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Truth Commissions after Economic Crises: Political Learning or Blame Game?
This article addresses an important but understudied aspect of the recent Great Recession in Europe: the institutional strategies political elites deployed to learn from past policy failures and address accountability, more specifically, truth commissions. We raise two overlapping puzzles. The first concerns the timing of the decision to adopt an economic truth commission: while Iceland established a truth commission at an early stage of the crisis, Greece and Ireland did so much later. What accounts for ‘early’ versus ‘delayed’ truth seekers? The second concerns variations in learning outcomes. Iceland’s commission paved the way for learning institutional lessons, but truth commissions in Greece and Ireland became overtly politicised. What accounts for these divergences? This article compares truth commissions in Iceland, Greece and Ireland and identifies two types of political learning – institutional and instrumental – related to the establishment of a truth commission. It argues that political elites in countries with higher pre-crisis levels of trust in institutions and public transparency are more likely to establish economic truth commissions quickly; this is the ‘institutional logic’ of learning. The ‘instrumental logic’ of learning, in contrast, leads governments interested in apportioning blame to their predecessors to establish commissions at a later date, usually proximal to critical elections
Attainment of Low Disease Activity and Remission Targets reduces the risk of severe flare and new damage in Childhood Lupus
Objectives: To assess the achievability and effect of attaining low disease activity (LDA) or remission in childhood (cSLE). /
Methods: Attainment of three adult-SLE derived definitions of LDA (LLDAS, LA, Toronto-LDA), and four definitions of remission (clinical-SLEDAI-defined remission on/off treatment, pBILAG-defined remission on/off treatment) was assessed in UK JSLE Cohort Study patients longitudinally. Prentice-Williams-Petersen-GAP recurrent event models assessed the impact of LDA/remission attainment on severe flare/new damage. /
Results: LLDAS, LA and Toronto-LDA targets were reached in 67%, 73% and 32% of patients, after a median of 18, 15 or 17 months, respectively. Cumulatively, LLDAS, LA and Toronto-LDA was attained for a median of 23%, 31% and 19% of total follow-up-time, respectively. Remission on-treatment was more common (61% cSLEDAI-defined, 42% pBILAG-defined) than remission off-treatment (31% cSLEDAI-defined, 21% pBILAG-defined). Attainment of all target states, and disease duration (>1 year), significantly reduced the hazard of severe flare (p 0.05). Attainment of all targets reduced the hazards of new damage (p< 0.05). /
Conclusions: This is the first study demonstrating that adult-SLE-derived definitions of LDA/remission are achievable in cSLE, significantly reducing risk of severe flare/new damage. Of the LDA definitions, LLDAS performed best, leading to a statistically comparable reduction in the hazards of severe flare to attainment of clinical-remission
Clinical and laboratory characteristics in juvenile-onset systemic lupus erythematosus across age groups
BACKGROUND
Systemic lupus erythematous (SLE) is a systemic autoimmune/inflammatory condition. Approximately 15–20% of patients develop symptoms before their 18th birthday and are diagnosed with juvenile-onset SLE (JSLE). Gender distribution, clinical presentation, disease courses and outcomes vary significantly between JSLE patients and individuals with adult-onset SLE. This study aimed to identify age-specific clinical and/or serological patterns in JSLE patients enrolled to the UK JSLE Cohort Study.
METHODS
Patient records were accessed and grouped based on age at disease-onset: pre-pubertal (≤7 years), peri-pubertal (8–13 years) and adolescent (14–18 years). The presence of American College of Rheumatology (ACR) classification criteria, laboratory results, disease activity [British Isles Lupus Assessment Group (BILAG) and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) scores] and damage [Systemic Lupus International Collaborating Clinics (SLICC) damage index] were evaluated at diagnosis and last follow up.
RESULTS
A total of 418 JSLE patients were included in this study: 43 (10.3%) with pre-pubertal disease onset; 240 (57.4%) with peri-pubertal onset and 135 (32.3%) were diagnosed during adolescence. At diagnosis, adolescent JSLE patients presented with a higher number of ACR criteria when compared with pre-pubertal and peri-pubertal patients [pBILAG2004 scores: 9(4–20] vs. 7(3–13] vs. 7(3–14], respectively, p = 0.015] with increased activity in the following BILAG domains: mucocutaneous (p = 0.025), musculoskeletal (p = 0.029), renal (p = 0.027) and cardiorespiratory (p = 0.001). Furthermore, adolescent JSLE patients were more frequently ANA-positive (p = 0.034) and exhibited higher anti-dsDNA titres (p = 0.001). Pre-pubertal individuals less frequently presented with leukopenia (p = 0.002), thrombocytopenia (p = 0.004) or low complement (p = 0.002) when compared with other age groups. No differences were identified in disease activity (pBILAG2004 score), damage (SLICC damage index) and the number of ACR criteria fulfilled at last follow up.
CONCLUSIONS
Disease presentations and laboratory findings vary significantly between age groups within a national cohort of JSLE patients. Patients diagnosed during adolescence exhibit greater disease activity and “classic” autoantibody, immune cell and complement patterns when compared with younger patients. This supports the hypothesis that pathomechanisms may vary between patient age groups
Accreting Millisecond X-Ray Pulsars
Accreting Millisecond X-Ray Pulsars (AMXPs) are astrophysical laboratories
without parallel in the study of extreme physics. In this chapter we review the
past fifteen years of discoveries in the field. We summarize the observations
of the fifteen known AMXPs, with a particular emphasis on the multi-wavelength
observations that have been carried out since the discovery of the first AMXP
in 1998. We review accretion torque theory, the pulse formation process, and
how AMXP observations have changed our view on the interaction of plasma and
magnetic fields in strong gravity. We also explain how the AMXPs have deepened
our understanding of the thermonuclear burst process, in particular the
phenomenon of burst oscillations. We conclude with a discussion of the open
problems that remain to be addressed in the future.Comment: Review to appear in "Timing neutron stars: pulsations, oscillations
and explosions", T. Belloni, M. Mendez, C.M. Zhang Eds., ASSL, Springer;
[revision with literature updated, several typos removed, 1 new AMXP added
X-ray Absorption and Reflection in Active Galactic Nuclei
X-ray spectroscopy offers an opportunity to study the complex mixture of
emitting and absorbing components in the circumnuclear regions of active
galactic nuclei, and to learn about the accretion process that fuels AGN and
the feedback of material to their host galaxies. We describe the spectral
signatures that may be studied and review the X-ray spectra and spectral
variability of active galaxies, concentrating on progress from recent Chandra,
XMM-Newton and Suzaku data for local type 1 AGN. We describe the evidence for
absorption covering a wide range of column densities, ionization and dynamics,
and discuss the growing evidence for partial-covering absorption from data at
energies > 10 keV. Such absorption can also explain the observed X-ray spectral
curvature and variability in AGN at lower energies and is likely an important
factor in shaping the observed properties of this class of source.
Consideration of self-consistent models for local AGN indicates that X-ray
spectra likely comprise a combination of absorption and reflection effects from
material originating within a few light days of the black hole as well as on
larger scales. It is likely that AGN X-ray spectra may be strongly affected by
the presence of disk-wind outflows that are expected in systems with high
accretion rates, and we describe models that attempt to predict the effects of
radiative transfer through such winds, and discuss the prospects for new data
to test and address these ideas.Comment: Accepted for publication in the Astronomy and Astrophysics Review. 58
pages, 9 figures. V2 has fixed an error in footnote
The importance of gas infrastructure in power systems with high wind power penetrations
Gas fired generation currently plays an integral support role ensuring security of supply in power systems with high wind power penetrations due to its technical and economic attributes. However, the increase in variable wind power has affected the gas generation output profile and is pushing the boundaries of the design and operating envelope of gas infrastructure. This paper investigates the mutual dependence and interaction between electricity generation and gas systems through the first comprehensive joined-up, multi-vector energy system analysis for Ireland. Key findings reveal the high vulnerability of the Irish power system to outages on the Irish gas system. It has been shown that the economic operation of the power system can be severely impacted by gas infrastructure outages, resulting in an average system marginal price of up to €167/MW h from €67/MW h in the base case. It has also been shown that gas infrastructure outages pose problems for the location of power system reserve provision, with a 150% increase in provision across a power system transmission bottleneck. Wind forecast error was shown to be a significant cause for concern, resulting in large swings in gas demand requiring key gas infrastructure to operate at close to 100% capacity. These findings are thought to increase in prominence as the installation of wind capacity increases towards 2020, placing further stress on both power and gas systems to maintain security of supply
Carpal tunnel syndrome and the "double crush" hypothesis: a review and implications for chiropractic
Upton and McComas claimed that most patients with carpal tunnel syndrome not only have compressive lesions at the wrist, but also show evidence of damage to cervical nerve roots. This "double crush" hypothesis has gained some popularity among chiropractors because it seems to provide a rationale for adjusting the cervical spine in treating carpal tunnel syndrome. Here I examine use of the concept by chiropractors, summarize findings from the literature, and critique several studies aimed at supporting or refuting the hypothesis. Although the hypothesis also has been applied to nerve compressions other than those leading to carpal tunnel syndrome, this discussion mainly examines the original application – "double crush" involving both cervical spinal nerve roots and the carpal tunnel. I consider several categories: experiments to create double crush syndrome in animals, case reports, literature reviews, and alternatives to the original hypothesis. A significant percentage of patients with carpal tunnel syndrome also have neck pain or cervical nerve root compression, but the relationship has not been definitively explained. The original hypothesis remains controversial and is probably not valid, at least for sensory disturbances, in carpal tunnel syndrome. However, even if the original hypothesis is importantly flawed, evaluation of multiple sites still may be valuable. The chiropractic profession should develop theoretical models to relate cervical dysfunction to carpal tunnel syndrome, and might incorporate some alternatives to the original hypothesis. I intend this review as a starting point for practitioners, educators, and students wishing to advance chiropractic concepts in this area
A study protocol for applying the co-creating knowledge translation framework to a population health study
BACKGROUND: Population health research can generate significant outcomes for communities, while Knowledge Translation (KT) aims to expressly maximize the outcomes of knowledge producing activity. Yet the two approaches are seldom explicitly combined as part of the research process. A population health study in Port Lincoln, South Australia offered the opportunity to develop and apply the co-KT Framework to the entire research process. This is a new framework to facilitate knowledge formation collaboratively between researchers and communities throughout a research to intervention implementation process. DESIGN: This study employs a five step framework (the co-KT Framework) that is formulated from engaged scholarship and action research principles. By following the steps a knowledge base will be cumulatively co-created with the study population that is useful to the research aims. Step 1 is the initiating of contact between the researcher and the study contexts, and the framing of the research issue, achieved through a systematic data collection tool. Step 2 refines the research issue and the knowledge base by building into it context specific details and conducting knowledge exchange events. Step 3 involves interpreting and analysing the knowledge base, and integrating evidence to inform intervention development. In Step 4 the intervention will be piloted and evaluated. Step 5 is the completion of the research process where outcomes for improvement will be instituted as regular practice with the facilitation of the community. In summary, the model uses an iterative knowledge construction mechanism that is complemented by external evidence to design interventions to address health priorities within the community. DISCUSSION: This is a systematic approach that operationalises the translational cycle using a framework for KT practice. It begins with the local context as its foundation for knowledge creation and ends with the development of contextually applicable interventions. It will be of interest to those involved in KT research, participatory action research, population health research and health care systems studies. The co-KT Framework is a method for embedding the principles of KT into all stages of a community-based research process, in which research questions are framed by emergent data from each previous stage.Kathryn Powell, Alison Kitson, Elizabeth Hoon, Jonathan Newbury, Anne Wilson and Justin Beilb
Proteogenomic elucidation of the initial steps in the benzene degradation pathway of a novel halophile, Arhodomonas sp. strain Rozel, isolated from a hypersaline environment
Lately, there has been a special interest in understanding the role of halophilic and halotolerant organisms for their ability to degrade hydrocarbons. The focus of this study was to investigate the genes and enzymes involved in the initial steps of the benzene degradation pathway in halophiles. The extremely halophilic bacteria Arhodomonas sp. strain Seminole and Arhodomonas sp. strain Rozel, which degrade benzene and toluene as the sole carbon source at high salinity (0.5 to 4 M NaCl), were isolated from enrichments developed from contaminated hypersaline environments. To obtain insights into the physiology of this novel group of organisms, a draft genome sequence of the Seminole strain was obtained. A cluster of 13 genes predicted to be functional in the hydrocarbon degradation pathway was identified from the sequence. Two-dimensional (2D) gel electrophoresis and liquid chromatography-mass spectrometry were used to corroborate the role of the predicted open reading frames (ORFs). ORFs 1080 and 1082 were identified as components of a multicomponent phenol hydroxylase complex, and ORF 1086 was identified as catechol 2,3-dioxygenase (2,3-CAT). Based on this analysis, it was hypothesized that benzene is converted to phenol and then to catechol by phenol hydroxylase components. The resulting catechol undergoes ring cleavage via the meta pathway by 2,3-CAT to form 2-hydroxymuconic semialdehyde, which enters the tricarboxylic acid cycle. To substantiate these findings, the Rozel strain was grown on deuterated benzene, and gas chromatography-mass spectrometry detected deuterated phenol as the initial intermediate of benzene degradation. These studies establish the initial steps of the benzene degradation pathway in halophiles.Peer reviewedMicrobiology and Molecular Genetic
A systematic review of high-fibre dietary therapy in diverticular disease
The exact pathogenesis of diverticular disease of the sigmoid colon is not well established. However, the hypothesis that a low-fibre diet may result in diverticulosis and a high-fibre diet will prevent symptoms or complications of diverticular disease is widely accepted. The aim of this review is to assess whether a high-fibre diet can improve symptoms and/or prevent complications of diverticular disease of the sigmoid colon and/or prevent recurrent diverticulitis after a primary episode. Clinical studies were eligible for inclusion if they assessed the treatment of diverticular disease or the prevention of recurrent diverticulitis with a high-fibre diet. The following exclusion criteria were used for study selection: studies without comparison of the patient group with a control group. No studies concerning prevention of recurrent diverticulitis with a high-fibre diet met our inclusion criteria. Three randomised controlled trials (RCT) and one case-control study were included in this systematic review. One RCT of moderate quality showed no difference in the primary endpoints. A second RCT of moderate quality and the case-control study found a significant difference in favour of a high-fibre diet in the treatment of symptomatic diverticular disease. The third RCT of moderate quality found a significant difference in favour of methylcellulose (fibre supplement). This study also showed a placebo effect. High-quality evidence for a high-fibre diet in the treatment of diverticular disease is lacking, and most recommendations are based on inconsistent level 2 and mostly level 3 evidence. Nevertheless, high-fibre diet is still recommended in several guideline
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