Major flaws in conflict prevention policies towards Africa : the conceptual deficits of international actors’ approaches and how to overcome them

Current thinking on African conflicts suffers from misinterpretations oversimplification, lack of focus, lack of conceptual clarity, state-centrism and lack of vision). The paper analyses a variety of the dominant explanations of major international actors and donors, showing how these frequently do not distinguish with sufficient clarity between the ‘root causes’ of a conflict, its aggravating factors and its triggers. Specifically, a correct assessment of conflict prolonging (or sustaining) factors is of vital importance in Africa’s lingering confrontations. Broader approaches (e.g. “structural stability”) offer a better analytical framework than familiar one-dimensional explanations. Moreover, for explaining and dealing with violent conflicts a shift of attention from the nation-state towards the local and sub-regional level is needed.Aktuelle Analysen afrikanischer Gewaltkonflikte sind häufig voller Fehlinterpretationen (Mangel an Differenzierung, Genauigkeit und konzeptioneller Klarheit, Staatszentriertheit, fehlende mittelfristige Zielvorstellungen). Breitere Ansätze (z. B. das Modell der Strukturellen Stabilität) könnten die Grundlage für bessere Analyseraster und Politiken sein als eindimensionale Erklärungen. häufig differenzieren Erklärungsansätze nicht mit ausreichender Klarheit zwischen Ursachen, verschärfenden und auslösenden Faktoren. Insbesondere die richtige Einordnung konfliktverlängernder Faktoren ist in den jahrzehntelangen gewaltsamen Auseinandersetzungen in Afrika von zentraler Bedeutung. Das Diskussionspapier stellt die große Variationsbreite dominanter Erklärungsmuster der wichtigsten internationalen Geber und Akteure gegenüber und fordert einen Perspektivenwechsel zum Einbezug der lokalen und der subregionalen Ebene für die Erklärung und Bearbeitung gewaltsamer Konflikte

Fiskalische Kosten einer steuerlichen Förderung von Forschung und Entwicklung in Deutschland - Eine empirische Analyse verschiedener Gestaltungsoptionen

Der Beitrag berechnet die Aufkommensausfälle verschiedener Gestaltungsmodelle für eine steuerliche Forschungsförderung in Deutschland auf Basis eines Mikrosimulationsmodells. Die fiskalischen Kosten betragen zwischen 464 Mio. € und 5.701 Mio. €. Eine Erstattungsoption der Steuergutschrift über die Gewerbe- und Körperschaftsteuerschuld hinaus ist unerlässlich, da sonst etwa ein Drittel der Unternehmen nicht oder nur teilweise in den Genuss der Förderung kommen würde und sich dadurch starke Verzerrungen zwischen ertragsstarken und ertragsschwachen Unternehmen ergeben. Eine Differenzierung der Fördersätze für KMU und große Unternehmen kann die Aufkommensausfälle wirksam begrenzen. Eine Kappungsgrenze in Höhe eines absoluten Betrages ist wegen der Verzerrungen innerhalb der Gruppe großer Unternehmen ungünstig. Als besonders pragmatisch erscheint eine Verrechnung der Steuergutschrift mit der abzuführenden Lohnsteuer

The development of an online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making: a usability and pilot study

An online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making was developed. A two-phase usability test was conducted among 12 couples (N = 22; 2 persons participated without their partner) at risk for hereditary cancer and 15 health care providers. Couples and health care providers expressed similar suggestions for improvements, and evaluated the modified decision aid as acceptable, easy to use, and comprehensible. The final decision aid was pilot tested (N = 16) with paired sample t tests comparing main outcomes (decisional conflict, knowledge, realistic expectations regarding the reproductive options and decision self-efficacy) before (T0), immediately (T1) and 2 weeks after (T2) use of the decision aid. Pilot testing indicated decreased decisional conflict scores, increased knowledge, and improved realistic expectations regarding the reproductive options, at T1 and T2. No effect was found for couples’ decision self-efficacy. The positive findings during usability testing were thus reflected in the pilot study. The decision aid will be further evaluated in a nationwide pretest–posttest study to facilitate implementation in the onco-genetic counselling setting. Ultimately, it is expected that the decision aid will enable end-users to make an informed decision

Phenotypic and molecular insights into CASK-related disorders in males

Background: Heterozygous loss-of-function mutations in the X-linked CASK gene cause progressive microcephaly with pontine and cerebellar hypoplasia (MICPCH) and severe intellectual disability (ID) in females. Different CASK mutations have also been reported in males. The associated phenotypes range from nonsyndromic ID to Ohtahara syndrome with cerebellar hypoplasia. However, the phenotypic spectrum in males has not been systematically evaluated to date. Methods: We identified a CASK alteration in 8 novel unrelated male patients by targeted Sanger sequencing, copy number analysis (MLPA and/or FISH) and array CGH. CASK transcripts were investigated by RT-PCR followed by sequencing. Immunoblotting was used to detect CASK protein in patient-derived cells. The clinical phenotype and natural history of the 8 patients and 28 CASK-mutation positive males reported previously were reviewed and correlated with available molecular data. Results: CASK alterations include one nonsense mutation, one 5-bp deletion, one mutation of the start codon, and five partial gene deletions and duplications; seven were de novo, including three somatic mosaicisms, and one was familial. In three subjects, specific mRNA junction fragments indicated in tandem duplication of CASK exons disrupting the integrity of the gene. The 5-bp deletion resulted in multiple aberrant CASK mRNAs. In fibroblasts from patients with a CASK loss-of-function mutation, no CASK protein could be detected. Individuals who are mosaic for a severe CASK mutation or carry a hypomorphic mutation still showed detectable amount of protein. Conclusions: Based on eight novel patients and all CASK-mutation positive males reported previously three phenotypic groups can be distinguished that represent a clinical continuum: (i) MICPCH with severe epileptic encephalopathy caused by hemizygous loss-of-function mutations, (ii) MICPCH associated with inactivating alterations in the mosaic state or a partly penetrant mutation, and (iii) syndromic/nonsyndromic mild to severe ID with or without nystagmus caused by CASK missense and splice mutations that leave the CASK protein intact but likely alter its function or reduce the amount of normal protein. Our findings facilitate focused testing of the CASK gene and interpreting sequence variants identified by next-generation sequencing in cases with a phenotype resembling either of the three groups

A systematic review of dietary, nutritional, and physical activity interventions for the prevention of prostate cancer progression and mortality

PURPOSE: Given the long-term, although potentially fatal, nature of prostate cancer, there is increasing observational evidence for the reduction in disease progression and mortality through changes in lifestyle factors. METHODS: We systematically reviewed dietary, nutritional, and physical activity randomized interventions aimed at modifying prostate cancer progression and disease-specific mortality, including a detailed assessment of risk of bias and methodological quality. RESULTS: Forty-four randomized controlled trials of lifestyle interventions, with prostate cancer progression or mortality outcomes, were identified. Substantial heterogeneity of the data prevented a meta-analysis. The included trials involved 3,418 prostate cancer patients, median 64 men per trial, from 13 countries. A trial of a nutritional supplement of pomegranate seed, green tea, broccoli, and turmeric; a trial comparing flaxseed, low-fat diet, flaxseed, and low-fat diet versus usual diet; and a trial supplementing soy, lycopene, selenium, and coenzyme Q10, all demonstrated beneficial effects. These trials were also assessed as having low risk of bias and high methodological quality (as were seven other trials with no evidence of benefit). The remaining trials were either underpowered, at high or unclear risk of bias, inadequately reported, of short duration or measured surrogate outcomes of unproven relationship to mortality or disease progression, which precluded any benefits reported being reliable. CONCLUSION: Large, well-designed randomized trials with clinical endpoints are recommended for lifestyle modification interventions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10552-015-0659-4) contains supplementary material, which is available to authorized users

Biological and clinical abnormalities leading to cardiovascular disease during antiretroviral treatment in a university hospital in Abidjan

Antiretroviral drugs are involved in the occurrence of adverse effects. In Côte d'Ivoire, HIV1 treatment protocols are non-nucleoside reverse transcriptase inhibitors based. No study has been undertaken in the country about cardiovascular risk. Thus, the objective of our study was to assess the prevalence of biological abnormalities and clinical markers of cardiovascular risk during antiretroviral therapy. We conducted a prospective cross-sectional study with 238 patients who were on antiretroviral treatment including nonnucleoside reverse transcriptase inhibitors for at least 6 months in the Pneumophtisiology department of the university hospital of Cocody (Abidjan). Metabolic syndrome was determined according to NCEP-ATP III criteria. Biological parameters investigated were: triglyceride, HDL cholesterol and LDL, glucose and clinical parameters: blood pressure and waist circumference. Eleven patients (4.62%) have a metabolic syndrome, 17.6% had hypertriglyceridemia. An increase in LDL cholesterol and lower HDL-cholesterol were found in both cases in 13.9% of patients and an atherogenic index greater than 4.5 in 5% of patients. Hyperglycemia occurred during antiretroviral therapy in 28% of the study population. Patients who developed hypertension and increased waist circumference during antiretroviral therapy were 9.75% and 15.5% respectively. Our results testify to the potential existence of a cardiovascular risk during the non-nucleoside inhibitor used.© 2015 International Formulae Group. All rights reserved.Keywords: Antiretrovirals, biological, clinical abnormalities, cardiovascular risk

Pleidooi voor een Wet toezicht kwaliteit zorgsector

__Abstract__ De afgelopen jaren zijn verschillende malen voorstellen gedaan om een algemene Toezichtwet op het terrein van de zorg te maken. Deze voorstellen behelsden vaak niet meer dan een globaal idee. Tot nu toe is nimmer onderzoek verricht naar de mogelijke opzet en meerwaarde van een dergelijke Toezichtwet. In het kader van de onlangs door ons afgeronde thematische wetsevaluatie bestuursrechtelijk toezicht op de kwaliteit van zorg1 kwam dit onderwerp nadrukkelijk bovendrijven. Een van de conclusies van deze evaluatie is dat er goede gronden zijn voor de realisatie van een integrale Toezichtwet. Daarbij gaat het in het bijzonder over de positie van de ‘leidende’ toezichthouder op het gebied van de kwaliteit van zorg, de Inspectie voor de Gezondheidszorg (IGZ). In deze bijdrage werken wij dit nader uit. In de eerste plaats gaan wij in op de lacunes in de huidige toezichtwetgeving op het gebied van de kwaliteit van zorg. Daarna besteden wij aandacht aan eerdere discussies met betrekking tot een Toezichtwet in de zorg. Vervolgens maken wij een uitstapje naar een integrale toezichtwet in een andere maatschappelijke sector, namelijk het onderwijs. Dit alles mondt uit in een pleidooi voor een nieuwe Wet toezicht kwaliteit zorgsector en in een hoofdlijnenschets van deze wet

This Other Eden: Exploring a Sense of Place in Twentieth-Century Reconstructions of Australian Childhoods

This thesis explores the sense of place formed during childhood, as remembered by adult Australians who reconstruct their youth through various forms of life writing. While Australian writers do utilize traditional tropes of Western autobiography, such as the mythology of Eden and the Wordsworthian image of the child communing with Nature, these themes are frequently transformed to meet a uniquely Australian context. Isolation and distance from Europe, and the apparent indifference of our landscape towards white settlement, have received much critical attention in Australian studies generally and, indeed, broadly influence the formation of children’s sense of place across the continent. However, writers are also concerned with the role of place on a more local level. Through a comparison of writing from Western Australia, Queensland and Victoria, this thesis explores regional landscape preoccupations that create an awareness of local identity, variously contributing to or frustrating the child’s sense of belonging. Western Australian writing is dominated by images of isolation, the fragility of white settlement in a dry land lacking fresh water, and a pervasive beach culture. A strong sense of the littoral pervades writing from this region. Queensland’s frontier mythology is of a different flavour: warm and tropical, nature here is exuberant, constantly threatening to overwhelm culture, already perceived as transient due to the flimsy aspect of the “Queenslander” house. Writing from Victoria, to some extent, tends to more closely follow English models, juxtaposing country and city environments, although there is a distinctly local flavour to many representations of urban Melbourne and its flat, grid-like organization. As Australian society becomes more concentrated on the coastal fringe, the beach is an increasingly significant environment. Though more prominent in writing from some regions than others, coastal imagery broadly reflects the modern Australian’s sense of inhabiting a liminal zone with negotiable boundaries