Impact of hard-bottom substrata on the small-scale distribution of fish and decapods in shallow subtidal temperate waters

The micro-scale spatial distribution patterns of a demersal fish and decapod crustacean assemblage were assessed in a hard-bottom kelp environment in the southern North Sea. Using quadrats along line transects, we assessed the in situ fish and crustacean abundance in relation to substratum types (rock, cobbles and large pebbles) and the density of algae. Six fish and four crustacean species were abundant, with Ctenolabrus rupestris clearly dominating the fish community and Galathea squamifera dominating the crustacean community. Differences in the substratum types had an even stronger effect on the micro-scale distribution than the density of the dominating algae species. Kelp had a negative effect on the fish abundances, with significantly lower average densities in kelp beds compared with adjacent open areas. Averaged over all of the substrata, the most attractive substratum for the fish was large pebbles. In contrast, crustaceans did not show a specific substratum affinity. The results clearly indicate that, similar to other complex systems, significant micro-scale species–habitat associations occur in northern hard-bottom environments. However, because of the frequently harsh environmental conditions, these habitats are mainly sampled from ships with sampling gear, and the resulting data cannot be used to resolve small-scale species–habitat associations. A detailed substratum classification and community assessment, often only possible using SCUBA diving, is therefore important to reach a better understanding of the functional relationships between species and their environment in northern temperate waters, knowledge that is very important with respect to the increasing environmental pressure caused by global climate change

Antimicrobial Peptides in Gastrointestinal Inflammation

Acute and chronic inflammations of mucosal surfaces are complex events in which the effector mechanisms of innate and adaptive immune systems interact with pathogenic and commensal bacteria. The role of constitutive and inducible antimicrobial peptides in intestinal inflammation has been investigated thoroughly over the recent years, and their involvement in various disease states is expanded ever more. Especially in the intestines, a critical balance between luminal bacteria and the antimicrobial peptides is essential, and a breakdown in barrier function by impaired production of defensins is already implicated in Crohn's disease. In this paper, we focus on the role of antimicrobial peptides in inflammatory processes along the gastrointestinal tract, while considering the resident and pathogenic flora encountered at the specific sites. The role of antimicrobial peptides in the primary events of inflammatory bowel diseases receives special attention

Ethikmanagement im Krankenhaus

Gute Führungskräfte im Krankenhaus tragen dazu bei, die medizinische und pflegerische Versorgung der Patienten auf hohem Niveau zu gewährleisten und zugleich die wirtschaftliche Existenzbasis ihres Hauses zu sichern. Sowohl innerhalb des Unternehmens als auch in der Interaktion mit Öffentlichkeit und Politik gilt es hier ständig zwischen den Ansprüchen an Wirtschaftlichkeit und gute Medizin zu vermitteln. Überzeugungskraft gewinnen Führungskräfte dabei durch einen präzisen Bezug auf die Werte und Ziele von Medizin und Ökonomie. Ein konstruktives Verständnis von Ethik – nicht nur auf Ebene der Patientenversorgung, sondern auch auf Ebene der Organisation – ist eine wesentliche Kompetenz für das Krankenhausmanagement. Ethik ist ein grundlegender Aspekt der Qualität – dies gilt sowohl für die Medizin als auch für das Management. Werte, Vertrauen, Kultur und Ethik im Krankenhaus werden von Patienten, Mitarbeitern und Bevölkerung erwartet und sollten nicht dem Zufall überlassen werden. Es bedarf gezielter Managementmaßnahmen im Sinne eines Ethikmanagements, um durch Institutionalisierung und Strukturierung die Ethik in der Organisation Krankenhaus zu unterstützen und so einen wichtigen Beitrag sowohl zur Verbesserung der Patientenversorgung als auch zur Zufriedenheit und Motivation der Mitarbeiter zu leisten. Dieses Buch vermittelt Wissen und Praxistipps zum Aufbau von Ethik-Kompetenz und Ethikmanagement als Schlüsselfaktoren für das nachhaltig erfolgreiche Krankenhausmanagement

Enhancing patient safety by integrating ethical dimensions to Critical Incident Reporting Systems

Background Critical Incident Reporting Systems (CIRS) provide a well-proven method to identify clinical risks in hospitals. All professions can report critical incidents anonymously, low-threshold, and without sanctions. Reported cases are processed to preventive measures that improve patient and staff safety. Clinical ethics consultations offer support for ethical conflicts but are dependent on the interaction with staff and management to be effective. The aim of this study was to investigate the rationale of integrating an ethical focus into CIRS. Methods A six-step approach combined the analysis of CIRS databases, potential cases, literature on clinical and organizational ethics, cases from ethics consultations, and experts' experience to construct a framework for CIRS cases with ethical relevance and map the categories with principles of biomedical ethics. Results Four main categories of critical incidents with ethical relevance were derived: (1) patient-related communication; (2) consent, autonomy, and patient interest; (3) conflicting economic and medical interests; (4) staff communication and corporate culture. Each category was refined with different subcategories and mapped with case examples and exemplary related ethical principles to demonstrate ethical relevance. Conclusion The developed framework for CIRS cases with its ethical dimensions demonstrates the relevance of integrating ethics into the concept of risk-, quality-, and organizational management. It may also support clinical ethics consultations' presence and effectiveness. The proposed enhancement could contribute to hospitals' ethical infrastructure and may increase ethical behavior, patient safety, and employee satisfaction

Understanding the demand for REDD+ credits

REDD (Reducing emissions from deforestation and forest degradation), broadened to REDD+, has recently emerged as a potentially important component of the global policy mix to mitigate climate change. In this context, it has been the hope of policy-makers that private sector stakeholders will turn into novel and active actors in many of the different components of REDD+ such as forest conservation and many have expected them to play a central role in providing funding for forest protection. However, even as REDD+ credits have become increasingly available on the voluntary market - private sector stakeholders seem to have lost interest REDD+ carbon credits. In order to better understand possible models of private sector engagement in REDD+ in the future, this report analyzes the motivation of a sample of private sector stakeholders to engage in REDD+, the perception of the potential of REDD+, the critical obstacles to making REDD+ functional and finally how private sector actors perceive themselves as part of future REDD+ scenarios. Based on a range of qualitative engagements with a wide grouping of private sector actors, we find that few seem to expect a regulatory market for REDD+ to emerge and that credits from the voluntary market have to be more tailor-made to their specific needs (ranging from demands based on Corporate Social Responsibility, to portfolio diversification and hedging strategies against stranded assets). The carbon value alone is currently not sufficient for many private actors. For REDD+ to become more attractive for most surveyed private sector stakeholders, the main problem is the uncertainty about how REDD+ will be designed in the future, along with building understanding of the values, barriers and risks that accompany REDD+

Taking Differences in Institutional Quality into Account in Global Forest Modelling

Forest cover and land-use change models are commonly used for climate scenarios and provide policy advice. The IIASA Global Forest Model (G4M) compares the net present value of agriculture and forestry, and makes a land-use change decision, based on this comparison. Moving beyond this purely economic rationale, we aimed at understanding in how far integrating differences in environmental institutional quality, could allow improving the representation of forest cover change processes of the model. Through an econometric regression analysis, we identified the most significant out of a larger set of variables on environmental institutional quality and created a composite index. We then implemented the composite index into the model. Its components are: the internalization of environmental norms, the strength of institutions, the ability of the institutions to guarantee macroeconomic stability, the quality of the administration and the efficiency of the bureaucracy. Through the inclusion of the composite index, the model’s residual could be significantly reduced. The results suggest that future research should consider taking differences in environmental institutional quality into account to improve modeling of deforestation processes. Moreover, the implementation of the index into the model allows for the first time to create scenarios for institutional quality and its impact on forest cover

Genetic Variants of Wnt Transcription Factor TCF-4 (TCF7L2) Putative Promoter Region Are Associated with Small Intestinal Crohn's Disease

Reduced expression of Paneth cell antimicrobial α-defensins, human defensin (HD)-5 and -6, characterizes Crohn's disease (CD) of the ileum. TCF-4 (also named TCF7L2), a Wnt signalling pathway transcription factor, orchestrates Paneth cell differentiation, directly regulates the expression of HD-5 and -6, and was previously associated with the decrease of these antimicrobial peptides in a subset of ileal CD. To investigate a potential genetic association of TCF-4 with ileal CD, we sequenced 2.1 kb of the 5′ flanking region of TCF-4 in a small group of ileal CD patients and controls (n = 10 each). We identified eight single nucleotide polymorphisms (SNPs), of which three (rs3814570, rs10885394, rs10885395) were in linkage disequilibrium and found more frequently in patients; one (rs3814570) was thereby located in a predicted regulatory region. We carried out high-throughput analysis of this SNP in three cohorts of inflammatory bowel disease (IBD) patients and controls. Overall 1399 healthy individuals, 785 ulcerative colitis (UC) patients, 225 CD patients with colonic disease only and 784 CD patients with ileal involvement were used to determine frequency distributions. We found an association of rs3814570 with ileal CD but neither with colonic CD or UC, in a combined analysis (allele positivity: OR 1.27, 95% CI 1.07 to 1.52, p = 0.00737), which was the strongest in ileal CD patients with stricturing behaviour (allele frequency: OR 1.32, 95% CI 1.08 to1.62, p = 0.00686) or an additional involvement of the upper GIT (allele frequency: OR 1.38, 95% CI 1.03 to1.84, p = 0.02882). The newly identified genetic association of TCF-4 with ileal CD provides evidence that the decrease in Paneth cell α-defensins is a primary factor in disease pathogenesis