993 resultados para services de santé de 1re ligne


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Global warming and its link to the burning of fossil fuels has prompted many governments around the world to set legally binding greenhouse gas reduction targets which are to be partially realised through a stronger reliance on renewable (e.g. wind) and other lower carbon (i.e. natural gas and nuclear) energy commodities. The marine environment will play a key role in hosting or supporting these new energy strategies. However, it is unclear how the construction, operation and eventual decommissioning of these energy systems, and their related infrastructure, will impact the marine environment, the ecosystem services (i.e. cultural, regulating, provisioning and supporting) and in turn the benefits it provides for human well-being. This uncertainty stems from a lack of research that has synthesised into a common currency the various effects of each energy sector on marine ecosystems and the benefits humans derive from it. To address this gap, the present study reviews existing ecosystem impact studies for offshore components of nuclear, offshore wind, offshore gas and offshore oil sectors and translates them into the common language of ecosystem service impacts that can be used to evaluate current policies. The results suggest that differences exist in the way in which energy systems impact ecosystem services, with the nuclear sector having a predominantly negative impact on cultural ecosystem services; oil and gas a predominately negative impact on cultural, provisioning, regulating and supporting ecosystem services; while wind has a mix of impacts on cultural, provisioning and supporting services and an absence of studies for regulating services. This study suggests that information is still missing with regard to the full impact of these energy sectors on specific types of benefits that humans derive from the marine environment and proposes possible areas of targeted research.

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Ecosystem services assessments are increasingly being used to inform marine policy and planning. These assessments involve significant time, effort, and expertise. It is important at the outset to determine which of many ecosystem services should be quantified and which measures of ecological output, economic impact, or value should be assessed. Furthermore, the literature shows that in practice such assessments are unevenly applied and rarely used effectively in decision-making processes. We develop a structured decision-making approach, called a triage, to assess what types of ecosystem services should be assessed to improve the uptake and usefulness of such information in marine planning. Two case studies, in France and the United Kingdom, provide examples of the application of the triage approach.

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Previous research and service development guidelines have highlighted the importance of psychological issues in diabetes care, and both people with diabetes and diabetes professionals recognise the need for specialist psychological input. This article outlines the development of a service delivery model for psychological services in diabetes care, based on a patient needs assessment and the advice of diabetes professionals. This involved an assessment of the psychological needs of people with diabetes within an urban Health Trust in Northern Ireland, and the collation of the views of local diabetes professionals. Questionnaires to assess for depression, anxiety, binge eating behaviour and diabetes-specific worries were completed by 300 people with diabetes. The participants were accessed through both primary and secondary care diabetes teams. As expected, a high level of psychological distress relative to population norms was illustrated by the patient needs assessment. Particularly high levels of binge eating behaviour were reported, and levels of distress were higher for community-managed patients than for hospital-managed patients. The diabetes professionals unanimously agreed that there is a need for specialist psychological input and contributed to the service delivery model which is outlined in this article.

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