Policy and practice certainty for effective uptake of diffuse pollution practices in a light touch regulated country

Although the link between agriculture and diffuse water pollution has been understood for decades, there is still a need to implement effective measures to address this issue. In countries with light-touch regulation, such as New Zealand and Australia, most efforts to promote environmental management practices have relied on voluntary initiatives such as participatory research and extension programmes; the success of which is largely dependent on farmers’ willingness and ability to adopt these practices. Increased understanding of the factors influencing farmer decision-making in this area would aid the promotion of effective advisory services. This study provides insights from 52 qualitative interviews with farmers and from observations of nine farmer meetings and field days. We qualitatively identify factors that influence farmer decision-making regarding the voluntary uptake of water quality practices and develop a typology for categorising farmers according to the factors that influence their decision-making. We find that in light-touch regulated countries certainty around policy and also around the effectiveness of practices is essential, particularly for farmers who delay action until compelled to act due to succession or regulation. The contribution of this paper is threefold: (i) it identifies factors influencing decision-making around the uptake of water quality practices in a light-touch regulated country; (ii) it develops a typology of different farmer types; and (iii) it provides recommendations on policy approaches for countries with light-touch regulation, which has potential relevance for any countries facing changes regarding their agricultural policy, such as post-Brexit policy in the UK

A review on equipment protection and system protection relay in power system

Power system equipment is configured and connected together with multiple voltage levels in existing electrical power system. There are varieties of electrical equipment obtainable in the power system predominantly from generation side up to the distribution side. Consequently, appropriate protections must be apt to prevent inessential disturbances that lead to voltage instability, voltage collapse and sooner a total blackout took place in the power system. The understanding of each component on the system protection is critical. This is due to any abnormal condition and failure can be analyzed and solved effectively due to the rapid changing and development on the power system network. Therefore, the enhancement of power quality can be achieved by sheltering the equipment with protection relay in power system. Moreover, the design of a systematic network is crucial for the system protection itself. Several types of protective equipment and protection techniques are taken into consideration in this paper. Hence, the existing accessible types and methods of system protection in the power system network are reviewed

Follow-up period of 13 years after endoscopic total extraperitoneal repair of inguinal hernias: a cohort study

Background: Endoscopic inguinal hernia repair was introduced in the Netherlands in the early 1990s. The authors' institution was among the first to adopt this technique. In this study, long-term hernia recurrence among patients treated by the total extraperitoneal (TEP) approach for an inguinal hernia is described. A cohort study was conducted. Methods: Between January 1993 and December 1997, 346 TEP hernia repairs were performed for 318 patients. After a mean follow-up period of 13-years, a senior resident examined each patient. An experienced surgeon subsequently examined the patients with a diagnosis of recurrent hernia. Data were collected on an intention-to-treat basis, meaning that conversions were included in the analysis. Univariant tests were used to analyze age older than 50 years, chronic obstructive pulmonary disease, body mass index, smoking habit, hernia type, history of open hernia repair, conversion, and surgeon as potential risk factors. Results: The analysis included 191 patients (62%) with 213 hernias. Of the original 318 patients, 59 patients died, and 68 were lost to follow-up evaluation. Perioperatively, 105 lateral, 55 medial, and 53 pantalon hernias were observed. Of the 213 hernias, 176 were primary and 37 were recurrent. The overall recurrence rate was 8.9% (8.5% for primary and 10.8% for recurrent hernias). Of the total study group, 48% of the patients experienced a bilateral inguinal hernia during their lifetime. No predicting factor for recurrent hernia could be identified. Conclusions: The current long-term results for TEP repair of primary and secondary inguinal hernia show an overall recurrence rate of 8.9%, which is slightly higher than in previous studies. The thorough examination at follow-up assessment, the learning curve effect, and the intention-to-treat-analysis may have influenced the observed recurrence rate. Also, the percentage of bilateral hernias was higher than known to date. Therefore, examination of the contralateral side should be standard procedure

Radioactive stents delay but do not prevent in-stent neointimal hyperplasia

BACKGROUND: Restenosis after conventional stenting is almost exclusively caused by neointimal hyperplasia. Beta-particle-emitting radioactive stents decrease in-stent neointimal hyperplasia at 6-month follow-up. The purpose of this study was to evaluate the 1-year outcome of (32)P radioactive stents with an initial activity of 6 to 12 microCi using serial quantitative coronary angiography and volumetric ECG-gated 3D intravascular ultrasound (IVUS). METHODS AND RESULTS: Of 40 patients undergoing initial stent implantation, 26 were event-free after the 6-month follow-up period and 22 underwent repeat catheterization and IVUS at 1 year; they comprised half of the study population. Significant luminal deterioration was observed within the stents between 6 months and 1 year, as evidenced by a decrease in the angiographic minimum lumen diameter (-0.43+/-0.56 mm; P:=0.028) and in the mean lumen diameter in the stent (-0.55+/-0. 63 mm; P:=0.001); a significant increase in in-stent neointimal hyperplasia by IVUS (18.16+/-12.59 mm(3) at 6 months to 27.75+/-11. 99 mm(3) at 1 year; P:=0.001) was also observed. Target vessel revascularization was performed in 5 patients (23%). No patient experienced late occlusion, myocardial infarction, or death. By 1 year, 21 of the initial 40 patients (65%) remained event-free. CONCLUSIONS: Neointimal proliferation is delayed rather than prevented by radioactive stent implantation. Clinical outcome 1 year after the implantation of stents with an initial activity of 6 to 12 microCi is not favorable when compared with conventional stenting

A cross-sectional investigation of communication in Do-Not-Resuscitate orders in Dutch hospitals

Background: The decision to attempt or refrain from resuscitation is preferably based on prognostic factors for outcome and subsequently communicated with patients. Both patients and physicians consider good communication important, however little is known about patient involvement in and understanding of cardiopulmonary resuscitation (CPR) directives. Aim: To determine the prevalence of Do No