782 resultados para Research needs


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The conference on Global Change and the World’s Mountains held in Perth, Scotland, in 2010 offered a unique opportunity to analyze the state and progress of mountain research and its contribution to sustainable mountain development, as well as to reflect on required reorientations of research agendas. In this paper we provide the results of a three-step assessment of the research presented by 450 researchers from around the world. First, we determined the state of the art of mountain research and categorized it based on the analytical structure of the Global Land Project (GLP 2005). Second, we identified emerging themes for future research. Finally, we assessed the contribution of mountain research to sustainable development along the lines of the Grand Challenges in Global Sustainability Research (International Council for Science 2010). Analysis revealed that despite the growing recognition of the importance of more integrative research (inter- and transdisciplinary), the research community gathered in Perth still focuses on environmental drivers of change and on interactions within ecological systems. Only a small percentage of current research seeks to enhance understanding of social systems and of interactions between social and ecological systems. From the ecological systems perspective, a greater effort is needed to disentangle and assess different drivers of change and to investigate impacts on the rendering of ecosystem services. From the social systems perspective, significant shortcomings remain in understanding the characteristics, trends, and impacts of human movements to, within, and out of mountain areas as a form of global change. Likewise, sociocultural drivers affecting collective behavior as well as incentive systems devised by policy and decision makers are little understood and require more in-depth investigation. Both the complexity of coupled social– ecological systems and incomplete data sets hinder integrated systems research. Increased understanding of linkages and feedbacks between social and ecological systems will help to identify nonlinearities and thresholds (tipping points) in both system types. This presupposes effective collaboration between ecological and social sciences. Reflections on the Grand Challenges in Sustainability Research put forth by the International Council for Science (2010) reveal the need to intensify research on effective responses and innovations. This will help to achieve sustainable development in mountain regions while maintaining the core competence of mountain research in forecasting and observation.

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Australia is unique as a populated continent in that canine rabies is exotic, with only one likely incursion in 1867. This is despite the presence of a widespread free-ranging dog population, which includes the naturalized dingo, feral domestic dogs and dingo-dog cross-breeds. To Australia's immediate north, rabies has recently spread within the Indonesian archipelago, with outbreaks occurring in historically free islands to the east including Bali, Flores, Ambon and the Tanimbar Islands. Australia depends on strict quarantine protocols to prevent importation of a rabid animal, but the risk of illegal animal movements by fishing and recreational vessels circumventing quarantine remains. Predicting where rabies will enter Australia is important, but understanding dog population dynamics and interactions, including contact rates in and around human populations, is essential for rabies preparedness. The interactions among and between Australia's large populations of wild, free-roaming and restrained domestic dogs require quantification for rabies incursions to be detected and controlled. The imminent risk of rabies breaching Australian borders makes the development of disease spread models that will assist in the deployment of cost-effective surveillance, improve preventive strategies and guide disease management protocols vitally important. Here, we critically review Australia's preparedness for rabies, discuss prevailing assumptions and models, identify knowledge deficits in free-roaming dog ecology relating to rabies maintenance and speculate on the likely consequences of endemic rabies for Australia.

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CONTEXT Enhanced Recovery after Surgery (ERAS) programs are multimodal care pathways that aim to decrease intra-operative blood loss, decrease postoperative complications, and reduce recovery times. OBJECTIVE To overview the use and key elements of ERAS pathways, and define needs for future clinical trials. EVIDENCE ACQUISITION A comprehensive systematic MEDLINE search was performed for English language reports published before May 2015 using the terms "postoperative period," "postoperative care," "enhanced recovery after surgery," "enhanced recovery," "accelerated recovery," "fast track recovery," "recovery program," "recovery pathway", "ERAS," and "urology" or "cystectomy" or "urologic surgery." EVIDENCE SYNTHESIS We identified 18 eligible articles. Patient counseling, physical conditioning, avoiding excessive alcohol and smoking, and good nutrition appeared to protect against postoperative complications. Fasting from solid food for only 6h and perioperative liquid-carbohydrate loading up to 2h prior to surgery appeared to be safe and reduced recovery times. Restricted, balanced, and goal-directed fluid replacement is effective when individualized, depending on patient morbidity and surgical procedure. Decreased intraoperative blood loss may be achieved by several measures. Deep vein thrombosis prophylaxis, antibiotic prophylaxis, and thermoregulation were found to help reduce postsurgical complications, as was a multimodal approach to postoperative nausea, vomiting, and analgesia. Chewing gum, prokinetic agents, oral laxatives, and an early resumption to normal diet appear to aid faster return to normal bowel function. Further studies should compare anesthetic protocols, refine analgesia, and evaluate the importance of robot-assisted surgery and the need/timing for drains and catheters. CONCLUSIONS ERAS regimens are multidisciplinary, multimodal pathways that optimize postoperative recovery. PATIENT SUMMARY This review provides an overview of the use and key elements of Enhanced Recovery after Surgery programs, which are multimodal, multidisciplinary care pathways that aim to optimize postoperative recovery. Additional conclusions include identifying effective procedures within Enhanced Recovery after Surgery programs and defining needs for future clinical trials.

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Issued Aug. 1979.

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National Highway Traffic Safety Administration, Washington, D.C.

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National Highway Traffic Safety Administration, Washington, D.C.