A regional environmental accounting matrix and integrated environmental economic analyses to support regional planning

This research deals with the deepening and use of an environmental accounting matrix in Emilia-Romagna, RAMEA air emissions (regional NAMEA), carried out by the Regional Environment Agency (Arpa) in an European project. After a depiction of the international context regarding the widespread needing to integrate economic indicators and go beyond conventional reporting system, this study explains the structure, update and development of the tool. The overall aim is to outline the matrix for environmental assessments of regional plans, draw up sustainable reports and monitor effects of regional policies in a sustainable development perspective. The work focused on an application of a Shift-Share model, on the integration with eco-taxes, industrial waste production, energy consumptions, on applications of the extended RAMEA as a policy tool, following Eurostat guidelines. The common thread is the eco-efficiency (economic-environmental efficiency) index. The first part, in English, treats the methodology used to build a more complete tool; in the second part RAMEA has been applied on two regional case studies, in Italian, to support decision makers regarding Strategic Environmental Assessments’ processes (2001/42/EC). The aim is to support an evidence-based policy making by integrating sustainable development concerns at all levels. The first case study regards integrated environmental-economic analyses in support to the SEA of the Regional Waste management plan. For the industrial waste production an extended and updated RAMEA has been developed as a useful policy tool, to help in analysing and monitoring the state of environmental-economic performances. The second case study deals with the environmental report for the SEA of the Regional Program concerning productive activities. RAMEA has been applied aiming to an integrated environmental-economic analysis of the context, to investigate the performances of the regional production chains and to depict and monitor the area where the program should be carried out, from an integrated environmental-economic perspective.

Sustainable development in Darjeeling Hills, India : ecological and socio-economic aspects for small-scale farmers with supportive observations from Kanagawa, Japan

Organic farming means a holistic application of agricultural land-use, hence, this study aimed to assess ecological and socio-economic aspects that show benefits of the strategy and achievements of organic farming in comparison to conventional farming in Darjeeling District, State of West Bengal, India and Kanagawa Prefecture/Kanto in Central Japan. The objective of this study has been empirically analysed on aspects of crop diversity, yield, income and sales prices in the two study regions, where 50 households each, i.e. in total 100 households were interviewed at farm-level. Therefore, the small sample size does not necessarily reflect the broad-scale of the use and benefit of organic farming in both regions. The problems faced in mountainous regions in terms of agriculture and livelihoods for small-scale farmers, which are most affected and dependant on their immediate environment, such as low yields, income and illegal felling leading to soil erosion and landslides, are analyzed. Furthermore, factors such as climate, soils, vegetation and relief equally play an important role for these farmers, in terms of land-use. To supplement and improve the income of farmers, local NGOs have introduced organic farming and high value organic cash crops such as ginger, tea, orange and cardamom and small income generating means (floriculture, apiary etc.). For non-certified and certified organic products the volume is given for India, while for Japan only certified organic production figures are given, as there are several definitions for organic in Japan. Hence, prior to the implementation of organic laws and standards, even reduced chemical input was sold as non-certified organic. Furthermore, the distribution and certification system of both countries are explained in detail, including interviews with distribution companies and cooperatives. Supportive observations from Kanagawa Prefecture and the Kanto region are helpful and practical suggestions for organic farmers in Darjeeling District. Most of these are simple and applicable soil management measures, natural insect repelling applications and describe the direct marketing system practiced in Japan. The former two include compost, intercropping, Effective Microorganisms (EM), clover, rice husk charcoal and wood vinegar. More supportive observations have been made at organic and biodynamic tea estates in Darjeeling District, which use citronella, neem, marigold, leguminous and soil binding plants for soil management and natural insect control. Due to the close ties between farmers and consumers in Japan, certification is often neither necessary nor wanted by the producers. They have built a confidence relationship with their customers; thus, such measures are simply not required. Another option is group certification, instead of the expensive individual certification. The former aims at lower costs for farmers who have formed a cooperative or a farmers' group. Consumer awareness for organic goods is another crucial aspect to help improve the situation of organic farmers. Awareness is slightly more advanced in Kanto than in Darjeeling District, as it is improved due to the close (sales) ties between farmers and consumers in Kanto. Interviews conducted with several such cooperatives and companies underline the positive system of TEIKEI. The introduction of organic farming in the study regions has shown positive effects for those involved, even though it still in its beginning stages in Darjeeling District. This study was only partly able to assess the benefits of organic agriculture at its present level for Darjeeling District, while more positively for the organic farmers of Kanto. The organic farming practice needs further improvement, encouragement and monitoring for the Darjeeling District farmers by locals, consumers, NGOs and politicians. The supportive observations from Kanagawa Prefecture and the Kanto region are a small step in this direction, showing how, simple soil improvements and thus, yield and income increases, as well as direct sales options can enhance the livelihood of organic farmers without destroying their environment and natural resources.

[White sponge naevus. Report of a family with respect to histopathologic, cytopathologic and DNA-cytometric aspects]

The white sponge naevus is a rare benign, hereditary autosomal dominant disorder of the mucosa. The oral mucosa is most often affected, but vaginal and anal mucosal surfaces may also be involved. Clinically, a whitish-grey, ragged, and folded surface that has no clear demarcation and appears sponge-like is characteristic, often creating problems in differential diagnosis. A potential risk for malignant transformation of white sponge naevus lesions has not been reported. The therapy for this benign hereditary disorder is unknown, however does not appear to be necessary. In the present report of a family with known white sponge naevus in three different generations, clinical, histopathologic, cytopathologic, DNA-cytomertric, and genetic aspects are described and discussed.

Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants

BACKGROUND: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. METHODOLOGY/PRINCIPAL FINDINGS: We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC) and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg) than preterm infants without BPD (23.4 mL/kg) and term-born infants (22.6 mL/kg), though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF)/t(E)) than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. CONCLUSIONS: Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

Late Glacial and Holocene environmental history of the Pirin Mountains (SW Bulgaria): a paleolimnological study of Lake Dalgoto (2310 m)

Diatoms, Cladocera, and chironomids preserved in the sediments of Lake Dalgoto were studied to reconstruct the history of the lake ecosystem in the context of the vegetation history as represented by the pollen stratigraphy. Younger Dryas silty sediments at the base of the core are characterized by low diversity of aquatic organisms. The transition to the Holocene is indicated by a sharp change from silt to clay-gyttja. The migration and expansion of trees at lower elevations between 10200 and 8500 14C-yr BP, along with higher diversities and concentrations of aquatic organisms and the decreased proportion of north-alpine diatoms, point to rapidly rising summer temperatures. After 6500 14C-yr BP the expansion of Pinus mugo in the catchment coincides with signs of natural eutrophication as recorded by an increase of planktonic diatoms. In the late Holocene (4000–0 14C-yr BP) Pinus peuce and Abies are reduced and Picea expands. Cereal grains and disturbance indicators suggest late-Holocene human modification of the vegetation.

What supports students' education in the operating room? A focus group study including students' and surgeons' views.

BACKGROUND AND METHODS We conducted a focus group analysis with students and surgeons on factors which influence medical school students' education in the operating room (OR). The interviews were analyzed using grounded theory. RESULTS The analysis resulted in 18 detailed and easily applyable themes, which were grouped into the four categories: "Students' preparation and organizational aspects", "Learning objectives", "Educational strategies for the teacher", and "Social-environmental aspects". CONCLUSION By including students and surgeons, we were able to extend existing knowledge and enable better understanding of factors influencing teaching in the OR.

The Gut Microbiome and Cirrhosis: Basic Aspects

In this chapter the basic aspects helping to understand the microbiome in terms of quantity, diversity, complexity, function, and interaction with the host are discussed. First the nomenclature, definitions of taxa, and measures of diversity as well as methods to unravel this kingdom are outlined. A brief summary on its physiological relevance for general health and the functions exerted specifically by the microbiome is presented. Differences in the composition of the microbiome along the gastrointestinal tract and across the gut wall and its interindividual variations, enterotypes, and stability are highlighted. The reader will be familiarized with all different modulators impacting on the microbiome, namely, intrinsic and extrinsic factors. Intrinsic factors include gastrointestinal secretions (gastric acid, bile, pancreatic juice, mucus), antimicrobial peptides, motility, enteric nervous system, and host genotype. Extrinsic factors are mainly dietary choices, hygiene, stress, alcohol consumption, exercise, and medications. The second part of the chapter focuses on quantitative and qualitative changes in microbiome in liver cirrhosis. The mechanisms contributing to dysbiosis, small intestinal bacterial overgrowth, and bacterial translocation are delineated underscoring their role for the liver-gut axis.