Colombia\u27s Conflicts: The Spillover Effects of a Wider War

This monograph is the first in a new Special Series of monographs that stems from the February 2001 and the March 2002 conferences--co-sponsored by the Strategic Studies Institute of the U.S. Army War College and The Dante B. Fascell North-South Center of the University of Miami--that dealt with the Implementation of Plan Colombia. It provides a careful examination of the so-called spillover problems generated by Colombia\u27s three simultaneous wars against illegal drug traffickers, insurgents, and self-appointed paramilitary groups. All seek, in one way or another, violently to change or depose the state. All use the uncontrolled gray areas in Colombia and its neighboring states to sustain, conduct, and replenish their nefarious operations without risk of significant interference. And, all these violent illegal entities constitute threats to stability and security that extend beyond Colombia and Latin America to Europe and the United States. Colombia is therefore a paradigm of the failing state that has enormous implications for U.S. foreign policy and military asset management for now and into the future.https://press.armywarcollege.edu/monographs/1812/thumbnail.jp

Can Pay-for-Performance Improve Quality and Reduce Health Disparities?

The authors discuss a new study that examined whether pay-for-performance improves or worsens existing disparities in health between ethnic groups

Model Estimation of Land-Use Effects on Water Levels of Northern Prairie Wetlands

Wetlands of the Prairie Pothole Region exist in a matrix of grassland dominated by intensive pastoral and cultivation agriculture. Recent conservation management has emphasized the conversion of cultivated farmland and degraded pastures to intact grassland to improve upland nesting habitat. The consequences of changes in land-use cover that alter watershed processes have not been evaluated relative to their effect on the water budgets and vegetation dynamics of associated wetlands. We simulated the effect of upland agricultural practices on the water budget and vegetation of a semipermanent prairie wetland by modifying a previously published mathematical model (WETSIM). Watershed cover/landuse practices were categorized as unmanaged grassland (native grass, smooth brome), managed grassland (moderately heavily grazed, prescribed burned), cultivated crops (row crop, small grain), and alfalfa hayland. Model simulations showed that differing rates of evapotranspiration and runoff associated with different upland plant-cover categories in the surrounding catchment produced differences in wetland water budgets and linked ecological dynamics. Wetland water levels were highest and vegetation the most dynamic under the managed-grassland simulations, while water levels were the lowest and vegetation the least dynamic under the unmanaged-grassland simulations. The modeling results suggest that unmanaged grassland, often planted for waterfowl nesting, may produce the least favorable wetland conditions for birds, especially in drier regions of the Prairie Pothole Region. These results stand as hypotheses that urgently need to be verified with empirical data

MODELING THE EFFECTS OF TILE DRAIN PLACEMENT ON THE HYDROLOGIC FUNCTION OF FARMED PRAIRIE WETLANDS1

The early 2000s saw large increases in agricultural tile drainage in the eastern Dakotas of North America. Agricultural practices that drain wetlands directly are sometimes limited by wetland protection programs. Little is known about the impacts of tile drainage beyond the delineated boundaries of wetlands in upland catchments that may be in agricultural production. A series of experiments were conducted using the well-published model WETLANDSCAPE that revealed the potential for wetlands to have significantly shortened surface water inundation periods and lower mean depths when tile is placed in certain locations beyond the wetland boundary. Under the soil conditions found in agricultural areas of South Dakota in North America, wetland hydroperiod was found to be more sensitive to the depth that drain tile is installed relative to the bottom of the wetland basin than to distance-based setbacks. Because tile drainage can change the hydrologic conditions of wetlands, even when deployed in upland catchments, tile drainage plans should be evaluated more closely for the potential impacts they might have on the ecological services that these wetlands currently provide. Future research should investigate further how drainage impacts are affected by climate variability and change

MODELING THE EFFECTS OF TILE DRAIN PLACEMENT ON THE HYDROLOGIC FUNCTION OF FARMED PRAIRIE WETLANDS1

The early 2000s saw large increases in agricultural tile drainage in the eastern Dakotas of North America. Agricultural practices that drain wetlands directly are sometimes limited by wetland protection pro- grams. Little is known about the impacts of tile drainage beyond the delineated boundaries of wetlands in upland catchments that may be in agricultural production. A series of experiments were conducted using the well-published model WETLANDSCAPE that revealed the potential for wetlands to have significantly shortened surface water inundation periods and lower mean depths when tile is placed in certain locations beyond the wet- land boundary. Under the soil conditions found in agricultural areas of South Dakota in North America, wetland hydroperiod was found to be more sensitive to the depth that drain tile is installed relative to the bottom of the wetland basin than to distance-based setbacks. Because tile drainage can change the hydrologic conditions of wetlands, even when deployed in upland catchments, tile drainage plans should be evaluated more closely for the potential impacts they might have on the ecological services that these wetlands currently provide. Future research should investigate further how drainage impacts are affected by climate variability and change

A cluster randomized controlled trial of the effectiveness and cost-effectiveness of Intermediate Care Clinics for Diabetes (ICCD) : study protocol for a randomized controlled trial

Background World-wide healthcare systems are faced with an epidemic of type 2 diabetes. In the United Kingdom, clinical care is primarily provided by general practitioners (GPs) rather than hospital specialists. Intermediate care clinics for diabetes (ICCD) potentially provide a model for supporting GPs in their care of people with poorly controlled type 2 diabetes and in their management of cardiovascular risk factors. This study aims to (1) compare patients with type 2 diabetes registered with practices that have access to an ICCD service with those that have access only to usual hospital care; (2) assess the cost-effectiveness of the intervention; and (3) explore the views and experiences of patients, health professionals and other stakeholders. Methods/Design This two-arm cluster randomized controlled trial (with integral economic evaluation and qualitative study) is set in general practices in three UK Primary Care Trusts. Practices are randomized to one of two groups with patients referred to either an ICCD (intervention) or to hospital care (control). Intervention group: GP practices in the intervention arm have the opportunity to refer patients to an ICCD - a multidisciplinary team led by a specialist nurse and a diabetologist. Patients are reviewed and managed in the ICCD for a short period with a goal of improving diabetes and cardiovascular risk factor control and are then referred back to practice. or Control group: Standard GP care, with referral to secondary care as required, but no access to ICCD. Participants are adults aged 18 years or older who have type 2 diabetes that is difficult for their GPs to control. The primary outcome is the proportion of participants reaching three risk factor targets: HbA1c (≤7.0%); blood pressure (<140/80); and cholesterol (<4 mmol/l), at the end of the 18-month intervention period. The main secondary outcomes are the proportion of participants reaching individual risk factor targets and the overall 10-year risks for coronary heart disease(CHD) and stroke assessed by the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Other secondary outcomes include body mass index and waist circumference, use of medication, reported smoking, emotional adjustment, patient satisfaction and views on continuity, costs and health related quality of life. We aimed to randomize 50 practices and recruit 2,555 patients

Reviews

The following publications have been reviewed by the mentioned authors;Introducing Craft Design and Technology by A. Breckon and D. Prest, reviewed by Richard KimbellThe Design Process by The Design Council, reviewed by R. MillettDesign Project No. 2 Heavy Plant by John Jeffrey and Nigel Billington, reviewed by R. LightfootThe Eighteenth Century Art, Design and Society, 1689-1789 by Bernard Denvir, reviewed by Marjorie A. CruickshankIndustrial Design Requirements of Industry by C. Hayes and K. Dorsey, reviewed by B. SmithModern Design in Plastics by D. P. Greenwood, reviewed by J. EgglestonWoodturning Projects for Dining by J. A. Sainsbury, reviewed by J. EgglestonWood Turning Music Boxes by J. A. Jacobson, reviewed by J. EgglestonYoung Blood: Britain's Art and Design Schools Today and Tomorrow edited by Kate Baynes, reviewed by A. E. LambethA. Century of Art Education 1882-1982 Hornsey College of Art Centenary Book by Clive Ashwin, reviewed by Oberta de Joi

Acceptability of dietary and physical activity lifestyle modification for men following radiotherapy or radical prostatectomy for localised prostate cancer:a qualitative investigation

Abstract Background The experience and acceptability of lifestyle interventions for men with localised prostate cancer are not well understood, yet lifestyle interventions are increasingly promoted for cancer survivors. We explored the opinions, experiences and perceived acceptability of taking part in nutritional and physical activity interventions amongst men with prostate cancer and their partners; with the ultimate plan to use such information to inform the development of nutritional and physical activity interventions for men with prostate cancer. Methods Semi-structured interviews with 16 men, and seven partners, undergoing curative surgery or radiotherapy for prostate cancer. Interviews explored experiences of lifestyle interventions, acceptable changes participants would make and perceived barriers and facilitators to change. Interviews were thematically analysed using the framework approach. Results Men were frequently open to lifestyle modification and family support was considered vital to facilitate change. Health beneficial, clinician endorsed, understandable, enjoyable interventions were perceived as attractive. Barriers included ‘modern’ digital technology, poor weather, competing commitments or physical limitations, most notably incontinence following radical prostatectomy. Men were keen to participate in research, with few negative aspects identified. Conclusions Men are willing to change behaviour but this needs to be supported by clinicians and health professionals facilitating lifestyle change. An ‘intention-behaviour gap’, when an intended behaviour does not materialise, may exist. Digital technology for data collection and lifestyle measurement may not be suitable for all, and post-surgery urinary incontinence is a barrier to physical activity. These novel findings should be incorporated into lifestyle intervention development, and implemented clinically

Bronchiectasis and the risk of cardiovascular disease: a population-based study

Background: There are limited data on the burden of cardiovascular comorbidities in people with bronchiectasis. Our cross-sectional study estimates the burden of pre-existing diagnoses of coronary heart disease (CHD) and stroke in people with bronchiectasis compared with the general population. The historical cohort study investigates if individuals with bronchiectasis are at increased risk of incident CHD and stroke events. Methods: We used primary care electronic records from the Clinical Practice Research Datalink. The cross-sectional study used logistic regression to quantify the association between bronchiectasis and recorded diagnoses of CHD or stroke. Cox regression was used to investigate if people with bronchiectasis experienced increased incident CHD and strokes compared with the general population, adjusting for age, sex, smoking habit and other risk factors for cardiovascular disease. Results Pre-existing diagnoses of CHD (OR 1.33, 95% CI 1.25 to 1.41) and stroke (OR 1.92, 95% CI 1.85 to 2.01) were higher in people with bronchiectasis compared with those without bronchiectasis, after adjusting for age, sex, smoking and risk factors for cardiovascular disease. The rate of first CHD and stroke were also higher in people with bronchiectasis (HR for CHD 1.44 (95% CI 1.27 to 1.63) and HR for stroke 1.71 (95% CI 1.54 to 1.90)). Conclusion: The risk of CHD and stroke are higher among people with bronchiectasis compared with the general population. An increased awareness of these cardiovascular comorbidities in this population is needed to provide a more integrated approach to the care of these patients

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland