Cell-Phones and Spears: Indigenous Cultural Transition Within the Maasai of East Africa

The Maasai of East Africa are excellent examples of Indigenous culture in transition. In spite of pressure from the outside, Maasai currently maintain their cultural identity to choose which parts of western culture and modernity they accept or reject. The major issues they now confront are Christianity, Education, Technology, and Tourism. Education is likely the most catalytic for long-term cultural change from the outside, but tourism is the most pressing of these issues. This article is not a study of colonized domination or the imposition of change from the outside~in, but of the internal dialogue among Indigenous people themselves about their relationship with the western world. It reveals a surprising degree of cultural autonomy and a dynamic culture that is adjusting to a new, globalizing world

Oral diagnosis and treatment planning: Part 6. Preventive and treatment planning for periodontal disease

A high level of sustained personal plaque control is fundamental for successful treatment outcomes in patients with active periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. Other risk factors for periodontal disease also should be identified and modified where possible. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Failure by patients to control dental plaque because of inappropriate designs and materials for restorations and prostheses will result in the long-term failure of the restorations and the loss of supporting tissues. Periodontal treatment planning considerations are also very relevant to endodontic, orthodontic and osseointegrated dental implant conditions and proposed therapies.E. Corbet and R. Smale

A nationwide survey to measure practice variation of catheterisation management in patients undergoing vaginal prolapse surgery

Urinary catheterisation following vaginal prolapse surgery causes inconvenience for patients, risk of urinary tract infections and potentially longer hospitalisation. Possibly, practice variation exists concerning diagnosis and management of abnormal postvoid residual (PVR) volume implying suboptimal treatment for certain subgroups. Nationwide questionnaire-based survey. Post-operatively, 77% performed transurethral indwelling catheterisation, 12% suprapubic catheterisation and 11% intermittent catheterisation. Catheterisation was applied 3 days (1-7 days) following anterior repair and 1 day (1-3 days) following all other procedures. The median cut-off point for abnormal PVR was 150 mL (range 50-250 mL). Treatment of abnormal PVR consisted mostly of prolonging transurethral indwelling catheterisation for 2 days (range 1-5 days; 57%), 29% by intermittent and 12% by suprapubic catheterisation. Antibiotics were administered by 21% either routinely or based on symptoms only. Due to insufficient evidence and suboptimal implementation of available evidence, practice variation in catheterisation regimens is hig

Costs and Effects of Abdominal versus Laparoscopic Hysterectomy: Systematic Review of Controlled Trials

Objective: Comparative evaluation of costs and effects of laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH). Data sources: Controlled trials from Cochrane Central register of controlled trials, Medline, Embase and prospective trial registers. Selection of studies: Twelve (randomized) controlled studies including the search terms costs, laparoscopy, laparotomy and hysterectomy were identified. Methods: The type of cost analysis, perspective of cost analyses and separate cost components were assessed. The direct and indirect costs were extracted from the original studies. For the cost estimation, hospital stay and procedure costs were selected as most important cost drivers. As main outcome the major complication rate was taken. Findings: Analysis was performed on 2226 patients, of which 1013 (45.5%) in the LH group and 1213 (54.5%) in the AH group. Five studies scored >= 10 points (out of 19) for methodological quality. The reported total direct costs in the LH group ($63,997) were 6.1$60,114). The reported total indirect costs of the LH group ($1,609) were half of the total indirect in the AH group ($3,139). The estimated mean major complication rate in the LH group (14.3%) was lower than in the AH group (15.9%). The estimated total costs in the LH group were $3,884 versus$3,312 in the AH group. The incremental costs for reducing one patient with major complication(s) in the LH group compared to the AH group was $35,750. Conclusions: The shorter hospital stay in the LH group compensates for the increased procedure costs, with less morbidity. LH points in the direction of cost effectiveness, however further research is warranted with a broader costs perspective including long term effects as societal benefit, quality of life and survival

River histories : A thematic review

Peer reviewe

Contested waters: an environmental history of the Colorado River

Includes bibliographical references and index.Part 1. A river through time -- Conquering the wild Colorado: the river before 1945 -- Farming the desert: agricultural water demands -- Saving the river: the environmental movement -- Sharing the shortage: a river in control -- Part 2. Currents of today -- The metropolis and the desert: growing cities in the west -- Owning the river: Indian water rights and settlements -- Crossing the border: US-Mexico relations and the river -- The water market: banking and selling the Colorado River -- Conclusion

For a White Revolution: John F. Kennedy and the Shah of Iran

The story of American relations with Iran during the Kennedy administration is one of misunderstandings and missed opportunities. Shah Muhammad Reza Pahlavi often manipulated and thwarted Kennedy\u27s policy toward Iran and used American fears of Communism to gain increased financial aid and military support. Disagreements among US policy-makers also contributed to an inconsistent policy toward Iran. These factors resulted in the bolstering of a dictatorship out of touch with the Iranian people, inevitably leading to the revolution that occurred in 1978-79