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Achilles tendon injuries are common overuse injuries in military populations. However, limited research has been undertaken looking specifically at the incidence and aetiology in army recruits. A pilot study was undertaken to investigate the incidence and aetiology of achilles tendinopathy in a group of 384 army recruits undertaking 12 weeks of intensive training. A descriptive questionnaire design was used to gather information. From this a total of 16 achilles tendon injuries were recorded during four intakes of recruits from the period January to August, 2003. An incident rate of 4.2% was recorded and a significant relationship (p<0.05) was shown between achilles tendon injury incidence, the female gender and footwear, indicating a problem with footwear in New Zealand Army recruits. A further aim of the study was to review the current literature with respect to achilles tendinopathy, the anatomy and function, biomechanics, histopathology and management. A systematic review was also undertaken looking at eccentrictype loading programs for achilles tendinopathy. A search of Cochrane Controlled Trials Register, PEDro physiotherapy System, Cochrane Musculoskeletal Injuries Group, MEDLINE and CINAHL were used to identify studies from January, 1990 to August, 2003. The methodological quality of the papers was assessed using The Cochrane Musculoskeletal Injuries Group generic evaluation tool. Following the evaluation it was concluded that the papers scored from poor to moderate indicating that the overall clinical efficacy of eccentrictype loading programs for the treatment of achilles tendinopathy may be questionable and that further more robust trials are required before strong conclusions can be drawn.

Execution of conveyancing documentation by companies has given rise to considerable anxiety to vendors, purchasers and their solicitors. Only gradually have the courts construed and applied the straightforward Section 20(1) and the enigmatic Section 23 of the Conveyancing and Property Ordinance, leaving in their wake a host of defective titles. Now the Hong Kong Legislature has come to our aid by enacting a new Section 23A. The purpose of this article is to examine the meaning of this section and to explore the extent of its curative effect. ; published_or_final_version

This paper sets out the historical background to the development of safety cases as a tool to manage and regulate major hazard industries, primarily in the UK. The main features of successful safety case systems are described and an assessment made of the successes and failures in their application. 1. It is probably only possible to achieve absolute safety if as a society we do not undertake hazardous activities. However we know that the application of technology brings great benefits to us as a society. The skill comes in exploiting potentially hazardous technology whilst minimising the risks - accepting it is probably not possible to totally eliminate the risks. 2. The concept of using the mechanism of a safety case as a tool to help manage major risks, although around for some considerable time, particularly in the nuclear field, continues to expand into new areas. This alone tells us something about the worth and success of the safety case concept. This paper will briefly trace some of the history of its development in the UK and Europe, outline some of the features of successful safety case regulatory regimes as well as some of the difficulties. 3. In the context of this paper the term "safety case" is used to cover the variety of legislative requirements which variously require "safety cases" or "safety reports". The term "installation" is used to describe the site that presents the major hazard whether it be a nuclear power station, an oil refinery or an offshore oil and gas facility and the term "operator" to describe the owner or employer in charge of the installation.

In a well known British case, the relatives of a dead man consented to the use of his organs for transplant on the condition that they were transplanted only into white people. The British government condemned the acceptance of racist offers and the panel they set up to report on the case condemned all conditional offers of donation. The panel appealed to a principle of altruism and meeting the greatest need. This paper criticises their reasoning. The panel's argument does not show that conditional donation is always wrong and anyway overlooks a crucial distinction between making an offer and accepting it. But even the most charitable reinterpretation of the panel's argument does not reject selective acceptance of conditional offers. The panel's reasoning has no merit.

On June 5, 1997, Secretary of the Interior Bruce Babbitt and Secretary of Commerce William Daley signed a jointly-released Secretarial Order entitled "American Indian Tribal Rights, Federal-Tribal Trust Responsibilities, and the Endangered Species Act"' The Order culminated a year-and-a-half of work by tribes and federal officials to craft an administrative system for resolving difficult questions involving tribal rights and the Endangered Species Act (ESA). The Order is important for the ESA's implementation. It also carries broader significance, for it serves as one major example of how the government-to-government relationship between the United States and Indian tribes can be successfully implemented.

Data from 1586 Francophone students in Northeastern Ontario concerning their attitudes towards French and English show seven independent factors affect linguistic beliefs. Three factors -believing French unimportant, believing English practically dominant, and believing their French inadequate - lead students to continue their post-secondary education solely in English. Believing French more pleasurable is positively, and believing English superior is negatively, related to continuing post-secondary education solely in French. Educational level is negatively related to believing English superior and to believing French unimportant but positively related to believing English dominant, French pleasurable, and their French inadequate. Policy should therefore focus on countering the belief in English dominance and the belief in the inadequacy of their ability in French. ; Les données recueillies par Laflamme et Dennie (1990) auprès de 1586 étudiants francophones du Nord-Est de l'Ontario, données portant notamment sur les attitudes envers le français et l'anglais, révèlent sept facteurs déterminants des croyances linguistiques. Trois facteurs - croire que le français n'est pas important, que l'anglais est en réalité dominant et que le français qu'on parle est inadéquat - incitent les étudiants à poursuivre leurs études en anglais seulement. Croire que le français constitue, plus que l'anglais, une langue de plaisir est positivement relié au fait de poursuivre des études postsecondaires en français seulement, alors que tenir l'anglais pour une langue supérieure est négativement relié au fait de poursuivre des études en français seulement. Le niveau d'éducation est négativement relié à la croyance en la supériorité de l'anglais et à celle en la non-importance du français, mais il est relié positivement au fait de croire en la domination de l'anglais, au français comme langue de plaisir et au manque de compétence à s'exprimer dans sa langue. Par conséquent, les décisions politiques devraient veiller à contrecarrer la croyance en la domination de l'anglais et celle en l'incompétence de la personne dans sa langue.

This is a conference paper. ; Sanitation service delivery in South Africa is directly linked to the history of the country. The number of households lacking basic sanitation services in 2001 was approximately 4.7 million. This amounts to approximately 18 million people or 42% of the population. During August 2000 to June 2001, South Africa experienced one of the worst cholera epidemics in the country's recent history. The outbreak was linked to outbreaks in Mozambique, Swaziland and Zambia. By December 2002, South Africa had reported a total of 151 852 cholera cases. The efforts to combat the epidemic involved government at all levels and included interventions such as access to potable water, sanitation, and education. This paper compares the conventional approach to sanitation which was implemented before the cholera outbreak to the accelerated approach which evolved in the KwaZulu-Natal Province as a result of the outbreak.

Since the mid 1990s, following the reception in Australia of Robert Putnam's theory about social capital, volunteering has been seen as a means of expanding democracy. Social researchers have stressed the role of friendly social networks and informal civil associations in generating reserves of trust and social capital. The broad social benefits of trust are now widely recognised as having the potential to sustain and renovate economic and political institutions. Robert Putnam uses volunteering as an index of civic participation and argues that the immanent decline of volunteering signals a potential crisis for democracy. In this paper, we challenge Putnam's thesis from two directions, empirically and theoretically. Using information about time spent in volunteering from 1974 to 1997, it can be shown that, far from the decline in volunteering Putnam predicts, there is likely to be a significant increase in the total number of volunteer hours supplied. While this does give us some reason to anticipate an expansion of democracy in the future, we will argue that Putnam also underestimates the democratising potential of volunteering by ignoring the relationships of care in which volunteering is anchored.

Teenagers represent a large proportion of the population and have the potential for considerable morbidity because of high smoking rates and unwanted teenage pregnancy. The government intends to reduce the incidence of this important morbidity, but there is no coherent strategy for attaining these improvements. Research in this area is limited in the United Kingdom, but research from elsewhere has clarified teenagers' attitudes. There have also been some intervention studies resulting in improvements in specific aspects of teenage health. A worrying theme which emerges from this research is of a new inverse care law. Teenagers with low self-esteem and less hope for their own future are more likely to lead lifestyles which put them at risk and are less likely to ask for advice in relation to their health or lifestyle. Thus, it may be more difficult to alter behaviour in these patients; overall population based improvements may be difficult to achieve. Teenagers' own concerns appear to be at variance with the goals dictated by government and health professionals. It is suggested that the only method of meeting the needs of teenagers and at the same time aiming to reduce morbidity in this age group is to foster an atmosphere of patient centredness in dealings with adolescent patients and for further ther research in this important health gain area.

Patterns of migration do not simply arise out of chance. In South Africa, for example, migration patterns are a result of decades of legislation aimed at restricting the movements of the majority of the population and providing a steady flow of cheap black labour to the gold mines and other industries. In the new democratic South Africa, restrictive laws have been lifted, but circular migration remains a way of life for several million black South Africans. This paper examines the social and epidemiological implications of widespread circular migration from the perspective of a rural South African Health District. In particular, we report our findings on the patterns and prevalence of migration into and out of the Hlabisa Health District in rural KwaZulu/Natal, and the patterns of sexual networking of migrants and their rural partners. We conclude by examining the implications of these patterns of migration and sexual networking for the spread of HIV and other STDs.

User fees are used to recover costs and discourage unnecessary attendance at primary care clinics in many developing countries. In South Africa, user fees for children aged under 6 years and pregnant women were removed in 1994, and in 1997 all user fees at all primary health care clinics were abolished. The intention of these policy changes was to improve access to health services for previously disadvantaged communities. We investigated the impact of these changes on clinic attendance patterns in Hlabisa health district. Average quarterly new registrations and total attendances for preventive services (antenatal care, immunization, growth monitoring) and curative services (treatment of ailments) at a mobile primary health care unit were studied from 1992 to 1998. Regression analysis was undertaken to assess whether trends were statistically significant. There was a sustained increase in new registrations (P = 0.0001) and total attendances (P = 0.0001) for curative services, and a fall in new registrations (P = 0.01) and total attendances for immunization and growth monitoring (P = 0.0002) over the study period. The upturn in demand for curative services started at the time of the first policy change. The decreases in antenatal registrations (P = 0.07) and attendances (P = 0.09) were not statistically significant. The number of new registrations for immunization and growth monitoring increased following the first policy change but declined thereafter. We found no evidence that the second policy change influenced underlying trends. The removal of user fees improved access to curative services but this may have happened at the expense of some preventive services. Governments should remain vigilant about the effects of new health policies in order to ensure that objectives are being met.

Enormous quantities of litter enter the stormwater system. It is most efficient to capture it at at its source through education, legislation, street vacuuming, and improved litter collection. We underook a literature review, field investigation, theoretical hydraulic analysis, physical and numerical modelling. At a particular boom location it is recommended that consideration be given to using angled booms and/or mesh skirts and/or deeper skirts where appropriate, with the best design for each site refined by physical and/or numerical modelling, balancing the need for litter retention, minimum forces on the boom, more permanent debris collection, navigability, performance over all water levels and minimum cost.

BACKGROUND: The British Journal of General Practice (BJGP) is the leading primary care journal in the world. By impact factor, it ranks 24th of all medical journals. However, despite major changes in the journal since its inception in 1954, there have been no published readership surveys since a limited report in 1969. AIM: To canvass members of the Midland Faculty and to add to the debate about the future of the BJGP. METHOD: A postal questionnaire was sent to a random sample of 299 members, fellows and associates of the Midland Faculty asking for their views about the BJGP. RESULTS: Two hundred replies were received (a response rate of 67%). The median year of qualification of responders was 1981, and 32 (16%) held academic posts. Ninety-nine (49%) disagreed with the present format of the BJGP, which compared poorly with the British Medical Journal (BMJ) in simple rank order of importance. Readership was equal to that of the BMJ (93% reading it within 28 days of arrival), but fewer people read it within a week of receiving it. The most popular sections were the editorials, original articles and letters; least popular were the book reviews and the pull-out magazine, Connection. All sections were rated excellent to average. Readers wished for an expansion of the BJGP to include clinical reviews, medical politics and humorous pieces. Most responders felt that Connection should remain separate. There was dissatisfaction with the delay between submission and publication of original articles, particularly among the academic general practitioners (GPs). Academics and fundholders did not differ from other readers in their views of the content or style of the BJGP. Half of the responders stated that the BJGP should be self-financing and should be open to more advertising. Responders' free comments largely related to improving the style of articles and expanding the BJGP. CONCLUSION: There is a view that the present BJGP is not relevant to the non-academic GP. This is probably due to style rather than content. Simple ...

In 1985 the French government created a unique circuit for the dissemination of doctoral theses: References went to a national database "Téléthèses" whereas the documents were distributed to the university libraries in microform. In the era of the electronic document this French network of deposit of and access to doctoral theses is changing. How do you discover and locate a French thesis today, how do you get hold of a paper copy and how do you access the full electronic text? What are the catalogues and databases referencing theses since the disappearance of "Téléthèses"? Where are the archives, and are they open? What is the legal environment that rules the emerging structures and tools? This paper presents national plans on referencing and archiving doctoral theses coordinated by the government as well as some initiatives for creating full text archives. These initiatives come from universities as well as from research institutions and learned societies. "Téléthèses" records have been integrated in a union catalogue of French university libraries SUDOC. University of Lyon-2 and INSA Lyon developed procedures and tools covering the entire production chain from writing to the final access in an archive: "Cyberthèses" and "Cither". The CNRS Centre for Direct Scientific Communication at Lyon (CCSD) maintains an archive ("TEL") with about 2000 theses in all disciplines. Another repository for theses in engineering, economics and management called "Pastel" is proposed by the Paris Institute of Technology (ParisTech), a consortium of 10 engineering and commercial schools of the Paris region.