Hands-on to hands-off : a study of a state agency’s preservation efforts

The General Land Office (GLO) is the oldest state agency in Texas. Within the agency is an archives department that acts as custodian to the records documenting the public lands of the state. Over the course of nearly two centuries, the GLO has pursued numerous preservation efforts and conservation techniques. This study reviews the preservation methods practiced by the GLO’s Archives and Records (A&R) program chronologically while discussing similar historical conservation practices. Comparisons are made to a nearby state agency, the Texas State Archives and Library Commission (TSLAC) to further explore the context of the GLO’s preservation practices.Informatio

The Meat and Potatoes of the North American Free Trade Agreement.

Agricultural trade has always been particularly susceptible to governmental intervention and imposition of protectionist barriers. This Article explores the evolution of agricultural trade regulation between the United States and Mexico culminating in the proposed North American Free Trade Agreement (NAFTA). First, the Article reviews the existing regulatory framework governing United States-Mexico agricultural trade. The Article then highlights major, proposed revisions to this regime under the NAFTA and offers perspectives on the effect of these revisions upon the United States’ agricultural industry sectors. This analysis includes a commodity reference guide, which highlights specific commodity trade sectors and the NAFTA treatment of such sectors. The initial mixed reaction of the agricultural industry to the NAFTA signals a bumpy road ahead for final ratification of the agreement. The NAFTA leaves many important agricultural trade issues unresolved. Debate will ensue on forms of implementing legislation proposed to deal with related, important issues not expressly covered by the agreement. Other separate proposals to deal with food safety and environmental and infrastructure-development issues are also proliferating. This underlines the fact that the NAFTA will in no way resolve all non-tariff trade barrier issues between the United States and Mexico. Furthermore, many of these issues, particularly relating to the reduction of trade subsidies, probably cannot be resolved in a bilateral context, but must await progress in the GATT negotiations. Still, the NAFTA represents a positive, substantial step forward in the evolution of United States-Mexico trade relations and represents a basis for the development of a new and lasting partnership

Eosinophilic gastroenteritis in a young girl – long term remission under Montelukast

BACKGROUND: Eosinophilic gastrointestinal disorders are an emerging disease entity characterized by eosinophilic infiltration of the intestinal wall. Oral steroids can be still considered as first line treatment. Unfortunately relapses are quite common. Usually long term low-dose prednisone or immunosuppressive therapy is required, which is especially problematic in young patients. Thus a reliable steroid sparing agent with low side effects suitable for long term use is needed. There are strong hints to a similar pathophysiology of eosinophilic gastrointestinal disorders to that of asthma. Indeed leukotriene D4 plays an important role in the recruitment of eosinophils into the intestinal tissue causing damage. This patho-mechanism provides the rationale for the treatment with a leukotriene D4 receptor antagonist. Recently there have been first reports about successful short term use of Montelukast in eosinophilic gastrointestinal disorders. CASE PRESENTATION: We report the case of a 17 year old girl with a long history of severe abdominal complaints leading to several hospitalizations in the past. Mimicking the picture of an intestinal tuberculosis she received an anti mycobacterial treatment without any success. Marked eosinophilia in blood, ascites and tissue samples of the intestinal tract finally lead to the diagnosis eosinophilic gastroenteritis. Tapering off prednisone caused another severe episode of abdominal pain. At that point leukotriene antagonist Montelukast was started at a dose of 10 mg once daily. Steroids could be tapered off completely within six weeks. The patient has been free of symptoms for over two years by now. Routine examinations, blood tests and endoscopy have rendered regular results. So far no side effects were noted. CONCLUSION: Here report about successful long term remission of eosinophilic gastroenteritis under Montelukast. Further randomized control trials are required to asses the full benefits of Montelukast therapy in the whole spectrum of eosinophilic gastrointestinal disorders

Methodologies for Assessing the Acceptability of Oral Formulations among children and older adults: A Systematic Review

This is an open access article distributed under the terms and conditions of the Creative Commons Attribution NonCommercial-NoDerivatives 4.0 International CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Acceptability of medicinal products in children and older populations is pivotal in ensuring adherence and therapeutic outcomes. This review systematically identifies studies reporting on formulation aspects of oral medications that affect their acceptability in these patient groups. Particular emphasis is placed on the evaluation of the methodologies employed in the studies. Sixty-eight studies were included for analysis, with 51 (75%) in children and 17 (25%) in older populations. The studies evaluated a range of oral formulations; however, the methodologies used differ considerably in participants’ characteristics, study settings, tools, acceptability definitions and criteria. It is evident that there is a lack of standardisation in study design as well as the assessment methods used in assessing acceptability of medicines in children and older populations. This review presents a systematic analysis on methods employed for assessing acceptability of oral medicines in children and older adults, to provide insights and recommendations regarding the design of reliable instruments in future studies.Peer reviewe

The cost-effectiveness of domiciliary non-invasive ventilation in patients with end-stage chronic obstructive pulmonary disease:a systematic review and economic evaluation

Background: Chronic obstructive pulmonary disease (COPD) is a chronic progressive lung disease characterised by non-reversible airflow obstruction. Exacerbations are a key cause of morbidity and mortality and place a considerable burden on health-care systems. While there is evidence that patients benefit from non-invasive ventilation (NIV) in hospital during an acute exacerbation, evidence supporting home use for more stable COPD patients is limited. In the UK, domiciliary NIV is considered on health economic grounds in patients after three hospital admissions for acute hypercapnic respiratory failure. Objective: To assess the clinical effectiveness and cost-effectiveness of domiciliary NIV by systematic review and economic evaluation. Data sources: Bibliographic databases, conference proceedings and ongoing trial registries up to September 2014. Methods: Standard systematic review methods were used for identifying relevant clinical effectiveness and cost-effectiveness studies assessing NIV compared with usual care or comparing different types of NIV. Risk of bias was assessed using Cochrane guidelines and relevant economic checklists. Results for primary effectiveness outcomes (mortality, hospitalisations, exacerbations and quality of life) were presented, where possible, in forest plots. A speculative Markov decision model was developed to compare the cost-effectiveness of domiciliary NIV with usual care from a UK perspective for post-hospital and more stable populations separately. Results: Thirty-one controlled effectiveness studies were identified, which report a variety of outcomes. For stable patients, a modest volume of evidence found no benefit from domiciliary NIV for survival and some non-significant beneficial trends for hospitalisations and quality of life. For post-hospital patients, no benefit from NIV could be shown in terms of survival (from randomised controlled trials) and findings for hospital admissions were inconsistent and based on limited evidence. No conclusions could be drawn regarding potential benefit from different types of NIV. No cost-effectiveness studies of domiciliary NIV were identified. Economic modelling suggested that NIV may be cost-effective in a stable population at a threshold of £30,000 per quality-adjusted life-year (QALY) gained (incremental cost-effectiveness ratio £28,162), but this is associated with uncertainty. In the case of the post-hospital population, results for three separate base cases ranged from usual care dominating to NIV being cost-effective, with an incremental cost-effectiveness ratio of less than £10,000 per QALY gained. All estimates were sensitive to effectiveness estimates, length of benefit from NIV (currently unknown) and some costs. Modelling suggested that reductions in the rate of hospital admissions per patient per year of 24% and 15% in the stable and post-hospital populations, respectively, are required for NIV to be cost-effective. Limitations: Evidence on key clinical outcomes remains limited, particularly quality-of-life and long-term (> 2 years) effects. Economic modelling should be viewed as speculative because of uncertainty around effect estimates, baseline risks, length of benefit of NIV and limited quality-of-life/utility data. Conclusions: The cost-effectiveness of domiciliary NIV remains uncertain and the findings in this report are sensitive to emergent data. Further evidence is required to identify patients most likely to benefit from domiciliary NIV and to establish optimum time points for starting NIV and equipment settings. Future work recommendations: The results from this report will need to be re-examined in the light of any new trial results, particularly in terms of reducing the uncertainty in the economic model. Any new randomised controlled trials should consider including a sham non-invasive ventilation arm and/or a higher- and lower-pressure arm. Individual participant data analyses may help to determine whether or not there are any patient characteristics or equipment settings that are predictive of a benefit of NIV and to establish optimum time points for starting (and potentially discounting) NIV. Study registration: This study is registered as PROSPERO CRD42012003286. Funding: The National Institute for Health Research Health Technology Assessment programme

Becoming with Rocks : Arriving in the Riddling Middle of (tourist) Places: touch, proximity, indeterminacy

The tourism industry is both large and growing, with private and public actors investing heavily in the commodification of places to travel to, supporting individuals with the wealth to do so, to be in different places for short time periods. Correspondingly, popular discourses and research within tourism studies have arisen, looking at attitudes and social and environmental impacts drawn along delineations of the tourist and the host and spatially enclosed tourist places or ‘destinations’.  In this thesis, I seek instead to focus on how we might be different in places. Using Deleuze and Guattari’s idea of assemblage and a focus on embodiment, I offer a reflexive account of an onto-epistemological inquiry into becoming with a range of other beings and things that are co-constitutive of the harbour wall or ‘the rocks’ at the Visby marina. Over a 6 month period of participant observation, I seek to be responsive to the emergent properties and knowledge of the fluctuating actors amidst the place assemblage of the rocks. The essay I offer within this thesis is part of what is resulting from these relationships and becomings. Within the essay, one of many themes I take up is a problematic view of place as being filled with objects of matter as opposed to an entangled, relational web of beings and things. Tourism easily commodifies places when they are seen as containers for bodies and objects, and this creates a distinct view of ‘tourist places’. I follow with a call to disrupt the imagined difference between tourist places and places in which we lead our daily lives in the hope of living outside of the shadow of human exceptionalism.  Accordingly, this thesis calls us to re-think tourism as but one part of our lives, as entanglements of bodies and things in and as place.

Louisa K Fast - Wilson 1935

The collection of Louisa K. Fast correspondence is related to the League of Women Voters. This letter is from a private collection and was loaned to the library by Bonnie Boroff. Full text: January 4th, 1935. H.W. Wilson Company, 960 University Ave., New York City. My dear Mr. Wilson:- Owing to lack of storage space, we are obliged to dispose of back copies of the reports of the Conferences on the Cause and Cure of War. If libraries care to have a complete set (except the report of the Third Conference, which is out of print), they need only send postage for six pounds, calculated on their distance from New York in zones. Can you insert a notice to this effect in your Bulletin. Sincerely yours, Mrs. J.M. Tuggey, Office Secretary. Miss Roth

Becoming with Rocks : Arriving in the Riddling Middle of (tourist) Places: touch, proximity, indeterminacy

The tourism industry is both large and growing, with private and public actors investing heavily in the commodification of places to travel to, supporting individuals with the wealth to do so, to be in different places for short time periods. Correspondingly, popular discourses and research within tourism studies have arisen, looking at attitudes and social and environmental impacts drawn along delineations of the tourist and the host and spatially enclosed tourist places or ‘destinations’.  In this thesis, I seek instead to focus on how we might be different in places. Using Deleuze and Guattari’s idea of assemblage and a focus on embodiment, I offer a reflexive account of an onto-epistemological inquiry into becoming with a range of other beings and things that are co-constitutive of the harbour wall or ‘the rocks’ at the Visby marina. Over a 6 month period of participant observation, I seek to be responsive to the emergent properties and knowledge of the fluctuating actors amidst the place assemblage of the rocks. The essay I offer within this thesis is part of what is resulting from these relationships and becomings. Within the essay, one of many themes I take up is a problematic view of place as being filled with objects of matter as opposed to an entangled, relational web of beings and things. Tourism easily commodifies places when they are seen as containers for bodies and objects, and this creates a distinct view of ‘tourist places’. I follow with a call to disrupt the imagined difference between tourist places and places in which we lead our daily lives in the hope of living outside of the shadow of human exceptionalism.  Accordingly, this thesis calls us to re-think tourism as but one part of our lives, as entanglements of bodies and things in and as place.