A case of the Emperor’s new clothes: A critical examination of public participation in environmental decision-making

The purpose of this doctoral research is to critically evaluate the public participation principle in environmental decision-making. Public participation is widely regarded as forming part of the corpus of international environmental law and has been recognised globally by the full breadth of legal doctrine from constitutional provisions, European Directives to human rights treaties. Proponents of the participation concept consider it to be a praised tool of environmental democracy which draws upon the principle’s underlying theoretical origins which are rooted in participative democratic theory. Participation is largely seen as an inherently good thing- but this status has not been subject to sufficient academic interrogation, this research will explore whether it is an appropriate tool for meeting the objectives claimed. Proponents of participation, of which there are many, can appeal to three distinct justifications for participation: first, that it is good for government because it can be applied to ensure administrative expedience; further that it is a process that confers democratic legitimacy, encouraging active citizenry; and finally that it can lead to better environmental decisions. In order to make a rigorous and original contribution to the literature in this field, the discussion is framed around an innovative conceptual analytical framework drawing on the justifications for participatory decision-making indicated by the 1969 Skeffington Report: People and Planning. This research interrogates the validity of the justifications by examining the experience of participation for all the major interests; the State, society and the environment. It does so with reference to the extended case study of the 2003 GM Nation public debate

Demographic Changes and Economic Growth in Pakistan: The Role of Capital Stock

Pakistan has experienced a decrease in population growth since the early 1990s leading to an increase in the ratio of working age population, known as demographic dividend. The demographic dividend may lead to higher savings and investments, which spurs economic growth. Given this postulation, the study is the first of its kind to analyse the impact of demographic variables on economic growth through physical capital for Pakistan from 1960 to 2014. In this regard, the demographic change is captured by taking four alternate measures, namely population growth, young age dependency ratio, old age dependency ratio and working age population ratio. In order to examine the channel effect, first the direct impact of demographic changes on physical capital is estimated. Later, the impact of demographically induced capital stock on economic growth is estimated. By using the FMOLS technique, the study concludes that the total negative impact is highest in the case of old age dependency, which means that higher old age dependency is the most threatening demographic change for economic growth. The least harmful demographic change is young age dependency. Moreover, the empirical findings highlight the importance of capital stock as the mediating channel in the demographic change and economic growth relationship. The study recommends effective long- term policies to increase youth employment and to enhance savings for maximising the benefits of demographic dividend. JEL Classification: J11; O47 Keywords: Direct and Indirect Impact, Demographic Transition, Demographic Age Structure, Capital Stock, FMOL

Anticipated and unanticipated complications of severe dengue in a primigravida

As the incidence of dengue is rising among adults more cases of dengue fever are being reported during pregnancy. Physiological changes of pregnancy mask the pathognomonic features of severe dengue such as increased hematocrit, thrombocytopenia, and leukopenia and a high index of suspicion are required in endemic areas. Massive hemorrhage may complicate operative deliveries in unsuspected patients. World Health Organization recommends that all patients with severe dengue should be admitted to a hospital with access to intensive care facilities and blood transfusion. We present the successful management of hemorrhage and unanticipated complications of severe dengue in a young primigravida admitted to the Intensive Care Unit after an emergency cesarean section

Safety of percutaneous transhepatic biliary stenting in patients with obstructive jaundice

OBJECTIVE: To determine the safety of percutaneous transhepatic biliary stenting (PTBS) in patients with obstructive jaundice. STUDY DESIGN: A case series. PLACE AND DURATION OF STUDY: Department of Radiology, The Aga Khan University Hospital Karachi, Pakistan, from February 2012 to April 2013. METHODOLOGY: Patients with obstructive jaundice due to any cause referred for percutaneous transhepatic biliary stenting were included in the study. Patients were excluded if they had undergone previous ERCP, had guided transhepatic biliary stenting, previous percutaneous transhepatic biliary stenting and were lost to follow-up. Follow-up was taken at a 2, 4 and 6 week interval and clinical outcome was assessed as the difference between the bilirubin levels at base line and 6 weeks after PTBS, which was measured using Freidman\u27s test. RESULTS: A total of 102 patients were included; 59 (58%) were males and 43 (42%) were females. The age ranged from 21 to 89 years. A total of 30 patients experienced complications making an overall complication rate of 29.4%; 20 experienced minor and 10 experienced major complications. Pain was the most frequent minor complication (n=15 patients, 14.7%) followed by biliary leakage, fever and cholangitis. Major complications included death in 10 (10%) patients followed by biliary peritonitis and septicemia. CONCLUSION: PTBS achieved satisfactory palliation with a low complication rate in patients with obstructive jaundic

Acute colonic pseudo obstruction (ogilvie syndrome) in a patient with hemorrhagic stroke: A case report.

Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome is a functional motility disorder of the colonic bowel without any organic or mechanical obstruction. Autonomic disturbance which is one of the underlying factors that can lead to Ogilvie syndrome, is caused by stroke. Acute colonic pseudo- obstruction (ACPO) in the setting of stroke is not often reported in medical literature. Various modalities of treatment strategies are recommended including conservative approaches, medical therapies, endoscopic and surgical procedures. We will discuss a patient suffering from a hemorrhagic stroke in the right basal ganglia that developed Acute Colonic Pseudo Obstruction and improved subsequently with conservative management

Burden and Depression among Caregivers of Visually Impaired Patients in a Canadian Population

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at risk for depression was determined by the Center for Epidemiologic Studies Depression scale. Results. 236 caregivers of 236 patients were included. Total mean BIC scores were higher in Group 2. Female caregivers, caregivers providing greater hours of care, and caregivers of patients who have not completed vision rehabilitation programs are at higher risk for depression

Comparative effects of Alpha Tocopherol and Ascorbic Acid on Chronic Stress Induced Neuropeptide Y Derangements

Background: Chronic stress decreases resilience of the body mainly due to hormonal imbalance. Neuropeptide Y-ergic system is abnormally regulated in chronic stress due to reduction-oxidation imbalance. The antioxidants such as alpha-tocopherol and ascorbic acid reduce this imbalance with positive effect on neuropeptide Y synthesis and release. This study was aimed to compare the protective effects of alpha-tocopherol and ascorbic acid on plasma neuropeptide Y levels in chronic stress.Material and Methods: This quasi-experimental study was done at Al-Nafees Medical College in collaboration with National Institute of Health Islamabad from January 2015 to January 2016 after taking institutional approval. Sixty male Sprague Dawley rats were obtained and divided equally into four groups; group I (control), group II (restraint stress group - chronic restraint stress six hours daily for 28 days), group III (restraint stress + alpha-tocopherol 50mg/kg body weight /day), and group IV (restraint stress + ascorbic acid 100mg /kg body weight /day). Cardiac puncture was done to obtain blood for biochemical analysis.Results: A significant decrease in plasma neuropeptide Y levels was seen in group II compared to group I, group III and group IV. However, alpha-tocopherol administration in group III showed positive effects on maintenance of plasma neuropeptide Y concentration with better p trend than that of ascorbic acid supplementation in group IV.Conclusions: Alpha-tocopherol supplementation has more potent effect than that of ascorbic acid on chronic restraint stress induced derangements in neuropeptide Y levels. It leads to less imbalance in neuropeptide Y levels during chronic stress.Key words: Ascorbic Acid, Alpha-Tocopherol, Chronic Stress, Neuropeptide

Current Knowledge and Therapeutic Strategies of Herbal Medicine for Acute Diarrhea

Diarrhea is a common gastrointestinal problem characterized by loose watery stool and mild to severe dehydration. Annually, about 1.7–5 billion new cases of diarrhea were reported. In developing countries, it is more common, where young kids have diarrhea approximately three times/year. In 2013, 1.26 million deaths occurred due to diarrhea, whereas in 1990, the figure was slightly higher (2.58 million). In 2012, diarrhea was the second most common reason of death (11%, n = 0.76 million) in children less than 5 years. Although various synthetic drugs are being prescribed as standard therapy for diarrhea, they have side effects. It is possible to prescribe the herbal medicine for diarrhea, which is safe and effective. In this study, medicinal plants discussed are proven to be scientifically active in diarrheal diseases. This study reviews about current medicinal plants used in the treatment of diarrhea. The use of medicinal plants for diarrhea results in improvement of the symptom. Moreover, studies on large scale are needed to characterize the beneficial role of medicinal plants in the treatment of diarrhea