Books on the topic 'Quality Increasing Process'

Agricultural land and woodland in the vicinity of urban settlements appear increasingly to represent a key element and strategic resource for addressing issues of residential quality, and hence the requalification of the urban construct. In effect, from a "vacuum" awaiting construction, the periurban agricultural territory is emerging as the yardstick for a new measurement and integration of the public policies governing urban and territorial plans and those for rural development. This book proposes a number of cues and methodological and operational elements to stimulate reflection on this new scenario. It does so through the exploration of a number of significant and innovative experiences in Italy and the rest of Europe, while at the same time also proposing an initial appraisal of the process of design and social mobilisation for the definition of the scenario for the Prato Agricultural Park.

The terminal phase is the period of time between living with a reasonable quality of life, and the process of dying. While lung cancer and pulmonary fibrosis have the potential to deteriorate rapidly, the majority of lung diseases worsen over years. Every exacerbation of the condition leads to a decline in both lung function and performance status, and often the pre-exacerbation level of functioning is never regained. There is not a defining point to indicate whether a patient is entering the terminal stages of their illness, but practice shows that the following signs are suggestive: increasing breathlessness and thus becoming increasingly housebound; increasing oxygen requirements; declining pulmonary function test results; increasingly frequent exacerbations requiring hospital admission and/or non-invasive ventilation; developing cor pulmonale; weight loss and difficulty maintaining weight; anxiety and depression; if the death of the patient within the next year would not be a surprise.

This chapter reviews and provides examples of elements and techniques of project management. In the good old days, when conception to completion was a few months, the process of project management was relatively informal. However, with the increasing complexity and cost of projects, many routinely costing millions and some costing billions, the process has become more formalized. This chapter discusses the roles of the client, the sponsor, the leader, the manager and the team member. In addition, the three key parameters of project management, quality, cost and schedule, are defined and discussed. Finally, various project management methodologies and tools, such as work breakdown structures, Gantt charts and milestones, are presented.

Op. 111 marks the culmination of a process across the last three sonatas by which the trill acquires an increasing autonomy from its conventional ornamental function. Among the quartets, it is perhaps only the Grosse Fugue that matches the Arietta’s transformation of the trill. As the fugue subject is fragmented, the trill is cut off from its conventional resolution. Trills then begin to saturate every note in the texture such that their functional potential is entirely eclipsed by their conversion into pure sound. This enjoyment of the trill for its exclusively timbral quality, rather than its capacity to signify harmonic closure, harks back to Beethoven’s idiosyncratic overuse of superfluous ties in the syncopations of the fugal exposition, and in the ...

Advance Care Planning (ACP) is an essential part of quality end of life care in the UK and in most developed countries, enabling more people to live well and die well as they would choose. In the context of the ageing population, with increasing possibilities for medical interventions, ACP is an crucial consideration, with important implications for the individual person and their family and for our wider population. This book takes a comprehensive look at the subject, helps readers explore a wide range of issues and practicalities in providing ACP; frames the purpose, process, and outcomes; provides updates on national and international research, policy, and practice and includes contributions from experts from around the world. Death will affect us all; it is the one certainty in life. Yet the subject of death remains something of a taboo, we rarely discuss what our preferences would be at end of life, what we would want, where we would want to be cared for, not even with loved ones.

Clinical research is heavily regulated and involves coordination of numerous pharmaceutical-related disciplines. Each individual trial involves contractual, regulatory, and ethics approval at each site and in each country. Clinical trials have become so complex and government requirements so stringent that researchers often approach trials too cautiously, convinced that the process is bound to be insurmountably complicated and riddled with roadblocks. A step back is needed, an objective examination of the drug development process as a whole, and recommendations made for streamlining the process at all stages. With Intelligent Drug Development, Michael Tansey systematically addresses the key elements that affect the quality, timeliness, and cost-effectiveness of the drug-development process, and identifies steps that can be adjusted and made more efficient. Tansey uses his own experiences conducting clinical trials to create a guide that provides flexible, adaptable ways of implementing the necessary processes of development. Moreover, the processes described in the book are not dependent either on a particular company structure or on any specific technology; thus, Tansey's approach can be implemented at any company, regardless of size. The book includes specific examples that illustrate some of the ways in which the principles can be applied, as well as suggestions for providing a better context in which the changes can be implemented. The protocols for drug development and clinical research have grown increasingly complex in recent years, making Intelligent Drug Development a needed examination of the pharmaceutical process.

In less than two decades, AIDS has been transformed from a rapidly fatal, untreatable illness to a manageable chronic disease. Early in the AIDS epidemic, HIV care and palliative care were inseparable; over time, these two treatment paradigms diverged. In the developed world, and to a lesser but increasing extent in the developing world, decreasing mortality rates have resulted in growing numbers of HIV-infected patients living with the disease for many years. As this long-surviving population increases, the challenges of chronic disease management, an expanding range of co-morbidities, and a process that has been described as ‘accelerated ageing’, have all emerged to present new needs and opportunities for palliative care expertise. Earlier in the epidemic, palliative care for AIDS focused primarily on end-of-life care and pain and symptom management related to the manifestations of AIDS-specific opportunistic infections and malignancies. Currently, pain and symptoms may be related to these as well as other co-morbid chronic diseases which commonly occur in HIV-infected patients, including cardiovascular, pulmonary, renal, hepatic, metabolic, and neurocognitive complications. Attention to these symptoms, quality of life issues, and psychosocial problems in long-surviving patients over many years will be increasingly important to support engagement with care and effective adherence with antiretroviral therapy over time. End-of-life care, while less frequent, also remains important, as patients may still die from AIDS, or even more commonly, from end-organ failure, non-AIDS defining malignancies, and/or other complications of ageing and chronic co-morbid disease. All these converging factors have now resulted in a new need for the re-integration of HIV care and palliative care, both to help HIV-infected patients live better and longer, as well as manage late-stage and end-of-life issues when they emerge.

Countries that have made the most progress toward universal coverage have public expenditures in health equivalent to at least 6% of their gross domestic product (GDP), which is the percentage established in PAHO’s universal health strategy as the benchmark for the countries. However, while higher expenditure is a prerequisite, it is not enough to combat inequities and advance toward universal health. In addition to greater resources, the quality of the expenditure must be improved, reducing health system inefficiencies. Moreover, public expenditure in health should be sustainably increased in a fiscally responsible manner. The concept of fiscal space for health refers to the ability of governments to provide additional budgetary resources for the health system without affecting the financial position of the public sector or supplanting other socially necessary expenditures. Any analysis of fiscal space, therefore, will attempt to identify the prospects for increasing health expenditure in the short and medium term to address a series of clearly established health needs. These efforts are under way at a critical time in the Region of the Americas, particularly in the countries of Latin America and the Caribbean, which are engaged in a singular health system reform process. For the first time in history, these countries have formalized their intention of increasing public expenditure in health, putting themselves firmly on the path to real and effective access to health care through the universal health strategy. Without achieving basic well-being at this level, it will be impossible to improve social cohesion and social development in the countries of the Region. This publication brings together and summarizes PAHO’s studies on fiscal space for universal health in the Americas and draws on the contributions of the regional forum held in Washington, D.C. on 7-8 December 2015. With this publication, whose target audience is the technical personnel responsible for policy development, decision-makers, and authorities, PAHO hopes to contribute to the analysis and discussion of health financing policies on the path toward universal health.

There are many risks associated with incarceration, and a substantial one is suicide. Virtually every completed suicide generates litigation. Prevalence, demographics, trends, screening and assessment of suicide risk, and recognition of the key factors associated with increased risk and managing that risk safely and appropriately in jails is presented. The factors relating to increasing suicide risk in prisons are often quite distinct from other correctional settings. Issues such as restrictive housing, facility transfers, loss of community social supports, and chronic management all play potential roles. Proactive recognition of such concerns and active management is critical to effective risk reduction. This chapter discusses such factors in the context of changing prison dynamics and trends. Following completed suicides, a formal protocol is often followed to assist staff in understanding the events that led to the suicide and specifically intervening to address staff feelings that follow such a trauma. Such a process assists quality improvement initiatives, whether in the form of a root cause analysis or other format. Best practice approaches to post-mortem review and staff intervention/ support have been developed and are in use in many facilities. Working to eliminate or reduce the frequency of suicide attempts absolutely requires a staff culture committed to continued learning and improving of both knowledge and skills. This chapter presents a review of the current standards of suicide risk reduction training.

There are many risks associated with incarceration, and a substantial one is suicide. Virtually every completed suicide generates litigation. Prevalence, demographics, trends, screening and assessment of suicide risk, and recognition of the key factors associated with increased risk and managing that risk safely and appropriately in jails is presented. The factors relating to increasing suicide risk in prisons are often quite distinct from other correctional settings. Issues such as restrictive housing, facility transfers, loss of community social supports, and chronic management all play potential roles. Proactive recognition of such concerns and active management is critical to effective risk reduction. This chapter discusses such factors in the context of changing prison dynamics and trends. Following completed suicides, a formal protocol is often followed to assist staff in understanding the events that led to the suicide and specifically intervening to address staff feelings that follow such a trauma. Such a process assists quality improvement initiatives, whether in the form of a root cause analysis or other format. Best practice approaches to post-mortem review and staff intervention/ support have been developed and are in use in many facilities. Working to eliminate or reduce the frequency of suicide attempts absolutely requires a staff culture committed to continued learning and improving of both knowledge and skills. This chapter presents a review of the current standards of suicide risk reduction training.

Human activities associated with environmental degradation are threatening urban and rural water supplies throughout the world. Although water quality in the United States surpasses that in most of the world, increasing challenges from an aging infrastructure, poorly controlled disposal of pharmaceuticals, household chemical products, and biologically active industrial chemicals are causing widespread degradation. Toxicology studies have highlighted the role of chronic, low-level chemical exposures of children in the development of disease later in life and demonstrated the chemicals’ epigenetic effects. Despite billions of dollars spent annually to purify diminishing water resources, most purified water is used for waste disposal a for agricultural and industrial processes that do not necessarily require good-quality water. Chapter 5 addresses some of the current threats to water supplies and proposes approaches to increase awareness and provide solutions for the protection of human and environmental health.

Although palliative and hospice care services are increasingly available, many adults and children still die without this kind of support or receive it only in the last few days of life, as many patients, family members, and clinicians equate the initiation of these services with loss of hope. This chapter presents a model of how hopeful patterns of thinking and a balance of positive and negative affect may facilitate a regoaling process in which individuals transition from cure-seeking goals to other personally meaningful goals that are attainable at the end of life or while living with a serious chronic illness. Understanding different forms of hopeful thinking, goals, and self-concepts among dying patients and their families can help clinicians provide support through this difficult experience and achieve better quality of life and symptom management for patients and better quality of life and long-term adjustment for family members.

This handbook is currently in development, with individual articles publishing online in advance of print publication. At this time, we cannot add information about unpublished articles in this handbook, however the table of contents will continue to grow as additional articles pass through the review process and are added to the site. Please note that the online publication date for this handbook is the date that the first article in the title was published online. For more information, please read the site FAQs. In order to make quality strategic decisions, managers need a deep understanding of industry dynamics and enterprise capabilities. In this book, we present a conceptual framework that will help executives lead their organizations in highly competitive global markets. For some, it will change frames of reference and accepted priorities in terms of what’s important for the enterprise to build, own, and manage. Management theory is young and fragmented, and generally not much of a guide for executives, except around certain narrow issues. The framework presented in this volume can be helpful with the big-picture issues. To be useful, a theoretical framework must be flexible enough to provide guidance in a variety of situations. However, the theory must not be so general that it fails to speak to practical management problems. Another useful attribute is parsimony, so that an overwhelming number of variables don’t render analysis an impossible task. This book includes a number of essays about the Dynamic Capabilities Framework (Teece et al., 1990, 1997; Teece, 2007), which increasingly provides an intellectual infrastructure for both theoretical and applied analyses of strategic management and other issues facing business decision makers. Since 2006, articles concerning dynamic capabilities have been published in business and management journals at a rate of more than 100 per year (Di Stefano et al., 2010). And an increasing number of these articles contain new empirical research validating the Dynamic Capabilities approach to competitive advantage. A broad panoply of scholars and executives are contributing to the further development of this framework. This book summarizes and integrates many of these contributions, and this introduction will introduce some of the major themes of the chapters that follow.

Compassion meditation is a form of mental training that cultivates compassion towards oneself and other people, and is thought to result in greater prosocial behavior in real-world settings. This framework views compassion as a quality that can be trained, rather than a stable trait, and scientists have started testing these hypotheses using neuroscientific and objective behavioral methods. How does this internal meditative practice translate to external behavioral changes? We propose an emotion-regulation model of compassion meditation, where responses to suffering may change through three processes: (1) increasing empathic responses, (2) decreasing avoidance responses, and (3) increasing compassionate responses to suffering. These altered responses to suffering may lead to behavioral transfer, where prosocial behavior is more likely to occur, even in a non-meditative state. We summarize the neuroscientific and behavioral literature that may provide early support for this model, and make recommendations for future research to further test the model.

As we have seen, numerous analysis and modeling tools that take into account the natural complexity of systems and dissemination and implementation processes are available, and the use of them is increasing over time. This chapter summarizes the characteristics, potential insights, and limitations of each modeling approach. It is important to note that modeling from a systems perspective, like all modeling approaches, requires assumptions about variables to include (or exclude), and hypothesized relationships dictate the quality of the model and the utility of the results. As such, using theory and empirical data to inform model design is paramount. Systems thinking and methods remain underutilized in dissemination and implementation despite demonstrations of the utility of incorporating systems thinking and methods into dissemination and implementation studies.

With recent developments in the classification and definitions for HIV-associated neurocognitive disorders (HAND), neuropsychological assessments have become central to the diagnostic process. The pattern and manifestation of neurocognitive dysfunction associated with HIV have changed since the introduction of effective antiretroviral medications and their increasingly widespread use. Prior to the introduction of antiretroviral therapy, severe cognitive disorder presenting as HIV-associated dementia (HAD) was a common manifestation of HIV-associated neurocognitive disorders. In more recent times, however, milder forms of neurocognitive impairment have become more common, often being asymptomatic and difficult to recognize without formal neuropsychological testing. Hence, recognizing individuals at most risk for cognitive decline through neuropsychological testing will offer opportunities for developing targeted interventions that could delay disease progression and improve individual functioning and quality of life.

Although contemporary migration in and from Africa can be understood as a continuation of earlier forms of interregional and international migration, current processes of migration seem to have taken on a new quality. This volume argues that one of the main reasons for this is the fact that local worlds are increasingly measured against a set of possibilities whose referents are global, not local. Due to this globalization of the personal and societal horizons of possibilities in Africa and elsewhere, in many contexts migration gains an almost inevitable attraction while, at the same time, actual migration becomes increasingly restricted. Based on detailed ethnographic accounts, the contributors to this volume focus on the imaginations, expectations, and motivations that propel the pursuit of migration. Decentring the focus of much of migration studies on the ‘receiving societies', the volume foregrounds the subjective aspect of migration and explores the impact which the imagination and practice of migration have on the sociocultural conditions of the various local settings concerned.

There are significant variations in how healthcare systems and health professionals are regulated globally. One feature that they increasingly have in common is an emphasis on the value of including members of the public in quality assurance processes. While many argue that this will help better serve the public interest, others question how far the changing regulatory reform agenda is still dominated by medical interests. Bringing together leading academics worldwide, this collection compares and critically examines the ways in which different countries are regulating healthcare in general, and health professions in particular, in the interest of users and the wider public. It is the first book in the Sociology of Health Professions series.

Chapter 8 concludes with both a summary and an analysis of some of the institutions and events surrounding the American art market—investment, auction estimates, artistic productivity, theft, and bubbles. The peculiar aspects of American art seen through a major market conduit for buying and selling art—the auction—are the basis of understanding the unique quality of American art. This art has been “commoditized” as investors increasingly perceive the return possibilities. Additionally, the American art market has never been more vibrant at any time in history. Technology, particularly the Internet, has become a part of the economic process through which buyers and sellers are brought together. Whether giant Coca-Cola bottles, balloon dogs, or all-white paintings are art or not is irrelevant to the economist. These items are bought and sold as art, and a free and open market must include winners and losers.

This chapter studies the transformation of the authority of the European Court of Human Rights (ECtHR) since its genesis. It shows how the ECtHR, until the mid-to-late 1970s, struggled to maintain narrow legal authority. Both the Court’s caseload and civil society engagement changed fundamentally however throughout the late 1980s and the 1990s when the ECtHR gained intermediate and extensive authority in large parts of Europe. During this period, the Court became the de facto Supreme Court of human rights in Europe. Starting around 2000, the Court became increasingly overburdened. It was in the context that a number of member states launched a systematic critique of both the Court’s power over national law and politics and the quality of the Court’s judges and their judgments. This discontent climaxed with the 2012 Brighton Declaration, adopted by all forty-seven member states, which began an institutionalized process that aimed to limit the ECtHR’s power.

In his philosophical writings, Coleridge increasingly developed his thinking about imagination, a symbolizing precursor to contemplation, to a theory of contemplation itself, which for him occurs in its purest form as a manifestation of ‘Reason’. Coleridge is a particularly challenging figure because he was a thinker in process, and something of an omnimath, a Renaissance man of the Romantic era. The dynamic quality of his thinking, the ‘dark fluxion’ pursued but ultimately ‘unfixable by thought’, and his extensive range of interests make essential an approach that is philosophical yet also multi-disciplinary. This is the first collection of essays to be written mainly by philosophers and intellectual historians on a wide range of Coleridge’s philosophical writings. With a foreword by Baroness Mary Warnock, and original essays on Coleridge and Contemplation by prominent philosophers such as Sir Roger Scruton, David E. Cooper, Michael McGhee, and Andy Hamilton, this volume provides a stimulating collection of insights and explorations into what Britain’s foremost philosopher-poet had to say about the contemplation that he considered to be the highest of the human mental powers. The essays by philosophers are supported by new developments in philosophically minded criticism from Coleridge scholars in English departments, including Jim Mays, Kathleen Wheeler, and James Engell. They approach Coleridge as an energetic yet contemplative thinker concerned with the intuition of ideas and the processes of cultivation in self and society. Other essays, from intellectual historians and theologians, clarify the historical background, and ‘religious musings’, of Coleridge’s thought regarding contemplation.

These Guidelines are one of the results of the four-year research project “Open Online Learning for Digital and Networked Society” (2017-2021). The project objective was to enable university teachers to design open and online learning through open and online learning curriculum and environment applying learning analytics as a metacognitive tool and creating open and online learning assessment and recognition practices, responding to the needs of digital and networked society. The research of the project resulted in 10 scientific publications and 2 studies prepared by Vytautas Magnus university Institute of Innovative Studies research team in collaboration with their international research partners from Germany, Spain and Portugal. The final stage of the research attempted creating open and online learning assessment and recognition practices, responding to the learner needs in contemporary digital and networked society. The need for open learning recognition has been increasing during the recent decade while the developments of open learning related to the Covid 19 pandemics have dramatically increased the need for systematic and high-quality assessment and recognition of learning acquired online. The given time also relates to the increased need to offer micro-credentials to learners, as well as a rising need for universities to prepare for micro-credentialization and issue new digital credentials to learners who are regular students, as well as adult learners joining for single courses. The increased need of all labour - market participants for frequent and fast renewal of competences requires a well working and easy to use system of open learning assessment and recognition. For learners, it is critical that the micro-credentials are well linked to national and European qualification frameworks, as well as European digital credential infrastructures (e.g., Europass and similar). For employers, it is important to receive requested quality information that is encrypted in the metadata of the credential. While for universities, there is the need to properly prepare institutional digital infrastructure, organizational procedures, descriptions of open learning opportunities and virtual learning environments to share, import and export the meta-data easily and seamlessly through European Digital Hub service infrastructures, as well as ensure that academic and administrative staff has digital competencies to design, issue and recognise open learning through digital and micro-credentials. The first chapter of the Guidelines provides a background view of the European Qualification Framework and National Qualification frameworks for the further system of gaining, stacking and modelling further qualifications through open online learning. The second chapter suggests the review of current European policy papers and consultations on the establishment of micro-credentials in European higher education. The findings of the report of micro-credentials higher education consultation group “European Approach to Micro-credentials” is shortly introduced, as well as important policy discussions taking place. Responding to the Rome Bologna Comunique 2020, where the ministers responsible for higher education agreed to support lifelong learning through issuing micro-credentials, a joint endeavour of DG Employment, Social Affairs and Inclusion and DG Research and Innovation resulted in one of the most important political documents highlighting the potential of micro-credentials towards economic, social and education innovations. The consultation group of experts from the Member States defined the approach to micro-credentials to facilitate their validation, recognition and portability, as well as to foster a larger uptake to support individual learning in any subject area and at any stage of life or career. The Consultation Group also suggested further urgent topics to be discussed, including the storage, data exchange, portability, and data standards of micro-credentials and proposed EU Standard of constitutive elements of micro-credentials. The third chapter is devoted to the institutional readiness to issue and to recognize digital and micro-credentials. Universities need strategic decisions and procedures ready to be enacted for assessment of open learning and issuing micro-credentials. The administrative and academic staff needs to be aware and confident to follow these procedures while keeping the quality assurance procedures in place, as well. The process needs to include increasing teacher awareness in the processes of open learning assessment and the role of micro-credentials for the competitiveness of lifelong learners in general. When the strategic documents and procedures to assess open learning are in place and the staff is ready and well aware of the processes, the description of the courses and the virtual learning environment needs to be prepared to provide the necessary metadata for the assessment of open learning and issuing of micro-credentials. Different innovation-driven projects offer solutions: OEPass developed a pilot Learning Passport, based on European Diploma Supplement, MicroHE developed a portal Credentify for displaying, verifying and sharing micro-credential data. Credentify platform is using Blockchain technology and is developed to comply with European Qualifications Framework. Institutions, willing to join Credentify platform, should make strategic discussions to apply micro-credential metadata standards. The ECCOE project building on outcomes of OEPass and MicroHE offers an all-encompassing set of quality descriptors for credentials and the descriptions of learning opportunities in higher education. The third chapter also describes the requirements for university structures to interact with the Europass digital credentials infrastructure. In 2020, European Commission launched a new Europass platform with Digital Credential Infrastructure in place. Higher education institutions issuing micro-credentials linked to Europass digital credentials infrastructure may offer added value for the learners and can increase reliability and fraud-resistant information for the employers. However, before using Europass Digital Credentials, universities should fulfil the necessary preconditions that include obtaining a qualified electronic seal, installing additional software and preparing the necessary data templates. Moreover, the virtual learning environment needs to be prepared to export learning outcomes to a digital credential, maintaining and securing learner authentication. Open learning opportunity descriptions also need to be adjusted to transfer and match information for the credential meta-data. The Fourth chapter illustrates how digital badges as a type of micro-credentials in open online learning assessment may be used in higher education to create added value for the learners and employers. An adequately provided metadata allows using digital badges as a valuable tool for recognition in all learning settings, including formal, non-formal and informal.

There is a high incidence of potentially preventable deaths and serious adverse events in acute hospitals. Most of these events occur on the general wards of the hospital. The concept of rapid response systems was developed as a way of identifying seriously-ill and at-risk patients in acute hospitals at an early stage in order to improve outcomes. The system has two major components—criteria to define the deteriorating patient linked to a rapid response. The criteria are based on a combination of abnormal vital signs and observations, and the response is based on matching the patient with staff with the appropriate skills. Implementing and evaluating hospital-wide systems present new challenges that are different to our approach to a new drug or procedure. As well as agreeing to the appropriate criteria and response, the system needs leadership and support across the whole hospital, including education programmes and, monitoring with appropriate quality assurance activities. Increasingly, the specialty of intensive care is designed around the needs of the seriously ill, rather than being geographically confined within the four walls of an intensive care unit. The concept of rapid response systems is part of that process.

The majority of molecular, physiological, and behavioural processes undergo substantial variations across a 24 h period. The health implications of such fluctuations, whether they are expressions of an intrinsic circadian rhythmicity or are secondary to changes in physical activity, posture, and/or sleep, are increasingly recognized. Similar to other biological functions, the cardiovascular system exhibits a prominent day–night profile, with profound haemodynamic, autonomic, and hormonal oscillations occurring during the sleep period. These time-dependent and sleep stage-dependent patterns of function have important clinical significance. The cardiovascular downregulation achieved throughout the night while asleep may be restorative and protective against adverse events, while the morning physiological activation coincident with awakening facilitates resumption of daytime activities. Nevertheless, rather than beneficial, these activity configurations may be pathogenic in individuals with a vulnerable substrate and may favour onset and progression of cardiovascular diseases. Cardiovascular complications may also arise as a consequence of abnormal day–night periodicity and disturbed sleep quantity and quality. Hence, consideration of the diurnal pattern of cardiovascular activity is critical in the clinical setting.

The first edition of Understanding Vineyard Soils has been praised for its comprehensive coverage of soil topics relevant to viticulture. However, the industry is dynamic--new developments are occurring, especially with respect to measuring soil variability, managing soil water, possible effects of climate change, rootstock breeding and selection, monitoring sustainability, and improving grape quality and the "typicity" of wines. All this is embodied in an increased focus on the terroir or "sense of place" of vineyard sites, with greater emphasis being placed on wine quality relative to quantity in an increasingly competitive world market. The promotion of organic and biodynamic practices has raised a general awareness of "soil health", which is often associated with a soil's biology, but which to be properly assessed must be focused on a soil's physical, chemical, and biological properties. This edition of White's influential book presents the latest updates on these and other developments in soil management in vineyards. With a minimum of scientific jargon, Understanding Vineyard Soils explains the interaction between soils on a variety of parent materials around the world and grapevine growth and wine typicity. The essential chemical and physical processes involving nutrients, water, oxygen and carbon dioxide, moderated by the activities of soil organisms, are discussed. Methods are proposed for alleviating adverse conditions such as soil acidity, sodicity, compaction, poor drainage, and salinity. The pros and cons of organic viticulture are debated, as are the possible effects of climate change. The author explains how sustainable wine production requires winegrowers to take care of the soil and minimize their impact on the environment. This book is a practical guide for winegrowers and the lay reader who is seeking general information about soils, but who may also wish to pursue in more depth the influence of different soil types on vine performance and wine character.

The flaws in the American electoral process have become increasingly apparent in recent years. The contemporary tipping point in public awareness occurred during the 2000 election count, and concern deepened due to several major problems observed in the 2016 campaign, worsening party polarization, and corroding public trust in the legitimacy of the outcome. To gather evidence about the quality of elections around the world, in 2012 the Electoral Integrity Project was established as an independent research project based at Harvard and Sydney universities. The results show that experts rated American elections as the worst among all Western democracies. Without reform, these problems risk damaging the legitimacy of American elections—further weakening public confidence in political parties, Congress, and the U.S. government, depressing voter turnout, and exacerbating the risks of mass protests. This book describes several major challenges observed during the 2016 U.S. elections arising from deepening party polarization over basic voting procedures, the serious risks of hacking and weak cyber-security, the consequences of deregulating campaign spending, and lack of professional and impartial electoral management. This book outlines the core concept and measure of electoral integrity, the key yardstick used to evaluate free and fair elections. Evidence from expert and mass surveys demonstrate the extent of problems in American elections. The book shows how these challenges could be addressed through several practical steps designed to improve electoral procedures and practices. If implemented, the reforms will advance free and fair elections, and liberal democracy, at home and abroad.

EU Law Directions explains the key topics and developments in this fast-paced and increasingly important subject area. Based on 35 years’ experience teaching and examining European Union (EU) law, this book provides a student-friendly text which is readable without compromising on academic quality. The text is easy to follow, with useful features throughout such as case summaries, key definitions, and diagrams. Cross-references and end-of-chapter summaries demonstrate how topics link together and enable students to quickly build up a comprehensive understanding of EU law. The text is clearly broken down into logical sections, guiding students through institutional, procedural, and substantive law from a European perspective. It also takes into account the fast-moving events in the UK generated by the result of the Brexit referendum and the consequent exit of the UK from the EU and entry into the transition period due to end 31 December 2020. A clear and uncomplicated writing style ensures students new to EU law quickly grasp the central elements of the subject. This book has been fully revised in this new edition to take account of new legislative and case law developments, in particular relating to the free movement of persons and equality law. This new edition includes a full consideration of the UK’s relationship with the EU, the 2016 referendum and the process of negotiating withdrawal concluding with the UK withdrawal on 31 January 2020.

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Climate Science. Please check back later for the full article.Africa, a continent with the largest number of countries falling under the category of Least Developed Countries (LDCs), remains highly dependent on rain-fed agriculture that suffers from low intake of water, exacerbating the vulnerability to climate variability and anthropogenic climate change. The increasing frequency and severity of climate extremes impose major strains on the economies of these countries. The loss of livelihoods due to interaction of climate change with existing stressors is elevating internal and cross-border migration. The continent is experiencing rapid urbanization, and its cities represent the most vulnerable locations to climate change due in part to incapacitated local governance. Overall, the institutional capacity to coordinate, regulate, and facilitate development in Africa is weak. The general public is less empowered to hold government accountable. The rule of law, media, and other watchdog organizations, and systems of checks and balances are constrained in different ways, contributing to poor governance and resulting in low capacity to respond to climate risks.As a result, climate policy and governance are inseparable in Africa, and capacitating the government is as essential as establishing climate policy. With the highest level of vulnerability to climate change compared with the rest of the world, governance in Africa is pivotal in crafting and implementing viable climate policies.It is indisputable that African climate policy should focus first and foremost on adaptation to climate change. It is pertinent, therefore, to assess Africa’s governance ability to identify and address the continent’s needs for adaptation. One key aspect of effective climate policy is access to up-to-date and contextually relevant information that encompasses indigenous knowledge. African countries have endeavored to meet international requirements for reports such as the National Communications on Climate Change Impacts and Vulnerabilities and the National Adaptation Programmes of Action (NAPAs). However, the capacity to deliver on-time quality reports is lacking; also the implementation, in particular integration of adaptation plans into the overall development agenda, remains a challenge. There are a few successes, but overall adaptation operates mainly at project level. Furthermore, the capacity to access and effectively utilize availed international resources, such as extra funding or technology transfer, is limited in Africa.While the continent is an insignificant source of emissions on a global scale, a more forward looking climate policy would require integrating adaptation with mitigation to put in place a foundation for transformation of the development agenda, towards a low carbon driven economy. Such a futuristic approach calls for a comprehensive and robust climate policy governance that goes beyond climate to embrace the Sustainable Development Goals Agenda 2030. Both governance and climate policy in Africa will need to be viewed broadly, encompassing the process of globalization, which has paved the way to a new geological epoch, the Anthropocene. The question is, what should be the focus of climate policy and governance across Africa under the Anthropocene era?

Day-stay surgery is becoming increasingly common the world over. There are several benefits of avoiding in-hospital care. Early ambulation reduces the risk for thromboembolic events, facilitates wound healing, and avoiding admission reduces the risk for hospital-related infection. Additionally, the risk of neurocognitive side-effects can be avoided by returning the elderly patient to their home environment. Day-stay anaesthesia calls for adequate and structured preoperative assessment and patient evaluation, and the potential risk associated with surgery and anaesthesia should be assessed on an individual basis. Need for preoperative testing should be based on functional status of the patient and preoperative medical history but even the surgical procedure should be taken into account. Preoperative fasting should be in accordance with modern guidelines, refraining from food for 6 hours and fluids for 2 hours prior to induction in low-risk patients. Preventive analgesia and prophylaxis of postoperative nausea and vomiting (PONV) should be administered preoperatively. Local anaesthesia should be administered prior to incision, constituting part of multimodal analgesia. The multimodal analgesia strategy should also include paracetamol and a non-steroidal anti-inflammatory drug in order to reduce the noxious stimulus from the surgical field. Third-generation inhaled anaesthetics or a propofol-based maintenance are both feasible alternatives. Titrating depth of anaesthesia by using an EEG-based depth of anaesthesia monitor may facilitate the recovery process. The laryngeal mask airway has become commonly used and has several advantages. Ultrasound-guided peripheral blocks may facilitate the early postoperative course by reducing pain and avoiding the use of opiates. Perineural catheters may be an option for prolongation of the block following painful orthopaedic procedures but a strict protocol and follow-up must be secured. Not only pain but even nausea and vomiting should be prevented, and therefore risk stratification, for example by the Apfel score, and PONV prophylaxis in accordance with the risk score is strongly recommended. Early ambulation should be encouraged postoperatively. Safe discharge should include an escort who also remains at home during the first postoperative night. Analgesics should be provided and be readily available for self-care when the patient comes home. Pain medication should include an opioid; however, the benefit versus risk must be assessed on an individual basis. Patients should also be instructed about a rescue return-to-hospital plan. Quality of care should include follow-up and analysis of clinical practice, and institution of methods to improve quality should be enforced for the benefit of the ambulatory surgical patient.