737 research outputs found

    Large-scale implementation of adaptation and mitigation actions in agriculture

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    This paper identifies sixteen cases of large-scale actions in the agriculture and forestry sectors that have adaptation and/or mitigation outcomes, and distils lessons from the cases. The cases cover policy and strategy development (including where climate-smart objectives were not the initial aim), climate risk management through insurance, weather information services and social protection, and agricultural initiatives that have a strong link to climate change adaptation and mitigation. Key lessons learned include: - Trade-offs can be avoided, at least in the near-term and over limited spatial scale - We need cost-effective and comparable indices for measuring GHG fluxes and for monitoring adaptive capacity - Strong government support is crucial to enable large-scale successes - Upfront costs may be substantial and can be met from multiple sources - An iterative and participatory learning approach with investment in capacity strengthening is critical

    Current anesthesia practice for preterm infants undergoing surgery for necrotizing enterocolitis:A European survey

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    Study objective: Necrotizing enterocolitis (NEC) is a life-threatening intestinal illness mostly affecting preterm infants, which commonly requires surgery. Anesthetic care for these patients is challenging, due to their prematurity and critical illness with hemodynamic instability. Currently, there are no guidelines for anesthetic care for these vulnerable patients. Therefore, this study aimed to describe current anesthesia practices across Europe for infants undergoing surgery for NEC. Design: Cross-sectional survey study. Participants: Anesthesiologists working in centers where surgery for NEC is performed across Europe. Measurements: A 46-item questionnaire assessing protocols for anesthesia practice, preoperative care, intraoperative care, postoperative care, and the respondent's opinion on the adequacy of anesthetic care for patients with NEC in their center. Main results: Out of the 173 responding anesthesiologists from 31 countries, approximately a third had a written standard protocol for anesthetic care in infants. Three quarters of the respondents screened all patients with NEC preoperatively, and a third structurally performed preoperative multidisciplinary consultation. For induction of general anesthesia, most respondents opted for intravenous anesthesia (n = 73, 43%) or a combination of intravenous and inhalation anesthesia (n = 57, 33%). For intravenous induction, they mostly used propofol (n = 58, 44%), followed by midazolam (n = 43, 33%) and esketamine (n = 42, 32%). For maintenance of anesthesia, inhalation anesthetic agents were more commonly used (solely: n = 71, 41%; in combination: n = 37, 22%), almost exclusively with sevoflurane. Postoperative analgesics mainly included paracetamol and/or morphine. Sixty percent of the respondents (n = 104) considered their anesthetic care for patients with NEC adequate. Suggestions for further improvement mainly revolved around monitoring, protocols, and collaboration. Conclusions: Anesthesia practice for infants undergoing surgery for NEC was highly variable. Most respondents considered the provided anesthetic care for patients with NEC adequate, but also recognized opportunities for further improvement, especially with regards to monitoring, protocols, and interdisciplinary collaboration.</p

    Current anesthesia practice for preterm infants undergoing surgery for necrotizing enterocolitis:A European survey

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    Study objective: Necrotizing enterocolitis (NEC) is a life-threatening intestinal illness mostly affecting preterm infants, which commonly requires surgery. Anesthetic care for these patients is challenging, due to their prematurity and critical illness with hemodynamic instability. Currently, there are no guidelines for anesthetic care for these vulnerable patients. Therefore, this study aimed to describe current anesthesia practices across Europe for infants undergoing surgery for NEC. Design: Cross-sectional survey study. Participants: Anesthesiologists working in centers where surgery for NEC is performed across Europe. Measurements: A 46-item questionnaire assessing protocols for anesthesia practice, preoperative care, intraoperative care, postoperative care, and the respondent's opinion on the adequacy of anesthetic care for patients with NEC in their center. Main results: Out of the 173 responding anesthesiologists from 31 countries, approximately a third had a written standard protocol for anesthetic care in infants. Three quarters of the respondents screened all patients with NEC preoperatively, and a third structurally performed preoperative multidisciplinary consultation. For induction of general anesthesia, most respondents opted for intravenous anesthesia (n = 73, 43%) or a combination of intravenous and inhalation anesthesia (n = 57, 33%). For intravenous induction, they mostly used propofol (n = 58, 44%), followed by midazolam (n = 43, 33%) and esketamine (n = 42, 32%). For maintenance of anesthesia, inhalation anesthetic agents were more commonly used (solely: n = 71, 41%; in combination: n = 37, 22%), almost exclusively with sevoflurane. Postoperative analgesics mainly included paracetamol and/or morphine. Sixty percent of the respondents (n = 104) considered their anesthetic care for patients with NEC adequate. Suggestions for further improvement mainly revolved around monitoring, protocols, and collaboration. Conclusions: Anesthesia practice for infants undergoing surgery for NEC was highly variable. Most respondents considered the provided anesthetic care for patients with NEC adequate, but also recognized opportunities for further improvement, especially with regards to monitoring, protocols, and interdisciplinary collaboration.</p

    The Microarcsecond Sky and Cosmic Turbulence

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    Radio waves are imprinted with propagation effects from ionized media through which they pass. Owing to electron density fluctuations, compact sources (pulsars, masers, and compact extragalactic sources) can display a wide variety of scattering effects. These scattering effects, particularly interstellar scintillation, can be exploited to provide *superresolution*, with achievable angular resolutions (<~ 1 microarcsecond) far in excess of what can be obtained by very long baseline interferometry on terrestrial baselines. Scattering effects also provide a powerful sub-AU probe of the microphysics of the interstellar medium, potentially to spatial scales smaller than 100 km, as well as a tracer of the Galactic distribution of energy input into the interstellar medium through a variety of integrated measures. Coupled with future gamma-ray observations, SKA observations also may provide a means of detecting fainter compact gamma-ray sources. Though it is not yet clear that propagation effects due to the intergalactic medium are significant, the SKA will either detect or place stringent constraints on intergalactic scattering.Comment: 20 pages, 8 figures in 8 PostScript files, to appear in "Science with the Square Kilometer Array," eds. C. Carilli and S. Rawlings, New Astronomy Reviews (Elsevier: Amsterdam

    The Global Forest Transition as a Human Affair

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    Forests across the world stand at a crossroads where climate and land-use changes are shaping their future. Despite demonstrations of political will and global efforts, forest loss, fragmentation, and degradation continue unabated. No clear evidence exists to suggest that these initiatives are working. A key reason for this apparent ineffectiveness could lie in the failure to recognize the agency of all stakeholders involved. Landscapes do not happen. We shape them. Forest transitions are social and behavioral before they are ecological. Decision makers need to integrate better representations of people’s agency in their mental models. A possible pathway to overcome this barrier involves eliciting mental models behind policy decisions to allow better representation of human agency, changing perspectives to better understand divergent points of view, and refining strategies through explicit theories of change. Games can help decision makers in all of these tasks

    Measuring process indicators and adverse events to assess the quality of care for inpatients with psychosis

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    Background: Research into the quality of care in psychiatry is scarce. Data collection is falling behind that for other fields of medicine and therefore the opportunity to improve care is missed. Aims: In this medical record study we aim to determine: (i) whether or not patients’ physical health indicators are assessed and pharmacological and behavioural treatment interventions applied; (ii) the incidence and nature of adverse events in psychotic inpatients. Methods: Medical records of inpatients with psychosis admitted to psychiatric wards at Amsterdam UMC, location AMC, Department of psychiatry, were screened with a previously developed and tested two-step patient safety tool. Results: Data of 299 admissions were included. Physical health indicators were not assessed in one-third of cases. Fifty-five percent of the patients were smokers but only 1% received an intervention. The family was actively involved in 43% of the cases. During 11,403 admission days, 235 adverse events had been recorded. The most frequent adverse event was adverse drug reactions (40%), which were mostly related to antipsychotic medication. Conclusions: In conclusion, quality of care auditing is useful to prioritize areas that need improvement. Future research should focus on interventions to improve the quality of psychiatric care

    Neutron cross-sections for advanced nuclear systems : The n-TOF project at CERN

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    © Owned by the authors, published by EDP Sciences, 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedThe study of neutron-induced reactions is of high relevance in a wide variety of fields, ranging from stellar nucleosynthesis and fundamental nuclear physics to applications of nuclear technology. In nuclear energy, high accuracy neutron data are needed for the development of Generation IV fast reactors and accelerator driven systems, these last aimed specifically at nuclear waste incineration, as well as for research on innovative fuel cycles. In this context, a high luminosity Neutron Time Of Flight facility, n-TOF, is operating at CERN since more than a decade, with the aim of providing new, high accuracy and high resolution neutron cross-sections. Thanks to the features of the neutron beam, a rich experimental program relevant to nuclear technology has been carried out so far. The program will be further expanded in the near future, thanks in particular to a new high-flux experimental area, now under construction.Peer reviewedFinal Published versio

    High accuracy 234U(n,f) cross section in the resonance energy region

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    New results are presented of the 234U neutron-induced fission cross section, obtained with high accuracy in the resonance region by means of two methods using the 235U(n,f) as reference. The recent evaluation of the 235U(n,f) obtained with SAMMY by L. C. Leal et al. (these Proceedings), based on previous n-TOF data [1], has been used to calculate the 234U(n,f) cross section through the 234U/235U ratio, being here compared with the results obtained by using the n-TOF neutron flux

    238U(n, Îł) reaction cross section measurement with C 6D6 detectors at the n-TOF CERN facility

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedThe radiative capture cross section of 238U is very important for the developing of new reactor technologies and the safety of existing ones. Here the preliminary results of the 238U(n,Îł) cross section measurement performed at n-TOF with C6D6 scintillation detectors are presented, paying particular attention to data reduction and background subtraction.Peer reviewe
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