Localization in Sardinia and Its Obstacles: A Reply to Hospers’ “Localization in Europe’s Periphery: Tourism Development in Sardinia”

In this reply to Hospers' “Localization in Europe's Periphery: Tourism Development in Sardinia” by Gert-Jan Hospers (2003), we argue that the author's advocacy of localized economic policies as a viable means to the economic development of Sardinia does not take into account current institutional assets that prevent Sardinia from pursuing localized interests effectively. We first discuss the historical background of these institutional assets, highlighting that a top-down approach to decision-making has characterized relations between Sardinia and the central state for most of the modern era. We then discuss the institutional and economic impediments to Sardinian attempts to pursue localized policies in light of recent institutional conflicts between region and central state. Our conclusion is that the localization of economic strategies necessitates entwined localization of decision-making powers in order to be effective.

Review of: Tykot, R.H. and Andrews, T.K. 1992. Sardinia: a footprint in the sea: studies in Sardinian Archaeology presented to Miriam Balmuth. Sheffield Academic Press

Proceedings of the Prehistoric Society, 1994. 60: p. 455-6.

Conference proceedings: Gardening Time: Reflections on Memory, Monuments and History in Sardinia and Scotland.

S. Stoddart and Malone, C. (eds) In Prep. 2013-4 Oxford, Oxbow Books. 25+ themed papers

Worldwide childhood type 1 diabetes incidence - what can we learn from epidemiology?

Type 1 diabetes is the most common form of diabetes in most part of the world, although reliable data are still unavailable in several countries. Wide variations exist between the incidence rates of different populations, incidence is lowest in China and Venezuela (0.1 per 100 000 per year) and highest in Finland and Sardinia (37 per 100 000 per year). In most populations girls and boys are equally affected. In general, the incidence increases with age, the incidence peak is at puberty. After the pubertal years, the incidence rate significantly drops in young women, but remains relatively high in young adult males up to the age 29-35 years. Prospective national and large international registries (DIAMOND and EURODIAB) demonstrated an increasing trend in incidence in most regions of the world over the last few decades and increases seem to be the highest in the youngest age group. Analytical epidemiological studies have identified environmental risk factors operating early in life which might have contributed to the increasing trend in incidence. These include enteroviral infections in pregnant women, older maternal age (39-42 years), preeclampsia, cesarean section delivery, increased birthweight, early introduction of cow's milk proteins and an increased rate of postnatal growth (weight and height). Optimal vitamin D supplementation during early life has been shown to be protective. Some of these environmental risk factors such as viruses may initiate autoimmunity toward the beta cell, other exposures may put on overload on the already affected beta cell and thus accelerate the disease process.

A systematic review of population based epidemiological studies in Myasthenia Gravis

Background: The aim was to collate all myasthenia gravis (MG) epidemiological studies including AChR MG and MuSK MG specific studies. To synthesize data on incidence rate (IR), prevalence rate (PR) and mortality rate (MR) of the condition and investigate the influence of environmental and technical factors on any trends or variation observed.

Methods: Studies were identified using multiple sources and meta-analysis performed to calculate pooled estimates for IR, PR and MR.

Results: 55 studies performed between 1950 and 2007 were included, representing 1.7 billion population-years. For All MG estimated pooled IR (eIR): 5.3 per million person-years (C.I.: 4.4, 6.1), range: 1.7 to 21.3; estimated pooled PR: 77.7 per illion persons (C.I.: 64.0, 94.3), range 15 to 179; MR range 0.1 to 0.9 per millions person-years. AChR MG eIR: 7.3 (C.I.: 5.5, 7.8), range: 4.3 to 18.0; MuSK MG IR range: 0.1 to 0.32. However marked variation persisted between populations studied with similar methodology and in similar areas.

Conclusions: We report marked variation in observed frequencies of MG. We show evidence of increasing frequency of MG with year of study and improved study quality. This probably reflects improved case ascertainment. But other factors must also influence disease onset resulting in the observed variation in IR across geographically and genetically similar populations.