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Main Changes (main + change)
Selected AbstractsTHE CHANGING STRUCTURE OF THE CENTRAL PLACE SYSTEM IN TRØNDELAG, NORWAY, OVER THE PAST 40 YEARS , VIEWED IN THE LIGHT OF OLD AND RECENT THEORIES AND TRENDSGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 2007Britt Dale ABSTRACT. The IGU Symposium on Urban Geography in Lund in 1960 was a path-breaking event towards new nomothetic thinking within the discipline. In nearly half of the papers, the state of the art in central place research was presented and debated. The symposium was the main source of inspiration for a study of the central place system in Midt-Norge in the 1960s, a research project that has been followed up in stages over a 40-year period. The result is a unique collection of data, covering all central places in the region and the location of approximately 200 service functions of different categories in the 1960s, 1980s and c. 2000. Despite the profound changes that have taken place on the part of the consumer, as well as the supplier, the main structure of the central place hierarchy has been surprisingly stable. However, when looking at the growth and decline of each of the different service functions, considerable dynamics have been found. There are tendencies of centralization/concentration as well as decentralization/dispersion. Furthermore, the functional division of labour by vertical steps and tiers in the 1960s has been supplemented by horizontal specialization between places, and also in the lower levels of the central place hierarchy. In this paper, we present and discuss some of the main changes that have taken place in the system in the light of older and newer theories and trends. [source] From Tyrannosaurus to Pokemon: autonomy in the teaching of writingLITERACY, Issue 1 2001Lynda Graham This article is about action research into the teaching of writing. In 1999,2000 primary teachers in Croydon took part in a project to raise standards in writing. Teachers undertook case studies of representative children, and made considered changes to their teaching of writing in the light of their observations of these children. The article focuses on case studies from four of these classes. (Reception, Y1, Y3 and Y6.) The four classes were chosen because in them children made most progress as writers during the project year. Brief outlines are made of case studies from these classes, followed by descriptions of the main changes to teaching in these classrooms. In conclusion, an analysis is made of common patterns of teaching across the four classes. These changes include the opportunity for children to: write about things that mattered to them; write as experts; hear their writing read aloud; and experience genuine response to this writing. In addition, it was also found that boys made most progress when given the opportunity to write in the company of other boys. [source] Latest news and product developmentsPRESCRIBER, Issue 2 2007Article first published online: 1 MAR 200 Venlafaxine: same suicide risk Venlafaxine (Efexor) is probably not associated with a higher risk of suicide than citalopram, fluoxetine or dosulepin, even when prescribed for patients at higher risk, according to an analysis of the UK General Practice Research Database (BMJ, doi:10.1136/bmj.39041.445104.BE. Published 12 December 2006). The retrospective cohort study found that venlafaxine was associated with a significantly higher risk of completed and attempted suicide in adults than the other antidepressants but, after adjusting for risk factors, the authors concluded that much, if not all, of the difference could be explained by confounding. Raised glucose with thiazides not clinically significant? A new analysis of the ALLHAT trial suggests that the small increase in blood glucose levels associated with long-term thiazide therapy is not associated with an increased risk of cardiovascular events (Arch Intern Med 2006;166:2191-201). The ALLHAT trial compared cardiovascular outcomes in over 18 000 patients with hypertension who were treated with chlortali- done (Hygroton), amlodipine and lisinopril. After two years, fasting blood glucose had increased in all groups (by 0.47, 0.31 and 0.19mmol per litre respectively); compared with chlortalidone, the odds of developing diabetes were 45 per cent lower with lisinopril and 27 per cent lower with amlodipine. However, there was no significant link between fasting blood glucose levels and cardiovascular events, end-stage renal disease or death; developing diabetes was associated with an increased risk of CHD overall but this was not statistically significant for chlortalidone in particular. Withdrawing alendronate after five years' treatment Discontinuing treatment of osteoporosis with alendronate after five years does not significantly increase fracture risk for many women, a US study has shown (J Am Med Assoc 2006;296:2927-38). In this five-year extension to the Fracture Intervention Trial, 1099 women who had taken alendronate for five years were randomised to continue treatment or switch to placebo for a further five years. In those taking placebo, bone mineral density decreased by 2.4 per cent at the hip and 3.7 per cent in the spine but remained above pre- treatment levels. Continuing with alendronate was associated with a lower risk of clinical vertebral fractures (2.4 vs 5.3 per cent) but no significant reduction in morphometric vertebral fractures (9.8 vs 11.3 per cent respectively). The cumulative risk of nonvertebral fractures was 19 per cent in each group. The authors conclude that women at very high risk of clinical vertebral fractures may benefit from continuing alendronate, but for many discontinuation does not appear to increase fracture risk. Instructions on labels Patients with low levels of literacy are at high risk of not understanding medicines labelling (Ann Intern Med 2006;145:887-94). In 395 English-speaking adults, 71 per cent correctly repeated simple label instructions, but only 35 per cent could demonstrate the correct number of tablets involved. Low literacy levels were associated with a twofold increased risk of misunderstanding labelling. Statins campaign The National Prescribing Centre (NPC) has launched a campaign to increase prescribing of low-cost statins. Resources available from its website at www.npc.co.uk/statins.htm are divided into four categories: policy and guidance, therapeutics, implementation resources and monitoring tools. Formats include documents and case studies, Powerpoint presentations and E-learning workshops. patients feeling rested on waking and daytime functioning. The Z-drugs were also believed to cause fewer adverse effects. GPs believe in ,Z' drugs A survey of GPs in Lincolnshire has revealed that their beliefs about nonbenzodiazepine hypnotics are inconsistent with NICE guidance and published evidence (Br J Gen Pract 2006; 56:964-7). Responders believed that zaleplon (Sonata), zopiclone and zolpidem were superior to benzodiazepines in increasing sleep time, patients feeling rested on waking and daytime functioning. The Z-drugs were also believed to cause fewer adverse effects. The authors note that, while benzodiazepine prescribing is declining, that of the Z-drugs is increasing, and they suggest this may be explained by misplaced beliefs about their relative effectiveness and safety. Pharmacy EHC guidance Pharmacists can supply emergency hormonal contraception (EHC) in advance but should consider when it is clinically appropriate to do so, according to revised guidance from the Royal Pharmaceutical Society. The move follows support for advance supply from the British Pregnancy Advisory Service and Marie Stopes International. Pharmacists are advised to decline repeated requests and recommend contraception instead, and to counsel users on using EHC safely and appropriately. More support from NICE NICE has developed two databases to support implementation of its recommendations. The shared learning database (www.nice.org.uk/ sharedlearning) includes experiences of implementing NICE guidance. The second, known as ERNIE (Evaluation and Review of NICE Implementation Evidence), includes data provided by NICE on uptake of its advice and external information (www.nice.org.uk/ernie). Mental health briefings The DoH (www.dh.gov.uk) has published several briefing documents to explain the main changes to mental health legislation, covering professional roles, criteria for detention and supervised community treatment (SCT). SCT applies to patients with a stable chronic mental disorder who have been discharged from hospital and who, but for their treatment, may pose a risk to themselves or others. Patients remain the responsibility of the mental health team. Copyright © 2007 Wiley Interface Ltd [source] Changes in the strategic management of technology: results of a global benchmarking studyR & D MANAGEMENT, Issue 2 2002Jakob Edler This contribution analyses main changes in the strategic management of technology of the world's most technology-intensive companies from western Europe, North America and Japan. The results presented here are based on a literature review and a survey which show the following main results: first, R&D and technology have become key cornerstones of corporate and business strategy. Second, there is a growing tendency to acquire technology from external sources throughout the sample. Third, internationalization of R&D plays a very important role in the strategies of the large companies investigated and the data shows that it will certainly gain further momentum. However, internationalization of R&D is confined to the Triad regions and is not ,global'. Based on our analysis, cornerstones of a future generation of R&D/technology management are developed. [source] Cabinet Government in the Twentieth CenturyTHE MODERN LAW REVIEW, Issue 5 2004Christopher Foster This paper examines the main features of the cabinet system as it had emerged during the twentieth century, and which Jennings did so much to crystallize in his pioneering study on Cabinet Government. It then assesses the main changes that have occurred over successive administrations since the late 1970s, and concludes that even if cabinet government seemed to return in 1990 and 2003, it was without the cabinet system that had underpinned and made it effective in the past. [source] Cleveland 20 years on: what have we learned about intervening in child sexual abuse?CHILD ABUSE REVIEW, Issue 4 2008Heather Bacon Abstract This is the first of two linked papers. It examines the main changes in approach to child sexual abuse that have occurred since the events in Cleveland 20 years ago. Comparison between estimated prevalence rates and registrations for sexual abuse suggests that we are aware of only the tip of the iceberg. It is argued that in many cases uncertainty may have to be accepted, and that protection may be better achieved through a protective parent than through the child protection system. Clinical examples of cases presenting to a specialist child and adolescent mental health service are given. It is argued that, although society is now more willing to recognise the existence of child sexual abuse and professionals are better at dealing with families, outcomes for this group of children are not much improved. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||