Use of a root bioassay to indicate the phosphorus status of forest trees

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Distributing power? Community energy projects' experiences of planning, policy and incumbents in the devolved nations of Scotland and Wales.

Community owned energy projects are viewed as compelling contributors towards renewable energy targets. They contribute to curtailing the use of carbon intensive energy sources, consequently aiding mitigation of climate change, and can contribute towards a sustainable, localised economy. The success and expansion of the sector varies. However, there is a lack of knowledge regarding the development of the sector between sub-state nations. This qualitative, comparative study looks at the sector in the sub-state, devolved nations of Wales and Scotland within the UK. Through a series of in-depth interviews with community energy practitioners in four case study sites in Scotland and Wales, this study shows how policy and governance practices can influence the sector and those working at grassroots level. The study shows a disparity in confidence and outlook for the sector, based on the perceived (in)effective governance in each devolved nation

Información hidrológica, primer paso para diseñar una política local de pago por servicios ambientales

Los recursos hidrológicos tienen significativa importancia en países con problemas de escasez de agua, parte de los cuales se atribuyen a la inexistencia de una relación entre los proveedores de servicios ambientales y de los usuarios. Los esquemas de pago por servicios ambientales hidrológicos (PSAH) surgen como una estrategia para conectarlos. El desarrollo de este esquema debería garantizar que los usos de la tierra de protección generen el servicio que se va a vender correctamente. Este estudio determinó el comportamiento hidrológico de los usos del suelo ubicados en un área de recarga de la Sierra de Otontepec, que correspondieron a: regeneración de bosques secundarios (SRF), pastizales estrella africana (GWT), pasto estrella africana y terrenos con arbustos (GS); bosque perturbado de Quercus oleoides (QF) y pastizales naturales (NG). Los indicadores fueron: precipitación, escorrentía, cambios de humedad del suelo, evapotranspiración y percolación. Los saldos hidrológicos mostraron que la percolación fue mayor en GWT (1 608 mm), GS (1 744 mm) y NG (1 314 mm), que en SRF (1 19 mm) y QF (974 mm). Los resultados indican que la recarga de agua subterránea durante el período de estudio proporcionó servicios ambientales hidrológicos convenientes, aun cuando la demanda del suministro de agua corriente en las tierras bajas está en un nivel máximo. Lo anterior implica que el uso del agua debe ser regulado y distribuido de manera más eficiente, en lugar de basarse en el aumento de la disponibilidad

Hydrological information, the first step to design a local policy of payment for ecosystem services

Los recursos hidrol?gicos tienen significativa importancia en pa?ses con problemas de escasez de agua, parte de los cuales se atribuyen a la inexistencia de una relaci?n entre los proveedores de servicios ambientales y de los usuarios. Los esquemas de pago por servicios ambientales hidrol?gicos (PSAH) surgen como una estrategia para conectarlos. El desarrollo de este esquema deber?a garantizar que los usos de la tierra de protecci?n generen el servicio que se va a vender correctamente. Este estudio determin? el comportamiento hidrol?gico de los usos del suelo ubicados en un ?rea de recarga de la Sierra de Otontepec, que correspondieron a: regeneraci?n de bosques secundarios (SRF), pastizales estrella africana (GWT), pasto estrella africana y terrenos con arbustos (GS); bosque perturbado de Quercus oleoides (QF) y pastizales naturales (NG). Los indicadores fueron: precipitaci?n, escorrent?a, cambios de humedad del suelo, evapotranspiraci?n y percolaci?n. Los saldos hidrol?gicos mostraron que la percolaci?n fue mayor en GWT (1 608 mm), GS (1 744 mm) y NG (1 314 mm), que en SRF (1 119 mm) y QF (974 mm). Los resultados indican que la recarga de agua subterr?nea durante el per?odo de estudio proporcion? servicios ambientales hidrol?gicos convenientes, aun cuando la demanda del suministro de agua corriente en las tierras bajas est? en un nivel m?ximo. Lo anterior implica que el uso del agua debe ser regulado y distribuido de manera m?s eficiente, en lugar de basarse en el aumento de la disponibilidad

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London