Somalia 2007: Starting from scratch on the long and winding road to peace and democracy?

Somalia, a country composed of four and a half major tribes, namely the Hawiye, centred in Mogadishu, the Darod based in the North, the Dir and the Rahanweyn (the other 40-odd minor tribes falling into the “half” category) blundered into the 21st century without a modern state or its institutions (Mbugua, 2004:26). While the country has been without an effective government since 1991, recent reports suggest that, unless immediate action is taken on an international scale, Somalia will continue on its downward trend towards internal collapse. Although much hope was pinned on the success of the Somali National Reconciliation Conference, which played host to more than 1 325 delegates from a selection of Somalia's various regions and clans to talk about and propose solutions to Somalia's protracted problems, the conference was concluded on 30 August 2007 showing little for participants' efforts. This initiative came after a spate of fighting in Somalia that has not only been labelled the “worst violence in Somalia's 16 years of war and turmoil”, but also, “the worst single displacement of people this year anywhere in the world” (Nordland, 2007:60). Scientia Militaria: South African Journal of Military Studies Vol. 36 (1) 2008: pp. 95-11

Collective learning in schools described: building collective learning capacity

Processes of collective learning are expected to increase the professionalism of teachers and school leaders. Little is known about the processes of collective learning which take place in schools and about the way in which those processes may be improved. This paper describes a research into processes of collective learning at three primary schools. Processes of collective learning are described which took place in small teams in these schools. It is also pointed out which attempts can be made in order to reinforce these processes in the schools mentioned

DC-SCRIPT is a novel regulator of the tumor suppressor gene CDKN2B and induces cell cycle arrest in ERα-positive breast cancer cells

Breast cancer is one of the most common causes of cancer-related deaths in women. The estrogen receptor (ERα) is well known for having growth promoting effects in breast cancer. Recently, we have identified DC-SCRIPT (ZNF366) as a co-suppressor of ERα and as a strong and independent prognostic marker in ESR1 (ERα gene)-positive breast cancer patients. In this study, we further investigated the molecular mechanism on how DC-SCRIPT inhibits breast cancer cell growth. DC-SCRIPT mRNA levels from 190 primary ESR1-positive breast tumors were related to global gene expression, followed by gene ontology and pathway analysis. The effect of DC-SCRIPT on breast cancer cell growth and cell cycle arrest was investigated using novel DC-SCRIPT-inducible MCF7 breast cancer cell lines. Genome-wide expression profiling of DC-SCRIPT-expressing MCF7 cells was performed to investigate the effect of DC-SCRIPT on cell cycle-related gene expression. Findings were validated by real-time PCR in a cohort of 1,132 ESR1-positive breast cancer patients. In the primary ESR1-positive breast tumors, DC-SCRIPT expression negatively correlated with several cell cycle gene ontologies and pathways. DC-SCRIPT expression strongly reduced breast cancer cell growth in vitro, breast tumor growth in vivo, and induced cell cycle arrest. In addition, in the presence of DC-SCRIPT, multiple cell cycles related genes were differentially expressed including the tumor suppressor gene CDKN2B. Moreover, in 1,132 primary ESR1-positive breast tumors, DC-SCRIPT expression also correlated with CDKN2B expression. Collectively, these data show that DC-SCRIPT acts as a novel regulator of CDKN2B and induces cell cycle arrest in ESR1-positive breast cancer cells

GPs’ perspectives on diagnostic testing in children with persistent non-specific symptoms:a qualitative study

Background: Diagnostic testing is prevalent among children with persistent non-specific symptoms (PNS), and both undertesting and overtesting have negative consequences for child and society. Research in adults with PNS has shown that GPs use diagnostic testing for reasons other than diagnosis, but comparable research has not, to the best of our knowledge, been conducted in children. Understanding GPs’ perspectives of testing decisions in children could provide insights into mechanisms of undertesting and overtesting.Aim: To investigate GPs’ perspectives of conducting or refraining from diagnostic testing in children with PNS and the differences compared with their motives when treating adults.Design and setting: Qualitative study using semi-structured interviews with Dutch GPs.Method: We purposively sampled GPs until data saturation. Reasons for conducting or refraining from diagnostic tests were explored using two real-life cases from daily practice. Online video interviews were transcribed verbatim. Data were collected and analysed concurrently by thematic content analysis.Results: Twelve GPs participated. Their decision making involved a complex trade-off among four themes: medical considerations (for example, alarm symptoms), psychosocial factors (for example, doctor–patient relationship), consultation management (for example, ‘quick fix’), and efficient resource utilisation (for example, sustainability). Compared with when treating adults, GPs were more hesitant to conduct diagnostic testing in children because of their higher vulnerability to fearing invasive procedures, lower probability of organic disease, and reduced autonomy.Conclusion: As in adults, GPs’ decisions to conduct diagnostic tests in children were motivated by reasons beyond diagnostic uncertainty. Educational programmes, interventions, and guidelines that aim to change the testing behaviours of GPs in children with PNS should target these reasons.<p/

Challenge clusters facing LCA in environmental decision-making—what we can learn from biofuels

Purpose Bioenergy is increasingly used to help meet greenhouse gas (GHG) and renewable energy targets. However, bioenergy’s sustainability has been questioned, resulting in increasing use of life cycle assessment (LCA). Bioenergy systems are global and complex, and market forces can result in significant changes, relevant to LCA and policy. The goal of this paper is to illustrate the complexities associated with LCA, with particular focus on bioenergy and associated policy development, so that its use can more effectively inform policymakers. Methods The review is based on the results from a series of workshops focused on bioenergy life cycle assessment. Expert submissions were compiled and categorized within the first two workshops. Over 100 issues emerged. Accounting for redundancies and close similarities in the list, this reduced to around 60 challenges, many of which are deeply interrelated. Some of these issues were then explored further at a policyfacing workshop in London, UK. The authors applied a rigorous approach to categorize the challenges identified to be at the intersection of biofuels/bioenergy LCA and policy. Results and discussion The credibility of LCA is core to its use in policy. Even LCAs that comply with ISO standards and policy and regulatory instruments leave a great deal of scope for interpretation and flexibility. Within the bioenergy sector, this has led to frustration and at times a lack of obvious direction. This paper identifies the main challenge clusters: overarching issues, application and practice and value and ethical judgments. Many of these are reflective of the transition from application of LCA to assess individual products or systems to the wider approach that is becoming more common. Uncertainty in impact assessment strongly influences planning and compliance due to challenges in assigning accountability, and communicating the inherent complexity and uncertainty within bioenergy is becoming of greater importance. Conclusions The emergence of LCA in bioenergy governance is particularly significant because other sectors are likely to transition to similar governance models. LCA is being stretched to accommodate complex and broad policy-relevant questions, seeking to incorporate externalities that have major implications for long-term sustainability. As policy increasingly relies on LCA, the strains placed on the methodology are becoming both clearer and impedimentary. The implications for energy policy, and in particular bioenergy, are large

Management of children with non-acute abdominal pain and diarrhea in Dutch primary care:a retrospective cohort study based on a routine primary care database (AHON)

Objective: To describe the testing, prescription, referral, and follow-up management by general practitioners (GPs) for children presenting with non-acute abdominal pain and/or diarrhea in primary care. Design: Retrospective cohort study with one-year follow-up. Setting: Registry data from a Dutch primary care database (AHON) between 2015 and 2019. Subjects: Children aged 4–18 years old who presented by face-to-face consultation in primary care for non-acute abdominal pain and/or diarrhea (&gt;7 days). Main outcome measures: We recorded the proportions of children who received (1) diagnostic testing, medicine prescriptions, follow-up consultations, and referrals at their first visit and (2) repeat consultations and referrals by one-year of follow-up. Results: Among the 2200 children (median age, 10.5 years; interquartile range, 7.0–14.6) presenting to a GP with non-acute abdominal pain and/or diarrhea, most reported abdominal pain (78.7%). At the first visit, GPs performed diagnostic testing for 32.2%, provided a prescription to 34.5%, and referred 2.5% to secondary care. Twenty-five percent of the children had a follow-up consultation within four weeks and 20.8% had a repeat consultation between four weeks and one year. Thirteen percent of the children were referred to secondary care by one year. However, only 1% of all children had documentation of an organic diagnosis needing management in secondary care. Conclusion: One-third of children received diagnostic testing or a medicine prescription. Few had a follow-up consultation and &gt;10% was referred to pediatric care. Future research should explore the motivations of GPs why and which children receive diagnostic and medical interventions.</p

Management of children with non-acute abdominal pain and diarrhea in Dutch primary care:a retrospective cohort study based on a routine primary care database (AHON)

Objective: To describe the testing, prescription, referral, and follow-up management by general practitioners (GPs) for children presenting with non-acute abdominal pain and/or diarrhea in primary care. Design: Retrospective cohort study with one-year follow-up. Setting: Registry data from a Dutch primary care database (AHON) between 2015 and 2019. Subjects: Children aged 4–18 years old who presented by face-to-face consultation in primary care for non-acute abdominal pain and/or diarrhea (&gt;7 days). Main outcome measures: We recorded the proportions of children who received (1) diagnostic testing, medicine prescriptions, follow-up consultations, and referrals at their first visit and (2) repeat consultations and referrals by one-year of follow-up. Results: Among the 2200 children (median age, 10.5 years; interquartile range, 7.0–14.6) presenting to a GP with non-acute abdominal pain and/or diarrhea, most reported abdominal pain (78.7%). At the first visit, GPs performed diagnostic testing for 32.2%, provided a prescription to 34.5%, and referred 2.5% to secondary care. Twenty-five percent of the children had a follow-up consultation within four weeks and 20.8% had a repeat consultation between four weeks and one year. Thirteen percent of the children were referred to secondary care by one year. However, only 1% of all children had documentation of an organic diagnosis needing management in secondary care. Conclusion: One-third of children received diagnostic testing or a medicine prescription. Few had a follow-up consultation and &gt;10% was referred to pediatric care. Future research should explore the motivations of GPs why and which children receive diagnostic and medical interventions.</p

The Politics of Exhaustion and the Externalization of British Border Control. An Articulation of a Strategy Designed to Deter, Control and Exclude

In response to contemporary forms of human mobility, there has been a continued hardening of borders seeking to deter, control and exclude certain groups of people from entering nation states in Europe, North America and Australasia. Within this context, a disconcerting evolution of new and increasingly sophisticated forms of border control measures have emerged, which often play out within bilateral arrangements of “externalised” or “offshore” border controls. Drawing on extensive first‐hand field research among displaced people in Calais, Paris and Brussels in 2016–2019, this paper argues that the externalization of the British border to France is contingent upon a harmful strategy, which can be understood as the “politics of exhaustion.” This is a raft of (micro) practices and methods strategically aimed to deter, control and exclude certain groups of people on the move who have been profiled as “undesirable,” with a detrimental (un)intended impact on human lives