993 resultados para service de santé


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Coastal zones and shelf-seas are important for tourism, commercial fishing and aquaculture. As a result the importance of good water quality within these regions to support life is recognised worldwide and a number of international directives for monitoring them now exist. This paper describes the AlgaRisk water quality monitoring demonstration service that was developed and operated for the UK Environment Agency in response to the microbiological monitoring needs within the revised European Union Bathing Waters Directive. The AlgaRisk approach used satellite Earth observation to provide a near-real time monitoring of microbiological water quality and a series of nested operational models (atmospheric and hydrodynamic-ecosystem) provided a forecast capability. For the period of the demonstration service (2008–2013) all monitoring and forecast datasets were processed in near-real time on a daily basis and disseminated through a dedicated web portal, with extracted data automatically emailed to agency staff. Near-real time data processing was achieved using a series of supercomputers and an Open Grid approach. The novel web portal and java-based viewer enabled users to visualise and interrogate current and historical data. The system description, the algorithms employed and example results focussing on a case study of an incidence of the harmful algal bloom Karenia mikimotoi are presented. Recommendations and the potential exploitation of web services for future water quality monitoring services are discussed.

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Ecosystems provide a range of goods and services that contribute toward human well-being through the environmental, economic, and cultural benefits they provide. Although the importance of these services is increasingly being recognized by governments, our understanding of the implications of different energy technologies on the provision of these services is limited. The chapter presents an assessment of four key energy technologies that considers the ecosystem services impacts across the entire lifecycle. In demonstrating the global implications of these energy technologies, the chapter makes the case that assessment of UK energy policy must consider a broad range of environmental and societal indicators both within the UK and overseas.

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A mixed-method approach was used to assess and value the ecosystem services derived from the Dogger Bank, an extensive shallow sandbank in the southern North Sea. Three parallel studies were undertaken that 1) identified and quantified, where possible, how indicators for ecosystem service provision may change according to two future scenarios, 2) assessed members of the public's willingness-to-pay for improvements to a small number of ecosystem services as a consequence of a hypothetical management plan, and 3) facilitated a process of deliberation that allowed members of the public to explore the uses of the Dogger Bank and the conflicts and dilemmas involved in its management. Each of these studies was designed to answer different and specific research questions and therefore contributes different insights about the ecosystem services delivered by the Dogger Bank. This paper explores what can be gained by bringing these findings together post hoc and the extent to which the different methods are complementary. Findings suggest that mixed-method research brings more understanding than can be gained from the individual approaches alone. Nevertheless, the choice of methods used and how these methods are implemented strongly affects the results obtained.

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Ecosystem services provided by the marine environment are fundamental to human health and well-being. Despite this, many marine systems are being degraded to an extent that may reduce their capacity to provide these ecosystem services. The ecosystem approach is a strategy for the integrated management of land, water and living resources that promotes conservation and sustainable use in an equitable way (UN Convention on Biological Diversity, 2000). Its application to marine management and spatial planning has been proposed as a means of maintaining the economic and social value of the oceans, not only in the present but for generations to come. Characterising the susceptibility of services (and combinations of services) to particular human activities based on knowledge of impacts on biodiversity and ecosystem functioning (as described in preceding chapters) is a challenge for future management of the oceans. In this chapter, we highlight the existing, but limited knowledge of how ecosystem services may be impacted by different human activities. We discuss how impacts on one service can impact multiple services and explore how the impacts on services can vary both spatially and temporally and according to context. We focus particularly on the effects on ecosystem services of activities whose impacts on biodiversity and ecosystem functioning have already been considered in previous chapters. Some of these activities are associated with poor management of ecosystem benefits, for example, from provisioning services (aquaculture and fisheries), or with excessive input of wastes, fertilisers and contaminants into the system overburdening the waste treatment and assimilation services. Other impacts are associated with the construction of structures or use of space designed to generate benefits from environmental services such as the presence of water as a carrier for shipping, or sources of wind, wave and tidal power. We discuss the trade-offs that are made, consciously or otherwise, between different ecosystem services, which arise from human activities to optimise or manage specific ecosystem services.

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The purpose of this research note is to demonstrate how an individualised quality of life instrument could be adapted to provide a more accurate estimate of the impact of a social service on a person’s quality of life. An increase in quality of life between the start and end of a service is often taken as an indication that the service impacted positively on quality of life. The modifications to the quality of life instrument suggested in this paper show that this assumption is not always accurate and should be questioned directly.

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Current policy and practice emphasises much more than ever before a need for purchasers and providers to reduce appropriately the length of hospital stay. Consequently, a number of early discharge “schemes” have been developed. This paper presents the findings from an evaluation of a “home from hospital” (HFH) scheme. The HFH service provides a maximum of six weeks intensive domiciliary care for older people on their discharge from hospital. The aim of the service is to facilitate early discharge from hospital and to assist patients to regain independence. The study reported here elicited the views and perceptions of clients and professionals involved in the HFH scheme about the quality, efficiency and effectiveness of the service. Seventy-five clients were discharged from hospital to the HFH scheme during a two month period and those who consented to participate in the study were interviewed after discharge from the HFH service (n = 40). Participants had attended hospital for various conditions but the largest group were fracture patients. Hospital staff and community based professionals completed a questionnaire about the service. Overall, clients and professionals perceived the HFH scheme as a beneficial service, though some minor problems existed at an individual level. Clients’ dependency levels generally decreased during their time on the scheme. Research using a controlled design is necessary in order to draw firm conclusions about the cost-effectiveness of a HFH service. Overall, home-from-hospital appears to be an effective model of an early discharge scheme worthy of further attention.

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This paper reports the results of an investigation, by postal questionnaire, of the views of 30 General Practitioners about a model of out of hospital care – the home from hospital (HFH) service, which mainly provides social care and rehabilitation for patients in their own home. The GPs, who all worked within one of the Health and Social Services Board areas in Northern Ireland during the time of the study (March-April 1998), indicated that the introduction of the HFH service, unlike other models of out of hospital care, did not increase their workload. Therefore, it is suggested that the HFH model of care should be given more attention in terms of research evaluation and service development.