Oxford University Press's Blog, page 959
April 8, 2013
The Arms Trade Treaty: a major achievement
On Tuesday, 2 April 2013, after seven years of discussions and negotiations, the United Nations General Assembly adopted the UN Arms Trade Treaty by an overwhelming margin — the first ever global agreement governing the transfer of conventional arms. A total of 154 States voted in favour of the resolution, three voted against, and 23 abstained. The treaty will now be opened for signature on 3 June 2013.
The treaty is a strong and balanced text that clearly enjoys very widespread support, and if adhered to and implemented in good faith it will significantly reduce the humanitarian impact from the irresponsible transfer of weapons. That it is a meaningful treaty is evidenced by the fact that in two successive diplomatic conferences, certain States blocked its adoption by consensus. First time around, in July 2012, it was the United States (followed by Russia) that asked for more time. In the ‘final’ diplomatic conference in late March 2013, three States — Iran, DPR Korea, and Syria — blocked the adoption of the text that had been skillfully negotiated by the new Conference President, Ambassador Peter Woolacott of Australia. These same three States went on to vote against the General Assembly resolution that adopted the treaty.
So what does the treaty provide? First, its scope is broad, covering most (though not quite all) conventional arms, ammunition and munitions, and parts and components of arms. Thus, the treaty covers tanks, armored combat vehicles, large-caliber artillery systems, combat aircraft, attack helicopters, warships, missiles and missile launchers, and small arms and light weapons, as well as the ammunition and munitions that are fired, launched, or dropped by all these weapons. Parts and components of arms are covered, but not those of ammunition/munitions. Somewhat strangely, the treaty does not apply to hand grenades or landmines.
Furthermore, despite occasional assertions to the contrary, the treaty does apply to the transfer of unmanned aerial vehicles (drones), at least when they are armed, as in this case they fall under the definition of combat aircraft. This is consistent with the coverage of the UN Register of Conventional Arms (UNROCA) and the discussions in the 2006 Group of Governmental Experts on the UNROCA. It also applies to armored vehicles that take more than four soldiers (despite press reports to the contrary), so the United Kingdom’s supply of ‘less-lethal’ weaponry to the Syrian rebels would be subject to the provisions of the treaty setting out prohibitions on transfer.
However, whether the treaty applies only to sale or also to gifts or loans was left deliberately ambiguous. China was insistent that the treaty not cover more than sale. Many other states sought to insist that it did. What is clear is that on the basis of pacta sunt servanda (the duty to apply and implement a treaty in good faith), no state party could simply seek to avoid the ambit of the treaty by listing all its transfers of conventional arms as ‘gifts’.
Despite calls by many States, the treaty does not explicitly prohibit any transfer to any armed non-state actor. Arguably, however, transfers to ANSAs are unlawful under the prohibition in Article 2(4) of the United Nations Charter, which is brought under the scope of the treaty by Article 6(2) (‘international agreements’ to which a State Party to the ATT is also party). Arguably, Article 6(2) also incorporates human rights treaties to which a State Party to the ATT is also party. This was stated by 100 States in a joint declaration following the adoption of the treaty at the UN General Assembly.
The treaty prohibits the transfer of any arms and ammunition/munitions within its scope that would be used in the commission of genocide, crimes against humanity, or war crimes (in non-international as well as international armed conflicts). This includes targeting civilian objects or civilians ‘protected as such’ (i.e. where they are not participating actively/directly in hostilities), as well as serious violations of Common Article 3 to the 1949 Geneva Conventions. Reflecting customary law as set out in Article 16 of the International Law Commission draft Articles on State responsibility for internationally wrongful acts, this provision could become an important norm of custom in and of itself in years to come. The intent standard suggested by the ILC (‘for the purpose of’) has rightly been replaced by a knowledge threshold (‘where a State has knowledge that’ the arms etc. ‘would’ be so used), consonant with the customary standard for individual responsibility under international criminal law (the 1998 Rome Statute of the International Criminal Court aside) as well as for State responsibility itself.
The precise standard of ‘overriding’ risk for the prohibitions set out in Article 7 to apply (serious violations of either international humanitarian law or human rights law) remains vague. It probably, though, requires a very significant potential contribution to peace and security to override the potential negative consequences.
There is a general obligation to ‘take measures necessary’ to implement the treaty (Art. 5(5)), as well as to ‘establish and maintain’ a national control system (Art. 5(2)). Reporting on measures to implement the treaty is obligatory (Art. 13(1)). Reporting on ‘authorized or actual exports or imports of arms’ (but not ammunition/munitions) is similarly obligatory but ‘commercially sensitive or national security information’ may be excluded (Art. 13(3)). There is, though, no specific obligation to penalize violations of the treaty. The obligation is only to ‘take appropriate measures to enforce national laws and regulations that implement’ the treaty (Art. 14).
The first Conference of States Parties will occur within a year of the treaty’s entry into force. The Conference will decide on the frequency of subsequent CSPs (Art. 17(1)). A provisional secretariat will be established prior to the first Conference of States Parties (Art. 18(1)). The location of the Secretariat is not fixed under the treaty.
Amendments may, as ‘a last resort’, be adopted by a three-quarter majority of States Parties present at voting at a CSP. The first amendments may only be proposed six years after entry into force of the treaty.
Finally, States Parties may conclude or continue to implement other agreements as long as the obligations are ‘consistent’ with the treaty (Art. 26(1)), and defense cooperation agreements may not be voided by reference to the Arms Trade Treaty (Art. 26(1)). This clause, proposed forcefully by India, was hard fought over, and it is ironic that India has announced that it will now not sign the treaty.
In sum, though, States and civil society may justly be proud of the Arms Trade Treaty they worked so hard to achieve. As Mexico stated in the General Assembly, however, ‘the hard work starts now.’
Stuart Casey-Maslen is Head of Research at the Geneva Academy of International Humanitarian Law and Human Rights. He is co-editor of The Convention on Cluster Munitions: A Commentary.
Oxford University Press is a leading publisher in Public International Law, including the Max Planck Encyclopedia of Public International Law, latest titles from thought leaders in the field, and a wide range of law journals and online products. We publish original works across key areas of study, from humanitarian to international economic to environmental law, developing outstanding resources to support students, scholars, and practitioners worldwide.
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Can we raise woolly mammoths from their Pleistocene graves?
Thousands of years after the last woolly mammoth died, some bioengineers dream of resurrecting the species. When I first heard their arguments, these folks struck me as the modern, high-tech version of snake-oil salesmen. The product they’re promoting is not what they lead people to believe it is, and it won’t do what people like to imagine it will.
Mammoths and mastodons once roamed throughout the Americas, as well as much of Europe and Asia. There were several species, but the best-known is the woolly mammoth, a creature of the far north. Well-preserved carcasses have been discovered melting out of the permafrost in Siberia and the Yukon. There’s been a lot of talk of ‘cloning’ a mammoth by using DNA recovered from bodies preserved in permafrost.
However, the genetic material in even the best-preserved mammoth specimens has been broken to bits, devoured by cold-adapted bacteria and shattered by thousands of years of freezing and thawing. No mammoth sperm cell holding intact DNA—a prerequisite for cloning—has ever been found. Using bits of ancient mammoth DNA, and referring to the genome of living elephants, researchers have pieced together much of the coding genome of the woolly mammoth—the segments that direct the building of proteins. But the vast majority of the genome, whose functions are little understood, remains unmapped.
Still, it’s now theoretically possible to create a pseudo-mammoth. This could be done by taking the genome of an Asian elephant, the closest living relative of the woolly mammoth, and splicing some sequences of mammoth DNA into it. This hybrid DNA could be inserted into an elephant sperm cell, which could then be used to artificially inseminate a female elephant. If the embryo developed and was carried to term, a mammoth-like animal would be born. This is a big ‘if’, because elephant reproduction is slow and complex. Even in efforts to clone living animals, there are often multiple abortions before a live infant is born. And those babies often don’t live long.
“We’d propose to make a hybrid elephant with the best features of modern elephants and of mammoths,” George Church said at a recent TEDx conference on De-Extinction. A genomics pioneer based at Harvard, Church is a master of genetic manipulation. His motivation for trying to raise the mammoth is obscure. When I spoke with him a couple of years back, he told me, “You can be very fussy and insist on getting the genome exactly right. Or you can go for something that has the main visible characteristics: the hair, the size, the tusk shape.” So, like many who imagine mammoths once again roaming the far north, Church was hung up on appearances.
Experiments using ancient mammoth DNA sequences have shown that these cold-adapted elephants had a different form of the blood protein hemoglobin compared to their modern cousins. Mammoth hemoglobin, which picks up oxygen in the lungs and offloads it in the tissues, was designed to release oxygen under cold conditions, a feat that modern elephant hemoglobin can’t perform. So a gene for cold-adapted hemoglobin is now on Church’s list of characteristics to splice into a mammothified elephant. But how many other subtle factors made the mammoth what it was? To believe that human technology can fabricate an animal that will fill the lost niche of the mammoth takes a lot of blind faith—or hubris.
Mammoths lived in cold, dry prairies, an Ice Age habitat that Palaeoecologists call the mammoth steppe, and that once covered great swathes of the planet. Today, the mammoth steppe has vanished. So if bioengineers managed to produce pseudo-mammoths, they’d likely have no place to go. With a lot of luck, they might help to create their own habitat. Ecologist Sergei Zimov is running a long-term experiment in northeastern Siberia which he calls Pleistocene Park. His goal is to bring large herbivores into the soggy tundra in the hope that their grazing will transform the landscape back into the productive grassland that existed in the days of the mammoth. Large herbivores can shape their own habitats, a phenomenon that’s been observed in African savannas as well as in the Arctic. Zimov has seen some signs of success with horses and muskoxen. But whether mammoth-like animals could survive there is unknowable.
While some dream of raising the mammoth, living elephants are under siege. Poaching has reached a new peak; 62 percent of forest elephants in Central Africa were killed for their ivory over the last decade. (It’s worth noting that mammoth tusks were considerably larger: meaning a bigger pay-off of ivory for every animal killed). Elephants often die in clashes with subsistence farmers in Africa and Asia. They need large stretches of habitat to survive, and land unoccupied by humans is becoming a rare and precious resource.
Even bringing back species that were deliberately wiped out in much of North America within the last century remains controversial. The reintroduced gray wolf population in Yellowstone National Park is by many measures a great success: the animals thrived, and have helped to restore an array of other creatures, from beaver to songbirds. Still, as the wolf population has expanded beyond the park’s boundaries, they’ve been met with outrage and gunshots. Yellowstone’s bison, the last free-roaming herd in the United States, gets the same reaction when the animals migrate out of the park in winters of heavy snow.
Conservation efforts for these living megafauna are chronically under-funded. So it’s hard to take the notion of raising a pseudo-mammoth, or any other long-extinct species, as a serious conservation move. The mammoth has been a favorite for resurrection, not because the idea is practical, but because the lost creature has such a strong hold on our imaginations.
Still, it’s probably not fair to compare all advocates of this idea to snake-oil salesmen. After watching a number of speakers at the TEDx De-Extinction conference passionately describe their dreams of raising not only the mammoth, but the thylacine and the passenger pigeon, I think many of these people are sincere. They believe they can raise dead species, and set them free to function in the wild. But they’re so focused on this vision that they seem disconnected from the reality of here and now.
Sharon Levy is a freelance science writer who specializes in making natural resource and conservation issues accessible for a broad audience. She is the author of Once and Future Giants, a book that introduces the idea that Ice Age megafauna extinctions hold important lessons for modern conservation. She lives in Humboldt County, California.
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Image credits: Smithsonian Woolly Mammoth. Photo by Kevin Burkett. Creative Commons License via Wikimedia Commons; Woolly Mammoth. Photo by Flying Puffin. Creative Commons License via Wikimedia Commons.
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April 7, 2013
Yom HaShoah and everyday genocide
For the historian Mary Fulbrook, the history of the small town of Będzin hits close to home. Her mother was a refugee from Nazi Germany and a close friend to the wife of Udo Klausa, a one-time civilian administrator in that small town so close to the infamous concentration camp Auschwitz. What role did Klausa, as countless local functionaries across the Third Reich, play in facilitating Nazi policy? Fulbrook traveled to Bedzin with her son to film a series of videos exploring the subject as a companion to her book, A Small Town Near Auschwitz: Ordinary Nazis and the Holocaust.
What is the history of Nazi-occupied Będzin?
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What was the role of the civilian administration during the occupation of Bedzin?
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What was it like to live in Nazi occupied Bedzin?
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Mary Fulbrook is Professor of German History at University College London and the author of A Small Town Near Auschwitz: Ordinary Nazis and the Holocaust. A leading authority on modern German history, her books include Dissonant Lives: Generations and Violence through the German Dictatorships, A Concise History of Germany, A History of Germany 1918-2000: The Divided Nation, German National Identity after the Holocaust, Anatomy of a Dictatorship: Inside the GDR, and The People’s State: East German Society from Hitler to Honecker. Fulbrook is also a Fellow of the British Academy, a former Chair of the German History Society, and a member of the Academic Advisory Board of the Foundation for the former Concentration Camps at Buchenwald and Mittelbau-Dora.
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April 6, 2013
Happy National Tartan Day: Celebrating Scottish American data
First observed nationally in 1997, Tartan Day celebrates the legacy and contributions of Scottish Americans. The annual festivities are held on April 6th, the anniversary of the Declaration of Arbroath, the 1320 Scottish Declaration of Independence.
As George Bush’s 2008 presidential proclamation stated, Tartan Day seeks to “celebrate the spirit and character of Scottish Americans and recognize their many contributions to our culture and our way of life.”
Though Census data does not go back as far as the 14th century Declaration of Arbroath, Social Explorer’s data resources offer a glimpse into the birth and development of the Scottish community in America. Back in 1790, the very first Census tracked the nationality of the foreign born population.
While the English and Welsh made up over four fifths of the population (81.4 percent), followed by the Germans (6.5 percent), the Scottish were the next most populous group (5.9 percent), followed by the Dutch (3.0 percent). (Calculations based on all available county data from the 1790 Census.)
Though small in number compared to other groups, they settled in particular communities of the early colonies, which you can explore in the following map.
Scottish Americans: Census 1790
Click the map to explore.
This detailed map of American Community Survey data shows where Americans with Scottish ancestry live today.
Scottish Ancestry: American Community Survey 2006-10
Click the map to explore.
The Scottish continue to immigrate to the US, and this detailed map data shows where residents originally born in Scotland live today.
Foreign-Born Scottish Residents: American Community Survey 2006-10
Click the map to explore.
Check out Social Explorer’s map and report tools for more Tartan Day data.
Sydney Beveridge is the Media and Content Editor for Social Explorer, where she works on the blog, curriculum materials, how-to-videos, social media outreach, presentations and strategic planning. She is a graduate of Swarthmore College and the Columbia University Graduate School of Journalism.
Social Explorer is an online research tool designed to provide quick and easy access to current and historical census data and demographic information. The easy-to-use web interface lets users create maps and reports to better illustrate, analyze and understand demography and social change. From research libraries to classrooms to the front page of the New York Times, Social Explorer is helping people engage with society and science.
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April 5, 2013
A Burns celebration of tartan
On the day before a yearly celebration of Scottish heritage (Tartan Day), Robert Burns brings us the first Duan (division) of his poem The Vision, an extract from Selected Poems and Songs.
THE VISION
Duan First
THE sun had clos’d the winter-day ,
The Curlers quat their roaring play,
And hunger’d Maukin taen her way
To kail-yards green,
While faithless snaws ilk step betray
Whare she has been.
The Thresher’s weary flingin-tree ,
The lee-lang day had tir’d me;
And when the Day had clos’d his e’e,
Far i’ the West, 10
Ben i’ the Spence , right pensivelie,
I gaed to rest.
There, lanely, by the ingle-cheek,
I sat and ey’d the spewing reek,
That fi ll’d, wi’ hoast-provoking smeek,
The auld, clay biggin;
And heard the restless rattons squeak
About the riggin.
All in this mottie, misty clime,
I backward mus’d on wasted time,
How I had spent my youthfu’ prime ,
An’ done nae-thing,
But stringing blethers up in rhyme
For fools to sing.
Had I to guid advice but harket,
I might, by this, hae led a market,
Or strutted in a Bank and clarket
My Cash-Account ;
While here, half-mad, half-fed, half-sarket,
Is a’ th’ amount.
I started, mutt’ring blockhead! coof!
And heav’d on high my wauket loof,
To swear by a’ yon starry roof,
Or some rash aith,
That I, henceforth, would be rhyme-proof
Till my last breath —
When click! the string the snick did draw;
And jee! the door gaed to the wa’;
And by my ingle-lowe I saw,
Now bleezan bright, 40
A tight, outlandish Hizzie , braw,
Come full in sight.
Ye need na doubt, I held my whisht;
The infant aith, half-form’d, was crusht;
I glowr’d as eerie’s I’d been dusht,
In some wild glen;
When sweet, like modest Worth , she blusht,
And stepped ben.
Green, slender, leaf-clad Holly-boughs
Were twisted, gracefu’, round her brows,
I took her for some SCOTTISH MUSE,
By that same token;
And come to stop those reckless vows,
Would soon been broken.
A ‘hare-brain’d, sentimental trace’
Was strongly marked in her face;
A wildly-witty, rustic grace
Shone full upon her;
Her eye , ev’n turn’d on empty space,
Beam’d keen with Honor .
Down fl ow’d her robe, a tartan sheen,
Till half a leg was scrimply seen;
And such a leg! my BESS, I ween,
Could only peer it;
Sae straught, sae taper, tight and clean,
Nane else came near it.
Her Mantle large, of greenish hue,
My gazing wonder chiefl y drew;
Deep lights and shades , bold-mingling, threw
A lustre grand;
And seem’d, to my astonish’d view,
A well-known Land.
Here, rivers in the sea were lost;
There, mountains to the skies were tost:
Here, tumbling billows mark’d the coast,
With surging foam;
There, distant shone, Art’s lofty boast,
The lordly dome.
Here, DOON pour’d down his far-fetch’d floods;
There, well-fed IRWINE stately thuds:
Auld, hermit AIRE staw thro’ his woods,
On to the shore;
And many a lesser torrent scuds,
With seeming roar.
Low, in a sandy valley spread,
An ancient BOROUGH rear’d her head;
Still, as in Scottish Story read,
She boasts a Race,
To ev’ry nobler virtue bred,
And polish’d grace.
Robert Burns was an eighteenth century Scottish poet and songwriter. Selected Poems and Songs offers Burns’s work as it was first encountered by contemporary readers, presenting the texts as they were originally published. It reproduces in its entirety the volume which made Burns famous–Poems, Chiefly in the Scottish Dialect, published at Kilmarnock in 1786–and it showcases a generous selection of songs from The Scots Musical Museum and A Select Collection of Scottish Airs, complete with their full scores.
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Friday procrastination: hatchet-man edition
If my grandfather could survive the Siege of Leningrad and still distinguish between a German and a Nazi, then so can I says Polina Aronson.
The Sight and Sound Film Poll: An International Tribute to Roger Ebert and His Favorite Films
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The Hawk Cam is back!
Pesticides are damaging bee brains.
#bbpBox_319779251735908352 a { text-decoration:none; color:#0084B4; }#bbpBox_319779251735908352 a:hover { text-decoration:underline; }Unusually detailed pic of medieval bookbinder. “@April 4, 2013 7:51 am via Twitter for iPhone Reply Retweet Favorite Erik Kwakkel
Can you help us antedate bromance?
Higher education spending is going downhill.
Physicists argue about sterile neutrinos.
How academics can talk about policy.
#bbpBox_319766453366693889 a { text-decoration:none; color:#0084B4; }#bbpBox_319766453366693889 a:hover { text-decoration:underline; }Interested in Philippine English? Don't miss @April 4, 2013 7:00 am via HootSuite Reply Retweet Favorite The OED
Social media and study abroad programs.
DPLA has launched.
International education, an Australian perspective.
Are ebooks a different genre?
A philosopher finds employment.
#bbpBox_316482118056280065 a { text-decoration:none; color:#0084B4; }#bbpBox_316482118056280065 a:hover { text-decoration:underline; }Fantastic! SHRINKING BLOB solves one of hardest problems in maths http://t.co/0knegk1LJY
March 26, 2013 5:29 am via web
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alex bellosDon’t think about how useful your degree is.
Next up for exhumation, Alfred the Great.
Hatchet-man of the railways is a great epithet.
Zoë Triska doesn’t want you begging any questions.
Alice Northover joined Oxford University Press as Social Media Manager in January 2012. She is editor of the OUPblog, constant tweeter @OUPAcademic, daily Facebooker at Oxford Academic, and Google Plus updater of Oxford Academic, amongst other things. You can learn more about her bizarre habits on the blog.
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Can a low-sodium diet endanger patients with heart problems?
To certain patients with heart disease, a little salt may not be a bad thing.
Patients suffering from cardiovascular disease are treated with drugs known as a renin-angiotensin system (RAS) blockers, which have been proven to reduce mortality in large clinical trials of patients with hypertension, heart disease, or diabetes. Now, a new study published this week in the American Journal of Hypertension has shown that some patients are concurrently salt depleted and may not benefit from the RAS blocking drugs; in fact, RAS blockers may endanger their health.
The authors of this new paper, Jean E. Sealey, Michael H. Alderman, Curt D. Furberg, and John H. Laragh, show relationships between high levels of plasma renin-activity (PRA), sodium depletion, and cardiovascular mortality. Dr. Sealey answered some questions about their latest work below. She also tells us about a free app she and other colleagues have developed to help train health care professionals to use the clinical PRA test to identify hypertensive patients who can benefit from sodium depleting agents, as distinct from other hypertensives who benefit instead from RAS blockers.
Is hypertension the clinical term for high blood pressure?
Yes. Everyone’s blood pressure varies throughout the day, but the blood pressure of a hypertensive patient varies around a higher level. The conventional level above which patients are described as having hypertension is 140/90 mmHg.
What is plasma renin activity (PRA) and why it is so important with regards to hypertensive patients?
Renin is secreted by the kidneys into the blood stream where it increases blood pressure by reducing the caliber of small arteries, in much the same way that tightening the nozzle of a garden hose increases the force of a stream of water. Plasma renin exerts its effect on the blood vessels through plasma angiotensin. The main function of the renin-angiotensin system is to stop blood pressure from falling too low when the amount of salt in the body becomes depleted. Salt itself does not affect blood pressure, but determines the volume of water in the body. The amount of salt in the body determines the amount of water within the blood vessels and that also affects the level of blood pressure. High blood pressure is caused either by too much plasma renin, or by too much body salt, or by both.
The main type of drugs examined in your paper — renin-angiotensin system (RAS) blockers — what do they do and how do they work?
RAS blockers counteract the effect of the renin-angiotensin system. The most common RAS blockers are ACE inhibitors, such as lisinopril, and angiotensin receptor blockers (ARBs), for example losartan.
Renin-angiotensin blockers are so commonly accepted as a treatment for cardiovascular disease: what led you and your co-authors to question their effectiveness for patients on a low salt diet? How did you make the link between the low salt diet and high levels of plasma renin-activity?
When we observed that treatment PRA levels were extremely high in some such patients, we calculated that they were in fact high enough to overwhelm the effects of the drugs.
John Laragh and I have spent many years studying the circulating renin-angiotensin system by monitoring plasma renin activity (PRA) levels in normotension, hypertension and various cardiovascular and renal patient groups. We observed that changes in PRA levels coordinate with body salt to support a normal level of blood pressure, and that renin-angiotensin can be life saving in sodium depleted patients. We have been very surprised by the widespread use of RAS blockers in patients whose blood pressure is not high, especially those simultaneously taking diuretics and/or low salt diets. When we observed that treatment PRA levels were extremely high in some such patients, we calculated that they were in fact high enough to overwhelm the effects of the drugs. Therefore, such patients appeared able to shrug off the hypotensive effects of the drugs. However, we became concerned when we read four reports showing that such patients were dying at a faster rate than others with lower PRA levels.
There is a correlation between high PRA levels and low salt diets?
There is a reciprocal relationship between the body sodium-volume content and PRA levels. PRA levels rise as people become increasingly salt depleted by low salt diets and they rise even more when a diuretic drug is added. On the other hand, PRA levels fall just as quickly when salt is restored to the diet and diuretics are reduced or withdrawn.
So are you saying certain cardiovascular patients might benefit from consuming more salt? Are there any possible dangers if patients begin to go this route?
We are saying that a high plasma renin (PRA) test helps to identify those patients who are likely to benefit from a higher salt intake and/or subtraction of diuretics. We are not suggesting an increase in salt intake or subtraction of diuretics from patients with medium or low PRA levels (< 6.5 ng/ml/hr using the Quest Diagnostics PRA assay).
Can you help us understand the numbers a little bit: how many patients in the US are currently in treatment for cardiovascular disease, and can you estimate how many might be affected by what you’ve found in this new paper in the American Journal of Hypertension?
Cardiovascular diseases affecting the heart, brain, and kidney, are the leading causes of morbidity and mortality.
Cardiovascular diseases affecting the heart, brain, and kidney, are the leading causes of morbidity and mortality. Many such patients also have hypertension. More than 50 million Americans are being treated for these conditions and the vast majority are taking RAS blockers and/or diuretics and often a restricted sodium diet as well. The percentage of such patients who develop high PRA levels, reflecting volume depletion, is unknown, but in the two trials we reviewed, high PRA levels occurred in less than 20% of the 2913 cardiovascular patients enrolled in the HOPE trial, but in more than half of the 3978 heart failure patients enrolled in Val-HeFT. Many more patients in the Val-HeFT trial were taking diuretics.
The theme this year for World Health Day is hypertension, so we should mention that you and your colleagues have developed an iPhone/iPad app for hypertensive patients. How does it work and what does it do?
Our free app is an approach to personalized medicine
Our free app is an approach to personalized medicine. It teaches how to use plasma renin (PRA) testing to control the blood pressure of untreated or uncontrolled hypertensive patients with one, or usually at most two antihypertensive agents. The app takes the user step by step through the process of identifying whether a patient is currently taking natriuretic or RAS blocking drugs and then, based on their current PRA level, recommends stopping drugs that are being used inappropriately and then, if necessary, adding the opposite type of drug. The algorithm is based on the volume-vasoconstriction concept of hypertension control that was developed by John Laragh in the 1970’s. Now, the PRA test is commercially available, reimbursed by most insurance companies (including Medicare), requires no special conditions for drawing or processing the specimen, and patients need not stop their current medications. The app is currently available on the iPhone and iPad and soon to be released for Android devices.
Does your report mean that any patient who is currently taking a diuretic, or an aldosterone receptor blocker, or a low salt diet should not be given a renin-angiotensin system (RAS) blocking drug as well, such as an ACEI (angiotensin converting enzyme inhibitor) or an ARB (angiotensin receptor blocker) or a direct renin inhibitor?
No, it does not mean that. Only patients with very high plasma renin levels and normal to low blood pressures might be at increased risk from adding a RAS blocker.
How do you know when a patient has been excessively salt depleted?
Signs of salt depletion are postural hypotension, with high BUN, uric acid, and serum creatinine levels. Our report shows that a high plasma renin level adds strong support for the diagnosis.
Has there been a clinical trial to test your hypothesis?
Not yet. In an accompanying editorial Dr. Ted Kurtz states that such trials are unlikely. However, he also thinks that it is logical to supplement clinical judgment with measurements of plasma renin when considering treating normotensive, high CV risk subjects with RAS inhibitors.
Is it dangerous to suggest increasing salt intake and subtracting natriuretic drugs in patients with hypertension, diabetes, or cardiovascular disease?
Concern about increasing salt intake and subtracting natriuretic drugs is based upon the fear that blood pressure will become too high. Blood pressure should be monitored. Nonetheless, we showed in our report that groups of hypertensives who were already treated with a low salt diet and a daily diuretic were able to increase their salt intake from low to medium without inducing any rise in systolic blood pressure. Moreover, Paterna et al have shown that compensated heart failure patients discharged from hospital on a low salt diet are more likely to be readmitted to hospital than those taking a medium salt diet. In other words, there appears to be an optimal level of salt intake that is neither too high or too low. Monitoring plasma renin levels may assist in determining what that is for each patient.
Jean Sealey is Research Professor Emerita of Physiology & Biophysics in Medicine at Weill Cornell Medical College. A native of Scotland, she received her medical training at Glasgow University and has been studying hypertension since the early 1970’s. She recently developed an app for the iPhone and iPad to help guide antihypertensive drug selection. She is the co-author with Michael H. Alderman, Curt D. Furberg, and John H. Laragh, of “Renin-Angiotensin System Blockers May Create More Risk Than Reward for Sodium-Depleted Cardiovascular Patients With High Plasma Renin Levels” in the American Journal of Hypertension.
The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.
Jeremy Wang-Iverson is a senior publicist at Oxford University Press.
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Television viewing time and mortality
Americans spend about five hours daily in front of a television set according to official statistics. Prolonged television viewing is one of the most common behaviors associated with a sedentary lifestyle and public health authorities consider physical inactivity a major problem. Clinical trials have revealed a dose-response relationship between sitting time and mortality, including from cardiovascular disease. However, the relationship of relatively new indices of vascular function, such as the peripheral augmentation index (a predictor of cardiovascular events), with a sedentary lifestyle has not yet been studied.
In a recent paper, we selected 732 participants in the EVIDENT study, between 20-80 years old and free of cardiovascular diseases. The EVIDENT study explores the association of lifestyle (physical activity, dietary pattern, smoking, or alcohol consumption) with vascular aging assessed by different markers. The study included 1,553 patients and was conducted in six clinics of the Spanish territory.
We found that television viewing time was directly associated with the peripheral augmentation index regardless of physical activity level and other cardiovascular risk factors. This association is equal in men, women, and all ages. Additionally, the nature of what individuals watch on television can play an important role on endothelial function and peripheral/central hemodynamics. This is a potential focus point for future research.
Family watching television, c. 1958. National Archives and Records Administration.
To discourage a sedentary lifestyle, different programs are implemented to promote physical activity among future generations. The First Lady recently launched one of those initiatives – “Let’s move”. We consider such interventions that produce beneficial changes in lifestyles important. Therefore, our group is working on developing new technologies to support the counseling of physicians and nurses.In conclusion, the results highlight the importance of avoiding typically sedentary activities to improve the vascular function. In the future we hope to provide new findings about the relation between healthy lifestyles, a balanced diet, or practice regular physical activity with a delay in the arterial aging and therefore a decrease in the cardiovascular risk.
Mr Jose I Recio-Rodriguez is an Investigator Scientist at the “La Alamedilla” Research Unit. He belongs to the preventive activities research network (REDIAPP) and Salamanca Institute for biomedical research (IBSAL). He is co-author of the paper “Association of Television Viewing Time With Central Hemodynamic Parameters and the Radial Augmentation Index in Adults”, published by the American Journal of Hypertension.
The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.
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A green equilibrium fosters a new behavior in Sri Lanka
The balancing act that keeps ecosystems intact results from interactions, not only among the animals and plants, but also among their many smaller pathogens, parasites, symbionts, and pollinators. Taken together, all these interactions among the visible and invisible world produce an ecological balance, a green equilibrium.
I traveled to Sri Lanka to visit colleagues who are working in a tropical rainforest. While I was there I visited Bundala, a bird sanctuary in the southern part of the island. Bundala’s green equilibrium has produced an unusual cross-species cooperative interaction that also depends on the invisible world. If you paddle around a coral reef, you will often see tiny fish or shrimp removing and eating parasites from the mouths and gills of larger fish. The large fish, which are sometimes fierce predators, go to specific regions of the reef known as cleaning stations. There they temporarily shelve their aggressive behavior while the small fish operate on them.
Such clearly cooperative behavior across species boundaries is common in the marine world but less obvious on dry land. Oxpecker birds, which clean parasites from the ears and nostrils of large grazing animals in East Africa, often stray over the line between beneficial symbiotic and harmful parasitic behavior. They can actually prey on the slow-moving grazers, opening wounds and drinking their blood.
At Bundala I was lucky to see a much clearer example of dry-land cross-species cooperation. In an open area fifty yards from our truck, a black-naped hare crouched down and half-closed its eyes while a common mynah walked across its back and plucked clearly visible ticks from its ears. My camera equipment was just adequate enough to get pictures. In Brazil, jacana birds have been photographed removing ticks from the tummies of capybaras, but so far as I know this is the first time such unequivocally cooperative behavior has been photographed outside of South America.
For this behavior to happen, there must be so many ticks in the park’s grassland that the hares, tormented by their itching, will permit the birds to administer a painful remedy. And the hares and mynahs must interact with each other often enough that trust can build up between them. We saw many jackals nearby, so the cooperative behavior must take place in open areas where the hares are safe.
The hares, mynahs, jackals and ticks have together shaped this remarkable interaction. Bundala’s green equilibrium is providing opportunities for such complex equilibria to evolve, opportunities that will be lost if we damage this precious ecosystem.
Christopher Wills is a Professor Emeritus, Section of Ecology, Behavior and Evolution at the University of California, San Diego. He has published numerous books including The Darwinian Tourist and the soon to be released Green Equilibrium: the Vital Balance of Humans and Nature.
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Image Credit: Copyright Christopher Wills. Do not reproduce without permission.
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Environmental History’s growing pains
In the fall of 1994, I was invited to offer my university’s first environmental history course. Entering this unchartered territory, I scrambled to find sample syllabi and appropriate books. Nearly two decades later, environmental history is a standard course offering and my university, like so many others, boasts a thriving Environmental Studies major as well as a major in Environmental Science. Environmental history books, textbooks, articles, blogs, podcasts, and documentary films are flooding the market. The ASEH/FHS has grown by leaps and bounds, and Environmental History is recognized as a leading journal.
Some historical fields have evolved slowly, with movement like a glacier’s—meaningful, but slow. Environmental history has been more like an avalanche—fast, furious, and undeniable. Some of this growth can be attributed to timing, as environmental history and the information revolution took hold almost simultaneously. Tools like GIS made unique contributions to the field’s success. And like all fields, environmental history reaps the benefits of the internet, such as immediate access to articles and essays. H-Environment has created a global community of scholars in which questions are raised and answered, and opportunities to present and publish scholarship are widely circulated. More importantly, even as some traditional fields of historical study are increasingly denigrated as no longer crucial to the historical canon, appreciation of the practical value of environmental history is on the rise on campuses all over the world. Many universities offer not only environmental courses, but are dedicated to applying lessons learned, making their campuses as green as possible. Their success is judged (and celebrated) by publications including E-Magazine and the Chronicle of Higher Education.
One of the best changes is the increasing interdisciplinarity of environmental history and its incorporation into a variety of related studies. This sets it apart from other relatively new disciplines. Women’s history, for example, too often still finds itself isolated in a kind of pink ghetto as professors (and texts) of history courses with more traditional emphases (political, economic, and specific periodization) either ignore women’s history entirely or incorporate it only superficially. Environmental history, on the other hand, has more quickly been accepted as crucial to the historical enterprise and is given considerable coverage in a wide variety of courses covering a range of places, historical periods, and topics (including science, religion, gender, race, economics, and politics).
Autumn scence. 6 October 2012. Photo by Dmitri Popov. Creative Commons License.
There are some drawbacks to all this exciting growth, and not just that it’s impossible to keep up with the mounting supply of new information. A common complaint among environmental history professors and students alike is that the courses are just so depressing. Students complain that, having gained a true understanding of the breadth, depth, and life-threatening nature of the problems, they feel overwhelmed and helpless. In the face of rapid global warming, their individual efforts, including recycling their bottles and cans and bringing their reusable containers to Starbucks, seem akin to rearranging the deck chairs on the Titanic.
One of the new challenges facing this thriving field is to replace, or at least temper, the doom and gloom with a sense of practical empowerment. In delineating the human role in the creation of our current environmental crises, some historians are taking care to teach, rather than preach or scold, and highlight the roles that people have played in responding constructively to those crises, and in heading off others entirely. Such approaches create not a false sense of security, but inspiration, instilling feelings of responsibility and providing tools to help implement positive change.
Environmental history continues to experience a variety of growing pains, but its growth, and its ability to inspire, challenge, and promote genuine understanding and meaningful reform, reveals in new and dynamic ways the profound value of the study of history.
Nancy C. Unger is Associate Professor of History at Santa Clara University. She is the author of Beyond Nature’s Housekeepers: American Women in Environmental History and the prize-winning biography Fighting Bob La Follette: The Righteous Reformer, and book review editor of The Journal of the Gilded Age and Progressive Era.
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