The impact of type 2 diabetes and Microalbuminuria on future cardiovascular events in patients with clinically manifest vascular disease from the Second Manifestations of ARTerial Disease (SMART) study

Aims Type 2 diabetes mellitus and microalbuminuria are important risk factors for cardiovascular disease (CVD). Whether these two complications are important and independent risk factors for future CVD events in a high-risk population with clinically manifest vascular disease is unknown. The objectives of this study were to examine the impact of Type 2 diabetes and microalbuminuria on future CVD events. Methods Patients with clinically manifest vascular disease (coronary, cerebral and peripheral vascular disease) from the Second Manifestation of Arterial disease study were followed up for 4 years. Data obtained from 1996–2006 were analysed. At baseline, there were 804 patients with Type 2 diabetes mellitus (mean age 60 years) and 2983 patients without. Incident CVD (n = 458) was defined as hospital-verified myocardial infarction, stroke, vascular death and the composite of these vascular events. Results Both Type 2 diabetes [hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.16, 1.75] and microalbuminuria (HR 1.86, 95% CI 1.49, 2.33) increased the risk of new cardiovascular events in univariate analyses. From multivariable models, presence of diabetes remained significantly and independently related to incident CVD (HR 1.42, 95% CI 1.11, 1.80). Presence of microalbuminuria also remained significantly independently related to incident CVD (HR 1.38, 95% CI 1.07, 1.77). In diabetes-stratified analyses, the effect of microalbuminuria on CVD risk was observed only in patients with diabetes. In microalbuminuria-stratified analyses, the significant and independent effect of diabetes on CVD risk was shown only in the non-microalbuminuric group. Conclusions In this high-risk population, both microalbuminuria and Type 2 diabetes are important and independent risk factors for future CV

Embracing complexity in international forest governance: a way forward; Policy Brief

This Policy Brief summarizes the findings of a comprehensive assessment of scientific information about international forest governance carried out by an Expert Panel of over 30 of the world's leading scientists working in the areas of environmental governance and international forest law. It aims to provide policy and decision makers with essential knowledge and building blocks required for a more effective and inclusive governance of the world's forest

Towards durable multistakeholder-generated solutions: The pilot application of a problem-oriented policy learning protocol to legality verification and community rights in Peru

This paper reports and reflects on the pilot application of an 11-step policy learning protocol that was developed by Cashore and Lupberger (2015) based on several years of Cashore’s multi-author collaborations. The protocol was applied for the first time in Peru in 2015 and 2016 by the IUFRO Working Party on Forest Policy Learning Architectures (hereinafter referred to as the project team). The protocol integrates insights from policy learning scholarship (Hall 1993, Sabatier 1999) with Bernstein and Cashore’s (2000, 2012) four pathways of influence framework. The pilot implementation in Peru focused on how global timber legality verification interventions might be harnessed to promote local land rights. Legality verification focuses attention on the checking and auditing of forest management units in order to verify that timber is harvested and traded in compliance with the law. We specifically asked: How can community legal ownership of, and access to, forestland and forest resources be enhanced? The protocol was designed as a dynamic tool, the implementation of which fosters iterative rather than linear processes. It directly integrated two objectives: 1) identifying the causal processes through which global governance initiatives might be harnessed to produce durable results ‘on the ground’; 2) generating insights and strategies in collaboration with relevant stakeholders. This paper reviews and critically evaluates our work in designing and piloting the protocol. We assess what seemed to work well and suggest modifications, including an original diagnostic framework for nurturing durable change. We also assess the implications of the pilot application of the protocol for policy implementation that works to enhance the influence of existing international policy instruments, rather than contributing to fragmentation and incoherence by creating new ones

The Legitimacy of Certification Standards in Climate Change Governance

This article explores the role of two private steering mechanisms, the Forest Stewardship Council (FSC) and the Climate, Community and Biodiversity Alliance (CCBA), in REDD+, the climate change mitigation policy that aims to avoid deforestation and forest degradation in developing countries. It does so by analyzing input and output legitimacy of the two certification standards at the global level, and at national and local levels in Peru. The findings show an increasing interest among REDD+ actors in using these standards, and a relatively large number of Peruvian REDD+ projects that are certified by the FSC or CCBA. The findings also suggest intrinsic linkages between input and output legitimacy of the FSC and CCBA within single governance levels and across different scales. The article also demonstrates the added value of studying the legitimacy of policy instruments, such as the FSC and CCBA, in a specific context such as REDD+. Copyright © 2014 John Wiley & Sons, Ltd and ERP Environmen

Фінанси санаторно-курортних підприємств України

Метою дослідження є аналіз стану санаторно-курортної сфери України як на рівні галузі, так і на рівні окремого санаторно-курортного підприємства

Теоретичні та практичні аспекти приватизації в Україні

Цели статьи заключаются в изучении спроса покупателей на объекты приватизации и анализе финансового состояния предприятий к принятию решения об их приватизации (на основе данных за I квартал 2006 года), раскрытии основных критериев целесообразности принятия решения о приватизации объектов ведения хозяйства.Цілі статті полягають у вивченні попиту покупців на об'єкти приватизації та аналізі фінансового стану підприємств до прийняття рішення про їх приватизацію (на основі даних за I квартал 2006 року), розкритті основних критеріїв доцільності прийняття рішення про приватизацію об'єктів господарювання

Interaction of human heat shock protein 70 with tumor-associated peptides

Molecular chaperones of the heat shock protein 70 (Hsp70) family play a crucial role in the presentation of exogenous antigenic peptides by antigen-presenting cells (APCs). In a combined biochemical and immunological approach, we characterize the biochemical interaction of tumor-associated peptides with human Hsp70 and show that the strength of this interaction determines the efficacy of immunological cross-presentation of the antigenic sequences by APCs. A fluorescein-labeled cytosolic mammalian Hsc70 binding peptide is shown to interact with human Hsp70 molecules with high affinity (K(d)=0.58 mu M at 25 degrees C). Competition experiments demonstrate weaker binding by Hsp70 of antigenic peptides derived from the tumor-associated proteins tyrosinase (K(d)=32 mu M) and melanoma antigen recognized by T cells (MART-1) (K(d)=2.4 mu M). Adding a peptide sequence (pep70) with high Hsp70 binding affinity (K(d)=0.04 mu M) to the tumor-associated peptides enables them to strongly interact with Hsp70. Presentation of tumor-associated peptides by B cells resulting in T cell activation in vitro is enhanced by Hsp70 when the tumor-associated peptides contain the Hsp70 binding sequence. This observation has relevance for vaccine design, as augmented transfer of tumor-associated antigens to APCs is closely linked to the vaccine's efficacy of T cell stimulation