Determining the long-term changes in biodiversity and provisioning services along a transect from Central Europe to the Mediterranean

Climate, land use and fire are strong determinants of plant diversity, potentially resulting in local extinctions, including rare endemic and economically valuable species. While climate and land use are decisive for vegetation composition and thus the species pool, fire disturbance can lead to landscape fragmentation, affecting the provisioning of important ecosystem services such as timber and raw natural resources. We use multi-proxy palaeoecological data with high taxonomic and temporal resolution across an environmental gradient to assess the long-term impact of major climate shifts, land use and fire disturbance on past vegetation openness and plant diversity (evenness and richness). Evenness of taxa is inferred by calculating the probability of interspecific encounter (PIE) of pollen and spores and species richness by palynological richness (PRI). To account for evenness distortions of PRI, we developed a new palaeodiversity measure, which is evenness-detrended palynological richness (DE-PRI). Reconstructed species richness increases from north to south regardless of time, mirroring the biodiversity increase across the gradient from temperate deciduous to subtropical evergreen vegetation. Climatic changes after the end of the last ice age contributed to biodiversity dynamics, usually by promoting species richness and evenness in response to warming. The data reveal that the promotion of diverse open-land ecosystems increased when human disturbance became determinant, while forests became less diverse. Our results imply that the today’s biodiversity has been shaped by anthropogenic forcing over the millennia. Future management strategies aiming at a successful conservation of biodiversity should therefore consider the millennia-lasting role of anthropogenic fire and human activities.

[Second victim : Critical incident stress management in clinical medicine]

BACKGROUND Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. METHODS A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. RESULTS In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. CONCLUSIONS The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

Dynamic Optimization of SLA-Based Services Scaling Rules

Current advanced cloud infrastructure management solutions allow scheduling actions for dynamically changing the number of running virtual machines (VMs). This approach, however, does not guarantee that the scheduled number of VMs will properly handle the actual user generated workload, especially if the user utilization patterns will change. We propose using a dynamically generated scaling model for the VMs containing the services of the distributed applications, which is able to react to the variations in the number of application users. We answer the following question: How to dynamically decide how many services of each type are needed in order to handle a larger workload within the same time constraints? We describe a mechanism for dynamically composing the SLAs for controlling the scaling of distributed services by combining data analysis mechanisms with application benchmarking using multiple VM configurations. Based on processing of multiple application benchmarks generated data sets we discover a set of service monitoring metrics able to predict critical Service Level Agreement (SLA) parameters. By combining this set of predictor metrics with a heuristic for selecting the appropriate scaling-out paths for the services of distributed applications, we show how SLA scaling rules can be inferred and then used for controlling the runtime scale-in and scale-out of distributed services. We validate our architecture and models by performing scaling experiments with a distributed application representative for the enterprise class of information systems. We show how dynamically generated SLAs can be successfully used for controlling the management of distributed services scaling.

Evaluating watershed service availability under future management and climate change scenarios in the Pangani Basin

Watershed services are the benefits people obtain from the flow of water through a watershed. While demand for such services is increasing in most parts of the world, supply is getting more insecure due to human impacts on ecosystems such as climate or land use change. Population and water management authorities therefore require information on the potential availability of watershed services in the future and the trade-offs involved. In this study, the Soil and Water Assessment Tool (SWAT) is used to model watershed service availability for future management and climate change scenarios in the East African Pangani Basin. In order to quantify actual “benefits”, SWAT2005 was slightly modified, calibrated and configured at the required spatial and temporal resolution so that simulated water resources and processes could be characterized based on their valuation by stakeholders and their accessibility. The calibrated model was then used to evaluate three management and three climate scenarios. The results show that by the year 2025, not primarily the physical availability of water, but access to water resources and efficiency of use represent the greatest challenges. Water to cover basic human needs is available at least 95% of time but must be made accessible to the population through investments in distribution infrastructure. Concerning the trade-off between agricultural use and hydropower production, there is virtually no potential for an increase in hydropower even if it is given priority. Agriculture will necessarily expand spatially as a result of population growth, and can even benefit from higher irrigation water availability per area unit, given improved irrigation efficiency and enforced regulation to ensure equitable distribution of available water. The decline in services from natural terrestrial ecosystems (e.g. charcoal, food), due to the expansion of agriculture, increases the vulnerability of residents who depend on such services mostly in times of drought. The expected impacts of climate change may contribute to an increase or decrease in watershed service availability, but are only marginal and much lower than management impacts up to the year 2025.

A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa--the International epidemiologic Databases to Evaluate AIDS (IeDEA)

INTRODUCTION There are limited data on paediatric HIV care and treatment programmes in low-resource settings. METHODS A standardized survey was completed by International epidemiologic Databases to Evaluate AIDS paediatric cohort sites in the regions of Asia-Pacific (AP), Central Africa (CA), East Africa (EA), Southern Africa (SA) and West Africa (WA) to understand operational resource availability and paediatric management practices. Data were collected through January 2010 using a secure, web-based software program (REDCap). RESULTS A total of 64,552 children were under care at 63 clinics (AP, N=10; CA, N=4; EA, N=29; SA, N=10; WA, N=10). Most were in urban settings (N=41, 65%) and received funding from governments (N=51, 81%), PEPFAR (N=34, 54%), and/or the Global Fund (N=15, 24%). The majority were combined adult-paediatric clinics (N=36, 57%). Prevention of mother-to-child transmission was integrated at 35 (56%) sites; 89% (N=56) had access to DNA PCR for infant diagnosis. African (N=40/53) but not Asian sites recommended exclusive breastfeeding up until 4-6 months. Regular laboratory monitoring included CD4 (N=60, 95%), and viral load (N=24, 38%). Although 42 (67%) sites had the ability to conduct acid-fast bacilli (AFB) smears, 23 (37%) sites could conduct AFB cultures and 18 (29%) sites could conduct tuberculosis drug susceptibility testing. Loss to follow-up was defined as >3 months of lost contact for 25 (40%) sites, >6 months for 27 sites (43%) and >12 months for 6 sites (10%). Telephone calls (N=52, 83%) and outreach worker home visits to trace children lost to follow-up (N=45, 71%) were common. CONCLUSIONS In general, there was a high level of patient and laboratory monitoring within this multiregional paediatric cohort consortium that will facilitate detailed observational research studies. Practices will continue to be monitored as the WHO/UNAIDS Treatment 2.0 framework is implemented.

SLA-driven predictive orchestration for distributed cloud-based mobile services

We describe a system for performing SLA-driven management and orchestration of distributed infrastructures composed of services supporting mobile computing use cases. In particular, we focus on a Follow-Me Cloud scenario in which we consider mobile users accessing cloud-enable services. We combine a SLA-driven approach to infrastructure optimization, with forecast-based performance degradation preventive actions and pattern detection for supporting mobile cloud infrastructure management. We present our system's information model and architecture including the algorithmic support and the proposed scenarios for system evaluation.

Mobile competence network for community health workers in rural Myanmar: a supportive information system that facilitates the improvement of health services.

The goal of this project is the development of international cooperation for fostering solutions to provide better access to basic healthcare services.

Landscape mosaics maps as a basis for spatial assessment and negotiation of ecosystem services and their trade-offs at the meso-scale: Examples from Laos, Madagascar and China

Mapping ecosystem services (ES) and their trade-offs is a key requirement for informed decision making for land use planning and management of natural resources that aim to move towards increasing the sustainability of landscapes. The negotiations of the purposes of landscapes and the services they should provide are difficult as there is an increasing number of stakeholders active at different levels with a variety of interests present on one particular landscape.Traditionally, land cover data is at the basis for mapping and spatial monitoring of ecosystem services. In light of complex landscapes it is however questionable whether land cover per se and as a spatial base unit is suitable for monitoring and management at the meso-scale. Often the characteristics of a landscape are defined by prevalence, composition and specific spatial and temporal patterns of different land cover types. The spatial delineation of shifting cultivation agriculture represents a prominent example of a land use system with its different land use intensities that requires alternative methodologies that go beyond the common remote sensing approaches of pixel-based land cover analysis due to the spatial and temporal dynamics of rotating cultivated and fallow fields.Against this background we advocate that adopting a landscape perspective to spatial planning and decision making offers new space for negotiation and collaboration, taking into account the needs of local resource users, and of the global community. For this purpose we introduce landscape mosaicsdefined as new spatial unit describing generalized land use types. Landscape mosaics have allowed us to chart different land use systems and land use intensities and permitted us to delineate changes in these land use systems based on changes of external claims on these landscapes. The underlying idea behindthe landscape mosaics is to use land cover data typically derived from remote sensing data and to analyse and classify spatial patterns of this land cover data using a moving window approach. We developed the landscape mosaics approach in tropical, forest dominated landscapesparticularly shifting cultivation areas and present examples ofour work from northern Laos, eastern Madagascarand Yunnan Province in China.

Tools for better SLM knowledge management and informed decision-making in addressing land degradation at different scales: the WOCAT–LADA–DESIRE methodology

Desertification research conventionally focuses on the problem – that is, degradation – while neglecting the appraisal of successful conservation practices. Based on the premise that Sustainable Land Management (SLM) experiences are not sufficiently or comprehensively documented, evaluated, and shared, the World Overview of Conservation Approaches and Technologies (WOCAT) initiative (www.wocat.net), in collaboration with FAO’s Land Degradation Assessment in Drylands (LADA) project (www.fao.org/nr/lada/) and the EU’s DESIRE project (http://www.desire-project.eu/), has developed standardised tools and methods for compiling and evaluating the biophysical and socio-economic knowledge available about SLM. The tools allow SLM specialists to share their knowledge and assess the impact of SLM at the local, national, and global levels. As a whole, the WOCAT–LADA–DESIRE methodology comprises tools for documenting, self-evaluating, and assessing the impact of SLM practices, as well as for knowledge sharing and decision support in the field, at the planning level, and in scaling up identified good practices. SLM depends on flexibility and responsiveness to changing complex ecological and socioeconomic causes of land degradation. The WOCAT tools are designed to reflect and capture this capacity of SLM. In order to take account of new challenges and meet emerging needs of WOCAT users, the tools are constantly further developed and adapted. Recent enhancements include tools for improved data analysis (impact and cost/benefit), cross-scale mapping, climate change adaptation and disaster risk management, and easier reporting on SLM best practices to UNCCD and other national and international partners. Moreover, WOCAT has begun to give land users a voice by backing conventional documentation with video clips straight from the field. To promote the scaling up of SLM, WOCAT works with key institutions and partners at the local and national level, for example advisory services and implementation projects. Keywords: Sustainable Land Management (SLM), knowledge management, decision-making, WOCAT–LADA–DESIRE methodology.

Desertification mitigation and water harvesting based on sustainable land management

Traditionally, desertification research has focused on degradation assessments, whereas prevention and mitigation strategies have not sufficiently been emphasised, although the concept of sustainable land management (SLM) is increasingly being acknowledged. SLM strategies are interventions at the local to regional scale aiming at increasing productivity, protecting the natural resource base, and improving livelihoods. The global WOCAT initiative and its partners have developed harmonized frameworks to compile, evaluate and analyse the impact of SLM practices around the globe. Recent studies within the EU research project DESIRE developed a methodological framework that combines a collective learning and decision-making approach with use of best practices from the WOCAT database. In-depth assessment of 30 technologies and 8 approaches from 17 desertification sites enabled an evaluation of how SLM addresses prevalent dryland threats such as water scarcity, soil and vegetation degradation, low production, climate change, resource use conflicts and migration. Among the impacts attributed to the documented technologies, those mentioned most were diversified and enhanced production and better management of water and soil degradation, whether through water harvesting, improving soil moisture, or reducing runoff. Water harvesting offers under-exploited opportunities for the drylands and the predominantly rainfed farming systems of the developing world. Recently compiled guidelines introduce the concepts behind water harvesting and propose a harmonised classification system, followed by an assessment of suitability, adoption and up-scaling of practices. Case studies go from large-scale floodwater spreading that make alluvial plains cultivable, to systems that boost cereal production in small farms, as well as practices that collect and store water from household compounds. Once contextualized and set in appropriate institutional frameworks, they can form part of an overall adaptation strategy for land users. More field research is needed to reinforce expert assessments of SLM impacts and provide the necessary evidence-based rationale for investing in SLM. This includes developing methods to quantify and value ecosystem services, both on-site and off-site, and assess the resilience of SLM practices, as currently aimed at within the new EU CASCADE project.

Ecosystem services, biodiversity and environmental change in a tropical mountain ecosystem of south Ecuador

An interdisciplinary research unit consisting of 30 teams in the natural, economic and social sciences analyzed biodiversity and ecosystem services of a mountain rainforest ecosystem in the hotspot of the tropical Andes, with special reference to past, current and future environmental changes. The group assessed ecosystem services using data from ecological field and scenario-driven model experiments, and with the help of comparative field surveys of the natural forest and its anthropogenic replacement system for agriculture. The book offers insights into the impacts of environmental change on various service categories mentioned in the Millennium Ecosystem Assessment (2005): cultural, regulating, supporting and provisioning ecosystem services. Examples focus on biodiversity of plants and animals including trophic networks, and abiotic/biotic parameters such as soils, regional climate, water, nutrient and sediment cycles. The types of threats considered include land use and climate changes, as well as atmospheric fertilization. In terms of regulating and provisioning services, the emphasis is primarily on water regulation and supply as well as climate regulation and carbon sequestration. With regard to provisioning services, the synthesis of the book provides science-based recommendations for a sustainable land use portfolio including several options such as forestry, pasture management and the practices of indigenous peoples. In closing, the authors show how they integrated the local society by pursuing capacity building in compliance with the CBD-ABS (Convention on Biological Diversity - Access and Benefit Sharing), in the form of education and knowledge transfer for application.

Assessing the state of Sustainable Land Management research in Kyrgyzstan and Tajikistan

This article synthesizes findings from a review of the state of research on sustainable land management in Kyrgyzstan and Tajikistan and from an analysis of the interface between research and action. Using the Global Land Project (GLP 2005) analytical framework, we analyzed the distribution of 131 selected publications (including a clearly defined set of local and international academic and gray literature) across the framework's components and links in a social–ecological system. There is a strong emphasis in the literature on the impact of changes in land use and management on ecosystems; however, there is little research on the implications for ecosystem services. This finding is opposed to that of a similar analysis of publications at the global scale (Björnsen Gurung et al 2012). Another major gap was the lack of research on Kyrgyzstan and Tajikistan regarding the influence of global factors on social and ecological systems, despite social, economic, and political integration into global structures since the collapse of the Soviet Union and the increasing influence of climate change. Our analysis disaggregated academic literature published in the region and international academic literature, revealing stark differences. These differences are partly attributable to the legacy of the late Soviet era principle of “rational use of land resources,” which fit the planned economy but lacks approaches for decentralized resource governance. Finally, the emphasis of research on systems knowledge, the lack of transdisciplinary research, and the critical feedback of stakeholders at a regional sustainable land management forum suggest that actionable sustainable land management research on Kyrgyzstan and Tajikistan is rare. Recommendations are made for targeted, application-focused, multistakeholder research and knowledge sharing, including local and international researchers as well as practitioners, policy-makers, and land users.

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice.

Physician perceptions of risk regarding mood disorders and pharmacological management during pregnancy: What is current practice?

Mood disorders are the most common form of mental illness and one of the leading causes of morbidity worldwide. Major depressive disorder and bipolar disorder have a lifetime prevalence of 16.2% and 4.4%, respectively. Women comprise a substantial proportion of this population, and an estimated 500,000 pregnancies each year involve women with a psychiatric condition. Management with psychotropic medications is considered standard of care for most patients with mood disorders. However, many of these medications are known human teratogens. Because pregnant women with mood disorders face a high risk of relapse if unmanaged, the obstetrician faces a unique challenge in providing the best care to both mother and baby. It has been suggested that many obstetricians overestimate the teratogenic risks associated with psychotropic medications, while concurrently underestimating the risks associated with unmanaged mood disorders. This may be due a knowledge gap regarding the most current teratogen information, and lack of official management guidelines. Therefore, the purpose of this study is to determine the current knowledge base of obstetricians regarding the teratogenic effects of common psychotropic medications, as wells as to capture current management practices for pregnant women with mood disorders. A total of 117 Texas obstetricians responded to a survey regarding teratogen knowledge and management practice. It was common for respondents to encounter women who disclose both having a mood disorder and taking a psychotropic medication during pregnancy. Many respondents did not utilize up-to-date drug counseling resources, and were unaware of or over-estimated the teratogenic risks of common medications used to treat mood disorders. Finally, many respondents reported wanting to refer pregnant patients with mood disorders to psychiatrists for co-management, but are reportedly restricted in doing so due to accessibility or insurance issues. This study demonstrates that there is a knowledge gap among obstetricians regarding the teratogenicity of common psychotropic medications utilized to manage a patient population they frequently encounter. Further, obstetricians have vastly different risk perceptions of these medications, resulting in various management approaches and recommendations. Future research should focus on establishing standard practice guidelines, as well as better accessibility to psychiatric services for pregnant women.

Managing Things and Services with Semantics: A Survey

This paper presents a survey on the usage, opportunities and pitfalls of semantic technologies in the Internet of Things. The survey was conducted in the context of a semantic enterprise integration platform. In total we surveyed sixty-one individuals from industry and academia on their views and current usage of IoT technologies in general, and semantic technologies in particular. Our semantic enterprise integration platform aims for interoperability at a service level, as well as at a protocol level. Therefore, also questions regarding the use of application layer protocols, network layer protocols and management protocols were integrated into the survey. The survey suggests that there is still a lot of heterogeneity in IoT technologies, but first indications of the use of standardized protocols exist. Semantic technologies are being recognized as of potential use, mainly in the management of things and services. Nonetheless, the participants still see many obstacles which hinder the widespread use of semantic technologies: Firstly, a lack of training as traditional embedded programmers are not well aware of semantic technologies. Secondly, a lack of standardization in ontologies, which would enable interoperability and thirdly, a lack of good tooling support.