103 research outputs found

    MEN1 Surveillance Guidelines:Time to (re)Think?

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    Clinical practice guidelines for patients with multiple endocrine neoplasia type 1 (MEN1) recommend a variety of surveillance options. Given progress over the past decade in this area, it is timely to evaluate their ongoing utility. MEN1 is characterized by the development of synchronous or asynchronous tumors affecting a multitude of endocrine and nonendocrine tissues, resulting in premature morbidity and mortality, such that the rationale for undertaking surveillance screening in at-risk individuals appears robust. Current guidelines recommend an intensive regimen of clinical, biochemical, and radiological surveillance commencing in early childhood for those with a clinical or genetic diagnosis of MEN1, with the aim of early tumor detection and treatment. Although it is tempting to assume that such screening results in patient benefits and improved outcomes, the lack of a strong evidence base for several aspects of MEN1 care, and the potential for iatrogenic harms related to screening tests or interventions of unproven benefit, make such assumptions potentially unsound. Furthermore, the psychological as well as economic burdens of intensive screening remain largely unstudied. Although screening undoubtedly constitutes an important component of MEN1 patient care, this perspective aims to highlight some of the current uncertainties and challenges related to existing MEN1 guidelines with a particular focus on the role of screening for presymptomatic tumors. Looking forward, a screening approach that acknowledges these limitations and uncertainties and places the patient at the heart of the decision-making process is advocated

    Physical soil quality indicators for monitoring British soils

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    The condition or quality of soils determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs) for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of its capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs were tested for robustness, spatial and temporal variability and expected rate of change using statistical analysis and modelling. Six SQIs were prioritised; packing density, soil water retention characteristics, aggregate stability, rate of erosion, depth of soil and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programs

    Qualitative impact assessment of land management interventions on ecosystem services (“QEIA”). Report-3 theme-3: soils

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    This project assessed the impacts of 741 potential land management actions, suitable for agricultural land in England, on the Farming & Countryside Programme’s Environmental Objectives (and therefore Environment Act targets and climate commitments) through 53 relevant environmental and cultural service indicators. The project used a combination of expert opinion and rapid evidence reviews, which included 1000+ pages of evidence in 10 separate reports with reference to over 2400 published studies, and an Integrated Assessment comprising expert-derived qualitative impact scores. The project has ensured that ELM schemes are evidence-based, offer good value for money, and contribute to SoS priorities for farming

    Qualitative impact assessment of land management interventions on ecosystem services (“QEIA”). Report-3 theme-4: water

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    This project assessed the impacts of 741 potential land management actions, suitable for agricultural land in England, on the Farming & Countryside Programme’s Environmental Objectives (and therefore Environment Act targets and climate commitments) through 53 relevant environmental and cultural service indicators. The project used a combination of expert opinion and rapid evidence reviews, which included 1000+ pages of evidence in 10 separate reports with reference to over 2400 published studies, and an Integrated Assessment comprising expert-derived qualitative impact scores. The project has ensured that ELM schemes are evidence-based, offer good value for money, and contribute to SoS priorities for farming

    Evaluation of the ECOSSE Model for Estimating Soil Respiration from Eight European Permanent Grassland Sites

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    Acknowledgments We are grateful to Lukas Hörtnagl, Keller Sabina, Shiva Ghiasi and people from other investigated sites for providing us with the data. Funding This work is funded by the Super-G project (funded under EU Horizon 2020 programme: project number 774124).Peer reviewedPublisher PD

    Does liming grasslands increase biomass productivity without causing detrimental impacts on net greenhouse gas emissions?

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    Acknowledgements This work contributes to the SUPER-G project (funded under EU Horizon 2020 programme). We appreciate the support from the Estonian Research Council (PRG352) and the European Regional Development Fund (Centre of Excellence EcolChange, Estonia).We are grateful to Sarah Perryman for proving us with pictures from the Park Grass Experiment.Peer reviewedPublisher PD

    Physical soil quality indicators for monitoring British soils

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    Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs) for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation) and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes

    The effectiveness of policies promoting sustainable permanent grasslands across five European countries (representing five biogeographic regions): mapping, understanding, and key stakeholder perceptions

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    The purpose of this report is to identify, map, and evaluate the most relevant European policies seen to influence permanent grassland (PG) management. To accomplish this, an interdisciplinary, crossnational team from the UK, Switzerland, Spain, Czech Republic, and Sweden reviewed over 50 in-depth policy frameworks. With direction from expert stakeholders and a review of the policy landscape, we identified the most relevant policy instruments influencing PGs across five different biogeographic regions in Europe (Alpine, Atlantic, Boreal, Continental, and Mediterranean). The mapping of each country’s policy mix was guided inter-alia by a ‘cascade framework’ to illustrate the entry points, intermediary actors, mechanisms and pathways through which policies deliver their intended effects on PGs. This entailed an in-depth analysis of publicly available government sources documenting the aims, objectives, targets, monitoring systems, outputs and outcomes of each policy instrument. In total, 24 policies were mapped using 50 different criteria, with 15 of the policies unique to the case study countries. This resulted in an extensive excel database of over 3400 unique cells containing rich qualitative data. The excel data were coded in a consistent manner across the country teams so that they could be compared, synthesized, and used to identify patterns in the policy mix and logic of intervention. We show, for instance, that across Europe, the dominant policy logic uses regulations and incentives to influence farmer adoption of desired landscape compositions. This directly influences, but does not guarantee, the range of ecosystem services (ES) that are possible from the landscape. At the same time, we discovered a lack of policies targeting consumer demand for PG ecosystem services and only a few designed to drive sustainable PG management by directly promoting the value of PGs with beneficiaries. To complement the policy mapping, stakeholders’ assessed the perceived effectiveness of the policy mix in each country. This evaluation included over 50 interviews with key stakeholders across Europe representing government, academia, farmers, and special interests, and covered perceptions of democracy, legitimacy, relevance, efficiency and impact in relation to the effectiveness of policies relevant to the management of PG. Our findings reveal generally positive perceptions of grassland policy effectiveness across Europe, with special interest groups being the least positive and governments the most. The in-depth country case studies reveal striking similarities, as well as differences between countries and stakeholder groups, which are illustrative of the problems, challenges, and barriers confronting policy effectiveness. We conclude this report by offering insights and policy implications. In particular, we suggest that the following four points are taken into consideration to improve the PG policy landscape: 1) Reduce complexity and administrative burden to make policies more understandable and accessible. 2) Require stakeholder involvement when developing strategic plans and assessing policy. 3) Encourage consideration of trade-offs between PG management and ES delivery, by designing policies to explicitly target the interaction between landscape structures and ES (or target them in parallel). 4) Encourage a balance of policy logic, by moving away from targeting farmers with regulation or subsidies to manage the landscape towards targeting consumer demand for ES (through information) and the value of ES (such as direct payments for regulating and cultural services)
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