Optimizing Triage and Hospitalization in Adult General Medical Emergency Patients. The Triage Project

Background: Patients presenting to the emergency department (ED) currently face inacceptable delays in initial treatment, and long, costly hospital stays due to suboptimal initial triage and site-of-care decisions. Accurate ED triage should focus not only on initial treatment priority, but also on prediction of medical risk and nursing needs to improve site-of-care decisions and to simplify early discharge management. Different triage scores have been proposed, such as the Manchester triage system (MTS). Yet, these scores focus only on treatment priority, have suboptimal performance and lack validation in the Swiss health care system. Because the MTS will be introduced into clinical routine at the Kantonsspital Aarau, we propose a large prospective cohort study to optimize initial patient triage. Specifically, the aim of this trial is to derive a three-part triage algorithm to better predict (a) treatment priority; (b) medical risk and thus need for in-hospital treatment; (c) post-acute care needs of patients at the most proximal time point of ED admission. Methods/design: Prospective, observational, multicenter, multi-national cohort study. We will include all consecutive medical patients seeking ED care into this observational registry. There will be no exclusions except for non-adult and non-medical patients. Vital signs will be recorded and left over blood samples will be stored for later batch analysis of blood markers. Upon ED admission, the post-acute care discharge score (PACD) will be recorded. Attending ED physicians will adjudicate triage priority based on all available results at the time of ED discharge to the medical ward. Patients will be reassessed daily during the hospital course for medical stability and readiness for discharge from the nurses and if involved social workers perspective. To assess outcomes, data from electronic medical records will be used and all patients will be contacted 30 days after hospital admission to assess vital and functional status, re-hospitalization, satisfaction with care and quality of life measures. We aim to include between 5000 and 7000 patients over one year of recruitment to derive the three-part triage algorithm. The respective main endpoints were defined as (a) initial triage priority (high vs. low priority) adjudicated by the attending ED physician at ED discharge, (b) adverse 30 day outcome (death or intensive care unit admission) within 30 days following ED admission to assess patients risk and thus need for in-hospital treatment and (c) post acute care needs after hospital discharge, defined as transfer of patients to a post-acute care institution, for early recognition and planning of post-acute care needs. Other outcomes are time to first physician contact, time to initiation of adequate medical therapy, time to social worker involvement, length of hospital stay, reasons fordischarge delays, patient’s satisfaction with care, overall hospital costs and patients care needs after returning home. Discussion: Using a reliable initial triage system for estimating initial treatment priority, need for in-hospital treatment and post-acute care needs is an innovative and persuasive approach for a more targeted and efficient management of medical patients in the ED. The proposed interdisciplinary , multi-national project has unprecedented potential to improve initial triage decisions and optimize resource allocation to the sickest patients from admission to discharge. The algorithms derived in this study will be compared in a later randomized controlled trial against a usual care control group in terms of resource use, length of hospital stay, overall costs and patient’s outcomes in terms of mortality, re-hospitalization, quality of life and satisfaction with care.

Isolation and functional characterization of a high affinity urea transporter from roots of Zea mays

Background: Despite its extensive use as a nitrogen fertilizer, the role of urea as a directly accessible nitrogen source for crop plants is still poorly understood. So far, the physiological and molecular aspects of urea acquisition have been investigated only in few plant species highlighting the importance of a high-affinity transport system. With respect to maize, a worldwide-cultivated crop requiring high amounts of nitrogen fertilizer, the mechanisms involved in the transport of urea have not yet been identified. The aim of the present work was to characterize the high-affinity urea transport system in maize roots and to identify the high affinity urea transporter. Results: Kinetic characterization of urea uptake (<300 mu M) demonstrated the presence in maize roots of a high-affinity and saturable transport system; this system is inducible by urea itself showing higher Vmax and Km upon induction. At molecular level, the ORF sequence coding for the urea transporter, ZmDUR3, was isolated and functionally characterized using different heterologous systems: a dur3 yeast mutant strain, tobacco protoplasts and a dur3 Arabidopsis mutant. The expression of the isolated sequence, ZmDUR3-ORF, in dur3 yeast mutant demonstrated the ability of the encoded protein to mediate urea uptake into cells. The subcellular targeting of DUR3/GFP fusion proteins in tobacco protoplasts gave results comparable to the localization of the orthologous transporters of Arabidopsis and rice, suggesting a partial localization at the plasma membrane. Moreover, the overexpression of ZmDUR3 in the atdur3-3 Arabidopsis mutant showed to complement the phenotype, since different ZmDUR3-overexpressing lines showed either comparable or enhanced 15N]-urea influx than wild-type plants. These data provide a clear evidence in planta for a role of ZmDUR3 in urea acquisition from an extra-radical solution. Conclusions: This work highlights the capability of maize plants to take up urea via an inducible and high-affinity transport system. ZmDUR3 is a high-affinity urea transporter mediating the uptake of this molecule into roots. Data may provide a key to better understand the mechanisms involved in urea acquisition and contribute to deepen the knowledge on the overall nitrogen-use efficiency in crop plants.

Relationships between functional traits and inorganic nitrogen acquisition among eight contrasting European grass species

Backgrounds and Aims Leaf functional traits have been used as a basis to categoize plants across a range of resource-use specialization, from those that conserve available resources to those that exploit them. However, the extent to which the leaf functional traits used to define the resource-use strategies are related to root traits and are good indicators of the ability of the roots to take up nitrogen (N) are poorly known. This is an important question because interspecific differences in N uptake have been proposed as one mechanism by which species coexistence may be determined. This study therefore investigated the relationships between functional traits and N uptake ability for grass species across a range of conservative to exploitative resource-use strategies.Methods Root uptake of NH4+ and NO3-, and leaf and root functional traits were measured for eight grass species sampled at three grassland sites across Europe, in France, Austria and the UK. Species were grown in hydroponics to determine functional traits and kinetic uptake parameters (Imax and Km) under standardized conditions.Key Results Species with high specific leaf area (SLA) and shoot N content, and low leaf and root dry matter content (LDMC and RDMC, respectively), which are traits associated with the exploitative syndrome, had higher uptake and affinity for both N forms. No trade-off was observed in uptake between the two forms of N, and all species expressed a higher preference for NH4+.Conclusions The results support the use of leaf traits, and especially SLA and LDMC, as indicators of the N uptake ability across a broad range of grass species. The difficulties associated with assessing root properties are also highlighted, as root traits were only weakly correlated with leaf traits, and only RDMC and, to a lesser extent, root N content were related to leaf traits.

“Se querem que façamos algo pela floresta tem que nos pagar”: As lógicas da participação dos camponeses nos Comités de Gestão dos Recursos Naturais nos distritos de Palma e Mocimboa da Praia em 2009: Relatório do trabalho de campo em Namiune, Nkonga e 5º Congresso, Maputo, Dezembro de 2010

Our study considers the natural resources of the Miombo forests in Cabo Delgado from a broad ecosystems perspective. Thus, our view goes beyond the disciplinary approaches of forestry, agronomy, biology or zoology, and also of the social sciences, namely anthropology, history, sociology, political science or economics. The present study aims to establish a dialogue and create synergies between Miti Ltd. – the logging company and owner of the forest concessions – as well as government and state structures at the various levels and the communities – through the Committees on Natural Resources – in order to promote the sustainable use of resources and ecosystems. The research methodology we used can broadly be described as moderated transdisciplinary interaction for action-research based on the approach known as Learning for Sustainability (LforS, http://www.cde.unibe.ch/Pages/Project/2/14/Learning-for-Sustainability-Extension-Approach.aspx). The research methods used include: LforS seminars; field work; forests observations focusing, among others, on ecosystems, trees, wildlife, and burned areas; visits to farms; and interviews. We conducted both collective interviews and individual interviews, including with key informants. The main results indicate that members of the Committee on Natural Resources have a dual attitude: their statements defend the paradigm of sustainable use of natural resources as well as their own immediate monetary gain. They are willing to apply the values, concepts and theories of sustainable development that underpin the establishment of Committees on Natural Resources if they are paid for their work or if they can derive direct benefits from it, i.e. if they can earn a salary or allowance. If this does not happen, however, they are willing to allow actors to engage in illegal hunting or logging activities. This dual attitude also exists in relation to forestry operators. If the concession workers pay the committee members in cash or provide goods, they can run their business even if they violate the law. Natural forest regeneration in Nkonga and Namiune already shows the impact of such use. Although there are many saplings that could basically ensure continuous regeneration under sustainable management, repeated burning is damaging the young trees, deforming them and killing a great number of them. Campaigns against uncontrolled fires are ineffective because the administrative and political authorities have a dual attitude as well and are also part of the group that uses resources to their own profit and benefit. There are institutional structures within the administration, populations, and communities to perform regulating functions, create and implement rules, punish offenders, and oversee resource use. However, they feel that since they are not paid for performing these functions, they do not have to do so. This attitude shows a lack of awareness, but also indicates a situation where everyone seeks to derive maximum benefits from existing resource use patterns. Anything goes.

Economic analysis of soil conservation: Case studies from the highlands of Amhara Region, Ethiopia

Soil degradation is widespread in the Ethiopian Highlands. Its negative impacts on soil productivity contribute to the extreme poverty of the rural population. Soil conservation is propagated as a means of reducing soil erosion, however, it is a costly investment for small-scale farming households. The present study is an attempt to show whether or not selected mechanical Soil and Water Conservation (SWC) technologies are profitable from a farmer’s point of view. A financial Cost-Benefit Analysis (CBA) is carried out to assess whether or not the considered SWC technologies are profitable from a farmer’s point of view. The CBA is supplemented by an evaluation of aspects from the economic and institutional environment. Whether or not soil conservation is profitable from a farmer’s point of view depends on a broad range of factors from the ecological, economic, political, institutional and socio-cultural sphere and also depends on the technology and the prevailing farming system. Because these factors are closely interlinked, it is often not sufficient to change or influence one to make SWC profitable. Several recommendations are formulated with regard to improving the profitability of SWC investments from a farmer’s point of view. Because the reasons for unsustainable resource use are manifold and highly interlinked, only a multi-stakeholder, multi-level and multi-objective approach is likely to offer solutions that address the underlying problems adequately.

Strengths, weaknesses, opportunities and threats: A SWOT analysis of the ecosystem services framework

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.

Biomarker-guided personalised emergency medicine for all - hope for another hype?

Polymorbid patients, diverse diagnostic and therapeutic options, more complex hospital structures, financial incentives, benchmarking, as well as perceptional and societal changes put pressure on medical doctors, specifically if medical errors surface. This is particularly true for the emergency department setting, where patients face delayed or erroneous initial diagnostic or therapeutic measures and costly hospital stays due to sub-optimal triage. A "biomarker" is any laboratory tool with the potential better to detect and characterise diseases, to simplify complex clinical algorithms and to improve clinical problem solving in routine care. They must be embedded in clinical algorithms to complement and not replace basic medical skills. Unselected ordering of laboratory tests and shortcomings in test performance and interpretation contribute to diagnostic errors. Test results may be ambiguous with false positive or false negative results and generate unnecessary harm and costs. Laboratory tests should only be ordered, if results have clinical consequences. In studies, we must move beyond the observational reporting and meta-analysing of diagnostic accuracies for biomarkers. Instead, specific cut-off ranges should be proposed and intervention studies conducted to prove outcome relevant impacts on patient care. The focus of this review is to exemplify the appropriate use of selected laboratory tests in the emergency setting for which randomised-controlled intervention studies have proven clinical benefit. Herein, we focus on initial patient triage and allocation of treatment opportunities in patients with cardiorespiratory diseases in the emergency department. The following five biomarkers will be discussed: proadrenomedullin for prognostic triage assessment and site-of-care decisions, cardiac troponin for acute myocardial infarction, natriuretic peptides for acute heart failure, D-dimers for venous thromboembolism, C-reactive protein as a marker of inflammation, and procalcitonin for antibiotic stewardship in infections of the respiratory tract and sepsis. For these markers we provide an overview on physiopathology, historical evolution of evidence, strengths and limitations for a rational implementation into clinical algorithms. We critically discuss results from key intervention trials that led to their use in clinical routine and potential future indications. The rational for the use of all these biomarkers, first, tackle diagnostic ambiguity and consecutive defensive medicine, second, delayed and sub-optimal therapeutic decisions, and third, prognostic uncertainty with misguided triage and site-of-care decisions all contributing to the waste of our limited health care resources. A multifaceted approach for a more targeted management of medical patients from emergency admission to discharge including biomarkers, will translate into better resource use, shorter length of hospital stay, reduced overall costs, improved patients satisfaction and outcomes in terms of mortality and re-hospitalisation. Hopefully, the concepts outlined in this review will help the reader to improve their diagnostic skills and become more parsimonious laboratory test requesters.

Association of nutritional risk and adverse medical outcomes across different medical inpatient populations

OBJECTIVE The aim of this study was to examine the prevalence of nutritional risk and its association with multiple adverse clinical outcomes in a large cohort of acutely ill medical inpatients from a Swiss tertiary care hospital. METHODS We prospectively followed consecutive adult medical inpatients for 30 d. Multivariate regression models were used to investigate the association of the initial Nutritional Risk Score (NRS 2002) with mortality, impairment in activities of daily living (Barthel Index <95 points), hospital length of stay, hospital readmission rates, and quality of life (QoL; adapted from EQ5 D); all parameters were measured at 30 d. RESULTS Of 3186 patients (mean age 71 y, 44.7% women), 887 (27.8%) were at risk for malnutrition with an NRS ≥3 points. We found strong associations (odds ratio/hazard ratio [OR/HR], 95% confidence interval [CI]) between nutritional risk and mortality (OR/HR, 7.82; 95% CI, 6.04-10.12), impaired Barthel Index (OR/HR, 2.56; 95% CI, 2.12-3.09), time to hospital discharge (OR/HR, 0.48; 95% CI, 0.43-0.52), hospital readmission (OR/HR, 1.46; 95% CI, 1.08-1.97), and all five dimensions of QoL measures. Associations remained significant after adjustment for sociodemographic characteristics, comorbidities, and medical diagnoses. Results were robust in subgroup analysis with evidence of effect modification (P for interaction < 0.05) based on age and main diagnosis groups. CONCLUSION Nutritional risk is significant in acutely ill medical inpatients and is associated with increased medical resource use, adverse clinical outcomes, and impairments in functional ability and QoL. Randomized trials are needed to evaluate evidence-based preventive and treatment strategies focusing on nutritional factors to improve outcomes in these high-risk patients.

Kentucky Bluegrass Response to Potassium and Nitrogen Fertilization

The response of Kentucky bluegrass (Poa pratensis L.) to potassium (K) fertilization has been inconsistent. The objective of this research was to determine the effects of K fertilization across varying nitrogen (N) rates and clipping management on Kentucky bluegrass clipping yields, quality, tissue K concentrations, apparent N recovery, and N use efficiency. A 2 x 4 x 4 factorial was arranged in a splitplot design and repeated across two years. Main plots were clipping treatments (returned vs. removed) and subplots were N rates (0, 98, 196, and 294 kg ha(-1) yr(-1)) in combination with K rates (0, 81, 162, and 243 kg ha(-1) yr(-1)). There was no positive effect of K on clipping yields and quality even though soil extractable K levels tested low. Higher K rates, however, increased N recovery and use efficiency for all but the highest N rate. Tissue K response to K fertilization was nonlinear. Yield and quality responses were not correlated to tissue K concentration. Nonexchangeable K levels were high in the native soil, and may have provided an additional source of K for bluegrass. The results suggest that extractable K values alone may not adequately predict available K to Kentucky bluegrass in this sandy loam soil.

Clipping Management and Nitrogen Fertilization of Turfgrass: Growth, Nitrogen Utilization, and Quality

The effect of returning grass clippings on turfgrass growth and quality has not been thoroughly examined. The objective of this research was to determine the effects of returning grass clippings in combination with varying N rates on growth, N utilization, and quality of turfgrass managed as a residential lawn. Two field experiments using a cool-season turfgrass mixture were arranged as a 2 x 4 factorial in a randomized complete block design with three replicates. Treatments included two clipping management practices (returned or removed) and four N rates (equivalent to 0, 98, 196, and 392 kg N ha(-1)). Soils at the two sites were a Paxton fine sandy loam (coarse-loamy, mixed, active, mesic Oxyaquic Dystrudepts) and a variant of a Hinckley gravelly sandy loam (sandy-skeletal, mixed, mesic Typic Udorthents). Returning clippings was found to increase clipping dry matter yields (DMYs) from 30 to 72%, total N uptake (NUP) from 48 to 60%, N recovery by 62%, and N use efficiency (NUE) from 52 to 71%. Returning grass clippings did not decrease turfgrass quality, and improved it in some plots. We found that N fertilization rates could be reduced 50% or more without decreasing turfgrass quality when clippings were returned. Overall, returning grass clippings was found to improve growth and quality of turfgrass while reducing N fertilization needs.

Producción de maíz bajo diferentes regímenes de riego complementario en Río Cuarto, Córdoba, Argentina. I. Rendimiento en grano de maíz y sus componentes

El maíz (Zea mays L.) es uno de los principales cultivos de la Pampa Húmeda de Argentina. El objetivo de este trabajo fue evaluar los efectos del riego complementario sobre el rendimiento de grano y sus componentes. El mismo se llevó a cabo en el ciclo agrícola 2001-2002, en el campo experimental de la Universidad Nacional de Río Cuarto. Se usó un diseño completamente al azar con 5 tratamientos y 4 repeticiones. Para efectuar la programación de los diferentes riegos se dividió el ciclo del cultivo en tres etapas: precrítico, crítico y poscrítico. Para la determinación del momento de riego se realizó un balance hídrico. El rendimiento de grano no mostró diferencias significativas en los cuatro tratamientos con riego, sin embargo, hubo diferencia significativa (α = 0,05) entre los tratamientos regados y no regados. En promedio el rendimiento en grano en los tratamientos regados fue de 72 % mayor que en el tratamiento sin riego. Los componentes del rendimiento fueron afectados significativamente (α = 0,05) por la falta de riego. La cantidad de agua aplicada varió entre 360 y 300 mm y el agua total consumida en el ciclo del cultivo (según el balance hídrico) fue para los tratamientos con riego, de 575 mm y para el testigo de 308 mm. La eficiencia del uso de agua para grano fue de 2.75 kg.m-3, en promedio.

Producción de maíz bajo diferentes regímenes de riego complementario en Río Cuarto, Córdoba, Argentina. II. Producción de materia seca

El objetivo de este trabajo fue evaluar el efecto del riego complementario sobre el rendimiento de materia seca del cultivo de maíz. Se usó un diseño completamente al azar con 5 tratamientos y 4 repeticiones. Para efectuar la programación de los diferentes tratamientos de riego se dividió el ciclo del cultivo en tres etapas (precrítico, crítico y poscrítico). Para la determinación del momento de riego se realizó un balance hídrico con datos climáticos obtenidos de la Estación Meteorológica ubicada en el lugar del ensayo. El riego se efectuó con un equipo presurizado de avance lateral. El maíz cumplió su ciclo en 138 días en todos los tratamientos y requirió 1660,6 grados día para alcanzar madurez fisiológica. El rendimiento de materia seca tuvo diferencias significativas (a = 0,05) entre los distintos tratamientos regados y entre éstos y el testigo. Los valores extremos de producción fueron de 34.628 kg.ha-1 en el tratamiento 1 y 20.414 kg.ha-1 en el tratamiento sin riego. La cantidad de agua aplicada varió entre 360 y 300 mm y el agua total consumida en el ciclo del cultivo, según el balance hídrico, fue para los tratamientos con riego de 575 mm ± 15 mm y para el testigo sin riego de 308 mm. La eficiencia de uso de agua para materia seca tuvo diferencias significativas (a = 0,05) entre los tratamientos regados (5,7 kg.m-3) y no regados (6,6 kg.m-3). El índice de cosecha fue de 0,49.

Influencia de restricciones hídricas poscosecha en el crecimiento vegetativo y reproductivo en plantaciones jóvenes de cerezo (Prunus avium L.)

En cerezos plantas con excesivo vigor son poco precoces, a menudo poco productivas y de difícil manejo en el cultivo. El exceso de vigor puede ser controlado con el uso de estrategias de riego deficitario controlado (RDC). Para contribuir a la racionalización del uso del recurso hídrico, controlar el crecimiento vegetativo vigoroso y estimular la producción precoz en plantaciones jóvenes de cerezo, se estableció un ensayo de RDC en un monte frutal comercial de la variedad Bing regado por goteo en la localidad de Agua Amarga, Mendoza, Argentina, Se evaluó la respuesta a distintos regímenes de riego poscosecha sobre parámetros de crecimiento vegetativo (crecimiento de brotes y tronco, área y peso seco foliar), reproductivo (densidad de floración, rendimiento y calidad de frutos) y estado nutricional (nutrimentos foliares y reservas de carbohidratos no estructurales). Los tratamientos de riego poscosecha fueron: riego a demanda plena (T1= Etc 100 %) y RDC reponiendo el 75 % (T2= Etc 75 %) y 50 % (T3= Etc 50 %) respecto de T1. Se midió el estado hídrico de la planta a través del potencial agua del tallo a mediodía y del suelo con sonda de capacitancia y gravimetría. En T3 disminuyó la longitud de brotes, número y longitud de entrenudos, número de hojas, área foliar y peso seco foliar, y área de tronco. En T2 disminuyó la longitud de brotes y de entrenudos. En T3 la intensidad del déficit hídrico impuesta aumentó la calidad de los ramilletes y la producción de yemas de flor, flores y frutos en el ciclo vegetativo siguiente. La calidad y madurez de frutos no fue afectada por los tratamientos de RDC, aunque en T3 aumentó levemente la proporción de frutos dobles. Luego del primer año de RDC en las plantas del T3 hubo una disminución significativa, aunque leve, del contenido de Ky P foliares y de almidón en raíces, El potencial hídrico del tallo a mediodía resultó un buen indicador del estado hídrico de las plantas. En cerezos un ajuste preciso del nivel de restricción hidrica poscosecha puede ser una estrategia de manejo para controlar el vigor y estimular la producción precoz, Al mismo tiempo se ahorran importantes cantidades de agua.

Desarrollo de herramientas y estrategias para el ordenamiento territorial

El presente no es un proyecto de investigación, sino de gestión y desarrollo de herramientas para la toma de decisiones. Su objetivo es colaborar dentro del marco de la "Red Nacional de Ordenamiento y Desarrollo Territorial" (Poder Ejecutivo Nacional, 2004) propuesta por el Gobierno Nacional, con los gobiernos provinciales y otros organismos en la planificación del uso de los recursos del territorio, procurando un manejo sostenible de los mismos, a fin de reducir en forma progresiva los desequilibrios espaciales, contribuyendo a elevar la calidad de vida de todos los habitantes del país. En las últimas décadas, ante la existencia de una creciente presión antrópica sobre el medio natural y, paralelamente, un mayor grado de conocimiento de las causas y efectos de los diferentes riesgos, éstos han comenzado a tener mayor influencia en la determinación de políticas y prioridades para inversiones o emprendimientos económicos en general y en la fijación de pautas de ocupación del territorio. La planificación aparece como una herramienta adecuada para orientar y organizar el desarrollo equitativo y sustentable de un territorio y la población que lo ocupa. El Ordenamiento Territorial (OT) significa disponer, con orden, la ocupación y usos del territorio según la mayor o menor aptitud de sus diferentes elementos constitutivos. Este proyecto se considera estratégico para el Programa Nacional Ecoregiones del INTA (PNECO), ya que encara los problemas territoriales desde un punto de vista global (aspectos económicos, sociales, productivos, culturales y ambientales), tradicionalmente tratados de forma sectorial, plantea directivas a mediano y largo plazo (escenarios) y guía la planificación regional y local. El enfoque central del OT es la visión participativa, acordando intereses contrapuestos (trade-offs1) y sinérgicos, transformando amenazas en oportunidades. Es este punto central el que permitirá vincular el PNECO con todos sus Proyecto Específicos (PE), considerando el marco de políticas públicas vinculadas al medio ambiente y la producción en cada ecoregión del país, asociado al Programa Nacional de Territorios del INTA

Uso de agua en las bodegas de Mendoza

El objetivo de este trabajo es conocer, a nivel de cuenca, el volumen de agua utilizado por las bodegas de Mendoza, el que se obtiene principalmente desde acuíferos. Dicha información puede ser utilizada para el cálculo del balance hídrico en el contexto del uso industrial del agua. Para realizar las estimaciones se utilizaron datos de elaboración de vino del Instituto Nacional de Vitivinicultura. A la producción de vino por cuenca se le aplicaron coeficientes de litros de agua utilizada por litros de vino elaborado, obtenidos de las entrevistas a informantes calificados y a partir de bibliografía local e internacional. Dichos coeficientes varían entre 1,5 y 6 litros de agua/litro de vino, los que no incluyen el uso de agua para riego en fincas. Para analizar el impacto en la eficiencia del uso del agua, los resultados se sensibilizaron para tres valores de coeficiente. Se estima que las bodegas de Mendoza utilizan entre 1,66 y 6,66 hm3/año, según sea la eficiencia del uso del agua. Del total de agua que utilizan, el 85,2% proviene de la cuenca norte, la que comprende el río Mendoza y el Tramo Inferior del Río Tunuyan.