959 resultados para Ecosystem services
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Cette thse est construite en quatre parties : trois annexes qui prsentent six tudes de cas (env. 800 pages), prcdes par une analyse transversale, plus synthtique (env. 150 pages), dont traite ce rsum. Chaque annexe contient une synthse dtaille des tudes de cas. Cette thse aborde la gestion des ressources naturelles en affirmant d'emble que l'appellation est inapproprie, car ce ne sont pas les ressources qui sont gres, mais leurs usages. Il s'agit donc d'identifier et d'analyser ce qui influence les comportements humains en lien avec la ressource. Cette affirmation fonde la perspective des sciences sociales sur la gestion des ressources naturelles, dans laquelle s'inscrit cette thse. L'approche no-institutionnaliste considre que les usages sont influencs par des institutions, qui sont elles-mmes influences par les usagers. Ces institutions sont des constructions humaines qui composent le contexte institutionnel dans lequel les acteurs dcident de leurs usages (abattre un arbre, prlever de l'eau, etc.). Les usages des ressources ne sont donc jamais libres et il s'agit de comprendre comment ces rgles du jeu influencent les pratiques. Elles sont nombreuses, interdpendantes et forment la trame sur laquelle se dcident les usages. Pour saisir cette complexit, l'auteur applique le cadre d'analyse des rgimes institutionnels des ressources (RIR) qui se limite l'analyse de deux types de droits d'usages : ceux issues des rgles de la proprit (titres de proprit, servitudes, etc.) et ceux issus des politiques publiques (lois, ordonnances, etc.). Le RIR permet d'identifier un rgime institutionnel , spcifique la ressource tudie, dont les volutions peuvent tre compares dans le temps ou entre plusieurs lieux. Dans cette recherche, ce cadre d'analyse a t appliqu au mme objet - la gestion forestire dans les zones de captage d'eau souterraine destine au rseau public - dans trois pays : en France, en Suisse et en Indonsie. Trois annes de recherche de terrain ont permis l'auteur de s'intresser non seulement aux rgles prdtermines (la rglementation), mais aussi aux rgles effectivement actives sur le terrain (la rgulation) par les acteurs rencontrs. Les tudes de cas montrent que les rgles prvues sont ingalement actives et que les acteurs privilgient parfois la ngociation directe pour rsoudre leurs rivalits d'usages, la place d'invoquer leurs droits acquis. Ce constat conduit l'auteur proposer un largissement de la focale du RIR, qui constitue le coeur de sa thse. On ne s'intresse plus seulement ce qui est rgul, mais aussi ce qui ne l' est pas et qui chappe l'application classique du RIR. Ce renversement de perspective est crucial pour comprendre les usages concrets des ressources dans les rgimes peu intgrs, o les pratiques s'expliquent davantage par la marge de manoeuvre laisse aux acteurs que par les rgles prdtermines. Cette relecture, teste avec succs dans cette thse, permet d'intgrer la marge de manoeuvre l'analyse au moyen du RIR. Elle se concrtise par l'identification des lacunes et incohrences dans les rgimes institutionnels tudis. Le champ d'application du RIR s'en trouve largi et sa vulgarisation pour des non-spcialistes est facilite, notamment pour les environnementalistes. La complmentarit entre les approches s'en trouve renforce. Les rsultats montrent deux choses : premirement les acteurs disposent toujours d'une marge de manoeuvre pour ngocier des rgulations ponctuelles, qui sont autant d'alternatives l'application des rgles prvues. Deuximement, la conclusion d'accords issus de la ngociation bi-/multilatrale dpend directement de la marge de manoeuvre laisse par le contexte institutionnel. Ceci explique pourquoi la ngociation entre les propritaires forestiers et les exploitants de captages s'imposent en Indonsie, est envisageable en France, mais n'aboutit pas en Suisse. Les nombreuses tentatives infructueuses de mise en oeuvre de solutions ngocies, notamment sous forme de paiements pour services environnementaux (PSE), trouvent ici une explication. - This thesis (written in French) is built in four parts: three annexes that present six case studies (approx. 800 pages), preceded by a transverse, more conceptual analysis (approx. 150 pages), which this summary is about. Each annexe contains a detailed summary of the case studies. 'Natural resource management' is an inappropriate designation because it is not the resources that are managed but the uses made of them, therefore this thesis addresses the identification and analysis of the influences on human behaviour in relation to the resource. This statement roots the social sciences perspective on the management of natural resources, in which this thesis fits. A neoinstitutionalist approach considers that the uses are influenced by institutions, which are themselves influenced by users. These institutions are human constructions that form the institutional context in which the actors decide on the use of resources (felling a tree, collecting water, etc.). Thus, the uses of resources are never independent from institutional influences and it becomes necessary to understand how these rules of the game affect practices. They are numerous, interrelated and form the basis for the uses of resources. To understand this complexity, the author applies the institutional regime resource framework (IRR) which limits the analysis to two types of use rights: those resulting from the property rights (deeds, easements, etc.) and those from public policies (laws, ordinances, etc.). The IRR identifies an 'institutional regime', specific to the resource, from which developments can be compared over time or between several places. In this research, this analytical framework has been applied to the same topic - forest management in the recharging areas of groundwater piped for public supply - in three countries: France, Switzerland and Indonesia. Three years of field research allow the author to look not only at predetermined rules (rules), but also at regulations that are actually activated on the ground (rules-in-use). The case studies show that the predetermined rules are unevenly applied and that sometimes actors favour direct negotiation to resolve their rivalry of uses, instead of invoking their vested rights. From this observation the author proposes an enlargement of the IRR's scope, forming the core of his thesis. The interest covers not only what 'is' regulated, but what 'is not' and so is beyond the classical application of the IRR. This shift in perspective is crucial to understand the concrete uses of resources in poorly integrated regimes, where practices are explained by the margin of manoeuvre left to the actors rather than predetermined rules. This reinterpretation, tested successfully in this research, allows the margin of manoeuvre to be integrated in the analysis using the IRR and is made concrete by the identification of gaps and inconsistencies in the investigated institutional context. The new interpretation of the IRR in this thesis complements and enhances its classical application. In particular, its use and understanding by non-specialists, especially environmentalists, is facilitated. The results show two things: first the actors always have leeway to negotiate ad hoc regulations, which are alternatives to the application of the predefined rules. Second, the conclusion of bi/multilateral negotiated agreements depends directly on the leeway left by the institutional context. This explains why the negotiation between forest owners and operators of water catchments is needed in Indonesia, is possible in France, but does not succeed in Switzerland. This offers an explanation for many unsuccessful attempts to implement negotiated solutions, notably payments for environmental services (PES).
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OBJECTIVE: To investigate the relationship between levels of cognitive impairment and health services utilization in older patients undergoing post-acute rehabilitation. DESIGN: Cross-sectional study. SETTING: Post-acute rehabilitation facility. PARTICIPANTS: Patients (N= 1764) aged 70 years and older admitted over 3 years. MEASUREMENTS: Sociodemographic, medical, and functional data were collected upon admission. Based on discharge diagnoses, patients were classified as cognitively intact, cognitively impaired with no dementia (CIND), and demented. RESULTS: Dementia and CIND were diagnosed in 425 (24.1%) and 301 (17.1%) patients, respectively. Gradients from cognitively intact to cognitively impaired to demented patients were observed in median length of stay (19, 22, and 25 days, P < .001), and institutionalization rates at discharge (4.2%, 7.6%, and 28.8%, P < .001). Among patients discharged home, similar gradients were observed in utilization of home care (68.2%, 79.7%, and 83.3%, P < .001) and day care (3.1%, 7.1%, and 14.3%, P < .001). After adjustment, compared with cognitively intact patients, only those with dementia still had longer stays (+2.7 days) and increased odds of institutionalization (adjOR 6.1, 95% CI 4.0-9.3, P < .001). Among patients discharged home, use of home and day care remained higher in those with dementia (adjOR 1.8, 95% CI 1.2-2.7, P= .005, and adjOR 1.8, 95% CI 1.2-2.7, P= .005, respectively), while CIND patients had higher odds of using home care (adjOR 1.6, 95% CI 1.1-2.4, P= .028). CONCLUSION: Among patients undergoing post-acute rehabilitation, those with dementia had increased use of both institutional and community care, whereas those with CIND had increased use of home care services only. Future studies should investigate specific strategies susceptible to reduce the related burden on health care systems.
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In this paper we address the complexity of the analysis of water use in relation to the issue of sustainability. In fact, the flows of water in our planet represent a complex reality which can be studied using many different perceptions and narratives referring to different scales and dimensions of analysis. For this reason, a quantitative analysis of water use has to be based on analytical methods that are semantically open: they must be able to define what we mean with the term water when crossing different scales of analysis. We propose here a definition of water as a resource that deal with the many services it provides to humans and ecosystems. WE argue that water can fulfil so many of them since the element has many characteristics that allow for the resource to be labelled with different attributes, depending on the end use such as drinkable. Since the services for humans and the functions for ecosystems associated with water flows are defined on different scales but still interconnected it is necessary to organize our assessment of water use across different hierarchical levels. In order to do so we define how to approach the study of water use in the Societal Metabolism, by proposing the Water Metabolism, tganized in three levels: societal level, ecosystem level and global level. The possible end uses we distinguish for the society are: personal/physiological use, household use, economic use. Organizing the study of water use across all these levels increases the usefulness of the quantitative analysis and the possibilities of finding relevant and comparable results. To achieve this result, we adapted a method developed to deal with multi-level, multi-scale analysis - the Multi-Scale Integrated Analysis of Societal and Ecosystem Metabolism (MuSIASEM) approach - to the analysis of water metabolism. In this paper, we discuss the peculiar analytical identity that water shows within multi-scale metabolic studies: water represents a flow-element when considering the metabolism of social systems (at a small scale, when describing the water metabolism inside the society) and a fund-element when considering the metabolism o ecosystems (at a larger scale when describing the water metabolism outside the society). The theoretical analysis is illustrated using two case which characterize the metabolic patterns regarding water use of a productive system in Catalonia and a water management policy in Andarax River Basin in Andalusia.
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IPH responded to the Department of Health, Social Services and Public Safety consultation on a draft maternity strategy for Northern Ireland. The strategy contains a number of proposals, which, if implemented, will significantly change how maternity services are delivered in the future. The draft strategy aims to provide women, professionals, commissioners and policy makers with a clear pathway for maternity services from preconceptual care through to postnatal care. It places an emphasis on early direct contact with a midwife and a better understanding of the role of the midwife and obstetricians. It sets out clear recommendations for tackling public health issues such as obesity, smoking and alcohol abuse in pregnancy; providing more choice; providing care closer to home and ensuring safe, high quality care tailored to meet the needs of the woman.
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Overview Report October 2012
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Improving Dementia Services in Northern Ireland - A Regional Strategy - November 2011
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Les praderies de posidnia de la costa catalana sn ecosistemes dalta importncia, ja que tenint en compte la seva poca extensi, ens aporten una gran multiplicitat de bns i serveis ecosistmics. No obstant, els danys observats en els prats en les ltimes dcades, tant pel que fa a la regressi en superfcie com a la prdua dintegritat ecolgica, ens indiquen que aquests ecosistemes sestan enfrontant a una crisi causada principalment per les pressions de les activitats antrpiques a les zones costaneres. En aquest projecte es pretenen identificar tots els bns i serveis que ens proporcionen aquests herbeis, aix com tamb dictaminar quina s la importncia de cada un dells en el context de la costa catalana. Daltra banda, es pretenen avaluar els impactes i conseqncies de la seva degradaci i tamb quantificar, de manera relativa, la prdua daquests bns i serveis a la costa catalana, partint de la base que, segons els resultats obtinguts, la prdua dabundncia en els prats ha estat daproximadament el 60% des dun hipottic estat pre-industrial fins lactualitat.
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Policy and Standards of Care for Paediatric ENT Surgery in Northern Ireland
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Policy and Standards of Care for Paediatric ENT Surgery in Northern Ireland
