Capturing elements of the Nature Futures Framework through in situ place descriptions:An empirical study in urban blue locations

Human-nature interaction is in constant flux, and capturing the present perceptions and imaginaries of urban nature could facilitate the development of scenarios that ensure positive futures for both nature and humans. This paper explores the feasibility of inferring and operationalizing the three key values of the Nature Futures Framework – Nature for Society, Nature as Culture, and Nature for Nature – through the language in place descriptions and place transformation suggestions, collected in situ in 57 urban blue spaces as part of a pilot citizen science project in the Netherlands. We suggest that cross-pollination between research working towards capturing place facets in natural discourse and the Nature Futures Framework has the potential to provide effective means for a better understanding and visualization of individual and collective nature-related values hold within communities in particular places, leading to transformations of urban nature in a way that is beneficial to both humans and nature

Interplay between land-use dynamics and changes in hydrological regime in the Vietnamese Mekong Delta

Policies supporting rice production and investments in water infrastructure enabled intensification and diversification of farming systems in the Vietnamese Mekong Delta (VMD) over the past 20 years. Yet, demands of food security, economic development, and climate change continue to pose diverging and often conflicting challenges for water resources management in the upper, central, and coastal zones of the delta. The major changes effected in the VMD’s hydrological regime and land-use patterns are acknowledged in the literature, but few studies have examined the interplay between these dynamics at the delta scale. Based on time-series maps and statistical data on land-use, flooding, and salinity intrusion, we investigated the interrelations between land-use dynamics and changes in hydrological regime across the VMD in three representative periods. Land-use was found to be highly variable, changing by 14.94% annually between 2001 and 2012. Rice cropping underwent the greatest change, evolving from single cropping of traditional varieties towards double and triple cropping of high-yielding varieties. Aquaculture remained stable after rapid expansion in the 1990s and early 2000s. Meanwhile, flooding and salinity intrusion were increasingly controlled by hydrological infrastructure erected to supply freshwater for agriculture. Effects of this infrastructure became particularly evident from 2001 to 2012. During this period, spatial and temporal impacts on flooding and salinity intrusion were found, which extended beyond the rice fields to affect adjacent lands and livelihood activities. Unforeseen effects will likely be aggravated by climate change, suggesting a need to rethink the scale of planning towards a more integrated hydrologic approach

Decompressing Stoma as Bridge to Elective Surgery is an Effective Strategy for Left-sided Obstructive Colon Cancer:A National, Propensity-score Matched Study

OBJECTIVE: The purpose of this population-based study was to compare decompressing stoma (DS) as bridge to surgery (BTS) with emergency resection (ER) for left-sided obstructive colon cancer (LSOCC) using propensity-score matching. SUMMARY BACKGROUND DATA: Recently, an increased use of DS as BTS for LSOCC has been observed in the Netherlands. Unfortunately, good quality comparative analyses with ER are scarce. METHODS: Patients diagnosed with nonlocally advanced LSOCC between 2009 and 2016 in 75 Dutch hospitals, who underwent DS or ER in the curative setting, were propensity-score matched in a 1:2 ratio. The primary outcome measure was 90-day mortality, and main secondary outcomes were 3-year overall survival and permanent stoma rate. RESULTS: Of 2048 eligible patients, 236 patients who underwent DS were matched with 472 patients undergoing ER. After DS, more laparoscopic resections were performed (56.8% vs 9.2%, P < 0.001) and more primary anastomoses were constructed (88.5% vs 40.7%, P < 0.001). DS resulted in significantly lower 90-day mortality compared to ER (1.7% vs 7.2%, P = 0.006), and this effect could be mainly attributed to the subgroup of patients over 70 years (3.5% vs 13.7%, P = 0.027). Patients treated with DS as BTS had better 3-year overall survival (79.4% vs 73.3%, hazard ratio 0.36, 95% confidence interval 0.20-0.65) and fewer permanent stomas (23.4% vs 42.4%, P < 0.001). CONCLUSIONS: In this nationwide propensity-score matched study, DS as a BTS for LSOCC was associated with lower 90-day mortality and better 3-year overall survival compared to ER, especially in patients over 70 years of age

Treatment of refractory post-esophagectomy anastomotic esophageal strictures using temporary fully covered esophageal metal stenting compared to repeated bougie dilation: results of a randomized controlled trial

Background and study aims Fully covered self-expanding metal stents (FCSEMS) provide an alternative to bougie dilation (BD) for refractory benign esophageal strictures. Controlled studies comparing temporary placement of FCSES to repeated BD are not available. Patients and methods Patients with refractory anastomotic esophageal strictures, dysphagia scores ≥ 2, and two to five prior BD were randomized to 8 weeks of FCSEMS or to repeated BD. The primary endpoint was the number of BD during the 12 months after baseline treatment. Results Eighteen patients were included (male 67 %, median age 66.5; 9 received metal stents, 9 received BD). Technical success rate of stent placement and stent removal was 100 %. Recurrent dysphagia occurred in 13 patients (72 %) during follow-up. No significant difference was found between the stent and BD groups for mean number of BD during follow-up (5.4 vs. 2.4, P = 0.159), time to recurrent dysphagia (median 36 days vs. 33 days, Kaplan-Meier: P = 0.576) and frequency of reinterventions per month (median 0.3 vs. 0.2, P = 0.283). Improvement in quality of life score was greater in the stent group compared to the BD group at month 12 (median 26 % vs. 4 %, P = 0.011). Conclusions The current data did not provide evidence for a statistically significant difference between the two groups in the number of BD during the 12 months after initial treatment. Metal stenting offers greater improvement in quality of life from baseline at 12 months compared to repeated BD for patients with refractory anastomotic esophageal stricture

Intensive Case Finding and Isoniazid Preventative Therapy in HIV Infected Individuals in Africa: Economic Model and Value of Information Analysis

Background: Tuberculosis (TB) accounts of much of the morbidity and mortality associated with HIV. We evaluate the costeffectiveness of different strategies to actively screen for TB disease in HIV positive individuals, where isoniazid preventative therapy (IPT) is given to those screening negative, and use value of information analysis (VOI) to identify future research priorities. Methodology / Principal Findings: We built an individual sampling model to investigate the costs (2010 US Dollars) and consequences of screening for TB, and providing TB treatment or IPT in adults testing HIV positive in Sub-Saharan Africa. A systematic review and meta-analysis was conducted to assess performance of the nine different TB screening strategies evaluated. Probabilistic sensitivity analysis was conducted to incorporate decision uncertainty, and expected value of perfect information for the entire model and for groups of parameters was calculated. Screening all HIV infected individuals with sputum microscopy was the least costly strategy, with other strategies not cost-effective at WHO recommended thresholds. Screening those with TB symptoms with sputum microscopy and CXR would be cost-effective at a threshold ICER of $7,800 per quality-adjusted life year (QALY), but associated with significant uncertainty. VOI analysis suggests further information would be of value. Conclusions / Significance: Resource-constrained countries in sub-Saharan Africa wishing to scale up TB preventativ