Prospective genetic screening decreases the incidence of abacavir hypersensitivity reactions in the Western Australian HIV cohort study

Abacavir therapy is associated with significant drug hypersensitivity in approximately 8% of recipients, with retrospective studies indicating a strong genetic association with the HLA-B*5701 allele. In this prospective study, involving 260 abacavir-naive individuals (7.7% of whom were positive for HLA-B*5701), we confirm the usefulness of genetic risk stratification, with no cases of abacavir hypersensitivity among 148 HLA-B*5701-negative recipients.

Four thousand years of vegetation and fire history in the spruce forests of northern Kyrgyzstan (Kungey Alatau, Central Asia)

Analyses of pollen, macrofossils and microscopic charcoal in the sediment of a small sub-alpine lake (Karakol, Kyrgyzstan) provide new data to reconstruct the vegetation history of the Kungey Alatau spruce forest during the late-Holocene, i.e. the past 4,000 years. The pollen data suggest that Picea schrenkiana F. and M. was the dominant tree in this region from the beginning of the record. The pollen record of pronounced die-backs of the forests, along with lithostratigraphical evidence, points to possible climatic cooling (and/or drying) around 3,800 cal year B.P., and between 3,350 and 2,520 cal year B.P., with a culmination at 2,800-2,600 cal B.P., although stable climatic conditions are reported for this region for the past 3,000-4,000 years in previous studies. From 2,500 to 190 cal year B.P. high pollen values of P. schrenkiana suggest rather closed and dense forests under the environmental conditions of that time. A marked decline in spruce forests occurred with the onset of modern human activities in the region from 190 cal year B.P. These results show that the present forests are anthropogenically reduced and represent only about half of their potential natural extent. As P. schrenkiana is a species endemic to the western Tien Shan, it is most likely that its refugium was confined to this region. However, our palaeoecological record is too recent to address this hypothesis thoroughly.

Tracing glacier wastage in the Northern Tien Shan (Kyrgyzstan/Central Asia) over the last 40 years

The status and dynamics of glaciers are crucial for agriculture in semiarid parts of Central Asia, since river flow is characterized by major runoff in spring and summer, supplied by glacier- and snowmelt. Ideally, this coincides with the critical period of water demand for irrigation. The present study shows a clear trend in glacier retreat between 1963 and 2000 in the Sokoluk watershed, a catchment of the Northern Tien Shan mountain range in Kyrgyzstan. The overall area loss of 28% observed for the period 1963–2000, and a clear acceleration of wastage since the 1980s, correlate with the results of previous studies in other regions of the Tien Shan as well as the Alps. In particular, glaciers smaller than 0.5 km2 have exhibited this phenomenon most starkly. While they registered a medium decrease of only 9.1% for 1963–1986, they lost 41.5% of their surface area between 1986 and 2000. Furthermore, a general increase in the minimum glacier elevation of 78 m has been observed over the last three decades. This corresponds to about one-third of the entire retreat of the minimum glacier elevation in the Northern Tien Shan since the Little Ice Age maximum.

An Assessment of Trends in the Extent of Swidden in Southeast Asia

Swidden systems consisting of temporarily cultivated land and associated fallows often do not appear on land use maps or in statistical records. This is partly due to the fact that swidden is a diverse and dynamic land use system that is difficult to map and partly because of the practice of grouping land covers associated with swidden systems into land use or land cover categories that are not self-evidently linked to swiddening. Additionally, in many parts of Southeast Asia swidden systems have changed or are in the process of changing into other land use systems. This paper assesses the extent of swidden on the basis of regional and national sources for nine countries, and determines the pattern of changes of swidden on the basis of 151 cases culled from 67 articles. Findings include (1) a majority of the cases document swidden being replaced by other forms of agriculture or by other livelihood systems; (2) in cases where swiddening is still practiced, fallow lengths are usually, but not always, shorter; and (3) shortened fallow length does not necessarily indicate a trend away from swidden since it is observed that short fallow swidden is sometimes maintained along with other more intensive farming practices and not completely abandoned. The paper concludes that there is a surprising lack of conclusive data on the extent of swidden in Southeast Asia. In order to remedy this, methods are reviewed that may lead to more precise future assessments.

Learner preferences regarding integrating, sequencing and aligning virtual patients with other activities in the undergraduate medical curriculum: A focus group study

CONTEXT: E-learning resources, such as virtual patients (VPs), can be more effective when they are integrated in the curriculum. To gain insights that can inform guidelines for the curricular integration of VPs, we explored students' perceptions of scenarios with integrated and non-integrated VPs aimed at promoting clinical reasoning skills. METHODS: During their paediatric clerkship, 116 fifth-year medical students were given at least ten VPs embedded in eight integrated scenarios and as non-integrated add-ons. The scenarios differed in the sequencing and alignment of VPs and related educational activities, tutor involvement, number of VPs, relevance to assessment and involvement of real patients. We sought students' perceptions on the VP scenarios in focus group interviews with eight groups of 4-7 randomly selected students (n = 39). The interviews were recorded, transcribed and analysed qualitatively. RESULTS: The analysis resulted in six themes reflecting students' perceptions of important features for effective curricular integration of VPs: (i) continuous and stable online access, (ii) increasing complexity, adapted to students' knowledge, (iii) VP-related workload offset by elimination of other activities, (iv) optimal sequencing (e.g.: lecture--1 to 2 VP(s)--tutor-led small group discussion--real patient) and (V) optimal alignment of VPs and educational activities, (vi) inclusion of VP topics in assessment. CONCLUSIONS: The themes appear to offer starting points for the development of a framework to guide the curricular integration of VPs. Their impact needs to be confirmed by studies using quantitative controlled designs.

Implementation of the Convention on the Protection and Promotion of the Diversity of Cultural Expressions in the Digital Age: Challenges, Priority Actions and Recommendations

Report presented to the Intergovernmental Committee of the Convention on the Protection and Promotion of the Diversity of Cultural Expressions Seventh Ordinary Session, Paris, December 10-­‐13, 2013

Strategy and Action Plan for Sustainable Land Management in the High Pamir and Pamir-Alai Mountains

This Strategy and Action Plan was written within the framework of the project on Sustainable Land Management in the High Pamir and Pamir-Alai Mountains (PALM). PALM is an integrated transboundary initiative of the governments of the Kyrgyz Republic and the Republic of Tajikistan. It aims to address the interlinked problems of land degradation and poverty within a region that is one of Central Asia’s crucial sources of freshwater and a location of biodiversity hotspots. The project is executed by the Committee on Environment Protection in Tajikistan and the National Center for Mountain Regions Development in Kyrgyzstan, with fi nancial support from the Global Environment Facility (GEF) and other donors. The United Nations Environment Programme (UNEP) is the GEF Implementing Agency for the project, and the United Nations University (UNU) is the International Executing Agency. This Strategy and Action Plan integrates the work of three main teams of experts, namely the Pamir-Alai Transboundary Strategy and Action Plan (PATSAP) team, the Legal Task Forces, and a team of Natural Disaster Risk specialists. The PATSAP team was coordinated by the Centre for Development and Environment (CDE), University of Bern, Switzerland. The Legal Task Force was led by the Australian Centre for Agriculture and Law of the University of New England (UNE), and responsibility for the Natural Disaster Risk assessment was with the Central- Asian Institute of Applied Geosciences (CAIAG) in Bishkek, Kyrgyzstan. The development of the strategy took place from June 2009 to October 2010. The activities included fi eld study tours for updating the information base with fi rst-hand information from the local level, coordination meetings with actors from the region, and two multi-level stakeholder forums conducted in Khorog and Osh to identify priorities and to collect ideas for concrete action plans. The baseline information collected for the Strategy and Action Plan has been compiled by the experts and made available as reports1. A joint multi-level stakeholder forum was conducted in Jirgitol, Tajikistan, for in-depth discussion of the transboundary aspects. In August 2010, the draft Strategy and Action Plan was distributed among local, national, and international actors for consultation, and their comments were discussed at feedback forums in Khorog and Bishkek. This Strategy and Action Plan is intended as a recommendation. Nevertheless, it proposes concrete mechanisms for implementing the proposed sustainable land management (SLM) activities: The Regional Natural Resources Governance Framework provides the legal and policy concepts, principles, and regulatory requirements needed to create an enabling environment for SLM in the High Pamir and Pamir-Alai region at the transboundary, national, and local levels. The priority directions outlined provide a framework for the elaboration of rayon-level strategies and for strategies on specifi c topics (forestry, livestock, etc.), as well as for further development of government programmes and international projects. The action plans may serve as a pool of concrete ideas, which can be taken up by diff erent institutions and in smaller or larger projects. Finally, this document provides a basis for the elaboration and signing of targeted cooperation agreements on land use and management between the leaders of Osh oblast (Kyrgyz Republic), Gorno Badakhshan Autonomous Oblast, and Jirgitol rayon (Republic of Tajikistan).