Die Landwirtschaft als stabilisierender Faktor ländlicher Räume: Beispiele Litauen und Weißrussland

Eine Betrachtung der aktuellen Situation in den ländlichen Räumen Litauens und Weißrusslands macht deutlich, dass man noch nicht von einem abgeschlossenen Transformationsprozess sprechen kann. Zu groß sind die Probleme vor allem in den peripheren ländlichen Regionen der Transformationsstaaten. Sie stehen allerdings nur äußerst selten im Mittelpunkt regionalplanerischer Überlegungen und Entwicklungsstrategien. Ihre Lage wird dadurch kompliziert, dass ihre wirtschaftliche Basis überwiegend von der Landwirtschaft gebildet wurde, die sich aus Grenzstandorten mehr und mehr zurückzieht. Die gegenwärtig häufig praktizierte Subsistenzwirtschaft ist eine Möglichkeit, den Bewohnern das Überleben zu sichern, ist aber nicht als dauerhafter Stabilisierungsfaktor dieser Räume anzusehen. Ebenso wenig kann dies der zur Zeit oft zitierte ”Agrotourismus” sein, denn nicht alle ländlichen Räume sind touristisch interessant und nicht alle Touristen zieht es auf einen Bauernhof. Ganz offensichtlich wird es sich dabei um Einzellösungen handeln, mit deren Hilfe die unterschiedlichen ländlichen Peripherien stabilisiert werden können. Es darf sicher nicht als voreilige Schlussfolgerung angenommen werden, wenn man das Schrifttum und eigene Untersuchungen dahingehend interpretiert, dass die unterschiedliche Herangehen an den Übergang von der Plan- zur Marktwirtschaft doch auch zu stark divergierenden Resultaten geführt hat. Litauens Schocktherapie hat den ländlichen Raum zunächst in eine tiefe Krise geführt und zur Wahlniederlage des Reformers Landsbergis beigetragen. Gegenwärtig beginnt eine vorsichtige Konsolidierung, ein Beitritt zur Europäischen Union gilt als realistisches Ziel und wird entschieden forciert. Zu erwartende Schwierigkeiten und Problem vor allem in der Landwirtschaft sieht man als lösbar an. Der gradualistische Weg Weißrusslands hat zwar den raschen Produktionsrückgang wie in Litauen verhindert, gleichermaßen hat er jedoch keine neuen Strukturen entstehen lassen, sondern eher die alten konserviert. Die bevorstehende EU-Osterweiterung wird sich in einem vermehrten Wettbewerbsdruck auf die landwirtschaftliche Produktion Weißrusslands äußern, und beim gegenwärtigen schlechten wirtschaftlichen Zustand vieler Betriebe ist eine erfolgreiche Etablier ung marktwirtschaftlicher Strukturen nicht zu erwarten. Für die ländlichen Räume bedeutet dies, dass ihre Zukunft vor allem davon abhängt, in welcher Weise sich die Regierung Weißrusslands zu umfassenden Reformen z. B. zum Bodeneigentum und zu privatrechtlichen Eigentumsformen.An assessment of the current situation of the rural regions of Lithuania and Belarus clearly indicates that the process of transformation is by no means over. Indeed, the problems in the peripheral, rural regions of the transformation states are far too big for any such claim to be justified. However, it is extremely rare for the problems to be the focus of considerations concerning regional planning and development strategies. Their position is made complicated by the fact th at the economic basis was primarily agriculture, which is now withdrawing increasingly from the border locations. Although the subsistence economy, wh ich is widespread at the moment, is one way of ensuring the inhabitants survive, it should not be seen as a permanent stabilisation factor for these regions. The currently much-quoted ”agro-tourism” is also unsuitable, as not all rural regions are interesting from the point of view of tourism and not all tourists are interested in spending their holidays on a farm. It is obvious that individual solutions will be necessary in order to stab ilise the different rural peripheries. It would by no means be a premature conclusion if one interpreted the relevant literature and own analyses along the lines that the different approaches to the transition from planned to free market economy has led to several divergent results. Lithuania’s shock therapy plunged the rural areas initially into a state of deep crisis and contributed to the election defeat of the reform politician Landsbergis. Tentative consolidation is taking place at the moment; it appears realistic to aim at joining the European Union, and every effort is being made in this respect. The general belief is that the expected difficulties and problems, especially in agriculture, will be surmountable. The gradual approach taken by Belarus did prevent the fast drop in productivity suffered in Lithuania, but it has not allowed any new structures to emerge and has instead preserved the old ones. The imminent EU Eastern enlargement will express itself in an increased competitive pressure on the agricultural production in Belarus; given the current precarious situation in which many business find themselves, there is no reason to expect a successful establishment of free market structures. This means that the future of rural regions is primarily dependent on the extent to which the government in Belarus is willing to engage in comprehensive reforms, e.g. ownership of land and private ownership of property

Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered

Background Shoulder pain is a very common symptom. Disorders of the rotator cuff tendons due to wear or tear are among the most common causes of shoulder pain and disability. Magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA) and ultrasound (US) are increasingly being used to assess the presence and size of rotator cuff tears to assist in planning surgical treatment. It is not known whether one imaging method is superior to any of the others.Objectives To compare the diagnostic test accuracy of MRI, MRA and US for detecting any rotator cuff tears (i.e. partial or full thickness) in people with suspected rotator cuff tears for whom surgery is being considered.Search methods We searched the Cochrane Register of Diagnostic Test Accuracy Studies, MEDLINE, EMBASE, and LILACS from inception to February 2011. We also searched trial registers, conference proceedings and reference lists of articles to identify additional studies. No language or publication restrictions were applied.Selection criteria We included all prospective diagnostic accuracy studies that assessed MRI, MRA or US against arthroscopy or open surgery as the reference standard, in people suspected of having a partial or full thickness rotator cuff tear. We excluded studies that selected a healthy control group, or participants who had been previously diagnosed with other specific causes of shoulder pain such as osteoarthritis or rheumatoid arthritis. Studies with an excessively long period (a year or longer) between the index and reference tests were also excluded.Data collection and analysis Two review authors independently extracted data on study characteristics and results of included studies, and performed quality assessment according to QUADAS criteria. Our unit of analysis was the shoulder. for each test, estimates of sensitivity and specificity from each study were plotted in ROC space and forest plots were constructed for visual examination of variation in test accuracy. Meta-analyses were performed using the bivariate model to produce summary estimates of sensitivity and specificity. We were unable to formally investigate potential sources of heterogeneity because of the small number of studies.Main results We included 20 studies of people with suspected rotator cuff tears (1147 shoulders), of which six evaluated MRI and US (252 shoulders), or MRA and US (127 shoulders) in the same people. Many studies had design flaws, with the potential for bias, thus limiting the reliability of their findings. Overall, the methodological quality of the studies was judged to be low or unclear. for each test, we observed considerable heterogeneity in study results, especially between studies that evaluated US for the detection of full thickness tears and studies that evaluated MRA for the detection of partial thickness tears. the criteria for a positive diagnostic test (index tests and reference standard) varied between studies.Meta-analyses were not possible for studies that assessed MRA for detection of any rotator cuff tears or partial thickness tears. We found no statistically significant differences in sensitivity or specificity between MRI and US for detecting any rotator cuff tears (P = 0.13), or for detecting partial thickness tears (P = 1.0). Similarly, for the comparison between MRI, MRA and US for detecting full thickness tears, there was no statistically significant difference in diagnostic performance (P = 0.7). for any rotator cuff tears, the summary sensitivity and specificity were 98% (95% CI 92% to 99%) and 79% (95% CI 68% to 87%) respectively for MRI (6 studies, 347 shoulders), and 91% (95% CI 83% to 95%) and 85% (95% CI 74% to 92%) respectively for US (13 studies, 854 shoulders). for full thickness tears, the summary sensitivity and specificity were 94% (95% CI 85% to 98%) and 93% (95% CI 83% to 97%) respectively for MRI (7 studies, 368 shoulders); 94% (95% CI 80% to 98%) and 92% (95% CI 83% to 97%) respectively for MRA (3 studies, 183 shoulders); and 92% (95% CI 82% to 96%) and 93% (95% CI 81% to 97%) respectively for US (10 studies, 729 shoulders).Because few studies were direct head-to-head comparisons, we could not perform meta-analyses restricted to these studies. the test comparisons for each of the three classifications of the target condition were therefore based on indirect comparisons which may be prone to bias due to confounding.Authors' conclusions MRI, MRA and US have good diagnostic accuracy and any of these tests could equally be used for detection of full thickness tears in people with shoulder pain for whom surgery is being considered. the diagnostic performance of MRI and US may be similar for detection of any rotator cuff tears. However, both MRI and US may have poor sensitivity for detecting partial thickness tears, and the sensitivity of US may be much lower than that of MRI. the strength of evidence for all test comparisons is limited because most studies were small, heterogeneous and methodologically flawed, and there were few comparative studies. Well designed studies that directly compare MRI, MRA and US for detection of rotator cuff tears are needed.Universidade Federal de São Paulo, BrazilParker Institute, DenmarkOak FoundationTeesside University, UKUniversidade Federal de São Paulo, Dept Orthopaed & Traumatol, BR-04038032 São Paulo, BrazilMonash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Monash Dept Clin Epidemiol,Cabrini Hosp, Malvern, AustraliaUniv Birmingham, Birmingham, W Midlands, EnglandUniv Teesside, Hlth & Social Care Inst, Middlesbrough, Cleveland, EnglandUniversidade Federal de São Paulo, Dept Orthopaed & Traumatol, BR-04038032 São Paulo, BrazilWeb of Scienc

The impact of electronic commerce on small scale businesses (Lagos state Nigeria)

This paper examine the impact of electronic commerce on small scale business in Lagos Nigeria, and believes that electronic means of communication has been very useful in both micro and macro enterprises and has resulted to steady increase of productivity in their dealings from various organization. Lately, there has been a change from the level of patronage of electronic use when compare to now, buyers and sellers now understood the importance role of electronic commerce as it relate to trade. Furthermore, the positive impact of electronic marketing cannot be overemphasized in that through the relevant channels and medium of exchange products and commodity are reached within the stipulated time. These services has become reliable, affordable, and accessible within the reach of customers and retailers. The increasing numbers of people using electronic commerce are enormous and various techniques are put in place to ensure that needs of the people are attain. The data was presented in tables and analyzed through descriptive statistics such as mean measure, one sample statistics. The finding of this study reveals the role business structure played in ecommerce and also how small scale businesses use this structure in their perspective trade; it is helpful to customers and the sellers, in that it enable them build a cordial relationship as it relate to business. In addition electronic commerce has offer profitable services to small scale business holder, it has reduced transaction delay usually encounter by customers, business men and women, it has also enhance communication skills with partners

Utility of ultrasonography in guiding modification of disease modifying anti‐rheumatic drugs and steroid therapy for inflammatory arthritis in routine clinical practice

Objective: To determine the utility of ultrasonography in guiding modification of disease‐modifying anti‐rheumatic drug (DMARD) and steroid therapy for inflammatory arthritis (IA) in routine clinical practice. Methods: In this retrospective study, we analyzed DMARD and steroid use in IA patients referred to a rheumatologist‐led ultrasound clinic. Power Doppler (PD) vascularity and greyscale (GS) synovial hypertrophy joint findings were categorized as positive/negative for each patient. The erythrocyte sedimentation rate (ESR) was used as a measure of disease activity. Results: We assessed single visit data for 46 adult IA patients: 67.4% (n = 31) rheumatoid arthritis (RA), 15.2% (n = 7) psoriatic arthritis, 10.9% (n = 5) spondyloarthritis, and 6.5% (n = 3) undifferentiated IA. The mean ESR was 28.8 mm/h. Thirty‐seven patients with both GS and PD ultrasound results were subsequently analyzed. All patients (n = 10) escalated and/or initiated on DMARD and 9/10 patients escalated or initiated on steroids were PD and GS positive. Six of seven patients with dose reduction and/or cessation of DMARDs and five of seven patients with dose reduction or cessation of steroids were PD negative. Of six patients who were GS positive and PD negative, three had dose reduction and/or cessation of DMARDs, while four had dose reduction of steroids; none of the six patients had DMARD/steroid escalation. Conclusion: By clarifying joint inflammation in an IA cohort with overall low ESR, ultrasonography of physician‐selected joints can improve clinical assessment, resulting in treatment modification. Positive PD findings were particularly influential, while the clinical significance of GS positivity alone requires further investigation

MOTION Case Studies From Overtourism to Sustainable Tourism

The time of the pandemic coincided with much of the lifecycle of the project MOTION, which aimed at combating overtourism with innovating sustainable solutions for SMEs in the tourism industry. SMEs faced a lot of challenges then and still encounter different barriers in their daily lives due to, for example, limited time or financial resources. This publication illustrates ways to develop sustainable services through innovation to inspire readers and actors in the tourism industry to work towards a sustainable future in tourism in the EU. The publication is also suitable for educational purposes, and is useful reading for both educators and students. The case studies generated in Rovaniemi in Finland, Fehmarn and Kiel in Germany, the Curonian Spit in Lithuania, Toruń in Poland, and Granada and Monachil in Spain provide ideas for other businesses in Europe to find their niche in a sustainable future. The project is funded by the Finnish National Agency of the EU for the years 2020–2023

MOTION Scenario Book

Given that tourism has been fluctuating tremendously during the past four years, the project MOTION has during that time been working on the issues of overtourism and ways on how to solve them, by finding new sustainable solutions for the future. The MOTION Scenario Book illustrates alternative futures through ideas generated in scenarios in five European regions, Rovaniemi in Finland, Fehmarn and Kiel in Germany, the Curonian Spit in Lithuania, Toruń in Poland, and Granada and Monachil in Spain. The book is intended to serve as an inspiration to those who wish to grow sustainable solutions in tourism and combat overtourism. The project was funded by the Finnish National Agency of the EU for the years 2020–2023