Stakeholders’ Perspective on Groundwater Management in Four Water-Stressed Mediterranean Areas: Priorities and Challenges

Recent studies highlight the fragility of the Mediterranean basin against climate stresses and the difficulties of managing the sustainable development of groundwater resources. In this work, the main issues related to groundwater management have been identified from the stakeholder’s perspective in the following four representative water-stressed Mediterranean areas: the coastal aquifer of Comacchio (Italy), the Alto Guadalentín aquifer (Spain), the alluvial aquifer of the Gediz River basin (Turkey), and the Azraq aquifer (Azraq Wetland Reserve, Jordan). This has been achieved by designing a methodology to involve and engage a representative set of stakeholders, including a questionnaire to learn their point of view concerning the current management of aquifer systems and their experience with the already available tools for groundwater resource management, such as monitoring networks and numerical models. The outcome of the survey has allowed us to identify both particular and common challenges among the four study sites and among the various groups of stakeholders. This information provides valuable insights to improve the transfer of scientific knowledge from the research centers to the authorities managing the groundwater resources and it will help to plan more effective research activities on aquifer management. The proposed methodology could be applied in other aquifers facing similar problems.This study has received funding in the framework of the RESERVOIR project: (sustainable groundwater RESources managEment by integrating eaRth observation deriVed monitoring and flOw modelIng Results), funded by the Partnership for Research and Innovation in the Mediterranean Area (PRIMA) programme supported by the European Union (Grant Agreement 1924; https://reservoir-prima.org/, accessed on 13 March 2022). The research was also funded by the University of Pavia in the framework of a research grant award “assegno di tipo A premiale” for research activities at the Dept. of Earth and Environmental Sciences, within the research project entitled “Sustainable groundwater resources management by integrating A-DInSAR derived monitoring and flow modeling results” assigned to Roberta Bonì from March 2019 to February 2021

Stakeholders’ Perspective on Groundwater Management in Four Water-Stressed Mediterranean Areas: Priorities and Challenges

none21sìopenBonì, Roberta; Teatini, Pietro; Zoccarato, Claudia; Guardiola-Albert, Carolina; Ezquerro, Pablo; Bru, Guadalupe; Tomás, Roberto; Valdes-Abellan, Javier; Pla, Conception; Navarro-Hernández, María I.; Elçi, Alper; Çaylak, Baris; Ören, Ali Hakan; Shatanawi, Khaldoun; Mohammad, Alsharifa Hind; Hajar, Husam Abu; Letterio, Tommaso; Genovesi, Roberto; Hreisha, Hazem; Al-Mimi, Qamar; Meisina, ClaudiaBonì, Roberta; Teatini, Pietro; Zoccarato, Claudia; Guardiola-Albert, Carolina; Ezquerro, Pablo; Bru, Guadalupe; Tomás, Roberto; Valdes-Abellan, Javier; Pla, Conception; Navarro-Hernández, María I.; Elçi, Alper; Çaylak, Baris; Ören, Ali Hakan; Shatanawi, Khaldoun; Mohammad, Alsharifa Hind; Hajar, Husam Abu; Letterio, Tommaso; Genovesi, Roberto; Hreisha, Hazem; Al-Mimi, Qamar; Meisina, Claudi

X-linked agammaglobulinemia (XLA) : Phenotype, diagnosis, and therapeutic challenges around the world

Background: X-linked agammaglobulinemia is an inherited immunodeficiency recognized since 1952. In spite of seven decades of experience, there is still a limited understanding of regional differences in presentation and complications. This study was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to better understand regional needs, challenges and unique patient features. Methods: A survey instrument was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to collect both structured and semi-structured data on X-linked agammaglobulinemia. The survey was sent to 54 centers around the world chosen on the basis of World Allergy Organization participation and/or registration in the European Society for Immunodeficiencies. There were 40 centers that responded, comprising 32 countries. Results: This study reports on 783 patients from 40 centers around the world. Problems with diagnosis are highlighted by the reported delays in diagnosis>24 months in 34% of patients and the lack of genetic studies in 39% of centers Two infections exhibited regional variation. Vaccine-associated paralytic poliomyelitis was seen only in countries with live polio vaccination and two centers reported mycobacteria. High rates of morbidity were reported. Acute and chronic lung diseases accounted for 41% of the deaths. Unusual complications such as inflammatory bowel disease and large granular lymphocyte disease, among others were specifically enumerated, and while individually uncommon, they were collectively seen in 20.3% of patients. These data suggest that a broad range of both inflammatory, infectious, and autoimmune conditions can occur in patients. The breadth of complications and lack of data on management subsequently appeared as a significant challenge reported by centers. Survival above 20 years of age was lowest in Africa (22%) and reached above 70% in Australia, Europe and the Americas. Centers were asked to report their challenges and responses (n = 116) emphasized the difficulties in access to immunoglobulin products (16%) and reflected the ongoing need for education of both patients and referring physicians. Conclusions: This is the largest study of patients with X-linked agammaglobulinemia and emphasizes the continued morbidity and mortality of XLA despite progress in diagnosis and treatment. It presents a world view of the successes and challenges for patients and physicians alike. A pivotal finding is the need for education of physicians regarding typical symptoms suggesting a possible diagnosis of X-linked agammaglobulinemia and sharing of best practices for the less common complications.Peer reviewe

Perspectiva de las partes interesadas en la gestión de las aguas subterráneas en cuatro cuencas mediterráneas bajo estrés hídrico: prioridades y desafíos

Estudios recientes ponen en manifiesto la vulnerabilidad de las cuencas del mediterráneo y las limitaciones de los actuales organismos gestores para mantener un desarrollo sostenible de los recursos hídricos subterráneos. Con el fin de abordar esta problemática, en este trabajo se han investigado los principales inconvenientes relacionados con la gestión de agua subterránea, teniendo en cuenta la perspectiva de las partes implicadas mediante la realización de encuestas. Para llevar a cabo esta investigación, se han seleccionado cuatro cuencas mediterráneas representativas que se encuentran actualmente bajo estrés hídrico: el acuífero costero de Comacchio (Italia), el acuífero del Alto Guadalentín (España), el acuífero aluvial de la cuenca del río Gediz (Turquía), y el acuífero de Azraq (Reserva de humedales de Azraq, Jordania). Los resultados revelan el punto de vista de las partes implicadas, relacionado con la gestión actual de los sistemas acuíferos y su experiencia con las herramientas disponibles para la gestión de las aguas subterráneas, como lo son las redes de monitoreo y los modelos numéricos. El análisis realizado y ha permitido identificar algunas peculiaridades y retos en común en las cuatro áreas de estudio. Uno de estos grandes desafíos es la falta de referencias para evaluar la adecuación de la red de monitoreo en relación con la frecuencia de muestreo y la distribución espacial. La metodología aquí propuesta junto con los resultados será útil para valorar la percepción de las partes implicadas en otros acuíferos que presenten una situación similar.El presente trabajo está basado en la investigación realizada por (Bonì et al., 2022) llevado a cabo en el marco del proyecto RESERVOIR: (sustainable groundwater RESources management by integrating earth observation deriVed monitoring and fOw modelIn Results), financiado por el programa Partnership for Research and Innovation in the Mediterranean Area (PRIMA) apoyado por la Unión Europea (Acuerdo de subvención de 1924; https://reservoir-prima.org/)

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