909 resultados para areas and volumes
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In situ methods used for water quality assessment have both physical and time constraints. Just a limited number of sampling points can be performed due to this, making it difficult to capture the range and variability of coastal processes and constituents. In addition, the mixing between fresh and oceanic water creates complex physical, chemical and biological environment that are difficult to understand, causing the existing measurement methodologies to have significant logistical, technical, and economic challenges and constraints. Remote sensing of ocean colour makes it possible to acquire information on the distribution of chlorophyll and other constituents over large areas of the oceans in short periods. There are many potential applications of ocean colour data. Satellite-derived products are a key data source to study the distribution pattern of organisms and nutrients (Guillaud et al. 2008) and fishery research (Pillai and Nair 2010; Solanki et al. 2001. Also, the study of spatial and temporal variability of phytoplankton blooms, red tide identification or harmful algal blooms monitoring (Sarangi et al. 2001; Sarangi et al. 2004; Sarangi et al. 2005; Bhagirathan et al., 2014), river plume or upwelling assessments (Doxaran et al. 2002; Sravanthi et al. 2013), global productivity analyses (Platt et al. 1988; Sathyendranath et al. 1995; IOCCG2006) and oil spill detection (Maianti et al. 2014). For remote sensing to be accurate in the complex coastal waters, it has to be validated with the in situ measured values. In this thesis an attempt to study, measure and validate the complex waters with the help of satellite data has been done. Monitoring of coastal ecosystem health of Arabian Sea in a synoptic way requires an intense, extensive and continuous monitoring of the water quality indicators. Phytoplankton determined from chl-a concentration, is considered as an indicator of the state of the coastal ecosystems. Currently, satellite sensors provide the most effective means for frequent, synoptic, water-quality observations over large areas and represent a potential tool to effectively assess chl-a concentration over coastal and oceanic waters; however, algorithms designed to estimate chl-a at global scales have been shown to be less accurate in Case 2 waters, due to the presence of water constituents other than phytoplankton which do not co-vary with the phytoplankton. The constituents of Arabian Sea coastal waters are region-specific because of the inherent variability of these optically-active substances affected by factors such as riverine input (e.g. suspended matter type and grain size, CDOM) and phytoplankton composition associated with seasonal changes.
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Landnutzungsänderungen sind eine wesentliche Ursache von Treibhausgasemissionen. Die Umwandlung von Ökosystemen mit permanenter natürlicher Vegetation hin zu Ackerbau mit zeitweise vegetationslosem Boden (z.B. nach der Bodenbearbeitung vor der Aussaat) führt häufig zu gesteigerten Treibhausgasemissionen und verminderter Kohlenstoffbindung. Weltweit dehnt sich Ackerbau sowohl in kleinbäuerlichen als auch in agro-industriellen Systemen aus, häufig in benachbarte semiaride bis subhumide Rangeland Ökosysteme. Die vorliegende Arbeit untersucht Trends der Landnutzungsänderung im Borana Rangeland Südäthiopiens. Bevölkerungswachstum, Landprivatisierung und damit einhergehende Einzäunung, veränderte Landnutzungspolitik und zunehmende Klimavariabilität führen zu raschen Veränderungen der traditionell auf Tierhaltung basierten, pastoralen Systeme. Mittels einer Literaturanalyse von Fallstudien in ostafrikanischen Rangelands wurde im Rahmen dieser Studie ein schematisches Modell der Zusammenhänge von Landnutzung, Treibhausgasemissionen und Kohlenstofffixierung entwickelt. Anhand von Satellitendaten und Daten aus Haushaltsbefragungen wurden Art und Umfang von Landnutzungsänderungen und Vegetationsveränderungen an fünf Untersuchungsstandorten (Darito/Yabelo Distrikt, Soda, Samaro, Haralo, Did Mega/alle Dire Distrikt) zwischen 1985 und 2011 analysiert. In Darito dehnte sich die Ackerbaufläche um 12% aus, überwiegend auf Kosten von Buschland. An den übrigen Standorten blieb die Ackerbaufläche relativ konstant, jedoch nahm Graslandvegetation um zwischen 16 und 28% zu, während Buschland um zwischen 23 und 31% abnahm. Lediglich am Standort Haralo nahm auch „bare land“, vegetationslose Flächen, um 13% zu. Faktoren, die zur Ausdehnung des Ackerbaus führen, wurden am Standort Darito detaillierter untersucht. GPS Daten und anbaugeschichtlichen Daten von 108 Feldern auf 54 Betrieben wurden in einem Geographischen Informationssystem (GIS) mit thematischen Boden-, Niederschlags-, und Hangneigungskarten sowie einem Digitales Höhenmodell überlagert. Multiple lineare Regression ermittelte Hangneigung und geographische Höhe als signifikante Erklärungsvariablen für die Ausdehnung von Ackerbau in niedrigere Lagen. Bodenart, Entfernung zum saisonalen Flusslauf und Niederschlag waren hingegen nicht signifikant. Das niedrige Bestimmtheitsmaß (R²=0,154) weist darauf hin, dass es weitere, hier nicht erfasste Erklärungsvariablen für die Richtung der räumlichen Ausweitung von Ackerland gibt. Streudiagramme zu Ackergröße und Anbaujahren in Relation zu geographischer Höhe zeigen seit dem Jahr 2000 eine Ausdehnung des Ackerbaus in Lagen unter 1620 müNN und eine Zunahme der Schlaggröße (>3ha). Die Analyse der phänologischen Entwicklung von Feldfrüchten im Jahresverlauf in Kombination mit Niederschlagsdaten und normalized difference vegetation index (NDVI) Zeitreihendaten dienten dazu, Zeitpunkte besonders hoher (Begrünung vor der Ernte) oder niedriger (nach der Bodenbearbeitung) Pflanzenbiomasse auf Ackerland zu identifizieren, um Ackerland und seine Ausdehnung von anderen Vegetationsformen fernerkundlich unterscheiden zu können. Anhand der NDVI Spektralprofile konnte Ackerland gut Wald, jedoch weniger gut von Gras- und Buschland unterschieden werden. Die geringe Auflösung (250m) der Moderate Resolution Imaging Spectroradiometer (MODIS) NDVI Daten führte zu einem Mixed Pixel Effect, d.h. die Fläche eines Pixels beinhaltete häufig verschiedene Vegetationsformen in unterschiedlichen Anteilen, was deren Unterscheidung beeinträchtigte. Für die Entwicklung eines Echtzeit Monitoring Systems für die Ausdehnung des Ackerbaus wären höher auflösende NDVI Daten (z.B. Multispektralband, Hyperion EO-1 Sensor) notwendig, um kleinräumig eine bessere Differenzierung von Ackerland und natürlicher Rangeland-Vegetation zu erhalten. Die Entwicklung und der Einsatz solcher Methoden als Entscheidungshilfen für Land- und Ressourcennutzungsplanung könnte dazu beitragen, Produktions- und Entwicklungsziele der Borana Landnutzer mit nationalen Anstrengungen zur Eindämmung des Klimawandels durch Steigerung der Kohlenstofffixierung in Rangelands in Einklang zu bringen.
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This key facts publication provides an interim update to the NI health & social care inequalities monitoring system (HSCIMS) regional reports which are published every other year. It presents a summary of the latest position and inequality gaps between the most deprived areas and both the least deprived areas and the NI average in addition to a regional comparison with rural areas for a range of health outcomes included within the HSCIMS series, in addition to the health survey Northern Ireland (HSNI).
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Thesis (Ph.D.)--University of Washington, 2016-08
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According to the U.S. National Environmental Policy Act of 1969 (NEPA), federal action to manipulate habitat for species conservation requires an environmental impact statement, which should integrate natural, physical, economic, and social sciences in planning and decision making. Nonetheless, most impact assessments focus disproportionately on physical or ecological impacts rather than integrating ecological and socioeconomic components. We developed a participatory social-ecological impact assessment (SEIA) that addresses the requirements of NEPA and integrates social and ecological concepts for impact assessments. We cooperated with the Bureau of Land Management in Idaho, USA on a project designed to restore habitat for the Greater Sage-Grouse (Centrocercus urophasianus). We employed questionnaires, workshop dialogue, and participatory mapping exercises with stakeholders to identify potential environmental changes and subsequent impacts expected to result from the removal of western juniper (Juniperus occidentalis). Via questionnaires and workshop dialogue, stakeholders identified 46 environmental changes and associated positive or negative impacts to people and communities in Owyhee County, Idaho. Results of the participatory mapping exercises showed that the spatial distribution of social, economic, and ecological values throughout Owyhee County are highly associated with the two main watersheds, wilderness areas, and the historic town of Silver City. Altogether, the SEIA process revealed that perceptions of project scale varied among participants, highlighting the need for specificity about spatial and temporal scales. Overall, the SEIA generated substantial information concerning potential impacts associated with habitat treatments for Greater Sage-Grouse. The SEIA is transferable to other land management and conservation contexts because it supports holistic understanding and framing of connections between humans and ecosystems. By applying this SEIA framework, land managers and affected people have an opportunity to fulfill NEPA requirements and develop more comprehensive management plans that better reflect the linkages of social-ecological systems.
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Le rapide déclin actuel de la biodiversité est inquiétant et les activités humaines en sont la cause directe. De nombreuses aires protégées ont été mises en place pour contrer cette perte de biodiversité. Afin de maximiser leur efficacité, l’amélioration de la connectivité fonctionnelle entre elles est requise. Les changements climatiques perturbent actuellement les conditions environnementales de façon globale. C’est une menace pour la biodiversité qui n’a pas souvent été intégrée lors de la mise en place des aires protégées, jusqu’à récemment. Le mouvement des espèces, et donc la connectivité fonctionnelle du paysage, est impacté par les changements climatiques et des études ont montré qu’améliorer la connectivité fonctionnelle entre les aires protégées aiderait les espèces à faire face aux impacts des changements climatiques. Ma thèse présente une méthode pour concevoir des réseaux d’aires protégées tout en tenant compte des changements climatiques et de la connectivité fonctionnelle. Mon aire d’étude est la région de la Gaspésie au Québec (Canada). La population en voie de disparition de caribou de la Gaspésie-Atlantique (Rangifer tarandus caribou) a été utilisée comme espèce focale pour définir la connectivité fonctionnelle. Cette petite population subit un déclin continu dû à la prédation et la modification de son habitat, et les changements climatiques pourraient devenir une menace supplémentaire. J’ai d’abord construit un modèle individu-centré spatialement explicite pour expliquer et simuler le mouvement du caribou. J’ai utilisé les données VHF éparses de la population de caribou et une stratégie de modélisation patron-orienté pour paramétrer et sélectionner la meilleure hypothèse de mouvement. Mon meilleur modèle a reproduit la plupart des patrons de mouvement définis avec les données observées. Ce modèle fournit une meilleure compréhension des moteurs du mouvement du caribou de la Gaspésie-Atlantique, ainsi qu’une estimation spatiale de son utilisation du paysage dans la région. J’ai conclu que les données éparses étaient suffisantes pour ajuster un modèle individu-centré lorsqu’utilisé avec une modélisation patron-orienté. Ensuite, j’ai estimé l’impact des changements climatiques et de différentes actions de conservation sur le potentiel de mouvement du caribou. J’ai utilisé le modèle individu-centré pour simuler le mouvement du caribou dans des paysages hypothétiques représentant différents scénarios de changements climatiques et d’actions de conservation. Les actions de conservation représentaient la mise en place de nouvelles aires protégées en Gaspésie, comme définies par le scénario proposé par le gouvernement du Québec, ainsi que la restauration de routes secondaires à l’intérieur des aires protégées. Les impacts des changements climatiques sur la végétation, comme définis dans mes scénarios, ont réduit le potentiel de mouvement du caribou. La restauration des routes était capable d’atténuer ces effets négatifs, contrairement à la mise en place des nouvelles aires protégées. Enfin, j’ai présenté une méthode pour concevoir des réseaux d’aires protégées efficaces et j’ai proposé des nouvelles aires protégées à mettre en place en Gaspésie afin de protéger la biodiversité sur le long terme. J’ai créé de nombreux scénarios de réseaux d’aires protégées en étendant le réseau actuel pour protéger 12% du territoire. J’ai calculé la représentativité écologique et deux mesures de connectivité fonctionnelle sur le long terme pour chaque réseau. Les mesures de connectivité fonctionnelle représentaient l’accès général aux aires protégées pour le caribou de la Gaspésie-Atlantique ainsi que son potentiel de mouvement à l’intérieur. J’ai utilisé les estimations de potentiel de mouvement pour la période de temps actuelle ainsi que pour le futur sous différents scénarios de changements climatiques pour représenter la connectivité fonctionnelle sur le long terme. Le réseau d’aires protégées que j’ai proposé était le scénario qui maximisait le compromis entre les trois caractéristiques de réseau calculées. Dans cette thèse, j’ai expliqué et prédit le mouvement du caribou de la Gaspésie-Atlantique sous différentes conditions environnementales, notamment des paysages impactés par les changements climatiques. Ces résultats m’ont aidée à définir un réseau d’aires protégées à mettre en place en Gaspésie pour protéger le caribou au cours du temps. Je crois que cette thèse apporte de nouvelles connaissances sur le comportement de mouvement du caribou de la Gaspésie-Atlantique, ainsi que sur les actions de conservation qui peuvent être prises en Gaspésie afin d’améliorer la protection du caribou et de celle d’autres espèces. Je crois que la méthode présentée peut être applicable à d’autres écosystèmes aux caractéristiques et besoins similaires.
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Open skull surgery of deeply located intracerebral lesions requires precise determination of the treatment area in 3-dimensional (3-D) space. 3-D MRI can give important additional information in presurgical determination of the surgical approach to the target, taking into account highly functional brain areas and important vascular structures. The day before surgery, a grid composed of 9 tubings intersecting at 90° at 1 cm intervals and filled with a Q1SO4 solution is firmly attached to the skin of the patient’s head in the presumed region of the craniotomy. A 3-D turbo-FLASH sequence is then performed in the sagittal plane after intravenous Gd-DOTA injection on a IT Magnetom. 3-D surface reconstruction of the cortical gyri and sulci is performed. Once the gyri are identified, the 3-D program is then implemented in order to perform a color display of the cortical veins and of the tumor boundaries. The surgical access is then chosen by the surgeon, taking into account highly functional areas. Finally, the boundaries of the tumor are projected on the cortex reconstruction and on the external reference placed on the skin. The entry place for surgery as well as the size of craniotomy are drawn on the skin and the tubed grid is removed. The accuracy of this method tested in 9 patients with deeply located brain tumors or arteriovenous malformations was very satisfactory. In daily practice, this method is a valuable technique providing important clinical information in determining the shortest and safest way through the brain tissue, decreasing possible functional deficit and reducing craniotomy size in cases of difficult to access deep brain areas. Our method does not require a stereotactic frame permanently fixed to the head of the patient during surgery. © 1994 S. Karger AG, Basel.
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Background Correctly diagnosing basal cell carcinoma (BCC) clinical type is crucial for the therapeutic management. A systematic description of the variability of all reported BCC dermoscopic features according to clinical type and anatomic location is lacking. Objectives To describe the dermoscopic variability of BCC according to clinical type and anatomic location and to test the hypothesis of a clinical/dermoscopic continuum across superficial BCCs (sBCCs) with increasing palpability. Methods Clinical/dermoscopic images of nodular BCCs (nBCCs) and sBCCs with different degrees of palpability were retrospectively evaluated for the presence of dermoscopic criteria including degree of pigmentation, BCC-associated patterns, diverse vascular patterns, melanocytic patterns and polarized light patterns. Results We examined 501 histopathologically proven BCCs (66.9% sBCCs; 33.1% nBCCs), mainly located on trunk (46.7%; mostly sBCCs) and face (30.5%; mostly nBCCs). Short fine telangiectasias, leaf-like areas, spoke-wheel areas, small erosions and concentric structures were significantly associated with sBCC, whereas arborizing telangiectasias, blue-white veil-like structures, white shiny areas and rainbow pattern with nBCCs. Short fine telangiectasia, spoke-wheel areas and small erosions were independently associated with trunk location, whereas arborizing telangiectasias with facial location. Scalp BCCs had significantly more pigmentation and melanocytic criteria than BCCs located elsewhere. Multiple clinical/dermoscopic parameters displayed a significant linear trend across increasingly palpable sBCCs. Conclusions Particular dermoscopic criteria are independently associated with clinical type and anatomic location of BCC. Heavily pigmented, scalp BCCs are the most challenging to diagnose. A clinical/dermoscopic continuum across increasingly palpable sBCCs was detected and could be potentially important for the non-surgical management of the disease.
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One of the main challenges urban areas, and more particularly the compact ones, are facing is their adaptation to climate change. In recent years, is had been recognized that a more ecosystem approach to spatial planning can play a critical role in meeting these challenges. Green Infrastructure (GI) and its integration in spatial planning emerges as one of the most appropriate and effective ways to improve microclimate and tackle the impacts of climate change and mainly the Urban Heat Island (UHI) effect. This paper initially attempts to clarify the term GI and portrays its benefits and its role as an important spatial planning tool to fulfill different environmental, social and economic needs of urban areas. Then, the paper proceeds to an empirical evaluation of the role of GI in reducing the vulnerability to UHI effect in a compact urban area of the city of Thessaloniki. For this reason, a simple methodology is developed with a twofold purpose: to recognize the risks posed by climate change and especially UHI and to assess the potential offered by available in a compact area GI assets as well as by their redesign in order to maximize their contribution to climate change adaptation.
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Lantana camara L. is a significant weed of which there are some 650 varieties in over 60 countries or island groups. It has been the focus of biological control attempts for a century, yet still poses major problems in many regions. Lantana has a significant impact on economic and environmental areas and is difficult to control. The key to good management of lantana is constant vigilance. Repeated control of new regrowth is critical to success. Control of new infestations should be a priority because the species is able to expand its range during good seasons, but does not die out during poor conditions. This book is a resource for land managers and researchers on methods of lantana control, particularly biocontrol.
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The use of the ‘commission-accession’ principle as a mechanism for sustainable collecting in public museums and galleries has been significantly under-researched, only recently soliciting attention from national funding bodies in the United Kingdom (UK). This research has assessed an unfolding situation and provided a body of current evaluative evidence for commission-based acquisitions and a model for curators to use in future contemporary art purchases. ‘Commission-accession’ is a practice increasingly used by European and American museums yet has seen little uptake in the UK. Very recent examples demonstrate that new works produced via commissioning which then enter permanent collections, have significant financial and audience benefits that UK museums could harness, by drawing on the expertise of local and national commissioning organisations. Very little evaluative information is available on inter-institutional precedents in the United States (US) or ‘achat par commande’ in France. Neither is there yet literature that investigates the ambition for and viability of such models in the UK. This thesis addresses both of these areas, and provides evaluative case studies that will be of particular value to curators who seek sustainable ways to build their contemporary art collections. It draws on a survey of 82 museums and galleries across the UK conducted for this research, which provide a picture of where and how ‘commission-accession’ has been applied, and demonstrates its impacts as a strategy. In addition interviews with artists and curators in the UK, US and France on the social, economic and cultural implications of ‘commission-accession’ processes were undertaken. These have shed new light on issues inherent to the commissioning of contemporary art such as communication, trust, and risk as well as drawing attention to the benefits and challenges involved in commissioning as of yet unmade works of art.
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This project was developed in collaboration with the South Carolina Department of Health and Environmental Control Primary Care Office in order to identify primary care market areas and resources within South Carolina. Primary Care Service Areas are designed to identify small geographic areas that are relatively self-contained markets for primary care. Included is a map and listing for Primary Care Service Areas in the state.
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Small-scale spatial and temporal variability in animal abundance is an intrinsic characteristic of marine ecosystems but remains largely unknown for most animals, including coral reef fishes. In this study, we used a remote autonomous unbaited video system and recorded reef fish assemblages during daylight hours, 10 times a day for 34 consecutive days in a branching coral patch of the lagoon of New Caledonia. In total, 50 031 fish observations belonging to 114 taxa, 66 genera and 31 families were recorded in 256 recorded videos. Carnivores and herbivore-detritus feeders dominated the trophic structure. We found significant variations in the composition of fish assemblages between times of day. Taxa richness and fish abundance were greater in the early morning and in the late afternoon than during the day. Fourteen taxa displayed well-defined temporal patterns in abundance with one taxon influenced by time of day, six influenced by tidal state and seven influenced by both time of day and tidal state. None of these 14 taxa were piscivores, 10 were herbivore-detritus feeders, three were carnivores and one was plankton feeder. Our results suggest a diel migration from feeding grounds to shelter areas and highlight the importance of taking into account small-scale temporal variability in animal diversity and abundance when studying connectivity between habitats and monitoring communities.
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O fogo é um processo frequente nas paisagens do norte de Portugal. Estudos anteriores mostraram que os bosques de azinheira (Quercus rotundifolia) persistem após a passagem do fogo e ajudam a diminuir a sua intensidade e taxa de propagação. Os principais objetivos deste estudo foram compreender e modelar o efeito dos bosques de azinheira no comportamento do fogo ao nível da paisagem da bacia superior do rio Sabor, localizado no nordeste de Portugal. O impacto dos bosques de azinheira no comportamento do fogo foi testado em termos de área e configuração de acordo com cenários que simulam a possível distribuição destas unidades de vegetação na paisagem, considerando uma percentagem de ocupação da azinheira de 2.2% (Low), 18.1% (Moderate), 26.0% (High), e 39.8% (Rivers). Estes cenários tiveram como principal objetivo testar 1) o papel dos bosques de azinheira no comportamento do fogo e 2) de que forma a configuração das manchas de azinheira podem ajudar a diminuir a intensidade da linha de fogo e área ardida. Na modelação do comportamento do fogo foi usado o modelo FlamMap para simular a intensidade de linha do fogo e taxa de propagação do fogo com base em modelos de combustível associados a cada ocupação e uso do solo presente na área de estudo, e também com base em fatores topográficos (altitude, declive e orientação da encosta) e climáticos (humidade e velocidade do vento). Foram ainda usados dois modelos de combustível para a ocupação de azinheira (áreas interiores e de bordadura), desenvolvidos com base em dados reais obtidos na região. Usou-se o software FRAGSATS para a análise dos padrões espaciais das classes de intensidade de linha do fogo, usando-se as métricas Class Area (CA), Number of Patches (NP) e Large Patches Index (LPI). Os resultados obtidos indicaram que a intensidade da linha de fogo e a taxa de propagação do fogo variou entre cenários e entre modelos de combustível para o azinhal. A intensidade média da linha de fogo e a taxa média de propagação do fogo decresceu à medida que a percentagem de área de bosques de azinheira aumentou na paisagem. Também foi observado que as métricas CA, NP e LPI variaram entre cenários e modelos de combustível para o azinhal, decrescendo quando a percentagem de área de bosques de azinheira aumentou. Este estudo permitiu concluir que a variação da percentagem de ocupação e configuração espacial dos bosques de azinheira influenciam o comportamento do fogo, reduzindo, em termos médios, a intensidade da linha de fogo e a taxa de propagação, sugerindo que os bosques de azinhal podem ser usados como medidas silvícolas preventivas para diminuir o risco de incêndio nesta região.
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At the first full conference of the European Academy of Occupational Health Psychology (Lund, 1999), the decision was ratified to organise activities around three fora. These together represented the pillars on which the European Academy had been founded that same year: education, research and professional practice. Each forum was convened by a chair person and a small group of full members; it was agreed that a forum meeting would take place at each full conference and working groups would be established to move developments forward between conferences. The forum system has proven an effective means by which to channel the energies of individual members, and the institutions that they represent, towards advancements in all three areas of activity in occupational health psychology (OHP) in Europe. During the meeting of the education forum at the third full European Academy conference (Barcelona, 2001), the proposal was made for the establishment of a working party that would be tasked with the production of a strategy document on The Promotion of Education in Occupational Health Psychology in Europe. The proposal was ratified at the subsequent annual business meeting held during the same conference. The draft outline of the strategy document was published for consultation in the European Academy’s e-newsletter (Vol. 3.1, 2002) and the final document presented to the meeting of the education forum at the fourth full conference (Vienna, 2002). The strategy document constituted a seminal piece of literature in so far as it provided a foundation and structure capable of guiding pan-European developments in education in OHP – developments that would ensure the sustained growth of the discipline and assure it of a long-standing embedded place in both the scholarly and professional domains. To these ends, the strategy document presented six objectives as important for the sustained expansion and the promotion of education in the discipline in Europe. Namely, the development of: [1] A core syllabus for education in occupational health psychology [2] A mechanism for identifying, recognising and listing undergraduate and postgraduate modules and courses (programmes) in occupational health psychology [3] Structures to support the extension of the current provision of education in occupational health psychology [4] Ways of enhancing convergence of the current provision of education in occupational health psychology [5] Ways of encouraging regional cooperation between education providers across the regions of Europe [6] Ways of ensuring consistency with North American developments in education and promoting world wide co-operation in education Five years has elapsed since the presentation of these laudable objectives to the meeting of the education forum in Vienna in December 2002. In that time OHP has undergone considerable growth, particularly in Europe and North America. Expansion has been reflected in the evolution of existing, and emergence of new, representative bodies for the discipline on both sides of the Atlantic Ocean. As such, it might be considered timely to pause to reflect on what has been achieved in respect of each of the objectives set out in the strategy document. The current chapter examines progress on the six objectives and considers what remains to be done. This exercise is entered into not merely in order to congratulate achievements in some areas and lament slow progress in others. Rather, on the one hand it serves to highlight areas where real progress has been made with a view to the presentation of these areas as ripe for further capitalisation. On the other hand it serves to direct the attention of stakeholders (all those with a vested interest in OHP) to those key parts of the jigsaw puzzle that is the development of a self-sustaining pan-European education framework which remain to be satisfactorily addressed.