Ancestors of Governmentality: Accounting and Pastoral Power in the 15th century

Foucault identified the roots of governmentality in religious beliefs and religious history with its genealogical core the equivalent of pastoral power, the art of governing people by relying on a dualistic logic; individualization and totalization. This technology of power arose and matured within the Roman Catholic Church and provided a model for many states in the achievement and exercise of power. Informed by the work of Foucault on pastoral power the present work examines the genealogical core of governmentality in the context of the Roman Catholic Church at a time of great crisis in the 15th century when the Roman Catholic Church was undergoing reform instituted by Pope Eugenius IV (1431–1447). The contributions of accounting to pastoral power are shown in this study to have been pivotal in restoring the Church's standing and influence. Accounting was one of the technologies that allowed the bishops to control both the diocese as a whole and each priest, to subjugate the priests to the bishops’ authority and, thereby, to govern the diocese through a never-ending extraction of truth

Can programme theory be used as a 'translational tool’ to optimise health service delivery in a national early years’ initiative in Scotland: a case study

Background Theory-based evaluation (TBE) approaches are heralded as supporting formative evaluation by facilitating increased use of evaluative findings to guide programme improvement. It is essential that learning from programme implementation is better used to improve delivery and to inform other initiatives, if interventions are to be as effective as they have the potential to be. Nonetheless, few studies describe formative feedback methods, or report direct instrumental use of findings resulting from TBE. This paper uses the case of Scotland’s, National Health Service, early years’, oral health improvement initiative (Childsmile) to describe the use of TBE as a framework for providing feedback on delivery to programme staff and to assess its impact on programmatic action.<p></p> Methods In-depth, semi-structured interviews and focus groups with key stakeholders explored perceived deviations between the Childsmile programme 'as delivered’ and its Programme Theory (PT). The data was thematically analysed using constant comparative methods. Findings were shared with key programme stakeholders and discussions around likely impact and necessary actions were facilitated by the authors. Documentary review and ongoing observations of programme meetings were undertaken to assess the extent to which learning was acted upon.<p></p> Results On the whole, the activities documented in Childsmile’s PT were implemented as intended. This paper purposefully focuses on those activities where variation in delivery was evident. Differences resulted from the stage of roll-out reached and the flexibility given to individual NHS boards to tailor local implementation. Some adaptations were thought to have diverged from the central features of Childsmile’s PT, to the extent that there was a risk to achieving outcomes. The methods employed prompted national service improvement action, and proposals for local action by individual NHS boards to address this.<p></p> Conclusions The TBE approach provided a platform, to direct attention to areas of risk within a national health initiative, and to agree which intervention components were 'core’ to its hypothesised success. The study demonstrates that PT can be used as a 'translational tool’ to facilitate instrumental use of evaluative findings to optimise implementation within a complex health improvement programme.<p></p&gt

Insulin detemir: A new option for the treatment of diabetes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73570/1/j.1745-7599.2007.00258.x.pd

Farmer perceptions and responses to soil degradation in Swaziland

Soil degradation is globally concerning due to its adverse effects on the environment and agricultural production. Much of Swaziland is at risk from degradation. This paper assesses farmer perceptions and responses to soil degradation in 2002 and 2014, focusing on two land uses that underpin rural livelihoods: arable land and rangeland areas. It uses repeat household surveys and semi-structured interviews, in two case study chiefdoms in the country’s middleveld (KaBhudla and Engcayini) in the first longitudinal study of its kind. We find that observations of land degradation are perceived mainly through changes in land productivity, with chemical degradation occurring predominantly on arable land and physical degradation and erosion mainly in rangeland areas. Changes in rainfall are particularly important in determining responses. While perceptions of the causes and impacts of degradation largely concur with the scientific literature, responses were constrained by poor land availability, shorter and more unpredictable cropping seasons because of changing rains and low awareness, access to or knowledge of agricultural inputs. We suggest that sustainable arable land management can be enhanced through improved access to alternative sources of water, use of management practices that retain soil and moisture and greater access to agricultural inputs and capacity building to ensure their appropriate use. We suggest collaborative management for settlement planning that integrates soil conservation and livestock management strategies such as controlled stocking levels and rotational grazing could improve land quality in rangeland areas. Together, these approaches can help land users to better manage change

Consensus on the development of vaccines against naturally acquired melioidosis.

Several candidates for a vaccine against Burkholderia pseudomallei, the causal bacterium of melioidosis, have been developed, and a rational approach is now needed to select and advance candidates for testing in relevant nonhuman primate models and in human clinical trials. Development of such a vaccine was the topic of a meeting in the United Kingdom in March 2014 attended by international candidate vaccine developers, researchers, and government health officials. The focus of the meeting was advancement of vaccines for prevention of natural infection, rather than for protection from the organism's known potential for use as a biological weapon. A direct comparison of candidate vaccines in well-characterized mouse models was proposed. Knowledge gaps requiring further research were identified. Recommendations were made to accelerate the development of an effective vaccine against melioidosis

Patient empowerment: the LIFE approach

In spite of the great strides that have been made in the treatment of diabetes, many patients do not achieve optimal outcomes. In an effort to address the gap between the promise and the reality of diabetes care, empowerment has been recognised as an effective patient-centred approach to diabetes care and education. A great deal of effort has been spent training healthcare professionals and developing patient education strategies within this framework. However, less effort has been spent helping patients to learn the lessons and acquire the skills needed to collaborate in the design of a workable diabetes care plan. This article outlines four fundamental lessons that need to be addressed as part of patient education and provides a simple approach called the LIFE plan to help patients truly take charge of their diabetes. Copyright © 2008 FENDPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60963/1/114_ftp.pd

Healthcare Game Design: Behavioral Modeling of Serious Gaming Design for Children with Chronic Diseases

This article introduces the design principles of serious games for chronic patients based on behavioral models. First, key features of the targeted chronic condition (Diabetes) are explained. Then, the role of psychological behavioral models in the management of chronic conditions is covered. After a short review of the existing health focused games, two recent health games that are developed based on behavioral models are overviewed in more detail. Furthermore, design principles and usability issues regarding the creation of these health games are discussed. Finally, the authors conclude that designing healthcare games based on behavioral models can increase the usability of the game in order to improve the effectiveness of the game’s desired healthcare outcomes

National Standards for Diabetes Self-Management Education

Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and is necessary in order to improve patient outcomes. The National Standards for DSME are designed to define quality diabetes self-management education and to assist diabetes educators in a variety of settings to provide evidence-based education. Because of the dynamic nature of health care and diabetes-related research, these Standards are reviewed and revised approximately every 5 years by key organizations and federal agencies within the diabetes education community. A Task Force was jointly convened by the American Association of Diabetes Educators and the American Diabetes Association in the summer of 2006. Additional organizations that were represented included the American Dietetic Association, the Veteran's Health Administration, the Centers for Disease Control and Prevention, the Indian Health Service, and the American Pharmaceutical Association. Members of the Task Force included a person with diabetes; several health services researchers/behaviorists, registered nurses, and registered dietitians; and a pharmacist. The Task Force was charged with reviewing the current DSME standards for their appropriateness, relevance, and scientific basis. The Standards were then reviewed and revised based on the available evidence and expert consensus. The committee convened on 31 March 2006 and 9 September 2006, and the Standards were approved 25 March 2007

A HER2 selective theranostic agent for surgical resection guidance and photodynamic therapy

In many cancers early intervention involves surgical resection of small localised tumour masses. Inadequate resection leads to recurrence whereas overzealous treatment can lead to organ damage. This work describes production of a HER2 targeting antibody Fab fragment dual conjugated to achieve both real time near-infrared fluorescent imaging and photodynamic therapy. The use of fluorescence emission from a NIR-dye could be used to guide resection of tumour bulk, for example during endoscopic diagnosis for oesophago-gastric adenocarcinoma, this would then be followed by activation of the photodynamic therapeutic agent to destroy untreated localised areas of cancer infiltration and tumour infiltrated lymph nodes. This theranostic agent was prepared from the Fab fragment of trastuzumab initially by functional disulfide re-bridging and site-specific click reaction of a NIR-dye. This was followed by further reaction with a novel pre-activated form of the photosensitiser chlorin e6 with the exposed fragments' lysine residues. Specific binding of the theranostic agent was observed in vitro with a HER2 positive cell line and cellular near-infrared fluorescence was observed with flow cytometry. Specific photo-activity of the conjugates when exposed to laser light was observed with HER2 positive but not HER2 negative cell lines in vitro, this selectivity was not seen with the unconjugated drug. This theranostic agent demonstrates that two different photo-active functions can be coupled to the same antibody fragment with little interference to their independent activities