41 research outputs found

    Urban blue: A global analysis of the factors shaping people's perceptions of the marine environment and ecological engineering in harbours.

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    Marine harbours are the focus of a diverse range of activities and subject to multiple anthropogenically induced pressures. Support for environmental management options aimed at improving degraded harbours depends on understanding the factors which influence people's perceptions of harbour environments. We used an online survey, across 12 harbours, to assess sources of variation people's perceptions of harbour health and ecological engineering. We tested the hypotheses: 1) people living near impacted harbours would consider their environment to be more unhealthy and degraded, be more concerned about the environment and supportive of and willing to pay for ecological engineering relative to those living by less impacted harbours, and 2) people with greater connectedness to the harbour would be more concerned about and have greater perceived knowledge of the environment, and be more supportive of, knowledgeable about and willing to pay for ecological engineering, than those with less connectedness. Across twelve locations, the levels of degradation and modification by artificial structures were lower and the concern and knowledge about the environment and ecological engineering were greater in the six Australasian and American than the six European and Asian harbours surveyed. We found that people's perception of harbours as healthy or degraded, but not their concern for the environment, reflected the degree to which harbours were impacted. There was a positive relationship between the percentage of shoreline modified and the extent of support for and people's willingness to pay indirect costs for ecological engineering. At the individual level, measures of connectedness to the harbour environment were good predictors of concern for and perceived knowledge about the environment but not support for and perceived knowledge about ecological engineering. To make informed decisions, it is important that people are empowered with sufficient knowledge of the environmental issues facing their harbour and ecological engineering options

    Past and present of risk management in healthcare

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    An insight into the occurrence of suicides in jails of an Italian region

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    The objective of this study is to explore the personal and environmental causes of suicides in jails of an Italian region, by evaluating the extent of the phenomenon, in order to devise strategies for prevention. The examined documentation deals with all cases of suicide among detainees in the 14 prisons of the region Lazio between 01/01/2008 and 31/12/2014. The factors considered for evaluation concerns the are socio-demographics (age, gender, nationality) as well as legal aspects, prison characteristics (type of crime, judicial state) and method used for the suicide. The results show that the method to commit suicide in prisoners of Lazio is hanged. Suicides occur especially in Italian prisoners. Most prison inmates commit suicide less than one year before the end of the detention period. Since the majority of risk factors for suicide are present before the subject enters prison, it is not easy to observe and check the prisoners once they are in jail. The evaluation of the prisoners should be done during the phase when they first enter the jail and not after the intervening variables associated with the detention have had their effects. This suggests that further studies are necessary to better understand the phenomenon and evaluate the possibility to introduce effective preventive measures

    Prognostic significance of CEA, CA 19-9 and CA 72-4 preoperative serum levels in gastric carcinoma

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    The prognostic value of preoperative serum levels of CEA, CA 19-9 and CA 72-4 tumor markers was investigated in 153 patients resected for gastric cancer. The positivity rates for CEA, CA 19-9 and CA 72-4 were 20.9, 34.6 and 28.1%, respectively. Multiple logistic regression analysis for positive levels of tumor markers indicates that CEA positivity is significantly related to the depth of invasion (p < 0.005) and the presence of distant metastasis (p < 0. 05), CA 19-9 positivity is related to nodal involvement (p < 0.05) and the depth of invasion (p < 0.05), whereas CA 72-4 positivity is influenced by tumor size (p < 0.005) and noncurative surgery (p < 0. 05). Positive levels of each tumor marker were associated with a worse prognosis if compared with negative cases using univariate analysis. Multivariate analysis of curatively resected cases identified depth in gastric wall (p < 0.0001), nodal status (p < 0. 0005), and tumor location in the upper third (p < 0.05) as significant prognostic variables; CEA, CA 19-9 and CA 72-4 serum positivity did not reach statistical significance. However, when the positivity of the three markers was associated, a p value < 0.05 was observed. The analysis of survival curves stratified by tumor stage revealed that marker positivity significantly affects survival in stages I, II and IV (p < 0.05). The combined assay of CEA, CA 19-9 and CA 72-4 preoperative serum levels provides additional prognostic information in patients resected for gastric cancer; patients with preoperative positivity for one of these tumor markers should be considered at high risk of recurrence even in early stages of gastric carcinoma
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