A controlled study of hand function in nodal and erosive osteoarthritis.

Hand function using a standardised test of activities of daily living was assessed in (a) 57 patients (53 female, four male; mean age 69 years) with established (that is, symptom onset greater than 10 years before) nodal generalised osteoarthritis (NGOA); (b) 10 patients (nine female, one male; mean age 70 years) with established erosive osteoarthritis (EOA); and (c) 52 matched controls (48 female, four male; mean age 71 years) with asymptomatic, clinically normal hands. Although significant differences between controls and patient groups were observed for individual tasks, only minor global impairment was seen, the worst function occurring in patients with EOA. There was no consistent correlation between tested aspects of hand function and extent of radiographic change assessed by summated graded score for separate osteoarthritic features in individual joints. In controls increasing age correlated with longer time to complete all tasks and weaker power grip; a similar, less pronounced correlation occurred in patients. Differences between controls and patients with NGOA were most apparent in younger subjects; in the elderly (greater than 80 years) hand function was essentially the same. This study shows good functional outcome for patients with NGOA, and suggests that the OA process is of little functional importance to the aging hand

Approach to management of the Mokau coal resource

The Mokau Coalfield, North Taranaki, New Zealand contains about 73 million tonnes of mineable coal which may be required to fire a 1000 MW thermal power station. Planning for development of the coalfield is at an early stage and current investigations are oriented towards coal resource measurement and infrastructure requirements. The predominantly rural environment of the Mokau Coalfield region will suffer a number of impacts if coal development is to proceed at the proposed scale. Early recognition of these impacts, together with recognition of possible constraints on development, is desirable so that development planning may maximise environmental benefits. Traditionally coal development does not incorporate environmental information until the late feasibility stage of planning. It is however desirable to initiate environmental management planning at an early stage of coal resource development planning. Early inclusion of environmental aspects is possible and an approach to environmentally aware management of the Mokau coal resource is illustrated. The approach relies on development of a materials balance for both mining and use sectors of the development. The materials balance details inputs to the development (i.e. resource requirements) and identifies all outputs as primary product, increased inventory or residuals. A planning framework is described whereby environmental factors are incorporated into mainstream planning at the pre-feasibility stage. A number of potential impacts and constraints are identified in this largely indicative study. Before all impacts and constraints can be identified a more detailed study, using the methods developed here, is warranted

Performance versus values in sustainability transformation of food systems

Questions have been raised on what role the knowledge provided by sustainability science actually plays in the transition to sustainability and what role it may play in the future. In this paper we investigate different approaches to sustainability transformation of food systems by analyzing the rationale behind transformative acts-the ground that the direct agents of change act upon- and how the type of rationale is connected to the role of research and how the agents of change are involved. To do this we employ Max Weber’s distinction between instrumental rationality and value-rationality in social action. In particular, we compare two different approaches to the role of research in sustainability transformation: (1) Performance-based approaches that measure performance and set up sustainability indicator targets and benchmarks to motivate the agents in the food system to change; (2) Values-based approaches that aim at communicating and mediating sustainability values to enable coordinated and cooperative action to transform the food system. We identify their respective strengths and weaknesses based on a cross-case analysis of four cases, and propose that the two approaches, like Weber’s two types of rationality, are complementary-because they are based on complementary observer stances—and that an optimal in-between approach therefore cannot be found. However, there are options for reflexive learning by observing one perspective-and its possible blind spots-from the vantage point of the other, so we suggest that new strategies for sustainability transformation can be found based on reflexive rationality as a third and distinct type of rationalit