Limitations in assessment of mucosal healing in inflammatory bowel disease

An emerging parameter to define the effectiveness of new therapeutic agents in clinical trials,and by extension,for use in day-to-day clinical practice has been labeled mucosal healing.It has been hypothesized that complete healing of the intestinal mucosa in inflammatory bowel diseases should result in reduced disease complications,reduced hospitalization and reduced surgical treatment.By implication,the natural history of inflammatory bowel disease might then be altered. Measurement of mucosal healing,how...     

Advising Ministers – The Special Problem of Defence

Successive Australian Defence Ministers have been frustrated and occasionally embarrassed by the quality of advice and information provided to them by the Defence organisation. Decades of reviews and reorganisations have failed to find solutions to the special difficulties that Defence faces in providing accurate, timely information and advice to ministers across the broad spectrum of their responsibilities. This article argues that there are multiple explanations for the concerns that are frequently expressed about its policy advisory capacity – most of which are inherent to Defence organisations around the world. While the Defence culture of secrecy is partly responsible, other factors such as the scale of Defence's operations, the multiple cultures that exist within it (military, civilian, and intelligence) that make coherence harder than in more homogenous departments, the long‐time horizons of defence planning as well as the high costs of procurement, must also be considered. The erosion of trust between the organisation and minister has been exacerbated by the intense scrutiny of the media that overburdens ministers and adds another layer of complexity to their role. As history shows, there are push and pull factors that continue to embroil ministers in the minutiae of defence difficulties, while the complexity and scale of operations will undoubtedly continue to impact on the timeliness of advice.     

Union participation in economic policy making in France,Italy, Germany and Britain, 1970–1993

This study uses a specially‐developed measure of union participation in economic policy making to classify and compare the historical experiences of France, Italy, the Federal Republic of Germany and Britain between 1970 and 1993 in order to present a clearer view of the variability of union participation in economic policy making in these countries over this period than has been available up to now. It is found that union participation was concentrated in certain areas of economic policy, in particular labour market policy, and that even high levels of participation were not necessarily linked to union agreement on wage restraint. Over the period as a whole, participation was highest in Italy and lowest in Britain and France, but varied considerably over time as well as between countries. These variations were clearly linked to whether the Left was included in the government of the day as well as to the nature of the national union movements.     

Maritime security in the United States: Latent threats and latent vulnerabilities

Americans and their government are seemingly unconcerned about the possibility that maritime facilities and personnel might be at risk to armed violence. Not only are current maritime security efforts minimal, they feature a curious dichotomy: one thrust is directed toward occasional acts of terrorism, the other toward coastal defense in wartime. Despite a manifestly more interactive world marked by the ready availability of powerful, mobile weapons, no serious efforts have been directed toward protecting maritime facilities and personnel in the United States against special operations or unconventional warfare. This indifference reflects the prevalence of the Clausewitzian paradigm in America's attitude toward war and the country's historical experience with coastal defense in the wars of this century. The fragmented structure of civil and military protection available to protect ports and other facilities suggests that protection could not be quickly upgraded in the face of a rapidly‐developing threat.     

Learning about terrorism: Analysis,simulations, and future directions

This paper surveys the various activities of the Study Group on International Terrorism at the University of Oklahoma. The Study Group has employed the following phases in analyzing a form of conflict that has increasingly seized the world's headlines and challenged the capacity of governments to meet a particularly insidious type of political violence. In PHASE I, Ascertaining the Scope of the Investigation, problems related to defining “terrorism” and evolving a focus for analysis are recounted. In PHASE II, The Collection of Data and Initial Analysis, the techniques employed by the Study Group in collecting and evaluating data dealing with incidents of terrorism are discussed. In addition, a number of the preliminary findings of the studies are presented. In PHASE III, Application and Evaluation, the methods by which the initial findings were employed to develop a wide variety of programs related to developing alternatives to meet the threat of terrorism are discussed. Particular emphasis is placed on problems related to reconciling the need for an effective tactical response when an incident occurs with the equally pressing requirement for effective hostage negotiation. Under the section entitled Simulations, the techniques employed in developing a series of highly realistic simulations involving: (1) the University of Oklahoma Security Department, (2) the Norman Police Department, (3) members of a U.S. Army Special Forces Unit, and (4) flight attendants aboard the mock‐up of a cabin at the training facility of a leading international airline are presented. In addition, certain patterns that emerge from the simulations are noted. In PHASE IV, Policy Implications, the patterns mat emerged from the simulations are related to broader policy questions that not only include the need for more effective training techniques for law enforcement personnel, but also stresses the need to provide exercises that would promote administrative cooperation among senior level officials from the different jurisdictions that would be involved if an incident were to occur. In PHASE V, Future Directions, new areas of analysis and training are presented as they particularly relate to the need to sensitize personnel from both the public and private sector who may be high‐risk targets for terrorists attacks.     

Assessing oral skills—time for reflection,time for risk

Abstract

THIS PAPER aims to establish a framework from which we can explain our dissatisfaction with defining what we teach and what and how we assess within legal education. To what extent can we, the professions or the public, have confidence that our assessment processes predict effective professional competence?

We will try to establish this framework by placing the discussion in the context of a workshop of assessment of oral skills run at the 2001 Bar Vocational Course conference. The workshop raised issues which we believe encapsulate the difficulties of measuring performance in such a way that it reliably predicts professional effectiveness. From this we will attempt to highlight the shortcomings of the current teaching, learning and assessment strategies more generally.

We go on to consider the role of student reflection in support of summative assessment: is it a reliable way of helping to plug the competence‐performance gap we have identified? What is its role in summative assessment? What demands does it make on tutor and learner? Since we cannot guarantee to find the best solutions first time, we make a plea for taking the risk of failure as well as success, and trying out ideas.     

Reforming the electoral system of Metropolitan Toronto: doing away with dual representation

Abstract: Since its creation in the mid-1950s, the elected council of Metropolitan Toronto was composed of politicians who had first been directly elected in their home municipalities (Scarborough, North York, etc.)- Over the years, various observers had noted the representational weaknesses of this arrangement, but little had changed by the mid-1980s. Metro concerns often appeared to be overlooked in the interest of local concerns, and lines of accountability from Metro to the public were weak. During the period 1986–88 a provincial government initiative led to a joint review of Metro's electoral arrangements and to enactment of major procedural reforms. By the 1988 Ontario municipal elections a system for direct election of the Metro council was in place. The provincial government's approach to reform, a provincial-municipal task force, merits examination, for the municipal affairs ministry was able to bring reforms forward despite opposition from certain local government leaders. Reviewing this experience sheds light on some of the complexities involved in analysing representational options as well as in assessing the provincial relationship with Metro issues. Study of the reform process utilized here illustrates the ability of a committed provincial government to place discussion of Metro change firmly on the political agenda. Reflection on the procedures and representation issues of the mid-1980s is now timely as the Ontario government is developing a yet larger entity, the Greater Toronto Area (GTA), which encompasses about 40 per cent of the province's population. Sommaire: Depuis son etablissement vers le milieu des annees 1950, le conseil elu du Toronto metropolitain etait compose de politiciens qui avaient d'abord ete elus directement dans leur propre municipality (Scarborough, North York, etc.). Au fil des annees, divers observateurs ont note les faiblesses de ce systeme de representation, mais tres peu changea jusqu'au milieu des annees 1980. Les preoccupations de