Success Attributes of Regional Natural Resource Management

The complexity of natural resource management (NRM), which is socially an evolving 'discipline of disciplines', creates challenges for society. With the continual degradation of the natural resource base it can be hypothesised that the past and present approaches to NRM in Australia have failed. NRM is recognised in the 21st century as having assumed importance as a development strategy because of the claims that it can contribute towards sustainable livelihoods; thus NRM has two facets: the natural resource base and the institutional arrangements required to maintain this base. Australia is presently going through a transformation with the evolution of a regional NRM systems approach. This paper reports a hypothesised model of a sustainable regional NRM system for Australia

A strategic use of the communication mix in the destination image-formation process

National tourist offices and tourism stakeholders are challenged to maintain and secure travel markets. Travelers are constantly bombarded with travel marketing messages. Compounding the challenge is a lack of research on effective, efficient, and optimal methods in convincing tourists to travel to a particular destination. To address this literature gap, a questionnaire survey on destination brand image research was conducted on outbound travelers from four major cities, examining their image perceptions of Macao and the degree of influence that various information sources had on destination selection. Results show that a communication mix strategy could be designed to more effectively manage tourist destination image perceptions. A cross-tabulation of the data revealed that the information sources affecting travel destination choice had varying levels of influence. A "Communication Effectiveness Grid" (CEG) was conceptualized from the research with quadrants indicating marketing resource effectiveness. The CEG has significant implications for destinations with limited budgets wishing to influence travelers

CD4-Positive effector memory T cells participate in disease expression in ANCA-Associated vasculitis

Although the cause of ANCA-associated vasculitis (AAV) remains undetermined, the presence of lymphocytic infiltrates in inflammatory lesions of patients suggests that vascular damage is immune mediated. Studies over the past decade have implicated a role for T cells in the pathogenesis of AAV as altered T cell phenotype has been observed in this disorder. The distribution of T cell subpopulations has been analyzed most intensely in Wegener's granulomatosis (WG), where an expanded population of circulating CD4(+) effector memory T cells (CD4(+)T(EM)) was demonstrated. CD4(+)T(EM) cells play a major role in the pathogenesis of several autoimmune diseases. Specific suppression of CD4(+)T(EM) cells inhibits delayed-type hypersensitivity (DTH) and has therapeutic potential in autoimmune disease. Thus, CD4(+)T(EM) cells may act as inducers of tissue injury and participate in the development of AAV. Therapies that target CD4(+)T(EM), without impairing the activity of other lymphocyte subsets, may hold therapeutic promise for AAV.</p

Patient blood management : a solution for South Africa

For more than 70 years the default therapy for anaemia and blood loss was mostly transfusion. Accumulating evidence demonstrates a significant dose-dependent relationship between transfusion and adverse outcomes. This and other transfusion-related challenges led the way to a new paradigm. Patient blood management (PBM) is the application of evidence-based practices to optimise patient outcomes by managing and preserving the patient’s own blood. ‘Real-world’ studies have shown that PBM improves patient outcomes and saves money. The prevalence of anaemia in adult South Africans is 31% in females and 17% in males. Improving the management of anaemia will firstly improve public health, secondly relieve the pressure on the blood supply, and thirdly improve the productivity of the nation’s workforce. While high-income countries are increasingly implementing PBM, many middle- and low-income countries are still trying to upscale their transfusion services. The implementation of PBM will improve South Africa’s health status while saving costs.http://www.samj.org.zapm2020Medical Oncolog

Persistent expansion of CD4(+) effector memory T cells in Wegener's granulomatosis

In order to test the hypothesis that Wegener's granulomatosis (WG) is associated with an ongoing immune effector response, even in remission, we examined the distribution of peripheral naive and memory T-lymphocytes in this disease, and analyzed the function-related phenotypes of the memory T-cell population. Peripheral blood mononuclear cells (PBMCs) were freshly isolated from WG-patients in remission (R-WG, n=40), active WG-patients (A-WG, n=17), and age-matched healthy controls (HCs, n=21). Expression of CD4, CD8, CD45RO, CCR7, interleukin (IL)-18Rα, ST2L, and FoxP3 were determined by four-color flow cytometric analysis. CD45RO and CCR7 were used for distinction between naive and memory T cells, IL-18Rα, ST2L, and FoxP3 for the assessment of Type1, Type2, and regulatory T-cells, respectively. In R-WG, the CD4+CD45RO+CCR7− effector memory T-cell subpopulation (TEM) was relatively increased, whereas the CD4+CD45RO−CCR7+ naive T-cell population (TNaive) was decreased as compared to HC. The distribution of naive and memory CD8+T cells did not differ between R-WG, A-WG, and HC, nor did CD4+CD45RO+CCR7+ central memory T cells (TCM). In contrast to HC, the percentage of CD4+TNaive cells in R-WG correlated negatively with age, whereas CD4+TEM cells showed a positive correlation. In R-WG, a skewing towards Type2 T cells was observed in CD4+TEM cells. No differences were detected in FoxP3+CD4+TEM cells between R-WG and A-WG, whereas the FoxP3−CD4+TEM cells were increased in R-WG and decreased in A-WG as compared to HC. Collectively, peripheral blood homeostasis of CD4+T cells is disturbed in R-WG with the persistent expansion of non-regulatory CD4+TEM cells. These cells might be involved in relapse and may constitute a target for therapy