Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata: an assessment from the ARTEMIS DISK Global Antifungal Surveillance Program.

Geographic differences in frequency and azole resistance among Candida glabrata may impact empiric antifungal therapy choice. We examined geographic variation in isolation and azole susceptibility of C. glabrata. We examined 23 305 clinical isolates of C. glabrata during ARTEMIS DISK global surveillance. Susceptibility testing to fluconazole and voriconazole was assessed by disk diffusion, and the results were grouped by geographic location: North America (NA) (2470 isolates), Latin America (LA) (2039), Europe (EU) (12 439), Africa and the Middle East (AME) (728), and Asia-Pacific (AP) (5629). Overall, C. glabrata accounted for 11.6% of 201 653 isolates of Candida and varied as a proportion of all Candida isolated from 7.4% in LA to 21.1% in NA. Decreased susceptibility (S) to fluconazole was observed in all geographic regions and ranged from 62.8% in AME to 76.7% in LA. Variation in fluconazole susceptibility was observed within each region: AP (range, 50-100% S), AME (48-86.9%), EU (44.8-88%), LA (43-92%), and NA (74.5-91.6%). Voriconazole was more active than fluconazole (range, 82.3-84.2% S) with similar regional variation. Among 22 sentinel sites participating in ARTEMIS from 2001 through 2007 (84 140 total isolates, 8163 C. glabrata), the frequency of C. glabrata isolation increased in 14 sites and the frequency of fluconazole resistance (R) increased in 11 sites over the 7-year period of study. The sites with the highest cumulative rates of fluconazole R were in Poland (22% R), the Czech Republic (27% R), Venezuela (27% R), and Greece (33% R). C. glabrata was most often isolated from blood, normally sterile body fluids and urine. There is substantial geographic and institutional variation in both frequency of isolation and azole resistance among C. glabrata. Prompt species identification and fluconazole susceptibility testing are necessary to optimize therapy for invasive candidiasis.

The short arm of the law: judicial institutions and local governance in Brazil

This paper estimates the effect of judicial institutions on governance at the local level in Brazil. Our estimation strategy exploits a unique institutional feature of state judiciary branches which assigns prosecutors and judges to the most populous among contiguous counties forming a judiciary district. As a result of this assignment mechanism there are counties with nearly identical populations, some with and some without local judicial presence, which we exploit to impute counterfactual outcomes. Conditional on observable county characteristics, offenses per civil servant are about 35% lower in counties that have a local seat of the state judiciary. The lower incidence of infractions stems mostly from fewer violations of financial management regulations by local administrators, fewer instances of problems in project execution and project managment, fewer cases of non-existent or ineffective civil society oversight and fewer cases of improper handling of remittances to local residents.

Towards Integrated Governance of Landscape Development : The Swiss Model of Regional Nature Parks

Coherent regulation of landscape as a resource is a major challenge. How can the development interests of some actors (eg cable car operators and property developers) be reconciled with those of others (agriculture, forestry) and with conservation of biodiversity and scenic value? To help understand how the newly introduced Regional Nature Parks (RNPs) can improve the coherence of the regulation regime in Switzerland, we highlight current direct mechanisms for regulation of landscape as a resource (bans, inventories, subsidies) as well as indirect mechanisms (taking place through the regulation of the physical basis of landscapes, eg forest, land, and water planning policies). We show that RNPs are fundamentally innovative because they make it possible to manage and coordinate indirect strategies for appropriate regulation of resources at a landscape scale. In other words, RNPs enable organization of governance of landscape as a resource in a perimeter that is not necessarily restricted to administrative boundaries.

Global Prospects for Dairy in Argentina and Chile: Evidence from Field Visits and Model Simulations, August 2006

We assess the international competitiveness of the dairy industries in Argentina and Chile, combining recent market intelligence gathered from field visits with quantitative simulations of global policy reform scenarios. Both countries exhibit strong potential for export growth but face significant internal and external barriers to expanding their dairy industries. Global policy reforms would resolve some of the international obstacles to their expansion. Argentina has great potential, but it is handicapped by its current macroeconomic policies, trade policy distortions, and the uncertainty associated with policy implementation. Chile is more limited in terms of natural capacity for expansion, but it has a positive trade and investment environment.

Hormonal, global, and regional haemodynamic responses to a vascular antagonist of vasopressin in patients with congestive heart failure with and without hyponatraemia.

The pathophysiological role of an increase in circulating vasopressin in sustaining global and regional vasoconstriction in patients with congestive heart failure has not been established, particularly in patients with hyponatraemia. To assess this further, 20 patients with congestive heart failure refractory to digoxin and diuretics were studied before and 60 minutes after the intravenous injection (5 micrograms/kg) of the vascular antagonist of vasopressin [1(beta-mercapto-beta,beta-cyclopentamethylene-propionic acid), 2-(0-methyl) tyrosine] arginine vasopressin. Ten patients were hyponatraemic (plasma sodium less than 135 mmol/l) and 10 were normonatraemic. In both groups of patients the vascular vasopressin antagonist did not alter systemic or pulmonary artery pressures, right atrial pressure, pulmonary capillary wedge pressure, cardiac index, or vascular resistances. Furthermore, there was no change in skin and hepatic blood flow in either group after the injection of the vascular antagonist. Only one patient in the hyponatraemic group showed considerable haemodynamic improvement. He had severe congestive heart failure and a high concentration of plasma vasopressin (51 pmol/l). Plasma renin activity, vasopressin, or catecholamine concentrations were not significantly changed in response to the administration of the vasopressin antagonist in either the hyponatraemic or the normonatraemic groups. Patients with hyponatraemia, however, had higher baseline plasma catecholamine concentrations, heart rate, pulmonary pressure and resistance, and lower hepatic blood flow than patients without hyponatraemia. Plasma vasopressin and plasma renin activity were slightly, though not significantly, higher in the hyponatraemic group. Thus the role of vasopressin in sustaining regional or global vasoconstriction seems limited in patients with congestive heart failure whether or not concomitant hyponatraemia is present. Vasopressin significantly increases the vascular tone only in rare patients with severe congestive heart failure and considerably increased vasopressin concentrations. Patients with hyponatraemia do, however, have raised baseline catecholamine concentrations, heart rate, pulmonary arterial pressure and resistance, and decreased hepatic blood flow.

Technology Governance Board Information Technology Strategic Plan, 2006

The Technology Governance Board (TGB), established pursuant to Iowa Code Section 8A.204, developed and published this strategic information technology plan in December 2006. This plan contains the TGB's vision, mission, goals, and strategies that will lead the executive branch to an information technology infrastructure and policies that will enhance and unify the technology infrastructure to support business operations for electronic government, consistent with the vision of providing sustained support for “extraordinary customer service”.

Iowa Technology Governance Board Annual Report, January 8, 2007

This Technology Governance Board Annual Report provides information o the total annual executive branch information technology expenditures (hardware, software, and personnel) and estimates for the amount of technology spending to be requested for the succeeding fiscal year. The report contains a projection of technology cost savings, an accounting of the level of technology cost savings for the current fiscal year, and a comparison of the level of technology cost savings for the current fiscal year with that of the previous fiscal year. This report was produced in compliance with Iowa Code §8A.204(3a) and was submitted to the Governor, the Department of Management, and the General Assembly on January 8, 2007.

RELATÓRIO GLOBAL DE SEGUIMENTO DA EXECUÇÃO DA ESTRATÉGIA DE CRESCIMENTO E DE REDUÇÃO DA POBREZA DECRP II

DIRECÇÃO NACIONAL DO PLANEAMENTO

The Role of Public Administration: A Global Perspective

From my experience with public administration in my country, Cape Verde, and through readings in the area of development administration, I have found that a distinctive role and specific societal goals are usually ascribed to public administration in developing country. In studying American public administration approaches and operation, I was stuck by the fact that the definition of roles and societal goals for public administration seems not to be a forefront concern in the field. How to do things and achieve efficiency, in a managerial and rational perspective, seemed to draw much more attention than the purpose of doing things. Somehow, the contrast with the concept of development administration seemed too sharp, and I became curious about the reasons for such disparate approaches. Historical, cultural, and environmental differences would probably not be the only explanation for that since the concept of development administration was shaped, in the late 50’s and 60’s, by American authors and institutional aid agencies, and then “offered” to developing countries. At the same time, looking to poor results of the successive prescriptions of the development administration movement, I was no sure that such a concept and the framework it establishes was worthwhile. What practical answers and arrangement did they bring to the needs and challenges of public administrations in developing countries? …

Reconciling global mammal prioritization schemes into a strategy.

The huge conservation interest that mammals attract and the large datasets that have been collected on them have propelled a diversity of global mammal prioritization schemes, but no comprehensive global mammal conservation strategy. We highlight some of the potential discrepancies between the schemes presented in this theme issue, including: conservation of species or areas, reactive and proactive conservation approaches, conservation knowledge and action, levels of aggregation of indicators of trend and scale issues. We propose that recently collected global mammal data and many of the mammal prioritization schemes now available could be incorporated into a comprehensive global strategy for the conservation of mammals. The task of developing such a strategy should be coordinated by a super-partes, authoritative institution (e.g. the International Union for Conservation of Nature, IUCN). The strategy would facilitate funding agencies, conservation organizations and national institutions to rapidly identify a number of short-term and long-term global conservation priorities, and act complementarily to achieve them.

Estratégia e Plano de Acção Nacional para o Desenvolvimento das Capacidades na Gestão Ambiental Global em Cabo Verde

- A ligação entre a Gestão Ambiental Global e o Desenvolvimento Durável é capital para um país como Cabo Verde. Os “cenários” de desenvolvimento humano e económico, tendo em conta a vulnerabilidade ambiental e no contexto de um pequeno estado insular em desenvolvimento (SIDS), devem ser bem avaliados e implementados com uma visão estratégica integrada, sinérgica e de longo prazo. - É necessário ultrapassar as políticas e traduzir essas políticas em acções práticas e concretas, principalmente em acções de capacitação em gestão ambiental, é assim que surge o projecto NCSA-GEM para desenvolver as capacidades nacionais em termos individuais, institucionais e sistémico, nos domínios prioritários das Convenções Internacionais de Rio e, consequentemente reforçar a implementação do PANA II enquanto instrumento nacional para a gestão do ambiente. - A implementação das Convenções Internacionais do Rio revela muitas interacções, semelhanças e intersecções. A sua compreensão e apreensão através de uma abordagem coordenada são susceptíveis de melhorar a eficácia e eficiência. As ligações existentes entre as convenções devem ser entendidas como oportunidades favorecendo a implementação de acções concretas. A implementação das obrigações ou engajamentos das convenções necessita fortes capacidades nacionais e locais de acordo com a importância dos seus objectivos. As Convenções Internacionais já foram implantadas em Cabo Verde há vários anos; no entanto, o problema da coordenação das suas implementações quer separada ou sinérgica não teve ainda solução, revelando se necessário a elaboração de uma Estratégia e Plano de Acção para o Desenvolvimento das Capacidades. - A abordagem utilizada, de acordo com a metodologia e orientações do projecto NCSA, foi a análise de toda a documentação existente sobre as três Convenções (CCD, CBD; CCC), Gestão Ambiental, Estratégias Nacionais de Desenvolvimento, DCRP, Planos de Acção Nacionais, CCD, CBD, CCC, PANA II, Guia Metodológico do NCSA-GEF, Modelos existentes em outros países, Perfis Temáticos e Estudo de Transversalidade e Sinergia entre as três Convenções do Rio em Cabo Verde, entre outros. Também priorizou se a abordagem participativa e pró-activa com os diferentes actores e parceiros técnicos e financeiros, através de realizações de sessões de trabalho, jornadas e ateliers a nível central e descentralizado. - Para que haja uma implementação efectiva do EPAN-NCSA, recomenda-se : • Garantir um suporte de político de alto nível para a gestão do processo (playdoyer/lobbying junto das mais altas autoridades governamentais do país e dos parceiros estratégicos de desenvolvimento); • Escolher a opção para a estrutura de coordenação e implementação do EPAN-NCSA ou a combinação das opções apresentadas; Elaborar os TDR para a organização ou entidade líder do processo de coordenação implementação do EPAN-NCSA, incluindo todos os requisitos organizacionais e operacionais; • Elaborar e divulgar brochuras NCSA de informação sobre as (oportunidades) das Convenções de Rio e um Manual de Procedimentos integrando o papel e responsabilidades dos actores/parceiros chaves no desenvolvimento das capacidades para a gestão ambiental; • Procurar fundos para a instalação da estrutura/organização responsável pela implementação do EPAN-NCSA e procurar fundos operacionais para as acções específicas propostas no Plano. Algumas fontes de financiamento podem ser abordadas nomeadamente: (1) Os orçamentos nacionais; (2) Fundos e programas País – do sistema das NU; (3) Fundos do GEF; (4) Fundo para o Ambiente; (5) Mecanismos financeiros Inovadores no âmbito das Convenções. - A sustentabilidade da implementação do EPAN no âmbito do processo NCSA é condicionada por alguns riscos, nomeadamente: • Mudanças ou revisões institucionais; • Necessário enquadramento no novo sistema de gestão para o apoio orçamental com obrigação de apresentação de resultados sustentáveis; • Capacidade de resposta do País tendo em conta a sua graduação para PDM; • Consistência e viabilidade a longo prazo das Convenções do Rio. Esses riscos devem ser deliberadamente considerados nas opções governamentais, em como as capacidades prioritárias podem ser desenvolvidas, os mecanismos de sustentabilidade e mobilização de fundos podem ser alargados/ampliados e o desenho do sistema de seguimento e avaliação nacional pode ser implementado de forma a permitir a avaliação do progresso do desenvolvimento das capacidades no país. Esses riscos poderão ser mitigados para a sustentabilidade do Processo NCSA através de implementação de : (1) Uma estratégia NCSA de Mobilização de Recursos; (2) Uma Estratégia de Comunicação e Integração Estratégica do NCSA com o SIA e IEC; (3) Uma Estratégia PANNCSA para a investigação integrada, interdisciplinar e sustentável.