The shape of change: memetic analysis of poverty definitions from the 1970s to the 2000s

The authors illustrate how notions of poverty are constructed around specific ‘memes’, or replicating units of cultural information, around which concepts and ideas develop and change. Three ‘memes’ characterising definitions of poverty over the previous years were identified: ‘basic needs’, ‘multidimensional’ and ‘deprivation’. The analysis illustrated the semantic space in which each term was utilised and to the extent it changed and modified over time by different actors. The results revealed how ‘memes’ compete with one another across the discourse. Within this competition, older concepts are almost never fully abandoned, but rather repackaged and reutilised. Thus, new definitions of poverty are less innovative than portrayed in the wider literature.

Local space for local people? Trends in the provision and management of urban outdoor recreation in the UK

This paper examines the growing trend in the UK towards the effective privatisation of formerly public open space and the relationship of this trend to the recent shifts in public sector management. A case study of Reading, England, illustrates the growing cultural and spatial dysfunction, particularly in terms of the declining knowledge and use of the town's urban gardens by the local population. Where once the gardens were a focus of social activity, therefore, they are now a largely irrelevant site of urban decline. In contrast to central urban space, it is clear that other types of open space in other areas can still assume a significance in peoples' lives. In many cases the use of these areas illustrates a counter cultural position in which the consumerism of the city management is actively being resisted. The paper concludes that while there appear to be ways in which local space could be reclaimed for local people, the power to achieve this lies predominantly in the same hands as those responsible for appropriating central space to the imperative of the market in the first instance

Recent trends in UK Government policy on the provision and management of leisure facilities

Since the first election victory of the Thatcher administration in 1979, Britain has witnessed a cultural transformation from the municipal socialism of the post-World War 2 Welfare State to a form of post-industrial entrepreneurialism. This has had a profound effect on all aspects of civil society, not least the redefinition of the role of active leisure from the 1950s evocation of 'Sport For All' to the market rationality of the 1980s. The transformation has signalled a shift from government support for active leisure as an element of citizen rights to the use of leisure to promote the government's interest in legitimating a new social order based not on rights but on means. Thus access to active living is no longer a societal goal for all, but a discretionary consumer good, the consumption of which signifies 'active' citizenship. It furthermore signifies differentiation from the growing mass of 'deviants' who are unwilling or unable to embrace this new construction of citizenship and are, therefore, increasingly denied access to active living and, hence, active citizenship.

Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA)

As the mean age of the global population increases, breast cancer in older individuals will be increasingly encountered in clinical practice. Management decisions should not be based on age alone. Establishing recommendations for management of older individuals with breast cancer is challenging because of very limited level 1 evidence in this heterogeneous population. In 2007, the International Society of Geriatric Oncology (SIOG) created a task force to provide evidence-based recommendations for the management of breast cancer in elderly individuals. In 2010, a multidisciplinary SIOG and European Society of Breast Cancer Specialists (EUSOMA) task force gathered to expand and update the 2007 recommendations. The recommendations were expanded to include geriatric assessment, competing causes of mortality, ductal carcinoma in situ, drug safety and compliance, patient preferences, barriers to treatment, and male breast cancer. Recommendations were updated for screening, primary endocrine therapy, surgery, radiotherapy, neoadjuvant and adjuvant systemic therapy, and metastatic breast cancer.

Towards effective water reuse: drivers, challenges and strategies shaping the organisational management of reclaimed water in Jordan

Treated wastewater or reclaimed water is gaining recognition as a valuable water resource around the world. To assess why, where and how water reuse takes place in Jordan, semi-structured interviews were conducted with representatives of 29 key organisations in 2008. The analysis reveals that water scarcity is a key driver for water reuse. However, despite such recognition, reuse was described positively by only a small proportion of the interviewees (n = 6). Negative and neutral perceptions regarding reuse dominated and the research found that this was related to two underlying challenges: (i) the requirement for more intensive management when using reclaimed water compared with freshwater and (ii) concern over societal acceptance of water reuse. These factors were found to be associated with the risks posed to humans and their environments, combined with negative emotional and cultural responses to human waste and its applications. Numerous strategies are identified that are employed by organisations to overcome these challenges. Wastewater treatment, regulation, monitoring, the mixing of treated effluent with freshwater and limited public discussion of water reuse are all employed to achieve maximum use of reclaimed water. Each strategy presents benefits of sort, but some may paradoxically also inhibit optimal use of reclaimed water. Careful modifications to the existing strategies of Jordanian agencies, such as more open discussion of reuse, could lead to greater social, economic and environmental gains.

Soy products in the management of breast cancer

Purpose of review: Meta-analyses of epidemiological studies of soy consumption and breast cancer risk have demonstrated modest protective effects, usually attributed to isoflavones. Concern has been expressed, however, that the estrogenic activity of isoflavones may have adverse effects on breast cancer recurrence. Recent findings: The review covers epidemiological studies that have investigated the impact of soy consumption in breast cancer patients on recurrence and mortality. There are preliminary data to suggest that soy has differential effects on recurrence in human epidermal growth factor receptor-2 positive and human epidermal growth factor receptor-2 negative tumours. Recent studies on mechanisms of action of soy in breast cancer provide insights into epigenetic effects and the interaction of isoflavones with IGF-1 and with a number of polymorphisms of genes associated with breast cancer risk such as MDM2 and CYP1B1. Summary: Overall, these studies indicate that soy foods consumed at levels comparable to those in Asian populations have no detrimental effects on risk of breast cancer recurrence and in some cases significantly reduce the risk. Importantly, soy does not appear to interfere with tamoxifen or anastrozole therapy. Recent research suggests that women who are at increased risk of breast cancer due to polymorphisms in genes associated with the disease may especially benefit from high soy isoflavone intake.

Professionalism and professional institutions in times of change

Professionalism and professional institutions have developed and changed very gradually in recent decades, such that there are conflicting and competing definitions of what it means to be a professional. The direction of travel is examined through an institutional lens in terms of current trends and practices that have transformed professional life. At first sight, the evolution of professionalism appears to be developing into a new professionalism that requires less of professional institutions and more of the institutions of societal governance, such as contracts and statutes. These transformations are explored with reference to the need for a sustainable urban environment, showing that despite a reduced role of professional institutions, certain aspects of professionalism remain crucially important, especially in those jurisdictions where societal governance is not well developed. With the growing sophistication of legislation, insurance and commerce, the emphasis of what it means to be a professional is evolving. One key aspect of professionalism that is not usually listed in most texts is role definition and how this provides a sense of identity. Professionalism remains a relevant and important concept, but the exigencies of a sustainable urban environment transcend the objectives of the professions and demand a broader, collaborative and participative agenda.

Denial of change: the 'Military Revolution' as seen by contemporaries

Writers on military matters from the 14th century until the late 18th century either regretted the decadence of their times compared with Antiquity, or they saw no great change in military affairs since Antiquity. Few saw a revolutionary change ushered in by gunpowder, although this number increased since the great "querelle" about the Ancients and the Moderns under Louis XIV. In the early 19th century, the balance tipped, and few would have denied that technology had profoundly changed warfare. All this is a far cry, however, from any contemporary perception of a "Military Revolution" in the 16th and 17th centuries.

Fenced in: Common property struggles in the management of communal rangelands in central Eastern Cape Province, South Africa

This paper takes as its starting point the assertion that current rangeland management in the central Eastern Cape Province (former Ciskei) of South Africa, is characterised primarily by an ‘open access’ approach. Empirical material drawn from three case-study communities in the region is used to examine the main barriers to management of rangeland as a ‘commons’. The general inability to define and enforce rights to particular grazing resourses in the face of competing claims from ‘outsiders’, as well as inadequate local institutions responsible for rangeland management are highlighted as being of key importance. These are often exacerbated by lack of available grazing land, diffuse user groups and local political and ethnic divisions. Many of these problems have a strong legacy in historical apartheid policies such as forced resettlement and betterment planning. On this basis it is argued that policy should focus on facilitating the emergence of effective, local institutions for rangeland management. Given the limited grazing available to many communities in the region, a critical aspect of this will be finding ways to legitimise current patterns of extensive resource use, which traverse existing ‘community’ boundaries. However, this runs counter to recent legislation, which strongly links community management with legal ownership of land within strict boundaries often defined through fencing. Finding ways to overcome this apparent disjuncture between theory and policy will be vital for the effective management of common pool grazing resources in the region.

The relationship between community-based organisations and the effective management of coastal and marine resources in the Western Indian Ocean region

This study examines the relationship between community based organisations and marine and coastal resource management in the Western Indian Ocean Region.

The interactive responses of water quality and hydrology to changes in multiple stressors, and implications for the long-term effective management of phosphorus

Soluble reactive phosphorus (SRP) plays a key role in eutrophication, a global problem decreasing habitat quality and in-stream biodiversity. Mitigation strategies are required to prevent SRP fluxes from exceeding critical levels, and must be robust in the face of potential changes in climate, land use and a myriad of other influences. To establish the longevity of these strategies it is therefore crucial to consider the sensitivity of catchments to multiple future stressors. This study evaluates how the water quality and hydrology of a major river system in the UK (the River Thames) respond to alterations in climate, land use and water resource allocations, and investigates how these changes impact the relative performance of management strategies over an 80-year period. In the River Thames, the relative contributions of SRP from diffuse and point sources vary seasonally. Diffuse sources of SRP from agriculture dominate during periods of high runoff, and point sources during low flow periods. SRP concentrations rose under any future scenario which either increased a) surface runoff or b) the area of cultivated land. Under these conditions, SRP was sourced from agriculture, and the most effective single mitigation measures were those which addressed diffuse SRP sources. Conversely, where future scenarios reduced flow e.g. during winters of reservoir construction, the significance of point source inputs increased, and mitigation measures addressing these issues became more effective. In catchments with multiple point and diffuse sources of SRP, an all-encompassing effective mitigation approach is difficult to achieve with a single strategy. In order to attain maximum efficiency, multiple strategies might therefore be employed at different times and locations, to target the variable nature of dominant SRP sources and pathways.

Rapid-onset opioids and the management of episodic pain

This is the fourth in a short series of articles that focus on what GPs should consider when monitoring and prescribing specialist-initiated palliative-care medicines. Here, the authors summarise the key issues around the use of apid onset opioids in palliative care.