81,066 research outputs found

    Cities of culture and the regeneration game

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    Capital of Culture (ECoC) programme exactly a year on from its inauguration. This event also saw the transition from Liverpool's "Year of Culture 08‟ to "Year of Environment 09" and a simultaneous event in the Austrian city of Linz to which the Capital of Culture mantle passed, along with Vilnius, Lithuania. An estimated 60,000 people congregated at the Pier Head as well as at the Albert Dock and Wirral bank, for a celebration that included sing-a-longs, firework displays, street artists on illuminated bikes and light projections onto a famous refurbished new museum building making up this World Heritage city. This "Light Night" celebration also kick-started similar events held in cities in England and Scotland, with extended opening of venues. The Light Night theme chosen for Liverpool 08's swansong emulates the Nuit Blanche festival celebrated in dozens of cities such as Paris, Rome, Montreal and Toronto - the largest of which attract 1 to 3 million participants over "late night" weekend extravaganzas (Jiwa et al., 2009). These "eventful cities" (Richards and Palmer 2010) reflect a global trend and network that spreads virtually and geographically (Evans, 2011)

    Finding the balance in complex regional pain syndrome. Expertise, optimism, and evidence

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    Complex regional pain syndrome (CRPS), perhaps more than any other chronic pain disorder, is perplexing. It is highly disabling, particularly once it has “set in,” and it has a tendency to polarize the community—some view it as a quasidiagnosis to obscure malingering or conceal substandard clinical skills,1 and others as a multiple system overprotective response.2 What is agreed is that its pathophysiology is not completely understood and that it is difficult to treat. In light of this rather murky backdrop, we welcome the new perspectives article in this issue of Neurology® by Birklein et al.3 They describe their own clinical approach to the problem and their impressions of what works, what does not, and where the field might be heading. The lead author is the most prolific and arguably the most important researcher in this field, and the article clearly draws on a wealth of expertise and clinical experience probably unmatched globally. The article reminds us of the remaining substantial challenges that we face: for example, the need for prospective studies, higher quality clinical trials and audits, and a putative model that accounts for the transition from acute CRPS to chronic CRPS, which is arguably characterized by distinct pathophysiology. Anyone who treats a good number of CRPS patients will recognize the clinical patterns to which the authors allude and be comforted by the realization that even this group, at the top of the field, share the same substantial treatment challenges.G.L.M. is supported by a Principal Research Fellowship from the National Health & Medical Research Council of Australia ID 1061279

    The use of diatom records to establish reference conditions for UK lakes subject to eutrophication

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    A knowledge of pre-disturbance conditions is important for setting realistic restoration targets for lakes. For European waters this is now a requirement of the European Council Water Framework Directive where ecological status must be assessed based on the degree to which present day conditions deviate from reference conditions. Here, we employ palaeolimnological techniques, principally inferences of total phosphorus from diatom assemblages (DI-TP) and classification of diatom composition data from the time slice in sediment cores dated to similar to 1850 AD, to define chemical and ecological reference conditions, respectively, for a range of UK lake types. The DI-TP results from 169 sites indicate that reference TP values for low alkalinity lakes are typically 3 m mean depth) generally had lower reference TP concentrations than the shallow sites. A small group of shallow marl lakes had concentrations of similar to 30 mu g L-1. Cluster analysis of diatom composition data from 106 lakes where the key pressure of interest was eutrophication identified three clusters, each associated with particular lake types, suggesting that the typology has ecological relevance, although poor cross matching of the diatom groups and the lake typology at type boundaries highlights the value of a site-specific approach to defining reference conditions. Finally the floristic difference between the reference and present day (surface sample) diatom assemblages of each site was estimated using the squared chord distance dissimilarity coefficient. Only 25 of the 106 lakes experienced insignificant change and the findings indicate that eutrophication has impacted all lake types with > 50% of sites exhibiting significant floristic change. The study illustrates the role of the sediment record in determining both chemical and ecological reference conditions, and assessing deviation from the latter. Whilst restoration targets may require modification in the future to account for climate induced alterations, the long temporal perspective offered by palaeolimnology ensures that such changes are assessed against a sound baseline

    Impacts of river engineering on river channel behaviour : implications for managing downstream flood risk

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    Although knowledge of sediment transport has improved over the last 25 years, our understanding of bedload transfer and sediment delivery is still based on a limited set of observations or on models that make assumptions on hydraulic and sediment transport processes. This study utilises repeat lidar survey data of the River Caldew above the City of Carlisle in the UK to investigate the balance of erosion and deposition associated with channel switching from an engineered and managed single thread channel to a naturalising incipient wandering system. Over the 11-year survey period (four bankfull flood events) around 271,000 m3 of sediment were delivered to the river and floodplain and 197,000 m3 eroded suggesting that storage rates of around 7000 m3/annum occurred. The balance of erosion and deposition is influenced by channelisation with very restricted overbank sedimentation and only limited local and transient in-channel bar deposition along the engineered reach (8000 m3 eroded). This contrasts with the activity of the naturalising reach downstream where a developing wandering channel system is acting to store coarse sediment in-stream as large bar complexes and the associated upstream aggrading plane bed reaches and overbank as splay deposits (87,000 m3 stored). Such behavior suggests that naturalisation of channelised systems upstream of flood vulnerable urban areas can have a significant impact on sediment induced flooding downstream. This conclusion must, however, be moderated in the light of the relatively small volumes of material needed to instigate local aggradation in over-capacity urban channels

    Potential impact of adjustment policies on vulnerability of women and children to HIV/AIDS in sub-Saharan Africa

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    This paper evaluates the potential impact of adjustment policies of the International Monetary Fund and the World Bank on the vulnerability of women and children to HIV/AIDS in sub-Saharan Africa. A conceptual framework, composed of five different pathways of causation, is used for the evaluation. These five pathways connect changes at the macro level (e.g. removal of food subsidies) with effects at the meso (e.g. higher food prices) and micro levels (e.g. exposure of women and children to commercial sex) that influence the vulnerability of women and children to HIV/AIDS. Published literature on adjustment policies and socioeconomic determinants of HIV/AIDS among women and children in sub-Saharan Africa was reviewed to explore the cause-effect relationships included in the theoretical framework. Evidence suggests that adjustment policies may inadvertently produce conditions facilitating the exposure of women and children to HIV/AIDS. Complex research designs are needed to further investigate this relationship. A shift in emphasis from an individual approach to a socioeconomic approach in the study of HIV infection among women and children in the developing world is suggested. Given the potential for adjustment policies to exacerbate the AIDS pandemic among women and children, a careful examination of the effects of these policies on maternal and child welfare is urgently needed

    Interventions to Reduce Spasticity and Improve Function in People With Chronic Incomplete Spinal Cord Injury: Distinctions Revealed by Different Analytical Methods.

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    Background. Spinal cord injury (SCI) results in impaired function, and ankle joint spasticity is a common secondary complication. Different interventions have been trialed with variable results. Objective. We investigated the effects of pharmacological and physical (locomotor training) interventions on function in people living with incomplete motor function loss caused by SCI and used different analytical techniques to understand whether functional levels affect recovery with different interventions. Methods. Participants with an incomplete SCI were assigned to 3 groups: no intervention, Lokomat, or tizanidine. Outcome measures were the 10-m walk test, 6-minute walk test, and the Timed Up and Go. Participants were classified in 2 ways: (1) based on achieving an improvement above the minimally important difference (MID) and (2) using growth mixture modeling (GMM). Functional levels of participants who achieved the MID were compared and random coefficient regression (RCR) was used to assess recovery in GMM classes. Results. Overall, walking speed and endurance improved, with no difference between interventions. Only a small number of participants achieved the MID. Both MID and GMM-RCR analyses revealed that tizanidine improved endurance in high-functioning participants. GMM-RCR classification also showed that speed and mobility improved after locomotor training. Conclusions. Improvements in function were achieved in a limited number of people with SCI. Using the MID and GMM techniques, differences in responses to interventions between high-and low-functioning participants could be identified. These techniques may, therefore, have potential to be used for characterizing therapeutic effects resulting from different interventions
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