Knowledge for sustainable development in the Tajik Pamir Mountains

The paper presents the results of a multi-year baseline study project in which 10 sectors ranging from agriculture to natural hazards were assessed by a transdisciplinary Swiss–Tajik research team. This knowledge base was enhanced in a development strategy workshop that brought together stakeholders from the local to the international levels. The methodology applied was found appropriate to initiate a broad reflection and negotiation process among various stakeholder groups, leading to a joint identification of possible measures to be taken. Knowledge—and its enhancement through the involvement of all stakeholder levels— appeared to be an effective carrier of innovation and changes of attitudes, thus containing the potential to effectively contribute to sustainable development in marginalized and resource-poor mountain areas.

Promoting palliative care in the community: production of the primary palliative care toolkit by the European Association of Palliative Care Taskforce in primary palliative care

BACKGROUND A multidisciplinary European Association of Palliative Care Taskforce was established to scope the extent of and learn what facilitates and hinders the development of palliative care in the community across Europe. AIM To document the barriers and facilitators for palliative care in the community and to produce a resource toolkit that palliative care specialists, primary care health professionals or policymakers, service developers, educationalists and national groups more generally could use to facilitate the development of palliative care in their own country. DESIGN (1) A survey instrument was sent to general practitioners with knowledge of palliative care services in the community in a diverse sample of European countries. We also conducted an international systematic review of tools used to identify people for palliative care in the community. (2) A draft toolkit was then constructed suggesting how individual countries might best address these issues, and an online survey was then set up for general practitioners and specialists to make comments. Iterations of the toolkit were then presented at international palliative care and primary care conferences. RESULTS Being unable to identify appropriate patients for palliative care in the community was a major barrier internationally. The systematic review identified tools that might be used to help address this. Various facilitators such as national strategies were identified. A primary palliative care toolkit has been produced and refined, together with associated guidance. CONCLUSION Many barriers and facilitators were identified. The primary palliative care toolkit can help community-based palliative care services to be established nationally.

Caplacizumab for Acquired Thrombotic Thrombocytopenic Purpura.

BACKGROUND Acquired thrombotic thrombocytopenic purpura (TTP) is caused by aggregation of platelets on ultralarge von Willebrand factor multimers. This microvascular thrombosis causes multiorgan ischemia with potentially life-threatening complications. Daily plasma exchange and immunosuppressive therapies induce remission, but mortality and morbidity due to microthrombosis remain high. METHODS Caplacizumab, an anti-von Willebrand factor humanized single-variable-domain immunoglobulin (Nanobody), inhibits the interaction between ultralarge von Willebrand factor multimers and platelets. In this phase 2, controlled study, we randomly assigned patients with acquired TTP to subcutaneous caplacizumab (10 mg daily) or placebo during plasma exchange and for 30 days afterward. The primary end point was the time to a response, defined as confirmed normalization of the platelet count. Major secondary end points included exacerbations and relapses. RESULTS Seventy-five patients underwent randomization (36 were assigned to receive caplacizumab, and 39 to receive placebo). The time to a response was significantly reduced with caplacizumab as compared with placebo (39% reduction in median time, P=0.005). Three patients in the caplacizumab group had an exacerbation, as compared with 11 patients in the placebo group. Eight patients in the caplacizumab group had a relapse in the first month after stopping the study drug, of whom 7 had ADAMTS13 activity that remained below 10%, suggesting unresolved autoimmune activity. Bleeding-related adverse events, most of which were mild to moderate in severity, were more common with caplacizumab than with placebo (54% of patients vs. 38%). The frequencies of other adverse events were similar in the two groups. Two patients in the placebo group died, as compared with none in the caplacizumab group. CONCLUSIONS Caplacizumab induced a faster resolution of the acute TTP episode than did placebo. The platelet-protective effect of caplacizumab was maintained during the treatment period. Caplacizumab was associated with an increased tendency toward bleeding, as compared with placebo. (Funded by Ablynx; ClinicalTrials.gov number, NCT01151423.).

Shakers : compendium of the origin, history, princicples, rules and regulations, government, and doctrines of the United Society of Believers in Christ's Second Appearing : with biographies of Ann Lee, William Lee, Jas. Whittaker, J. Hocknell, J. Meacham, and Lucy Wright

by F. W. Evans

Jesus of Nazareth in the light of Jewish and Christian thought and history : a sunday lecture delivered January 10, 1926

by Samuel H. Goldenson

Effectiveness of a nutrition education program for women in a residential program after incarceration

Background: The number of incarcerated women has increased dramatically over the past two decades. During their stay in prison, the medical and nutritional needs of these women are frequently ignored. Overweight or obesity related to poor dietary habits and low-income status are important risk factors for health inequities. Women in this population are at risk for dietary-related chronic diseases such as hypertension, diabetes, and cardiovascular diseases. This is an indication that there is a need for nutrition education in this population. ^ Purpose: The purpose of this study was to provide an evidence-based nutrition education program at a facility for previously incarcerated women in Downtown Houston, Texas (Brigid's Hope). This nutrition education program focused on promoting better health and prevention of chronic diseases by increasing fruit and vegetable (FV) intake and healthy eating on a limited budget. Constructs such as knowledge, skills, self-efficacy, and perceived barriers were evaluated as well as acceptability, feasibility, and sustainability of the program. ^ Methods: The Hope for Health Nutrition Education Program occurred in four weekly sessions at Brigid's Hope. The evaluation design was a one-group quasi-experimental design with pre- and post-test measures. Identical pre- and post-tests were administered before and after the intervention. A total of 11 residents and 2 staff members participated in the study. Results: After four nutrition education sessions, post-tests revealed an overall increase in knowledge, skills, and self-efficacy scores, and decrease in perceived barrier scores towards FV consumption. Changes in skills, self-efficacy, and perceived barriers scores were found to be statistically significant. Participant satisfaction surveys revealed overall high satisfaction of the program and that continuing the program in the future would be possible with support from staff member and mentors. ^ Conclusions: Results from this study show that a nutrition education program can have positive effects towards knowledge, skills, self-efficacy, and perceived barriers towards FV consumption for previously incarcerated women. The high satisfaction for this program shows that a health promotion program with focus on diet and nutrition can play an important role in helping this unique population of women re-enter society.^

The Children’s Bureau’s Role in Promoting Parent Engagement and Family Support: A Brief History and Current Efforts

Over the years, federal child welfare policy has supported parent engagement and family support strategies through various Children’s Bureau funded state formula grant programs, research and demonstration discretionary grants, and technical assistance. This article highlights programs funded by two federal laws, Promoting Safe and Stable Families and the Child Abuse Prevention and Treatment Act, and Children’s Bureau’s efforts to test innovations and disseminate knowledge about promising and evidence-based practices regarding parent engagement and family support. The article begins with a brief legislative history and then describes several grant programs that are supported by the legislation. The article concludes with lessons learned and a discussion of the new opportunities for system changes through the Title IV-E Waiver Demonstration projects.

Environmental policy and knowledge. Copying with complexity through inclusive management

Scholars agree that governance of the public environment entails cooperation between science, policy and society. This requires the active role of public managers as catalysts of knowledge co-production, addressing participatory arenas in relation to knowledge integration and social learning. This paper deals with the question of whether public managers acknowledge and take on this task. A survey accessing Directors of Environmental Offices (EOs) of 64 municipalities was carried out in parallel for two regions - Tuscany (Italy) and Porto Alegre Metropolitan Region (Brazil). The survey data were analysed using the multiple correspondence method. Results showed that, regarding policy practices, EOs do not play the role of knowledge co-production catalysts, since when making environmental decisions they only use technical knowledge. We conclude that there is a gap between theory and practice, and identify some factors that may hinder local environmental managers in acting as catalyst of knowledge co-production, raising a further question for future research.

The observatory of intelligence and territorial development, tool for innovation in processes of territorial planning in municipalities of the province of Jujuy

El municipio es considerado como un espacio donde sus habitantes comparten no sólo el territorio sino también los problemas y los recursos existentes. La institución municipal -como gobierno local- es el ámbito en el cual se toman decisiones sobre el territorio, que implican a sus habitantes. En cuanto a los actores, estos pueden ser funcionarios, empleados y la comunidad (individual y organizada en ongs), todos aportan sus conocimientos y valores, pero tienen diferentes intereses y diferentes tiempos. Vinculada a las decisiones, encontramos que la forma en que se gestiona la información territorial, es determinante si se pretende apuntar hacia acciones con impacto positivo, y sustentables en lo ambiental y en el tiempo. Este trabajo toma tres municipios: San Salvador de Jujuy, capital de la provincia localizada en los Valles Templados; San Pedro de Jujuy, principal municipio de la región de las Yungas y Tilcara en la Quebrada de Humahuaca. El aporte de la Inteligencia Territorial, a través del observatorio OIDTe, permite analizar los modos de gestión de la información, especialmente mediante el uso de las tecnologías de la información y comunicación (pagina web municipal, equipamiento informático en las oficinas, estrategias de comunicación y vinculación con la población) y mediante la organización de las estructuras administrativas (organigrama) por las cuales circula la información municipal. Además, con la participación enriquecedora de equipos multidisciplinarios en las diferentes etapas. Se busca, a partir de un diagnóstico, generar estrategias para la introducción de innovaciones con los propios actores municipales, a partir de las situaciones y modos culturales propios de cada lugar, incorporando los marcos conceptuales de la Inteligencia Territorial. En este sentido el OIDTe al promover el entendimiento entre los actores, institucionales y la sociedad, facilita la coordinación de diferentes intereses propiciando la toma de decisiones por acuerdos. Asimismo, el método Portulano, puede orientar la introducción de innovaciones en la coordinación de la información cartográfica, para que las diferentes oficinas puedan complementar sus aportes y la comunicación hacia fuera de la institución. En la fase de diagnóstico, se aplicaron entrevistas a informantes claves, se realizó un workshop con técnicos de planta permanente y funcionarios de áreas que manejan información territorial, y de planificación. También por la importancia de la capacidad instalada de recursos humanos, se analizó el nivel de instrucción y la capacitación con que cuenta el personal de planta permanente de cada área

Charles Segal. Sophocles' Tragic World. Divinity, Nature. Sociery. Cambridge, Massachusetts, Harvard University Press, 1998, XII + 276 pp.

Fil: Nelli, María Florencia. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Society, family and learning. The role of home literacy environments

This paper explores the relation between society, family, and learning. In particular, it addresses the features of home literacy environments in low income families and their impact on children's pre-literacy skills and knowledge. Sixty-two four/five-year-old children and their mothers were randomly selected for this study. The mothers were interviewed using an adaptation of a family literacy environment survey (Whitehurst, 1992). The children were assessed with specific tests to examine the scope of their 'early literacy'. The results revealed significant variability in the features and practices of home literacy environments as well as in the children's emerging pre-literacy skills and knowledge. The correlation between the two variables shows low to moderate statistical significance. The implications of such findings are discussed. Additionally, the purpose of isolating relevant features of the children and their home environments is to identify specific indicators related to the literacy fostering process. Ultimately, the goal is to design adequate, timely, and systematic intervention strategies aimed at preventing difficulties related to written language learning in children that could be considered at risk.

Charles Segal. Sophocles' Tragic World. Divinity, Nature. Sociery. Cambridge, Massachusetts, Harvard University Press, 1998, XII + 276 pp.

Fil: Nelli, María Florencia. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.