Suchergebnisse

In 2014, the Third International Conference on the resilience of social-ecological systems chose the theme "resilience and development: mobilizing for transformation." The conference aimed specifically at fostering an encounter between the experiences and thinking focused on the issue of resilience through a social and ecological system perspective, and the experiences focused on the issue of resilience through a development perspective. In this perspectives piece, we reflect on the outcomes of the meeting and document the differences and similarities between the two perspectives as discussed during the conference, and identify bridging questions designed to guide future interactions. After the conference, we read the documents (abstracts, PowerPoints) that were prepared and left in the conference database by the participants (about 600 contributions), and searched the web for associated items, such as videos, blogs, and tweets from the conference participants. All of these documents were assessed through one lens: what do they say about resilience and development? Once the perspectives were established, we examined different themes that were significantly addressed during the conference. Our analysis paves the way for new collective developments on a set of issues: (1) Who declares/assign/cares for the resilience of what, of whom? (2) What are the models of transformations and how do they combine the respective role of agency and structure? (3) What are the combinations of measurement and assessment processes? (4) At what scale should resilience be studied? Social transformations and scientific approaches are coconstructed. For the last decades, development has been conceived as a modernization process supported by scientific rationality and technical expertise. The definition of a new perspective on development goes with a negotiation on a new scientific approach. Resilience is presently at the center of this negotiation on a new science for development.

This final report of the Lancet Commission into liver disease in the UK stresses the continuing increase in burden of liver disease from excess alcohol consumption and obesity, with high levels of hospital admissions which are worsening in deprived areas. Only with comprehensive food and alcohol strategies based on fiscal and regulatory measures (including a minimum unit price for alcohol, the alcohol duty escalator, and an extension of the sugar levy on food content) can the disease burden be curtailed. Following introduction of minimum unit pricing in Scotland, alcohol sales fell by 3%, with the greatest effect on heavy drinkers of low-cost alcohol products. We also discuss the major contribution of obesity and alcohol to the ten most common cancers as well as measures outlined by the departing Chief Medical Officer to combat rising levels of obesity—the highest of any country in the west. Mortality of severely ill patients with liver disease in district general hospitals is unacceptably high, indicating the need to develop a masterplan for improving hospital care. We propose a plan based around specialist hospital centres that are linked to district general hospitals by operational delivery networks. This plan has received strong backing from the British Association for Study of the Liver and British Society of Gastroenterology, but is held up at NHS England. The value of so-called day-case care bundles to reduce high hospital readmission rates with greater care in the community is described, along with examples of locally derived schemes for the early detection of disease and, in particular, schemes to allow general practitioners to refer patients directly for elastography assessment. New funding arrangements for general practitioners will be required if these proposals are to be taken up more widely around the country. Understanding of the harm to health from lifestyle causes among the general population is low, with a poor knowledge of alcohol consumption and dietary guidelines. The Lancet Commission has serious doubts about whether the initiatives described in the Prevention Green Paper, with the onus placed on the individual based on the use of information technology and the latest in behavioural science, will be effective. We call for greater coordination between official and non-official bodies that have highlighted the unacceptable disease burden from liver disease in England in order to present a single, strong voice to the higher echelons of government.

Beckwith–Wiedemann syndrome (BWS), a human genomic imprinting disorder, is characterized by phenotypic variability that might include overgrowth, macroglossia, abdominal wall defects, neonatal hypoglycaemia, lateralized overgrowth and predisposition to embryonal tumours. Delineation of the molecular defects within the imprinted 11p15.5 region can predict familial recurrence risks and the risk (and type) of embryonal tumour. Despite recent advances in knowledge, there is marked heterogeneity in clinical diagnostic criteria and care. As detailed in this Consensus Statement, an international consensus group agreed upon 72 recommendations for the clinical and molecular diagnosis and management of BWS, including comprehensive protocols for the molecular investigation, care and treatment of patients from the prenatal period to adulthood. The consensus recommendations apply to patients with Beckwith–Wiedemann spectrum (BWSp), covering classical BWS without a molecular diagnosis and BWS-related phenotypes with an 11p15.5 molecular anomaly. Although the consensus group recommends a tumour surveillance programme targeted by molecular subgroups, surveillance might differ according to the local health-care system (for example, in the United States), and the results of targeted and universal surveillance should be evaluated prospectively. International collaboration, including a prospective audit of the results of implementing these consensus recommendations, is required to expand the evidence base for the design of optimum care pathways. ; This Consensus Statement was organized by the European Network of Human Congenital Imprinting Disorders (EUCID.net) with financial support from European Cooperation in Science and Technology (COST; BM1208). Newlife the Charity for Disabled Children, the European Society of Pediatric Endocrinology (ESPE) and the Société Française de lutte contre les Cancers et leucémies de l'enfant et de l'adolescent (SFCE) provided funding for the consensus meeting. The European Society of Pediatric Nephrology (ESPN) provided support for the meeting. Individual authors would like to thank the following funders for research support: Alex's Lemonade Stand Foundation (J.M.K.); Bundesministerium für Bildung und Forschung (BMBF) (number 01GM1513C) (D.P.); Child Growth Foundation (K.T.-B.); European Union FP7 Innovative Training Network (ITN) Ingenium N. 290123 (Y.LeB., A.R., I.N., E.R.M.); FIS (grant PI15/01481) (P.L., J.T.); Fondation de Recherche Médicale (Y.LeB.); Margaret Q. Landenberger Foundation (J.M.K.); MIUR PRIN 2015 JHLY35 (A.R., G.B.F., S.Ru.); MOH Grants to Istituto Auxologico Italiano (grant: RC 08C502_2015) (S.Ru.); US National Institutes of Health (grant K08CA193915) (J.M.K.); UK National Institute for Health Research (NIHR) Rare Diseases Translational Research Collaboration (A.C.F.); St. Baldrick's Scholar Award (J.M.K.); The Estonian Research Council (grant PUT355) (K.O.); Université P et M Curie, Institut National de la Santé Et de la Recherche Médicale (Y.L.B.); Telethon-Italia GGP15131 and AIRC IG18671 (A.R.); Wellcome Trust (M.D.K.); European Research Council (E.R.M.); and NIHR Senior Investigator Award (E.R.M.). The University of Cambridge has received salary support in respect of E.R.M. from the National Health Service (NHS) in the East of England through the Clinical Academic Reserve. The views expressed are those of the authors and not necessarily those of the NHS or UK Department of Health. No funding was received from pharmaceutical companies.