941 resultados para INTEGRATED MEDICINES MANAGEMENT


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The objective of this study is to examine the social impacts of the integrated conservation and development project (ICDP) aimed at biodiversity conservation and local socio-economic development in the Ranomafana National Park (RNP), Madagascar. Furthermore, the study explores social sustainability and justice of the ICDP in Ranomafana. This ethnographically informed impact study uses of various field methods. The research material used consists of observation, interviews (key-person and focus group), school children's writings, official statistics and project documents. Fieldwork was conducted in three phases in 2001, 2002 and 2004 in twelve villages around the park, as well as in neighbouring areas of Ranomafana. However, four of those twelve villages were chosen for closer study. This study consists of five independent articles and a concluding chapter. Social impacts were studied through reproductive health indicators as well as a life security approach. Equity and distribution of benefits and drawbacks of ICDP were analysed and the actors related to the conservation in Ranomafana were identified. The children and adolescents' environmental views were also examined. The reproductive health indicators studied showed a poor state of reproductive health in the park area. Moreover, the existing social capital in the villages seemed to be fragmented due to economic difficulties that were partly caused by the conservation regulations. The ICDP in Ranomafana did not pay attention to the heterogeneity of the affected communities even though the local beneficiaries of the ICDP varied according to their ethnicity, living place, wealth, social position and gender. In addition, various conservation actors (local people in various groups, local authorities, tourist business owners, conservation NGOs and scientists) contest their interests over the forest, conservation and its related activities. This study corroborates the same type of evidence and conclusions discussed in other similar cases elsewhere: so called social conservation programmes still cannot meet the needs of the people living near the protected areas; on the contrary, they even have a reverse impact on the people's lives. A fundamental misunderstood assumption in the conservation process in Ranomafana was to consider the local people as a problem for biodiversity conservation. Major reasons for the failure of the ICDP in Ranomafana include a lack of local institutions that would have been able to communicate as equals with the conservation NGOs as well as to transfer the tradition of the authoritarian governance in conservation management together with the over-appreciation of scientific biodiversity, and lack of will to understand the local people's rights to use the forest for their livelihoods.

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This book is on cross-border competence management in Russia and China. Corporations are facing a number of problems and challenges in their international operations, to which there typically are no simple solutions. For instance, they need to understand and respond to cultural and institutional diversity and ascertain that their foreign units are integrated with the rest of the corporation. Throughout this report we will discuss a range of challenges confronting firms as they seek to develop their capabilities to operate internationally. Some of the challenges are clearly case specific, and although this book aims to offer research-based advice to practicing managers there is a potential danger in applying lessons from other companies to the own firm. Our hope is that our analyses of the challenges facing Finnish corporations in China and Russia reported together with extensive quotes from our interviews and insights from other recent studies will help readers draw their own conclusions as to how to deal with issues related to competence management across borders. With this book we also aspire to contribute to the academic literature by providing new insights into cross-border competence management in general and the operations of Finnish corporations in Russia and China in particular.

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In Taita Hills, south-eastern Kenya, remnants of indigenous mountain rainforests play a crucial role as water towers and socio-cultural sites. They are pressurized due to poverty, shortage of cultivable land and the fading of traditional knowledge. This study examines the traditional ecological knowledge of Taitas and the ways it may be applied within transforming natural resource management regimes. I have analyzed some justifications for and hindrances to ethnodevelopment and participatory forest management in light of recently renewed Kenyan forest policies. Mixed methods were applied by combining an ethnographic approach with participatory GIS. I learned about traditionally protected forests and their ecological and cultural status through a seek out the expert method and with remote sensing data and tools. My informants were: 107 household interviewees, 257 focus group participants, 73 key informants and 87 common informants in participatory mapping. Religious leaders and state officials shared their knowledge for this study. I have gained a better understanding of the traditionally protected forests and sites through examining their ecological characteristics and relation to social dynamics, by evaluating their strengths and hindrances as sites for conservation of cultural and biological diversity. My results show that, these sites are important components of a complex socio-ecological system, which has symbolical status and sacred and mystical elements within it, that contributes to the connectivity of remnant forests in the agroforestry dominated landscape. Altogether, 255 plant species and 220 uses were recognized by the tradition experts, whereas 161 species with 108 beneficial uses were listed by farmers. Out of the traditionally protected forests studied 47 % were on private land and 23% on community land, leaving 9% within state forest reserves. A paradigm shift in conservation is needed; the conservation area approach is not functional for private lands or areas trusted upon communities. The role of traditionally protected forests in community-based forest management is, however, paradoxal, since communal approaches suggests equal participation of people, whereas management of these sites has traditionally been the duty of solely accredited experts in the village. As modernization has gathered pace such experts have become fewer. Sacredness clearly contributes but, it does not equal conservation. Various social, political and economic arrangements further affect the integrity of traditionally protected forests and sites, control of witchcraft being one of them. My results suggest that the Taita have a rich traditional ecological knowledge base, which should be more determinately integrated into the natural resource management planning processes.

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The proportion of patients over 75 years of age, receiving all different types of healthcare, is constantly increasing. The elderly undergo surgery and anaesthetic procedures more often than middle-aged patients. Poor pain management in the elderly is still an issue. Although the elderly consumes the greatest proportion of prescribed medicines in Western Europe, most clinical pharmacological studies have been performed in healthy volunteers or middle-aged patients. The aim of this study was to investigate pain measurement and management in cognitively impaired patients in long term hospital care and in cognitively normal elderly patients after cardiac surgery. This thesis incorporated 366 patients, including 86 home-dwelling or hospitalized elderly with chronic pain and 280 patients undergoing cardiac surgery with acute pain. The mean age of patients was 77 (SD ± 8) years and approximately 8400 pain measurements were performed with four pain scales: Verbal Rating Scale (VRS), the Visual Analogue Scale (VAS), the Red Wedge Scale (RWS), and the Facial Pain Scale (FPS). Cognitive function, depression, functional ability in daily life, postoperative sedation and postoperative confusion were assessed with MMSE, GDS, Barthel Index, RASS, and CAM-ICU, respectively. The effects and plasma concentrations of fentanyl and oxycodone were measured in elderly (≥ 75 years) and middle-aged patients (≤ 60 years) and the opioid-sparing effect of pregabalin was studied after cardiac surgery. The VRS pain scores after movement correlated with the Barthel Index. The VRS was most successful in the groups of demented patients (MMSE 17-23, 11-16 and ≤ 10) and in elderly patients on the first day after cardiac surgery. The elderly had a higher plasma concentration of fentanyl at the end of surgery than younger patients. The plasma concentrations of oxycodone were comparable between the groups. Pain intensity on the VRS was lower and the sedation scores were higher in the elderly. Total oxycodone consumption during five postoperative days was reduced by 48% and the CAM-ICU scores were higher on the first postoperative day in the pregabalin group. The incidence of postoperative pain during movement was lower in the pregabalin group three months after surgery. This investigation demonstrates that chronic pain did not seem to impair daily activities in home-dwelling Finnish elderly. The VRS appeared to be applicable for elderly patients with clear cognitive dysfunction (MMSE ≤17) and it was the most feasible pain scale for the early postoperative period after cardiac surgery. After cardiac surgery, plasma concentrations of fentanyl in elderly were elevated, although oxycodone concentrations were at similar level compared to middle-aged patients. The elderly had less pain and were more sedated after doses of oxycodone. Therefore, particular attention must be given to individual dosing of the opioids in elderly surgical patients, who often need a smaller amount for adequate analgesia than middle-aged patients. The administration of pregabalin reduced postoperative oxycodone consumption after cardiac surgery. Pregabalin-treated patients had less confusion, and additionally to less postoperative pain on the first postoperative day and during movement at three months post-surgery. Pregabalin might be a new alternative as analgesic for acute postoperative and chronic pain management in the elderly. Its clinical role and safety remains to be verified in large-scale randomized and controlled studies. In the future, many clinical trials in the older category of patients will be needed to facilitate improvements in health care methods.

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The purpose of this study was to examine the integrated climatic impacts of forestry and the use fibre-based packaging materials. The responsible use of forest resources plays an integral role in mitigating climate change. Forests offer three generic mitigation strategies; conservation, sequestration and substitution. By conserving carbon reservoirs, increasing the carbon sequestration in the forest or substituting fossil fuel intensive materials and energy, it is possible to lower the amount of carbon in the atmosphere through the use of forest resources. The Finnish forest industry consumed some 78 million m3 of wood in 2009, while total of 2.4 million tons of different packaging materials were consumed that same year in Finland. Nearly half of the domestically consumed packaging materials were wood-based. Globally the world packaging material market is valued worth annually some €400 billion, of which the fibre-based packaging materials account for 40 %. The methodology and the theoretical framework of this study are based on a stand-level, steady-state analysis of forestry and wood yields. The forest stand data used for this study were obtained from Metla, and consisted of 14 forest stands located in Southern and Central Finland. The forest growth and wood yields were first optimized with the help of Stand Management Assistant software, and then simulated in Motti for forest carbon pools. The basic idea was to examine the climatic impacts of fibre-based packaging material production and consumption through different forest management and end-use scenarios. Economically optimal forest management practices were chosen as the baseline (1) for the study. In the alternative scenarios, the amount of fibre-based packaging material on the market decreased from the baseline. The reduced pulpwood demand (RPD) scenario (2) follows economically optimal management practices under reduced pulpwood price conditions, while the sawlog scenario (3) also changed the product mix from packaging to sawnwood products. The energy scenario (4) examines the impacts of pulpwood demand shift from packaging to energy use. The final scenario follows the silvicultural guidelines developed by the Forestry Development Centre Tapio (5). The baseline forest and forest product carbon pools and the avoided emissions from wood use were compared to those under alternative forest management regimes and end-use scenarios. The comparison of the climatic impacts between scenarios gave an insight into the sustainability of fibre-based packaging materials, and the impacts of decreased material supply and substitution. The results show that the use of wood for fibre-based packaging purposes is favorable, when considering climate change mitigation aspects of forestry and wood use. Fibre-based packaging materials efficiently displace fossil carbon emissions by substituting more energy intensive materials, and they delay biogenic carbon re-emissions to the atmosphere for several months up to years. The RPD and the sawlog scenarios both fared well in the scenario comparison. These scenarios produced relatively more sawnwood, which can displace high amounts of emissions and has high carbon storing potential due to the long lifecycle. The results indicate the possibility that win-win scenarios exist by shifting production from pulpwood to sawlogs; on some of the stands in the RPD and sawlog scenarios, both carbon pools and avoided emissions increased from the baseline simultaneously. On the opposite, the shift from packaging material to energy use caused the carbon pools and the avoided emissions to diminish from the baseline. Hence the use of virgin fibres for energy purposes, rather than forest industry feedstock biomass, should be critically judged if optional to each other. Managing the stands according to the silvicultural guidelines developed by the Forestry Development Centre Tapio provided the least climatic benefits, showing considerably lower carbon pools and avoided emissions. This seems interesting and worth noting, as the guidelines are the current basis for the forest management practices in Finland.

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An integrated reservoir operation model is presented for developing effective operational policies for irrigation water management. In arid and semi-arid climates, owing to dynamic changes in the hydroclimatic conditions within a season, the fixed cropping pattern with conventional operating policies, may have considerable impact on the performance of the irrigation system and may affect the economics of the farming community. For optimal allocation of irrigation water in a season, development of effective mathematical models may guide the water managers in proper decision making and consequently help in reducing the adverse effects of water shortage and crop failure problems. This paper presents a multi-objective integrated reservoir operation model for multi-crop irrigation system. To solve the multi-objective model, a recent swarm intelligence technique, namely elitist-mutated multi-objective particle swarm optimisation (EM-MOPSO) has been used and applied to a case study in India. The method evolves effective strategies for irrigation crop planning and operation policies for a reservoir system, and thereby helps farming community in improving crop benefits and water resource usage in the reservoir command area.

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Expanding energy access to the rural population of India presents a critical challenge for its government. The presence of 364 million people without access to electricity and 726 million who rely on biomass for cooking indicate both the failure of past policies and programs, and the need for a radical redesign of the current system. We propose an integrated implementation framework with recommendations for adopting business principles with innovative institutional, regulatory, financing and delivery mechanisms. The framework entails establishment of rural energy access authorities and energy access funds, both at the national and regional levels, to be empowered with enabling regulatory policies, capital resources and the support of multi-stakeholder partnership. These institutions are expected to design, lead, manage and monitor the rural energy interventions. At the other end, trained entrepreneurs would be expected to establish bioenergy-based micro-enterprises that will produce and distribute energy carriers to rural households at an affordable cost. The ESCOs will function as intermediaries between these enterprises and the international carbon market both in aggregating carbon credits and in trading them under CDM. If implemented, such a program could address the challenges of rural energy empowerment by creating access to modern energy carriers and climate change mitigation. (C) 2011 Elsevier Ltd. All rights reserved.

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Solid material thrown away as unused from various sectors such as agricultural, commercial, domestic, industrial and institutional constitutes solid wastes. This places an enormous strain on natural resources and seriously undermines efficient and sustainable development. Management of Municipal Solid Waste discusses the ways to salvage the situation through efficient management of solid wastes from waste generation to final disposal. The various processes such as waste generation, collection, storage, processing, recovery, transport, and disposal, are explained with the support of case studies. The book discusses reduction of waste at the source and to foster implementation of integrated solid waste management systems that are cost-effective and protect human health and the environment.

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Aquatic Ecosystems perform numerous valuable environmental functions. They recycle nutrients, purify water, recharge ground water, augment and maintain stream flow, and provide habitat for a wide variety of flora and fauna and recreation for people. A rapid population increase accompanied by unplanned developmental works has led to the pollution of surface waters due to residential, agricultural, commercial and industrial wastes/effluents and decline in the number of water bodies. Increased demands for drainage of wetlands have been accommodated by channelisation, resulting in further loss of stream habitat, which has led to aquatic organisms becoming extinct or imperiled in increasing numbers and to the impairment of many beneficial uses of water, including drinking, swimming and fishing. Various anthropogenic activities have altered the physical, chemical and biological processes within aquatic ecosystems. An integrated and accelerated effort toward environmental restoration and preservation is needed to stop further degradation of these fragile ecosystems. Failure to restore these ecosystems will result in sharply increased environmental costs later, in the extinction of species or ecosystem types, and in permanent ecological damage.

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We present a centralized integrated approach for: 1) enhancing the performance of an IEEE 802.11 infrastructure wireless local area network (WLAN), and 2) managing the access link that connects the WLAN to the Internet. Our approach, which is implemented on a standard Linux platform, and which we call ADvanced Wi-fi Internet Service EnhanceR (ADWISER), is an extension of our previous system WLAN Manager (WM). ADWISER addresses several infrastructure WLAN performance anomalies such as mixed-rate inefficiency, unfair medium sharing between simultaneous TCP uploads and downloads, and inefficient utilization of the Internet access bandwidth when Internet transfers compete with LAN-WLAN transfers, etc. The approach is via centralized queueing and scheduling, using a novel, configurable, cascaded packet queueing and scheduling architecture, with an adaptive service rate. In this paper, we describe the design of ADWISER and report results of extensive experimentation conducted on a hybrid testbed consisting of real end-systems and an emulated WLAN on Qualnet. We also present results from a physical testbed consisting of one access point (AP) and a few end-systems.

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Multiobjective fuzzy methodology is applied to a case study of Khadakwasla complex irrigation project located near Pune city of Maharashtra State, India. Three objectives, namely, maximization of net benefits, crop production and labour employment are considered. Effect of reuse of wastewater on the planning scenario is also studied. Three membership functions, namely, nonlinear, hyperbolic and exponential are analyzed for multiobjective fuzzy optimization. In the present study, objective functions are considered as fuzzy in nature whereas inflows are considered as dependable. It is concluded that exponential and hyperbolic membership functions provided similar cropping pattern for most of the situations whereas nonlinear membership functions provided different cropping pattern. However, in all the three cases, irrigation intensities are more than the existing irrigation intensity.

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EXECUTIVE SUMMARY INTRODUCTION OVERVIEW OF INTERNATIONAL EBM HISTORY References CANADA Overview Activities to date Integrated Management implementation in Canada Objectives, indicators and reference points Assessment approaches Research directions for the future Management directions for the future References JAPAN Overview Conservation and sustainable use of marine living resources Harvest control by TAC system Stock Recovery Plan and effort regulation system Stock enhancement by hatchery-produced juvenile release Conservation and sustainable develop-ment on coastal waters The implementation of ecosystem-based management PEOPLE’S REPUBLIC OF CHINA Overview Current actions Output control Input control Summer fishing ban Enhance ecosystem health REPUBLIC OF KOREA Initiatives and actions of ecosystem-based management in Korea Current ecosystem-based management initiatives in Korea Precautionary TAC-based fishery management Closed fishing season/areas Fish size- and sex-controls Fishing gear design restrictions Marine protected areas (MPA) RUSSIA Existing and anticipated ecosystem-based management initiatives Issues related to the implementation of ecosystem-based management UNITED STATES OF AMERICA Definitions and approaches to ecosystem-based fishery management in the United States Present U.S. legislative mandates relating to ecosystem-based fishery management Target species Bycatch species Threatened or endangered species Habitats Food webs Ecosystems Integration of legislative mandates into an ecosystem approach Scientific issues in implementing ecosystem-based approaches References DISCUSSION AND RECOMMENDATIONS APPENDICES Appendix 10.1 Study group membership and participants Appendix 10.2 Terminology definitions Appendix 10.3 Present state of implementing ecosystem-based fishery management in Alaska: Alaska groundfish fisheries Appendix 10.4 Present state of implementing ecosystem-based fishery management off the West Coast of the United States: Pacific Coast groundfish fisheries Appendix 10.5 Descriptions of multi-species and ecosystem models developed or under development in the U.S. North Pacific region that might be used to predict effects of fishing on ecosystems Appendix 10.6 A potential standard reporting format (developed by Australia, and currently being used by the U.S.A in their contribution to this report) (83 page document)

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Excess fishing capacity has been identified as one of the most pernicious problems affecting long-term sustainability and biodiversity of fishery resources and economic viability of fishing operations. Significant economic gains could be achieved by eliminating excess capacity, in addition to attaining objectives of resource sustainability. In this paper, approaches to fishing capacity management are reviewed in the context of Indian fisheries. A rights based regulated access system under a co-management regime based on a strong inclusive cooperative movement of stakeholders with built-in transferable quota system and buy-back or rotational right of entry schemes seems to hold potential for capacity management in the shelf fisheries of Indian states, which need to be implemented in collaboration with the Union Government and the neighboring states with confluent ecosystems and shared fishing grounds. A key advantage of the use of rights based approaches for managing fishing capacity is that they provide a mechanism through which stakeholders can more easily and actively participate in the management process.