Adaptive forest governance to face land use change impacts in Italy: a review

Il cambiamento dell’uso del suolo è uno dei driver principali della riduzione della resilienza ecosistemica, così come della perdita di biodiversità e approvvigionamento di servizi. Rappresenta una sfida peculiare, specialmente negli ambienti mediterranei, dove i fenomeni di abbandono e ricolonizzazione naturale stanno minacciando in modo sempre più crescente la capacità delle foreste di fornire benefici alle comunità locali. In queste condizioni, il sistema di governance forestale è chiamato a bilanciare gli impatti del cambiamento dell’uso del suolo con l’assicurazione della salute e della stabilità degli ecosistemi forestali, al fine di garantire la sostenibilità a lungo termine degli ambienti, soprattutto di quelli marginali. Questo lavoro si propone di analizzare in modo più approfondito gli impatti del cambiamento dell’uso del suolo sugli ecosistemi forestali negli ambienti montani italiani. In primo luogo, esegue un’analisi bibliografica dei concetti legati al cambiamento dell’uso del suolo e all’approvvigionamento dei servizi ecosistemici, dalla scala globale a quella locale. In seguito, indaga le relazioni fra le potenzialità adattive di gestione e pianificazione forestali e il cambiamento dell’uso del suolo. Infine, vengono proposte alcune strategie future di possibili strumenti di governance adattiva per affrontare i cambiamenti dell’uso del suolo. Questa infatti può migliorare la resilienza degli ecosistemi forestali riducendo il gap nel campo della ricerca tra il contesto nazionale e quello globale, utilizzando strumenti di valutazione e monitoraggio per simulare cambiamenti e disturbi esterni, e adottando strategie e misure politiche coerenti a scala locale.Land use change is one of the most important drivers for the reduction of ecosystem resilience, and the loss ofbiodiversity and services provision. This is a peculiar challenge, especially in Mediterranean mountain environments,where abandonment and forest transition phenomena increasingly threaten the forest capacity to provide benefits for local communities. Under these conditions, forest governance is called to balance the landuse change impacts and the health and stability of forest ecosystems, in order to ensure the long-term sustainabilityof such marginal environments. This paper aims at deeper understanding the impacts of land use change on forest ecosystem on mountain environments in Italy. At first, a downscaled review on the conceptsof land use change and ecosystem services provision is carried out. Then, according to the review results, therelationships between adaptive capacity of forest management and planning, and land use change is deeply described. Finally, future-oriented strategies of adaptive governance to face land use change are proposed. Inthe context of land use change, adaptive governance can improve forest resilience through filling the researchgaps between the national and the global contexts, adopting monitoring and assessment tools to simulate external changes and disturbances, and effectively implement consistent policy measures and strategies at localscale

MEDICAL SCIENCE. GISSI-2: A factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12 490 patients with acute myocardial infarction

A multicentre, randomised, open trial with a 2 x 2 factorial design was conducted to compare the benefits and risks of two thrombolytic agents, streptokinase (SK, 1\ub75 MU infused intravenously over 30-60 min) and alteplase (tPA, 100 mg infused intravenously over 3 h) in patients with acute myocardial infarction admitted to coronary care units within 6 h from onset of symptoms. The patients were also randomised to receive heparin (12 500 U subcutaneously twice daily until discharge from hospital, starting 12 h after beginning the tPA or SK infusion) or usual therapy. All patients without specific contraindications were given atenolol (5-10 mg iv) and aspirin (300-325 mg a day). The end-point of the study was the combined estimate of death plus severe left ventricular damage. 12 490 patients were randomised to four treatment groups (SK alone, SK plus heparin, tPA alone, tPA plus heparin). No specific differences between the two thrombolytic agents were detected as regards the combined end-point (tPA 23\ub71%; SK 22\ub75%; relative risk 1\ub704, 95% Cl 0\ub795-1\ub713), nor after the addition of heparin to the aspirin treatment (hep 22\ub77%, no hep 22\ub79%; RR 0\ub799, 95% Cl 0\ub791-1\ub708). The outcome of patients allocated to the four treatment groups was similar with respect to baseline risk factors such as age, Killip class, hours from onset of symptoms, and site and type of infarct. The rates of major in-hospital cardiac complications (reinfarction, post-infarction angina) were also similar. The incidence of major bleeds was significantly higher in SK and heparin treated patients (respectively, tPA 0\ub75%, SK 1\ub70%, RR 0\ub757, 95% Cl 0\ub738-0\ub785; hep 1\ub70%, no hep 0\ub76%, RR 1\ub764, 95% Cl 1\ub709-2\ub745), whereas the overall incidence of stroke was similar in all groups. SK and tPA appear equally effective and safe for use in routine conditions of care, in all infarct patients who have no contraindications, with or without post-thrombolytic heparin treatment. The 8\ub78% hospital mortality of the study population (compared with approximately 13% in the control cohort of the GISSI-1 trial) indicates the beneficial impact of the proven acute treatments for AMI. \ua9 1990