Search

Agroforestry is known to have multiple economic and environmental benefits. Despite this, the adoption of agroforestry in Viet Nam is limited both in extent and diversity of components and practices. Our study identified gaps for agroforestry adoption in current policies and policy implementation. National policy and provincial instructions and decisions were reviewed and discussed during ten stakeholders’ consultation workshops. The review and workshops concluded that there were no specific national and few provincial specific policies promoting agroforestry. In addition, the segregation of policies into agriculture and forestry, promoted monoculture practices and discouraged the integration of mixed annual and perennial tree species. Completing the forestland allocation process was considered essential for long-term investment on land and providing collateral for loans. More holistic policies, such as a provincial strategy for agroforestry development that would enable flexible integration of agriculture, forestry and livestock were perceived to be more effective and inclusive to poor and non-poor farmers. Specific cross-cutting budget allocation would be necessary for capacity building, upscaling agroforestry models, procurement of high-quality inputs, and establishing post-harvest processing and marketing investments.

Background Medical training traditionally focuses on disease diagnosis and management. The need to incorporate preventive medicine, economics, and health promotion is increasingly apparent. Because problem-based learning (PBL) encourages multidisciplinary thinking, it is ideal for linking traditional medical education and population-oriented training. Although use of PBL has grown in medical education, cases typically focus upon patho-physiology, diagnosis, and therapy of individuals. Even when cases are intended to integrate multidisciplinary topics such as behavioral sciences or prevention, the biological aspects are emphasized. Purpose To describe approaches to case design that emphasize population perspectives of health. Description Specific examples drawn from actual cases we have used illustrate how five basic components of a case--namely, title, context, intrigue, indicators of problem resolution, and tight structure--facilitate discussion of, and enhance concern for, population issues. Conclusion The literature indicates that health professional students tend to favor biological over population content in clinical cases. We illustrate how population content can be represented in specifically designed cases.

To outline current practice regarding the prehospital use of subcutaneous epinephrine, and systematically review the existing literature to determine the level of support for its use in the elderly. Many health care personnel are reluctant to administer subcutaneous epinephrine for potentially life-threatening conditions such as asthma and anaphylaxis in older patients. This sytematic review examined the following focused question: "For older patients not known to have coronary artery disease, does administration of subcutaneous epinephrine carry a significant enough risk of cardiovascular side effects to mandate age as a relative contraindication to self-administration or emergency medical services administration in the prehospital setting?"The MEDLINE and Health Star databases were searched to identify studies evaluating the use of subcutaneous epinephrine in the treatment of asthma and anaphylaxis. Bibliographies from included studies, known reviews, and textbooks were examined to identify additional studies. The strength of evidence presented in each study was assessed in accordance with the classification system proposed by the American Heart Association's Emergency Cardiovascular Care Committee.The review of the literature revealed only three case reports (level VII evidence) that record adverse reactions of epinephrine when used for anaphylaxis and allergy, while several level III and V studies found no adverse effects when used for asthma. No controlled trials documenting adverse effects were found.The authors did not find significant evidence to contraindicate the use of subcutaneous epinephrine in older patients who are not known to have coronary artery disease, who present with either asthma or allergic reactions.

Plasma transthyretin (TTR, formerly called prealbumin) is a 55-kd protein that participates in the plasma transport of both thyroxine and retinol (vitamin A). TTR concentrations are disproportionately high in human ventricular CSF, suggesting that TTR is either selectively transported across or synthesized de novo within the blood-CSF barrier. To address this question, we adopted a molecular genetic approach; after isolating a cDNA clone encoding human TTR, we previously demonstrated specific TTR messenger RNA (mRNA) synthesis in rat choroid plexus. We have now extended these investigations to the human brain. Northern analysis of postmortem brain homogenates revealed abundant TTR mRNA in choroid plexus, but not in cerebellum or cerebral cortex. Choroid plexus mRNA was readily translated into TTR preprotein in an in vitro translation system. An immunocytochemical survey of human postmortem brain sections revealed the presence of TTR protein specifically and uniquely in the cytoplasm of choroid plexus epithelial cells; these results were corroborated at the mRNA level by an extensive survey of whole rat-brain sections by in situ hybridization. Therefore, within the mammalian CNS, TTR is the first known protein synthesized solely by the choroid plexus, suggesting a special role for TTR in the brain or CSF. Whether this function differs from its established plasma transport functions is presently unknown.