Evaluating the Impact of Nature-Based Solutions: A Handbook for Practitioners

The Handbook aims to provide decision-makers with a comprehensive NBS impact assessment framework, and a robust set of indicators and methodologies to assess impacts of nature-based solutions across 12 societal challenge areas: Climate Resilience; Water Management; Natural and Climate Hazards; Green Space Management; Biodiversity; Air Quality; Place Regeneration; Knowledge and Social Capacity Building for Sustainable Urban Transformation; Participatory Planning and Governance; Social Justice and Social Cohesion; Health and Well-being; New Economic Opportunities and Green Jobs. Indicators have been developed collaboratively by representatives of 17 individual EU-funded NBS projects and collaborating institutions such as the EEA and JRC, as part of the European Taskforce for NBS Impact Assessment, with the four-fold objective of: serving as a reference for relevant EU policies and activities; orient urban practitioners in developing robust impact evaluation frameworks for nature-based solutions at different scales; expand upon the pioneering work of the EKLIPSE framework by providing a comprehensive set of indicators and methodologies; and build the European evidence base regarding NBS impacts. They reflect the state of the art in current scientific research on impacts of nature-based solutions and valid and standardized methods of assessment, as well as the state of play in urban implementation of evaluation frameworks

Uso de plantas com finalidade medicinal por pessoas vivendo com HIV/ AIDS em terapia antirretroviral

Este foi um estudo observacional, transversal analítico realizado em ambulatório de referência do Estado do Maranhão-Brasil, no período de maio de 2009 a fevereiro de 2010, com o objetivo de estudar o uso de plantas com finalidade medicinal entre pessoas vivendo com HIV/AIDS, em uso de antirretrovirais. Um total de 339 pessoas respondeu um questionário abordando o uso de plantas e características demográficas, socioeconômicas, comportamentais, relacionadas à soropositividade e ao uso de antirretrovirais. A prevalência de utilização de plantas foi de 34,81%. As mais utilizadas foram: Turnera ulmifolia (12,09%); Melissa officinalis (10,62%); Plectranthus barbatus (7,67%); Cymbopogan citratus (capim limão) (4,72%) e Mentha spp. (hortelã) (2,36%). A maioria das pessoas (96,61%) referiu melhora após a utilização. Um percentual de 75,42% dos usuários de plantas não informou essa prática ao médico. Entre os que informaram o uso, 55,17% afirmaram que o médico estava de acordo e somente uma pessoa foi orientada a interromper o uso (3,45%). Apenas um médico (3,45%) indicou o uso de plantas. A análise ajustada evidenciou diferença para uso de plantas em relação ao sexo feminino (RP=1,58, 95% IC 1,15-2,15 p 0,004) e à orientação sexual do tipo homossexual (RP=0,63 IC 0,44-0,90 p 0,012). Este estudo aponta para a necessidade de melhor diálogo entre médico e pacientes sobre o uso de plantas com finalidade medicinal, alertando sobre possíveis perigos quando associados aos antirretrovirais, especialmente entre usuários do sexo feminino ou com prática do tipo homossexual.It is an observational, analytic study, developed at a hospital in Maranhao-Brazil, from May-2009 to February-2010. The objective was to study the use of plants with medicinal purpose in people living with HIV/AIDS and using retroviral therapy. A total of 339 (three hundred and thirty-nine) people answered a questionnaire about the use of plants and demographic, socioeconomic, behavioral characteristics, including those related to HIV status and use of antiretroviral therapy The prevalence of the use of plants with medicinal purpose was 34,81%. The most often used were: Turnera ulmifolia (chanana) (12,09%), Melissa officinalis (erva cidreira,) (10,62%), Plectranthus barbatus (boldo) (7,67%), Cymbopogan citratus (capim limão) (4,72%) and Mentha spp. (hortelã) (2,36%). Most people interviewed (96,61%) reported improvement after use. A rate of 75,42% of the plant users had not reported their practice to a medical doctor. Among respondents who reported use, 55.17% said their doctor agreed to it, and only one person was advised to discontinue the use (3,45%); only one doctor (3,45%) indicated the use of plants. Multivariate analysis showed differences for the use of plants in relation to gender (female PR= 1,58, 95% CI 1,15 - 2,15 p 0,004) and homosexual practices (PR= 0,63, CI 0,44 - 0,90 p 0,012). This study highlights the need for a better dialogue between doctors and patients about the use of plants with medicinal purposes, and warns about possible dangers when they are combined with antirretroviral therapy, particularly between female and homossexual users