33 resultados para Current awareness services
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Current nutrient deposition shows episodic variations which likely may impact the local nutrient cycle at the RBSF. Comparing analyses of deposition data during present-day atmospheric circulation and phases of high biomass burning in the Amazon, characteristic relationships between remote emissions and local deposition are determined. By using projections drawn from the special report on emission scenarios (SRES) in combination with a trajectory modeling tool, future nutrient deposition conditions of the mountain ecosystem are assessed. Observations of relations between climatic variables, current time series of nutrient deposition, and tree growth point to an impact of the remote fertilization effect of atmospheric matters, emitted primarily by human activities like biomass burning and agricultural and industrial sources. The increasing emissions in the future may have adverse effects on the ecosystem in the long run.
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This paper presents a survey on the usage, opportunities and pitfalls of semantic technologies in the Internet of Things. The survey was conducted in the context of a semantic enterprise integration platform. In total we surveyed sixty-one individuals from industry and academia on their views and current usage of IoT technologies in general, and semantic technologies in particular. Our semantic enterprise integration platform aims for interoperability at a service level, as well as at a protocol level. Therefore, also questions regarding the use of application layer protocols, network layer protocols and management protocols were integrated into the survey. The survey suggests that there is still a lot of heterogeneity in IoT technologies, but first indications of the use of standardized protocols exist. Semantic technologies are being recognized as of potential use, mainly in the management of things and services. Nonetheless, the participants still see many obstacles which hinder the widespread use of semantic technologies: Firstly, a lack of training as traditional embedded programmers are not well aware of semantic technologies. Secondly, a lack of standardization in ontologies, which would enable interoperability and thirdly, a lack of good tooling support.
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PRINCIPLES To assess gynaecologists' awareness of bone healthcare in women and the prevalence of application of national recommendations on bone healthcare in Switzerland. METHODS During the annual meeting of the Swiss Society of Gynaecology and Obstetrics 2012, the Swiss Association against Osteoporosis (SVGO) performed standardised interviews with conference participants (n = 210). Questions addressed responsibility for bone healthcare, and whether diagnostic procedures, initiation of bone-specific treatment and follow-up were performed in accordance with SVGO recommendations. RESULTS The majority of respondents were aged 30-50 years (60%), female (70%) and working as board-certified gynaecologists (69%). Ninety-three percent of respondents considered care for bone health as part of the gynaecologist's expertise. As diagnostic procedures, 44% recommended performing bone densitometry (DXA) only, 34% ordered additional laboratory testing. Seventy-two percent of respondents initiated a bone-specific treatment. Predictors for not performing diagnostic procedures and not initiating a bone-specific treatment were physician's age below 30, being a trainee gynaecologist, and working at a university clinic. Particularly, young trainee gynaecologists working at a university clinic were especially unlikely to initiate a bone-specific treatment (regression coefficient = -2.68; odds ratio [OR] 0.069, 95% confidence interval [CI] 0.01-0.61; p = 0.16). Follow-ups were performed by 77% of respondents, but were less likely to be by female physicians (OR 0.27, 95% CI 0.09-0.84; p = 0.024). CONCLUSIONS Although the majority of board-certified gynaecologists follow national recommendations on bone healthcare, current medical training in obstetrics and gynaecology does not sufficiently cover the subject of women's health. However, since this is a small study our findings may not reflect the findings in the total population.
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Equipped with state-of-the-art smartphones and mobile devices, today's highly interconnected urban population is increasingly dependent on these gadgets to organize and plan their daily lives. These applications often rely on current (or preferred) locations of individual users or a group of users to provide the desired service, which jeopardizes their privacy; users do not necessarily want to reveal their current (or preferred) locations to the service provider or to other, possibly untrusted, users. In this paper, we propose privacy-preserving algorithms for determining an optimal meeting location for a group of users. We perform a thorough privacy evaluation by formally quantifying privacy-loss of the proposed approaches. In order to study the performance of our algorithms in a real deployment, we implement and test their execution efficiency on Nokia smartphones. By means of a targeted user-study, we attempt to get an insight into the privacy-awareness of users in location-based services and the usability of the proposed solutions.
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Mountain socio-ecological systems produce valuable but complex ecosystem services resulting from biomes stratified by altitude and gravity. These systems are often managed and shaped by smallholders whose marginalization is exacerbated by uncertainties and a lack of policy attention. Human–environment interfaces in mountains hence require holistic policies. We analyse the potential of the Global Mountain Green Economy Agenda (GMGEA) in building awareness and thus prompting cross-sectoral policy strategies for sustainable mountain development. Considering the critique of the green economy presented at the Rio + 20 conference, we argue that the GMGEA can nevertheless structure knowledge and inform regional institutions about the complexity of mountain socio-ecological systems, a necessary pre-condition to prompt inter-agency collaboration and cross-sectoral policy formulation. After reviewing the content of the GMGEA, we draw on two empirical cases in the Pakistani and Nepali Himalayas. First, we show that lack of awareness has led to a sequence of fragmented interventions with unanticipated, and unwanted, consequences for communities. Second, using a green economy lens, we show how fragmentation could have been avoided and cross-sectoral policies yielded more beneficial results. Project fragmentation reflects disconnected or layered policies by government agencies, which inherently keep specialized agendas and have no incentive to collaborate. Awareness makes agencies more likely to collaborate and adopt cross-sectoral approaches, allowing them to target more beneficiaries, be more visible, and raise more funds. Nevertheless, we also identify four factors that may currently still limit the effect of the GMGEA: high costs of inter-agency collaboration, lack of legitimacy of the green economy, insufficiently-secured smallholder participation, and limited understanding of the mechanisms through which global agendas influence local policy.
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– Swiss forests experience strong impacts under the CH2011 scenarios, partly even for the low greenhouse gas scenario RCP3PD. Negative impacts prevail in low-elevation forests, whereas mostly positive impacts are expected in high-elevation forests. – Major changes in the distribution of the two most important tree species, Norway spruce and European beech, are expected. Growth conditions for spruce improve in a broad range of scenarios at presently cool high-elevation sites with plentiful precipitation, but in the case of strong warming (A1B and A2) spruce and beech are at risk in large parts of the Swiss Plateau. – High elevation forests that are temperature-limited will show little change in species composition but an increase in biomass. In contrast, forests at low elevations in warm-dry inner-Alpine valleys are sensitive to even moderate warming and may no longer sustain current biomass and species. – Timber production potential, carbon storage, and protection from avalanches and rockfall react differently to climate change, with an overall tendency to deteriorate at low elevations, and improve at high elevations. – Climate change will affect forests also indirectly, e.g., by increasing the risk of infestation by spruce bark beetles, which will profit from an extended flight period and will produce more generations per year.
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We report the first measurement of the neutrino-oxygen neutral-current quasielastic (NCQE) cross section. It is obtained by observing nuclear deexcitation γ rays which follow neutrino-oxygen interactions at the Super-Kamiokande water Cherenkov detector. We use T2K data corresponding to 3.01 × 1020 protons on target. By selecting only events during the T2K beam window and with well-reconstructed vertices in the fiducial volume, the large background rate from natural radioactivity is dramatically reduced. We observe 43 events in the 4–30 MeV reconstructed energy window, compared with an expectation of 51.0, which includes an estimated 16.2 background events. The background is primarily nonquasielastic neutral-current interactions and has only 1.2 events from natural radioactivity. The flux-averaged NCQE cross section we measure is 1.55 × 10−38 cm2 with a 68% confidence interval of ð1.22; 2.20Þ × 10−38 cm2 at a median neutrino energy of 630 MeV, compared with the theoretical prediction of 2.01 × 10−38 cm2.
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BACKGROUND Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. METHODS We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. RESULTS Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care. CONCLUSIONS Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.
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OBJECTIVE To assess the current state of reporting of pain outcomes in Cochrane reviews on chronic musculoskeletal painful conditions and to elicit opinions of patients, healthcare practitioners, and methodologists on presenting pain outcomes to patients, clinicians, and policymakers. METHODS We identified all reviews in the Cochrane Library of chronic musculoskeletal pain conditions from Cochrane review groups (Back, Musculoskeletal, and Pain, Palliative, and Supportive Care) that contained a summary of findings (SoF) table. We extracted data on reported pain domains and instruments and conducted a survey and interviews on considerations for SoF tables (e.g., pain domains, presentation of results). RESULTS Fifty-seven SoF tables in 133 Cochrane reviews were eligible. SoF tables reported pain in 56/57, with all presenting results for pain intensity (20 different outcome instruments), pain interference in 8 SoF tables (5 different outcome instruments), and pain frequency in 1 multiple domain instrument. Other domains like pain quality or pain affect were not reported. From the survey and interviews [response rate 80% (36/45)], we derived 4 themes for a future research agenda: pain domains, considerations for assessing truth, discrimination, and feasibility; clinically important thresholds for responder analyses and presenting results; and establishing hierarchies of outcome instruments. CONCLUSION There is a lack of standardization in the domains of pain selected and the manner that pain outcomes are reported in SoF tables, hampering efforts to synthesize evidence. Future research should focus on the themes identified, building partnerships to achieve consensus and develop guidance on best practices for reporting pain outcomes.
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The ecosystem services concept (ES) is becoming a cornerstone of contemporary sustainability thought. Challenges with this concept and its applications are well documented, but have not yet been systematically assessed alongside strengths and external factors that influence uptake. Such an assessment could form the basis for improving ES thinking, further embedding it into environmental decisions and management. The Young Ecosystem Services Specialists (YESS) completed a Strengths–Weaknesses–Opportunities–Threats (SWOT) analysis of ES through YESS member surveys. Strengths include the approach being interdisciplinary, and a useful communication tool. Weaknesses include an incomplete scientific basis, frameworks being inconsistently applied, and accounting for nature's intrinsic value. Opportunities include alignment with existing policies and established methodologies, and increasing environmental awareness. Threats include resistance to change, and difficulty with interdisciplinary collaboration. Consideration of SWOT themes suggested five strategic areas for developing and implementing ES. The ES concept could improve decision-making related to natural resource use, and interpretation of the complexities of human-nature interactions. It is contradictory – valued as a simple means of communicating the importance of conservation, whilst also considered an oversimplification characterised by ambiguous language. Nonetheless, given sufficient funding and political will, the ES framework could facilitate interdisciplinary research, ensuring decision-making that supports sustainable development.
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BACKGROUND After the introduction of instruments for benchmarking, certification and a national guideline for acute pain management, the aim of this study was to describe the current structure, processes and quality of German acute pain services (APS). METHODS All directors of German departments of anaesthesiology were invited to complete a postal questionnaire on structures und processes of acute pain management. The survey asked for staff, techniques and quality criteria, which enabled a comparison to previous data from 1999 and surveys from other countries. RESULTS Four hundred and eight (46%) questionnaires were returned. APS have increased considerably and are now available in 81% of the hospitals, mainly anaesthesia based. However, only 45% fulfilled the minimum quality criteria, such as the assignment of personnel, the organization of patient care during nights and weekends, written protocols for postoperative pain management, regular assessments and documenting pain scores. Staff resources varied considerably, but increased compared to 1999. Two daily rounds were performed in 71%, either by physicians and nurses (42%), by physicians only (25%) or by supervised nurses (31%). Most personnel assigned to the APS shared this work along with other duties. Only 53% of the hospitals had an integrated rotation for training their specialty trainees. CONCLUSIONS The availability of APS in Germany and other countries has increased over the last decade; however, the quality of nearly half of the APS is questionable. Against the disillusioning background of recently reported unfavourable pain-related patient outcomes, the structures, organization and quality of APS should be revisited.
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Survivors of childhood cancer carry a substantial burden of morbidity and are at increased risk for premature death. Furthermore, clear associations exist between specific therapeutic exposures and the risk for a variety of long-term complications. The entire landscape of health issues encountered for decades after successful completion of treatment is currently being explored in various collaborative research settings. These settings include large population-based or multi-institutional cohorts and single-institution studies. The ascertainment of outcomes has depended on self-reporting, linkage to registries, or clinical assessments. Survivorship research in the cooperative group setting, such as the Children's Oncology Group, has leveraged the clinical trials infrastructure to explore the molecular underpinnings of treatment-related adverse events, and to understand specific complications in the setting of randomized risk-reduction strategies. This review highlights the salient findings from these large collaborative initiatives, emphasizing the need for life-long follow-up of survivors of childhood cancer, and describing the development of several guidelines and efforts toward harmonization. Finally, the review reinforces the need to identify populations at highest risk, facilitating the development of risk prediction models that would allow for targeted interventions across the entire trajectory of survivorship.
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Despite numerous research efforts over the last decades, integrating the concept of ecosystem servicesinto land management decision-making continues to pose considerable challenges. Researchers havedeveloped many different frameworks to operationalize the concept, but these are often specific to acertain issue and each has their own definitions and understandings of particular terms. Based on acomprehensive review of the current scientific debate, the EU FP7 project RECARE proposes an adaptedframework for soil-related ecosystem services that is suited for practical application in the preventionand remediation of soil degradation across Europe. We have adapted existing frameworks by integratingcomponents from soil science while attempting to introduce a consistent terminology that is understand-able to a variety of stakeholders. RECARE aims to assess how soil threats and prevention and remediationmeasures affect ecosystem services. Changes in the natural capital’s properties influence soil processes,which support the provision of ecosystem services. The benefits produced by these ecosystem servicesare explicitly or implicitly valued by individuals and society. This can influence decision- and policymak-ing at different scales, potentially leading to a societal response, such as improved land management.The proposed ecosystem services framework will be applied by the RECARE project in a transdisciplinaryprocess. It will assist in singling out the most beneficial land management measures and in identifyingtrade-offs and win–win situations resulting from and impacted by European policies. The framework thusreflects the specific contributions soils make to ecosystem services and helps reveal changes in ecosystemservices caused by soil management and policies impacting on soil. At the same time, the framework issimple and robust enough for practical application in assessing soil threats and their management withstakeholders at various levels.
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Think piece by Pierre Sauvé for the E15 Initiative on Strengthening the Global Trade System In his latest essay for the ICTSD-World Economic Forum E15 initiative on Strengthening the Global Trade and Investment System for Sustainable Development, WTI Director of External Programmes and Academic Partnerships and faculty member Pierre Sauvé explores the case for fusing the law of goods with that of services in a world of global value chains. The paper does so by directing attention to the questions of whether the current architectures of multilateral and preferential trade governance are compatible with a world of trade in tasks; whether the existing rules offer globally active firms a coherent structure for doing business in a predictable environment; whether it is feasible to redesign the structure and content of existing trade rules to align them to the reality of production fragmentation; and what steps can be envisaged to better align policy and realities in the marketplace if the prospects for restructuring appear unfavourable. The paper argues that fusing trade disciplines for goods and services is neither needed nor feasible and may actually deflect attention from a number of worthwhile policy initiatives where more realistic (if never easily secured) prospects of generic rule-making may well exist.