Biophysical and Socioeconomic Factors Associated with Forest Transitions at Multiple Spatial and Temporal Scales

Forest transitions (FT) occur when socioeconomic development leads to a shift from net deforestation to reforestation; these dynamics have been observed in multiple countries across the globe, including the island of Puerto Rico in the Caribbean. Starting in the 1950s, Puerto Rico transitioned from an agrarian to a manufacturing and service economy reliant on food imports, leading to extensive reforestation. In recent years, however, net reforestation has leveled off. Here we examine the drivers of forest transition in Puerto Rico from 1977 to 2000 at two subnational, nested spatial scales (municipality and barrio) and over two time periods (1977-1991 and 1991-2000). This study builds on previous work by considering the social and biophysical factors that influence both reforestation and deforestation at multiple spatial and temporal scales. By doing so within one analysis, this study offers a comprehensive understanding of the relative importance of various social and biophysical factors for forest transitions and the scales at which they are manifest. Biophysical factors considered in these analyses included slope, soil quality, and land-cover in the surrounding landscape. We also considered per capita income, population density, and the extent of protected areas as potential factors associated with forest change. Our results show that, in the 1977-1991 period, biophysical factors that exhibit variation at municipality scales (~100 km²) were more important predictors of forest change than socioeconomic factors. In this period, forest dynamics were driven primarily by abandonment of less productive, steep agricultural land in the western, central part of the island. These factors had less predictive power at the smaller barrio scale (~10 km²) relative to the larger municipality scale during this time period. The relative importance of socioeconomic variables for deforestation, however, increased over time as development pressures on available land increased. From 1991-2000, changes in forest cover reflected influences from multiple factors, including increasing population densities, land development pressure from suburbanization, and the presence of protected areas. In contrast to the 1977-1991 period, drivers of deforestation and reforestation over this second interval were similar for the two spatial scales of analyses. Generally, our results suggest that although broader socioeconomic changes in a given region may drive the demand for land, biophysical factors ultimately mediate where development occurs. Although economic development may initially result in reforestation due to rural to urban migration and the abandonment of agricultural lands, increased economic development may lead to deforestation through increased suburbanization pressures

Global Application of the Assessment of Communication Skills of Paediatric Endocrinology Fellows in the Management of Differences in Sex Development Using the ESPE E-Learning.Org Portal

Background: Information sharing in chronic conditions such as disorders of/differences in sex development (DSD) is essential for a comprehensive understanding by parents and patients. We report on a qualitative analysis of communication skills of fellows undergoing training in paediatric endocrinology. Guidelines are created for the assessment of communication between health professionals and individuals with DSD and their parents. Methods: Paediatric endocrinology fellows worldwide were invited to study two interactive online cases (www.espe-elearning.org) and to describe a best practice communication with (i) the parents of a newborn with congenital adrenal hyperplasia and (ii) a young woman with 46,XY gonadal dysgenesis. The replies were analysed regarding completeness, quality, and evidence of empathy. Guidelines for structured assessment of responses were developed by 22 senior paediatric endocrinologists worldwide who assessed 10 selected replies. Consensus of assessors was established and the evaluation guidelines were created. Results: The replies of the fellows showed considerable variation in completeness, quality of wording, and evidence of empathy. Many relevant aspects of competent clinical communication were not mentioned; 15% (case 1) and 17% (case 2) of the replies were considered poor/insufficient. There was also marked variation between 17 senior experts in the application of the guidelines to assess communication skills. The guidelines were then adjusted to a 3-level assessment with empathy as a separate key item to better reflect the qualitative differences in the replies and for simplicity of use by evaluators. Conclusions: E-learning can play an important role in assessing communication skills. A practical tool is provided to assess how information is shared with patients with DSD and their families and should be refined by all stakeholders, notably interdisciplinary health professionals and patient representatives.Fil: Kranenburg, Laura J.C.. Erasmus University Medical Center; Países BajosFil: Reerds, Sam T.H.. Erasmus University Medical Center; Países BajosFil: Cools, Martine. University of Ghent; BélgicaFil: Alderson, Julie. NHS Foundation Trust. University Hospitals Bristol; Reino UnidoFil: Muscarella, Miriam. University of California; Estados UnidosFil: Magrite, Ellie. Ffounder And Trustee;Fil: Kuiper, Martijn. Erasmus University Medical Center;Fil: Abdelgaffar, Shereen. Cairo University; EgiptoFil: Balsamo, Antonio. Universidad de Bologna; ItaliaFil: Brauner, Raja. Universite de Paris V; FranciaFil: Chanoine, Jean Pierre. British Columbia Children’s Hospital. Department of Paediatrics; CanadáFil: Deeb, Asma. Mafraq Hospital; Emiratos Arabes UnidosFil: Fechner, Patricia. University of Washington; Estados UnidosFil: German, Alina. Technion - Israel Institute of Technology; IsraelFil: Holterhus, Paul Martin. Universitätsklinikum Schleswig-Holstein; Alemania. Christian-Albrechts-Universität zu Kiel; AlemaniaFil: Juul, Anders. Universidad de Copenhagen; DinamarcaFil: Mendonca, Berenice B.. Universidade de Sao Paulo; BrasilFil: Neville, Kristen. Sydney Children's Hospital; AustraliaFil: Nordenstrom, Anna. Karolinka Institutet; SuizaFil: Oostdijk, Wilma. Leiden University; Países BajosFil: Rey, Rodolfo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas "Dr. César Bergada". Gobierno de la Ciudad de Buenos Aires. Centro de Investigaciones Endocrinológicas "Dr. César Bergada". Fundación de Endocrinología Infantil. Centro de Investigaciones Endocrinológicas "Dr. César Bergada"; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Rutter, Meilan M.. University of Cincinnati; Estados UnidosFil: Shah, Nalini. Seth GS Medical College & KEM Hospital; IndiaFil: Luo, Xiaoping. Tongji Hospital; ChinaFil: Grijpink, Kalinka. Delft University of Technology; Países BajosFil: Drop, Stenvert L.S.. Erasmus University Medical Center; Países Bajo

Erratum: Global disorders of sex development update since 2006: perceptions, approach and care (Hormone Research in Paediatrics (2016) 85 (158-180) DOI: 10.1159/000442975)

In the appendix of the recent publication by Lee et al. entitled 'Global disorders of sex development update since 2006: perceptions, approach and care' [Horm Res Paediatr 2016;85:158–180, DOI: 10.1159/000442975], Massimo Di Grazia, Psychologist, is incorrectly mentioned to be from Cosenga, Italy. The correct city is Trieste, Italy