Placing Tourism Among the Options for Small Forest Owners in Northern Japan

All too often, a small, private forest property fails to meet its potential for the owner or for the community. This is particularly true of depopulating rural areas in industrialized countries where community demographics are changing most. Some attention has recently been given to rural tourism as an option to assist Asian farmers in these circumstances, but what of its potential to assist small-scale forestry producers? This paper examines a population of small forest property owners in Hokkaido Prefecture, Japan. The paper assesses the receptiveness of this community of forest owners to the idea of tourism in their forests. Using original survey data, the paper illustrates that private forest owners' openness to tourism is strongly related to their interpretation of 'forest' in metaphorical terms. The paper concludes by suggesting the best way to pursue the development of 'forest tourism' in this community is to rely on the forest owners cooperative to re-package the concept as a 'secondary forest use', more closely reflecting forest owners' interpretations of the forest resource

The St Andrews Institute for Clinical Research: An early Experiment in Collaboration

Sir James Mackenzie is revered by general practitioners as the father of general practice-based research.' His name is associated with the University Department of General Practice at Edinburgh and with the Chair at Aberdeen, and he is commemorated in the James Mackenzie lecture given annually at the Royal College of General Practitioners. His fame rests largely on his achievements as a solitary researcher while he worked as a GP in Burnley, a mill town in Lancashire, between 1879 and 1907. It was here that he carried out the pioneering work which contributed to the development of the "new cardiology" at the beginning of the century.2 His work in Burnley took him away from general practice and he moved to London to take up private and hospital consulting work to further the impact of his research. He regarded himself, however, as first and foremost a GP, and believed general practice was the proper place for clinical research.3 Mackenzie was so committed to this belief that he left London in 1919, an ill man at the age of sixty-six, and the GPs of St Andrews working together in collaborative research under Mackenzie's leadership. This paper will reassess Mackenzie's significance for the development of general practice-based research and for general practice as a specialty by examining this project of his later years. The Institute was an innovative venture at this time. Clinical research was still very much an individualistic activity and, as fewer GPs were doing research in the form of MD degrees, individual GPs were generally less likely to be involved in research.4 The St Andrews Institute can be seen as an attempt by Mackenzie to set up the kind of research structure for GPs that was beginning to emerge in the London teaching hospitals: specialist clinicians associated with university scientists. Mackenzie's model did not continue and there was a long gap before university departments of general practice emerged (the first professor of general practice was Richard Scott appointed in 1963 in Edinburgh).' The first section of the paper will fill in some background of Mackenzie's life and work before he came to St Andrews in order to give some understanding of his motivation and experience, and of his early fame. The second section will describe the Institute, its members, what it set out to do, and, particularly, how it was funded; and the final section will discuss why Mackenzie did not succeed in establishing the Institute on a permanent basis and assess its significance in the history of GP research

The dangerous practice of empathy

Chronic pain affects more persons than cancer and heart disease. Chronic pain increases the risk for depression and decreased coping, especially in the elderly, further increasing the cost of care. The psychological and emotional components of chronic pain are often not addressed in the treatment plan. An overview of chronic pain and literature to support the use of music to decrease the perception of pain in community-dwelling adults with chronic osteoarthritis pain and in hospitalized adults who have higher levels of acute pain after hip and knee surgery due to long periods of chronic pain preceding surgery is presented. The results of several randomized controlled trials are reviewed in depth. Results from these studies demonstrate decreased pain, improved ability to ambulate after surgery and fewer episodes of post-operative acute confusion in older adults who listened to music compared with those who did not. Music, therefore, has the ability to reduce chronic pain in older adults with osteoarthritis. Selecting appropriate music for listening should be based on patient preference. Music is a safe, non-invasive, inexpensive and easy-to-use intervention that should be added to the treatment plan for older adults with chronic pain. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Clostridium difficile

No Abstrac

Promoting Clean Water in Nineteenth-Century Public Policy: Professors, Preachers, and Polliwogs in Kingston, Ontario

A case study of Kingston, Ontario, reveals that growing confidence in the response of science and statistics to the threat of epidemic disease supported the development and expansion of municipal water and sewer services in the late nineteenth century. Informed by science and statistics, professional city managers and sanitary experts sought solutions combining fiduciary responsibility with public service. Preliminary evidence also suggests that, in some cases, Protestant-inspired rhetoric contributed to this support for new sanitary measures.Une étude de cas de la ville de Kingston, en Ontario, révèle que la confiance grandissante envers la réaction de la science et de la statistique à la menace de maladies épidémiques a contribué au développement et à l’expansion des services municipaux d’aqueduc et d’égout à la fin du XIXe siècle. Informés par la science et la statistique, les administrateurs municipaux et les experts sanitaires cherchèrent des solutions alliant responsabilité fiduciaire et service au public. Les données préliminaires semblent aussi indiquer que, dans certains cas, la rhétorique d’inspiration protestante a contribué à cet appui à de nouvelles mesures sanitaires

Health Disparities

Americans believe that we are a classless society, largely because just about everyone thinks they are members of the struggling middle class. In actuality the United States is a highly stratified society in terms of wealth, meaning that we have a much more significant problem of poverty than most industrialized nations. Members of ethnic minorities are more likely to be poorer and less powerful. Racist beliefs on the part of the dominant white ethnic groups exacerbate the problem of socioeconomic inequality (Brown, 1998 p. 259). In healthcare we like to believe that we do not discriminate amongst patient populations and that everyone is treated equally regardless of race or ethnicity. This is simply not true. Disparities/inequalities have been seen in healthcare in the past and continue to the present. According to the dictionary disparity (ies) is defined as lack of similarity or equality; difference (Random House, 1975). This review will explore the issue of disparity in healthcare as it is found in the healthcare literature and on government Internet sites. Key points in the literature will be discussed. However, in order to ensure common understanding of the issues raised it is important to have a clear understanding of some key definitions

Human Rights Education for All: A Proposal for the Post-2015 Development Agenda

The Millennium Development Goals (“MDGs”) have been highly successful in bringing commitment, expertise and funding to key human development targets in education, health, gender equality and other poverty reduction measures. Yet, the MDGs failed to integrate, or even align with, the international human rights laws to which states have committed themselves. Many commentators argue that linking the post-2015 Sustainable Development Goals with human rights would bring greater participation by people living in poverty in creating the agenda intended for their benefit, higher levels of accountability from governments and international organizations, greater attention to marginalized groups and economic inequality, and a universal framework that addresses poverty in high- and middle-income states, as well as low-income states. Universal human rights education–mandated during the free and compulsory school years–is one goal that could effectively integrate human rights into the post-2015 development agenda. This goal promotes universality, equality and nondiscrimination, participation and accountability, key human rights principles missing from the current MDG framework. It also furthers one of the main purposes of the United Nations–to promote respect for, and observance of, human rights for all–and derives from the international legal obligation to provide free and compulsory primary education that aims to promote the realization of human rights. Finally, it will build the capacity of rightsholders to demand their rights and duty-bearer to meet their obligations. In sum, universal human rights education is a human rights-based approach to development and merits serious consideration as a goal for the post-2015 agenda

Inequalities, Human Rights, and Sustainable Development Goal 10

Most of the 17 new Sustainable Development Goals (SDGs) and targets echo the goals and targets in the Millennium Development Goals (MDGs) framework. SDG 10 — reduce inequality within and among countries — is, however, completely new. The idea that the global community should work together toward equality had no part in the MDG framework, which focused on reducing poverty rather than making a more equal world. From a human rights perspective, the inclusion of the new SDG on reducing inequality is a great step forward. Notably, Oxfam reported in January 2017 that the eight wealthiest men in the world own the same wealth as the 3.6 billion people who make up the poorest half of the global population. Such a distribution of wealth and other economic and social outcomes cannot be consistent with the Universal Declaration of Human Rights proclamation that “[a]ll human beings are born free and equal in rights and dignity.” Nonetheless, the targets under SDG 10 are disappointing, as they do not aim at reducing economic or social inequality specifically but rather at raising the income and other human development indicators for those worst off. None of the SDG 10 targets references reducing the glaring inequalities between the wealthy and the poor. This paper examines SDG 10 on reducing inequality from a holistic human rights perspective. It begins by examining the meanings of equality and nondiscrimination in international human rights law. Through this lens, the paper seeks to decipher the meanings of inequality in SDG 10 and its targets by delving into the debates during the consultations on the post-2015 development agenda and the subsequent discussion on indicators. It concludes that the new SDG on inequality, although seemingly promising, makes little change to the MDG framework that focused on poverty reduction