Accounting for the Ocean Economy Using the System of National Accounts

The increasing importance to measure the ocean economy cannot be discounted. A number of countries attempted to measure the ocean economy based on their needs and perceptions. At this point, however, there is no agreed scope and coverage of the ocean economy nor is there an agreed operational definition of the variables needed for its measurement. Moreover, there is no internationally endorsed framework that will guide and lead to comparable estimates across countries or regions. Utilizing the 2008 System of National Accounts (SNA) as a framework, this paper endeavors to estimate the contribution of the ocean economy in the Philippines using the present Philippine System of National Accounts (PSNA) and taking into consideration the agreement in the Inception Workshop on the Blue Economy Assessment held last 28-30 July 2015 in Manila on the initial list of sectors relevant to the ocean economy. The current PSNA has adopted the 2008 SNA in May 2011 and has incorporated estimates of the “unorganized sector”, which is an approximation of the informal sector in the Philippine economy. The paper also explores the possibility of utilizing the System of Environmental Economic Accounting (SEEA) and the Experimental Ecosystem Approach being done in the Philippines to complement the existing national accounts estimates. Key words and Phrases: ocean economy, system of national accounts, industrial classification, unorganized sector, environmental accounting, ecosystem

Response of the Asian summer Monsoons to a high-latitude thermal forcing: mechanisms and nonlinearities

This study investigates mechanisms and nonlinearities in the response of the Asian Summer Monsoons (ASM) to high-latitude thermal forcings of different amplitudes. Using a suite of runs carried out with an intermediate-complexity atmospheric general circulation model, we find that the imposed forcings produce a strong precipitation response over the eastern ASM but a rather weak response over the southern ASM. The forcing also causes a precipitation dipole with wet conditions over the eastern Tibetan Plateau (TP) and dry conditions over the Bay of Bengal (BoB) and southeast Asia. A moderate increase of precipitation along the southern margin of the TP is also produced. Simulations designed to isolate the causal mechanisms show that thermodynamic interactions involving the tropical surface oceans are far less important than the water-vapour feedback for the transmission of information from the high-latitudes to the ASM. Additionally, we assess the nonlinearity of the ASM precipitation response to the forcing amplitude using a novel application of the empirical orthogonal function method. The response can be decomposed in two overlapping patterns. The first pattern represents a precipitation dipole with wet conditions over the eastern TP and dry conditions over BoB, which linearly increases with forcing amplitude becoming quasi-stationary for large forcing amplitudes (i.e. amplitudes leading to Arctic temperature anomalies larger than 10 °C). The second pattern is associated with increased precipitation over the southeastern TP and is nonlinearly dependent on forcing, being most important for intermediate forcing amplitudes (i.e. amplitudes leading to Arctic temperature anomalies between 5 and 10 °C). © 2020, The Author(s)

Respective impacts of Arctic sea ice decline and increasing greenhouse gases concentration on Sahel precipitation

The impact of climate change on Sahel precipitation is uncertain and has to be widely documented. Recently, it has been shown that Arctic sea ice loss leverages the global warming effects worldwide, suggesting a potential impact of Arctic sea ice decline on tropical regions. However, defining the specific roles of increasing greenhouse gases (GHG) concentration and declining Arctic sea ice extent on Sahel climate is not straightforward since the former impacts the latter. We avoid this dependency by analysing idealized experiments performed with the CNRM-CM5 coupled model. Results show that the increase in GHG concentration explains most of the Sahel precipitation change. We found that the impact due to Arctic sea ice loss depends on the level of atmospheric GHG concentration. When the GHG concentration is relatively low (values representative of 1980s), then the impact is moderate over the Sahel. However, when the concentration in GHG is levelled up, then Arctic sea ice loss leads to increased Sahel precipitation. In this particular case the ocean-land meridional gradient of temperature strengthens, allowing a more intense monsoon circulation. We linked the non-linearity of Arctic sea ice decline impact with differences in temperature and sea level pressure changes over the North Atlantic Ocean. We argue that the impact of the Arctic sea ice loss will become more relevant with time, in the context of climate change

European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study.

The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25-33%) while Italy and Turkey had the highest C. parapsilosis proportions (24-26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence

Predictors for prolonged hospital stay solely to complete intravenous antifungal treatment in patients with candidemia: Results from the ECMM candida III multinational European observational cohort study

Background To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx). Methods Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx. Findings Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 – 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 – 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 – 0.45; p < 0.03). Interpretation Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis

Suporte humanizado no pronto socorro: um desafio para a enfermagem Soporte humanizado en un servicio de emergencia: un desafío para la enfermería Humanized support in emergency: a challenge for nursing

Este relato de experiência descreve o suporte humanizado prestado pela enfermeira no atendimento a pacientes em situação eminentemente crítica de saúde, do Hospital de Pronto Socorro de Porto Alegre (Brasil). A proposta foi baseada em pressupostos da Teoria de Jean Watson. A experiência rendeu momentos para o autoconhecimento pessoal e profissional, assim como reflexões acerca das possibilidades de construção do processo humanístico interpessoal no ambiente de emergência. Ainda foi possível identificar algumas limitações da opção teórica referentes à sua aplicabilidade prática.<br>Este relato de experiencia describe el soporte humanizado desarollado por la enfermera durante la asistencia del paciente en situación crítica de salud, en un Servicio de Emergencia de Porto Alegre (Brasil). El soporte se ha basado en los presupuestos de Jean Watson. La experiencia resultó en momentos de auto-conocimiento y reflexiones acerca de las posibilidades de construcción del proceso humanístico interpersonal en el ambiente de emergencia. Incluso se ha podido identificar algunas limitaciones de la opción teórica referente a su aplicación práctica.<br>This experience report describes the humanized support given by the nurse in the attendance to patients in eminently critical health situation in the Emergency Hospital of Porto Alegre (Brasil). The proposal was based on Jean Watson theory. The experience gave moments for personal and professional self-knowledge, and thoughts concerning the possibilities of construction of interpersonal humanist process in the emergency environment as well. Yet, it was possible to identify some limitations of the theory options referent to its practical applicability

Glacial inception through rapid ice area increase driven by albedo and vegetation feedbacks

We present transient simulations of the last glacial inception using the Earth system model CLIMBER-X with dynamic vegetation, interactive ice sheets, and visco-elastic solid Earth responses. The simulations are initialized at the middle of the Eemian interglacial (125 kiloyears before present, ka) and run until 100 ka, driven by prescribed changes in Earth's orbital parameters and greenhouse gas concentrations from ice core data. CLIMBER-X simulates a rapid increase in Northern Hemisphere ice sheet area through MIS5d, with ice sheets expanding over northern North America and Scandinavia, in broad agreement with proxy reconstructions. While most of the increase in ice sheet area occurs over a relatively short period between 119 and 117 ka, the larger part of the increase in ice volume occurs afterwards with an almost constant ice sheet extent. We show that the vegetation feedback plays a fundamental role in controlling the ice sheet expansion during the last glacial inception. In particular, with prescribed present-day vegetation the model simulates a global sea level drop of only ∼ 20 m, compared with the ∼ 35 m decrease in sea level with dynamic vegetation response. The ice sheet and carbon cycle feedbacks play only a minor role during the ice sheet expansion phase prior to ∼ 115 ka but are important in limiting the deglaciation during the following phase characterized by increasing summer insolation. The model results are sensitive to climate model biases and to the parameterization of snow albedo, while they show only a weak dependence on changes in the ice sheet model resolution and the acceleration factor used to speed up the climate component. Overall, our simulations confirm and refine previous results showing that climate–vegetation–cryosphere feedbacks play a fundamental role in the transition from interglacial to glacial states characterizing Quaternary glacial cycles

Atenção e presença física: dimensões expressivas e a prática dialógica do cuidado de enfermagem na perspectiva do cliente hospitalizado Atención y presencia física: dimensiones expresivas y práctica dialógica de la atención de enfermería en la perspectiva del cliente hospitalizado Attention and physical presence: expressive dimensions and the dialogical practice of nursing care according to the perpective of the hospitalized client

Estudo qualitativo, discutiu a atenção e a presença física como cuidados fundamentais expressos na relação dialógica entre o cliente vivendo com AIDS e a equipe de enfermagem hospitalar, utilizando conceitos de atividades expressivas e cuidado humano, segundo Watson e de diálogo, conforme Freire. Participaram cinco pessoas com vivência de internação, sob acompanhamento ambulatorial num hospital do Rio de Janeiro. Utilizou-se a triangulação de técnicas: almanaque, entrevista semi-estruturada e observação participante. Mostrou a importância da valorização daquilo que é necessário e de interesse do cliente a partir da atenção e da presença física como requisitos indispensáveis no cuidado humano, expressos na experiência dialógica e na participação do cliente em todo o processo de cuidado.<br>Estudio cualitativo, discutió la atención y la presencia física como cuidados fundamentales expresos en la relación dialógica entre el cliente que vive con AIDS y el equipo de enfermería hospitalaria, utilizando conceptos de actividades expresivas y cuidado humano, según Watson y de diálogo,según Freire. Participarón cinco personas con experiencia de hospitalización y bajo acompañamiento ambulatorio, en un hospital de Río de Janeiro. Se utilizó la triangulación de técnicas: almanaque, entrevista semi estructurada y observación participante. Mostró la importancia de la valorización de aquello que es necesario y de interés para el cliente a partir de la atención y de la presencia física como requisitos indispensables en el cuidado humano, expresos en la experiencia dialógica y en la participación del cliente en todo el proceso del cuidado.<br>Qualitative study, discusses the attention and the physical presence as the fundamental care in the dialogical relation between the client living with AIDS and the hospital nursing, using concepts of expressive activities and human care, according to Watson and dialogue, according to Freire. Five persons participated with internment experience, under ambulatory follow up in a hospital of Rio de Janeiro city. It used the triangulation techniques: almanac, semi-structured interview and participant observation. It showed the importance of the valorization of that is necessary and of interest of the client from the attention and the physical presence as essential requirements in the human care, expressed in the dialogical experience and in the participation of the client in the whole care process