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Terms modified by Vital Selected AbstractsA CHARIOT FOR THE SHEKHINAH: Identity and the Ideal Life in Sixteenth-Century KabbalahJOURNAL OF RELIGIOUS ETHICS, Issue 3 2009Eitan P. Fishbane ABSTRACT In this paper, I seek to present the range of issues involved in the efforts of sixteenth-century kabbalists to understand the nature of selfhood, and the paths prescribed for the formation of an ideal life. I reflect on the mystical writings of Moshe Cordovero, Eliyahu de Vidas, and ayyim Vital,probing their conceptions of core identity, the polarity between body and soul, and the ethical guidance for a life well lived. In so doing, I consider the following additional themes, and their relation to the matrix of self-formation and religious identity: reincarnation and rebirth; the virtue of humility and self-effacement; the cultivation of wisdom; ideals of piety and prophetic experience; asceticism; and the spiritual transcendence of desire. In presenting this wide range of constituent themes, I argue that sixteenth-century kabbalists understood the soul to be the ultimate marker of personal identity (nuanced and complicated by the doctrine of reincarnation), and that they formulated a vision of an ideal ethics in which the human being functions as an earthly vessel for the divine presence. What is more, the preparation of that vessel required a degree of humility so extreme that the attainment of ideal personhood ultimately involved the effacement of that very identity. [source] T1N0 Triple Negative Breast Cancer: Risk of Recurrence and Adjuvant ChemotherapyTHE BREAST JOURNAL, Issue 5 2009Henry G. Kaplan MD Abstract:, Adjuvant treatment of T1N0 breast cancer (BC) has evolved in recent years with chemotherapy options dependent on tumor size and cellular characteristics. Our goal is to describe the difference in outcome between T1N0 triple negative (TriNeg) and estrogen/progesterone receptor positive/her2/neu-negative BC. From our institute's registry, we identified primary BC patients diagnosed from 1998 to 2005, estrogen/progesterone receptor negative (ER,/PR,)/her-2/neu negative (her2,) (TriNeg = 110) and ER+/PR+/her2, (HR+/her2, = 919). Clinical diagnosis and treatment variables were chart abstracted. Vital and disease status were updated annually. Pearson chi-squared tests were used for bivariate analysis. Hazard ratios were calculated using the Cox proportional hazards model. Average patient age was 59 years, range 23,93 years and average length of follow-up was 4.22 years. T-stage distribution for HR+/her2, patients was 9% T1a (>0.1, ,0.5 cm), 34% T1b (>0.5 cm, ,1 cm), 57% T1c (>1 cm, ,2 cm) and for TriNeg, 6% T1a, 21% T1b, and 73% T1c. Sixty-five per cent of T1b and 73% T1c TriNeg patients received chemotherapy versus 7% of T1b and 32% of T1c HR+/her2, patients with TriNeg patients more likely to receive doxorubicin/cyclophosphamide/paclitaxel combined therapy. Recurrence rates were the following, T1b: 8.7%, TriNeg (2/23) versus 0%, HR+/her2, (0/315) and T1c: 8.8%, TriNeg (7/80) versus 2.1%, HR+/her2, (11/523). Five year relapse-free survival was 98% in the HR+/her2, group and 89% in the TriNeg group (log rank test = 27.77, p < 0.001). The hazard ratio for recurrence in the TriNeg group was 6.57 (95% CI = 2.34, 18.49) adjusted for age, tumor size, and adjuvant chemotherapy. Triple negative T1N0 patients have greater recurrence risk in spite of more aggressive therapy by both number treated and adjuvant chemotherapy type even in a low-risk category. New treatment modalities specific for triple negative disease are urgently needed. [source] Competing Rationales for Corporate Governance in France: Institutional Complementarities between Financial Markets and Innovation SystemsCORPORATE GOVERNANCE, Issue 2 2008Soo H. Lee ABSTRACT Manuscript Type: Conceptual Research Question/Issue: This paper identifies the causes and consequences of corporate governance reform with reference to the French case. By disaggregating institutional complementarities into global and domestic dimensions, we analyze the path of institutional change compelled by financial efficiency and cooperative innovation. Research Findings/Results: Our analysis of the French case shows that both converging and diverging forces of institutional change coexist, shaping selective responses to globalization. While the adoption of the shareholder model is necessary for resource acquirement from the global capital markets, resource allocation in the cooperative innovation systems reinforces the stakeholder model. The French case confirms the sustainability of distinctive institutional complementarities, albeit with selective adaptation based on a sense-making social compromise. Theoretical Implications: The French case reminds us of the importance of distinctive institutional traditions and dominant social rationalities to understand the underlying logic of governance reform. The comparative research on corporate governance needs to address not just the cross-country variations in institutional arrangements and practices, but also the clash of competing rationales for reform explicitly in comparative terms within a single country context. Practical Implications: For foreign investors, it is vital to understand the unique institutional environment of state-centred stakeholder economies if they are to negotiate the best terms of return and to avoid unnecessary conflicts. French managers are expected to devise strategic choices responding to the competing rationales of governance. Managerial sense-making is essential for achieving sound long-term performance, upon which the legitimacy and sustainability of the constellation of selective governance rests. [source] Examining the role of the forest industry in collaborative ecosystem management: implications for corporate strategyCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 1 2005Jennifer Dyke Abstract The North American timber industry owns or controls a substantial amount of commercial timberland, and it is within this privately held acreage that major portions of critical natural habitat and areas of biodiversity are found. Because significant ecosystem components and processes lie within the ownership of forestry operations, industry participation in collaborative ecosystem management initiatives is vital to protect the integrity of ecological units at the landscape scale. This article analyzes and identifies the role of industry in ecosystem management projects, industry's willingness to participate in collaborative ecosystem management and the motivations behind company participation. Companies indicated active involvement in collaborative ecosystem management as both project initiators and collaborators. Motivations for participating in collaborative ecosystem management initiatives include the desires to decrease governmental regulations, collect data, develop relationships and improve current practices. Many companies also feel that participation is financially beneficial because it positively impacts corporate public relations. We discuss the implications of these results for developing an effective corporate environmental strategy associated with resource-based industries. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment. [source] Clinical applications of laser scanning cytometryCYTOMETRY, Issue 3 2002Attila Tárnok Abstract This study reviews existing and potential clinical applications of laser scanning cytometry (LSC) and outlines possible future developments. LSC provides a technology for solid phase cytometry. Fluorochrome-labeled specimens are immobilized on microscopic slides that are placed on a conventional epifluorescence microscope and analyzed by one or two lasers. Data comparable to flow cytometry are generated. In addition, the position of each event is recorded, a feature that allows relocalization and visualization of each measured event. The major advantage of LSC compared with other cytometric methods is the combination of two features: (a) the minimal clinical sample volume needed and (b) the connection of fluorescence data and morphological information for the measured event. Since the introduction of LSC, numerous methods have been established for the analysis of cells, cellular compartments, and tissues. Although most cytometric methods use only two or three colors, the characterization of specimens with up to five fluorochromes is possible. Most clinical applications have been designed to determine ploidy and immunophenotype; other applications include analyses of tissue biopsies and sections, fluorescence in situ hybridization, and the combination of vital and nonvital information on a single-cell basis. With the currently available assays, LSC has proven its wide spectrum of clinical applicability in slide-based cytometry and can be introduced as a standard technology in multiple clinical settings. Cytometry (Clin. Cytometry) 50:133,143, 2002. © 2002 Wiley-Liss, Inc. [source] CPA assessment , the regional assessors' experienceCYTOPATHOLOGY, Issue 2007G. Guthrie With the introduction in January 2006 of the new posts of Regional Assessors, the process and focus of CPA assessment changed to reflect the inclusion in the current standards of Quality Management systems and processes. Regional Assessors, trained in Quality Management Systems and their assessment against international standards, now form a vital part of the CPA assessment teams, looking specifically at this aspect of laboratory service provision. Their role in the new assessment process will be explained. The presentation will cover differences and similarities in the nature and number of non-compliances experienced since April 2006 when the new format of assessment was introduced. It will also look at a new format of timetable for assessment visits and explain the benefits of good two-way communication between all parties involved in the process - the laboratory, the assessors, particularly the Regional Assessor assigned to that site, and CPA Office staff. Understanding what is required by the standards, particularly in terms of evidential material, their interpretation and their classification of status , Critical, Non-Critical or Observation - is an aspect of assessment which is often not well understood. The presentation will seek to clarify these issues. The successful and timely clearance by laboratories of any non-compliances raised during the visits is vital to the achievement of accredited status and the presentation will give guidance as to how this is best achieved. The current standards, based on the international ISO 15189 standards, are considerably more challenging than the old ones. There is now a significant emphasis on Quality Management and its understanding, ethos and implementation within the laboratory, a key element which underpins all aspects of a laboratory's service. The achievement of accredited status assures our users of,the type of client and patient focused service expected of a modern laboratory. [source] Fascin1 is dispensable for mouse development but is favorable for neonatal survivalCYTOSKELETON, Issue 8 2009Yoshihiko Yamakita Abstract Fascin1, an actin-bundling protein, has been demonstrated to be critical for filopodia formation in cultured cells, and thus is believed to be vital in motile activities including neurite extension and cell migration. To test whether fascin1 plays such essential roles within a whole animal, we have generated and characterized fascin1-deficient mice. Unexpectedly, fascin1-deficient mice are viable and fertile with no major developmental defect. Nissl staining of serial coronal brain sections reveals that fascin1-deficient brain is grossly normal except that knockout mouse brain lacks the posterior region of the anterior commissure neuron and has larger lateral ventricle. Fascin1-deficient, dorsal root ganglion neurons are able to extend neurites in vitro as well as those from wild-type mice, although fascin1-deficient growth cones are smaller and exhibit fewer and shorter filopodia than wild-type counterparts. Likewise, fascin1-deficient, embryonic fibroblasts are able to assemble filopodia, though filopodia are fewer, shorter and short-lived. These results indicate that fascin1-mediated filopodia assembly is dispensable for mouse development. Cell Motil. Cytoskeleton 2009. © 2009 Wiley-Liss, Inc. [source] The deaf mouse mutant whirler suggests a role for whirlin in actin filament dynamics and stereocilia developmentCYTOSKELETON, Issue 7 2007Mette M. Mogensen Abstract Stereocilia, finger-like projections forming the hair bundle on the apical surface of sensory hair cells in the cochlea, are responsible for mechanosensation and ultimately the perception of sound. The actin cytoskeleton of the stereocilia contains hundreds of tightly cross-linked parallel actin filaments in a paracrystalline array and it is vital for their function. Although several genes have been identified and associated with stereocilia development, the molecular mechanisms responsible for stereocilia growth, maintenance and organisation of the hair bundle have not been fully resolved. Here we provide further characterisation of the stereocilia of the whirler mouse mutant. We found that a lack of whirlin protein in whirler mutants results in short stereocilia with larger diameters without a corresponding increase in the number of actin filaments in inner hair cells. However, a decrease in the actin filament packing density was evident in the whirler mutant. The electron-density at the tip of each stereocilium was markedly patchy and irregular in the whirler mutants compared with a uniform band in controls. The outer hair cell stereocilia of the whirler homozygote also showed an increase in diameter and variable heights within bundles. The number of outer hair cell stereocilia was significantly reduced and the centre-to-centre spacing between the stereocilia was greater than in the wildtype. Our findings suggest that whirlin plays an important role in actin filament packing and dynamics during postnatal stereocilium elongation. Cell Motil. Cytoskeleton 2007. © 2007 Wiley-Liss, Inc. [source] Replantation of an immature permanent central incisor following pre-eruptive traumatic avulsionDENTAL TRAUMATOLOGY, Issue 5 2008Esti Davidovich Avulsion of a pre-eruptive left permanent maxillary incisor in a 6-year-old boy is presented. The immature tooth was replanted after rinsing with saline following 10 min dry extra-oral time. This case report describes treatment and a 2-year follow-up of the tooth. During the follow-up period, continuation of root development, pulp revascularization, and irregular dentin formation were demonstrated. The tooth is vital, functional, and esthetic. To the best of our knowledge, no such case of replantation of a pre-eruptive tooth has been reported previously. [source] Efficacy of laser Doppler flowmetry for the diagnosis of revascularization of reimplanted immature dog teethDENTAL TRAUMATOLOGY, Issue 2 2001Kallaya Yanpiset Abstract , This study was performed to assess if laser Doppler flowmetry (LDF) is an improved method for the detection of revascularization of replanted teeth. Teeth were extracted and reimplanted under different experimental conditions. LDF readings were taken before extraction and weekly for 3 months. In control teeth, LDF baseline readings were taken and then repeated after the apical blood vessels were cut surgically. At the end of 3 months it was determined radiographically and histologically whether revascularization had occurred, i.e. vitality had returned. Results: LDF readings correctly predicted the pulp status (vital vs. non-vital) in 83.7% of the readings. 73.9% (17 of 23) were correct for the vital teeth and 95% (19 of 20) were correct for the non-vital teeth. Fisher's exact test (2-tail) indicated that there was no significant association between the efficacy of LDF and tooth type (P=0.166), although P2 was the least accurate tooth tested. Wilcoxon's matched-pair signed rank test demonstrated that in the revascularized (vital) teeth, the flux value between the baseline and week 2 dropped significantly (P=0.0001), increased significantly from week 2 to week 4 (P=0.0001) and then decreased steadily until week 12. However, at week 12 the flux was still significantly higher than at week 2 (P=0.010). In the teeth that failed to revascularize, the flux value dropped significantly by weeks 1 and 2 (P=0.004 and P=0.0001, respectively). Flux values did not increase from week 2. A Fast Fourier Transform (FFT) analysis confirmed a pulse of dominant frequency of 2 Hz in the teeth that returned to vitality and the lack thereof in those that stayed non-vital. One tooth in which the flux value evaluation indicated a non-vital tooth but the radiographic/histologic findings showed vital (false negative) possessed a pulse of dominant frequency and proved by this method to have successfully revascularized. [source] Soft tissue augmentation 2006: filler fantasyDERMATOLOGIC THERAPY, Issue 3 2006Arnold William Klein ABSTRACT:, As an increasing number of patients seek esthetic improvement through minimally invasive procedures, interest in soft tissue augmentation and filling agents is at an all-time high. One reason for this interest is the availability of botulinum toxin type A, which works superbly in the upper face. The rejuvenation of the upper face has created much interest in injectable filling agents and implant techniques that work equally well in the restoration of the lower face. One of the central tenets of soft tissue augmentation is the concept of the three-dimensional face. The youthful face has a soft, full appearance, as opposed to the flat, pulled, two-dimensional look often achieved by more traditional surgical approaches. Injectable filling agents can augment and even at times, replace pulling. Additionally, with the lip as the focal center of the lower face, subtle lip enhancement is here to stay, and is in fact, the number one indication for injectable fillers. Moreover, minimally invasive soft tissue augmentation offers cosmetic enhancement without the cost and recovery time associated with more invasive procedures. As more and more physicians take interest in minimally invasive surgery, courses in cosmetic surgery techniques are becoming increasingly popular at the medical meetings of many specialties. Today, physicians have a much larger armamentarium of techniques and materials with which to improve facial contours, ameliorate wrinkles, and provide esthetic rejuvenation to the face. For a substance or device to be amenable for soft tissue augmentation in the medical community, it must meet certain criteria. It must have both a high "use" potential, producing cosmetically pleasing results with a minimum undesirable reactions, and have a low abuse potential in that widespread or incorrect or indiscriminate use would not result in significant morbidity. It must be nonteratogenic, noncarcinogenic, and nonmigratory. In addition, the agent must provide predictable, persistent correction through reproducible implantation techniques. Finally, the substance, agent or device must be approved by the U.S. Food and Drug Administration, which assures purity, safety, and accessibility, as well as much-needed information regarding use. Having a thorough understanding of the filling agents available, their indications and contraindications, as well as having thorough knowledge of implant technique are vital in providing the patient with an esthetically pleasing result. [source] Cutaneous melanoma: methods of biopsy and definitive surgical excisionDERMATOLOGIC THERAPY, Issue 5 2005Adam I. Riker ABSTRACT:, The proper method of biopsy and definitive surgical excision of cutaneous melanoma is vital for optimal patient outcome. Clearly, the present authors' understanding of the pathophysiology of cutaneous melanoma continues to change at a rapid pace. Indeed, as the present authors' research efforts begin to expose some of the mysteries of melanoma, so do they begin to better understand the intricacies of this dreaded cancer. This article will highlight methods of biopsy for melanoma and the management of the primary tumor. The present authors review current recommendations for excision margins for the primary tumor, usefulness of lymphoscintigraphy, timing of definitive surgical excision, and issues unique for head and neck melanoma. [source] ACCESS TO ESSENTIAL MEDICINES: A HOBBESIAN SOCIAL CONTRACT APPROACHDEVELOPING WORLD BIOETHICS, Issue 2 2005RICHARD E. ASHCROFT ABSTRACT Medicines that are vital for the saving and preserving of life in conditions of public health emergency or endemic serious disease are known as essential medicines. In many developing world settings such medicines may be unavailable, or unaffordably expensive for the majority of those in need of them. Furthermore, for many serious diseases (such as HIV/AIDS and tuberculosis) these essential medicines are protected by patents that permit the patent-holder to operate a monopoly on their manufacture and supply, and to price these medicines well above marginal cost. Recent international legal doctrine has placed great stress on the need to globalise intellectual property rights protections, and on the rights of intellectual property rights holders to have their property rights enforced. Although international intellectual property rights law does permit compulsory licensing of protected inventions in the interests of public health, the use of this right by sovereign states has proved highly controversial. In this paper I give an argument in support of states' sovereign right to expropriate private intellectual property in conditions of public health emergency. This argument turns on a social contract argument for the legitimacy of states. The argument shows, further, that under some circumstances states are not merely permitted compulsory to license inventions, but are actually obliged to do so, on pain of failure of their legitimacy as sovereign states. The argument draws freely on a loose interpretation of Thomas Hobbes's arguments in his Leviathan, and on an analogy between his state of War and the situation of public health disasters. [source] The role of Pax7 in determining the cytoarchitecture of the superior colliculusDEVELOPMENT GROWTH & DIFFERENTIATION, Issue 3 2004Jennifer Thompson Pax genes are a family of transcriptional regulators vital for embryonic development. One member of the family, Pax7, functions early in neural development to establish dorsal polarity of the neural tube, and continuous refinement of its expression affords regional identity to brain nuclei, in particular the superior colliculus. Pax7 expression within the superior colliculus is eventually restricted to the stratum griseum et fibrosum superficiale (SGFS), the retinorecipient layer to which the optic nerve projects. The key role of Pax7 in specification of the superior colliculus has been highlighted by misexpression studies which result in ectopic formation of superior collicular tissue with characteristic laminae innervated by retinal ganglion cell axons. Here we review the role of Pax7 in formation of the superior colliculus and discuss the possibility that Pax7 may also assist in refinement of correct topographic mapping. [source] The hippocampus and caudomedial neostriatum show selective responsiveness to conspecific song in the female zebra finchDEVELOPMENTAL NEUROBIOLOGY, Issue 1 2002David J. Bailey Abstract The perception of song is vital to the reproductive success of both male and female songbirds. Several neural structures underlying this perception have been identified by examining expression of immediate early genes (IEGs) following the presentation of conspecific or heterospecific song. In the few avian species investigated, areas outside of the circuit for song production contain neurons that are active following song presentation, specifically the caudal hyperstriatum ventrale (cHV) and caudomedial neostriatum (NCM). While studied in detail in the male zebra finch, IEG responses in these neural substrates involved in song perception have not been quantified in females. Therefore, adult female zebra finches were presented with zebra finch song, nonzebra finch song, randomly generated tones, or silence for 30 min. One hour later they were sacrificed, and their brains removed, sectioned, and immunocytochemically processed for FOS expression. Animals exposed to zebra finch song had a significantly higher density of FOS-immunoreactive cells in the NCM than those presented with other songs, tones, or silence. Neuronal activation in the cHV was equivalent in birds that heard zebra finch and non-zebra finch song, expression that was higher than that observed in the groups that heard no song. Interestingly, the hippocampus (HP) and adjacent parahippocampal area (AHP) were activated in a manner comparable to the NCM. These results suggest a general role for the cHV in song perception and a more specific role for the NCM and HP/AHP in facilitating recognition of and responsiveness to species-specific song in female zebra finches. © 2002 Wiley Periodicals, Inc. J Neurobiol 52: 43,51, 2002 [source] Oral insulin , a review of current statusDIABETES OBESITY & METABOLISM, Issue 3 2010Harish Iyer Oral insulin is one of the most exciting areas of development in the treatment of diabetes because of its potential benefit in patient convenience, rapid insulinization of liver, adequate insulin delivery avoiding peripheral hyperinsulinaemia while potentially avoiding adverse effects of weight gain and hypoglycaemia. Growing evidence that earlier initiation of intensive insulin therapy produces sustained tight glycaemic control resulting in substantial delay in complications makes an effective oral insulin product even more vital for the management of patients with diabetes. Despite knowledge of this unmet medical need, oral delivery of insulin has been unsuccessful because of several barriers. For several decades, researchers have tried to develop oral insulin using various technologies without much clinical or commercial success. This review summarizes the development status of oral insulins which are publicly reported to be undergoing clinical studies. Currently, two oral insulin products are in an advanced stage of clinical development and first data from long-term therapy are expected to be available in the second half of 2010. [source] Insulin resistance, diabetes and cardiovascular risk: approaches to treatmentDIABETES OBESITY & METABOLISM, Issue 6 2005Daniel E. Rosenberg Abstract:, The prevalence of diabetes is increasing worldwide. Insulin resistance and diabetes mellitus are major predictors of cardiovascular ischaemic disease. Other risk factors for cardiovascular death including hypertension, dyslipidaemia, smoking and visceral obesity are especially lethal in diabetics. C-reactive protein, plasminogen activator inhibitor-1, matrix metalloproteinases and other emerging risk factors and their roles are continually being researched and discovered. Treatment of this syndrome must be aimed at lifestyle modification, glycaemic control and management of concomitant risk factors. Diet and exercise play a vital role in the treatment of diabetes and the metabolic syndrome. Weight reduction and increased physical activity will improve insulin resistance, hyperglycaemia, hypertension and dyslipidaemia. Hypertension management has been shown to be especially important in diabetics to prevent cardiovascular events. Likewise, multiple clinical trials show that reduction of cholesterol is even more vital in diabetics than the general population for risk reduction of coronary disease. There is a great deal of evidence that tight control of glycaemia is essential to treatment of this condition. There are a variety of available pharmacological agents available including metformin, insulin secretagogues, alpha-glucosidase inhibitors, thiazolidinediones and insulin. The mechanisms and side effects of these medications are discussed. As macrovascular disease is the major cause of morbidity and mortality, an early, aggressive, multi-factorial approach to treatment of the metabolic syndrome and diabetes is vital to prevent adverse cardiac outcomes. [source] ENDOSCOPIC MANAGEMENT OF BILIARY and PANCREATIC DUCTS STRICTURESDIGESTIVE ENDOSCOPY, Issue 2004Hiroyuki Maguchi ABSTRACT Endoscopic treatment is applied to a relatively large number of biliary and pancreatic duct strictures, and is a practical matter. It is essential to select the most appropriate treatment for each lesion. For instance, when treating malignant biliary stricture, accurate diagnosis of whether surgical treatment is required or not is vital; and in choosing a stent for an inoperable case, location of the stricture, with or without anticancer treatment, prognosis, and management of possible post-stenting re-stricture must be taken into consideration. For benign strictures, not only short-term results in mobility and motality, but also decades of long-term results must be cautiously questioned. Bearing these in mind, we need to accumulate the worldwide data of the treatments and establish a proper treatment guideline. [source] Standardising and mapping open-source information for crisis regions: the case of post-conflict IraqDISASTERS, Issue 3 2005Sarah Mubareka Abstract Painting an accurate picture of the situation on the ground in countries in crisis is vital for the efficiency of humanitarian aid and reconstruction agencies. This study describes a method for standardising and mapping the plethora of open-source information. The test site for the study is post-conflict Iraq. Important information on aid distribution, reconstruction and security in Iraq can be derived from the reports of humanitarian aid agencies and the media, before being formatted, inserted into a database and mapped. The product is a visual, cartographic structure of otherwise random information, showing which organisations are working in the country, which thematic and geographic areas are being prioritised in the field, and which areas most frequently experience security events. This type of mapping not only highlights the overall working environment within different parts of the country, but it may also serve as a decision-making tool for donors and humanitarian aid agencies planning to deploy personnel. [source] Planning Environmental Sanitation Programmes in EmergenciesDISASTERS, Issue 2 2005Peter A. Harvey Environmental sanitation programmes are vital for tackling environmental-related disease and ensuring human dignity in emergency situations. If they are to have maximum impact they must be planned in a rapid but systematic manner. An appropriate planning process comprises five key stages: rapid assessment and priority setting; outline programme design; immediate action; detailed programme design; and implementation. The assessment should be based on carefully selected data, which are analysed via comparison with suitable minimum objectives. How the intervention should be prioritised is determined through objective ranking of different environmental sanitation sector needs. Next, a programme design outline is produced to identify immediate and longer-term intervention activities and to guarantee that apposite resources are made available. Immediate action is taken to meet acute emergency needs while the detailed programme design takes shape. This entails in-depth consultation with the affected community and comprehensive planning of activities and resource requirements. Implementation can then begin, which should involve pertinent management and monitoring strategies. [source] When documents are destroyed or lost: lay people and archives in the early Middle AgesEARLY MEDIEVAL EUROPE, Issue 4 2002Warren Brown In this paper, I discuss some largely unexplored evidence about lay archives in early medieval Europe. This evidence consists of a set of formulae from late Roman, Merovingian, and Carolingian Gaul, and from Carolingian Bavaria. According to these formulae, lay men and women in these regions from the sixth to the ninth centuries kept documents in private archivesbecause they regarded documents as vital to the security of their property holdings. The manuscripts in which the formulae survive indicate that lay people continued to keep archives throughout the ninth century and into the tenth. They also suggest, however, that by the end of the eighth century traditions about how lay people used and stored documents were being preserved and maintained to a large degree by churches and monasteries. [source] Field-based and spectral indicators for soil erosion mapping in semi-arid mediterranean environments (Coastal Cordillera of central Chile)EARTH SURFACE PROCESSES AND LANDFORMS, Issue 1 2007Renaud Mathieu Abstract The Coastal Cordillera of central Chile is naturally sensitive to soil erosion due to moderate to steep slopes, intense winter rains when the vegetation cover is scarce, and deeply weathered granitic rocks. In 1965, 60 per cent of its surface was moderately to very severely eroded. Today this process is still largely active, but no data are currently available to evaluate the real extent, distribution and severity of soil degradation on a regional scale. This information is vital to support efficient soil conservation plans. A multi-scale approach was implemented to produce regional land degradation maps based on remote sensing technologies. Fieldwork has shown that the surface colour or ,redness' and the density of coarse fragments are pertinent erosion indicators to describe a typical sequence of soil degradation in the context of mediterranean soil developed on granitic materials and micaschists. Field radiometric experiments concluded that both factors influence the reflectance of natural surfaces and can be modelled using radiometric indices accessible from most satellites operating in the optical domain, i.e. redness index and brightness index. Finally the radiometric indices were successfully applied to SPOT images to produce land degradation maps. Only broad classes of erosion status were discriminated and the detection of the degradation processes was only possible when most of the fertile layer had already been removed. This technology provides decision-making information required to develop regional soil conservation plans and to prioritize actions between catchment areas, especially in vast inter-tropical regions where spatialized data are not always readily available. Copyright © 2006 John Wiley & Sons, Ltd. [source] Geological controls on the formation of alluvial meanders and floodplain wetlands: the example of the Klip River, eastern Free State, South AfricaEARTH SURFACE PROCESSES AND LANDFORMS, Issue 8 2002S. Tooth Abstract Floodplain wetlands are common features of rivers in southern Africa, but they have been little studied from a geological or geomorphological perspective. Study of the upper Klip River, eastern Free State, South Africa, indicates strong geological controls on the formation of alluvial meanders and associated floodplain wetlands. Along this river, pronounced and abrupt changes in valley width are strongly linked to lithological variations. Where weakly cemented sandstone crops out, the Klip has laterally eroded bedrock and carved valleys up to 1500 m wide. In these valleys, the river meanders (sinuosity up to ,1·75) on moderate gradients (<0·001) within extensive floodplains marked by numerous oxbow lakes, backswamps and abandoned channels, many of which host substantial wetlands. In contrast, where highly resistant dolerite crops out, lateral erosion of bedrock is restricted, with the Klip tending instead to erode vertically along joints or fractures. Here, valleys are narrower (<200 m), channel-bed gradients are steeper (>0·003), the river follows a much straighter course (sinuosity ,1·10,1·34), and floodplains are restricted in width. Long-term landscape development in the Klip and numerous similar catchments depends on the interaction between fluvial processes in the sandstone and dolerite valleys. In the sandstone valleys, vertical erosion rates are controlled by erosion rates of the more resistant dolerites downstream. Hence, in the short- to medium-term (decades to tens of thousands of years), lateral erosion dominates over vertical erosion, with the river concomitantly planing sandstone in the channel floor and reworking floodplain sediments. The thickness of alluvial fill in the sandstone valleys is limited (<4 m), but the resultant meanders are naturally dynamic, with processes such as point bar deposition, cutoff formation and channel avulsion resulting in an assemblage of fluvial landforms. In the longer term (greater than tens of thousands of years), however, vertical erosion will occur in the sandstone valleys as the downstream dolerites are lowered by erosion, resulting in channel incision, floodplain abandonment, and desiccation of the wetlands. Identification of the geological controls on meander and wetland formation provides information vital for the design of effective management guidelines for these ecologically rich habitats, and also contributes to a better understanding of rivers that are intermediate between fully alluvial and fully bedrock. Copyright © 2002 John Wiley & Sons, Ltd. [source] Distribution, abundance, and individual strategies: a multi-scale analysis of dasyurid marsupials in arid central AustraliaECOGRAPHY, Issue 3 2006Adele S. Haythornthwaite We investigated the effects of different environmental factors on the distribution and abundance of 6 species of dasyurid marsupials using a multiple-scale analysis. Data collected in the spinifex dunefields of the Simpson Desert, Australia, were analysed at 3 spatial scales spanning more than 5 orders of magnitude: "metasite" (covering an area of 1000,2000 km2), site (2,12 km2) and grid (0.01 km2). Temporal variability was also investigated, using data collected in March, April, and May in 4 consecutive years from 1997 to 2000. Both abiotic and biotic factors influenced the capture rates of different species at different times and spatial scales. At the coarsest spatial scale, Dasycercus cristicauda (mulgara) was consistently limited in its distribution by the intensity of rainfall, probably as an indirect result of increased grazing pressure from pastoral activity and a higher density of feral predators in high rainfall areas. However, at the finest spatial scale, this partly carnivorous species was scarce in areas of dense spinifex, perhaps because such habitats yield lowest returns during foraging, and was more common in areas where small invertebrate prey were abundant. Factors affecting the distribution of the most abundant dasyurid species in the study area, Sminthopsis youngsoni (lesser hairy-footed dunnart), could not be identified at any scale; we conclude that this reflects the opportunistic foraging strategies and flexible habitat requirements of this insectivorous species. Both Ningaui ridei (wongai ningaui) and Sminthopsis hirtipes (hairy-footed dunnart) were less abundant throughout the study region. For N. ridei, a spinifex specialist, predictors of occurrence could be identified only at the finest scale of analysis; at the grid level, a close positive association was detected in 2 of the 4 study years between capture rate and spinifex cover. For S. hirtipes, all 3 levels of spatial analysis revealed a negative association between capture rate and both rainfall and spinifex density. For the rarely-caught S. crassicaudata (fat-tailed dunnart) and Planigale tenuirostris (narrow-nosed planigale), no clear results were obtained at any spatial scale, and we interpret this to indicate that the study region represents sub-optimal habitat for these species. Given that different factors affected the distribution and abundance of dasyurids at different spatial scales over time, we conclude that a multiple-scale approach to population and community analysis is vital to accurately identify which environmental processes shape population and community dynamics. Understanding the interplay between regional and local processes will be crucial for management of existing species populations and for prediction of their distributions and abundances in future. [source] Substance use and common child mental health problems: examining longitudinal associations in a British sampleADDICTION, Issue 8 2010Anna Goodman ABSTRACT Aims To examine the longitudinal associations in both directions between mental health and substance use in adolescence. Design Three-year longitudinal cohort. Setting Britain (nationally representative sample). Participants 3607 youths aged 11,16 years at baseline. Measurements Externalizing and internalizing mental health problems were measured using brief questionnaires (parent-reported Strengths and Difficulties Questionnaire) and diagnostic interviews, including clinician-rated diagnoses of mental disorder. Substance use was measured by youth self-report, and included regular smoking, frequent alcohol consumption, regular cannabis use and ever taking other illicit drugs. Findings Externalizing (specifically behavioural) problems at baseline independently predicted all forms of substance use, with a particularly strong effect on smoking. In all cases this association showed a dose,response relationship. In contrast, although internalizing problems had a strong univariable association with smoking, this disappeared after adjusting for comorbid externalizing problems. There was little or no evidence that baseline substance use predicted mental health at follow-up. Conclusions Externalizing problems predict adolescent substance use, and adjusting for comorbid externalizing problems is vital when investigating the effects of internalizing problems. A dose,response effect of externalizing problems is seen across the full range. Programmes seeking to prevent adolescent substance use by reducing externalizing problems may therefore wish to consider population-wide interventions rather than targeting individuals only at the negative extreme. [source] Population viability and perturbation analyses in remnant populations of the Andean catfish Astroblepus ubidiaiECOLOGY OF FRESHWATER FISH, Issue 2 2005L. A. Vélez-Espino Abstract ,Astroblepus ubidiai (Actinopterygii; Siluriformes), which is the only native fish of the highlands of the Province of Imbabura, Ecuador, was abundant in the past in the Imbakucha watershed and adjacent drainages but currently it is restricted to a few isolated refuges. Population viability analysis (PVA) was used to detect critical aspects in the ecology and conservation biology of this unique fish. The annual population growth rate (,) was estimated for six remnant populations of this Andean catfish using a deterministic matrix population model. Sensitivity and elasticity analyses complemented the PVA by providing constructive insights into vital rates affecting projections and extinction probabilities. Positive population growth rates were found in all the study populations. The high contributions of juvenile survival to the variance of , and its high elasticity indicated that A. ubidiai population dynamics are highly sensitive to the transition values of this vital rate, which can promptly respond to management or antagonistic perturbations. Allowing fish to survive until the age of first reproduction and permitting the successful reproduction of these individuals will facilitate positive population growth rates, however the very small areas of occupancy, small extent of occurrence and severe fragmentation may still contribute to the extinction risk. Resumen 1. Astroblepus ubidiai (Actinopterygii; Siluriformes), el único pez nativo de los altos Andes en la Provincia de Imbabura, Ecuador, era abundante en el pasado en la cuenca de Imbakucha y en las cuencas adyacentes, pero actualmente existe en unos cuantos refugios geográficamente aislados. 2. Un Análisis de Viabilidad Poblacional (AVP) fue necesario para detectar los aspectos críticos en la ecología y biología de conservación de la especie. La tasa anual de crecimiento poblacional (,) se estimó en seis poblaciones remanentes de este pez andino usando un modelo matricial de población. Análisis de sensitividad y elasticidad permitieron la complementación de interpretaciones derivadas del AVP mediante la facilitación de exploraciones constructivas de los efectos relativos de las tasas vitales en proyecciones demográficas y probabilidades de extinción. 3. Todas las poblaciones estudiadas presentaron tasas positivas de crecimiento poblacional a pesar de que factores determinísticos tales como la pérdida de hábitat y fragmentación han llevado la ocurrencia de esta especie a pequeños fragmentos. La alta contribución a la varianza de , y la alta elasticidad de la supervivencia juvenil indicaron que las dinámicas poblacionales de A. ubidiai son altamente sensibles a los valores de transición de esta tasa vital, la cual puede responder con facilidad a actividades de manejo o perturbaciones antagónicas. 4. Facilitando que los peces sobrevivan hasta la edad de primera reproducción y permitiendo la reproducción exitosa de estos individuos son condiciones determinantes para mantener tasas positivas de crecimiento. Sin embargo, aún existe la necesidad de confrontar el riesgo de extinción derivado de pequeñas áreas de ocupación, limitada extensión de ocurrencia, y fragmentación severa. En este artículo también se discute la manera en que el conocimiento de estas circunstancias específicas es esencial para tomar acciones efectivas de conservación. [source] The cost-effectiveness of consistent and early intervention of harm reduction for injecting drug users in BangladeshADDICTION, Issue 2 2010Lorna Guinness ABSTRACT Aims To assess the cost-effectiveness of the CARE-SHAKTI harm reduction intervention for injecting drug users (IDUs) over a 3-year period, the impact on the cost-effectiveness of stopping after 3 years and how the cost-effectiveness might vary with baseline human immunodeficiency virus (HIV) prevalence. Design Economic cost data were collected from the study site and combined with impact estimates derived from a dynamic mathematical model. Setting Dhaka, Bangladesh, where the HIV prevalence has remained low despite high-risk sexual and injecting behaviours, and growing HIV epidemics in neighbouring countries. Findings The cost per HIV infection prevented over the first 3 years was US$110.4 (33.1,182.3). The incremental cost-effectiveness of continuing the intervention for a further year, relative to stopping at the end of year 3, is US$97 if behaviour returns to pre-intervention patterns. When baseline IDU HIV prevalence is increased to 40%, the number of HIV infections averted is halved for the 3-year period and the cost per HIV infection prevented doubles to US$228. Conclusions The analysis confirms that harm reduction activities are cost-effective. Early intervention is more cost-effective than delaying activities, although this should not preclude later intervention. Starting harm reduction activities when IDU HIV prevalence reaches as high as 40% is still cost-effective. Continuing harm reduction activities once a project has matured is vital to sustaining its impact and cost-effectiveness. [source] Expenditure on the NHS in PerspectiveECONOMIC OUTLOOK, Issue 3 2000Martin Chalkley In the wake of the recently-announced increases in health spending, Martin Chalkley reviews the record of health spending in the UK both historically and comparatively. It is clear that prices paid by the NHS have increased more than prices in general, and once this is allowed for then it appears that real health spending today is only twice that of 50 years ago as compared with the fourfold increase suggested when using a general price deflator. Such differential inflation is obviously not a problem which is confined to the UK, and it does add considerably to problems in making proper comparisons between levels of health spending in different countries. In spite of these difficulties, it seems that compared with many other developed countries, health spending in the UK as a proportion of GDP is modest. So, looking ahead, there is some way to go before the UK attains the levels of spending achieved in many other countries. But understanding the reasons for relative price changes is vital if any proposed increases in spending is to be translated into increases in the quantity and quality of services provided. [source] ECONOMIC AND FINANCIAL ASPECTS OF AGED CAREECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2005Warren P. Hogan The focus of this article is on the Report of the inquiry into residential aged care in Australia. Consideration is given to the results of a confidential survey of financial submissions from providers of aged care. Most attention is given to labour costs and earnings before interest, taxes, depreciation and amortization (EBITDA). The most important result is the evidence showing providers whatever their size, location, ownership and resident mix, can perform in the top 10 per cent and 25 per cent of providers as measured by EBITDA. Management is vital to the performance of entities whether they be ,for-profit' or ,not-for-profit' entities. Attention is also directed to other studies about efficiency and productivity and modelling. Treating technical efficiency as a measure by which the industry lags behind best practice, the analysis of regulatory efficiency explains much about ways to secure gains in efficiency. [source] WHY THE BEST ISN'T SO BAD: MODERATION AND IDEALS IN EDUCATIONAL REFORMEDUCATIONAL THEORY, Issue 5 2009Deborah Kerdeman In Moderating the Debate: Rationality and the Promise of American Education, Michael Feuer counsels reformers to "satisfice": moderate their expectations and accept that flawed reforms can be good enough. Implicit in Feuer's view of satisficing is the assumption that moderating expectations entails eschewing ideals and replacing optimal goals with modest, real-world solutions. In this essay, Deborah Kerdeman agrees with Feuer that moderation is vital for reform, but maintains that embracing moderation does not contradict pursuing goals. To show how goals and moderation work in concert to promote reform, Kerdeman examines and reframes Feuer's assumptions about ideals. She also distinguishes moderation from satisficing and argues that satisficing, not ideals, can be deleterious to reform. Kerdeman concludes that sensible policy and research, while important, will not necessarily help reformers embrace moderation; cultivating moderation instead requires ongoing self-examination. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||