Communism and Cold War Policies
In: Journal of the Royal United Service Institution, Band 96, Heft 584, S. 620-628
ISSN: 1744-0378
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In: Journal of the Royal United Service Institution, Band 96, Heft 584, S. 620-628
ISSN: 1744-0378
Metadata only record ; This article presents a case study in the application of community based natural resource management (CBNRM) in regard to the specific experience of the management of mangrove forests in a commune in central Vietnam. This is accomplished by tracing the history of mangrove management over periods of political and economic reform, ultimately showcasing the power of CBNRM as a solution that more equitably distributes benefit and responsibility in relation to mangrove forests. Le argues that CBNRM more effectively manages resources by incorporating previously marginalized stakeholders and thereby encouraging them to demonstrate more wise conservation practices.
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Siponimod is a selective sphingosine 1-phosphate receptor subtype 1 (S1P(1)) and 5 (S1P(5)) modulator approved in the United States and the European Union as an oral treatment for adults with relapsing forms of multiple sclerosis (RMS), including active secondary progressive multiple sclerosis (SPMS). Preclinical and clinical studies provide support for a dual mechanism of action of siponimod, targeting peripherally mediated inflammation and exerting direct central effects. As an S1P(1) receptor modulator, siponimod reduces lymphocyte egress from lymph nodes, thus inhibiting their migration from the periphery to the central nervous system. As a result of its peripheral immunomodulatory effects, siponimod reduces both magnetic resonance imaging (MRI) lesion (gadolinium-enhancing and new/enlarging T2 hyperintense) and relapse activity compared with placebo. Independent of these effects, siponimod can penetrate the blood–brain barrier and, by binding to S1P(1) and S1P(5) receptors on a variety of brain cells, including astrocytes, oligodendrocytes, neurons, and microglia, exert effects to modulate neural inflammation and neurodegeneration. Clinical data in patients with SPMS have shown that, compared with placebo, siponimod treatment is associated with reductions in levels of neurofilament light chain (a marker of neuroaxonal damage) and thalamic and cortical gray matter atrophy, with smaller reductions in MRI magnetization transfer ratio and reduced confirmed disability progression. This review examines the preclinical and clinical data supporting the dual mechanism of action of siponimod in RMS.
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Governments in tropical countries are still responding to increasing forest degradation by implementing different types of protected areas. In general, due to their negative image as causes of deforestation, local communities are being excluded from any management role in these conservation areas. However, in Vietnam, since 1986 various incentives have been proposed for alternative conservation models. Our surveys used a multidisciplinary combination of methods to work with one Pahy ethnic minority around the degraded forests of the proposed Phong Dien Nature Reserve in Central Vietnam. From the results of these surveys we obtained clear indication that conservation can be enhanced if local priorities, perspectives and wishes are better identified and taken into account. The local communities identified the need for, at least, limited extractive activities in the protected area. They also frequently stressed their willingness to participate in the monitoring and control of the area, and in the selection of local species for reforestation programmes. Communities can and should be actively involved in building a shared understanding of what the forest provides, how it can be conserved and the benefits to be obtained. Conservation in Vietnam has much to gain from local participation. However, suitable safeguards and incentives need to be in place to insure sustainable use of the forest resources
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Introduction: Child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence) is widely understood to be associated with multiple mental health disorders, physical health problems and health risk behaviours throughout life. However, Australia lacks fundamental evidence about the prevalence and characteristics of child maltreatment, its associations with mental disorders and physical health, and the associated burden of disease. These evidence gaps impede the development of public health strategies to better prevent and respond to child maltreatment. The aims of this research are to generate the first comprehensive population-based national data on the prevalence of child maltreatment in Australia, identify associations with mental disorders and physical health conditions and other adverse consequences, estimate attributable burden of disease and indicate targeted areas for future optimal public health prevention strategies. Methods and analysis: The Australian Child Maltreatment Study (ACMS) is a nationwide, cross-sectional study of Australia's population aged 16 years and over. A survey of approximately 10 000 Australians will capture retrospective self-reported data on the experience in childhood of all five types of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence). A customised, multimodule survey instrument has been designed to obtain information including: the prevalence and characteristics of these experiences; diagnostic screening of common mental health disorders; physical health; health risk behaviours and health service utilisation. The survey will be administered in March-November 2021 to a random sample of the nationwide population, recruited through mobile phone numbers. Participants will be surveyed using computer-assisted telephone interviews, conducted by trained interviewers from the Social Research Centre, an agency with extensive experience in studies of health and adversity. Rigorous protocols protect the safety of both participants and interviewers, and comply with all ethical and legal requirements. Analysis will include descriptive statistics reporting the prevalence of individual and multitype child maltreatment, multiple logistic and linear regression analyses to determine associations with mental disorders and physical health problems. We will calculate the population attributable fractions of these putative outcomes to enable an estimation of the disease burden attributable to child maltreatment. Ethics and dissemination: The study has been approved by the Queensland University of Technology Human Research Ethics Committee (#1900000477, 16 August 2019). Results will be published to the scientific community in peer-reviewed journals, scientific meetings and through targeted networks. Findings and recommendations will be shared with government policymakers and community and organisational stakeholders through diverse engagement activities, a dedicated Advisory Board and a systematic knowledge translation strategy. Results will be communicated to the public through an organised media strategy and the ACMS website.
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Background Carbapenem-resistant Enterobacteriaceae (CRE) is an increasing problem worldwide, but particularly problematic in low- and middle-income countries (LMIC) due to limitations of resources for surveillance of CRE and infection prevention and control (IPC). Methods A point prevalence survey (PPS) with screening for colonisation with CRE was conducted on 2233 patients admitted to neonatal, paediatric and adult care at 12 Vietnamese hospitals located in northern, central and southern Vietnam during 2017 and 2018. CRE colonisation was determined by culturing of faecal specimens on selective agar for CRE. Risk factors for CRE colonisation were evaluated. A CRE admission and discharge screening sub-study was conducted among one of the most vulnerable patient groups; infants treated at an 80-bed Neonatal ICU from March throughout June 2017 to assess CRE acquisition, hospital-acquired infection (HAI) and treatment outcome. Results A total of 1165 (52%) patients were colonised with CRE, most commonly Klebsiella pneumoniae (n=805), Escherichia coli (n=682) and Enterobacter spp. (n=61). Duration of hospital stay, HAI and treatment with a carbapenem were independent risk factors for CRE colonisation. The PPS showed that the prevalence of CRE colonisation increased on average 4.2 % per day and mean CRE colonisation rates increased from 13% on the day of admission to 89% at day 15 of hospital stay. At the NICU CRE colonisation increased from 32% at admission to 87% at discharge, mortality was significantly associated (OR 5•5, P < 0•01) with CRE colonisation and HAI on admission. Conclusion These data indicate that there is an epidemic spread of CRE in Vietnamese hospitals with rapid transmission to hospitalised patients. ; Funding agencies: Karolinska Institute, Solna, Sweden; Linkoping University, County of Ostergotland, Sweden; Swedish Foundation for International Cooperation in Research and Higher Education, STINT, Stockholm, Sweden; European Union, Marie Slodowska Curie Grants; ReAct, Up
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