Maritime shipping must come to grips with its CO2 emissions

Low public awareness contributes to the problem, write Jane Lister, René Taudal Poulsen and Stefano Pont

Proceedings of the workshop on External Emergency Response Planning: First workshop organised under the Virtual Centre of Offshore Safety Expertise

Ensuring high levels of safety in the European offshore oil and gas industry is of paramount importance to the European Commission and to the Member States. To this purpose, Directive 2013/30/EU (also known as Offshore Safety Directive) introduced new safety requirements, and imposed additional duties on both the offshore industry and EU regulators. In particular, Article 29 of Directive 2013/30/EU requires Member States to prepare, in cooperation with the relevant operators or owners and, as appropriate, licensees and the competent authority, external emergency response plans covering all offshore oil and gas installations or connected infrastructure and potentially affected areas within their jurisdiction. The workshop on External Emergency Response Planning – supported by the European Commission's Directorate General for Energy (DG ENER) – was jointly organised by Directorate General Joint Research Centre (JRC) and the Italian Ministry of Economic Development (Directorate General for Safety of Mining and Energy Activities – National Mining Office for Hydrocarbons and Geo-resources) in collaboration with the Italian Coast Guard. The event was the first workshop to be held under the Virtual Centre of Offshore Safety Expertise, and it covered one of the topics of primary interest to the Member States to guarantee high levels of safety and environmental protection in the EU waters. The workshop was held on April 5th-7th April, 2017 at the premises of the Italian Coast Guard in Ravenna, Italy. The objectives of the workshop were fully achieved. The JRC launched a survey just after the event and the feedback received from participants was excellent.JRC.C.3-Energy Security, Distribution and Market

A Typology of Power in Global Value Chains

‘Power’ has been a foundational concept in examining global value chains and production networks for understanding patterns and dynamics in the global political economy. Yet, in most GVC scholarship, power is not explicitly defined and is applied as a unitary concept, rather than as having multiple dimensions. Clarifying the concept of power has become particularly urgent in recent years given the proliferation of new GVC frameworks, which extend beyond dyads of transacting firms or firm-state linkages, to incorporate other stakeholders and mechanisms – including NGOs, labor unions, standards and conventions. In this paper, we propose a typology for the varied meanings and usages of power in GVCs. We delineate two principal dimensions of power: transmission mechanisms – direct and diffuse; and arena of actors – dyads and collectives. Combined, these two dimensions yield four ideal types of power exercised in GVCs: bargaining, demonstrative, institutional and constitutive. We offer brief illustrations of these four types of power and provide an agenda for further research in the field

Transmyocardial laser revascularization. Personal experience

Background. Indirect revascularization is a therapeutic approach in case of severe angina not suitable for percutaneous or surgical revascularization. Transmyocardial revascularization (TMR) is one of the techniques used for indirect revascularization and it allows to create transmyocardial channels by a laser energy bundle delivered on left ventricular epicardial surface. Benefits of the procedure are related mainly to the angiogenesis caused by inflammation and secondly to the destruction of the nervous fibers of the heart. Patients and method. From September 1996 up to July 1997, 14 patients (9 males – 66.7%, mean age 64.8±7.9 years) underwent TMR. All patients referred angina at rest; Canadian Angina Class was IV in 7 patients (58.3%), III in 5 (41.7%). Before the enrollment, coronarography was routinely performed to find out the feasibility of Coronary Artery Bypass Graft (CABG): 13 patients (91,6%) had coronary arteries lesions not suitable for direct revascularization; this condition was limited only to postero-lateral area in one patient submitted to combined TMR + CABG procedures. Results. Mean discharge time was 3,2±1,3 days after surgery. All patients were discharged in good clinical conditions. Perfusion thallium scintigraphy was performed in 7 patients at a mean follow-up of 4±2 months, showing in all but one an improvement of perfusion defects. Moreover an exercise treadmill improvement was observed in the same patients and all of them are in good clinical conditions, with significantly reduced use of active drugs. Conclusion. Our experience confirms that TMR is a safe and feasible procedure and it offers a therapeutic solution in case of untreatable angina. Moreover, it could be a hybrid approach for patients undergoing CABGs in case of absence of vessels suitable for surgical approach in limited areas of the heart

Custom-Made Implants in Ankle Bone Loss: A Retrospective Assessment of Reconstruction/Arthrodesis in Sequelae of Septic Non-Union of the Tibial Pilon

Background and Objectives: Treating segmental tibial and ankle bone loss after radical surgery for chronic osteomyelitis is one of the most challenging problems encountered by orthopaedic surgeons. Open tibia and ankle fractures occur with an incidence of 3.4 per 100,000 and 1.6 per 100,000, respectively, and there is a high propensity of developing fracture-related infection with associated chronic osteomyelitis in patients. Segmental tibial and ankle bone loss have recently received new and improved treatments. Materials and Methods: Above all, 3D printing allows for the customization of implants based on the anatomy of each patient, using a personalized process through the layer-by-layer deposition of materials. Results: This article presents different cases from the authors' experience. Specifically, four patients suffered tibia and ankle fractures and after radical surgery for chronic osteomyelitis combined with high-performance antibiotic therapy underwent ankle reconstruction/arthrodesis with custom-made tibial spacers. Conclusions: Thanks to 3D-printed patient-specific devices, it is possible to perform surgical procedures that, for anatomical reasons, would have been impossible otherwise. Moreover, an improvement in overall functionality and an important reduction in pain were shown in the last follow-up in all patients

Sustainability Partnerships for the Governance of Coastal Resources in Tanzania

The paper examines the experience of sustainability partnerships for the management of coastal resources in Tanzania. It identifies key actors and governance dynamics, with focus on decentralization processes, legitimacy-building and participation of local communities. The paper first provides a brief status of coastal resources in Tanzania and a historical overview of the evolution of co-management practices. Then, it examines actors and processes at the national and local levels in relation to two types of co-management: Marine Parks (MPAs) and Beach Management Units (BMUs). In view of ongoing research under the New Partnerships for Sustainability project (NEPSUS), it provides guidance on research gaps in specific relation to the Mnazi Bay Ruvuma Estuary Marine Park (MBREMP) and selected BMUs in Mtwara region, Southern Tanzania

Nursing students' interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study

To explore nursing students' interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences

Nursing students' involvement in shift-to-shift handovers: Findings from a national study

Background Effective performance of clinical handovers should be one of the priorities of nursing education to promote efficient communication skills and ensure patient safety. However, to date, no studies have explored to what extent nursing students are involved in handovers. Objective To explore nursing students' handover involvement during their clinical rotations and associated factors. Method This was a secondary analysis of a large national cross-sectional study that involved 9607 undergraduate nursing students in 27 universities across 95 three-year Italian baccalaureate nursing programs. The involvement in the clinical handovers was the end point (from 0, never, to 3, always). A path analysis was performed to identify variables directly and indirectly affecting students' handover involvement. Results Handover involvement was reported as \u2018only a little\u2019, \u2018to some extent\u2019, and \u2018always\u2019 by 1739 (18.1%), 2939 (30.6%), and 4180 (43.5%) students, respectively; only 749 (7.8%) of students reported never being involved. At the path analysis explaining the 19.1% of variance of nursing students' involvement, some variables emerged that directly increased the likelihood of being involved in handovers. These were being female (\u3b2\u202f=\u202f0.115, p\u202f<\u202f0.001); having children (\u3b2\u202f=\u202f0.107, p\u202f=\u202f0.011); being a 3rd-year student (\u3b2\u202f=\u202f0.142, p\u202f<\u202f0.001) and being a 2nd-year student as compared to a 1st-year student (\u3b2\u202f=\u202f0.050, p\u202f=\u202f0.036); and having a longer clinical rotation (\u3b2\u202f=\u202f0.015, p\u202f<\u202f0.001) in units with high \u2018quality of the learning environment\u2019 (\u3b2\u202f=\u202f0.279, p\u202f<\u202f0.001). Moreover, students who were supervised by the nurse teacher (\u3b2\u202f=\u202f 120.279, p\u202f<\u202f0.001), or by a nurse on a daily basis (\u3b2\u202f=\u202f 120.253, p\u202f=\u202f0.004), or by the staff (\u3b2\u202f=\u202f 120.190, p\u202f<\u202f0.001) reported being less involved in handovers as compared to those students supervised by a clinical nurse. Variables with indirect effects also emerged (model of student's supervision adopted at the unit level, and number of previous clinical rotations attended by students). Moreover, handover involvement explained 11.5% of students self-reported degree of competences learned during the clinical experience. Conclusions Limiting students' opportunity to be involved in handover can prevent the development of communication skills and the professional socialization processes. Strategies at different levels are needed to promote handover among undergraduate nursing students

Nursing students' interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study

To explore nursing students' interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences