Recurrent governance challenges in the implementation and alignment of flood risk management strategies: a review

In Europe increasing flood risks challenge societies to diversify their Flood Risk Management Strategies (FRMSs). Such a diversification implies that actors not only focus on flood defence, but also and simultaneously on flood risk prevention, mitigation, preparation and recovery. There is much literature on the implementation of specific strategies and measures as well as on flood risk governance more generally. What is lacking, though, is a clear overview of the complex set of governance challenges which may result from a diversification and alignment of FRM strategies. This paper aims to address this knowledge gap. It elaborates on potential processes and mechanisms for coordinating the activities and capacities of actors that are involved on different levels and in different sectors of flood risk governance, both concerning the implementation of individual strategies and the coordination of the overall set of strategies. It identifies eight overall coordination mechanisms that have proven to be useful in this respect

Alterations in T and B lymphocytes in heart transplant patients early and late postoperatively.

Alterations in the percent and absolute number of thymus-derived (T) and bursa-equivalent (B) lymphocytes in peripheral blood were followed in 10 patients treated with antithymocyte globulin, prednisone, and azathioprine after cardiac transplantation. During the 1st postoperative wk the percent of T cells dropped below 10% in almost all cases (normal range, 65-91%) with a concomitant rise in the percent of B cells. However, the absolute T- and B-cell counts were both markedly depressed (less than 200 cells/mm3). During the 7-wk postoperative period the percent of T cells rose to 45-60% and the absolute count rose from 100 to 350 cells/mm3 (normal range, 1,092-2,400 cells/mm3). Although the percent of B cells was elevated (35-50%) during this period, the absolute B-cell count remained below the range of normals (268-640 cells/mm3). Follow-up of long-term survivors (3-60 mo postoperative) showed a continued marked T (467 cells/mm3) and B (95 cells/mm3) lymphocytopenia. Chronological relationships between the percent and absolute T-cell count and episodes of graft rejection in individual patients are discussed as possible adjuncts in the prediction of rejection crises