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Many locals in British Columbia's Broughton Archipelago welcomed the salmon-farming industry in the early 1980s. It promised jobs, more schools, and higher incomes. It was not until some regular pods of killer whales stopped returning - and later, when some wild salmon populations became diseased - that the locals became concerned.

In Alaska, coastal ecosystems were protected from these impacts by a statewide ban on finfish farming in 1989. However, when the price of their commercial salmon catch plummeted in the mid-1990s, Alaskans became worried. Throughout the Pacific Northwest and Alaska, people now see the close connection between salmon farming, the environment, and international markets. As the global aquaculture industry continues to expand, what impacts will it have on local ecosystems and fishing economies?

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Environment
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Rosamond L. Naylor
Whitney L. Smith
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%people1%, CESP Senior Fellow and Director of the Program on Energy and Sustainable Development is quoted in New York Times, September 6, 2003 article.

The United States needs natural gas. Developing countries many thousands of miles away are willing to supply it. This sleepy beachfront town and other communities along the Gulf of Mexico are likely to become the links between producers and consumers.

Altogether, energy companies are planning to spend more than $100 billion in the next decade to bring gas from developing countries to rich nations, according to PFC Energy, a Washington consulting firm. The only way to do it is to supercool the gas so that it condenses into a liquid, which is then compact enough to load onto tankers and send across oceans.

For years, this process was too costly to compete with relatively cheap domestic supplies of natural gas and with imports from Canada. But those supplies are tightening just as the demand for clean-burning gas is soaring. That has led to the most severe gas shortage in the last 25 years and caused domestic gas prices to double this year.

The gap between domestic supply and total demand is forecast to grow significantly over the next 20 years. That has made liquefied natural gas competitive, if only companies can find places that are willing to accept having L.N.G. terminals built nearby. "We've entered the gas age, and there's no turning back if we want a firm supply of a strategically crucial fuel," said Michael S. Smith, an investor who controls Freeport LNG, a Houston company that plans to build a receiving terminal on Quintana Island.

Mr. Smith and his partners, Cheniere Energy and Contango Oil and Gas, both of Houston, expect to begin construction of the terminal early next year on this tiny island about 70 miles south of Houston. The $400 million operation will be able to receive ships full of liquefied natural gas, warming the gas and piping it to a nearby plant owned by the Dow Chemical Company.

Quintana Island's attraction lies not only in its proximity to a plant that uses natural gas as a raw material but also in its location near the center of the nation's energy industry. That, it is hoped, will make political resistance to such projects tepid compared with the safety, aesthetic and environmental concerns in places like Northern California and Massachusetts.

Despite such concerns and worries that large, potentially explosive gas terminals could become terrorist targets, energy companies are eager to import liquefied natural gas. It is a shift that could avoid gas shortages forecast for the future, but could also increase the nation's dependence on foreign energy supplies.

"Just as we're debating the need to diversify our oil supplies, we're faced with an array of challenges to secure reliable and politically stable sources of gas," said David G. Victor, director of the Program on Energy and Sustainable Development at Stanford University.

More than a dozen projects like the one here are seeking approval from regulators in North America, including several on the Gulf Coast and in the northern Mexican state of Baja California.

The United States is already the world's largest natural gas producer, and domestic production is expected to increase to 28.5 trillion cubic feet in 2020 from 19.1 trillion cubic feet in 2000, according to the Energy Information Administration. Still, demand is expected to far outstrip production, growing to 33.8 trillion cubic feet by 2020 from 22.8 trillion cubic feet in 2000.

The gas to close that gap - more than five trillion cubic feet, a 40 percent increase in 20 years - will have to come largely from outside the United States.

Almost all of America's imported natural gas currently comes by pipeline from Canada. But a growing market for gas within Canada and rapidly depleting Canadian wells are expected to weaken that country's ability to increase exports. Mexico, though believed to have large untapped gas reserves, is mired in nationalist debate over making it easier for foreign financiers and companies to explore for gas.

As a result, Mexico, a power in crude oil, is a growing importer of natural gas - and an attractive base for liquefied natural gas receiving terminals, which cost as much as $700 million to build. The Organization for Economic Cooperation and Development recently forecast that the percentage of North America's gas from imports would climb to 26 percent by 2030 from just 1 percent today.

Those imports will come mostly from developing nations like Equatorial Guinea, a former Spanish colony in West Africa where Marathon Oil of Houston plans to build an L.N.G. plant able to serve gas fields throughout the Gulf of Guinea.

Ambitious ventures are also under way in other West African countries, including Angola and Nigeria, where energy companies were recently burning gas escaping from oil drilling operations because there was no ready market for it. In the Middle East, small countries like Oman, a sultanate on the Strait of Hormuz, and Qatar, are emerging as important gas powers.

In South America, Trinidad and Tobago has become an early leader in exporting liquefied natural gas, although companies in Bolivia and Peru have had difficulties advancing efforts to export L.N.G. to California. Producers in Indonesia, Malaysia and Russia could step in to supply the West Coast, pushing the Andean countries to the margins of the business.

In some ways, the scramble for natural gas projects resembles the heady early days of the oil industry a century ago. Then, British, Dutch and American investors raced around the world to stake out interests in remote oil fields in the Middle East, Central Asia and the archipelagoes of the Java Sea.

Some regions are considered more promising than others. Industry executives point out that just three countries  Iran, Qatar and Russia  hold more than half of the world's natural gas reserves, inevitably focusing attention on the delicate interplay between politics and commerce in these places.

Russia, with the largest proven reserves, plans to start exporting liquefied natural gas in 2007 with deliveries to Japan. Iran, while off limits to American companies because of trade restrictions by the United States, has attracted Japanese, French, British, Indian and South Korean concerns interested in mounting gas ventures.

There are important differences, however, between past oil booms and the current interest in natural gas. For one thing, studies show the world will be swimming in natural gas supplies while oil reserves are expected to dwindle in the decades ahead. Just one area in Qatar, a monarchy near Saudi Arabia with fewer than a million people, is thought to have enough gas to supply the United States for 40 years, according to a study by Deutsche Bank.

The natural gas industry has to overcome several obstacles before evolving into a vibrant global market. Even with ample supplies there is no market for trading liquefied natural gas, as there is for crude oil. Instead, producers and customers sign long-term contracts, sometimes resulting in significant price differences from one year to the next or from one country to another.

One reason the natural gas market has remained fragmented is because the fuel is difficult and expensive to extract and transport. But these costs are declining, adding to the appeal of gas projects. Lord Browne, the chief executive of BP, said the cost of developing gas liquefaction plants had halved since the 1980's, while shipping costs had also fallen.

Shipbuilders are seeking to meet demand for tankers, with the global gas fleet expected to grow to 193 ships by 2006 from 136 in 2002, according to LNG One World, a gas- shipping information service operated by Drewry International of Britain and Nissho Iwai of Japan.

Natural gas is still not considered as crucial as oil for overall energy security since oil's main use is for transportation and there is no short-term alternative. Natural gas has a variety of important industrial uses, like serving as a raw material for fertilizer and generating electricity.

Still, the growth in demand for liquefied natural gas in the United States is expected to outstrip other parts of the world. It is likely to grow 35 percent in the next five years, compared with 20 percent in other North Atlantic countries and 12 percent worldwide, according to Deutsche Bank. Hence the rush to proceed with projects that supply liquefied natural gas to the United States.

"The world could be consuming more gas than oil by 2025," Philip Watts, the chairman of the Royal Dutch/Shell Group, the large British-Dutch energy company, said in a recent address to industry executives in Tokyo. "We must be prepared for growing geopolitical turbulence and volatility in an increasingly interdependent world."

The United States has only five terminals capable of receiving L.N.G., including one in Puerto Rico. Almost 20 are on the drawing board, but opposition to the terminals has already prevented the start of work on several of them. Earlier this year, for instance, Shell and Bechtel Enterprises shelved a plan to build a terminal about 30 miles north of San Francisco because of stiff public opposition.

California remains perhaps the most difficult place in the country to gain approval for gas-receiving terminals. This has encouraged imaginative proposals like one last month from BHP Billiton, Australia's largest energy company, for a $600 million floating terminal 20 miles off the coast of Oxnard in the southern part of the state. It remains to be seen whether any of the California projects will be built.

An air of resignation hangs over even the critics of the plan to build the terminal on Quintana, which is scheduled to start operating by 2007. Officials from Freeport LNG have told residents that they expect to make more than $1 million a year in tax payments to the city, a substantial sum for a community of 40 homes that is the smallest municipality in Texas.

At the Jetties, a restaurant on the island's edge overlooking the brown water of the Gulf of Mexico, the walls are plastered with warnings of the perceived dangers of receiving tankers full of potentially combustible gas from far-flung parts of the world. But the restaurant's employees seem to believe that the terminal will be built, inevitably changing the island's easygoing atmosphere.

"People come out here to drink beer on the beach and look at the birds and the gulf," said Dana Difatta, a cook at the restaurant. "Imagine what they'll think when they're staring at some huge vats holding natural gas. Will they be horrified or relieved?"

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A short while ago, one of the worlds most brutal and entrenched dictatorships was swiftly toppled by the military force of the United States and the United Kingdom. The 2003 Iraq war was launched to disarm Saddam Hussein, but for many of its advocates and supporters, the more compelling aim was to bring about regime change. In fact, the goal is not simply regime change but a sweeping political transformation in that country  and, it is hoped, in states throughout its neighborhood  towards what has never existed there before: democracy.

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Policy Review
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Larry Diamond
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Imagine a scenario in which terrorists begin attacking urban centers. The government responds with widespread detention; extended powers of arrest, search and seizure; increased surveillance capabilities; and the creation of a special court to try terrorist suspects. Before long it is sanctioning inhumane treatment of prisoners and the use of military force.

That is how the British government responded in the early 1970s to the start of Northern Ireland's Troubles. The effect was devastating. The new measures alienated the minority Catholic population and breathed life into a near-defunct Republican movement. More than 3,600 people died in the decades of violence that ensued. The provisions also carried heavy economic and political costs, both at home and abroad. Most critically, they undermined the state's political legitimacy at a time when an avowedly violent movement sought to destabilize the government.

The erosion of individual rights carries significant domestic and foreign-relations consequences. Beyond this, a more fundamental question arises: Has America remained true to its founding principles?

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Washington Post
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Diabetes mellitus is a leading cause of morbidity and death in the United States. Type 2 diabetes mellitus accounts for the majority of affected persons (90% to 95%) and affects older adults, particularly those older than 50 years of age. It affects an estimated 16 million Americans, 11 million of whom have both diabetes and hypertension. Most adverse diabetes outcomes are a result of vascular complications. These complications are generally classified as microvascular, such as retinopathy, nephropathy, and neuropathy (although neuropathy may not be entirely a microvascular disease), or macrovascular, such as coronary artery disease, cerebrovascular disease, and peripheral vascular disease.

In order to prevent, or diminish the progression of, microvascular and macrovascular complications, recommended diabetes management necessarily encompasses both metabolic control and cardiovascular risk factor control. The need for good glycemic control is supported by the Diabetes Control and Complications Trial in type 1 diabetes mellitus and, more recently, the United Kingdom Prospective Diabetes Study (UKPDS) in type 2 diabetes mellitus. In these studies, tight blood sugar control reduced microvascular complications, such as nephropathy and retinopathy, but had little effect on macrovascular outcomes. Up to 80% of patients with type 2 diabetes mellitus will develop or die of macrovascular disease, underscoring the importance of preventing macrovascular complications.

In an effort to provide internists and other primary care physicians with effective management strategies for diabetes care, the American College of Physicians decided to develop guidelines on the management of hypertension in people with type 2 diabetes mellitus. The target audience for this guideline is all clinicians who provide care to patients with type 2 diabetes. The target patient population is all persons with type 2 diabetes who have hypertension, defined as systolic blood pressure of at least 140 mm Hg or diastolic blood pressure of at least 90 mm Hg. This target patient population includes those who already have some form of microvascular complication and, of particular importance, premenopausal women with diabetes. We will attempt to answer the following questions: 1) What are the benefits of tight blood pressure control in type 2 diabetes? 2) What should the target levels of systolic blood pressure and diastolic blood pressure be for patients with type 2 diabetes? and 3) Are certain antihypertensive agents more effective or beneficial in patients with diabetes?

When analyzing benefit or effectiveness for this review, we included only studies that measured clinical end points. The four major classes of clinical end points were all-cause mortality, cardiovascular mortality, cardiovascular events (myocardial infarction, stroke, or congestive heart failure), and microvascular complications (photocoagulation, nephropathy, neuropathy, or amputation).

The review was divided into two categories. The first included studies that evaluated the effects of blood pressure control if the comparison examined an antihypertensive drug versus placebo or the effects of different target blood pressure levels. The second category evaluated the effect of different classes of drugs. A discussion of this evidence follows.

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Annals of Internal Medicine
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Douglas K. Owens
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The United States, physicians insert more than 5 million central venous catheters every year. Central venous catheters allow measurement of hemodynamic variables that cannot be measured accurately by noninvasive means and allow delivery of medications and nutritional support that cannot be given safely through peripheral venous catheters. Unfortunately, the use of central venous catheters is associated with adverse events that are both hazardous to patients and expensive to treat. More than 15 percent of patients who receive these catheters have complications. Mechanical complications are reported to occur in 5 to 19 percent of patients,5,6,8 infectious complications in 5 to 26 percent,5,7,9 and thrombotic complications in 2 to 26 percent. In this review, we explain methods for reducing the frequency of complications in adult patients.

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New England Journal of Medicine
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The world of Eli Ginzberg can readily be thought of as a triptych-a career in three parts. In his early years, Ginzberg's work was dedicated to understanding the history of economics, from Adam Smith to C. Wesley Mitchell, and placing that understanding in what might well be considered economic ethnography. His studies took him on travels from Wales in the United Kingdom to California in the United States. For example, the poignant account of Welsh miners in an era of economic depression and technological change remains a landmark work. His report of a cross country trip taken in the first year of the New Deal provides insight and evaluation that can scarcely be captured in present-day writings.

The second period of his career corresponds to Ginzberg's increasing involvement in the practice of economics. He deals with issues related to manpower allocation, employment shifts, and gender and racial changes in the workforce. His writing reflects a growing concern for child welfare and education. In this period, his work increasingly focuses on federal, state and city governments, and how the public sector impacts all basic social issues. His work was sufficiently transcendent of political ideology that seven presidents sought and received his advice and participation.

After receiving all due encomiums and congratulations for intellectual work and policy research well done, Ginzberg then went on to spend the next thirty years of his life carving out a place as a preeminent economist of health, welfare services, and hospital administration. It is this portion of his life that is the subject of Eli Ginzberg: The Economist as a Public Intellectual. What is apparent in Ginzberg's work of this period is his sense of the growing interaction of all the social sciences-pure and applied-to develop a sense of the whole. The contributors to this festschrift, join together to provide a portrait of a figure whose life and work have spanned the twentieth century, and yet pointed the way to changes in the twenty-first century. Eli Ginzberg from the start possessed a strong sense of social justice and economic equality grounded in a Judaic-Christian tradition. All of these aspects come together in the writings of a person who transcends all parochialism and gives substantive content to the often-cloudy phrase, public intellectual.

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Transaction Publishers (New Brunswick, NJ) in "Eli Ginzberg: The Economist as a Public Intellectual", edited by Louis Horowitz
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