Parks of the future: Protected areas in Europe challenging regional and global change

Climate change, declines in biodiversity, increasing consumption of resources, urbanisation, urban sprawl and demographic change continue to challenge theregions of Europe. In response to these processes of regional and global change, there has been an unmistakeable boom in parks in Europe since the 1990s. Morethan a fifth of the continent is now protected using designations such as regionalnature parks, national parks, UNESCO Biosphere Reserves and World Heritagesites. The responsibilities of these areas are usually diverse and, in addition tonature protection and the conservation of cultural landscapes, increasingly involvethe promotion of sustainable development. In the 22 chapters of this volume, 28 authors from all over Europe analyse and comment on experiences of tackling the challenges of regional and global changein parks. They illustrate discussions with selected case studies and deal with keyissues of current protected area policy: How do parks address the pending challengesand what successes have they had thus far? What pioneering approaches are there in spatial planning and regional development? Which forms of park managementand governance are most promising? This informative and well-illustratedbook also considers which tasks will be assumed by parks in the future and whatroles parks may play in the debate concerning transformations required to promotesustainability in Europe.

The care of adults with congenital heart disease across the globe: Current assessment and future perspective

The number of adults with congenital heart disease (CHD) has increased markedly over the past few decades as a result of astounding successes in pediatric cardiac care. Nevertheless, it is now well understood that CHD is not cured but palliated, such that life-long expert care is required to optimize outcomes. All countries in the world that experience improved survival in CHD must face new challenges inherent to the emergence of a growing and aging CHD population with changing needs and medical and psychosocial issues. Founded in 1992, the International Society for Adult Congenital Heart Disease (ISACHD) is the leading global organization of professionals dedicated to pursuing excellence in the care of adults with CHD worldwide. Recognizing the unique and varied issues involved in caring for adults with CHD, ISACHD established a task force to assess the current status of care for adults with CHD across the globe, highlight major challenges and priorities, and provide future direction. The writing committee consisted of experts from North America, South America, Europe, South Asia, East Asia, and Oceania. The committee was divided into subgroups to review key aspects of adult CHD (ACHD) care. Regional representatives were tasked with investigating and reporting on relevant local issues as accurately as possible, within the constraints of available data. The resulting ISACHD position statement addresses changing patterns of worldwide epidemiology, models of care and organization of care, education and training, and the global research landscape in ACHD.

The relationship between leadership practices and a medication safety regime

Errors in healthcare are commonplace and have significant impact on mortality, morbidity, and costs. Other high-risk industries are credited with strong safety records. These successes are due in part to a strong, committed organizational culture and their leadership. A consistent pattern of effective leadership behaviors; creating change, establishing a vision and strategic actions, and enabling and inspiring the organization's members to act, is present in these high-risk industries. This research examined the relationship between leadership practices and a medication safety regime. The hypothesis is strong leadership practices have a positive relationship with the degree of sophistication of a medication safety program (safety performance). Leadership was used as a surrogate for organizational culture and was measured in this research through the Kouzes and Posner's Leadership Practices Inventory. The Institute of Medicine's 14 Selected Strategies to Improve Medication Safety was used to measure the development of a medication safety regime. Leadership practices towards safety were assessed by surveying 2,478 critical care Registered Nurses in the greater Houston area. A response rate of 19% was achieved. Thirteen hospitals participated in the medication safety regime assessment. Data from 386 RN respondents from 53 institutions provided an overall description of unit (ICU) and organization (hospital) leader's practices towards safety. There is some recognition of the medical error problem and that leaders exhibit moderate levels of leadership practices to promote safety. There were no differences noted in unit and hospital leaders' behaviors, with the exception that unit leaders promote change and enable staff to act more often than hospital leaders. There were no statistically significant relationships between overall leadership, or individual leadership practices and the organization's safety performance. There was a significant relationship between leadership and safety performance when other factors in organizational culture were considered. Teaching and Magnet hospitals also exhibited stronger behaviors towards safety. Organizational culture, as measured by academic affiliation and Magnet recognition, is strongly related to safety performance as measured by the degree of development of a medication safety regime. ^

Supporting Whole-Class Collaborative Inquiry in a Secondary Mathematics Classroom

Recent mathematics education reform efforts call for the instantiation of mathematics classroom environments where students have opportunities to reason and construct their understandings as part of a community of learners. Despite some successes, traditional models of instruction still dominate the educational landscape. This limited success can be attributed, in part, to an underdeveloped understanding of the roles teachers must enact to successfully organize and participate in collaborative classroom practices. Towards this end, an in-depth longitudinal case study of a collaborative high school mathematics classroom was undertaken guided by the following two questions: What roles do these collaborative practices require of teacher and students? How does the community’s capacity to engage in collaborative practices develop over time? The analyses produced two conceptual models: one of the teacher’s role, along with specific instructional strategies the teacher used to organize a collaborative learning environment, and the second of the process by which the class’s capacity to participate in collaborative inquiry practices developed over time.

Trends in anti-tuberculosis drug resistance from 2003--2007 at Pham Ngoc Thach tuberculosis and lung disease hospital, Ho Chi Minh City, Vietnam

Vietnam is one of the countries with the highest prevalence and incidence of tuberculosis (TB) in the world (1). Although Vietnam has had many successes in TB control, it still faces the challenge of drug resistant and multidrug-resistant tuberculosis (MDR-TB). MDR-TB appears to be relatively stable, but data on MDR-TB continues to be scarce and routine testing of all isolates for drug susceptibility is not performed under Vietnam's National Tuberculosis Program (6). Pham Ngoc Thach Hospital (PNT), the leading tuberculosis and lung disease hospital in Ho Chi Minh City, serves as a reference hospital and laboratory for both Ho Chi Minh City and the Southern Vietnam region. This study is an unmatched, nested case-control study consisting of a secondary analysis of a previously created dataset composed of drug susceptibility and basic demographic data from a cohort of patients diagnosed with tuberculosis at PNT from 2003 through 2007 in order to calculate the prevalence of resistance among acid-fast bacilli smear-positive patients. The susceptibility records for the years 2003-2004 were not representative of the entire population, but over the years 2005-2007 the investigator found a decrease in resistance to all primary TB drugs on which records were available, as well as MDR-TB. Overall, females showed a higher proportion of resistance to TB drugs than males, and females had a greater likelihood of presenting with MDR-TB than males (OR=1.77). Persons 35-54 had greater likelihood of having MDR-TB than younger and older age groups. Among the population with HIV data, HIV-positivity was associated with greater likelihood of MDR-TB (OR=1.70, 95% CI=0.97-3.11). This study shows that rates of TB drug resistance are high, but declining, in one of Vietnam's largest TB hospitals, and that females and HIV-positive individuals are possible high-risk groups in this population.^

Effective interventions for lowering HbA1C in African Americans with type 2 diabetes: A review

This synthesis of the literature provides descriptive analysis and outlines current self-management interventions for African Americans with type 2 diabetes. Specifically, this study describes and explores the design of those studies whose interventions have been shown to lower HbA1C levels in this population by at least 0.5% points, an improvement that provides approximately 10% reduction in long term complications from this disease.^ Results. In total, 37 articles were reviewed and 17 articles met inclusion criteria for analysis. Analysis of each study's methodology and results was performed and selected studies with interventions that resulted in improvements in HbA1C outcomes equal to 0.5% or greater for both group 1 and 2 were summarized by intervention type in table format. Descriptive analysis, outlining the number and characteristics of proximal and distal mediating components addressed in Group 1 studies, was performed in order to determine whether mediating components may have had some relation to effectiveness of intervention on outcome HbA1C. Descriptive analysis revealed that no particular design is substantially more effective than another among Behavioral studies although, there may be an advantage in using culturally sensitive, group interventions that address greater numbers of distal mediating components. Among Process studies, structured approaches (i.e. algorithm care and scheduled follow up), as well as utilization of specialty and group care are represented as effective for African American populations. ^ Conclusions. It may be summarized that by targeting behavior and addressing provider delivery (i.e. algorithm use, group care, home care, and provider follow up) in this population, a greater yield in outcome improvements may be accomplished. However, many gaps exist in a review process that stratifies results and focuses on identifying group specific intervention successes and failures. Further research in different populations will aid researchers and practitioners in discovering the best evidence, and identifying models that could be utilized in practice to achieve the best diabetes management for at risk groups.^

The theory of runs with application to drought predictions

The primary interest was in predicting the distribution runs in a sequence of Bernoulli trials. Difference equation techniques were used to express the number of runs of a given length k in n trials under three assumptions (1) no runs of length greater than k, (2) no runs of length less than k, (3) no other assumptions about the length of runs. Generating functions were utilized to obtain the distributions of the future number of runs, future number of minimum run lengths and future number of the maximum run lengths unconditional on the number of successes and failures in the Bernoulli sequence. When applying the model to Texas hydrology data, the model provided an adequate fit for the data in eight of the ten regions. Suggested health applications of this approach to run theory are provided. ^

An evaluation of Employee Assistance Programs: An overview and case study

Methodologies for the analysis and cross-evaluations of Employee Assistance Programs (EAPs) are necessary to indicate program weaknesses and strengths for both present and future EAP services.^ As EAPs have matured from simplistic industrial alcoholism programs to all problem-encompassing, complex programs, an aggressive group of entrepreneurs has developed. Business and industrial managements need established criteria to select the most suitable professional services for their needs, as well as the best investment value for cost containments.^ Four major EAPs were compared to determine critical areas necessary for cross evaluation. Future standardization of terminology and definitions of services will facilitate both the evaluation of a specific program and its comparison to problems or successes of other EAPs.^ Past evaluation difficulties have been caused by the lack of EAP program accreditations and professional personnel licensure requirements. The Association of Labor Management Administrators and Consultants on Alcoholism (ALMACA) has recently set certification criteria for personnel, which will enhance the professional standards for EAPs. ^

Family Preservation Journal, 2002, Volume 6, Issue 2. (Entire issue)

Entire issue (large pdf file) Articles include: Applying the Strengths Perspective to Increase Safety and Well-Being: Views from Families and Providers. Diane DePanfilis, Joshua Okundaye, Esta Glazer-Semmel, Lisa Kelly, and Joy Swanson Ernst Changing Tides and Changing Focus: Mapping the Challenges and Successes of One State's Implementation Of the Adoption and Safe Families Act of 1997. Scottye J. Cash, Scott D. Ryan, and Alison Glover Promising Practices to Engage Families and Support Family Preservation. Marianne Berry Implementing Intensive Family Preservation Services: A Case of lnfidelity. Raymond S. Kirk, Kellie Reed-Ashcrafi, and Peter J. Pecora Supporting Families through Short-Term Foster Care: An Essay Review. Anthony Maluccio Failed Child Welfare Policy: An Essay Review. Anthony Maluccio

Éxitos y desafíos en política de transporte público : análisis comparativo de las innovaciones en la prestación del servicio de transporte público de pasajeros en las ciudades de Curitiba, Brasil; Santiago de Chile, Chile y Rosario, Argentina

En esta artículo realizamos un análisis comparativo de los sistemas de servicio de transporte público de pasajeros en las ciudades de Curitiba, Brasil; Santiago de Chile, Chile y Rosario, Argentina para poder comparar las similitudes, diferencias y dificultades que presentan estos sistemas en la etapa de implementación de las políticas públicas; como así también presentar una sistematización de las políticas, instrumentos y acciones que permitieron gestionar con éxito las reestructuraciones de los sistemas de transporte y sus aportes para el desarrollo de una Política pública de transporte en el Gran Mendoza.

El bienestar social durante el peronismo clásico. La expansión de los servicios de salud hacia las áreas rurales de los municipios de la provincia de Mendoza (1946-1955)

Con la llegada del peronismo al gobierno se produjeron reformas en relación a la organización y funcionamiento del sistema de salud pública. Pero más allá de sus éxitos o fracasos, el cuidado y la preservación de la salud de la población, incluyendo la de las zonas más apartadas y atrasadas del interior del país, fue una de las metas principales del gobierno de Juan Domingo Perón. A partir de esto, nuestro objetivo central es estudiar las políticas sanitarias en los municipios de la provincia de Mendoza durante el período 1946-1955, atendiendo a dos aspectos: el primero de ellos, relacionado con el rol del gobierno nacional y provincial en la ejecución de esta política pública, y el segundo, con los resultados, logros y efectos de la misma en los departamentos mendocinos. Este estudio empírico, en el cual se cotejan programas con resultados, permitirá conocer entonces el real cumplimiento de los objetivos establecidos por el peronismo.

El bienestar social durante el peronismo clásico. La expansión de los servicios de salud hacia las áreas rurales de los municipios de la provincia de Mendoza (1946-1955)

Con la llegada del peronismo al gobierno se produjeron reformas en relación a la organización y funcionamiento del sistema de salud pública. Pero más allá de sus éxitos o fracasos, el cuidado y la preservación de la salud de la población, incluyendo la de las zonas más apartadas y atrasadas del interior del país, fue una de las metas principales del gobierno de Juan Domingo Perón. A partir de esto, nuestro objetivo central es estudiar las políticas sanitarias en los municipios de la provincia de Mendoza durante el período 1946-1955, atendiendo a dos aspectos: el primero de ellos, relacionado con el rol del gobierno nacional y provincial en la ejecución de esta política pública, y el segundo, con los resultados, logros y efectos de la misma en los departamentos mendocinos. Este estudio empírico, en el cual se cotejan programas con resultados, permitirá conocer entonces el real cumplimiento de los objetivos establecidos por el peronismo.

El bienestar social durante el peronismo clásico. La expansión de los servicios de salud hacia las áreas rurales de los municipios de la provincia de Mendoza (1946-1955)

Con la llegada del peronismo al gobierno se produjeron reformas en relación a la organización y funcionamiento del sistema de salud pública. Pero más allá de sus éxitos o fracasos, el cuidado y la preservación de la salud de la población, incluyendo la de las zonas más apartadas y atrasadas del interior del país, fue una de las metas principales del gobierno de Juan Domingo Perón. A partir de esto, nuestro objetivo central es estudiar las políticas sanitarias en los municipios de la provincia de Mendoza durante el período 1946-1955, atendiendo a dos aspectos: el primero de ellos, relacionado con el rol del gobierno nacional y provincial en la ejecución de esta política pública, y el segundo, con los resultados, logros y efectos de la misma en los departamentos mendocinos. Este estudio empírico, en el cual se cotejan programas con resultados, permitirá conocer entonces el real cumplimiento de los objetivos establecidos por el peronismo.

De la ciudad en vibración al ser resonante: Una investigación a propósito de los conciertos de campanas de Llorenç Barber

Este trabajo tiene la vocación de dibujar el mapa de los dominios de oportunidad que hay a disposición de un arquitecto, al imaginar el aspecto sonoro de la ciudad en relación con la campana. Muchas de las dimensiones señaladas, tanto conocidas como desconocidas, son sencillamente despertadas al estudio de lo que un diseñador del espacio sonoro, como Llorenç Barber, viene a decirnos, desde una disciplina aparentemente contactada, pero muchas veces paralela a la arquitectónica. Tomando los conciertos de campanas celebrados hasta la fecha como puestas en práctica real de la condición instrumental de más de doscientas ciudades de todo el mundo, el estudio analiza los hallazgos, éxitos y fracasos, obtenidos a lo largo de estos últimos veinticinco años de experiencia, como resultados explícitos de un trabajo sonoro en la ciudad, probado, contrastado y afinado, del que extraer indicaciones concretas susceptibles de ser aplicadas en el diseño del espacio urbano. Mediante un análisis triangular de vértices definidos: emisor-campana, medio-ciudad, receptor-ciudadano; la investigación aborda los aspectos relativos a la producción y recepción del fenómeno sonoro generado por la campana en la ciudad. En relación con la producción, una parte del trabajo se dedica al estudio de los efectos acústicos observados, ordenado por escalas graduales en las que se produce una distribución del sonido susceptible de diseño: el vaso de la campana, la sala de campanas, el campanario, el cuerpo del edificio, la ciudad y el territorio. A modo de cajas de resonancia y leídas como muñecas rusas, unas dentro de otras, los espacios identificados muestran cualidades sonoras específicas, definidas tanto por sus condiciones geométricas, formales, constructivas o de uso; como por las correspondientes a las subsiguientes cajas que alojan. A fin de esclarecer la influencia de tales cuestiones en el aspecto sonoro de la ciudad, se propone un modelo ordenado de conexión y desconexión de escalas, utilizando una paramétrica puramente técnica creada ex profeso, junto con variables metodológicas más tradicionales. Al mismo tiempo, y tratando de esclarecer cómo, al ser puesta en vibración, la ciudad es aprehendida, disfrutada y rememorada por el ciudadano-oyente, otra parte del trabajo se dedica al estudio de los aspectos relativos a su recepción aural en deambulación compartida. En este caso la investigación se propone reclamar otras dimensiones más subversivas que, si bien escapan a los modos habituales de trabajar del arquitecto, se revelan intensamente en la experiencia plurifocal, multiplicando los efectos a considerar: efectos funcionales y significativos, de reconocimiento, integración y pertenencia a un cuerpo territorial y social de coordenadas históricas y geográficas de nuevo significadas; efectos perceptuales de inmersión, ubicuidad, temporalidad o inestabilidad; efectos estéticos, de rememoración, interpretación simbólica y recreación poética; e incluso efectos políticos, descubriendo un espacio urbano en continua regeneración, lugar para la exposición en su doble acepción, para la exhibición y el peligro, o como contenedor situacional del más profundo sentido ciudadano. Para afinar la relevancia de lo obtenido en cada una de las dimensiones señaladas, el trabajo se articula en tres aproximaciones graduales: el corpus general de los conciertos celebrados hasta la fecha; los conciertos celebrados en España; los tres conciertos para Madrid: Magna Mater (1991), Festi Clamores (2000) y Aurea Catena (2007). Si bien el modelo propuesto nace a la luz de los conciertos de campanas de Llorenç Barber, a escala de una ciudad entera y con una intención compositiva individual, se entiende que sería útil para el uso ordenado de cualquier profesional interesado en el aspecto sonoro de la ciudad, faceta escasamente atendida, dicho sea de paso, desde la disciplina arquitectónica. ABSTRACT This work has the vocation of drawing out the numerous opportunities an architect has at his disposal, upon imagining the sonorous aspect of the city in relation to the bell. Many of the dimensions indicated, both known and unknown, are just awakened to the study of what a sound space designer, as Llorenç Barber, comes to tell us, from a discipline apparently contacted, but often parallel to the architecture. Taking the bell concerts held so far as actual implementation of the instrumental condition of over two hundred cities around the world, the study analyzes the findings, successes and failures, obtained over the last twenty years of experience, as explicit results of a sound work in the city, tested, verified and refined, from which to extract specific indications that can be applied in the design of urban space. By triangular analyzing of defined vertices: sender-bell, half-city, receptor-citizen; the research addresses issues relating to the production and reception of sound phenomenon generated by the bell in the city. In relation to production, part of the work is devoted to the study of observed acoustic effects, ordered gradual scale which produces a distribution of sound capable of design: the glass of the bell, the bell room, the bell tower and the body of the building, the city and territory. By way of sounding boards and read as if they were Russian dolls, one inside the other, the show spaces identified specific sound qualities, defined both for their geometric, formal, constructive use, such as those for hosting the subsequent boxes. In order to clarify the influence of such issues in the sound aspect of the city, we propose an ordered pattern of connection and disconnection of scales, using a purely parametric technique created on purpose, along with more traditional methodological variables. At the same time, and trying to clarify how, when set in vibration, the city is apprehended, enjoyed and remembered for the citizen-listener, another part of the work is devoted to the study of aspects of aural reception in shared ambulation. In this case the research aims to claim more subversive than other dimensions, but beyond the usual ways in which an architect works, the experience reveals intensely plurifocal multiplying effects to consider: functional effects and significant recognition and integration belonging to a body of territorial and social historical and geographical coordinates of new meaning and perceptual effects of immersion, ubiquity, timeliness or instability; aesthetic effects of recall, interpretation and recreation of symbolic poetic; and even political effects, revealing a continuous urban space regeneration site for the exhibition in its double meaning, for display and danger, or as a citizen sense container. To sharpen the relevance of what was obtained in each of the dimensions mentioned, the work is divided into three incremental approaches: the general corpus of the concerts held so far, the concerts in Spain, the three concerts for Madrid: Magna Mater (1991), Festi Clamores (2000) and Aurea Catena (2007). While the proposed model comes in the light of the bells concert Llorenç Barber, the scale of a whole city and individual compositional intent, it is understood that it would be useful for the orderly use of any professional interested in the sound aspect of the city, an aspect sparsely attended, incidentally, from the architectural discipline.