Stressed caregivers. An observational study in a rehabilitation care home in western Sicily

Introduction: Caregiver is the person who takes care of the patient from the practical point of view, helping him in managing the disease and carrying out daily activities, but also supporting him on an emotional level. Caregiver burnout is a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude from positive and caring to negative and unconcerned. The aim of the study was to understand what factors were associated with having panic attacks or crying crises in the caregivers of our study population. Materials and methods: The study design is observational. An anonymous questionnaire was administered to caregivers of the patients of a hospital for the intensive post-acute rehabilitation from April 2016 to December 2018. The statistical significance level chosen for the entire analysis was 0.05. The covariates to be included were selected using a stepwise backward selection process, with a univariate p-value <0.25 as the main criterion. Results are expressed as adjusted Odds Ratio (aOR) with 95% Confidence Intervals (CI). Results: The sample consists of 302 caregivers (60.93% was females and 39.07% was males). The mean age of the sample is 53.42 years old (SD ± 12.19). The multivariable logistic regression model shows that the risk to have panic or crying crisis is significantly associated with the following indipendent variables: female gender (aOR 27.06); living with the patient (aOR 4.38); had claimed that the problems related to the illness of their family member is a source of stress (aOR 23.54), smoking cigarettes (aOR 14.68); had claimed that taking care of their client affected their personal financial statement/career (aOR 5.95), having free time (aOR 7.68). Conclusions: In our study we found a greater probability of having panic attacks or crying crises in female subjects, smokers, who think they have sacrificed their careers to take care of the person they follow from a welfare point of view. Certainly in the light of what has emerged it is necessary to dedicate and pay close attention to the psychological and social aspects of the caregiver

Acid rain in Europe : A framework to assist decision making.

The ratification of the Geneva Convention on Transboundary Air Pollution in March of 1983 showed that nations of Eastern and Western Europe were determined to control the problem of acid rain. In the same year, IIASA offered its analytical skills to the international community to help solve the problem. It did so by entering into official cooperation with the UN Economic Commission of Europe (ECE) which is responsible for implementing the convention. As part of this cooperation IIASA is developing a computer model which can be used by decision makers to evaluate policies for controlling the impact of acid rain in Europe. In addition, we hope that our work will help identify gaps in understanding the acid rain problem and stimulate the research necessary to overcome these gaps. This paper describes the status of the acid rain model after approximately one year's work. It also presents some examples of how the model is used and the type of information it provides

Integrated Analysis of Acidification in Europe.

This paper presents the interim status of the RAINS model developed at IIASA. The principle purpose of the model is to provide a tool to assist decision-makers in their evaluation of strategies to control acidification of Europe's environment. Model design emphasizes user comprehension and ease of use. The overall framework of RAINS consists of three linked compartments: "Pollutant Generation," "Atmospheric Processes" and "Environmental Impact." Each of these compartments can be filled by different substitutable submodels. The four submodels currently available are "Sulfur Emissions," EMEP Sulfur Transport," Forest Soil Acidity" and "Lake Acidity." Submodels which deal with NOx emissions and deposition and other environmental impacts will be added to the model. To operate the model, a user must select (1) an energy pathway, (2) a pollution control strategy and (3) an environmental impact indicator. This information is inputed to RAINS and yields a "scenario" which is a consistent set of energy pathway, sulfur emissions, forest soil acidity and lake acidity. In an iterative fashion, a model user can quickly evaluate the consequences of many different alternatives to control acidification in Europe

A global assessment of the impact of climate change on water scarcity

This paper presents a global scale assessment of the impact of climate change on water scarcity. Patterns of climate change from 21 Global Climate Models (GCMs) under four SRES scenarios are applied to a global hydrological model to estimate water resources across 1339 watersheds. The Water Crowding Index (WCI) and the Water Stress Index (WSI) are used to calculate exposure to increases and decreases in global water scarcity due to climate change. 1.6 (WCI) and 2.4 (WSI) billion people are estimated to be currently living within watersheds exposed to water scarcity. Using the WCI, by 2050 under the A1B scenario, 0.5 to 3.1 billion people are exposed to an increase in water scarcity due to climate change (range across 21 GCMs). This represents a higher upper-estimate than previous assessments because scenarios are constructed from a wider range of GCMs. A substantial proportion of the uncertainty in the global-scale effect of climate change on water scarcity is due to uncertainty in the estimates for South Asia and East Asia. Sensitivity to the WCI and WSI thresholds that define water scarcity can be comparable to the sensitivity to climate change pattern. More of the world will see an increase in exposure to water scarcity than a decrease due to climate change but this is not consistent across all climate change patterns. Additionally, investigation of the effects of a set of prescribed global mean temperature change scenarios show rapid increases in water scarcity due to climate change across many regions of the globe, up to 2°C, followed by stabilisation to 4°C

A Human Development Framework for CO2 Reductions

Although developing countries are called to participate in CO2 emission reduction efforts to avoid dangerous climate change, the implications of proposed reduction schemes in human development standards of developing countries remain a matter of debate. We show the existence of a positive and time-dependent correlation between the Human Development Index (HDI) and per capita CO2 emissions from fossil fuel combustion. Employing this empirical relation, extrapolating the HDI, and using three population scenarios, the cumulative CO2 emissions necessary for developing countries to achieve particular HDI thresholds are assessed following a Development As Usual approach (DAU). If current demographic and development trends are maintained, we estimate that by 2050 around 85% of the world's population will live in countries with high HDI (above 0.8). In particular, 300Gt of cumulative CO2 emissions between 2000 and 2050 are estimated to be necessary for the development of 104 developing countries in the year 2000. This value represents between 20% to 30% of previously calculated CO2 budgets limiting global warming to 2{\deg}C. These constraints and results are incorporated into a CO2 reduction framework involving four domains of climate action for individual countries. The framework reserves a fair emission path for developing countries to proceed with their development by indexing country-dependent reduction rates proportional to the HDI in order to preserve the 2{\deg}C target after a particular development threshold is reached. Under this approach, global cumulative emissions by 2050 are estimated to range from 850 up to 1100Gt of CO2. These values are within the uncertainty range of emissions to limit global temperatures to 2{\deg}C.Comment: 14 pages, 7 figures, 1 tabl

Temporal nutrient dynamics in the Mediterranean Sea in response to anthropogenic inputs

The temporal dynamics of the concentrations of nitrate (N), phosphate (P), and the N:P ratio in the upper water column (200-600m) of the Mediterranean (MED) Sea were investigated using observational data (~123,100 data points) collected between 1985 and 2014. The studied variables were found to evolve similarly in the western and eastern MED Sea. In both basins, the N concentration increased during the first part of the observational period (1985-1998), and the temporal trend of N was broadly consistent with the history of riverine and atmospheric nitrogen input from populated areas in Europe, with a lag period of 20years. In subsequent years, the N concentration was high and relatively constant between 1998 and 2005, after which N decreased gradually, although the decreasing trend was indistinct in the western basin. In particular, the trend of constant then declining N after 1998 is consistent with the history of pollutant nitrogen emissions from the European continent, allowing a 20 year lag following the introduction of regulation of pollutant nitrogen in the 1970s. The three-phase temporal transition in P in both basins was more consistent with the riverine phosphorus input, with a lag period of 20years. Our analysis indicates that the recent dynamics of N and P in the upper MED Sea has been sensitive to the dynamics of anthropogenic nitrogen and phosphorus input from atmospheric deposition and river

The impacts of environmental warming on Odonata: a review

Climate change brings with it unprecedented rates of increase in environmental temperature, which will have major consequences for the earth's flora and fauna. The Odonata represent a taxon that has many strong links to this abiotic factor due to its tropical evolutionary history and adaptations to temperate climates. Temperature is known to affect odonate physiology including life-history traits such as developmental rate, phenology and seasonal regulation as well as immune function and the production of pigment for thermoregulation. A range of behaviours are likely to be affected which will, in turn, influence other parts of the aquatic ecosystem, primarily through trophic interactions. Temperature may influence changes in geographical distributions, through a shifting of species' fundamental niches, changes in the distribution of suitable habitat and variation in the dispersal ability of species. Finally, such a rapid change in the environment results in a strong selective pressure towards adaptation to cope and the inevitable loss of some populations and, potentially, species. Where data are lacking for odonates, studies on other invertebrate groups will be considered. Finally, directions for research are suggested, particularly laboratory studies that investigate underlying causes of climate-driven macroecological patterns

Managing uncertainty: a review of food system scenario analysis and modelling

Complex socio-ecological systems like the food system are unpredictable, especially to long-term horizons such as 2050. In order to manage this uncertainty, scenario analysis has been used in conjunction with food system models to explore plausible future outcomes. Food system scenarios use a diversity of scenario types and modelling approaches determined by the purpose of the exercise and by technical, methodological and epistemological constraints. Our case studies do not suggest Malthusian futures for a projected global population of 9 billion in 2050; but international trade will be a crucial determinant of outcomes; and the concept of sustainability across the dimensions of the food system has been inadequately explored so far. The impact of scenario analysis at a global scale could be strengthened with participatory processes involving key actors at other geographical scales. Food system models are valuable in managing existing knowledge on system behaviour and ensuring the credibility of qualitative stories but they are limited by current datasets for global crop production and trade, land use and hydrology. Climate change is likely to challenge the adaptive capacity of agricultural production and there are important knowledge gaps for modelling research to address

Combining qualitative and quantitative understanding for exploring cross-sectoral climate change impacts, adaptation and vulnerability in Europe

Climate change will affect all sectors of society and the environment at all scales, ranging from the continental to the national and local. Decision-makers and other interested citizens need to be able to access reliable science-based information to help them respond to the risks of climate change impacts and assess opportunities for adaptation. Participatory integrated assessment (IA) tools combine knowledge from diverse scientific disciplines, take account of the value and importance of stakeholder ‘lay insight’ and facilitate a two-way iterative process of exploration of ‘what if’s’ to enable decision-makers to test ideas and improve their understanding of the complex issues surrounding adaptation to climate change. This paper describes the conceptual design of a participatory IA tool, the CLIMSAVE IA Platform, based on a professionally facilitated stakeholder engagement process. The CLIMSAVE (climate change integrated methodology for cross-sectoral adaptation and vulnerability in Europe) Platform is a user-friendly, interactive web-based tool that allows stakeholders to assess climate change impacts and vulnerabilities for a range of sectors, including agriculture, forests, biodiversity, coasts, water resources and urban development. The linking of models for the different sectors enables stakeholders to see how their interactions could affect European landscape change. The relationship between choice, uncertainty and constraints is a key cross-cutting theme in the conduct of past participatory IA. Integrating scenario development processes with an interactive modelling platform is shown to allow the exploration of future uncertainty as a structural feature of such complex problems, encouraging stakeholders to explore adaptation choices within real-world constraints of future resource availability and environmental and institutional capacities, rather than seeking the ‘right’ answers