Central Asia: Kyrgyzstan and the learning experience in the design of pastoral institutions.

The authors analyse the nature of policy development to understand the reasons for institutional change in pasture management in Kyrgyzstan. They use the concept of intentional institutional change, emphasising its incremental nature and the important relationship between belief systems and institutions. The paper explores the relationship between the perceptions and beliefs of policy-makers, the policy interventions they undertake, and the consequences for pastoral migration and practices. The study reveals the gap between the intentions behind such policies and their outcomes, the persistence and importance of pastoral migration, and the learning process that policy-makers undergo. This close look at the development and institutionalisation of new dominant societal beliefs highlights the possible direction of the future development of formal pastoral institutions in Central Asia. Policy-makers should respond better to changes in pastoral mobility and the unsustainable increase in intensified use of natural pastures. Policy-makers must also respond to the growth in conflict over pasture use by becoming more aware of the need for inter-sectoral cooperation. The authors argue that a crucial test for the new formal institutions still lies ahead. The key questions are: whether policy-makers and pasture users can eventually come to hold the same beliefs about what is needed in their society, and what new effective institutions will emerge to define the future of pastoralism in Central Asia.

Les auteurs tentent d'élucider les raisons du changement institutionnel de la gestion des pâturages au Kirghizstan en analysant les modifications apportées dans ce domaine au niveau réglementaire. Ils recourent au concept de changement institutionnel volontariste en soulignant son caractère progressif et l'importance des liens entre les systèmes de croyances et les institutions. Cet article explore les liens entre les perceptions et les croyances des décideurs, leurs interventions en matière réglementaire et les conséquences de ces décisions sur les migrations et les pratiques des pasteurs. L'étude met en lumière le fossé qui sépare les intentions qui animent ces décisions et les résultats concrets obtenus, la persistance et l'ampleur des migrations pastorales et les enseignements que les décideurs en tirent actuellement. Cet examen approfondi de l'élaboration et de l'institutionnalisation de nouvelles croyances sociétales dominantes met en avant des perspectives d'orientations pour le développement futur d'institutions pastorales formelles en Asie centrale. Les décideurs politiques doivent prendre acte du déclin du nomadisme pastoral et de la généralisation d'utilisations intensives et non durables des prairies naturelles, et concevoir des réponses adaptées. Ils doivent également répondre à l'intensification des situations conflictuelles en prenant davantage conscience de la nécessité d'une coopération intersectorielle. Les auteurs estiment que les nouvelles institutions formelles n'ont pas encore pleinement démontré leur efficacité. Il conviendra de répondre à deux questions cruciales, à savoir : les décideurs politiques et les utilisateurs des prairies parviendront-ils à partager une vision commune des besoins de leur société ? Quelles institutions nouvelles et efficaces verront-elles le jour pour définir l'avenir du pastoralisme en Asie centrale ?

Los autores analizan la naturaleza de la planificación de políticas con el fin de entender las razones del cambio institucional en la gestión de los pastizales de Kirguistán. Para ello emplean el concepto de cambio institucional intencionado, haciendo hincapié en su carácter progresivo y en el importante vínculo que existe entre sistemas de creencias e instituciones. Asimismo, examinan la relación entre las percepciones y convicciones de los planificadores, las intervenciones normativas que impulsan y las consecuencias que ello tiene en la migración y los usos de los grupos de pastores. El estudio evidencia el desfase existente entre las intenciones que animan estas políticas y sus resultados, la persistencia e importancia de la migración pastoral y el proceso de aprendizaje por el que pasan los planificadores de políticas. Este detenido análisis de la aparición e institucionalización de nuevas creencias que arraigan en la sociedad señala la posible dirección que puede seguir en el futuro la creación de instituciones pastorales formales en Asia Central. Los planificadores deben tener más en cuenta la menor movilidad de los pastores y el insostenible incremento del uso intensivo de los pastos naturales y encontrar respuesta a esos fenómenos. También deben responder a un nivel creciente de conflicto, para lo cual deben entender la necesidad de procesos de cooperación intersectorial. Los autores postulan que las nuevas instituciones formales aún deben superar pruebas cruciales. Las cuestiones básicas que se plantean son, por un lado, si a la larga los planificadores de políticas y los usuarios de pastizales pueden llegar a compartir una misma visión de lo que necesita su sociedad y, por el otro, qué tipo de instituciones nuevas y eficaces verán la luz para definir el futuro del pastoreo en Asia Central.

[Modern principals of antibacterial therapy of suppurative-septic diseases]. / Sovremennye printsipy antibakterial'noi terapii gnoino-septicheskikh zabolevanii.

The carried out researches concerning initial nidus of infection have shown a high rate of anaerobic infection especially in patients with destructive-suppurative lung disease, liver abscess, peritonitis (up to 82.8%). An aerobic-anaerobic association of microbes remarkably often is found in the nidus of infection. We recommend the following preventive scheme to treat patients with different pyoseptic diseases. The scheme is based on the results of our 10 years experience treatment of such patients. It consists of a combination of 2.0 gr. cefoperazoli twice daily, metronidasoli 500 mg. 3 times and amycacini 500 mg twice daily. The intra-arterial or intravenous introduction of the medications was possibly preferred. Having analyzed the results of the treatment of 13,747 patients treated at the center of contaminated surgery, we would note that in 30.2% of the cases were reached excellent results. The above-mentioned scheme of antibacterial therapy with surgical correction of suppurative focus allowed us to reach good results in 45.4%. The satisfactory results of the treatment were achieved in 22.8% of patients. Mortality rate was up to 1.9%.

[Role of prolonged intraarterial catheter therapy in general peritonitis]. / Rol' i mesto dlitel'noi vnutriarterial'noi keteternoi terapii pri rasprostranennom gnoinom peritonite.

The analyses of treatment results in 82 patients with general purulent peritonitis are presented. In these patients long-term intraarterial catheter therapy (IACT) was included in the complex of postoperative treatment after elimination of infection source. Postoperative peritonitis was in 66 patients, 52 patients of them underwent reoperations for persisting general peritonitis. Use of IACT promoted arrest of abdominal inflammatory process and polyorganic insufficiency due to high concentration of antibiotics in the affection focus, improvement of regional circulation, reduced number of postoperative complications and a sharp fall of lethality of 8.5%.

[Surgical aspects of non-respiratory activity of the lungs during acute pyonecrotizing diseases]. / Khirurgicheskie aspekty nerespiratornoi deiatel'nosti legkikh pri ikh ostrykh gnoino-destruktivnykh zabolevaniiakh.

The preoperative preparation program based upon the experience of treating 465 patients with acute pyonecrotizing diseases of lungs was developed. This system takes into account the stage of the disease (I--septic, II--stabilization, III--remission), endotoxicosis intensity and non respiratory activity of the affected lung (NRAL). The patients of the first group (I stage of the disease) with long-term subclavian vein catheterization were on the special scheme of NRAL correction, their supurative focuses being treated with electrized hypochlorite sodium solution. The system appeared to be effective in managing patients, in the first group--254 patients of which 202 (79,9%) were successfully treated without operation, as for the second group, there were only 52 (40,6%), in the third--26 (31,3%). By limiting and stabilizing the process, the effect of this preoperative preparation program was also seen in other patients. It allowed to perform less traumatic operations (lung resection) in 109 patients of the 179 operated on, with 8,7% of postoperative complications in 8,7% in the first group vers. 18,4% and 24,6% in the second and third, respectively. Thus the above mentioned results show the proposed system to be effective.

[Glucose tolerance disorders in patients with hypothyroidism]. / O narusheniiakh tolerantnosti k gliukoze u bol'nykh gipotireozom.

Altogether 42 patients with hypothyrosis of different etiology (aged 17 to 57) were investigated. According to the results of oral glucose tolerance test (OGTT) all the patients were divided into 3 groups: normal OGTT, disturbed OGTT and a flat type of glycemic curves. High levels of cortisol and free fatty acids (FFA) were detected in persons with disturbed OGTT. A lowered reaction to insulin was found in 15 patients with high levels of cortisol and FFA. Persons with unchanged sensitivity to insulin demonstrated a normal type of OGTT and normal blood levels of cortisol and FFA, and among patients with a low reaction to insulin there were persons with disturbed OGTT and high blood levels of cortisol and OGTT. Positive correlation was found between OGTT disturbances, on the one hand, and lowered sensitivity to insulin, increased blood levels of cortisol and FFA, on the other hand. A conclusion has been made that one of the causes of GTT disturbance in patients with hypothyrosis is an increase in the blood levels of cortisol and FFA and a decrease of sensitivity to insulin.