Concorrenza e programmazione nel sistema delle autorizzazioni sanitarie: brevi riflessioni sull\u2019adeguatezza del sistema vigente tra regole nazionali ed assetti regionali

Il lavoro analizza il tema delle autorizzazioni sanitarie nella dinamica tra principio di concorrenza e principio di programmazione. Dopo aver brevemente analizzato, in generale, l\u2019istituto dell\u2019autorizzazione nel diritto amministrativo, si delinea pi\uf9 dettagliatamente il sistema delle autorizzazioni in ambito sanitario. Ci si sofferma, in particolare, sul procedimento di autorizzazione alla realizzazione, procedimento nel quale la presenza di valutazioni discrezionali da parte dei pubblici poteri (la c.d. verifica di compatibilit\ue0) rende delicato e complesso il bilanciamento tra gli opposti interessi della tutela della salute e della libera iniziativa economica

Assessing the effectiveness of different approaches to species conservation

Humans are the main cause of the on-going large-scale biodiversity crisis, mostly through processes like habitat loss and fragmentation, and habitat degradation. The recent recognition of the scale and rate of biodiversity erosion has stimulated strong political and institutional reactions, culminating in the implementation of a large number of conservation initiatives. Such efforts have been largely insufficient to revert or slow down the rapid loss of biodiversity. Commonly, conservation resources have been allocated based on decisions supported by traditional knowledge or expert opinion rather than scientific evidence. Therefore, it is relevant that interventions are evaluated, to ultimately allow learning from past actions and taking better decisions in the future. With this thesis I aim to provide evidence needed to improve the effectiveness of different approaches to conservation of some species affected by anthropogenic activities. In doing so, I considered conservation interventions implemented mostly on private land with different underlying approaches: voluntary and inexpensive (based on self-motivation of landowners); voluntary market-based (landowners are compensated); Compulsory land reservation or legislation (landowners have no choice). I first evaluate the effectiveness of a conservation program aimed at protecting raptor nests in private forests of North Karelia in eastern Finland. I show that here an inexpensive voluntary approach, based on self-motivation of landowners, may represent an effective instrument for achieving conservation with very limited financial resources. This approach was effective not only at eliciting participation of local forest owners, but it also provided ecological benefits to the raptor species considered. Relevant outcomes for practical conservation can also emerge when multiple interventions are compared. This was the case for nest protection of the Montagu s harrier breeding in cropland of Spain and France. In France, protection of nests from harvesting operations has been achieved on a voluntary basis. Here I show that the most effective interventions to enhance nest productivity were those that not only protect from harvesting, but also from predation. This was achieved by erecting a protective fence around the nest. On the other hand, some nest protection measures in Spain were more expensive due to payments to farmers. Here, temporary removal of the chicks during harvest operations or relocation of the nest to a nearby safe place, as well as harvest delay, were the most effective measures to enhance nest productivity. Harvest delay was also the most expensive among all measures, therefore removal or relocation of the nest should be prioritized wherever it is operationally feasible. Interestingly, the most commonly employed measure, the retention of a small buffer of un-harvested crop, was also less effective compared to the other means. Unexpected but positive outcomes for conservation management emerged also from an evaluation of the effects of nest site protection for breeding White-tailed eagles in south-western Finland. The species was breeding as often and successfully in protected and unprotected areas, which suggests that compulsory and expensive protection through land reservation may not be necessary under the studied conditions. The species apparently thrives also in unprotected land subject to some levels of anthropogenic activities. I found opposite results in a study on protection of flying squirrel sites in Finland. Here I provide evidence indicating that the enforced legislation to protect the species habitat in Finnish forests is ineffective. The species occupancy at sites protected according to the law strongly declined following tree harvest. This indicates that the primary objective of the legislation (i.e. prevent deterioration of the sites where the species occurs) are not met. This is due to the fact that conservation of flying squirrel s habitat may conflict with forestry interests, and thus restrictions have been largely set in favour of the latter and at the detriment of the former. The case studies presented here indicate that evaluating the effectiveness of past actions is important. This step allows understanding whether past efforts have reached their initial objectives. Only with the strength of this evidence it is possible to adaptively revise current conservation plans and increase the chances of reaching the desired outcome from any given action. This is particularly relevant in the modern era, where conservation challenges are enormous, and the resources limited. Therefore, it is crucial that any implemented effort produces the best possible outcome for conservation.Ihmistoiminta on tärkein syy meneillään olevaan laaja-alaiseen biodiversiteettikriisiin, lähinnä habitaatin vähenemisen, fragmentaation ja laadun heikkenemisen kautta. Biodiversiteetin vähenemisen mittakaava on synnyttänyt voimakkaita poliittisia ja institutionaalisia reaktioita, jotka ovat johtaneet useisiin erilaisiin suojelualoitteisiin. Nämä toimenpiteet ovat olleet riittämättömiä pysäyttämään biodiversiteetin katoamista. Suojeluun varattujen resurssien käytöstä on usein jouduttu päättämään ilman tieteellistä tutkimustietoa. On tärkeää, että suojelutoimenpiteiden vaikutuksia arvioidaan, jotta niitä voidaan kehittää ja jotta suojelun käytössä olevia rajallisia resursseja voidaan allokoida oikein. Väitöskirjani tavoite on arvioida erilaisten suojelukeinojen tehokkuutta joidenkin ihmisvaikutuksen piirissä olevien lajien kohdalla. Tutkin erityisesti seuraavien yksityismailla toteutettujen suojelukeinojen tehokkuutta: vapaaehtoinen ja halpa (maanomistajan motivaatioon perustuva), vapaaehtoinen markkinahintaiseen korvaukseen perustuva ja pakollinen lakisääteinen suojelu. Tutkin ensin Pohjois-Karjalassa toteutetun yksityismailla sijaitsevien petolintujen pesien suojeluun tähdänneen projektin tehokkuutta. Maanomistajien pesäpaikkojen vapaaehtoiseen suojeluun perustuva osoittautui hyväksi keinoksi suojella pesäpaikkoja hakkuilta vähillä kustannuksilla. Lähestymistapa osoittautui hyväksi myös petolintujen kannalta, sillä ne jatkoivat pesintäänsä hakkuun jälkeen. Käytännön suojelutyön kannalta tärkeitä tuloksia voidaan löytää vertaamalla eri suojelumenetelmien tehokkuutta. Vertasin Ranskan ja Espanjan viljelymailla sijaitsevien niittysuohaukkojen pesäpaikkojen suojeluun käytettyjen menetelmien onnistumista. Ranskassa pesäpaikkoja suojellaan vapaaehtoisesti. Osoitan, että pesien tuottavuuden kannalta paras tulos saavutetaan kun pesä suojataan paitsi sadonkorjuulta myös pedoilta pystyttämällä pesän ympärille verkkoaita. Espanjassa pesäpaikkojen suojelu on kalliimpaa silloin kun viljelijöille maksetaan korvauksia. Pesimätuloksen kannalta parhaat suojelukeinot olivat poikasten väliaikainen tai pysyvä siirtäminen sadonkorjuun tieltä tai sadonkorjuun myöhentäminen. Sadonkorjuun myöhentäminen oli menetelmistä kallein, joten poikasten siirtäminen oli kustannustehokkain vaihtoehto. Tähän asti yleisimmin käytetty menetelmä, pesän ympärille jätetty pieni suojavyöhyke, osoittautui heikoimmin toimivaksi vaihtoehdoksi. Suojelun kannalta yllättäviä mutta positiivisia tuloksia sain tutkiessani merikotkien pesäpaikkojen suojelun vaikutuksia lajin pesintään Lounais-Suomen rannikkoalueella. Pesissä pesittiin yhtä usein ja yhtä onnistuneesti sekä suojelluilla että suojelemattomilla alueilla. Pesäpaikkojen ympäristön laajamittainen suojelu ei nykyisissä olosuhteissa vaikuta siten tarpeelliselta vaan laji menestyy myös ihmistoiminnan vaikutuksessa olevilla alueilla. Päinvastaisia tuloksia sain tutkiessani liito-oravia, joiden lakisääteisen suojelun keinot eivät vaikuta odotetulla tavalla. Lajin esiintyminen paikalla hakkuun jälkeen aleni merkittävästi kun paikalle jätettiin vain ohjeiden mukainen suojapuusto. Tämä ei vastaa lakia, jonka mukaan liito-oravan esiintyminen ei saa vaarantua. Liito-oravien suojelun ja metsätalouskäytön välinen ristiriita on siten nykykäytännön mukaan ratkaistu jälkimmäisen hyväksi. Nämä tutkimukset ovat esimerkkejä siitä, että käytettyjen suojelukeinojen tehokkuutta on syytä arvioida. Vain tällaisen todistusaineiston kautta on mahdollista sopeuttaa käytettyjä suojelukeinoja ja lisätä todennäköisyyttä saavuttaa haluttu päämäärä. Tämä on oleellista, sillä suojelun haasteet ovat valtavia mutta siihen käytettävissä olevat resurssit vähäisiä. On siksi erittäin tärkeää, että tehty panostus tuottaa suojelun kannalta parhaan mahdollisen lopputuloksen

Plastic and environmental safety: the effects of EDCs on metabolism, reproduction and epigenetic processes

Per inquinamento causato dalle materie plastiche si intende l’accumulo in ambiente di prodotti plastici in grado di indurre problemi sia all’ambiente che alle specie selvatiche. Il Bisfenolo A (BPA) è uno dei distruttori endocrini maggiormente prodotti a livello mondiale durante la lavorazione della plastica. Numerosi studi hanno mostrato la capacità di questo inquinante di creare effetti dannosi sia sull’uomo che sulle specie selvatiche, per cui nel tempo sono stati compiuti diversi tentativi volti a trovare delle valide alternative. Tra i possibili sostituti, in questo studio di dottorato, l’attenzione è stata focalizzata sul Dhietylene dibenzoato (DGB) ed il Diisononilftalato (DiNP). Lo scopo principale di questo progetto è stato quindi quello di studiare l’impatto di questi plastificanti, focalizzando l’attenzione sui loro effetti nella riproduzione e nel metabolismo lipidico. Gli effetti del nonilfenolo, dell’ottilfenolo (t-OP) e del BPA sul metabolismo lipidico, sono stati inoltre analizzati in giovanili di orata. I risultati ottenuti hanno dimostrato come, sia il BPA, che il DiNP, siano in grado di interferire con il processo di oogenesi e che, sia il BPA che il DGB, sono in grado di interferire con il metabolismo lipidico nello zebrafish. La somministrazione a giovanili di orata di mangimi contaminati con diversi inquinanti tra cui il BPA, ha mostrato la loro capacità di indurre disordini metabolici, mostrando come oltre all’esposizione ambientale, anche il consumo di cibi contaminati possa essere considerata una fonte di esposizione importante ai contaminanti. Concludendo, il presente progetto di dottorato, mostra la capacità di alcuni distruttori endocrini, utilizzati nella lavorazione della plastica e nei detergenti, di interferire con la riproduzione ed il metabolismo lipidico nei teleostei, agendo prevalentemente in maniera dose dipendente, secondo curve non-monotoniche e, nel caso del BPA, interferendo con i meccanismi epigenetici.Plastic pollution involves the accumulation of plastic products in the environment that adversely affects wildlife and wildlife habitat. Bisphenol A (BPA) is one of the highest volume endocrine disruptor produced worldwide during the manufacturing of plastic. Due to his well-documented detrimental effects, several substitute for BPA, but also for other plasticizer of common use, have been suggested, such as Diethylene glycol dibenzoate (DGB) and Diisononyl Phthalate (DiNP). The aim of this project is therefore to investigate the impact of several plasticizers, which are supposed to act as endocrine disruptor compounds (EDCs), focusing the attention on their effects on metabolic and reproductive system. Due to the necessity of testing a different range of concentrations in various plastic pollutants, an experimental model easy to reproduce, treat and analyse was needed; thus the choice to introduce zebrafish as experimental model for these studies. Concomitantly, the effects of nonylpnenol (NP), 4-tert-octylphenol (t-OP) and BPA on lipid metabolism were studied in sea bream juveniles. The results we obtained, using a multidisciplinary approach ranging from molecular to spectroscopic techniques, showed the ability of BPA and DiNP to interfere with female’s reproduction in a dose dependent manner. Concerning BPA its epigenetic effects were also demonstrated and eventually both BPA and DGB were found able to interfere with lipid metabolism in a dose dependent manner. Furthermore t-OP, NP and BPA were demonstrated to give rise to hepatic metabolic disorders in sea bream juveniles. In conclusion, the present PhD project, demonstrates that endocrine disruptors compounds, used in the manufacturing of plastics, are able to interfere with reproductive and metabolic system of teleost fish. Furthermore, we demonstrates the capacity of BPA to affect gene expression through the deregulation of epigenetic patterns

The representation potential of raptors for globally important nature conservation areas

Stemming from a pervasive lack of knowledge on biodiversity, important areas for conservation are typically identified using a subset of well known species, commonly termed surrogate or indicator groups. Birds have been commonly used as biodiversity surrogates due to the good level of knowledge on their taxonomy, ecology and distribution. Raptors in particular have been often proposed as an effective surrogate for other biodiversity based on their dietary diversity, being at the top of the food chain, their preference for highly productive areas, their generally threatened status and high public appeal. However, so far the surrogacy effectiveness of raptors has been largely studied locally or using a narrow selection of surrogate and surrogated taxa. Here we use a spatial conservation planning tool to quantify the surrogacy performance of raptors, overall and by different raptor groups (hawks and eagles, falcons, vultures, owls) to represent important biodiversity areas (such as IUCN protected areas and key biodiversity areas), wilderness areas and the worlds ecoregions. We compared the above surrogacy performance with that of all other non-raptor avian species. We show that raptors perform marginally worse than all other avian species in representing important biodiversity areas and ecoregions. However, raptors representation for wilderness areas was similar or slightly better compared to that of using all non-raptor birds. We also report a large variation in the representation performance by the four raptor groups. Falcons had a particularly high potential in representing protected areas and wilderness areas, equaling or largely surpassing the representation potential provided by all raptors and all other non-raptor birds. Overall, the results suggest that raptors, and particularly falcons, can perform relatively well in representing some important areas for conservation, such as protected areas and wilderness areas, but are relatively poor surrogates for key biodiversity areas and ecoregions. These rather contrasting results call for caution on the use of raptors as global surrogates of wider biodiversity.Peer reviewe

The Financial Return from Measuring Impact

In conservation, as in most other subjects, there is a division of expenditure into problem identification, solution testing, and practice. However, research concentrates on problem identification rather than solution testing. We calculate the return on the investment of research (a PhD thesis) examining the effectiveness of conservation interventions for birds of prey in three European countries. We show that the economic return from investing in a PhD thesis could be substantial, in the order of hundreds of thousands euros over 10 years or a return on investment of between 292% and 326% over that period. We derived the values of return on investment by first setting a common biological target (the total number of raptor fledglings produced per year). We then compared overall costs in achieving such target via the wide implementation of the results from the thesis (i.e., allocating resources to the most effective intervention) versus a business as usual scenario. We identify other theses that also show considerable benefits in improving effectiveness. We suggest that further research examining effectiveness would be cost-effective in improving practice.Peer reviewe

BPA-Induced Deregulation of Epigenetic Patterns: Effects on Female Zebrafish Reproduction

Bisphenol A (BPA) is one of the commonest Endocrine Disruptor Compounds worldwide. It interferes with vertebrate reproduction, possibly by inducing deregulation of epigenetic mechanisms. To determine its effects on female reproductive physiology and investigate whether changes in the expression levels of genes related to reproduction are caused by histone modifications, BPA concentrations consistent with environmental exposure were administered to zebrafish for three weeks. Effects on oocyte growth and maturation, autophagy and apoptosis processes, histone modifications, and DNA methylation were assessed by Real-Time PCR (qPCR), histology, and chromatin immunoprecipitation combined with qPCR analysis (ChIP-qPCR). The results showed that 5 μg/L BPA down-regulated oocyte maturation-promoting signals, likely through changes in the chromatin structure mediated by histone modifications, and promoted apoptosis in mature follicles. These data indicate that the negative effects of BPA on the female reproductive system may be due to its upstream ability to deregulate epigenetic mechanism

The tragedy of the science-policy gap – Revised legislation fails to protect an endangered species in a managed boreal landscape

Unsustainable use of forest resources poses a serious threat to biodiversity worldwide. This threat is particularly important in boreal biomes, where intensive production-oriented forestry is widely applied. Legislation is one of the key tools for preserving nature from anthropogenic damage. Designation of environmental legislation should be grounded on sound scientific evidence in order to be effective. We assess the impact of guidelines enforcing the Finnish ad-hoc legislation aimed at preserving breeding sites and resting places of the Siberian flying squirrel (Pteromys volans), a protected species in Finland and in the European Union under the Habitats Directive. Its habitat is under pressure from widespread forest clear-cutting practices. We collected data on site occupancy by breeding female flying squirrels from 81 sites spanning 12 years (2005-2016) and on relevant habitat variables around the site. Using generalized linear mixed models we quantified the predicted occupancy of breeding female flying squirrels in relation to the cover of breeding habitat around a site. We then compared the resulting habitat requirements of breeding females with the habitat that would be retained according to the initial national legislation guidelines and their proposed first revision. We show that both the initial and the proposed revision of the habitat protection guidelines allow the retention of breeding habitat patches of minimal size, which would yield a very low (less than 5%) predicted occupancy by a breeding flying squirrel female. The current revised guidelines are not science-driven and remain ineffective in safeguarding the species habitat from expanding forestry. These results expose the wide gap between science and policy for the implementation of environmental legislation, in this case the Habitats Directive, to protect species of conservation concern. There is an urgent need to fill the science-policy gap in order to achieve the preservation of biodiversity in a world under rapid transformation.Peer reviewe

Communal farmers of Namibia appreciate vultures and the ecosystem services they provide

Ecosystem services are cited as one of the many reasons for conserving declining vulture populations in Africa. We aimed to explore how communal farmers in Namibia perceive vultures and the ecosystem services they provide, with special focus on cultural and regulating ecosystem services. We surveyed 361 households across Namibia’s communal farmlands and found that over two-thirds of households liked vultures and found them useful, stating that they were harmless and useful for locating dead livestock. The minority of households who disliked vultures believed that they were killing their livestock. Poisoning was the main cause of vulture mortalities reported by farmers. While poisoning appears to be a concern for vultures in the communal farmlands, it appears that cultural use of vulture body parts is a minimal threat. We found that few farmers knew of cultural beliefs about vultures or uses for body parts; most farmers believed these beliefs and practices to be outdated. It is further promising that communal farmers have an overall positive perception of vultures. This highlights the potential for communal conservancies to bring attention to vulture conservation in their constituencies.Peer reviewe

The tragedy of the science-policy gap – Revised legislation fails to protect an endangered species in a managed boreal landscape

Unsustainable use of forest resources poses a serious threat to biodiversity worldwide. This threat is particularly important in boreal biomes, where intensive production-oriented forestry is widely applied. Legislation is one of the key tools for preserving nature from anthropogenic damage. Designation of environmental legislation should be grounded on sound scientific evidence in order to be effective. We assess the impact of guidelines enforcing the Finnish ad-hoc legislation aimed at preserving breeding sites and resting places of the Siberian flying squirrel (Pteromys volans), a protected species in Finland and in the European Union under the Habitats Directive. Its habitat is under pressure from widespread forest clear-cutting practices. We collected data on site occupancy by breeding female flying squirrels from 81 sites spanning 12 years (2005-2016) and on relevant habitat variables around the site. Using generalized linear mixed models we quantified the predicted occupancy of breeding female flying squirrels in relation to the cover of breeding habitat around a site. We then compared the resulting habitat requirements of breeding females with the habitat that would be retained according to the initial national legislation guidelines and their proposed first revision. We show that both the initial and the proposed revision of the habitat protection guidelines allow the retention of breeding habitat patches of minimal size, which would yield a very low (less than 5%) predicted occupancy by a breeding flying squirrel female. The current revised guidelines are not science-driven and remain ineffective in safeguarding the species habitat from expanding forestry. These results expose the wide gap between science and policy for the implementation of environmental legislation, in this case the Habitats Directive, to protect species of conservation concern. There is an urgent need to fill the science-policy gap in order to achieve the preservation of biodiversity in a world under rapid transformation.Peer reviewe

Effects of flyway-wide weather conditions and breeding habitat on the breeding abundance of migratory boreal waterbirds

Anthropogenic habitat loss and climate change are among the major threats to biodiversity. Bioclimatic zones such as the boreal and arctic regions are undergoing rapid environmental change, which will likely trigger changes in wildlife communities. Disentangling the effects of different drivers of environmental change on species is fundamental to better understand population dynamics under changing conditions. Therefore, in this study we investigate the synergistic effect of winter and summer weather conditions and habitat type on the abundance of 17 migratory boreal waterbird species breeding in Finland using three decades (1986–2015) of count data. We found that above-average temperatures and precipitations across the western and northern range of the wintering grounds have a positive impact on breeding numbers in the following season, particularly for waterbirds breeding in eutrophic wetlands. Conversely, summer temperatures did not seem to affect waterbird abundance. Moreover, waterbird abundance was higher in eutrophic than in oligotrophic wetlands, but long term trends indicated that populations are decreasing faster in eutrophic than in oligotrophic wetlands. Our results suggest that global warming may apparently benefit waterbirds, e.g. by increased winter survival due to more favourable winter weather conditions. However, the observed population declines, particularly in eutrophic wetlands, may also indicate that the quality of breeding habitat is rapidly deteriorating through increased eutrophication in Finland which override the climatic effects. The findings of this study highlight the importance of embracing a holistic approach, from the level of a single catchment up to the whole flyway, in order to effectively address the threats that waterbirds face on their breeding as well as wintering groundsPeer reviewe