Farmer intentional pathways for net zero carbon: exploring the lock-in effects of forestry and renewables

Climate smart farming requires food production to sit alongside practices which sequester greenhouse gas emissions. Given the requirement to meet net zero emissions by the middle of the century, agricultural policies are now seeking to embed climate smart approaches within future support schemes. Path dependency, the influence of past choices on decision making, has been found to constrain future growth pathways. We apply this concept within a survey of 2494 farmers in Scotland to understand their intentions towards uptake of two prominent climate smart approaches, namely forestry expansion and on-farm renewable energy. We employ a bivariate probit model to estimate the single and joint dependences of these two activities within a farm decision making framework. Factors such as succession planning, the level of agricultural diversification and risk seeking perceptions were found to be positively related to influencing uptake. However, the strongest predictors for uptake were past expansion of these activities and, conversely, a limiting factor for those who did not intend to increase activities. This provides some evidence that path dependencies will limit large scale adoption to meet a net zero target. We argue for a dual approach to intervention which differentiates between past adopters and those who are reluctant to adopt. More targetted support for these two cohorts would address these high level policy ambitions.</p

Future priorities of acute hospitals for surgical site infection surveillance in England

BACKGROUND: Since the launch of the national surgical site infection (SSI) surveillance service in 1997, successive expansions of the programme provided hospitals with increasing flexibility in procedures to target through surveillance. Ensuring the programme continues to meet hospitals' needs remains essential. AIM: As a means to inform the future direction of the service, a survey of all acute NHS Trusts was undertaken to assess and understand priorities for surveillance. METHODS: A web-based survey was circulated to acute NHS Trust infection control teams in England asking them to identify and rank i) reasons for undertaking current SSI surveillance ii) priority surgical categories for future SSI surveillance and iii) reasons for prioritising these categories. FINDINGS: Of the 161 Trusts surveyed, 84 (52%) responded. Assessment of quality of care was identified as the most common driver for SSI surveillance activity. Considerable heterogeneity in priority areas was observed, with 24 different surgical categories selected as top priority. Of the procedures undertaken by 15 or more Trusts, Caesarean section (2.7), hip replacement (2.8) and coronary artery bypass graft (2.9) were highest ranked. All 17 categories in the current surveillance programme were selected as a top priority by one or more Trusts. CONCLUSION: Whilst the majority of hospitals' priorities for SSI surveillance are included in the current programme, the top ranked priority, Caesarean section, is not included. Given the diversity of priority areas, maintaining a comprehensive spectrum of categories in the national programme is essential to assist hospitals in addressing local prioritie

Accelerating Low Carbon Development in the World’s Cities

Cities are engines of economic growth and social change. About 85% of global GDP in 2015 was generated in cities. By 2050, two-thirds of the global population will live in urban areas. Compact, connected and efficient cities can generate stronger growth and job creation, alleviate poverty and reduce investment costs, as well as improve quality of life through lower air pollution and traffic congestion. Better, more resilient models of urban development are particularly critical for rapidly urbanizing cities in the developing world. International city networks, such as the C40 Cities Climate Leadership Group, Local Governments for Sustainability (ICLEI) and United Cities and Local Governments (UCLG), are scaling up the sharing of best practices and developing initiatives to facilitate new flows of finance, enabling more ambitious action on climate change. Altogether, low-carbon urban actions available today could generate a stream of savings in the period to 2050 with a current value of US$16.6 trillion

Investigation of the impact of the NICE guidelines regarding antibiotic prophylaxis during invasive dental procedures on the incidence of infective endocarditis in England: an electronic health records study

Background Infective endocarditis is an uncommon but serious infection, where evidence for giving antibiotic prophylaxis before invasive dental procedures is inconclusive. In England, antibiotic prophylaxis was offered routinely to patients at risk of infective endocarditis until March 2008, when new guidelines aimed at reducing unnecessary antibiotic use were issued. We investigated whether changes in infective endocarditis incidence could be detected using electronic health records, assessing the impact of inclusion criteria/statistical model choice on inferences about the timing/type of any change. Methods Using national data from Hospital Episode Statistics covering 1998–2017, we modelled trends in infective endocarditis incidence using three different sets of inclusion criteria plus a range of regression models, identifying the most likely date for a change in trends if evidence for one existed. We also modelled trends in the proportions of different organism groups identified during infection episodes, using secondary diagnosis codes and data from national laboratory records. Lastly, we applied non-parametric local smoothing to visually inspect any changes in trend around the guideline change date. Results Infective endocarditis incidence increased markedly over the study (22.2–41.3 per million population in 1998 to 42.0–67.7 in 2017 depending on inclusion criteria). The most likely dates for a change in incidence trends ranged from September 2001 (uncertainty interval August 2000–May 2003) to May 2015 (March 1999–January 2016), depending on inclusion criteria and statistical model used. For the proportion of infective endocarditis cases associated with streptococci, the most likely change points ranged from October 2008 (March 2006–April 2010) to August 2015 (September 2013–November 2015), with those associated with oral streptococci decreasing in proportion after the change point. Smoothed trends showed no notable changes in trend around the guideline date. Conclusions Infective endocarditis incidence has increased rapidly in England, though we did not detect any change in trends directly following the updated guidelines for antibiotic prophylaxis, either overall or in cases associated with oral streptococci. Estimates of when changes occurred were sensitive to inclusion criteria and statistical model choice, demonstrating the need for caution in interpreting single models when using large datasets. More research is needed to explore the factors behind this increase

Chemical injuries of the oesophagus: aetiopathological issues in Nigeria

<p>Abstract</p> <p>Background</p> <p>Chemical injuries of the oesophagus occur worldwide. There is paucity of information on aetiopathological profile of chemical injuries of the oesophagus in Nigeria.</p> <p>Aim</p> <p>The aim of the study was to determine the aetiopathological pattern of chemical injuries of the oesophagus in Nigeria.</p> <p>Materials and methods</p> <p>This is a multi-centre hospital based study in Lagos metropolis spanning a period of 10 years.</p> <p>The patients' bio data, substances ingested, sources of corrosives, reasons for ingesting corrosives and patients' mental state were recorded.</p> <p>Results</p> <p>In all, there were 78 patients (61 Males, 17 Females). The offending agents were acids in 55.1% of cases and it was accidental ingestion in 62 patients. The highest incidence of 57.6% was found in the middle 1/3 of the oesophagus.</p> <p>Conclusion</p> <p>Accidental ingestion of acids is the commonest cause of oesophageal injuries in Nigeria. The incidence of severe strictures necessitating oesophageal substitution could be reduced if early management of corrosive oesophagitis improves in Nigeria.</p