Parks for people—a case study from the Aïr Mountains of Niger

The Aïr Mountains of north-central Niger are relatively unspoilt and contain some of the last remaining populations of addax Addax nasomaculatus, ostrich Struthio camelus and dama gazella Gazella dama in in West Africa. The Aïr Mountain are also home for some 5000 Twaregs, half of whom are cultivators and the other half herders. The Aïr and Tùnùrù National Nature Reserve, which was gazetted in 1988, covers more than 77,000 sq km. It was inspired by concern for the region's unique and increasingly threatened wildlife, wcology. The Nigerien Wildlife Service and the IUCN/WWF project that supports the reserve are attempting to reconcile conservation with development through a broadly based programme geared to protection, resoration and sustainable use of the area's natural resource

Following up the head injured driver: self versus family assessment.

Driving is an important issue after head injury. This study explores the usefulness of self and family report measures in enhancing our knowledge of head injured peoples' driving. The data was gained from a screening questionnaire given to a head injury clinic cohort and from separate interviews with both head injured drivers and healthy family members. Fifty head injured people who had driven pre-injury participated in the screen and 18 of those who had returned to driving participated in interviews with a close family member. It was predicted changes compared to pre-injury would be perceived in head injured people's driving across the domains of driving skills, behaviours/attitudes and accident rates. It was further predicted issues of insight would be raised from differences between the perceptions of head injured people themselves and family members.Respondents suggested driving was an important issue for head injured people regardless of whether they had returned to driving. Despite this, some had not received information or informed the authorities about their head injuries. Three consistent themes were suggested about post-injury driving. Firstly, there was no evidence of perceived declines in basic driving aspects or increased accident rates. Secondly, specific changes were perceived in: variables similar to the residual psychological difficulties of head injury; head injured drivers' attempts to engage in less risky driving; and the amount of anxiety engendered by driving. Thirdly, although less of an issue than expected, single cases were highlighted where insight may have been a problem.Although interpretation of the results was tempered by methodological considerations, the findings are discussed and the service implications considered. A further longitudinal research programme has been proposed

A case series on fixed drug eruptions

A 60 year old male truck driver with a history of recurrent skin boils presented with painful lesions on the glans penis that started a few days prior. A week ago he was treated with co-trimoxazole for skin abscesses on the left leg. The penile lesions were noted as vesicular eruptions that eventually coalesced and there was absence of discharge, scrotal involvement, or lymphadenopathy. He reported a similar episode one year ago following a course of co-trimoxazole for skin abscesses

Conservation of the Okapi Wildlife Reserve, Zaïre

The Okapi Wildlife Reserve was created in May 1992 to conserve a representative area of the Ituri rainforest in north-eastern Zaïre. This article examines the threats facing this large protected area and summarizes the management actions proposed to address these problems within the next 10 years. Emphasis is placed on the need to integrate the local population into reserve management and to empower people as much as possible to manage their own resources. The long-term future of the reserve in the context of national economic and political instability is discusse

Cardiovascular computed tomography imaging for coronary artery disease risk: plaque, flow and fat

Cardiac imaging is central to the diagnosis and risk stratification of coronary artery disease, beyond symptoms and clinical risk factors, by providing objective evidence of myocardial ischaemia and characterisation of coronary artery plaque. CT coronary angiography can detect coronary plaque with high resolution, estimate the degree of functional stenosis and characterise plaque features. However, coronary artery disease risk is also driven by biological processes, such as inflammation, that are not fully reflected by severity of stenosis, myocardial ischaemia or by coronary plaque features. New cardiac CT techniques can assess coronary artery inflammation by imaging perivascular fat, and this may represent an important step forward in identifying the ‘residual risk’ that is not detected by plaque or ischaemia imaging. Coronary artery disease risk assessment that incorporates clinical factors, plaque characteristics and perivascular inflammation offers a more comprehensive individualised approach to quantify and stratify coronary artery disease risk, with potential healthcare benefits for prevention, diagnosis and treatment recommendations. Furthermore, identifying new biomarkers of cardiovascular risk has the potential to refine early-life prevention strategies, before atherosclerosis becomes established

Anxious childhood attachment predicts childlessness in later-life

The objective of this study was to test the hypothesis that childhood attachment predicts whether a person has children in later life. Although being a parent is considered a typical part of the human life cycle in most parts of the world, childlessness has increased substantially in recent decades in developed parts of the world. It is possible that insecure childhood attachment has contributed to this phenomenon, but this hypothesis has been relatively little explored. This study is a cross-sectional survey of 394 men and women aged over 50 years old, stratified by geographical UK region from a research panel, and analysed using hierarchical logistic regression. Validated measures of childhood attachment and other psychological and demographic factors were used. The main finding was that, independent of the impact of other variables (age, sex, education level, marital status, life stress, health-related quality of life, mental positivity, and avoidant attachment style), people who were childless were significantly more likely to have developed an anxious attachment to their primary caregiver in childhood. This study is the first to demonstrate the significance of anxious childhood attachment as a predictor of producing children in one’s lifetime

Older people are ‘happier’ whether they have children or not, but ‘happiness’ is impacted by health and childhood attachment

Childlessness has increased substantially in recent decades. Although the psychological consequences for women have been explored, those of men have been little researched. This study asked the views of heterosexual men and women, aged over 50, on parenthood and childlessness. An online survey of 235 men and 157 women aged 50 years and over was conducted. The sample had a mean age (SD) for men of 76.9 (+ 7.6) and for women 77.0 (+ 7.4). Men and women who were childless due to ‘not finding the right person’ had the lowest Positive Mindset Index (PMI) scores. The variable that had the greatest impact on mental health was Health Related Quality of Life. After controlling for seven covariates using ANCOVA, the main effects of PMI for Sex and Reasons for having children or not, and their interaction, were non significant. Post-hoc LSD tests (2-tailed) showed that the Childfree men had borderline significantly higher PMI than men who were parents (p<.071) and men who were Childless (p<.063). Although the subgroups were small, making it difficult to detect statistically significant results, the findings arguably shed new light on the mental positivity of older people who don’t have children. We believe the findings might inform improved ways of delivering psychological therapy services to people experiencing distress due to childless-by-circumstance

Methodology of a reevaluation of cardiovascular outcomes in the RECORD trial: study design and conduct

Background In 2010, after regulatory review of rosiglitazone licensing, the US Food and Drug Administration (FDA) requested a reevaluation of cardiovascular end points in the RECORD trial.&lt;p&gt;&lt;/p&gt; Methods Automated screening of the original clinical trial database and manual case report form review were performed to identify all potential cardiovascular and noncardiovascular deaths, and nonfatal myocardial infarction (MI) and stroke events. Search techniques were used to find participants lost to follow-up, and sites were queried for additional source documents. Suspected events underwent blinded adjudication using both original RECORD end point definitions and new FDA end point definitions, before analysis by the Duke Clinical Research Institute.&lt;p&gt;&lt;/p&gt; Results The reevaluation effort included an additional 328 person-years of follow-up. Automated screening identified 396 suspected deaths, 2,052 suspected MIs, and 468 suspected strokes. Manual review of documents by Duke Clinical Research Institute clinical events classification (CEC) coordinators identified an additional 31 suspected deaths, 49 suspected MIs, and 28 suspected strokes. There were 127 CEC queries issued requesting additional information on suspected deaths; 43 were closed with no site response, 61 were closed with a response that no additional data were available, and additional data were received for 23. Seventy CEC queries were issued requesting additional information for suspected MI and stroke events; 31 were closed with no site response, 20 were closed with a response that no additional data were available, and 19 resulted in additional data.&lt;p&gt;&lt;/p&gt; Conclusions Comprehensive procedures were used for rigorous event reascertainment and readjudication in a previously completed open-label, global clinical trial. These procedures used in this unique situation were consistent with other common approaches in the field, were enhanced to address the FDA concerns about the original RECORD trial results, and could be considered by clinical trialists designing event readjudication protocols for drug development programs that have been completed.&lt;p&gt;&lt;/p&gt