Drought management: a multi-level governance approach in rural China

Drought has always been a serious problem in many parts of the world, and climate change may further exacerbate this problem. Much literature is available on providing information on drought instruments in rural China covering establishing national drought relief (Zhang et al., 2005) and water scarcity management systems (Qu et al., 2010), promoting water saving and agricultural technology (Huang et al., 2009; Blanke, et al., 2007), analyzing Water Users Association (WUA) (Wang et al., 2010), initiating water pricing measures (Yang et al., 2003; Zhong and Mol, 2010), popularizing agricultural subsidies (Du et al., 2011), and experimenting with policy-oriented microfinance and agricultural insurance (Du, 2003; Zeng and Mu, 2010). But very few has addressed the issues on multi-level governance in this area in general, and in China in particular. This paper focuses on the question: How can an examination of institutional and non-institutional causes of drought and the performance of existing instruments at multiple levels of governance help us to develop more appropriate policy instruments for drought management in China

Patient-reported causes of heart failure in a large European sample

Background:  Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods:  European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. Results:  Patients who did not report any cause (11%) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46%, mainly comorbidities), followed by behavioral (38%, mainly smoking), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58% had hypertension, while only 5% reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95% confidence interval (95% CI) = 0.95-2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95% CI = 0.94-2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40-1.01, p = 0.06). Conclusion:  European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions

Sandalwood as a Component of Agroforestry: Exploration of Parasitism and Competition with the Wanulcas Model

Sandalwood is an important component of agroforestry systems in the drier Eastern parts of Indonesia, although its value to farmers is still limited by existing policies and regulation of marketing. As a relatively slow growing root parasite, sandalwood will interact with other components in a complex pattern of competition and host-parasite relationships, depending on root distribution and rooting depth of potential hosts. We describe a number of modifications to the generic tree-soil-crop simulation model WaNuLCAS, that allow exploration of the transition between parasitism and competition. The key variable in this transition is the effectiveness of formation of the parasitic link for all situations where roots of the host and parasite occur in the same volume of soil. At low values of this effectiveness competition dominates, at higher values sandalwood will weaken the host, until it effectively kills it, leading to an optimum response of sandalwood to the effectiveness parameter. Unresolved questions in the formulation of the model are the lifespan of parasitized roots and the question whether or not sandalwood will allocate energy resources for maintenance respiration of host roots after the formation of haustoria. The'desk study' reported here was intended to focus subsequent field studies on these unresolved issues

Йосиф Конрадович Пачоський: історіографія проблеми

Проаналізовано наукові, науково-популярні, публіцистичні, літературні джерела щодо біографії і наукової діяльності Й.К. Почоського, розділені на три періоди: перший — дореволюційний період вивчення життєвого шляху та наукової діяльності вченого (1882—1917), другий — радянський (1917—1989), третій — сучасний (1989 р.). Окрім вітчизняних, висвітлено праці дослідників із Польщі.Проанализированы научные, научно-популярные, публицистические, литературные источники по биографии и научной деятельности И.К.Пачоского, разделенные на три периода: первый — дореволюционный период изучения жизненного пути и научной деятельности ученого (1882—1917), второй советский (1917—1989), третий — современный (с 1989 г. ). Кроме отечественных, освещены работы исследователей из Польши.The paper contains analysis of scientific, popular-scientific, publicistic and literary sources on the scientific biography of I.K. Pachosky, divided in the three periods: first — pre-revolutionary (1882—1917), second — soviet (1917—1989), third — contemporary (1989 and on). Apart from national scientists, works of scientists from Poland also included

Reduction of blood culture contamination rate by an educational intervention

Background: Although mechanical dyssynchrony parameters derived by speckle tracking echocardiography (STE) may predict response to cardiac resynchronization therapy (CRT), comparability of parameters derived with different STE vendors is unknown. Methods: In the MARC study, echocardiographic images of heart failure patients obtained before CRT implantation were prospectively analysed with vendor specific STE software (GE EchoPac and Philips QLAB) and vendor-independent software (TomTec 2DCPA). Response was defined as change in left ventricular (LV) end-systolic volume between examination before and six-months after CRT implantation. Basic longitudinal strain and mechanical dyssynchrony parameters (septal to lateral wall delay (SL-delay), septal systolic rebound stretch (SRSsept), and systolic stretch index (SSI)) were obtained from either separate septal and lateral walls, or total LV apical four chamber. Septal strain patterns were categorized in three types. The coefficient of variation and intra-class correlation coefficient (ICC) were analysed. Dyssynchrony parameters were associated with CRT response using univariate regression analysis and C-statistics. Results: Two-hundred eleven patients were analysed. GE-cohort (n = 123): age 68 years (interquartile range (IQR): 61-73), 67% male, QRS-duration 177ms (IQR: 160-192), LV ejection fraction: 26 +/- 7%. Philips-cohort (n = 88): age 67 years (IQR: 59-74), 60% male, QRS-duration: 179 ms (IQR: 166-193), LV ejection fraction: 27 +/- 8. LV derived peak strain was comparable in the GE-(GE: -7.3 +/- 3.1%, TomTec: -6.4 +/- 2.8%, ICC: 0.723) and Philips-cohort (Philips: -7.7 +/- 2.7%, TomTec: -7.7 +/- 3.3%, ICC: 0.749). SL-delay showed low ICC values (GE vs. TomTec: 0.078 and Philips vs. TomTec: 0.025). ICC's of SRSsept and SSI were higher but only weak (GE vs. TomTec: SRSsept: 0.470, SSI: 0.467) (Philips vs. QLAB: SRSsept: 0.419, SSI: 0.421). Comparability of septal strain patterns was low (Cohen's kappa, GE vs. TomTec: 0.221 and Philips vs. TomTec: 0.279). Septal strain patterns, SRSsept and SSI were associated with changes in LV end-systolic volume for all vendors. SRSsept and SSI had relative varying C-statistic values (range: 0.530-0.705) and different cut-off values between vendors. Conclusions: Although global longitudinal strain analysis showed fair comparability, assessment of dyssynchrony parameters was vendor specific and not applicable outside the context of the implemented platform. While the standardization taskforce took an important step for global peak strain, further standardization of STE is still warranted

Association of ECG characteristics with clinical and echocardiographic outcome to CRT in a non-LBBB patient population

Purpose: Effectiveness of cardiac resynchronization therapy (CRT) in patients without left bundle branch block (non-LBBB) QRS morphology is limited. Additional selection criteria are needed to identify these patients. Methods: Seven hundred ninety consecutive patients with non-LBBB morphology, who received a CRT-device in 3 university centers in the Netherlands, were selected. Pre-implantation 12-lead ECGs were evaluated on morphology, duration, and area of the QRS complex, as well as on PR interval, left ventricular activation time (LVAT), and the presence of fragmented QRS (fQRS). Association of these ECG features with the primary endpoint: a combination of left ventricular assist device (LVAD) implantation, cardiac transplantation and all-cause mortality, and secondary endpoint—echocardiographic reduction of left ventricular end-systolic volume (LVESV)—were evaluated. Results: The primary endpoint occurred more often in non-LBBB patients with with PR interval ≥ 230ms, QRS area < 109μVs, and with fQRS. Multivariable regression analysis showed independent associations of QRS area (HR 2.33 [1.44, 3.77], p = 0.001) and PR interval (HR 2.03 [1.51, 2.74], p < 0.001) only. Mean LVESV reduction was significantly lower in patients with baseline RBBB, QRS duration < 150 ms, PR interval ≥ 230 ms, and in QRS area < 109 μVs. Multivariable regression analyses only showed significant associations between QRS area ≥ 109 μVs (OR 2.00 [1.09, 3.66] p = 0.025) and probability of echocardiographic response to CRT. Conclusions: In the heterogeneous non-LBBB patient population, QRS area and PR prolongation rather than traditional QRS duration and morphology are associated to both clinical and echocardiographic outcomes of CRT

The emergence of a commercial trade in pangolins from Gabon

Recent seizures of illegally-held wildlife indicate a mounting global trade in pangolins involving all eight species. Seizures of illegally-traded African pangolins are increasing as wild populations of Asian species decline. We investigated trade in pangolins and law enforcement efforts in Gabon; a country likely to have intact wild populations of three of the four species of African pangolin. We compared village sales and trade chains between 2002-3 and 2014. Hunters reported pangolins to be the most frequently requested species in 2014 and the value of pangolins had increased at every point along their trade chain. In Libreville, giant pangolin prices increased 211% and arboreal pangolin prices 73% whilst inflation rose only 4.6% over the same period. We documented a low rate of interception of illegally-traded pangolins despite increased law enforcement. Surveys of potential export routes detected exports across forest borders, in conjunction with ivory, but not through public transport routes. We conclude that whilst there is clear potential and ikelihood that a wild pangolin export trade is emerging from Gabon, traditional bushmeat trade chains may not be the primary supply route. We recommend adjusting conservation policies and actions to impede further development of illegal trade within and from Gabon

Категоріальна ситуація перфектності як засіб вираження відношень різночасності дій у рамках абзацу

Мета - довести, що категоріальна ситуація перфектності є основним із засобів вираження різночасності дій у тексті

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned.</p> <p>Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal.</p> <p>Findings</p> <p>We analysed 3165 medical appraisals, 2444 (77%) of them from the public disability insurance, 678 (22%) from private accident, liability and loss of income insurances and 43 (1%) from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3).</p> <p>Conclusions</p> <p>From the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.</p