Managing ecosystem services at Loch Leven, Scotland, UK: actions, impacts and unintended consequences

Rivers, lakes and wetlands are good examples of ecosystems that provide multiple, concurrent, services to mankind. Human society has often exploited these systems by enhancing one ecosystem service at the expense of another. Loch Leven, Scotland, UK, is a good example of this. Over the past 150 years, the lake has been subjected to hydrological modification, fish stocking and pollution control to improve the delivery of key goods and services. This study uses historical records to explore the results of these interventions on the ecosystem services that were targeted for improvement and the knock-on effects on other services provided by the lake. The results suggest that, when management changes are being considered to enhance particular ecosystem services, the potentially damaging effects on other ecosystem services should be taken into account. This requires a better understanding of the role of ecosystem function in delivering ecosystem services, and of the links between multiple ecosystem services, than is currently available. While further research is clearly needed, the value of long term datasets in providing knowledge and understanding through ‘hindsight’ should not be underestimated. The study concludes that successful management actions are likely to be those that incorporate lessons learned from previous decisions

Objective Assessment of Patient Inhaler User Technique Using an Audio-Based Classification Approach

Abstract Many patients make critical user technique errors when using pressurised metered dose inhalers (pMDIs) which reduce the clinical efficacy of respiratory medication. Such critical errors include poor actuation coordination (poor timing of medication release during inhalation) and inhaling too fast (peak inspiratory flow rate over 90 L/min). Here, we present a novel audio-based method that objectively assesses patient pMDI user technique. The Inhaler Compliance Assessment device was employed to record inhaler audio signals from 62 respiratory patients as they used a pMDI with an In-Check Flo-Tone device attached to the inhaler mouthpiece. Using a quadratic discriminant analysis approach, the audio-based method generated a total frame-by-frame accuracy of 88.2% in classifying sound events (actuation, inhalation and exhalation). The audio-based method estimated the peak inspiratory flow rate and volume of inhalations with an accuracy of 88.2% and 83.94% respectively. It was detected that 89% of patients made at least one critical user technique error even after tuition from an expert clinical reviewer. This method provides a more clinically accurate assessment of patient inhaler user technique than standard checklist methods