Investing in the New Blue Economy: The Changing Role of International Development Organizations in Catalyzing Private Sector Investment in Support of Regional Strategic Action Programmes for the Sustainable Development of Coasts and Oceans

Over the last 20 years, governments sharing common coastal and ocean ecosystems have developed and agreed on concrete regional action programs to stop and, in some cases, reverse a trend of deteriorating coastal and ocean resources. Implementation of these action programs requires significant investments by the public and private sectors alike, with the potential for substantial economic growth and enhanced social well-being. For this to happen, new institutional arrangements, technologies, and financial vehicles and asset classes are needed to mainstream innovative “blue economy” projects that have the potential to transition economies and communities to more sustainable development paths. This paper proposes one such set of transformative approaches for private and public investments in the blue economy and the role of the international development community in catalyzing this transformation. It proposes using the government approved regional action programs as guides to investment, as strategic frameworks to prioritize action, and as tools to reduce private sector investment risks. Establishing regional pre-investment facilities supported by the international development and donor community could serve as a new institutional arrangement to help cultivate pipelines of sustainable and bankable projects for financing by specialized blue economy commercial funds. To finance these pre-investment facilities, success fees can be agreed upon by all stakeholders and leveraged on closed investment deals supported by the specialized blue economy commercial funds or by an ecosystem of emerging sustainable investment funds. These success fees can assist the pre-investment facilities in becoming donor independent over time. This paper examines the development of such a pre-investment facility to cultivate an ecosystem of sustainable blue economy investment projects for the Seas of East Asia and presents the lessons for development organizations, local and national governments, and investors from pilot investment cases in four ocean-related sectors: sustainable seafood, marine protected areas and sustainable tourism, wastewater management, and plastic pollution

Physical Mistreatment in Persons with Alzheimer’s Disease

Physical mistreatment has been estimated to affect 2 million older persons each year and dramatically affects health outcomes. While researchers have attempted to examine risk factors for specific forms of abuse, many have been able to focus on only victim or perpetrator characteristics, or a limited number of psychosocial variables at any one time. Additionally, data on risk factors for subgroups such as persons with Alzheimer’s disease who may have heightened and/or unique risk profiles has also been limited. This paper examines risk for physical violence in caregiver/patient dyads who participated in the Aggression and Violence in Community-Based Alzheimer’s Families Grant. Data were collected via in-person interview and mailed survey and included demographics as well as measures of violence, physical and emotional health, and health behaviors. Logistic regression analysis indicated that caregivers providing care to elders with high levels of functional impairment or dementia symptoms, or who had alcohol problems, were more likely to use violence as a conflict resolution strategy, as were caregivers who were providing care to elders who used violence against them. By contrast, caregivers with high self-esteem were less likely to use violence as a conflict resolution strategy. Significant interaction effects were also noted

Explosion of knowledge and of scientific information?: what should be changed in the education of veterinarians?

Veterinarians play an important role in five related fields of work: public health, bio-medical research, global food safety and security, ecosystem health as well as in the more traditional role of caring for animals. As a consequence of societal needs and expectations, external demands on the profession are increasingly critical and far-reaching. Explosion of knowledge and multiplication of scientific information sources change the context of education. The objective for learners is to develop competencies to be able to manage new, sometimes complex, professional situations while they do not have acquired the necessary knowledge at school. This situation has implies to design competency frameworks, to develop educational interventions focusing on the transfer of knowledge, to take into account the characteristics of a new generation of students, and to be trained to the use of scientific information. Actions are required from all stakeholders: researchers, editors, veterinary practitioners and teachers. Reduction in the amount of face-to-face teaching, increased active learning (Problem Based Learning, Team Based Learning), and increased connections with practice (Case Based Learning, implication of practitioners in teaching) are neededLa variété des missions du vétérinaire praticien, associée à une augmentation exponentielle des savoirs, modifie désormais le cadre de l’apprentissage. Il devient impossible de maîtriser tous les sujets d’une discipline avec la même profondeur. L’apprentissage de la médecine vétérinaire n’est plus tellement d’accumuler des savoirs disciplinaires, mais bien d’apprendre à gérer des situations complexes, souvent sans avoir formellement acquis les connaissances nécessaires au cours des études. Ce contexte implique de déterminer les compétences indispensables au métier de vétérinaire, de privilégier le transfert des connaissances, de former à l’utilisation de l’information scientifique et de tenir compte du nouveau profil des étudiants. Face à ces enjeux, des actions doivent être envisagées par les différents protagonistes : chercheurs, éditeurs, praticiens et enseignants. Une contraction des matières enseignées est indispensable pour s’assurer que les connaissances essentielles soient acquises et transférées. Les dispositifs permettant de s’entraîner aux situations professionnelles prototypes doivent être favorisés (Problem Based Learning, Team Based Learning). Pour motiver les étudiants et permettre l’application des connaissances, des activités pratiques doivent être privilégiées en milieu scolaire et en milieu professionnel. À ce titre le compagnonnage et l’alternance pourraient être développés moyennant une formation des praticiens au rôle de formateur. Plus que jamais, il semble utile que tous les protagonistes s’accordent pour participer à ce changement indispensable de l’apprentissage de la médecine vétérinair

Evidence-based medicine (EBM) applied to veterinary nutraceuticals

In veterinary medicine as in human medicine, practitioners are required to make complex diagnostic, therapeutic or preventive decisions. The concept of evidence-based medicine (EBM) was first developed in human medicine in the early 1990s to help the decision-making process, and refers to the conscientious, explicit and judicious use of current best research evidence for the care of patients. It was introduced in veterinary medicine in 2003, and has since been developed in French-speaking countries. Although recent studies indicate that EBM cannot be applied to veterinary medicine to the extent recommended in human medicine, veterinary practitioners are still ethically bound to make scientifically valid decisions. The promotion of EBM in veterinary medicine requires the development of specific tools, such as systematic reviews, as well as specific improvements in the standards of veterinary studies, with a particular emphasis on teaching a reflective approach to future veterinarians. The lack of scientific evidence on the efficacy of nutraceuticals illustrates both the difficulties to make fully informed decisions and the methodological pitfalls of veterinary researchEn médecine vétérinaire comme en médecine humaine, le praticien est amené à prendre des décisions diagnostiques, thérapeutiques ou préventives complexes. Le concept de la médecine fondée sur les preuves (evidence-based medicine ou EBM) est apparu pour la première fois au début des années 1990 en médecine humaine pour améliorer le processus de prise de décision, et consiste à intégrer de manière consciencieuse, explicite et judicieuse les meilleures preuves scientifiques (evidence) du moment dans la prise en charge du patient. Le concept fut introduit en médecine vétérinaire dans les pays anglo-saxons en 2003, et il a depuis été développé dans les pays francophones. Bien que des études récentes montrent que l’EBM ne peut être appliquée en médecine vétérinaire dans les mêmes termes qu’en médecine humaine, les praticiens vétérinaires sont tenus sur le plan éthique de prendre des décisions scientifiquement valides. La promotion de l’EBM en médecine vétérinaire requiert le développement d’outils adaptés, tels que des revues systématiques, ainsi que des améliorations spécifiques des études vétérinaires, avec en particulier l’enseignement d’une démarche de réflexion aux futurs praticiens. Le manque de preuves scientifiques de l’efficacité des nutraceutiques illustre à la fois les obstacles rencontrés pour la prise de décisions parfaitement informées et les faiblesses méthodologiques de la recherche en médecine vétérinair

Managment of thoraco-lumbar pain in the horse

Back pain has been described in the horse and impacts locomotion and performances. Since lameness and back pain can coexist, it is important to determine whether they are linked. Primary back pain is caused by lesions of vertebrae, joints, ligaments or discs. Secondary back pain is due to lameness originating from one or several limbs. The treatment aims restoring normal function by alleviating pain and implementing controlled exercise. Main primary causes of back pain are overriding of supraspinous processes and osteoarthritis of the articular facets. In absence of significant lesion, the treatment of pain relies upon injection of trigger-points, mesotherapy and controlled exercise. However many aspects of back pain managment remain empirical and further research is required to strengthen scientific evidence.Les thoraco-lombalgies sont décrites depuis longtemps chez le cheval. Elles peuvent avoir un impact sur la locomotion et les performances sportives. Thoraco-lombalgie et boiterie peuvent coexister. Il est important de déterminer si c’est une boiterie qui induit la douleur du dos, si c’est cette dernière qui provoque la boiterie, ou encore si deux conditions pathologiques sont présentes. Les thoraco-lombalgies sont primaires lorsque les vertèbres ou leurs structures anatomiques annexes (ligaments, disques, articulations) sont la cause. Elles sont secondaires lorsqu’elles sont consécutives à une boiterie trouvant son origine au niveau d’un membre. La stratégie thérapeutique des thoraco-lombalgies vise à restaurer une fonction biomécanique normale et repose sur une réhabilitation raisonnée faisant intervenir gestion de la douleur et exercice. Les principales étiologies des thoraco-lombalgies primaires sont les conflits de processus épineux et l’ostéoarthrite des articulations diarthrodiales intervertébrales; un traitement chirurgical ou médical de la lésion peut être envisagé. En absence de lésion significative expliquant la thoraco-lombalgies, le traitement de la douleur repose sur l’injection des points-détentes, la mésothérapie et l’exercice. Des thérapies alternatives sont décrites. La gestion de la douleur du dos reste encore empirique et nécessite davantage de preuves scientifiques. Les publications ne sont pas nombreuses et peu d’études contrôlées sont disponibles. Une codification de l’approche des thoraco-lombalgies et sa démonstration scientifique sont nécessaires

The impact of detailed explanatory leaflets on patient satisfaction with urodynamic consultation: A double-blind randomized controlled trial.

peer reviewedAims To develop and validate a scale that is applicable in Belgium to investigate the aspects of female patients' satisfaction with urodynamic consultation, and to use it to measure the impact of a detailed explanatory leaflet on their satisfaction. Materials and Methods Question items were obtained from a group consensus (Delphi process). Each item was scored on a five-point Likert scale. The satisfaction scale was administered to two groups of patients attending the clinics for urodynamics. One hundred twenty-nine patients were included in the study and randomized in two groups. One group (n = 60) received a detailed explanatory leaflet about urodynamic consultation and the other did not (n = 69). Responses were subjected to a reliability and principal component analysis (PCA) to achieve data reduction and analysis, and to assess the reliability of the new scale. Relevant items were retained to compare both interventions using regression analysis. Results A 15-item scale was derived from the Delphi process. Exploratory factor analysis suggested a single factor solution with 11 meaningful items. No significant difference was noted in global scores of satisfaction between the two groups (P = 0.051). Conclusions A short-form patient satisfaction scale with acceptable validity and reliability was developed and used to measure patient satisfaction with urodynamic consultation in this population of Belgian women. This study did not provide support for the effectiveness of explanatory leaflets in improving satisfaction