Farmer-Managed Natural Regeneration Enhances Rural Livelihoods in Dryland West Africa

Declining agricultural productivity, land clearance and climate change are compounding the vulnerability of already marginal rural populations in West Africa. 'Farmer-Managed Natural Regeneration' (FMNR) is an approach to arable land restoration and reforestation that seeks to reconcile sustained food production, conservation of soils and protection of biodiversity. It involves selecting and protecting the most vigorous stems regrowing from live stumps of felled trees, pruning off all other stems, and pollarding the chosen stems to grow into straight trunks. Despite widespread enthusiasm and application of FMNR by environmental management and development projects, to date, no research has provided a measure of the aggregate livelihood impact of community adoption of FMNR. This paper places FMNR in the context of other agroforestry initiatives, then seeks to quantify the value of livelihood outcomes of FMNR. We review published and unpublished evidence about the impacts of FMNR, and present a new case study that addresses gaps in the evidence base. The case study focuses on a FMNR project in the district of Talensi in the semi-arid Upper East Region in Ghana. The case study employs a Social Return on Investment (SROI) analysis, which identifies proxy financial values for non-economic as well as economic benefits. The results demonstrate income and agricultural benefits, but also show that asset creation, increased consumption of wild resources, health improvements and psycho-social benefits created more value in FMNR-adopting households during the period of the study than increases in income and agricultural yields.

Associations between perceived discrimination and health status among frequent Emergency Department users

Objective: Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually associated with increased vulnerability. The aim of this study was to investigate frequent ED users' perceptions of discrimination and to test whether they were associated with increased vulnerability. Methods: In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues - dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) - mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer's exact tests, Mann-Whitney U-tests)

Maladaptive emotion regulation strategies and stress sensitivity mediate the relation between adverse life events and attenuated positive psychotic symptoms.

INTRODUCTION: There is now solid evidence for a relation between adverse life events (ALE) and psychotic symptoms in patients with psychosis and in the general population. A recent study has shown that this relation may be partially mediated by stress sensitivity, suggesting the influence of other factors. The aim of this study was to assess the mediation effect of emotion regulation strategies and stress sensitivity in the relation between ALE and attenuated positive psychotic symptoms (APPS) in the general population. METHODS: Hundred and twelve healthy volunteers were evaluated with measures of APPS, emotion regulation strategies, ALE and stress sensitivity. RESULTS: Results demonstrated that the relation between ALE, hallucination and delusion proneness was completely mediated by maladaptive emotion regulation strategies, but not by stress sensitivity. However, in addition to maladaptive emotion regulation strategies, stress sensitivity demonstrated a mediation effect between ALE and attenuated positive psychotic positive symptoms when positive psychotic symptoms were grouped together. CONCLUSIONS: There are probably several possible trajectories leading to the formation of positive psychotic symptoms and the results of the present study reveal that one such trajectory may involve the maladaptive regulation of negative emotions alongside a certain general vulnerability after experiencing ALE.

The updated Swiss guidelines 2016 for the treatment and follow-up of cutaneous melanoma.

Cutaneous melanoma is the most deadly cutaneous neoplasm. In order to guide treatment decisions and follow-up of melanoma patients, guidelines for the management of melanoma in Switzerland were inaugurated in 2001 and revised in 2006 and 2016. Recent data on surgical and medical treatments from randomised trials necessitated modification of the treatment and follow-up recommendations.

High expression levels of macrophage migration inhibitory factor sustain the innate immune responses of neonates.

The vulnerability to infection of newborns is associated with a limited ability to mount efficient immune responses. High concentrations of adenosine and prostaglandins in the fetal and neonatal circulation hamper the antimicrobial responses of newborn immune cells. However, the existence of mechanisms counterbalancing neonatal immunosuppression has not been investigated. Remarkably, circulating levels of macrophage migration inhibitory factor (MIF), a proinflammatory immunoregulatory cytokine expressed constitutively, were 10-fold higher in newborns than in children and adults. Newborn monocytes expressed high levels of MIF and released MIF upon stimulation with Escherichia coli and group B Streptococcus, the leading pathogens of early-onset neonatal sepsis. Inhibition of MIF activity or MIF expression reduced microbial product-induced phosphorylation of p38 and ERK1/2 mitogen-activated protein kinases and secretion of cytokines. Recombinant MIF used at newborn, but not adult, concentrations counterregulated adenosine and prostaglandin E2-mediated inhibition of ERK1/2 activation and TNF production in newborn monocytes exposed to E. coli. In agreement with the concept that once infection is established high levels of MIF are detrimental to the host, treatment with a small molecule inhibitor of MIF reduced systemic inflammatory response, bacterial proliferation, and mortality of septic newborn mice. Altogether, these data provide a mechanistic explanation for how newborns may cope with an immunosuppressive environment to maintain a certain threshold of innate defenses. However, the same defense mechanisms may be at the expense of the host in conditions of severe infection, suggesting that MIF could represent a potential attractive target for immune-modulating adjunctive therapies for neonatal sepsis.

Neuronal activity controls the antagonistic between PGC-1α and SMRT in regulating antioxidant defences

Transcriptional coactivators and corepressors often have multiple targets and can have opposing actions on transcription and downstream physiological events. The coactivator peroxisome proliferator-activated receptor-γ coactivator (PGC)-1α is under-expressed in Huntington's disease and is a regulator of antioxidant defenses and mitochondrial biogenesis. We show that in primary cortical neurons, expression of PGC-1α strongly promotes resistance to excitotoxic and oxidative stress in a cell autonomous manner, whereas knockdown increases sensitivity. In contrast, the transcriptional corepressor silencing mediator of retinoic acid and thyroid hormone receptors (SMRT) specifically antagonizes PGC-1α-mediated antioxidant effects. The antagonistic balance between PGC-1α and SMRT is upset in favor of PGC-1α by synaptic activity. Synaptic activity triggers nuclear export of SMRT reliant on multiple regions of the protein. Concommitantly, synaptic activity post-translationally enhances the transactivating potential of PGC-1α in a p38-dependent manner, as well as upregulating cyclic-AMP response element binding protein-dependent PGC-1α transcription. Activity-dependent targeting of PGC-1α results in enhanced gene expression mediated by the thyroid hormone receptor, a prototypical transcription factor coactivated by PGC-1α and repressed by SMRT. As a consequence of these events, SMRT is unable to antagonize PGC-1α-mediated resistance to oxidative stress in synaptically active neurons. Thus, PGC-1α and SMRT are antagonistic regulators of neuronal vulnerability to oxidative stress. Further, this coactivatorcorepressor antagonism is regulated by the activity status of the cell, with implications for neuronal viability.

Psychosocial Quality-of-Life, Lifestyle and Adiposity: A Longitudinal Study in Pre-schoolers (Ballabeina Study).

PURPOSE: In obesity prevention, understanding psychosocial influences in early life is pivotal. Reviews reported contradictory results and a lack of longitudinal studies focusing on underlying lifestyle factors. This study tested whether psychosocial Quality-Of-Life (QOL) was associated with pre-schoolers' lifestyle and adiposity changes over one school year and whether lifestyle moderated the latter. It was hypothesised that QOL might not impact adiposity in everybody but that this might depend on preceding lifestyle. METHOD: Longitudinal data from 291 Swiss pre-schoolers (initially 3.9-6.3 years) was available. The following measures were used in longitudinal regressions: psychosocial QOL by PedsQL, adiposity (BMI z-score, waist, fat%), diet (food frequency), sedentary time and accelerometer-based activity. RESULTS: Concerning lifestyle, low psychosocial QOL was only related to unfavourable changes in diet (less fruit β = 0.21 and more fat intake β = -0.28) and lower physical activity (β = 0.21). Longitudinal QOL-adiposity relations appeared only after moderation by lifestyle factors (beta-range 0.13-0.67). Low psychosocial QOL was associated with increased adiposity in children with an unhealthy diet intake or high sedentary time. By contrast, low psychosocial QOL was associated with decreasing adiposity in high fruit consumers or more physically active pre-schoolers. CONCLUSION: Results emphasise the need for testing moderation in the QOL-adiposity relation. An unhealthy diet can be a vulnerability factor and high physical activity a protective factor in QOL-related adiposity. Consequently, QOL and lifestyle should be targeted concurrently in multi-factorial obesity prevention. The environment should be an 'activity encouraging, healthy food zone' that minimises opportunities for stress-induced eating. In addition, appropriate stress coping skills should be acquired.

Itineraris formatius de joves en situació de risc social que participen en programes de suport acadèmic

Els programes de suport acadèmic són dispositius que pretenen esdevenir un factor compensatori en els itineraris formatius dels joves, principalment en contextos de vulnerabilitat social. Amb aquest treball es vol exemplificar un cas concret, comparant les dades estadístiques del Departament d’Educació amb les dades d’un centre obert. També s’exposen els factors que incideixen en la concreció dels itineraris d’aquests joves per tal de determinar si els programes de suport acadèmic han esdevingut una pràctica d’èxit

Association of early repolarization with risk of cardiac mortality in the general population

Early repolarization, which is characterized by an elevation of the J-point on 12-lead electrocardiography, is a common finding that has been considered as benign for decades. However, in the last years, it has been related with vulnerability to idiopathic ventricular fibrillation and with cardiac mortality in the general population. Recently, 4 potential ECG predictors that could differentiate the benign from the malignant form of early repolarization have been suggested. Any previous study about early repolarization has been done in Spain. Aim. To ascertain whether the presence of early repolarization pattern in a resting electrocardiogram is associated with a major risk of cardiac death in a Spanish general population and to determine whether the presence of potential predictors of malignancy in a resting electrocardiogram increases the risk of cardiac mortality in patients with early repolarization pattern. Methods. We will analyse the presence of early repolarization and the occurrence of cardiac mortality in a retrospective cohort study of 4,279 participants aged 25 to 74 years in the province of Girona. This cohort has been followed during a mean of 9.8 years. Early repolarization will be stratified according to the degree of J-point elevation (≥0.1 mV or ≥0.2 mV), the morphology of the J-wave (slurring, notching or any of these two), the ST-segment pattern (ascending or descending) and the localization (inferior leads, lateral leads, or both). Association of early repolarization with cardiac death will be assessed by adjusted Cox-proportional hazards models

The role of different factors related to social impact of heavy events: considerations about the intensity thresholds in densely populated areas

In the assessment of social impact caused by meteorological events, factors of different natures need to be considered. Not only does hazard itself determine the impact that a severe weather event has on society, but also other features related to vulnerability and exposure. The requests of data related to insurance claims received in meteorological services proved to be a good indicator of the social impact that a weather event causes, according to studies carried out by the Social Impact Research Group, created within the framework of the MEDEX project. Taking these requests as proxy data, diverse aspects connected to the impact of heavy rain events have been studied. The rainfall intensity, in conjunction with the population density, has established itself as one of the key factors in social impact studies. One of the conclusions we obtained is that various thresholds of rainfall should be applied for areas of varying populations. In this study, the role of rainfall intensity has been analysed for a highly populated urban area like Barcelona. A period without significant population changes has been selected for the study to minimise the effects linked to vulnerability and exposure modifications. First, correlations between rainfall recorded in different time intervals and requests were carried out. Afterwards, a method to include the intensity factor in the social impact index was suggested based on return periods given by intensity duration frequency (IDF) curves.

Haja-asutusalueiden sähkönjakelujärjestelmien kehittäminen – erityisesti 1000 V jakelujännitteen käyttömahdollisuudet

Yhteiskunnan riippuvuus sähköstä on lisääntynyt voimakkaasti viime vuosikymmenien aikana. Sähkönjakelussa esiintyneet lyhyet ja pitkät keskeytykset ovat osoittaneet yhteiskunnan haavoittuvuuden ja yhteiskunta kestää entistä vähemmän sähkönjakelussa tapahtuvia häiriöitä. Keskeytyksistä aiheutuneiden haittojen arvostus on kasvanut ja tämä on luonut taloudelliset perusteet sähkön laatua parantaville investoinneille. Haja-asutusalueiden keskijänniteverkon johdot on rakennettu avojohtoina ja siten ne ovat alttiita sääolosuhteista johtuville myrsky- ja lumikuormavaurioille. Ilmastomuutoksen ennustetaan lisäävän tuulisuutta ja siten ongelmat sähkönjakelussa mahdollisesti lisääntyvät. Taajamissa käytetään enemmän kaapeleita ja johtolähdöt ovat lyhyitä, joten myrskyistä aiheutuvia keskeytyksiä on vähemmän kuin haja-asutusalueella. Olemassa olevat jakeluverkot ovat käytössä vielä vuosikymmeniä, joten uuden tekniikan kehittämisen rinnalla on kehitettävä myös olemassa olevaa jakeluverkkoa ja sen ylläpitoa. Ylläpidon tavoitteena on käyttövarmuuden parantamisen lisäksi huolehtia siitä, että jakeluverkkoihin sitoutunut omaisuus säilyttää arvonsa mahdollisimman hyvin pitoajan loppuun saakka. Jakeluverkkoihin investoitiin paljon 1950–70-luvuilla. Tältä ajalta on yhä käytössä puupylväitä, joiden ikääntymisen takia korvausinvestointien tarve kasvaa. Hyvänä puolena tässä on että käyttövarmuuden parantamiseksi olemassa olevaa jakeluverkkoa ei tarvitse uusia ennenaikaisesti. Tutkimuksessa päähuomio on haja-asutusalueiden 20 kV keskijänniteverkon kehittämisessä, sillä yli 90 % asiakkaiden kokemista keskeytyksistä johtuu keskijänniteverkon vioista. Erityisesti johtorakenteisiin ja johtojen sijoittamiseen on kiinnitettävä huomiota. Käyttövarmuuden lisäksi jakeluverkkojen kehittämistä ohjaavia tekijöitä ovat taloudellisuus, ympäristön huomioiminen, viranomaisvalvonta sekä asiakkaiden ja omistajien odotukset. Haja-asutusalueilla taloudelliset haasteet ovat suuret vakituisen väestön vähenemisen ja mahdollisesti sähköntarpeen pienenemisen takia. Taloudellisuus korostuu ja riskit kasvavat, kun tuottojen määrä supistuu tarvittaviin jakeluverkon investointeihin ja ylläpitokustannuksiin verrattuna. Ristiriitaa aiheuttaa se, että asiakkaat odottavat sähkönjakelulta parempaa luotettavuutta, mutta paremmasta sähkönlaadusta ei olla valmiita maksamaan juurikaan nykyistä enempää. Jakeluverkkojen kehittämistä voi hidastaa myös viranomaisvalvonta, jos tuottoja ei voida lisätä investointien lisätarpeiden suhteessa. Tutkimuksessa on analysoitu yleisellä tasolla kaapeloinnin lisäämistä, korkeiden pylväiden käyttämistä, leveitä johtokatuja, edullisten ja yksinkertaisten sähköasemien rakentamista haja-asutusalueille ja automaatioasemien lisäämistä keskijänniteverkon solmupisteisiin. Erityisesti tutkimuksessa on analysoitu uutena tekniikkana 1000 V jännitteen käyttömahdollisuutta jakeluverkkojen kehittämisessä. Sähköjohtojen siirtäminen teiden varsiin parantaa käyttövarmuutta, vaikka johdot rakennetaan samalla tekniikalla kuin olemassa olevat johdot. Hajaasutusalueille rakennettavilla sähköasemilla pitkät syöttöjohdot voidaan jakaa pienemmiksi syöttöalueiksi, jolloin keskeytyksistä aiheutuvat haitat koskettavat kerrallaan pienempää asiakasmäärää. Samaan tulokseen päästään oikein sijoitetuilla ja toteutetuilla automaatioasemilla. Tutkimuksen mukaan lupaavaksi tekniikaksi jakeluverkkojen kehittämisessä on osoittautumassa 1000 V jänniteportaan ottaminen 400 V pienjännitteen lisäksi. 1000 V verkoilla voidaan korvata häiriöherkkiä 20 kV keskijänniteverkon lyhyitä, alle viiden kilometrin pituisia haarajohtoja ja haarajohtojen jatkeita, missä siirrettävät tehot ovat pieniä. Uudessa jakelujärjestelmässä sähkö tuodaan 1000 V jännitteellä lähelle asiakasta, jossa jännite muunnetaan normaaliksi asiakkaille soveltuvaksi 400/230 V jännitteeksi. Edullisuus perustuu siihen, että rakentamisessa käytetään samoja pienjännitejohtoja kuin asiakkaille menevässä 400 V pienjänniteverkossa. 1000 V jakelutekniikassa sekä investointikustannukset että ylläpitokustannukset ovat pienemmät kuin perinteisessä 20 kV ilmajohtotekniikassa. 1000 V johdot säästävät maisemaa, sillä ne eivät tarvitse leveää johtokatua kuten 20 kV keskijännitejohdot. 1000 V verkkojen käyttö soveltuukin erityisesti vapaa-ajanasuntojen sähköistykseen herkissä ranta- ja järvimaisemissa. 1000 V verkot mahdollistavat kaapeliauraamisen lisäämisen ja näin voidaan vähentää ympäristöä haittaavien kyllästettyjen pylväiden käyttöä. 1000 V jakeluverkkojen osalta tutkimustyön tuloksia on sovellettu suomalaisessa Suur-Savon Sähkö Oy:ssä. Käytännön kokemuksia 1000 V jakelujärjestelmästä on useista kymmenistä kohteista. Tutkimustulokset osoittavat, ettei keskijänniteverkon maakaapelointi hajaasutusalueilla ole taloudellisesti kannattavaa nykyisillä keskeytyksistä aiheutuvilla haitta-arvoilla, mutta jos keskeytyskustannusten arvostus kasvaa, tulee kaapelointi kannattavaksi monissa paikoissa. Myös myrskyisyyden ja myrskyistä aiheutuvien jakelukeskeytysten lisääntyminen tekisi kaapeloinnista kannattavan. Tulevaisuudessa jakeluverkkojen rakentaminen on entistä monimuotoisempi tehtävä, jossa taloudellisuuden ja käyttövarmuuden lisäksi on huomioitava asiakkaat, omistajat, viranomaiset ja ympäristö. Tutkimusta jakelutekniikan kehittämiseksi tarvitaan edelleen. Tulevaisuuden osalta haja-asutusalueiden jakeluverkkojen kehittämiseen liittyy paljon epävarmuuksia. Hajautetun kiinteistökohtaisen sähköntuotannon lisääntyminen voi tehdä jakeluverkoista nykyistä tarpeettomampia, mutta esimerkiksi liikenteen sähköistyminen voi kasvattaa jakeluverkkojen merkitystä. Tästä syystä jakeluverkkojen rakentamisessa tarvitaan joustavuutta, jotta tarvittaessa voidaan helposti sopeutua erilaisiin kehityssuuntiin.

Supply Risk Management in Pharmaceutical

Fast development in the operating environment and fierce competition have driven companies to pursue efficiency and success through lean and global supply chains. At the same time overall uncertainty has increased in the business environment and supply chains have become a priority in risk management since their vulnerability may endanger business continuity. Although risk management should start at procurement strategy development phase, proactive contingency planning is also essential because it enables correct reaction and fast changes in process execution in the case of risk realization. This thesis is a case study conducted in the pharmaceutical industry where purchasing and materials management organizations face a number of challenges and limitations that have to be considered in supply risk management. The goal of the study was to discuss the operating environment, and identify and analyze supply risks and potential risk management practices. The study was concluded with suggestions for purchasing strategy development that take risk management considerations into account. This copy is the public version of the thesis.

La invasión en la ciencia ficción y la construcción de la identidad americana

This dissertation examines the issue of invasion as represented in American science fiction. American SF appears as a scenario in which to explore national identity-an identity that has been marked by the imaginary of invasion. The dissertation focuses in particular on the 1983 television series V, which articulates concerns typical of a nation that has established its hegemony on the basis of the separation between oneself and the other. V, as we argue, equals the expression of American identity with the fear of physical otherness, and the fear of the vulnerability of the national borders as the imaginary boundary that separates the American I from everything else

The Problematic Internet Entertainment Use Scale for Adolescents: Prevalence of Problem Internet Use in Spanish High School Students

Many researchers and professionals have reported nonsubstance addiction to online entertainments in adolescents. However, very few scales have been designed to assess problem Internet use in this population, in spite of their high exposure and obvious vulnerability. The aim of this study was to review the currently available scales for assessing problematic Internet use and to validate a new scale of this kind for use, specifically in this age group, the Problematic Internet Entertainment Use Scale for Adolescents. The research was carried out in Spain in a gender-balanced sample of 1131 high school students aged between 12 and 18 years. Psychometric analyses showed the scale to be unidimensional, with excellent internal consistency (Cronbach"s alpha of 0.92), good construct validity, and positive associations with alternative measures of maladaptive Internet use. This selfadministered scale can rapidly measure the presence of symptoms of behavioral addiction to online videogames and social networking sites, as well as their degree of severity. The results estimate the prevalence of this problematic behavior in Spanish adolescents to be around 5 percent.

Imaging of the Vulnerable Atherosclerotic Plaque. Pre-Clinical Evaluation of PET Tracers for Vascular Inflammation

Atherosclerosis is a vascular inflammatory disease causing coronary artery disease, myocardial infarct and stroke, the leading causes of death in Finland and in many other countries. The development of atherosclerotic plaques starts already in childhood and is an ongoing process throughout life. Rupture of a plaque and the following occlusion of the vessel is the main reason for myocardial infarct and stroke, but despite extensive research, the prediction of rupture remains a major clinical problem. Inflammation is considered a key factor in the vulnerability of plaques to rupture. Measuring the inflammation in plaques non-invasively is one potential approach for identification of vulnerable plaques. The aim of this study was to evaluate tracers for positron emission tomography (PET) imaging of vascular inflammation. The studies were performed with a mouse model of atherosclerosis by using ex vivo biodistribution, autoradiography and in vivo PET and computed tomography (CT). Several tracers for inflammation activity were tested and compared with the morphology of the plaques. Inflammation in the atherosclerotic plaques was evaluated as expression of active macrophages. Systematic analysis revealed that the uptake of 18F-FDG and 11C-choline, tracers for metabolic activity in inflammatory cells, was more prominent in the atherosclerotic plaques than in the surrounding healthy vessel wall. The tracer for αvβ3 integrin, 18Fgalacto- RGD, was also found to have high potential for imaging inflammation in the plaques. While 11C-PK11195, a tracer targeted to receptors in active macrophages, was shown to accumulate in active plaques, the target-to-background ratio was not found to be ideal for in vivo imaging purposes. In conclusion, tracers for the imaging of inflammation in atherosclerotic plaques can be tested in experimental pre-clinical settings to select potential imaging agents for further clinical testing. 18F-FDG, 18F-galacto-RGD and 11C-choline choline have good properties, and further studies to clarify their applicability for atherosclerosis imaging in humans are warranted.