10 research outputs found

    Towards sustainable production and consumption: A novel DEcision-Support Framework IntegRating Economic, Environmental and Social Sustainability (DESIRES)

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    AbstractThe idea of sustainable production and consumption is becoming a widely-accepted societal goal worldwide. However, its implementation is slow and the world continues to speed down an unsustainable path. One of the difficulties is the sheer complexity of production and consumption systems that would need to be re-engineered in a more sustainable way as well as the number of sustainability constraints that have to be considered and satisfied simultaneously. This paper argues that bringing about sustainable production and consumption requires a systems approach underpinned by life cycle thinking as well as an integration of economic, environmental and social aspects. In an attempt to aid this process, a novel decision-support framework DESIRES has been developed comprising a suite of tools, including scenario analysis, life cycle costing, life cycle assessment, social sustainability assessment, system optimisation and multi-attribute decision analysis. An application of the framework is illustrated by a case study related to energy

    Tropical Africa’s first testbed for high-impact weather forecasting and nowcasting

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    Testbeds have become integral to advancing the transfer of knowledge and capabilities from research to operational weather forecasting in many parts of the world. The first high-impact weather testbed in tropical Africa was recently carried out through the African SWIFT program, with participation from researchers and forecasters from Senegal, Ghana, Nigeria, Kenya, the United Kingdom, and international and pan-African organizations. The testbed aims were to trial new forecasting and nowcasting products with operational forecasters, to inform future research, and to act as a template for future testbeds in the tropics. The African SWIFT testbed integrated users and researchers throughout the process to facilitate development of impact-based forecasting methods and new research ideas driven both by operations and user input. The new products are primarily satellite-based nowcasting systems and ensemble forecasts at global and regional convection-permitting scales. Neither of these was used operationally in the participating African countries prior to the testbed. The testbed received constructive, positive feedback via intense user interaction including fishery, agriculture, aviation, and electricity sectors. After the testbed, a final set of recommended standard operating procedures for satellite-based nowcasting in tropical Africa have been produced. The testbed brought the attention of funding agencies and organizational directors to the immediate benefit of improved forecasts. Delivering the testbed strengthened the partnership between each country’s participating university and weather forecasting agency and internationally, which is key to ensuring the longevity of the testbed outcomes

    Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

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    Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status
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