Putting the magic in magic bullets: top three global priorities for sexually transmitted infection control

Setting practical priorities for sexually transmitted infection (STI) control is a balance between idealism and pragmatism. Infections transmitted through unsafe sex (chlamydia, gonorrhoea, syphilis, HIV, hepatitis B and human papillomavirus (HPV) infections) rank in the top five causes of the global burden of disease.1 Their distribution in populations is driven by a complex mixture of individual behaviours, social and community norms and societal and historical context. Ideally, we would be able to reduce exposure to unsafe sex to its theoretical minimum level of zero and thus eliminate a significant proportion of the current global burden of disease, particularly in resource-poor settings.2 Ideally, we would have ‘magic bullets’ for diagnosing and preventing STI in addition to specific antimicrobial agents for specific infections.3 Arguably, we have ‘bullets’ that work at the individual level; highly accurate diagnostic tests and highly efficacious vaccines, antimicrobial agents and preventive interventions.4 Introducing them into populations to achieve similarly high levels of effectiveness has been more challenging.4 In practice, the ‘magic’ in the magic bullet can be seen as overcoming the barriers to sustainable implementation in partnerships, larger sexual networks and populations (figure 1).4 We have chosen three (pragmatic) priorities for interventions that we believe could be implemented and scaled up to control STI other than HIV/AIDS. We present these starting with the partnership and moving up to the population level.

Trial history biases the spatial programming of antisaccades

The historical context in which saccades are made influences their latency and error rates, but less is known about how context influences their spatial parameters. We recently described a novel spatial bias for antisaccades, in which the endpoints of these responses deviate towards alternative goal locations used in the same experimental block, and showed that expectancy (prior probability) is at least partly responsible for this 'alternate-goal bias'. In this report we asked whether trial history also plays a role. Subjects performed antisaccades to a stimulus randomly located on the horizontal meridian, on a 40° angle downwards from the horizontal meridian, or on a 40° upward angle, with all three locations equally probable on any given trial. We found that the endpoints of antisaccades were significantly displaced towards the goal location of not only the immediately preceding trial (n - 1) but also the penultimate (n - 2) trial. Furthermore, this bias was mainly present for antisaccades with a short latency of <250 ms and was rapidly corrected by secondary saccades. We conclude that the location of recent antisaccades biases the spatial programming of upcoming antisaccades, that this historical effect persists over many seconds, and that it influences mainly rapidly generated eye movements. Because corrective saccades eliminate the historical bias, we suggest that the bias arises in processes generating the response vector, rather than processes generating the perceptual estimate of goal location.

Public Drinking in the Early Modern World: Voices from the Tavern, 1500-1800

Until recently the role of the public drinking house has been approached from elitist, folkloric and anecdotal perspectives. The work of a new generation of social historians, however, has raised the tavern’s profile in the academic consciousness and confirmed its position within the mainstream of social and cultural history. It is now recognized that an understanding of the centrality of public drinking to the development of both elite and popular culture is vital to studies of social behaviour. The study of taverns has also been at the forefront of emerging interest in the history of consumption and material culture, and has contributed to a richer understanding of economic history. Constructions of gender and identity are also visible through research into the patterns of behaviour and discourse in and around the public house. This four-volume reset edition presents a wide-ranging collection of primary sources which uncover the language and behaviour of local and state authorities, of peasants and town-dwellers, and of drinking companions and irate wives. The documents are translated and set in their social and historical context, providing a multidisciplinary collection that will be of great importance to scholars of all areas of social and cultural history of the early modern period. The vast majority of this material is published here for the first time, ensuring that the collection will open up new avenues of research. Volume 1 draws heavily from the Parisian police archives and includes inspectors’ reports, complaints by the general public and details of court cases to build a picture of drinking in early modern France. Volumes 2 and 3 address public drinking in the Holy Roman Empire through a variety of chronicles, civic ordinances, court records, travel reports and surveys of public houses. Volume 4 locates taverns within a broader analysis of America’s public houses, drawing on visual material as well as journal entries, business reports and newspaper articles. Each volume is accompanied by editorial introductions and is annotated to provide readers with a high-quality resource of scholarly material.

A Comparative Study of Central and Eastern European Social Policy Concernig Mental Disability

The main goal of this project was to identity whether an imported system of social policy can be suitable for a host country, and if not why not. Romanian social policy concerning the mentally disabled represents a paradoxical situation in that while social policy is designed to ensure both an institutional structure and a juridical environment, in practice it is far from successful. The central question which Ms. Ciumageanu asked therefore was whether this failure was due to systemic factors, or whether the problem lay in reworking an imported social policy system to meet local needs. She took a comparative approach, also considering both the Scandinavian model of social policy, particularly the Danish model which has been adopted in Romania, and the Hungarian system, which has inherited a similar universal welfare system and perpetuated it to some extent. In order to verify her hypothesis, she also studied the transformation of the welfare system in Great Britain, which meant a shift from state responsibility towards community care. In all these she concentrated on two major aspects: the structural design within the different countries and, at a micro level, the societal response. Following her analyses of the various in the other countries concerned, Ms. Ciumageanu concluded that the major differences lie first in the difference between the stages of policy design. Here Denmark is the most advanced and Romania the most backwards. Denmark has a fairly elaborate infrastructure, Britain a system with may gaps to bridge, and Hungary and Romania are struggling with severe difficulties owing both to the inherited structure and the limits imposed by an inadequate GDP. While in Denmark and Britain, mental patients are integrated into an elaborate system of care, designed and administered by the state (in Denmark) or communities (in Britain), in Hungary and Romania, the state designs and fails to implement the policy and community support is minimal, partly due to the lack of a fully developed civil society. At the micro level the differences are similar. While in Denmark and Britain there is a consensus about the roles of the state and of civil societies (although at different levels in the two countries, with the state being more supportive in Denmark), in Romania and to a considerable extent in Hungary, civil society tends to expect too much from the state, which in its turn is withdrawing faster from its social roles than from its economic ones, generating a gap between the welfare state and the market economy and disadvantaging the expected transition from a welfare state to a welfare society and, implicitly, the societal response towards those mentally disabled persons in it. On an intermediate level, the factors influencing social policy as a whole were much the same for Hungary and Romania. Economic factors include the accumulated economic resources of both state and citizens, and the inherited pattern of redistribution, as well as the infrastructure; institutional resources include the role of the state and the efficiency of the state bureaucracy, the strength and efficiency of the state apparatus, political stability and the complexity of political democratisation, the introduction of market institutions, the strength of civil society and civic sector institutions. From the standpoint of the societal response, some factors were common to all countries, particularly the historical context, the collective and institutional memories and established patterns of behaviour. In the specific case of Romania, general structural and environmental factors - industrialisation and forced urbanisation - have had a definite influence on family structure, values and behavioural patterns. The analysis of Romanian social policy revealed several causes for failure to date. The first was the instability of the policy and the failure to consider the structural network involved in developing it, rather than just the results obtained. The second was the failure to take into account the relationship between the individual and the group in all its aspects, followed by the lack of active assistance for prevention, re-socialisation or professional integration of persons with mental disabilities. Finally, the state fails to recognise its inability to support an expensive psychiatric enterprise and does not provide any incentive to the private sector. This creates tremendous social costs for both the state and the individual. NGOs working in the field in Romania have been somewhat more successful but are still limited by their lack of funding and personnel and the idea of a combined system is as yet utopian in the circumstances in the country.

The Ideology, Politics and Autonomous Art of Richard Weiner: (An Event in Discourse)"

The first aim of the project was to compile documentation on the life and work of Richard Weiner, a Czech journalist, writer and poet who spent the best part of his life as Paris correspondent for Lidove noviny. Langerova looked at the contexts and the growing independence of certain parts of his work, the distribution of thematic compositional elements into different parts of discourse and their position in the autonomous space of a work of art. Looking at the features of minority literature and the contemporary contexts of Weiner's life and work Langerova focuses on the situation of the Jewish community (Wiener came from an assimilated Jewish family). For this minorities, the function of language as a medium of communication which is able to create an autonomous world became increasingly important. Literature, which is based on this function of language, is a political matter par excellence before it begins forming as an autonomous, independent and divergent place. This means that everything private and intimate is closely connected to political and social responsibility, while supposedly objective genres contain subjective features. Another important characteristic is "nomadism", which asks the question of "Where do I belong". This was very important in Czechoslovakia after World War I , as in the issue of Zionism. Although Weiner rejected Zionism, he asks this question in his writing and it is reflected at a symbolic level in his work, which shows a fundamental thematic and compositional plan of a journey, cross-roads and wandering. These theses were reflected in Weiner's life, which was a series of continuous transfers and unplanned moves, often when he thought he had found his place. As well as tracing the course of his life, and his relations with and views of other writers, Langerova looks at his writings in various areas. Her major focus is the divergence of trivial and great events into different types of discourse in Richard Weiner's work, their transfer (small into great, trivial into mythical) and their historical context.

Panel Discussion - Finns in the United States

“Book Notes with Four Authors from Finns in the United States: A History of Settlement, Dissent, and Integration” This panel presentation will highlight chapters in the newly released book, Finns in the United States, published by Michigan State University Press. Authors will discuss their contribution to the book, and highlight key aspects of their work. Finns in the United States has been touted as a fresh and up-to-date analysis of Finnish Americans, an insightful volume that lays the groundwork for exploring this unique culture through a historical context, followed by an overview of the overall composition and settlement patterns of these newcomers.

"Army of One" to "Army Strong" : visual media and U.S. Army recruitment during Bush"s "War on Terror"

From Bush’s September 20, 2001 “War on Terror” speech to Congress to President-Elect Barack Obama’s acceptance speech on November 4, 2008, the U.S. Army produced visual recruitment material that addressed the concerns of falling enlistment numbers—due to the prolonged and difficult war in Iraq—with quickly-evolving and compelling rhetorical appeals: from the introduction of an “Army of One” (2001) to “Army Strong” (2006); from messages focused on education and individual identity to high-energy adventure and simulated combat scenarios, distributed through everything from printed posters and music videos to first-person tactical-shooter video games. These highly polished, professional visual appeals introduced to the American public during a time of an unpopular war fought by volunteers provide rich subject matter for research and analysis. This dissertation takes a multidisciplinary approach to the visual media utilized as part of the Army’s recruitment efforts during the War on Terror, focusing on American myths—as defined by Barthes—and how these myths are both revealed and reinforced through design across media platforms. Placing each selection in its historical context, this dissertation analyzes how printed materials changed as the War on Terror continued. It examines the television ad that introduced “Army Strong” to the American public, considering how the combination of moving image, text, and music structure the message and the way we receive it. This dissertation also analyzes the video game America’s Army, focusing on how the interaction of the human player and the computer-generated player combine to enhance the persuasive qualities of the recruitment message. Each chapter discusses how the design of the particular medium facilitates engagement/interactivity of the viewer. The conclusion considers what recruitment material produced during this time period suggests about the persuasive strategies of different media and how they create distinct relationships with their spectators. It also addresses how theoretical frameworks and critical concepts used by a variety of disciplines can be combined to analyze recruitment media utilizing a Selber inspired three literacy framework (functional, critical, rhetorical) and how this framework can contribute to the multimodal classroom by allowing instructors and students to do a comparative analysis of multiple forms of visual media with similar content.

Fish contaminants through the tribal perspective : an ethnography of the Keweenaw Bay Indian Community's tribal fish harvest

It has been well documented that many tribal populations and minority groups across the nation have been identified as being at high risk of the adverse health effects created by consuming fish that have been contaminated with mercury, PCBs, DDT, dioxins, and other chemicals. Although fish consumption advisories are intended to inform fish consumers of risks associated with specific species and water bodies, advisories have been the subject of both environmental injustices and treaty rights’ injustices. This means that understanding fish contaminants, through community perspectives is essential to good environmental policy. This study examined the fish contaminant knowledge, impacts on fishing and fish consumption, and the factors that contribute to harvesting decisions and behaviors in one tribal nation in the Upper Peninsula of Michigan, the Keweenaw Bay Indian Community. Using ethnographic methods, participant observation and semi-structured interviewing, fieldnotes were kept and all interviews were fully transcribed for data analysis. Among seventeen fishermen and women, contaminants are poorly understood, have had a limited impact on subsistence fishing but have had a substantial impact on commercial fishing activity. But ultimately, all decisions and behaviors are based on their own criteria and within a larger context of knowledge and understanding: the historical and cultural context. The historical context revealed that advisories are viewed as another attack on tribal fishing. The cultural context revealed that it is the fundamental guidance and essential framework associated with all harvesting beliefs, values, and traditional lifeways. These results have implications for advisories. ‘Fish’ and ‘contaminants’ appear differently based on the perceptions and priorities of those who encounter them.

The Social Dynamics of Communal Violence in India

Contrasting strands of explanation of the motives underlying collective action, as either culturally determined, as an attempt at compensation, point towards an understanding of identity politics as a reaction to given conditions. They pay little attention to the social dynamics that evolve in relation to the conflict within a group, and the possible motivation that can ensue from these. This article analyses the mobilisation among Hindu-nationalist organisations. Rather than seeking their attraction in their discursive outputs and the possible answers they might give in times of change, the contention is that they are to be sought in the specific internal dynamics and the possibilities they create within their historical context. These specific opportunities for action are inherent firstly in the mode of operation relying on participation and involvement, on their direct intervention, their localness and accessibility. Moreover, the dichotomisation inherent in violence makes possible the integration of different interests and different discontents under one banner and therefore contributes to the project of unification undertaken by Hindu-nationalism.

Aerological observations in the Tropics in the Early Twentieth Century

In the first decades of the 20th century, aerological observations were for the first time performed in tropical regions. One of the most prominent endeavours in this respect was ARTHUR BERSON’s aerological expedition to East Africa. Although the main target was the East African monsoon circulation, the expedition provided also other insights that profoundly changed meteorology and climatology. BERSON observed that the tropical tropopause was much higher and colder than that over midlatitudes. Moreover, westerly winds were observed in the lower stratosphere, apparently contradicting the high-altitude equatorial easterly winds that were known since the Krakatoa eruption (‘‘Krakatoa easterlies’’). The puzzle was only resolved five decades later with the discovery of the Quasi-Biennial Oscillation (QBO). In this paper we briefly summarize the expedition of BERSON and review the results in a historical context and in the light of the current research. In the second part of the paper we re-visit BERSON’s early aerological observations, which we have digitized. We compare the observed wind profiles with corresponding profiles extracted from the ‘‘Twentieth Century Reanalysis’’, which provides global three-dimensional weather information back to 1871 based on an assimilation of sea-level and surface pressure data. The comparison shows a good agreement at the coast but less good agreement further inland, at the shore of Lake Victoria, where the circulation is more complex. These results demonstrate that BERSON’s observations are still valuable today as input to current reanalysis systems or for their validation.

Little-known Swiss contributions to the description, diagnosis, and surgery of lumbar disc disease before the Mixter and Barr era

The understanding of lumbar spine pathologies made substantial progress at the turn of the twentieth century. The authors review the original publication of Otto Veraguth in 1929 reporting on the successful resection of a herniated lumbar disc, published exclusively in the German language. His early report is put into the historical context, and its impact on the understanding of pathologies of the intervertebral disc (IVD) is estimated. The Swiss surgeon and Nobel Prize laureate Emil Theodor Kocher was among the first physicians to describe the traumatic rupture of the IVD in 1896. As early as 1909 Oppenheim and Krause published 2 case reports on surgery for a herniated lumbar disc. Goldthwait was the first physician to delineate the etiopathogenes is between annulus rupture, symptoms of sciatica, and neurological signs in his publication of 1911. Further publications by Middleton and Teacher in 1911 and Schmorl in 1929 added to the understanding of lumbar spinal pathologies. In 1929, the Swiss neurologist Veraguth (surgery performed by Hans Brun) and the American neurosurgeon Walter Edward Dandy both published their early experiences with the surgical therapy of a herniated lumbar disc. Veraguth's contribution, however, has not been appreciated internationally to date. The causal relationship between lumbar disc pathology and sciatica remained uncertain for some years to come. The causal relationship was not confirmed until Mixter and Barr's landmark paper in 1934 describing the association of sciatica and lumbar disc herniation, after which the surgical treatment became increasingly popular. Veraguth was among the first physicians to report on the clinical course of a patient with successful resection of a herniated lumbar disc. His observations should be acknowledged in view of the limited experience and literature on this ailment at that time.

Words, words, words: Philology and Beyond: Festschrift for Andreas Fischer on the Occasion of his 65th Birthday

This Festschrift comprises a series of papers written in honour of the philologist Andreas Fischer, on the occasion of his sixty-fifth birthday. As in Andreas Fischer s own research, the main focus of the volume is on words: words in modern varieties, such as emergent conjunctions in Australian, American and British English; words in their cultural and historical context, such as English keywords in Old Norse literature; and words in a diachronic perspective, such as Romance suffixation in the history of English. Many contributions are anchored in the philological tradition that has informed much of Andreas Fischer s own scholarship, such as the study of verbal duelling in the late thirteenth-century romance Kyng Alisaunder. Others examine the construction ofdiscourses, such as those surrounding the Black Death. The volume, with its innovative studies,offers fascinating insights into words, discourses,and their contexts, both past and present.

Community participation in health services

This study critically analyzes and synthesizes community participation (CP) theory across disciplines, defining and beginning to map out the elements of CP according to a preliminary framework of structure, process, intermediate outcomes, and ultimate outcomes. The first study component sought to determine the impact of Sight N' Soul, a CP project utilizing neighborhood health workers (NHWs), on appointment missing in an indigent urban African-American population. It found that persons entering the vision care system through contact with an NEW were about a third less likely to miss an appointment than those persons entering the system through some other avenue. While theory in this area remains too poorly developed to hypothesize causal relationships between structure, process, and outcomes, a summary of the elements of Sight N' Soul's structure and process both developed the preliminary framework and serves as a first step to mapping these relationships. The second component of the study uncovered the elements of structure and process that may contribute to a sustained egalitarian partnership between community people and professionals, a CP program called Project HEAL. Elements of Project HEAL's structure and process included a shared belief in the program; spirituality; contribution, ownership, and reciprocation; a feeling of family; making it together; honesty, trust, and openness about conflict; the inevitability of uncertainty and change; and the guiding interactional principles of respect; love, care, and compassion; and personal responsibility. The third component analyzed the existing literature, identifying and addressing gaps and inconsistencies and highlighting areas needing more highly developed ethical analysis. Focal issues include the political, economic, and historical context of CP; the power of naming; the issue of purpose; the nature of community; the power to muster and allocate resources; and the need to move to a systems view of health and well-being, expanding our understanding of the universe of potential outcomes of CP, including iatrogenic outcomes. Intermediate outcomes might include change in community, program, and individual capacity, as well as improved health care delivery. Ultimate outcomes include increased positive interdependencies and opportunities for contribution; improved mental, physical, and spiritual health; increased social justice; and decreased exploitation. ^

Slow Cities: Sustainable Places in a Fast World

This article examines the Slow Food and Slow City movement as an alternative approach to urban development that focuses on local resources, economic and cultural strengths, and the unique historical context of a town. Following recent discussions about the politics of alternative economic development, the study examines the Slow City movement as a strategy to address the interdependencies between goals for economic, environmental, and equitable urban development. In particular, we draw on the examples of two Slow Cities in Germany—Waldkirch and Hersbruck, and show how these towns are retooling their urban policies. The study is placed in the context of alternative urban development agendas as opposed to corporate-centered development. We conclude the article by offering some remarks about the institutional and political attributes of successful Slow Cities and the transferability of the concept.

The social construction of infant mortality: From grassroots to medicalization

Infant mortality as a problematic situation has been recognized for some 130 years in one form or another. It has undergone various changes in its empirical dimensions relative to whom we study within the population, what we study--low birth-weight vs. pre-term births--and how we study it--whether demographically or medically. An analysis of the process by which the condition was raised by claims makers as an intolerable situation among America's urban residents reveals that demographic and medical data were sparse. Nonetheless, a judgement about the meaning and significance of the condition was made, and that interpretation led to the promulgation of systems to both document and address the condition as it has come to be defined.^ This investigation depicts the historical context and natural history of infant mortality as one of a number of social problems that came to be defined through the interplay among groups and individuals making claims and how their claims came to the public policy agenda as worthy of collective resources--who won, who lost and why. The process of social definition focuses attention on the claims makers and the ways they contrast the meaning, origins and remedies for this troubling condition. The historical context becomes the frame of reference for understanding the actions of the claims makers and the meaning and significance they attached to the problem.^ We purport that "context" provides a closer reality than disjoined "value free" accounts. Context provides the evidence for the definition, who participated in the process, why and by what means.^ The role of women in the definitional process reveals the differences in approaches utilized by the women of the settlement house reform movement and African-American women working at the grass-roots. Much of the work done by these two groups provided options to the problem's remedy; however, their differences paved the way to our current (principally medically-oriented) definition and its inherent limitations. ^