Factors controlling patterns of deforestation in moist evergreen Afromontane forests of Southwest Ethiopia

This study aims to contribute to a better understanding of deforestation processes of moist evergreen Afromontane forests by disentangling the role of biophysical and socio-economic factors. Hitherto deforestation patterns between 1957 and 2007 were mapped for 9 villages in the Jimma zone of the Oromia regional state in Southwest Ethiopia on the basis of aerial photographs and high- resolution satellite images. The results show a 19% decline in forest cover since 1957. A spatial analysis of the observed deforestation patterns showed that the way of living and the accessibility to markets has controlled to a large extent the spatial pattern of deforestation during the past 50 years. Forest was lost mainly at remote locations away from the main roads where market integration is difficult. Farmers in these locations are relatively poor and self-subsistent which implies that population increase automatically led to new deforestation. Places very nearby to market places were spared from deforestation because of the presence of off-farm jobs in the towns. Significantly less deforestation was observed in areas that are suitable for the growth of shaded coffee. The areas above 2000 m.a.s.l that are not suited for shaded coffee are typically inhabited by relatively poor households who are living far from roadsides and thus are less integrated to the surrounding major markets. As a result, they depend more on subsistence farming causing more deforestation than other households.status: publishe

Willingness to work of hospital staff in disasters: a pilot study in Belgian hospitals

Study/Objective: Willingness to work, promoting factors, and hospital disaster management, including the role of the hospital disaster coordinator. Background: Following a disaster, hospitals are at-risk for sudden crowding of victims. However, can they recruit extra staff willing to work? Is disaster management a daily concern? Methods: This mixed-method study encompasses an explanatory sequential design with a quantitative data collection and analysis,followed by a second phase with a qualitative research track to explore the willingness to work. A quantitative survey with 11 different virtual disaster situations was offered at four different hospital staff groups (nurses, doctors, administrative, and supporting staff). In the qualitative part, we performed focus groups and semistructured face-to-face interviews with a purposeful sample of staff members. A “within” the cases analysis was performed to retain the uniqueness of each setting, followed by a cross-case analysis. Results: Twenty-two Belgian hospitals participated from March 2014 to July 2016. The willingness to work differs between doctors (33.8%), supporting staff (28.1%), nurses (23.6%), and administrative staff (23.1%). Both quantitative and qualitative research at three regional hospitals, from February 2016 to July 2016, confirmed a high willingness to work in all groups. Willingness was strongly related to the disaster type. The greatest willingness detected was with a seasonal influenza epidemic, the lowest for Ebola and nuclear incidents. Four facilitators increased the willingness to work: availability of personal protective equipment,insurance that their family is safe, feedback on the incident, and previous training. The hospital disaster coordinator is the key figure concerning “awareness” and “preparedness” within the hospital. Conclusion: Although differences in willingness to work depending the context, specific measures, and a concerned, dutiful hospital disaster coordinator all play an important role to enhance this willingness. Hospital disaster planning must reflect continuously on quality and safety policies within the organization.status: publishe

Landslide damage in hilly regions: a spatial and economic analysis from the Flemish Ardennes, Belgium

status: publishe

Conservation Science and Practice Must Engage With the Realities of Complex Tropical Landscapes

There is a growing disconnect between the international conferences where grand solutions for tropical conservation are designed and the complex local realities in tropical landscapes where plans need to be implemented. Every tropical landscape is different and no ?one size will fit all.? There is a tendency for global processes to prescribe simple generalized solutions that provide good sound bites that can be communicated with political actors and the media. Sustainable outcomes in tropical landscapes require locally adapted, unique approaches supported by long-term processes of learning and adaptation. Tropical biologists and conservationists can play a key role by establishing effective local?global links and by directly engaging in local policy discourses while remaining connected to evolving political imperatives

Quality of life and patient satisfaction after one-stage implant-based breast reconstruction with an acellular dermal matrix versus two-stage breast reconstruction (BRIOS): primary outcome of a randomised, controlled trial

Background There is increasing interest in the use of acellular dermal matrices (ADMs) in implant-based breast reconstruction (IBBR). Suggested advantages are that ADMs facilitate one-stage IBBR and improve aesthetic outcomes. We compared immediate one-stage ADM-assisted IBBR with two-stage IBBR (current standard of care). Our previously reported secondary endpoint showed that one-stage ADM-assisted IBBR was associated with significantly more adverse outcomes. Here, we present the primary endpoint results aiming to assess whether one-stage IBBR with ADM provides higher patient-reported quality of life (QOL) compared with two-stage IBBR. Methods This multicentre, open-label, randomised controlled trial (BRIOS study) was done in eight hospitals in the Netherlands. We recruited women aged older than 18 years with breast carcinoma or a genetic predisposition who intended to undergo skin-sparing mastectomy and immediate IBBR. Participants were randomly assigned to undergo one-stage IBBR with ADM (Strattice, LifeCell, Branchburg, NJ, USA) or two-stage IBBR. Randomisation was stratified by centre and indication for surgery (oncological or prophylactic) in blocks of ten participants. The primary endpoint was patient-reported QOL, as measured with the BREAST-Q (ie, health-related QOL scales and satisfaction scales), in the modified intention-to-treat population. The study follow-up is complete. This study is registered with the Netherlands Trial Register, number NTR5446. Findings Between April 14, 2013, and May 29, 2015, we enrolled 142 women, of whom 69 were randomly assigned to receive one-stage ADM-assisted IBBR and 73 to receive two-stage IBBR. After exclusions, the modified intention-to-treat population comprised 60 patients in the one-stage group and 61 patients in the two-stage group. Of these, 48 women (mean follow-up 17·0 months [SD 7·8]) in the one-stage group and 44 women (17·2 months [SD 6·7]) in the two-stage group completed the BREAST-Q at least 1 year after implant placement. We found no significant differences in postoperative patient-reported QOL domains, including physical wellbeing (one-stage mean 78·0 [SD 14·1] vs two-stage 79·3 [12·2], p=0·60), psychosocial wellbeing (72·6 [17·3] vs 72·8 [19·6], p=0·95), and sexual wellbeing (58·0 [17·0] vs 57·1 [19·5], p=0·82), or in the patient-reported satisfaction domains: satisfaction with breasts (63·4 [15·8] vs 60·3 [15·4], p=0·35) and satisfaction with outcome (72·8 [19·1] vs 67·8 [16·3], p=0·19). Interpretation Taken together with our previously published findings, one-stage IBBR with ADM does not yield superior results in terms of patient-reported QOL compared with two-stage IBBR. Risks for adverse outcomes were significantly higher in the one-stage ADM group. Use of ADM for one-stage IBBM should be considered on a case-by-case basis