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Offers Hope (offer + hope)
Selected AbstractsPeaks and troughs,an exploration of patient perspectives of dangerous and severe personality disorder assessment (Peaks Unit, Rampton Hospital)PERSONALITY AND MENTAL HEALTH, Issue 1 2008Lisa Maltman Rationale,Although accessing user-perspectives is a key National Health Service initiative, the literature reporting user's views of forensic services, particularly dangerous and severe personality disorder (DSPD) services, is in its infancy. Aim and Design,This qualitative study applied thematic analysis to 12 semi-structured interviews aimed to enhance professional understanding of how Peaks Unit treatment-ward participants retrospectively perceive their experience of being admitted and assessed at the unit. Findings,Reported themes include ,fear' associated with participants' personal safety concerns and apprehensions regarding inhumane treatment and prolonged detention. The local metaphor of the DSPD Unit as the ,dark side' exacerbated such fears. ,Shock' also emerged as a primary theme resulting from unexpected admissions, security measures and some staff responses. ,Offering hope' provided a further theme with many participants reporting a climate of therapeutic optimism within staff teams and ,refreshing' opportunities for change. Reservations were also expressed about the service potentially offering ,false hope'. Several suggestions are proposed for future assessment strategy including escalating user-involvement activity, managing expectations, promoting therapeutic optimism and helping patients to attain a realistic sense of hope in order to maximise therapeutic engagement. Copyright © 2008 John Wiley & Sons, Ltd. [source] Education and the Dangerous Memories of Historical Trauma: Narratives of Pain, Narratives of HopeCURRICULUM INQUIRY, Issue 2 2008MICHALINOS ZEMBYLAS ABSTRACT The purpose of this article is to explore the meanings and implications of dangerous memories in two different sites of past traumatic memories: one in Israel and the other in Cyprus. Dangerous memories are defined as those memories that are disruptive to the status quo, that is, the hegemonic culture of strengthening and perpetuating existing group-based identities. Our effort is to outline some insights from this endeavor,insights that may help educators recognize the potential of dangerous memories to ease pain and offer hope. First, a discussion on memory, history and identity sets the ground for discussing the meaning and significance of dangerous memories in the history curriculum. Next, we narrate two stories from our longitudinal ethnographic studies on trauma and memory in Israel and Cyprus; these stories are interpreted through the lens of dangerous memories and their workings in relation to the hegemonic powers that aim to sustain collective memories. The two different stories suggest that collective memories of historical trauma are not simply "transmitted" in any simple way down the generations,although there are powerful workings that support this transmission. Rather, there seems to be much ambivalence in the workings of memories that under some circumstances may create openings for new identities. The final section discusses the possibilities of developing a pedagogy of dangerous memories by highlighting educational implications that focus on the notion of creating new solidarities without forgetting past traumas. This last section employs dangerous memories as a critical category for pedagogy in the context of our general concern about the implications of memory, history and identity in educational contexts. [source] Nutritional advice and treatment by dietitians to patients with amyotrophic lateral sclerosis/motor neurone disease: a survey of current practice in England, Wales, Northern Ireland and CanadaJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2007A. Rio Abstract Background, The management of amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) has shifted from an attitude of nihilism to treatments that prolong survival and offer hope. Nutrition is an integral component of ALS/MND care requiring coordination among acute and community multi-disciplinary teams (MDT). Evidence-based nutrition guidelines exist for this patient group but their use among dietitians is unknown. The aim of this study was to survey the knowledge, practice and guideline use of dietitians working in ALS/MND centres/clinics across England, Wales, Northern Ireland (EWNI) and Canada. Method, Dietetic contact details were obtained from the Motor Neurone Disease Association (MNDA) and the ALS Society of Canada (ALSSC) websites. Telephone interviews were conducted with 23 dietitians using a standardized questionnaire. Results, Multi-disciplinary team membership was high (78%). Only 22% dietitians had >4-years experience in ALS/MND care. Dietitians reported using body weight, percentage weight loss (PWL) and body mass index (BMI) to assess nutritional status. Equations used to estimate energy and protein requirements differed. Most frequent dietary advice was high calorie, texture modification and prescription nutritional supplements. Artificial nutrition and hydration (ANH) was discussed when patients developed dysphagia, energy intake was inadequate, weight loss of 10% or forced vital capacity (FVC) was reduced. A percutaneous endoscopic gastrostomy (PEG) service was available at all clinics/centres. Conclusion, Nutritional assessment techniques and dietary advice should be standardized. Dietetic collaboration at national and international level is recommended to reduce professional isolation. Training and support in ALS/MND nutrition should be made available as part of post-dietetic registration. Further dietetic research is required to stimulate nutritional care. [source] Characterization of exopolysaccharides produced by three moderately halophilic bacteria belonging to the family AlteromonadaceaeJOURNAL OF APPLIED MICROBIOLOGY, Issue 2 2008J.A. Mata Abstract Aims:, To study the exopolysaccharides (EPSs) produced by three novel moderately halophilic species belonging to the family Alteromonadaceae to optimize EPS yields, characterize their physical and chemical properties and evaluate possible biotechnological applications for these polymers. Methods and Results:, EPSs synthesized by Idiomarina fontislapidosi F32T, Idiomarina ramblicola R22T and Alteromonas hispanica F23T were collected and analysed under optimum conditions: MY medium supplemented with 7·5% (w/v) salts; 32°C; and 1% (w/v) glucose. Polymers were synthesized mainly during the early stationary growth phase with yields ranging from 1 to 1·5 g l,1. The Idiomarina species each produced an anionic EPS composed mainly of glucose, mannose and galactose. A. hispanica synthesized an anionic EPS composed mainly of glucose, mannose and xylose. Solutions of all the polymers were low in viscosity and pseudoplastic in their behaviour. They showed emulsifying activity and the capacity to bind some metals. Conclusions:, The Alteromonadaceae species studied in this work produced EPSs with physical and chemical properties different from those produced by other halophilic and nonhalophilic bacteria, suggesting that the wide diversity of micro-organisms being encountered nowadays in hypersaline environments offers enormous potential resources for biotechnological applications. Significance and Impact of the Study:, We have optimized the EPS production and analysed new biopolymers produced by some recently described, moderately halophilic bacteria. These biopolymers are chemically and physically different from others already in use in biotechnology and offer hopes for new applications, especially in the case of A. hispanica, which may prove to be a viable source of xylo-oligosaccharides. [source] Glucose-responsive insulin-producing cells from stem cellsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 6 2002David J. Kaczorowski Abstract Recent success with immunosuppression following islet cell transplantation offers hope that a cell transplantation treatment for type 1 (juvenile) diabetes may be possible if sufficient quantities of safe and effective cells can be produced. For the treatment of type 1 diabetes, the two therapeutically essential functions are the ability to monitor blood glucose levels and the production of corresponding and sufficient levels of mature insulin to maintain glycemic control. Stem cells can replicate themselves and produce cells that take on more specialized functions. If a source of stem cells capable of yielding glucose-responsive insulin-producing (GRIP) cells can be identified, then transplantation-based treatment for type 1 diabetes may become widely available. Currently, stem cells from embryonic and adult sources are being investigated for their ability to proliferate and differentiate into cells with GRIP function. Human embryonic pluripotent stem cells, commonly referred to as embryonic stem (ES) cells and embryonic germ (EG) cells, have received significant attention owing to their broad capacity to differentiate and ability to proliferate well in culture. Their application to diabetes research is of particular promise, as it has been demonstrated that mouse ES cells are capable of producing cells able to normalize glucose levels of diabetic mice, and human ES cells can differentiate into cells capable of insulin production. Cells with GRIP function have also been derived from stem cells residing in adult organisms, here referred to as endogenous stem cell sources. Independent of source, stem cells capable of producing cells with GRIP function may provide a widely available cell transplantation treatment for type 1 diabetes. Copyright © 2002 John Wiley & Sons, Ltd. [source] After Cancún: what next for agricultural subsidies?EUROCHOICES, Issue 3 2003Tim Josling Summary After Cancún: what next for agriculturalsubsidies? The collapse of the Ministerial in Cancún highlighted the enhanced role of the developing countries in the WTO and the reduced ability of the US and the EU to manage the trade system. One aspect of these changes has been that developing countries have taken much more interest in the level of domestic support in developed countries. Developed countries believe that the shift of support from production-linked to decoupled instruments has had a positive impact on trade. Developing countries maintain that this reform has not helped them, and has perpetuated inequities in the trade system. Research suggests that the output effect of decoupled support is limited, if not negligible. Such decoupling may be necessary to reform domestic polices. Additionally, domestic policies are being challenged by developing countries using the trade litigation of the WTO. But such challenges risk undermining support for the WTO. Until agreement is reached on these issues there will be little progress in further agricultural trade reform. A political solution must be found that continues the slow process of improvement of domestic farm policies and at the same time offers hope to developing countries that they will benefit from the improvement in the trade conditions for agricultural products. Après Cancún:quel avenir pour les subventions? L'échec de la conférence ministérielle de Cancun met en évidence !e rôle accru des pays en voie de développement à l'OMC, ainsi que la faible aptitude des Etats-Unis et de l'Europe à gérer le système des échanges internationaux. Ces changements impliquent que les pays en voie de développement s'intéressent de plus en plus aux niveaux de protection internes des pays développés. Les pays développés croient que le glissement des aides vers plus de découplage aura eu un effet positif sur les échanges. Mais les pays en voie de développement continuent à penser que ces réformes ne les ont pas aidés, et qu'elles ont perpétué les inégalités du commerce mondial. Le travail présenté ici semble montrer que l'effet du découplage sur l'offre est très faible, voire nul. Peut-être le decouplage est-il utile pour la réforme des politiques internes. Mais, au delà, ces politiques internes sont mises en cause par les pays en voie de développement, qui utilisent à leur encontre les ressources de procédure mises à leur disposition par l'OMC. De telles mises en cause sont de nature à détruire le soutien de l'opinion à l'OMC. II ne faut pas s'attendre à beaucoup de progrès dans les réformes du commerce international agricole tant qu'on n'aura pas trouve un accord sur ces questions. II est done necessaire d'élaborer des solutions qui confortent le lent progrès des politiques internes des pays developpes, tout en offrant aux pays en voie de développement 1, espoir de bénéficier de l'amélioration des conditions des échanges agricoles. Nach Cancún: Was geschieht als nächstes mitAgrarsubventionen? Das Scheitern des Ministerialtreffensin Cancún hob die verbesserte Position der Entwicklungsländer in der WTO und die verminderte Fähigkeit der USA und der EU hervor, das Handelssystem zu lenken. Finer der Aspekte dieser Veränderungen bestand darin, dass die Entwicklungsländer ein sehr viel größeres Interesse am Ausmaß der Inlandsstützung in Industrieländern gezeigt haben. Die Industrieländer glauben, dass sich der Schritt von einer produktionsgebundenen Inlandsstützung hin zu einer entkoppelten Inlandsstützung positiv auf den Handel ausgewirkt hat. Die Entwicklungsländer behaupten jedoch, dass ihnen diese Reform nicht geholfen habe und dass so Ungerechtigkeiten im Handelssystem aufrecht erhalten würden. Forschungsergebnisse legen es nahe, dass sich die entkoppelte Inlandsstützung sehr begrenzt, möglicherweise nur geringfügig, auf die Produktion auswirkt. Eine solche Entkopplung ist möglicherweise notwendig, urn inländische Politikmaßnahmen zu reformieren. Zusátzlich werden die inländischen Politikmaßnahmen von den Entwicklungsländern zur Zeit im Rahmen der WTO-Verfahren zur Beilegung von Handelsstreitigkeiten angefochten. Solche Anfechtungen bergen jedoch immer das Risiko einer abgeschwächten Unterstützung für die WTO. Bis in diesen Punkten Einigkeit herrscht, wird es nur geringe Fortschritte für die Agrarhandelsreformen geben. Es muss eine politische Lösung gefunden werden, welche den langsamen Verbesserungsprozess bei den inländischen Agrarpolitikmaßnahmen voran treibt und welche die Entwicklungsländer zugleich hoffen lässt, von der Verbesserung der Handelsbedingungen für landwirtschaftliche Erzeugnisse profitieren zu können. [source] Assessing the Value of the NHIS for Studying Changes in State Coverage Policies: The Case of New YorkHEALTH SERVICES RESEARCH, Issue 6p2 2007Sharon K. Long Research Objective. (1) To assess the effects of New York's Health Care Reform Act of 2000 on the insurance coverage of eligible adults and (2) to explore the feasibility of using the National Health Interview Survey (NHIS) as opposed to the Current Population Survey (CPS) to conduct evaluations of state health reform initiatives. Study Design. We take advantage of the natural experiment that occurred in New York to compare health insurance coverage for adults before and after the state implemented its coverage initiative using a difference-in-differences framework. We estimate the effects of New York's initiative on insurance coverage using the NHIS, comparing the results to estimates based on the CPS, the most widely used data source for studies of state coverage policy changes. Although the sample sizes are smaller in the NHIS, the NHIS addresses a key limitation of the CPS for such evaluations by providing a better measure of health insurance status. Given the complexity of the timing of the expansion efforts in New York (which encompassed the September 11, 2001 terrorist attacks), we allow for difference in the effects of the state's policy changes over time. In particular, we allow for differences between the period of Disaster Relief Medicaid (DRM), which was a temporary program implemented immediately after September 11th, and the original components of the state's reform efforts,Family Health Plus (FHP), an expansion of direct Medicaid coverage, and Healthy New York (HNY), an effort to make private coverage more affordable. Data Sources. 2000,2004 CPS; 1999,2004 NHIS. Principal Findings. We find evidence of a significant reduction in uninsurance for parents in New York, particularly in the period following DRM. For childless adults, for whom the coverage expansion was more circumscribed, the program effects are less promising, as we find no evidence of a significant decline in uninsurance. Conclusions. The success of New York at reducing uninsurance for parents through expansions of both public and private coverage offers hope for new strategies to expand coverage. The NHIS is a strong data source for evaluations of many state health reform initiatives, providing a better measure of insurance status and supporting a more comprehensive study of state innovations than is possible with the CPS. [source] Progress towards achieving new vaccine and vaccination goalsINTERNAL MEDICINE JOURNAL, Issue 7 2003G. Ada Abstract Viral and bacterial vaccines, especially for childhood use, are one of the most successful public health measures of the last two centuries and have a good safety record. However, there are still many diseases that are caused by infectious agents for which vaccines are not available. Our increasing ability to manipulate the immune system offers hope that, in the future, at least some of these infections may be prevented by vaccination. A surprising recent development is the use of vaccine technology to test whether a range of other generally non-communicable diseases can be prevented (or at least controlled) in this way. Investigation of these diseases is still mainly at the experimental level, however the list includes different types of cancers, allergies, drug addiction and neurodegenerative diseases. (Intern Med J 2003; 33: 297,304) [source] Aspects of the reproductive biology and breeding management of Asian and African elephants Elephas maximus and Loxodonta africanaINTERNATIONAL ZOO YEARBOOK, Issue 1 2006T. B. HILDEBRANDT Elephants possess many unique qualities, including some that relate directly to their reproductive biology. Thus, comparative studies on elephants provide valuable information to the growing biological database for extant mammals. Left undisturbed, Asian Elephas maximus and African Loxodonta Africana elephants reproduce well in the wild. It is ironic then that most captive populations face possible,extinction'because of historically poor reproductive performance. Some of the problems with breeding elephants in captivity are logistical but others, like ovarian and uterine pathologies and bull infertility, have management-related aetiology. Through advances in endocrine monitoring and ultrasound imaging techniques, we are beginning to understand some of the complex mechanisms controlling reproductive function in elephants. Several reproductive characteristics appear to be unique to the taxon, such as luteal steroidogenic function, follicular development patterns, pituitary gonadotrophin secretion, a 22 month-long gestation and musth (in ,,). One example is the,double LH surge'occurring 3 weeks apart during the follicular or non-luteal phase of the cycle, with only the second surge inducing ovulation. These qualities have at times both enhanced and hampered efforts to understand and control reproduction. We have learned that techniques developed for domestic or laboratory species are not always directly applicable to elephants. However, the recent success of artificial insemination based on new ultrasound and endocrine methodology offers hope that establishing selfsustaining populations is possible. This paper reviews our current knowledge of elephant reproduction and how it is being used to aid species conservation for maximal reproductive efficiency and enhancement of genetic management. [source] | |||||||||||||