862 resultados para Vietnam limitations and exceptions


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Previous cross-sectional magnetic resonance imaging (MRI) studies of healthy aging in young adults have indicated the presence of significant inverse correlations between age and gray matter volumes, although not homogeneously across all brain regions. However, such cross-sectional studies have important limitations and there is a scarcity of detailed longitudinal MRI studies with repeated measures obtained in the same individuals in order to investigate regional gray matter changes during short periods of time in non-elderly healthy adults. In the present study, 52 healthy young adults aged 18 to 50 years (27 males and 25 females) were followed with repeated MRI acquisitions over approximately 15 months. Gray matter volumes were compared between the two times using voxel-based morphometry, with the prediction that volume changes would be detectable in the frontal lobe, temporal neocortex and hippocampus. Voxel-wise analyses showed significant (P < 0.05, family-wise error corrected) relative volume reductions of gray matter in two small foci located in the right orbitofrontal cortex and left hippocampus. Separate comparisons for males and females showed bilateral gray matter relative reductions in the orbitofrontal cortex over time only in males. We conclude that, in non-elderly healthy adults, subtle gray matter volume alterations are detectable after short periods of time. This underscores the dynamic nature of gray matter changes in the brain during adult life, with regional volume reductions being detectable in brain regions that are relevant to cognitive and emotional processes.

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[EN]The aim of this work is to study several strategies for the preservation of flow discontinuities in variational optical flow methods. We analyze the combination of robust functionals and diffusion tensors in the smoothness assumption. Our study includes the use of tensors based on decreasing functions, which has shown to provide good results. However, it presents several limitations and usually does not perform better than other basic approaches. It typically introduces instabilities in the computed motion fields in the form of independent \textit{blobs} of vectors with large magnitude...

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We investigate the benefits that emerge when the fields of constraint programming and concurrency meet. On one hand, constraints can be use in concurrency theory to increase the conciseness and the expressive power of concurrent languages from a pragmatic point of view. On the other hand, problems modeled by using constraints can be solved faster and more efficiently using a concurrent system. We explore both directions providing two separate lines of contribution. Firstly we study the expressive power of a concurrent language, namely Constraint Handling Rules, that supports constraints as a primitive construct. We show what features of this language make it Turing powerful. Then we propose a framework to solve constraint problems that is intended to be deployed on a concurrent system. For the development of this framework we used the concurrent language Jolie following the Service Oriented paradigm. Based on this experience, we also propose an extension to Service Oriented Languages to overcome some of their limitations and to improve the development of concurrent applications.

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Nel panorama motoristico ed automobilistico moderno lo sviluppo di motori a combustione interna e veicoli è fortemente influenzato da diverse esigenze che spesso sono in contrasto le une con le altre. Infatti gli obiettivi di economicità e riduzione dei costi riguardanti la produzione e la commercializzazione dei prodotti sono in contrasto con gli sforzi che devono essere operati dalle case produttrici per soddisfare le sempre più stringenti normative riguardanti le emissioni inquinanti ed i consumi di carburante dei veicoli. Fra le numerose soluzioni presenti i veicoli ibridi rappresentano una alternativa che allo stato attuale è già presente sul mercato in varie forme, a seconda della tipologie di energie accoppiate. In letteratura è possibile trovare numerosi studi che trattano l’ottimizzazione dei componenti o delle strategie di controllo di queste tipologie di veicoli: in moltissimi casi l’obiettivo è quello di minimizzare consumi ed emissioni inquinanti. Normalmente non viene posta particolare attenzione agli effetti che l’aggiunta delle macchine elettriche e dei componenti necessari per il funzionamento delle stesse hanno sulla dinamica del veicolo. Il presente lavoro di tesi è incentrato su questi aspetti: si è considerata la tipologia di veicoli ibridi termici-elettrici di tipo parallelo andando ad analizzare come cambiasse il comportamento dinamico del veicolo in funzione del tipo di installazione considerato per la parte elettrica del powertrain. In primo luogo è stato quindi necessario costruire ed implementare un modello dinamico di veicolo che permettesse di applicare coppie alle quattro ruote in maniera indipendente per considerare diverse tipologie di powertrain. In seguito si sono analizzate le differenze di comportamento dinamico fra il veicolo considerato e l’equivalente versione ibrida e i possibili utilizzi delle macchine elettriche per correggere eventuali deterioramenti o cambiamenti indesiderati nelle prestazioni del veicolo.

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Seit Anbeginn der Menschheitsgeschichte beeinflussen die Menschen ihre Umwelt. Durch anthropogene Emissionen ändert sich die Zusammensetzung der Atmosphäre, was einen zunehmenden Einfluss unter anderem auf die Atmosphärenchemie, die Gesundheit von Mensch, Flora und Fauna und das Klima hat. Die steigende Anzahl riesiger, wachsender Metropolen geht einher mit einer räumlichen Konzentration der Emission von Luftschadstoffen, was vor allem einen Einfluss auf die Luftqualität der windabwärts gelegenen ruralen Regionen hat. In dieser Doktorarbeit wurde im Rahmen des MEGAPOLI-Projektes die Abluftfahne der Megastadt Paris unter Anwendung des mobilen Aerosolforschungslabors MoLa untersucht. Dieses ist mit modernen, zeitlich hochauflösenden Instrumenten zur Messung der chemischen Zusammensetzung und Größenverteilung der Aerosolpartikel sowie einiger Spurengase ausgestattet. Es wurden mobile Messstrategien entwickelt und angewendet, die besonders geeignet zur Charakterisierung urbaner Emissionen sind. Querschnittsmessfahrten durch die Abluftfahne und atmosphärische Hintergrundluftmassen erlaubten sowohl die Bestimmung der Struktur und Homogenität der Abluftfahne als auch die Berechnung des Beitrags der urbanen Emissionen zur Gesamtbelastung der Atmosphäre. Quasi-Lagrange’sche Radialmessfahrten dienten der Erkundung der räumlichen Erstreckung der Abluftfahne sowie auftretender Transformationsprozesse der advehierten Luftschadstoffe. In Kombination mit Modellierungen konnte die Struktur der Abluftfahne vertieft untersucht werden. Flexible stationäre Messungen ergänzten den Datensatz und ließen zudem Vergleichsmessungen mit anderen Messstationen zu. Die Daten einer ortsfesten Messstation wurden zusätzlich verwendet, um die Alterung des organischen Partikelanteils zu beschreiben. Die Analyse der mobilen Messdaten erforderte die Entwicklung einer neuen Methode zur Bereinigung des Datensatzes von lokalen Störeinflüssen. Des Weiteren wurden die Möglichkeiten, Grenzen und Fehler bei der Anwendung komplexer Analyseprogramme zur Berechnung des O/C-Verhältnisses der Partikel sowie der Klassifizierung der Aerosolorganik untersucht. Eine Validierung verschiedener Methoden zur Bestimmung der Luftmassenherkunft war für die Auswertung ebenfalls notwendig. Die detaillierte Untersuchung der Abluftfahne von Paris ergab, dass diese sich anhand der Erhöhung der Konzentrationen von Indikatoren für unprozessierte Luftverschmutzung im Vergleich zu Hintergrundwerten identifizieren lässt. Ihre eher homogene Struktur kann zumeist durch eine Gauß-Form im Querschnitt mit einem exponentiellen Abfall der unprozessierten Schadstoffkonzentrationen mit zunehmender Distanz zur Stadt beschrieben werden. Hierfür ist hauptsächlich die turbulente Vermischung mit Umgebungsluftmassen verantwortlich. Es konnte nachgewiesen werden, dass in der advehierten Abluftfahne eine deutliche Oxidation der Aerosolorganik im Sommer stattfindet; im Winter hingegen ließ sich dieser Prozess während der durchgeführten Messungen nicht beobachten. In beiden Jahreszeiten setzt sich die Abluftfahne hauptsächlich aus Ruß und organischen Partikelkomponenten im PM1-Größenbereich zusammen, wobei die Quellen Verkehr und Kochen sowie zusätzlich Heizen in der kalten Jahreszeit dominieren. Die PM1-Partikelmasse erhöhte sich durch die urbanen Emissionen im Vergleich zum Hintergrundwert im Sommer in der Abluftfahne im Mittel um 30% und im Winter um 10%. Besonders starke Erhöhungen ließen sich für Polyaromaten beobachten, wo im Sommer eine mittlere Zunahme von 194% und im Winter von 131% vorlag. Jahreszeitliche Unterschiede waren ebenso in der Größenverteilung der Partikel der Abluftfahne zu finden, wo im Winter im Gegensatz zum Sommer keine zusätzlichen nukleierten kleinen Partikel, sondern nur durch Kondensation und Koagulation angewachsene Partikel zwischen etwa 10nm und 200nm auftraten. Die Spurengaskonzentrationen unterschieden sich ebenfalls, da chemische Reaktionen temperatur- und mitunter strahlungsabhängig sind. Weitere Anwendungsmöglichkeiten des MoLa wurden bei einer Überführungsfahrt von Deutschland an die spanische Atlantikküste demonstriert, woraus eine Kartierung der Luftqualität entlang der Fahrtroute resultierte. Es zeigte sich, dass hauptsächlich urbane Ballungszentren von unprozessierten Luftschadstoffen betroffen sind, advehierte gealterte Substanzen jedoch jede Region beeinflussen können. Die Untersuchung der Luftqualität an Standorten mit unterschiedlicher Exposition bezüglich anthropogener Quellen erweiterte diese Aussage um einen Einblick in die Variation der Luftqualität, abhängig unter anderem von der Wetterlage und der Nähe zu Emissionsquellen. Damit konnte gezeigt werden, dass sich die entwickelten Messstrategien und Analysemethoden nicht nur zur Untersuchung der Abluftfahne einer Großstadt, sondern auch auf verschiedene andere wissenschaftliche und umweltmesstechnische Fragestellungen anwenden lassen.

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Regulatorische T-Zellen sind essentiell für die Aufrechterhaltung der peripheren Toleranz. Hierbei sorgen diese hocheffektiven Suppressorzellen für ein immunologisches Gleichgewicht, indem sie Immunantworten gegen Autoantigene sowie harmlose Nahrungs- und Umweltantigene verhindern. Andererseits können diese bei chronischen Infekten Immunantworten reduzieren sowie effektive Antitumor-Immunantworten hemmen. Aufgrund ethischer Erwägungen ist die Erforschung regulatorischer T-Zellen und deren Rolle bei der Tumorentwicklung weitestgehend auf Mausmodelle oder humane in vitro oder ex vivo Analysen beschränkt. Um diese Limitationen zu überwinden und translationale immunologische Experimente zu ermöglichen, wurde hier ein humanisiertes Mausmodell verwendet. T- und B-Zell-defiziente NOD-scid IL2Rgammanull (NSG) Mäuse wurden mit humanen CD34+ hämatopoetischen Stammzellen aus Nabelschnurblut rekonstituiert. Aus diesen Stammzellen entstanden in den Tieren vielfältige humane Immunzellen. Im murinen Thymus der NSG Tiere entwickelten sich CD4+ und CD8+ einzelpositive T-Zellen, welche als funktionelle Effektorpopulationen in die Peripherie auswanderten. Humane regulatorische T-Zellen (CD4+ CD25+ Foxp3+ CD127-) entwickelten sich ebenfalls im murinen Thymus der Tiere und machten ca. 10% der humanen peripheren CD4+ T-Zellen in den Mäusen aus. Diese humanen regulatorischen T-Zellen zeigten vorwiegend einen HLA-DR+ Phänotyp, welcher mit höchster Suppressivität assoziiert ist. Weiter verhielten sich die regualtorischen T-Zellen anergisch und bewiesen ihre Funktionalität unter anderem durch die Inhibition der Proliferation von Effektor-T-Zellen in vitro. rnSubkutan injizierte Tumorzellen eines humanen undifferenzierten pleomorphen Sarkoms wurden in den humanisierten Mäusen nicht abgestoßen und der Tumor konnte, trotz Infiltration humaner Immunzellen, ungehindert wachsen. Als mögliche Ursache hierfür zeigte sich die selektive Akkumulation regulatorischer T-Zellen im Tumor. Zusammen mit dem erhöhten Anteil humaner regulatorischer T-Zellen in der Peripherie, weisen diese Beobachtungen deutliche Parallelen mit Befunden aus humanen Patienten auf. Dies bietet somit erstmalig die Option in vivo die Rolle humaner regulatorischer T-Zellen im undifferenzierten pleomorphen Sarkom zu analysieren. Die hier gezeigten Daten machen deutlich, dass es das humanisierte Mausmodell ermöglicht, die Entstehung und Funktion humaner regulatorischer T-Zellen in vivo zu analysieren, deren Bedeutung in klinisch relevanten Modellen zu charakterisieren und somit innovative Therapien zu etablieren.

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The evaluation of the knee joint behavior is fundamental in many applications, such as joint modeling, prosthesis and orthosis design. In-vitro tests are important in order to analyse knee behavior when simulating various loading conditions and studying physiology of the joint. A new test rig for in-vitro evaluation of the knee joint behavior is presented in this paper. It represents the evolution of a previously proposed rig, designed to overcome its principal limitations and to improve its performances. The design procedure and the adopted solution in order to satisfy the specifications are presented here. Thanks to its 6-6 Gough-Stewart parallel manipulator loading system, the rig replicates general loading conditions, like daily actions or clinical tests, on the specimen in a wide range of flexion angles. The restraining actions of knee muscles can be simulated when active actions are simulated. The joint motion in response to the applied loads, guided by passive articular structures and muscles, is permitted by the characteristics of the loading system which is force controlled. The new test rig guarantees visibility so that motion can be measured by an optoelectronic system. Furthermore, the control system of the new test rig allows the estimation of the contribution of the principal leg muscles in guaranteeing the equilibrium of the joint by the system for muscle simulation. Accuracy in positioning is guaranteed by the designed tibia and femur fixation systems,which allow unmounting and remounting the specimen in the same pose. The test rig presented in this paper permits the analysis of the behavior of the knee joint and comparative analysis on the same specimen before and after surgery, in a way to assess the goodness of prostheses or surgical treatments.

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Der Tauchtourismus übernimmt innerhalb des gesamten internationalen Tourismus in Ägypten eine wichtige Rolle. Besonders in Krisenzeiten sind es die Taucher, die aufgrund der einzigartigen Tauchgebiete weiterhin in das Land kommen und somit einen wesentlichen Beitrag zum Erhalt der Arbeitsplätze und der Infrastruktur beitragen. Doch der Konkurrenzkampf zwischen den Tauchbasen, das derzeit schlechte Image Ägyptens und die Attraktivität weltweiter Tauchdestinationen, zwingt die Betreiber von Tauchbasen dazu, sich einer wandelnden Gästestruktur und deren Reisegewohnheiten anzupassen. In der vorliegenden Untersuchung wird am Beispiel der Tauchbasenbetreiber in Ägypten untersucht, wie kulturelles Handeln eine Rolle bei der Bildung von Vertrauen zwischen einem Anbieter einer touristischen Dienstleistung und dem Kunden einnehmen kann. Als Ausgangspunkt dient dazu das Modell der „Transkulturalität als Praxis“ nach PÜTZ (2004), welches um den Aspekt der internationalen Kooperationsbeziehungen erweitert wird. Es besagt, dass im wirtschaftlichen Handeln zwischen den Akteuren das kulturelle Verständnis eine entscheidende Rolle bei der Bildung von Vertrauen einnimmt. Durch die Fähigkeit, einen kulturellen Blickwinkel in das alltägliche Handeln einzubeziehen, kann ein Unternehmer den Wettbewerbsvorsprung zu seinen Mitkonkurrenten ausbauen.rnrnIm Mittelpunkt des Forschungsinteresses stand dabei die Frage inwieweit die Basenbetreiber über die ihnen zur Verfügung stehenden Möglichkeiten kulturgebundenen Handelns Vertrauen zu den Tauchern generieren. Geschieht die Anwendung aus eigener Initiative heraus oder nur unter dem Konkurrenzdruck? Die Ergebnisse der Studie belegen, dass das Arbeiten im Umfeld kultureller Unterschiede den Blick der Basenbetreiber für die Notwendigkeit einer starken Vertrauensbeziehung zum Kunden von Anfang an geprägt hat. Das Handeln aller Interviewteilnehmer orientiert sich zuerst unbewusst an zahlreichen branchenüblichen Handlungsweisen und Symbolen, stößt aber ab einem bestimmten Punkt an seine Grenzen. Aufgrund von bewusstem kulturellen Handeln ist jedoch die Möglichkeit gegeben, diese Grenzen zu überwinden und individuelle und situationsspezifische Arten der Kundengewinnung in das Handeln einzubeziehen.

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The objective of this study was to develop a criteria catalogue serving as a guideline for authors to improve quality of reporting experiments in basic research in homeopathy. A Delphi Process was initiated including three rounds of adjusting and phrasing plus two consensus conferences. European researchers who published experimental work within the last 5 years were involved. A checklist for authors provide a catalogue with 23 criteria. The “Introduction” should focus on underlying hypotheses, the homeopathic principle investigated and state if experiments are exploratory or confirmatory. “Materials and methods” should comprise information on object of investigation, experimental setup, parameters, intervention and statistical methods. A more detailed description on the homeopathic substances, for example, manufacture, dilution method, starting point of dilution is required. A further result of the Delphi process is to raise scientists' awareness of reporting blinding, allocation, replication, quality control and system performance controls. The part “Results” should provide the exact number of treated units per setting which were included in each analysis and state missing samples and drop outs. Results presented in tables and figures are as important as appropriate measures of effect size, uncertainty and probability. “Discussion” in a report should depict more than a general interpretation of results in the context of current evidence but also limitations and an appraisal of aptitude for the chosen experimental model. Authors of homeopathic basic research publications are encouraged to apply our checklist when preparing their manuscripts. Feedback is encouraged on applicability, strength and limitations of the list to enable future revisions.

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Stroke is a significant cause of serious disability and death worldwide. A substantial proportion of strokes are related to an underlying cardiac embolic source, most commonly in association with atrial arrhythmias (fibrillation/flutter). Atrial fibrillation is considered a major risk factor for stroke. Although long-term prophylactic oral anticoagulation has been shown to be very effective in reducing stroke in patients with atrial fibrillation, it has a number of major limitations and is not feasible in all patients. In such cases, the use of percutaneously (transvenous) implanted left atrial appendage occlusive devices or surgical appendage obliteration is being explored. Similarly, the presence of a patent foramen ovale, especially in the presence of an atrial septal aneurysm, is now recognized as an important potential mediator of paradoxical cardiogenic embolism. Percutaneous patent foramen ovale closure is becoming increasingly established as a safe and effective means of preventing recurrent strokes in the presence of a patent foramen ovale. In this account, the authors discuss the intracardiac devices and techniques available and the relative merits of their use for stroke prevention.

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Triggered event-related functional magnetic resonance imaging requires sparse intervals of temporally resolved functional data acquisitions, whose initiation corresponds to the occurrence of an event, typically an epileptic spike in the electroencephalographic trace. However, conventional fMRI time series are greatly affected by non-steady-state magnetization effects, which obscure initial blood oxygen level-dependent (BOLD) signals. Here, conventional echo-planar imaging and a post-processing solution based on principal component analysis were employed to remove the dominant eigenimages of the time series, to filter out the global signal changes induced by magnetization decay and to recover BOLD signals starting with the first functional volume. This approach was compared with a physical solution using radiofrequency preparation, which nullifies magnetization effects. As an application of the method, the detectability of the initial transient BOLD response in the auditory cortex, which is elicited by the onset of acoustic scanner noise, was used to demonstrate that post-processing-based removal of magnetization effects allows to detect brain activity patterns identical with those obtained using the radiofrequency preparation. Using the auditory responses as an ideal experimental model of triggered brain activity, our results suggest that reducing the initial magnetization effects by removing a few principal components from fMRI data may be potentially useful in the analysis of triggered event-related echo-planar time series. The implications of this study are discussed with special caution to remaining technical limitations and the additional neurophysiological issues of the triggered acquisition.

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Light-frame wood buildings are widely built in the United States (U.S.). Natural hazards cause huge losses to light-frame wood construction. This study proposes methodologies and a framework to evaluate the performance and risk of light-frame wood construction. Performance-based engineering (PBE) aims to ensure that a building achieves the desired performance objectives when subjected to hazard loads. In this study, the collapse risk of a typical one-story light-frame wood building is determined using the Incremental Dynamic Analysis method. The collapse risks of buildings at four sites in the Eastern, Western, and Central regions of U.S. are evaluated. Various sources of uncertainties are considered in the collapse risk assessment so that the influence of uncertainties on the collapse risk of lightframe wood construction is evaluated. The collapse risks of the same building subjected to maximum considered earthquakes at different seismic zones are found to be non-uniform. In certain areas in the U.S., the snow accumulation is significant and causes huge economic losses and threatens life safety. Limited study has been performed to investigate the snow hazard when combined with a seismic hazard. A Filtered Poisson Process (FPP) model is developed in this study, overcoming the shortcomings of the typically used Bernoulli model. The FPP model is validated by comparing the simulation results to weather records obtained from the National Climatic Data Center. The FPP model is applied in the proposed framework to assess the risk of a light-frame wood building subjected to combined snow and earthquake loads. The snow accumulation has a significant influence on the seismic losses of the building. The Bernoulli snow model underestimates the seismic loss of buildings in areas with snow accumulation. An object-oriented framework is proposed in this study to performrisk assessment for lightframe wood construction. For home owners and stake holders, risks in terms of economic losses is much easier to understand than engineering parameters (e.g., inter story drift). The proposed framework is used in two applications. One is to assess the loss of the building subjected to mainshock-aftershock sequences. Aftershock and downtime costs are found to be important factors in the assessment of seismic losses. The framework is also applied to a wood building in the state of Washington to assess the loss of the building subjected to combined earthquake and snow loads. The proposed framework is proven to be an appropriate tool for risk assessment of buildings subjected to multiple hazards. Limitations and future works are also identified.

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Dental undertreatment is often seen in the older population. This is particularly true for the elderly living in nursing homes and geriatric hospitals. The progression of chronic diseases results in loss of their independence. They rely on daily support and care due to physical or mental impairment. The visit of a dentist in private praxis becomes difficult or impossible and is a logistic problem. These elderly patients are often not aware of oral and dental problems or these are not addressed. The geriatric hospital Bern, Ziegler, has integrated dental care in the concept of physical rehabilitation of geriatric patients. A total of 139 patients received dental treatment in the years 2005/2006. Their mean age was 83 years, but the segment with > 85 years of age amounted to 46%. The general health examinations reveald multiple and complex disorders. The ASA classification (American Society of Anesthesiologists, Physical Status Classification System) was applied and resulted in 15% = P2 (mild systemic disease, no functional limitation), 47% = P3 (severe systemic disease, definite functional limitations) and 38% = P4 (severe systemic disease, constant threat to life). Eighty-seven of the patients exhibited 3 or more chronic diseases with a prevalence of cardiovascular diseases, musculoskelettal disorders and dementia. Overall the differences between men and women were small, but broncho-pulmonary dieseases were significantly more frequent in women, while men were more often diagnosed with dementia and depression. Verbal communication was limited or not possible with 60% of the patients due to cognitive impairment or aphasia after a stroke. Although the objective treatment need is high, providing dentistry for frail and geriatric patients is characterized by risks due to poor general health conditions, difficulties in communication, limitations in feasibility and lack of adequate aftercare. In order to prevent the problem of undertreatment, elderly independently living people should undergo dental treatment regularly and in time. Training of nurses and doctors of geriatric hospitals in oral hygiene should improve the awareness. A multidisciplinary assessment of geriatric patients should include the oral and dental aspect if they enter the hospital.

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The rise of evidence-based medicine as well as important progress in statistical methods and computational power have led to a second birth of the >200-year-old Bayesian framework. The use of Bayesian techniques, in particular in the design and interpretation of clinical trials, offers several substantial advantages over the classical statistical approach. First, in contrast to classical statistics, Bayesian analysis allows a direct statement regarding the probability that a treatment was beneficial. Second, Bayesian statistics allow the researcher to incorporate any prior information in the analysis of the experimental results. Third, Bayesian methods can efficiently handle complex statistical models, which are suited for advanced clinical trial designs. Finally, Bayesian statistics encourage a thorough consideration and presentation of the assumptions underlying an analysis, which enables the reader to fully appraise the authors' conclusions. Both Bayesian and classical statistics have their respective strengths and limitations and should be viewed as being complementary to each other; we do not attempt to make a head-to-head comparison, as this is beyond the scope of the present review. Rather, the objective of the present article is to provide a nonmathematical, reader-friendly overview of the current practice of Bayesian statistics coupled with numerous intuitive examples from the field of oncology. It is hoped that this educational review will be a useful resource to the oncologist and result in a better understanding of the scope, strengths, and limitations of the Bayesian approach.

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As staff and mobility cost have the lion share of the costs of extension work, there have been many alternatives to assign farmers the job of facilitators, trainers and advisors. The arguments behind are that they are geopraphically closer to the clients, but also mentally and culturally, because they are members of the client group themselves, speak their language and share their experience and daily life. The article starts with the origins of the larger movement in Latin-America, and then discusses potentials and limitations, and finally experience from elsewhere.