Climate Policy in a Fragmented World - Transformative Governance Interactions at Multiple Levels

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Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review

Transanal irrigation (TAI) has received increasing attention as a treatment option in patients with bowel dysfunction. This systematic review was conducted according to the PRISMA guidelines and evaluates the effect of TAI in neurogenic bowel dysfunction (NBD), low anterior resection syndrome (LARS), faecal incontinence (FI) and chronic constipation (CC). The primary outcome was the effect of TAI on bowel function. Secondary outcomes included details on TAI, quality of life (QoL), the discontinuation rate, adverse events, predictive factors for a successful outcome, and health economics. A systematic search for articles reporting original data on the effect of TAI on bowel function was performed, and 27 eligible studies including 1435 individuals were included. Three randomised controlled trials, one non-randomised trial, and 23 observational studies were included; 70% of the studies were assessed to be of excellent or good methodological quality. Results showed an improvement in bowel function among patients with NBD, LARS, FI, and CC with some studies showing improvement in QoL. However, discontinuation rates were high. Side effects were common, but equally prevalent among comparative treatments. No consistent predictive factors for a successful outcome were identified. Results from this review show that TAI improves bowel function and potentially QoL; however, evidence remains limited

Evaluation of the Casimir Force for a Dielectric-diamagnetic Cylinder with Light Velocity Conservation Condition and the Analogue of Sellmeir's Dispersion Law

We study the Casimir pressure for a dielectric-diamagnetic cylinder subject to light velocity conservation and with a dispersion law analogous to Sellmeir's rule. Similarities to and differences from the spherical case are pointed out.Comment: 19 pages Latex, no figures; discussion expanded. To appear in Physica Script

Teaching Chinese to international students in China: political rhetoric and ground realities

This paper presents an on-going study of the enactment of The International Promotion of Chinese Policy (国际汉语推广政策). It explores how Chinese teaching and learning take place in a Chinese university under the Study in China Programme which allows international students, after a period of intensive Chinese language learning, to transfer to academic courses taught in Chinese for Chinese students at the tertiary level. This programme has expanded in recent years in response to the government's goal to enhance China's soft power globally. By studying policy documents, engaging in conversations with students and teachers, and observing classrooms, our study reveals that there are conflicting interests of social actors at national, institutional and individual levels, causing considerable conflicts and tensions in three aspects:1) the divergent goals of internationalisation between the government and the higher education institution; 2) the imperative need of academic Chinese for subject learning and the actual offer of Chinese for everyday communication; and 3) the competing role of English versus Chinese as a lingua franca for communication in the university setting. These conflicts make it difficult for international students to benefit from the subject courses, and for universities to implement successful language programmes for international students, and this renders the political objective of this programme difficult to achieve

The effect of the North Atlantic Subpolar Front as a boundary in pelagic biogeography decreases with increasing depth and organism size

Broad-scale patterns in the distribution of deep-sea pelagic species and communities are poorly known. An important question is whether biogeographic boundaries identified from surface features are important in the deep mesopelagic and bathypelagic. We present community analyses of discrete-depth samples of mesozooplankton and micronekton to full-ocean depth collected in the area where the Mid-Atlantic Ridge is crossed by the Subpolar Front. The results show that the distributional discontinuity associated with the front, which is strong near the surface, decreases with increasing depth. Both the frontal separation near the surface and the community convergence at increasing depths were clearer for mesozooplankton than for micronekton

Atrioventricular block of intraoperative device closure perimembranous ventricular septal defects; a serious complication

<p>Abstract</p> <p>Background</p> <p>Atrioventricular block (AVB) is a well-reported complication after closure of perimembranous ventricular septal defects (VSDs). To report the occurrence of AVB either during or following closure of perimembranous VSDs using a novel "hybrid" method involving a minimal inferior median incision and of intraoperative device closure of the perimembranous VSDs.</p> <p>Methods</p> <p>Between January 2009 and January 2011, patients diagnosed with perimembranous VSDs eligible for intraoperative device closure with a domestic occluder were identified. All patients were assessed by real-time transesophageal echocardiography (TEE) and electrocardiography.</p> <p>Results</p> <p>Of the 97 included patients, 94 were successfully occluded using this approach. Complete AVB occurred in only one case and one case of Mobitz type II AVB was diagnosed intraoperatively. In both patients, the procedure was aborted and the AVBs quickly resolved. Glucocorticosteroids were administered to another two patients who developed Mobitz type II AVB intraoperatively. Those two patients converted to Mobitz type I AVB 3 days and 5 days postsurgically. During the follow-up period (range, 6-24 months), one patient developed complete AVB 1 week following device insertion. Surgical device removal was followed by a rapid and complete recovery of atrioventricular conduction.</p> <p>Conclusions</p> <p>Intraoperative device closure of perimembranous VSDs with a domestic occluder resulted in excellent closure rates; however, AVB is a serious complication that can occur either during or any time after device closure of perimembranous VSDs. The technique described herein may reduce the incidence of perioperative AVB complications. Surgeons are encouraged to closely monitor all patients postsurgically to ensure AVB does not occur in their patients. Additional long-term data to better identify the prevalence and risk factors for AVB in treated patients are needed.</p

APOLO-Bari, an internet-based program for longitudinal support of bariatric surgery patients: study protocol for a randomized controlled trial

Background: Despite evidence of successful weight loss for bariatric surgery patients, some patients experience considerable weight regain over the long term. Given the strong association between post-surgery health behaviors and outcomes, aftercare intervention to address key behaviors appears to be a reasonable relapse-prevention strategy. As the burden of obesity rates increases in healthcare centers, an internet-based program appears to be a reasonable strategy for supporting bariatric surgery patients in the long term. The primary purpose of the current project is to develop and test the efficacy and perceived utility of APOLO-Bari.Methods/design: This study is a randomized control trial, which will be conducted in two hospital centers in the North of Portugal; it includes a control group receiving treatment as usual and an intervention group receiving the APOLO-Bari program for one year in addition to treatment as usual. A total of 180 male and female participants who underwent bariatric surgery (gastric sleeve or gastric bypass surgery) for 12 to 20 months will be recruited. Both groups will complete a similar set of questionnaires at baseline, every 4 months until the end of the intervention, and at 6 and 12 months follow-up. Assessment includes anthropometric variables and psychological self-report measures. The primary outcome measure will be weight regain measured at the end of treatment, and at 6 and 12 months follow-up. The secondary aims are to test the cost-effectiveness of the intervention and to investigate psychological predictors and trajectories of weight regain. APOLO-Bari was developed to address the weight regain problem in the bariatric population by offering additional guidance to bariatric patients during the postoperative period. The program includes: (a) a psychoeducational cognitive-behavioral-based self-help manual, (b) a weekly feedback messaging system that sends a feedback statement related to information reported by the participant, and (c) interactive chat sessions scheduled witThis research was partially supported by the Fundacao para a Ciencia e a Tecnologia through a European Union COMPETE program grant to Eva Conceicao (IF/01219/2014 and PTDC/MHC-PCL/4974/2012), a doctoral scholarship to Ana Pinto-Bastos (SFRH/BD/104159/2014), a doctoral scholarship to Sofia Ramalho (SFRH/BD/104182/2014), and a postdoctoral scholarship to Ana Rita Vaz (SFRH/BPD/94490/2013), co-financed by FEDER under the PT2020 Partnership Agreement (UID/PSI/01662/2013).info:eu-repo/semantics/publishedVersio

Discussion of "Probabilistic Index Models," by Thas, O., de Neve, J., Lieven, C. and Ottoy., J.-P.

We present a semiparametric statistical model for the probabilistic index which can be defined as P (Y \u3c-Y*) where Y and Y* are independent random response variables associated with covariate patterns X and X* respectively. A link function defines the relationship between the probabilistic index and a linear predictor. Asymptotic normality of the estimators and consistency of the covariance matrix estimator are established through semiparametric theory. The model is illustrated with several examples, and the estimation theory is validated in a simulation study

Diffusion of climate policy integration in adaptation strategies: Translating the EU mandate into UK and Danish national contexts

This is the author accepted manuscript/In this paper, we examine how EU Climate Adaptation Strategy and especially its pivotal principle of policy integration of climate adaptation has diffused to the climate adaptation strategies of Member States. We explore how this quest for climate adaptation policy integration was pushed by vertical diffusion of the framing and policy mixes launched at EU level. To do so, we analyse and compare national climate adaptation strategies in two EU Member States – the UK and Denmark – over a period of time 2013-2021 that witnessed Brexit and increased attention to climate impacts. Conceptually and analytically, we draw on the policy diffusion literature centring on four potential drivers of vertical policy diffusion: interests, rights, ideology, and recognition which inform the analysis. Further, to scrutinize what is diffused, we conceptualise climate policy integration including the rationale and policy instruments for CPI. We find that both countries’ approaches to climate change adaptation have been shaped by rights-based diffusion in a mixture of shadow hierarchy, soft power and activation of other policy areas with binding directives, and we further identify divergence between the cases in attention before and after Brexit and in mandating local level actions.European Commissio