369 research outputs found
Unravelling institutional work patterns:Planning offshore wind farms in contested space
Offshore wind farms (OWF) are considered important for a timely energy transition. However, offshore space is governed by sector-specific institutional frameworks representing various and sometimes conflicting interests. Therefore, institutional change towards improved cooperation and coordination between various stakeholders, their interests and alternative institutional frameworks is necessary. Institutional work is used as an analytical lens to explore patterns resulting from the interplay between different forms of institutional work by actors over time. Data was collected through participatory observation of the Dutch North Sea Dialogues (NSD) and focused on balancing interest in the context of multi-use of OFW. Institutional change in this case relied mostly on a highly subtle interplay between forms of creating and maintaining work that result in incremental changes to existing practices. Sustainability transitions could benefit from institutional harmonization as a pathway to institutional change for improved cross-sectoral coordination and cooperation
Marker assisted approach for incorporating durable rust resistance in popular Indian wheat cultivars
Item does not contain fulltextParkinson disease (PD) is common in long term care (LTC) facilities. The number of institutionalized patients with PD will rise sharply in the coming decades because of 2 concurrent phenomena: aging of the population leads to an increased PD prevalence and improved quality of care has led to a prolonged survival in advanced disease stages. Only a few studies have investigated the prevalence and clinical characteristics of patients with PD in LTC facilities. Even fewer studies have addressed the treatment strategies used to support these institutionalized patients, who are mostly in advanced stages of the disease. The available evidence suggests that current management of patients with PD in LTC facilities is less than optimal. In the Netherlands, and we suspect in many other countries, there are no formal guidelines for treating patients with PD who have been admitted to a LTC facility. In this review, we describe the epidemiology, clinical characteristics, and clinical management of patients with PD in LTC settings. We also address potentially modifiable elements of care and provide several recommendations to improve the management of PD in these facilities. We conclude by suggesting a possible guide for future research in this area
The Course of Quality of Life and Its Predictors in Nursing Home Residents With Young-Onset Dementia
OBJECTIVE: To explore the course of quality of life (QoL) and possible resident-related predictors associated with this course in institutionalized people with young-onset dementia (YOD). DESIGN: An observational longitudinal study. SETTING AND PARTICIPANTS: A total of 278 residents with YOD were recruited from 13 YOD special care units in the Netherlands. METHODS: Secondary analyses were conducted with longitudinal data from the Behavior and Evolution in Young-ONset Dementia (BEYOND)-II study. QoL was assessed with proxy ratings, using the Quality of Life in Dementia (QUALIDEM) questionnaire at 4 assessment points over 18 months. Predictors included age, gender, dementia subtype, length of stay, dementia severity, neuropsychiatric symptoms, and psychotropic drug use at baseline. Multilevel modeling was used to adjust for the correlation of measurements within residents and clustering of residents within nursing homes. RESULTS: The total QUALIDEM score (range: 0-111) decreased over 18 months with a small change of 0.65 (95% confidence interval -1.27, -0.04) points per 6 months. An increase in several domains of QoL regarding care relationship, positive self-image, and feeling at home was seen over time, whereas a decline was observed in the subscales positive affect, social relations, and having something to do. Residents with higher levels of QoL and more advanced dementia at baseline showed a more progressive decline in QoL over time. Sensitivity analyses indicated a more progressive decline in QoL for residents who died during the follow-up. CONCLUSION AND IMPLICATIONS: This study shows that although overall QoL in nursing home residents with YOD was relatively stable over 18 months, there were multidirectional changes in the QoL subscales that could be clinically relevant. Higher levels of QoL and more advanced stages of dementia at baseline predicted a more progressive decline in QoL over time. More longitudinal studies are needed to verify factors influencing QoL in YOD
Can the PROPER intervention reduce psychotropic drug prescription in nursing home residents with dementia?:Results of a cluster-randomized controlled trial
Objectives:To evaluate the effect of the PROPER intervention in nursing home residents with dementia on the prevalence of psychotropic drug use and neuropsychiatric symptoms.Design:A cluster-randomized controlled design with two parallel groups (intervention versus usual care) and assessments at 0, 6, 12, and 18 months.Setting:Thirty-one dementia special care units within 13 long-term care organizations in the Netherlands.Participants:Three hundred eighty nursing home residents with dementiaIntervention:The PROPER intervention consisted of a structured and repeated multidisciplinary medication review, supported by education and continuous evaluation.Measurements:Prescriptions of antipsychotics, antidepressants, anxiolytics, and hypnotics, and occurrence of neuropsychiatric symptoms.Results:The prescription of any type of psychotropic drugs increased in the intervention group, and decreased in the control group, with an estimated difference of 3.9 percentage points per 6 months (p = 0.01). Effects for the individual drug groups were minor (differences of 1.6 percentage points and below per 6 months) and not statistically significant. The occurrence of neuropsychiatric symptoms remained stable in both the intervention and control groups during the follow-up of 18 months.Conclusions:The PROPER intervention failed to demonstrate effectiveness in reducing the prevalence of psychotropic drugs. It may be interesting to enrich the intervention with components that address personal attitudes and communication between nursing home professionals, not only with respect to the prescription of psychotropic drugs, but also to neuropsychiatric symptoms
The Course and Predictors of Quality of Life in Nursing Home Residents with Young-onset Dementia
Designing multifunctional landscapes for forest conservation
A multifunctional landscape approach to forest protection has been advocated for tropical countries. Designing such landscapes necessitates that the role of different land uses in protecting forest be evaluated, along with the spatial interactions between land uses. However, such evaluations have been hindered by a lack of suitable analysis methodologies and data with fine spatial resolution over long time periods. We demonstrate the utility of a matching method with multiple categories to evaluate the role of alternative land uses in protecting forest. We also assessed the impact of land use change trajectories on the rate of deforestation. We employed data from Kalimantan (Indonesian Borneo) at three different time periods during 2000–2012 to illustrate our approach. Four single land uses (protected areas (PA), natural forest logging concessions (LC), timber plantation concessions (TC) and oil-palm plantation concessions (OC)) and two mixed land uses (mixed concessions and the overlap between concessions and PA) were assessed. The rate of deforestation was found to be lowest for PA, followed by LC. Deforestation rates for all land uses tended to be highest for locations that share the characteristics of areas in which TC or OC are located (e.g. degraded areas), suggesting that these areas are inherently more susceptible to deforestation due to foregone opportunities. Our approach provides important insights into how multifunctional landscapes can be designed to enhance the protection of biodiversity
Nut production in Bertholletia excelsa across a logged forest mosaic: implications for multiple forest use
Although many examples of multiple-use forest management may be found in tropical smallholder systems, few studies provide empirical support for the integration of selective timber harvesting with non-timber forest product (NTFP) extraction. Brazil nut (Bertholletia excelsa, Lecythidaceae) is one of the world’s most economically-important NTFP species extracted almost entirely from natural forests across the Amazon Basin. An obligate out-crosser, Brazil nut flowers are pollinated by large-bodied bees, a process resulting in a hard round fruit that takes up to 14 months to mature. As many smallholders turn to the financial security provided by timber, Brazil nut fruits are increasingly being harvested in logged forests. We tested the influence of tree and stand-level covariates (distance to nearest cut stump and local logging intensity) on total nut production at the individual tree level in five recently logged Brazil nut concessions covering about 4000 ha of forest in Madre de Dios, Peru. Our field team accompanied Brazil nut harvesters during the traditional harvest period (January-April 2012 and January-April 2013) in order to collect data on fruit production. Three hundred and ninety-nine (approximately 80%) of the 499 trees included in this study were at least 100 m from the nearest cut stump, suggesting that concessionaires avoid logging near adult Brazil nut trees. Yet even for those trees on the edge of logging gaps, distance to nearest cut stump and local logging intensity did not have a statistically significant influence on Brazil nut production at the applied logging intensities (typically 1–2 timber trees removed per ha). In one concession where at least 4 trees ha-1 were removed, however, the logging intensity covariate resulted in a marginally significant (0.09) P value, highlighting a potential risk for a drop in nut production at higher intensities. While we do not suggest that logging activities should be completely avoided in Brazil nut rich forests, when a buffer zone cannot be observed, low logging intensities should be implemented. The sustainability of this integrated management system will ultimately depend on a complex series of socioeconomic and ecological interactions. Yet we submit that our study provides an important initial step in understanding the compatibility of timber harvesting with a high value NTFP, potentially allowing for diversification of forest use strategies in Amazonian Perù
Joint effects of climate, tree size, and year on annual tree growth derived from tree-ring records of ten globally distributed forests
Atmospheric sulfur cycling in the southeastern Pacific – longitudinal distribution, vertical profile, and diel variability observed during VOCALS-REx
Dimethylsulfide (DMS) emitted from the ocean is a biogenic precursor gas for sulfur dioxide (SO<sub>2</sub>) and non-sea-salt sulfate aerosols (SO<sub>4</sub><sup>2&minus;</sup>). During the VAMOS-Ocean-Cloud-Atmosphere-Land Study Regional Experiment (VOCALS-REx) in 2008, multiple instrumented platforms were deployed in the Southeastern Pacific (SEP) off the coast of Chile and Peru to study the linkage between aerosols and stratocumulus clouds. We present here observations from the NOAA Ship <i>Ronald H. Brown</i> and the NSF/NCAR C-130 aircraft along ~20° S from the coast (70° W) to a remote marine atmosphere (85° W). While SO<sub>4</sub><sup>2&minus;</sup> and SO<sub>2</sub> concentrations were distinctly elevated above background levels in the coastal marine boundary layer (MBL) due to anthropogenic influence (~800 and 80 pptv, respectively), their concentrations rapidly decreased west of 78° W (~100 and 25 pptv). In the remote region, entrainment from the free troposphere (FT) increased MBL SO<sub>2</sub> burden at a rate of 0.05 &plusmn; 0.02 μmoles m<sup>&minus;2</sup> day<sup>&minus;1</sup> and diluted MBL SO<sub>4</sub><sup>2</sup> burden at a rate of 0.5 &plusmn; 0.3 μmoles m<sup>&minus;2</sup> day<sup>&minus;1</sup>, while the sea-to-air DMS flux (3.8 &plusmn; 0.4 μmoles m<sup>&minus;2</sup> day<sup>&minus;1</sup>) remained the predominant source of sulfur mass to the MBL. In-cloud oxidation was found to be the most important mechanism for SO<sub>2</sub> removal and in situ SO<sub>4</sub><sup>2&minus;</sup> production. Surface SO<sub>4</sub><sup>2&minus;</sup> concentration in the remote MBL displayed pronounced diel variability, increasing rapidly in the first few hours after sunset and decaying for the rest of the day. We theorize that the increase in SO<sub>4</sub><sup>2&minus;</sup> was due to nighttime recoupling of the MBL that mixed down cloud-processed air, while decoupling and sporadic precipitation scavenging were responsible for the daytime decline in SO<sub>4</sub><sup>2&minus;</sup>
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