The 2008 R-ISEW (regional index of sustainable economic well-being) for all the English regions

This report presents new data calculated in 2008 for the years 1994–2006. The latest data, which also includes the updating of several sets of figures which previously had to be estimated for 2005, show that a 10-year increase in R-ISEW since 1994 has come to a halt, and that R-ISEW per capita actually began declining between 2004 and 2006 despite increasing GVA

The 2009 R-ISEW (regional index of sustainable economic well-being) for all the English regions

This latest report presents new data calculated in 2009 for the years 1994–2007. The data, which also includes the updating of several sets of figures that previously had to be estimated for 2006, show that a nine-year increase in the English R-ISEW since 1994, began to peter out in 2003, such that total per capita growth between 2003 and 2007 was only 2.4%. Indeed, between 2005 and 2006, per capita R-ISEW fell slightly

The 2010 R-ISEW (regional index of sustainable economic well-being) for all the English regions

This is the fourth consecutive report presenting R-ISEW (regional index of sustainable economic well-being) calculations for the nine Government Office Regions (GORs) of England.1 New data available in the summer of 2010 allows a continuous time series from 1994 to 2008 – 15 years. Because of the nature of the data required for the R-ISEW, there is always a two-year lag before results for any given year can be completed

Beyond Goldwater-Nichols

This report culminated almost two years of effort at CSIS, which began by developing an approach for both revisiting the Goldwater-Nichols Department of Defense Reorganization Act of 1986 and for addressing issues that were beyond the scope of that landmark legislation

Traps of multi-level governance. Lessons from the implementation of the Water Framework Directive in Italy

During recent decades, different patterns of multi-level governance (MLG) have spread across Europe as a consequence of Europeanisation of public policies, which have increasingly adopted decentralized and participatory procedures conceived as a tool of more effective and accountable policy-making. It appears, however, that the implementation of operational designs based on MLG may be rather problematic and it does not necessarily bring to the expected performance improvements. Referring to the case of the EU Water Framework Directive (2000/60/EC), which conceives the creation of new multi-level institutional settings as a key tool for enacting a new holistic approach to water management and protection, this article explores the difficulties that the implementation of such settings has brought in Italy, despite some favorable pre-conditions existing in the country. Evidence is provided that along with institutional and agency variables, the implementation effectiveness of MLG arrangements promoted by the EU can be challenged by their inherent characteristics

Plasma-cell-rich infiltrates in paediatric renal transplant biopsies are associated with increased risk of renal allograft failure

BACKGROUND: Increased plasma cell infiltration in renal allograft biopsies is a rare finding associated with poor outcome in adult renal transplant recipients. The clinical impact of increased plasma cell infiltrates in paediatric renal transplant recipients (pRTR) remains unknown. METHODS: We conducted a retrospective case-control study from April 1996 to March 2014 comparing the outcome of pRTR with increased (>10 % of infiltrate) plasma cells in renal transplant biopsies to a control cohort of pRTR without increased plasma cell infiltration but similar grade of rejection according to Banff classification. RESULTS: Increased plasma cell infiltrates were present in 14 of 162 (9 %) reviewed pRTR aged 3.2-17.5 (median 13.4) years at time of transplantation. Compared with 14 pRTR renal transplant biopsies without significantly increased plasma cells, there were no significant differences in mismatch and baseline estimated glomerular filtration rate (eGFR). Plasma cells were present in case biopsies at a maximal density of 14-116 (median 33) plasma cells/HPF. Increased plasma cells were associated with decreased eGFR at biopsy (22 vs. 49 ml/min/1.73 m(2); p < 0.001) and 4 weeks post-biopsy (26 vs. 56 ml/min/1.73 m(2); p < 0.001) despite comparable eGFR 4 weeks prior to biopsy. Increased plasma cells were further associated with significantly increased frequency of renal allograft loss (71 % vs. 7 %; p < 0.001) at 0-27 (median 2) months after biopsy. CONCLUSION: Increased plasma cell infiltrates in pRTR are uncommon but associated with significantly reduced renal allograft survival as well as significantly reduced allograft function in surviving grafts