fragments can provide limited safe havens for unimproved grassland plant species. However, the identity of refuge features and their species richness and composition are likely to vary with local conditions. Three activities are therefore paramount in assessing their role in larger scale extensification schemes: (i) development of rapid ways of assessing the plant diversity and distribution of refuge features in local areas; (ii) quantification of the risks posed to the viability of residual source populations through implementation of different options for incorporating them into extensification schemes; (iii) maximization of scheme performance by targeting landscapes with sufficient residual diversity to enable increases in population size of the target species in the medium term. [source] Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factorsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2009S.-A. Cooper Abstract Introduction Aggressive behaviours can be disabling for adults with intellectual disabilities (ID), with negative consequences for the adult, their family and paid carers. It is surprising how little research has been conducted into the epidemiology of these needs, given the impact they can have. This study investigates point prevalence, 2-year incidence and 2-year remission rates for aggressive behaviour (physically aggressive, destructive and verbally aggressive), and it investigates which factors are independently associated with aggressive behaviour. Methods All adults with ID , within a geographically defined area of Scotland, UK , were recruited to a longitudinal cohort. At baseline, assessments were undertaken of demography, lifestyle, supports, development, problem behaviours, disabilities and physical and mental health. These were repeated for a 2-year period. Results At baseline, the participation rate was 1023 (65.5%). After 2 years, the cohort retention was 651 adults. The point prevalence of Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) aggressive behaviour was 9.8% (95% confidence interval = 8.0,11.8%), 2-year incidence was 1.8%, and 2-year remission rate from all types of aggressive behaviour meeting DC-LD criteria was 27.7%. The factors independently associated with aggressive behaviours were lower ability, female gender, not living with a family carer, not having Down syndrome, having attention-deficit hyperactivity disorder and having urinary incontinence. Incidence of aggressive behaviour meeting DC-LD criteria in adult life is similar to that for each of psychotic, anxiety and organic disorders. Conclusions Aggressive behaviour is common among adults with ID, but contrary to previous suggestions, more than a quarter remit within the short to medium term. This is important knowledge for professionals as well as the person and her/his family and paid carers. There is much yet to learn about the mechanisms underpinning aetiology and maintenance of aggressive behaviour in this population, and exploratory epidemiological investigations such as this have a role to play in progressing research towards further hypothesis testing and trials to influence clinical practice, service development and policy. [source] ORIGINAL ARTICLE: Long-term outcomes of vertebroplasty for osteoporotic compression fracturesJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2010J Thillainadesan Abstract Introduction: This study aimed to determine outcomes of percutaneous vertebroplasty for osteoporotic vertebral compression fractures (VCFs). Methods: Prospective assessment of short-term (,6 weeks), medium-term (6 months) and long-term (29 months) outcomes of vertebroplasty, followed by a retrospective long-term follow-up of patients treated with vertebroplasty compared with conservative therapy. Outcomes measured were visual analogue scale pain scores, analgesic use, disability scores using the Roland Morris Disability questionnaire and a number of new VCFs. Results: In 27 patients with acute VCFs followed prospectively, vertebroplasty resulted in significant reductions in pain levels (56-mm reduction on a 100-mm scale) and disability scores (11.8-point reduction on a 24-point scale) at all follow-up points up to a mean of 29 months compared with pre-vertebroplasty levels (P < 0.001). Analgesic use was significantly less intense in the short and medium term after vertebroplasty (P < 0.005). In 25 patients who had vertebroplasty for VCF, a sustained reduction in all outcomes was demonstrated at a mean follow-up of 30 months, with less pain, significantly lower disability scores (P < 0.05) and less analgesic use (P < 0.05) compared with nine conservatively treated subjects. During the follow-up period, six new VCFs occurred in 4/25 vertebroplasty patients compared with four new VCFs in 2/9 control subjects. Conclusions: Vertebroplasty provides significant and clinically meaningful reductions in pain, analgesic use, and disability in the short, medium and long term. Compared with conservative therapy, vertebroplasty provides significantly greater functional improvement and reduction in analgesic use. The procedure is relatively safe with no clearly increased risk of new vertebral fractures. [source] Introduction of a High-Energy Diet Acutely Up-Regulates Hypothalamic Cocaine and Amphetamine-Regulated Transcript, Mc4R and Brown Adipose Tissue Uncoupling Protein-1 Gene Expression in Male Sprague-Dawley RatsJOURNAL OF NEUROENDOCRINOLOGY, Issue 1 2005Z. A. Archer Abstract Obesity is an escalating problem in Western societies. Susceptibility to weight gain within an obesogenic environment is variable. It remains unclear how the range of weight gain responses are generated. It is possible that an individual's immediate and/or sustained appetite for apparently palatable foods, or metabolic adaptations to a new diet could be important. The present study therefore examined the short- to medium-term effects of a high-energy (HE) diet on bodyweight, food intake, and energy balance-related signalling systems. Sprague-Dawley rats were fed either chow or an HE diet for 12 h, 24 h, 48 h or 14 days. Blood hormones and metabolites were assayed, and expression of uncoupling protein-1 (UCP-1) and hypothalamic energy-balance related genes were determined by Northern blotting or in situ hybridisation, respectively. Short-term exposure (12 h, 24 h, 48 h) to the HE diet had no effect on grams of food consumed, but caloric intake was increased. Exposure to HE diet for 14 days (medium term) established a bodyweight differential of 7.7 g, and animals exhibited a transient increase in caloric intake of 5 days duration. Terminal levels of leptin, insulin, glucose and non-esterified fatty acids (NEFAs) were all increased in HE-fed animals. UCP-1 mRNA was elevated in interscapular brown adipose tissue from HE-fed rats only at 12 h. Cocaine and amphetamine-regulated transcript (CART) and Mc4R gene expression in the hypothalamus were increased after 12 h and 24 h on an HE diet, respectively. The rats appear to passively over-consume calories as a result of consuming a similar weight of a more energy dense food. This evokes physiological responses, which adjust caloric intake over several days. Circulating NEFA and insulin concentrations, UCP-1, Mc4R and CART gene expression are increased as an immediate consequence of consuming HE diet, and may be involved in countering hypercaloric intake. Circulating leptin is increased in the HE-fed animals after 48 h, reflecting their increasing adiposity. [source] National identity in Northern Ireland: stability or change?NATIONS AND NATIONALISM, Issue 4 2007JOHN COAKLEY ABSTRACT. This article addresses a set of fundamental, long-term factors associated with the Northern Ireland conflict: the pattern of underlying values and attitudes, especially those related to identity, that have helped to shape the nature of intercommunal competition. Using all generally available public opinion data, the article explores in particular the nature of national identity and of related forms of belonging for political behaviour. It notes the mutually reinforcing character of political loyalties within the Protestant community (where national identity, communal affiliation, constitutional preference and party support tend to coincide in a ,Protestant-unionist' package) and the failure of this to be matched within the Catholic community (where the components of the ,Catholic-nationalist' package are less closely interrelated). It concludes by speculating about the implications of these value configurations for political development, suggesting that they are unlikely to contribute to any fundamental political change in Northern Ireland in the short or medium term. [source] Enteric neurodegeneration in ageingNEUROGASTROENTEROLOGY & MOTILITY, Issue 4 2008M. Camilleri Abstract, The objective of this article is to review the clinical presentation and neurobiology of degeneration of the enteric nervous system with emphasis on human data where available. Constipation, incontinence and evacuation disorders are frequently encountered in the ageing population. Healthy lower gastrointestinal function is essential for successful ageing as it is critical to maintaining independence and autonomy to pursue further activity. One clinical expression of enteric neurodegeneration is constipation. However, the aetiology may be multifactorial as disturbances of epithelial, muscle or neural function may all result from neurodegeneration. There is evidence of loss of excitatory (e.g. cholinergic) enteric neurons and interstitial cells of Cajal, whereas inhibitory (including nitrergic) neurons appear unaffected. Understanding neurodegeneration in the enteric nervous system is key to developing treatments to reverse it. Neurotrophins have been shown to accelerate colonic transit and relieve constipation in the medium term; they are also implicated in maintenance programmes in adult enteric neurons through a role in antioxidant defence. However, their effects in ageing colon require further study. There is evidence that 5-HT2 and 5-HT4 mechanisms are involved in development, maintenance and survival of enteric neurons. Further research is needed to understand and potentially reverse enteric neurodegeneration. [source] Food Price Surges: Possible Causes, Past Experience, and Longer Term RelevancePOPULATION AND DEVELOPMENT REVIEW, Issue 4 2008Nikos Alexandratos The food price surges of recent years have created much misery and raised once again the Malthusian specter. Increases in the demand for food in the emerging economies, particularly China and India, have frequently been identified as the dominant factor behind a perceived shock on the demand side. Use of crops for biofuels was listed as an additional, though less important, factor. Yet global cereals utilization without biofuels has been growing at slowly decelerating rates, as in the past. It is the addition of biofuels that has resulted in its growing faster than in the past. In parallel, global production had been falling behind utilization for several years, leading to declining stocks. Weather shocks, depreciation of the dollar, and turbulence in the financial markets were added to these fundamentals of the supply,demand balance to generate the price surges. If energy prices remain high and/or rising and pro-biofuel policies remain in place, the diversion of crops to biofuels is likely to continue. This could prevent the current commodity cycle from unfolding in the "normal" way over the short to medium term with prices trending back toward their pre-surge levels. Conclusions are drawn about how these developments should influence the way we assess long-term food and agriculture prospects. [source] Exploring consumer knowledge structures using associative network analysisPSYCHOLOGY & MARKETING, Issue 4 2010Thorsten A. Teichert This paper offers a new perspective on consumer knowledge analysis that combines Human Associative Memory (HAM) models from cognitive psychology with network analytic approaches in order to gain deeper insights into consumers" mental representations, such as brand images. An illustrative case study compares the associative networks of a manufacturer brand with a retail brand and is used to demonstrate the application and interpretation of various network measures. Network analysis is conducted on three levels: Node-level analysis yields insights about salient brand image components that can be affected through short-term marketing activities. Group-level analysis is concerned with brand image dimensions that characterize a brand and can be strategically influenced in the medium term. Finally, network-level analysis examines the network structure as a whole, drawing parallels to brand imagery, which needs to be managed over the long term. Management implications are derived and suggestions for further research are provided. © 2010 Wiley Periodicals, Inc. [source] When soft regulation is not enough: The integrated pollution prevention and control directive of the European UnionREGULATION & GOVERNANCE, Issue 3 2010Charalampos Koutalakis Abstract Recent debates regarding the effectiveness of regulatory policymaking in the European Union (EU) focus on the merits of soft, non-binding forms of regulation between public and private actors. The emergence of less coercive forms of regulation is analyzed as a response to powerful functional pressures emanating from the complexity of regulatory issues, as well as the need to secure flexibility and adaptability of regulation to distinctive territorial economic, environmental, administrative, and social conditions. In this article we empirically assess the above normative claims regarding the effectiveness of soft regulation vis-à-vis uniformly binding legislation. We draw on an exploratory investigation of the application of the Integrated Pollution Prevention and Control Directive of the EU in four countries. Our study reveals that effectiveness in the application of soft policy instruments is largely contingent upon strong cognitive, material, and political capacities of both state regulators and industrial actors involved in regulatory policymaking. In the absence of those conditions, the application of soft, legally non-binding regulation may lead to adverse effects, such as non-compliance and the "hollowing out" of the systems of environmental permits to industry. In the medium term, such developments can undermine the normative authority of the EU. [source] Democracy, Diversification and Growth Reversals,THE ECONOMIC JOURNAL, Issue 540 2009David Cuberes There is much evidence that less democratic countries experience more high-frequency growth volatility. In this article we report a similar finding about volatility in the medium term: we find evidence that reversals of trend-growth are sharper and more frequent in non-democracies. Motivated by this evidence, we construct a model in which non-democracies have high barriers to entry for new firms. This leads to less sectoral diversification and so, in an uncertain environment, to larger growth swings in less democratic countries. We present empirical evidence that confirms the positive relation between democracy and industrial diversification. [source] Investigating the Balassa-Samuelson hypothesis in the transition: Do we understand what we see?THE ECONOMICS OF TRANSITION, Issue 2 2002A panel study This paper studies the Balassa-Samuelson (B-S) effect in the Czech Republic, Hungary, Poland, Slovakia and Slovenia. We use time series and panel cointegration techniques and show that the B-S effect works reasonably well in the transition economies under study during the period from 1991:Q1 to 2001:Q2. However, we find, that productivity growth does not fully translate into price increases because of the construction of the CPI indexes. We therefore argue that productivity growth will not hinder meeting the Maastricht criterion on inflation in the medium term. In addition, the observed appreciation of the CPI-deflated real exchange rate is found to be systematically higher compared with the real appreciation the B-S effect could justify, especially in the cases of the Czech Republic and Slovakia. This can be partly explained by the trend appreciation of the tradable price-based real exchange rate, increases in non-tradable prices due to price liberalization and demand-side pressures and the evolution of the nominal exchange rate determined by the nature of the exchange rate regime and the magnitude of capital inflows. JEL classification: E31, F31, O11, P17, [source] Retention of drug administration skills after intensive teachingANAESTHESIA, Issue 4 2008D. W. Wheeler Summary We have identified deficiencies in medical students' drug administration skills, and we attempted to address them with interactive online teaching modules and simulated critical incident scenarios. Short-term improvements have been evident with this intensive effort, but medium-term retention of skills has not been measured. A drug administration lecture, an online module and a simulated emergency scenario were offered to final year clinical students. None of the teaching was compulsory but participation was recorded, along with students' simulator performances and marks in an objective structured practical examination 9 months later. A poor simulator score predicted a poor performance in the later examination. Participation in the simulated scenario only significantly improved examination scores when supplemented by online teaching (p = 0.002). Intensive drug administration teaching using an online module and high fidelity simulation improves drug administration skills in the medium term. Students found simulation much more engaging than online teaching. [source] Prosthesis related sepsis following laparoscopic adjustable gastric bandingANZ JOURNAL OF SURGERY, Issue 7-8 2010Michael Facek Abstract Background:, Laparoscopic adjustable gastric banding (LAGB) is well-recognized as a superior method to achieving durable weight loss in the medium term when compared with non-surgical methods of weight loss. In this paper, we described the clinical presentation and outcomes of patients presenting with band or band-adjustment reservoir sepsis from our series from a single institution. Methods:, We conducted a retrospective review of prospectively collected clinical, anthropometric and biochemical data from patients who underwent LAGB placement over a five-year period at a metropolitan teaching hospital. Those patients requiring surgical intervention for prosthesis-related sepsis were included in the review. Results:, Of the 445 patients in this series, 10 (2.2%) developed prosthesis sepsis and required operative intervention. Three (0.7%) presented with reservoir sepsis requiring removal of the reservoir. One had band erosion identified and the entire prosthesis removed. In seven (1.5%) of the patients, infections occurred at the gastric band. Two patients presented with purulent peritonitis and underwent immediate band removal. The remainder presented with band abscesses and either had their band removed (three patients) or left in position and the sepsis treated with drainage and antibiotics (two patients). Conclusions:, In our current series, a small proportion of LAGB patients developed prosthesis-related infection that typically required port or band removal and usually occurred early in the post-operative course. We have modified our prophylactic antibiotic regime and surgical technique as a result of this review. In selected cases of band infection, bands were salvaged with subsequent acceptable weight loss, suggesting that LAGB salvage in the presence of sepsis may be achievable in some patients. [source] BT02 LAPAROSCOPIC SLEEVE GASTRECTOMY AS A SINGLE-STAGE BARIATRIC PROCEDUREANZ JOURNAL OF SURGERY, Issue 2009T. Sammour Purpose: , Laparoscopic sleeve gastrectomy is increasingly being recognised as a stand-alone procedure in bariatric surgery, with long term follow-up data now emerging. We present our early experience patients with a mean BMI in the super-obese range. Methodology: , Retrospective review of laparoscopic sleeve gastrectomies performed by two surgeons at Middlemore Hospital, between March 2007 and July 2008. Results: , One hundred and one patients were identified, with a mean age of 42.7 years (95% CI 40.9,44.5). Maori and Pacific Islanders made up 31% of the patient subset. Patients had a mean BMI of 50.2 kg/m2 (95% CI 48.8,51.7), and 45 patients were super-obese. They had a median hospital stay of 2 days (1,7 days), and a mean follow-up of 6.0 months. Mean excess BMI loss (excluding patients with a major complication) was 46% (95% CI 43.3,48.7). 64% of diabetics and 37% of hypertensives showed in an improvement in medication requirement. There was a major complication rate of 8%, including 3 staple line leaks (one of which required laparotomy), 2 staple line bleeds (one requiring laparotomy), 1 infected haematoma, and 1 critical stricture. There were no deaths. Conclusion: , Laparoscopic sleeve gastrectomy has achieved satisfactory weight-loss results with an acceptable complication rate in the short to medium term. [source] Integrating ecology with hydromorphology: a priority for river science and managementAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 1 2009I.P. Vaughan Abstract 1.The assessment of links between ecology and physical habitat has become a major issue in river research and management. Key drivers include concerns about the conservation implications of human modifications (e.g. abstraction, climate change) and the explicit need to understand the ecological importance of hydromorphology as prescribed by the EU's Water Framework Directive. Efforts are focusing on the need to develop ,eco-hydromorphology' at the interface between ecology, hydrology and fluvial geomorphology. Here, the scope of this emerging field is defined, some research and development issues are suggested, and a path for development is sketched out. 2.In the short term, major research priorities are to use existing literature or data better to identify patterns among organisms, ecological functions and river hydromorphological character. Another early priority is to identify model systems or organisms to act as research foci. In the medium term, the investigation of pattern,processes linkages, spatial structuring, scaling relationships and system dynamics will advance mechanistic understanding. The effects of climate change, abstraction and river regulation, eco-hydromorphic resistance/resilience, and responses to environmental disturbances are likely to be management priorities. Large-scale catchment projects, in both rural and urban locations, should be promoted to concentrate collaborative efforts, to attract financial support and to raise the profile of eco-hydromorphology. 3.Eco-hydromorphological expertise is currently fragmented across the main contributory disciplines (ecology, hydrology, geomorphology, flood risk management, civil engineering), potentially restricting research and development. This is paradoxical given the shared vision across these fields for effective river management based on good science with social impact. A range of approaches is advocated to build sufficient, integrated capacity that will deliver science of real management value over the coming decades. Copyright © 2007 John Wiley & Sons, Ltd. [source] Potential Payoff from R&D in the Coconut Industry of North Sulawesi, IndonesiaASIAN ECONOMIC JOURNAL, Issue 1 2010Benjamin Henderson D58; O13; O18 The coconut industry of North Sulawesi, one of the primary coconut-producing provinces of Indonesia, is dominated by a small number of products that are primarily exported overseas. As they only comprise a small share of the global coconut product export market, demand for coconut products from North Sulawesi is generally very elastic. Conversely, the supply of coconuts is highly inelastic, especially in the short to medium term. Hence, small shifts in supply and demand lead to large fluctuations in farmer incomes. In this context, an equilibrium displacement model is used to examine the intra-industry consequences of R&D investments in farm productivity and product development. These investments are assessed in terms of the producer surplus benefits that they generate. [source] Picking up the pieces: local government reorganisation and voluntary sector children's servicesCHILDREN & SOCIETY, Issue 2 2000Gary Craig Between 1995 and 1998, most of British local government was reorganised, leading to the creation of more, generally smaller, local authorities. Although social services were then the direct responsibility of local government, the potential impact of reorganisation on social work departments and partner organisations was barely considered prior to reorganisation. This article explores the consequences of reorganisation for children's services provided by voluntary sector organisations in Scotland, England and Wales. Drawing on two separate but complementary studies, the paper reviews the impact on funding, boundary problems, changing structures and the fragmentation of local authorities. It concludes that although some advances may be stimulated in the medium term by reorganisation, the overall short-term impact for projects and their users is likely to have been damaging. Copyright © 2000 John Wiley & Sons, Ltd. [source]
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