Declining agricultural productivity, land clearance and climate change are compounding the vulnerability of already marginal rural populations in West Africa. 'Farmer-Managed Natural Regeneration' (FMNR) is an approach to arable land restoration and reforestation that seeks to reconcile sustained food production, conservation of soils, and protection of biodiversity. It involves selecting and protecting the most vigorous stems regrowing from live stumps of felled trees, pruning off all other stems, and pollarding the chosen stems to grow into straight trunks. Despite widespread enthusiasm and application of FMNR by environmental management and development projects, to date, no research has provided a measure of the aggregate livelihood impact of community adoption of FMNR. This paper places FMNR in the context of other agroforestry initiatives, then seeks to quantify the value of livelihood outcomes of FMNR. We review published and unpublished evidence about the impacts of FMNR, and present a new case study that addresses gaps in the evidence-base. The case study focuses on a FMNR project in the district of Talensi in the semi-arid Upper East Region in Ghana. The case study employs a social return on investment analysis, which identifies proxy financial values for non-economic as well as economic benefits. The results demonstrate income and agricultural benefits, but also show that asset creation, increased consumption of wild resources, health improvements, and psycho-social benefits created more value in FMNR-adopting households during the period of the study than increases in income and agricultural yields.

for contributing the expertise, data, and information for the water case study. Finally, thanks to Eric Lockhart and Tim Reber from NREL as well as to the other members of the micro-grid development community who offered data, feedback, and time in support of this report. vii

In the 2 years following a change in the policy of admission following head injury in Nottingham, the number of patients admitted fell from 941 in 1977 to 534 and 460 in 1978 and 1979 respectively. No detrimental effects resulting from this change in policy have been noted. Previously, all patients who had been unconscious (however briefly) had been admitted. The changed policy stated that: 1. Patients who had been briefly unconscious or amnesic would only be admitted if one of the following factors was also present: abnormal neurological signs or obtunded consciousness on arrival at hospital, fits, vomiting, severe headaches or clinical or radiological evidence of a fracture of the skull. 2. Such patient would only be allowed home if instructions issued to the patients on a ":head injury instruction card' could be implemented satisfactorily. It is suggested that the implementation of such an admission policy will avoid the unnecessary admission of large numbers of patients, thus freeing beds for other purposes. The article leaves unanswered the question "Which patients should have a skull X-ray?"

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Objective: To evaluate the practicality and validity of using infra-red beam counters (IRBCs) to measure walking path use and overall park use.

The tables and figures in this report are limited to use in this report only and are not to be further disseminated or used without the permission of the sources cited.

This paper presents the results of a series of thirty-one finger tip injuries treated by local triangular advancement flaps. Criteria for selection of patients for this type of repair and several points of technique are discussed.

Objective: This paper discusses some of the inherent methodological limitations of gathering data via direct observation using local parks as a case study.