ISPRM`S WAY FORWARD

This paper outlines approaches to developing the International Society of Physical and Rehabilitation Medicine (ISPRM) and addresses many current challenges Most importantly, these approaches provide the basis for ISPRM to develop its leadership role within the field of Physical and Rehabilitation Medicine (PRM) and in relation to the World Health Organization (WHO) and the United Nations (UN) system at large. They also address a number of specific critiques of the current situation. A positioning of ISPRM within the world architecture of the UN and WHO systems, as well as the consideration and fostering of respective emerging regional PRM societies, is central to establishing networking connections at different levels of the world society. Yearly congresses, possibly in co-operation with a regional society, based on a defined regional rotation, are suggested. Thus, frustration with the current bidding system for a biennial congress and an intermediate meeting could be overcome. Yearly congresses are also an important step towards increasing the organization`s funding base, and hence the possibility to expand the functions of ISPRM`s central office. ISPRM`s envisioned leadership role in the context of an international web of PRM journals complementing the formally defined official journal of ISPRM, regional societies and so forth, is an inclusive rather than exclusive approach that contributes to the development of PRM journals worldwide. An important prerequisite for the further development of ISPRM is the expansion and bureaucratization of its Central Office, adding professionalism and systematic allocation of resources to the strengths of the voluntary engagement of individual PRM doctors.

Population structure of Phytophthora cinnamomi in South Africa

Phytophthora cinnamomi isolates collected from 1977 to 1986 and 1991 to 1993 in two regions in South Africa were analyzed using isozymes. A total of 135 isolates was analyzed for 14 enzymes representing 20 putative loci, of which four were polymorphic. This led to the identification of nine different multilocus isozyme genotypes. Both mating types of P. cinnamomi occurred commonly in the Cape region, whereas, predominantly, the A2 mating type occurred in the Mpumalanga region of South Africa. A2 mating type isolates could be resolved into seven multilocus isozyme genotypes, compared with only two multilocus isozyme genotypes for the A1 mating type isolates. Low levels of gene (0.115) and genotypic (2.4%) diversity and a low number of alleles per locus (1.43) were observed for the South African P. cinnamomi population. The genetic distance between the Cape and Mpumalanga P. cinnamomi populations was relatively low (D-m = 0.165), and no specific pattern in regional distribution of multilocus isozyme genotypes could be observed. The genetic distance between the ''old'' (isolated between 1977 and 1986) and ''new'' (isolated between 1991 and 1993) P. cinnamomi populations from the Cape was low (D-m = 0.164), indicating a stable population over time. Three of the nine multilocus isozyme genotypes were specific to the ''old'' population, and only one multilocus isozyme genotype was specific to the ''new'' population. Significant differences in allele frequencies, a high genetic distance (D-m = 0.581) between the Cape A1 and A2 mating type isolates, significant deviations from Hardy-Weinberg equilibrium, a low overall level of heterozygosity, and a high fixation index (0.71) all indicate that sexual reproduction occurs rarely, if at all, in the South African P. cinnamomi population.

Cost implications of outpatient teleneurology

A randomized controlled trial was conducted to compare the costs of realtime teleneurology with the cost of conventional neurological care. Two district hospitals in Northern Ireland were equipped with videoconferencing units and were connected to the regional neurological centre by ISDN at 384 kbit/s. Of 168 patients randomized to the study, 141 kept their appointments (76 male, 65 female). Sixty-five patients were randomized to a conventional consultation while 76 were randomized to a teleconsultation. The average age was 44 years of those seen conventionally and 42 years of those seen by telemedicine. The groups had similar diagnoses. The telemedicine group required more investigations and reviews than the conventional group. The average cost of the conventional consultation was pound 49 compared with pound 72 for the teleconsultation. Realtime teleneurology was not as cost-effective as conventional care.

Estrogen receptors in human preadipocytes

Estrogen influences regional adipose tissue distribution and the accompanying cardiovascular disease risk. To elucidate the mechanisms of this link further, we assessed whether human preadipocytes (PAs) expressed estrogen receptors (ERs) and whether there were any regional or gender differences in ER complement. Human PAs expressed the ER alpha gene but not ERP by reverse transcriptase-polymerase chain reaction, possessed ER alpha protein on Western blotting, and displayed specific 17 beta -estradiol (E-2) binding with calculated dissociation constants of 0.78 nM, 0.96 nM, and 1.19 nM and maximal binding capacities of 9.3 fmol/mg, 14.6 fmol/ mg, and 18.2 fmol/mg from three whole cell binding assays. There were no regional differences in ER alpha complement for males or females. There were no gender differences in ER alpha complement for subcutaneous or visceral samples. We conclude that ER alpha but not ERP is present in human PAs. This suggests that the effect of estrogen on adipose tissue deposition has a contribution from the direct effect of estrogen on human PAs via ER alpha.

Engineering closure of an open pit gold operation in a semi-arid climate

Along with material characteristics and geometry, the climate in which a mine is located can have a dramatic effect on the appropriate options for rehabilitation. The paper outlines the setting, mining, milling and waste disposal at Kidston Gold Mine's open pit operations in the semi-arid climate of North Queensland, Australia, before focusing on the engineering aspects of the rehabilitation of Kidston. The mine took a holistic and proactive approach to rehabilitation, and was prepared to demonstrate a number of innovative approaches, which are described in the paper. Engineering issues that had to be addressed included the geotechnical stability and deformation of waste rock dumps, including a 240 m high in-pit dump: the construction and performance monitoring of a “store and release” cover over potentially acid forming mineralised waste rock; erosion from the side slopes of the waste rock dumps; the in-pit co-disposal of waste rock and thickened tailings; the geotechnical stability of the tailings dam wall; the potential for erosion of bare tailings; the water balance of the tailings dam; direct revegetation of the tailings; and the pit hydrology. The rehabilitation of the mine represents an important benchmark in mine site rehabilitation best practice, from which lessons applicable worldwide can be shared.

Conselhos locais de saúde : caminhos e (des)caminhos da participação social no Sistema Único de Saúde

A partir da descentralização, novas instâncias de negociação e novas alternativas de ordenamento da estrutura organizacional do Sistema Único de Saúde (SUS) foram criadas. Dentre estas alternativas, podemos citar os conselhos de saúde, importantes canais de participação social. Todavia, frente às limitações destes canais tradicionais de articulação entre Estado e sociedade, destacamos os ideais da gestão participativa e os Conselhos Locais de Saúde (CLS) como alternativa de renovação e criação de instâncias mais flexíveis, porosas e efetivas às complexas demandas sociais. Neste sentido, buscamos analisar o processo de criação e implementação dos CLS do município de Anchieta/ES, a partir de uma abordagem quali-quantativa. Inicialmente, traçamos o perfil socioeconômico e político dos conselheiros eleitos, a partir de um questionário aplicado a uma amostra de 54 conselheiros; dados que foram categorizados e analisados por meio do emprego de estatísticas descritivas. Em seguida, entrevistamos treze conselheiros, de dois conselhos distintos do município, procedendo à análise de conteúdo do material, a partir dos ideais de Bardin (2000). Os resultados demonstraram que os conselhos foram criados a partir da iniciativa da gestão municipal em 2011, e que simplesmente institucionalizá-los como espaço de participação social não foi suficiente para promover a mobilização social e o envolvimento comunitário. Quanto ao perfil dos conselheiros locais, 78% são mulheres, com predominância de raça/cor branca, idade entre os 20 e 39 anos e funcionárias públicas; 57% possuem Ensino Médio e participaram como conselheiro por dois anos, e 60% destes já tiveram outras experiências de participação similares aos CLS. Do material oriundo das entrevistas, emergiram quatro categorias de análise, a saber: 1) Ser ou não ser conselheiro de saúde? Eis a questão!; 2) O não pertencimento e a não-participação; 3) Conselhos Locais de Saúde: elos, meios e mediações; e 4) A exogenia da administração e os obstáculos à participação social. Os entraves ao funcionamento dos conselhos de saúde, mesmo em nível local, ainda são desafios a serem superados, para que estas instâncias sejam mais influentes na gestão pública, conforme os princípios de sua criação. A participação social e a democracia são fundamentais para a construção de políticas de saúde que correspondam às reais demandas da comunidade. Contudo, para garantir a democracia na sociedade não basta promover a descentralização. É necessário que os sujeitos políticos resistam às relações de dominação, opressão e subordinação. Para isso, torna-se imprescindível os programas de educação para cidadania dos sujeitos envolvidos nestes fóruns de participação. O que nos motiva, enfim, é notarmos a existência, entre os conselheiros eleitos, de sujeitos protagonistas de seu próprio devir; sujeitos que atuam como agentes transformadores, motivadores de sonhos e projetos em prol da saúde pública e de sua comunidade.

Sources of Brazil's Counter-Hegemony

There have been two key initiatives taken in the last two decades in Brazil to create a counter-hegemonic project for the country. One initiative resulted from Brazil's business community and high-level State bureaucracy and aimed at forming a regional economic and political bloc that would guarantee and enlarge a relative independence from the hegemonic powers. The other resulted from the emergence of the new unionist movement in São Paulo and from the formation of Partido dos Trabalhadores and aimed at promoting radical democratization and reducing social exclusion. Both initiatives have created policies and changes that have converged to enhance Brazil's counter-hegemonic position as a regional and emerging power.

What does the field of International Relations look like in South America?

Abstract This article provides a comprehensive picture of IR in South America by applying content analysis to 7,857 articles published in 35 journals from six South American countries from 2006 to 2014 in order to discover what the predominant theories, methods and research areas in this field are, how scholars tend to combine them in their research designs, and what the profiles of regional journals are, regarding their epistemological, methodological and subject preferences. The findings reveal a predominantly Positivist and largely Qualitative discipline, resembling North American and European IR.