Evaluation of a novel photography-based home assessment protocol for identification of environmental risk factors for falls in elderly persons

PRINCIPLES To evaluate the validity and feasibility of a novel photography-based home assessment (PhoHA) protocol, as a possible substitute for on-site home assessment (OsHA). METHODS A total of 20 patients aged ≥65 years who were hospitalised in a rehabilitation centre for musculoskeletal disorders affecting mobility participated in this prospective validation study. For PhoHA, occupational therapists rated photographs and measurements of patients' homes provided by patients' confidants. For OsHA, occupational therapists conducted a conventional home visit. RESULTS Information obtained by PhoHA was 79.1% complete (1,120 environmental factors identified by PhoHA vs 1416 by OsHA). Of the 1,120 factors, 749 had dichotomous (potential hazards) and 371 continuous scores (measurements with tape measure). Validity of PhoHA to potential hazards was good (sensitivity 78.9%, specificity 84.9%), except for two subdomains (pathways, slippery surfaces). Pearson's correlation coefficient for the validity of measurements was 0.87 (95% confidence interval [CI 0.80-0.92, p <0.001). Agreement between methods was 0.52 (95%CI 0.34-0.67, p <0.001, Cohen's kappa coefficient) for dichotomous and 0.86 (95%CI 0.79-0.91, p <0.001, intraclass correlation coefficient) for continuous scores. Costs of PhoHA were 53.0% lower than those of OsHA (p <0.001). CONCLUSIONS PhoHA has good concurrent validity for environmental assessment if instructions for confidants are improved. PhoHA is potentially a cost-effective method for environmental assessment.

Can the green economy enhance sustainable mountain development? The potential role of awareness building

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.

The applicability of non-local LCI data for LCA

This study evaluated how applicable European Life Cycle Inventory (LCI) data are to assessing the environmental impacts of the life cycle of Brazilian triple superphosphate (TSP). The LCI data used for the comparison were local Brazilian LCI data, European LCI data in its original version from the ecoinvent database and a modified version of the European LCI data, which had been adapted to better account for the Brazilian situation. We compared the three established datasets at the level of the inventory as well as for their environmental impacts, i.e. at the level of Life Cycle Environmental Assessment (LCIA). The analysis showed that the European LCIs (both the original and the modified ones) considered a broader spectrum of background processes and environmental flows (inputs and outputs). Nevertheless, TSP production had in all three cases similar values for the consumption of the main raw materials. The LCIA results obtained for the datasets showed important differences as well. Therefore we concluded that the European data in general lead to much higher environmental impacts than the Brazilian data. The differences between the LCIA results obtained with the Brazilian and the European data can be basically explained by the methodological differences underlying the data. The small differences at the LCI level for selected inputs and outputs between the Brazilian and the European LCIs from ecoinvent indicate that the latter can be regarded as applicable for characterizing the Brazilian TSP.

Expert opinion on toxicity profiling--report from a NORMAN expert group meeting.

This article describes the outcome and follow-up discussions of an expert group meeting (Amsterdam, October 9, 2009) on the applicability of toxicity profiling for diagnostic environmental risk assessment. A toxicity profile was defined as a toxicological "fingerprint" of a sample, ranging from a pure compound to a complex mixture, obtained by testing the sample or its extract for its activity toward a battery of biological endpoints. The expert group concluded that toxicity profiling is an effective first tier tool for screening the integrated hazard of complex environmental mixtures with known and unknown toxicologically active constituents. In addition, toxicity profiles can be used for prioritization of sampling locations, for identification of hot spots, and--in combination with effect-directed analysis (EDA) or toxicity identification and evaluation (TIE) approaches--for establishing cause-effect relationships by identifying emerging pollutants responsible for the observed toxic potency. Small volume in vitro bioassays are especially applicable for these purposes, as they are relatively cheap and fast with costs comparable to chemical analyses, and the results are toxicologically more relevant and more suitable for realistic risk assessment. For regulatory acceptance in the European Union, toxicity profiling terminology should keep as close as possible to the European Water Framework Directive (WFD) terminology, and validation, standardization, statistical analyses, and other quality aspects of toxicity profiling should be further elaborated.

Clustering Assessment: Enhancing Synergies among Multilateral Environmental Agreements

Against the background of a widely fragmented and diluted international environmental governance architecture, different reform options are currently being discussed. This issue brief considers whether streamlining international environmental regimes by grouping or ‘clustering’ international agreements could improve effectiveness and efficiency. It outlines the general idea of the clustering approach, draws lessons from the chemicals and waste cluster and examines the implications and potentials of clustering multilateral environmental agreements.

Ecosystem services, biodiversity and environmental change in a tropical mountain ecosystem of south Ecuador

An interdisciplinary research unit consisting of 30 teams in the natural, economic and social sciences analyzed biodiversity and ecosystem services of a mountain rainforest ecosystem in the hotspot of the tropical Andes, with special reference to past, current and future environmental changes. The group assessed ecosystem services using data from ecological field and scenario-driven model experiments, and with the help of comparative field surveys of the natural forest and its anthropogenic replacement system for agriculture. The book offers insights into the impacts of environmental change on various service categories mentioned in the Millennium Ecosystem Assessment (2005): cultural, regulating, supporting and provisioning ecosystem services. Examples focus on biodiversity of plants and animals including trophic networks, and abiotic/biotic parameters such as soils, regional climate, water, nutrient and sediment cycles. The types of threats considered include land use and climate changes, as well as atmospheric fertilization. In terms of regulating and provisioning services, the emphasis is primarily on water regulation and supply as well as climate regulation and carbon sequestration. With regard to provisioning services, the synthesis of the book provides science-based recommendations for a sustainable land use portfolio including several options such as forestry, pasture management and the practices of indigenous peoples. In closing, the authors show how they integrated the local society by pursuing capacity building in compliance with the CBD-ABS (Convention on Biological Diversity - Access and Benefit Sharing), in the form of education and knowledge transfer for application.