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Rumination syndrome involves bringing up partially digested food into the pharynx voluntarily, followed by reswallowing or expelling. It was discovered in the 17th century; however, knowledge of the disorder has remained sparse until recently. Indeed, the first case of adult rumination in Japan was reported as recently as 2006. Due to this recent increase in awareness, notions about the disease have remained in a state of constant fluctuation. While first believed to be a disease of neurologically-impaired children between 3 and 8 months of age, it is now widely recognized as occurring in men and women of all ages and cognitive abilities. Originally rumination was labeled benign; however, it is now known to cause such complications as weight loss, malnutrition, dental erosions, halitosis, electrolyte abnormalities, abdominal discomfort, weight loss, choking, aspiration, and pneumonia. Similarly, while the absence of gastroesophageal reflux disease was an original criterion for the syndrome, it has been found that many of these patients have evidence of “pathologic gastroesophageal reflux.” Some suggest that thorough upper gastrointestinal workup, such as upper esophageal barium studies and EGD, not be done on children presenting with rumination, despite the presence of abdominal pain or other accompanying gastrointestinal symptoms. We performed a thorough upper gastrointestinal workup on a patient with concurrent rumination syndrome and heartburn, and were intrigued to find erosive eosinophilic esophagitis on EGD. These lesions were successfully treated with a proton pump inhibitor. The following article is a discussion on the starndard of care in Rumination Syndrome. That is, while knowledge of the disease has evolved, the treatment regimen has not.

The research results provide a snapshot of civil society networks in Malawi today, whilst highlighting the critical organisational challenges in 2006. The project did not aim for nor did it achieve an exhaustive impact assessment of all civil society networks in the country. Interviews focussed on three networks: Malawi Economic Justice Network (MEJN), Land Task Force (LTF) and Civil Society Coalition on Basic Quality Education (CSCQBE). The findings therefore directly relate to thesethree networks; although they have resonance with other civil society networks in Malawi and globally.The main elements of the research methodology included: Literature review to provide an overview of current thinking (see references);Semi-structured interviews with up to 25 stakeholders for Malawi Economic Justice Network (MEJN), Civil Society Coalition for Quality Basic Education (CSCQBE), Land Task Force (LTF), other CSO networks, donors, and government;Analysis of consultancy work with MEJN and Civil Society Agriculture Network (CISANET);Analysis and write up;Publication and dissemination.The paper will briefly discuss the development impact of the CSOs before proceeding to discuss the critical organisational capacity issues facing the networks.

This major catalogue for an exhibition composed of approximately ninety works by forty-one contemporary artists from British Columbia, contains essays by each member of the three person curatorial team. Arnold situates "Topographies..." within the context of other large-scale exhibitions organized by the Vancouver Art Gallery, drawing attention to themes addressed within the works he selected (themes considered include: counter-history, the destabilization of painting, and relations between the body/subjectivity). Gagnon's descriptive analysis of works she selected focuses on how the subjects of travel narrative, cultural migration, nature and landscape relate to the notions of "home" and "transitional space". Jensen's interpretation of the carvings and weavings by First Nations artists is centered on how the concept of metamorphosis relates to time, space, place and being. The destruction of the forest in building Vancouver, and distinctions between culture/environment and art/craft are also discussed. Includes artists' statements. Bibliography. List of works. Biographical notes. Circa 76 bibl. ref.