The effectiveness of a 6-year oral health education programme for primary schoolchildren

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DIAPHRAGM PLICATION FOR UNILATERAL DIAPHRAGM PARALYSIS: A CASE REPORT AND REVIEW OF THE LITERATURE

Unilateral diaphragm paralysis is an often not recognised cause of dyspnoea. We present a patient with a unilateral phrenic nerve paralysis treated with diaphragmatic plication. Patient presented with life-style limiting dyspnoea and pulmonary function showed a decrease in FVC when lying down. Since there was no improvement after respiratory muscle training, plication of the hemidiaphragm was performed by a small thoracotomy. The patient improved with regard to respiratory complaints and lung function. Furthermore, we also demonstrate for the first time a significant improvement in exercise capacity with accompanying striking amelioration of quality of life. The patient is now in follow up up for more than 2 years and the impressive improvement in exercise capacity remains present. Surgical treatment of unilateral diaphragm paralysis has been described in case reports and in small series since 1985. Although comparison of the available data is difficult a diaphragm plication seems an effective and safe procedure for patients with symptomatic, acquired unilateral diaphragm paralysis. Improvement of dyspnoea is present in the majority of patients and we even observed an impressive amelioration in exercise capacity. Consequently, it seems appropriate to propose plication to patients with clear symptoms from the moment spontaneous recovery seems unlikely; yet, prospective randomised controlled studies are needed to prove this.status: publishe

An ecosystem service approach to support integrated pond management: a case study using Bayesian belief networks: highlighting opportunities and risks

Freshwater ponds deliver a broad range of ecosystem services (ESS). Taking into account this broad range of services to attain cost-effective ESS delivery is an important challenge facing integrated pond management. To assess the strengths and weaknesses of an ESS approach to support decisions in integrated pond management, we applied it on a small case study in Flanders, Belgium. A Bayesian belief network model was developed to assess ESS delivery under three alternative pond management scenarios: intensive fish farming (IFF), extensive fish farming (EFF) and nature conservation management (NCM). A probabilistic cost-benefit analysis was performed that includes both costs associated with pond management practices and benefits associated with ESS delivery. Whether or not a particular ESS is included in the analysis affects the identification of the most preferable management scenario by the model. Assessing the delivery of a more complete set of ecosystem services tends to shift the results away from intensive management to more biodiversity-oriented management scenarios. The proposed methodology illustrates the potential of Bayesian belief networks. BBNs facilitate knowledge integration and their modular nature encourages future model expansion to more encompassing sets of services. Yet, we also illustrate the key weaknesses of such exercises, being that the choice whether or not to include a particular ecosystem service may determine the suggested optimal management practice

An ecosystem service approach to support integrated pond management: A case study using Bayesian belief networks - Highlighting opportunities and risks

Freshwater ponds deliver a broad range of ecosystem services (ESS). Taking into account this broad range of services to attain cost-effective ESS delivery is an important challenge facing integrated pond management. To assess the strengths and weaknesses of an ESS approach to support decisions in integrated pond management, we applied it on a small case study in Flanders, Belgium. A Bayesian belief network model was developed to assess ESS delivery under three alternative pond management scenarios: intensive fish farming (IFF), extensive fish farming (EFF) and nature conservation management (NCM). A probabilistic cost-benefit analysis was performed that includes both costs associated with pond management practices and benefits associated with ESS delivery. Whether or not a particular ESS is included in the analysis affects the identification of the most preferable management scenario by the model. Assessing the delivery of a more complete set of ecosystem services tends to shift the results away from intensive management to more biodiversity-oriented management scenarios. The proposed methodology illustrates the potential of Bayesian belief networks. BBNs facilitate knowledge integration and their modular nature encourages future model expansion to more encompassing sets of services. Yet, we also illustrate the key weaknesses of such exercises, being that the choice whether or not to include a particular ecosystem service may determine the suggested optimal management practice.publisher: Elsevier articletitle: An ecosystem service approach to support integrated pond management: A case study using Bayesian belief networks – Highlighting opportunities and risks journaltitle: Journal of Environmental Management articlelink: http://dx.doi.org/10.1016/j.jenvman.2014.06.015 content_type: article copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.status: publishe