European postgraduate curriculum in geriatric medicine developed using an international modified Delphi technique

the European Union of Medical Specialists (UEMS-GMS) recommendations for training in Geriatric Medicine were published in 1993. The practice of Geriatric Medicine has developed considerably since then and it has therefore become necessary to update these recommendations.under the auspices of the UEMS-GMS, the European Geriatric Medicine Society (EuGMS) and the European Academy of Medicine of Ageing (EAMA), a group of experts, representing all member states of the respective bodies developed a new framework for education and training of specialists in Geriatric Medicine using a modified Delphi technique. Thirty-two expert panel members from 30 different countries participated in the process comprising three Delphi rounds for consensus. The process was led by five facilitators.the final recommendations include four different domains: General Considerations on the structure and aim of the syllabus as well as quality indicators for training (6 sub-items), Knowledge in patient care (36 sub-items), Additional Skills and Attitude required for a Geriatrician (9 sub-items) and a domain on Assessment of postgraduate education: which items are important for the transnational comparison process (1 item).the current publication describes the development of the new recommendations endorsed by UEMS-GMS, EuGMS and EAMA as minimum training requirements to become a geriatrician at specialist level in EU member states

More than Eco-efficiency is Required to Improve Food Security

Agricultural eco-efficiency is promoted as a means of increasing agricultural production and improving the security of food systems in response to climate change. The rationale is that economic and environmental resources will be used more efficiently, enabling increased amounts of food to be produced from the same amount or fewer inputs. We used (i) a quantitative literature analysis to examine current usage of the eco-efficiency concept to assess strategies aimed at improving food security under climate change, and (ii) a wheat (Triticum aestivum L.) simulation experiment to consider possible tradeoffs between economic benefits of agricultural intensification, environmental performance, and social impacts. Two issues were highlighted from this. First, the relationship between economic and environmental outcomes is regularly assumed, leading to potentially erroneous conclusions and unintended outcomes. Second, the lack of any consideration for the social dimensions of food security ignores variability in incomes generated from agricultural production, and the potential for reduced quantities of food to be produced as a rational response to maximizing gross margins. We suggest the eco-efficiency concept explicitly include social as well as economic and environmental criteria if it is to avoid poor rates of uptake of eco-efficiency technologies, the promotion of practices that reduce the effectiveness of hunger-reduction efforts, and unintended environmental degradation