To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Psychiatric hospitalization is a major driver of cost in the treatment of schizophrenia. Here, we asked whether a technology-enhanced approach to relapse prevention could reduce days spent in a hospital after discharge.
The Improving Care and Reducing Cost (ICRC) study was a quasi-experimental clinical trial in outpatients with schizophrenia conducted between 26 February 2013 and 17 April 2015 at 10 different sites in the USA in an outpatient setting. Patients were between 18 and 60 years old with a diagnosis of schizophrenia, schizoaffective disorder, or psychotic disorder not otherwise specified. Patients received usual care or a technology-enhanced relapse prevention program during a 6-month period after discharge. The health technology program included in-person, individualized relapse prevention planning with treatments delivered via smartphones and computers, as well as a web-based prescriber decision support program. The main outcome measure was days spent in a psychiatric hospital during 6 months after discharge.
The study included 462 patients, of which 438 had complete baseline data and were thus used for propensity matching and analysis. Control participants (N = 89; 37 females) were enrolled first and received usual care for relapse prevention followed by 349 participants (128 females) who received technology-enhanced relapse prevention. During 6-month follow-up, 43% of control and 24% of intervention participants were hospitalized (χ2 = 11.76, p<0.001). Days of hospitalization were reduced by 5 days (mean days: b = −4.58, 95% CI −9.03 to −0.13, p = 0.044) in the intervention condition compared to control.
These results suggest that technology-enhanced relapse prevention is an effective and feasible way to reduce rehospitalization days among patients with schizophrenia.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.
Field studies were conducted for 3 yr to evaluate the persistence of metolachlor and alachlor applied to ‘Centennial’ soybean and to determine their residual effect on ‘Mars' rice. At labeled use rates of metolachlor at 2.8 kg ai/ha and alachlor at 3.9 kg ai/ha, soil residue levels in the fall 5 months after application on Crowley and Midland silt loam soils averaged 0.04 and 0.05 ppmw, respectively. Metolachlor fall soil residues averaged 3.5 times higher when applied at 5.6 and 11.2 kg/ha compared to 2.8 kg/ha, but residues for labeled and double rates of alachlor were similar. In the spring 9 months after herbicide application, soil residues averaged over years did not exceed 0.06 ppmw. The 3-yr rice yields were not affected by residual metolachlor or alachlor.
Unresolved land governance questions are at the heart of President Joko Widodo's political agenda. On 14 October 2014, a week before his inauguration, Widodo made a speech touching on several key issues facing Indonesia: reducing greenhouse gas emissions from annual forest fires; resolving a plethora of often violent disputes in the mining and agricultural sectors; and addressing the poverty of farmers eking out an existence on tiny plots of land (Saturi 2014). During his first months in office the president sought to develop infrastructure to promote development and ease land acquisition for investors. Many of these initiatives and policy statements responded to a deeply held desire among Indonesians for an administration that could steward development, pursue social justice and reduce conflict. Such policies depend on addressing land questions, which are central to economic development, social justice and environmental management.
The state needs to recognise and protect the insecure tenurial rights of many Indonesians while finding ways to support forms of development that assist the majority, to deal with proliferating land conflicts, to resolve the property rights question at the heart of Indonesia's unsustainable environmental transition and to provide affordable housing for the poor. In this introductory chapter we discuss these dilemmas in relation to wider international debates about natural resource management, land governance and social justice. For instance, what role might land reform play in poverty alleviation? Can the formalisation of property rights provide a significant means of ensuring development? How might initiatives to recognise customary (adat) tenure protect indigenous landowners? How can more effective land-tenure governance build on existing localised, vernacular forms of tenure? Can securing tenure in forest areas ensure effective carbon sequestration in forests and address deforestation? Do international governance initiatives, such as those that involve greater corporate social responsibility or that seek to ensure free, prior and informed consent (FPIC) in land transactions, provide an effective means of dealing with land grabs?
We find that land issues are becoming ever more urgent as demand for land, pressure for individual title over land and the increasing commercialisation of land, including the large-scale acquisition of land by corporate entities, continue to generate conflict. While the shift to a more democratic and decentralised political system has led to gradual progress, the reform of Indonesia's land tenure regime remains a perpetual work in progress.
Indonesia was founded on the ideal of the 'Sovereignty of the People', which suggests the pre-eminence of people's rights to access, use and control land to support their livelihoods. Yet, many questions remain unresolved. How can the state ensure access_to land for agriculture and housing while also supporting land acquisition for investment in industry and infrastructure? What is to be done about indigenous rights? Do registration and titling provide solutions? Is the land reform agenda - legislated but never implemented - still relevant? How should the land questions affecting Indonesia's disappearing forests be resolved?The contributors to this volume assess progress on these issues through case studies from across the archipelago: from large-scale land acquisitions in Papua, to asset ownership in the villages of Sulawesi and Java, to tenure conflicts associated with the oil palm and mining booms in Kalimantan, Sulawesi and Sumatra. What are the prospects for the 'people's sovereignty' in regard to land?