Social Sustainability, Past and Future

For a professional, educated non-academic audience, this book asks how our societies were caught in a socio-economic dynamic causing the sustainability conundrum. It develops an original view of social evolution as the history of human information-processing, studying the past to understand the present in order to deal with the future. This title is also available as Open Access

Durabilité et archéologie environnementale

Hervé Le Tellier —Redoux sur les pistes sans neige. Un homme skie sur l’herbe et sous le soleil, en moufles et en doudoune. Lui sait : tous ont tort, il fait froid. Claude Allègre est aux sports d’hiver. Check-list (lemonde.fr), 2 janvier 2007 avec l’aimable autorisation de son auteur et ayant droit. L’environnement, au risque de déplaire… Que cela plaise ou non, force est de constater que notre environnement est en train de changer. L’ouverture, dans le Grand Nord canadien, d’une route mar..

Un habitat perché et fortifié du Ve s. av. n. è. sur le mont Peigros, Sainte-Maxime (Var)

Au cours d’un siècle, le Ve av. n.è., qui voit les échanges économiques profondément modifiés par le commerce maritime et par l’activité économique des colons grecs de Marseille, l’habitat perché fortifié du Peigros témoigne, par son mobilier, de la persistance d’un mode de vie indigène, fondé sur des activités agro-pastorales, et peu tourné vers les échanges extérieurs. Édifié sur le sommet culminant des Maures orientales, il fait partie des sites fortifiés qui se situent sur le pourtour des Maures orientales et se range parmi les habitats fortifiés de petite dimension. La céramique importée de Marseille reste très minoritaire à côté d’une céramique modelée abondante. Les analyses palynologiques et carpologiques rendent compte d’un milieu de maquis en cours d’ouverture pour une agriculture de céréales et de légumineuses adaptée aux terrains pauvres et de prairies d’élevage.During the Vth century BC, economic exchanges are deeply modified by the expansion of the sea trade and by the economic activity of the Greeks of Massilia. However, the fortified hilltop settlement of le Peigros illustrates a traditional indigenous way of life, based upon an agro-pastoral activity, and barely dealing with outside imports. Settled on the highest point of Les Maures orientales ranges, it is located on the margins of this range, as all other known fortified sites. The Greek imported ceramic from Massilia remains scarce in comparison with the numerous hand-made common forms. Pollens and macro-remains analyses shed light on a maquis landscape partially cleared for cereals and pulses cultivation and grazing

All options, not silver bullets, needed to limit global warming to 1.5 °C: a scenario appraisal

Climate science provides strong evidence of the necessity of limiting global warming to 1.5 °C, in line with the Paris Climate Agreement. The IPCC 1.5 °C special report (SR1.5) presents 414 emissions scenarios modelled for the report, of which around 50 are classified as '1.5 °C scenarios', with no or low temperature overshoot. These emission scenarios differ in their reliance on individual mitigation levers, including reduction of global energy demand, decarbonisation of energy production, development of land-management systems, and the pace and scale of deploying carbon dioxide removal (CDR) technologies. The reliance of 1.5 °C scenarios on these levers needs to be critically assessed in light of the potentials of the relevant technologies and roll-out plans. We use a set of five parameters to bundle and characterise the mitigation levers employed in the SR1.5 1.5 °C scenarios. For each of these levers, we draw on the literature to define 'medium' and 'high' upper bounds that delineate between their 'reasonable', 'challenging' and 'speculative' use by mid century. We do not find any 1.5 °C scenarios that stay within all medium upper bounds on the five mitigation levers. Scenarios most frequently 'over use' CDR with geological storage as a mitigation lever, whilst reductions of energy demand and carbon intensity of energy production are 'over used' less frequently. If we allow mitigation levers to be employed up to our high upper bounds, we are left with 22 of the SR1.5 1.5 °C scenarios with no or low overshoot. The scenarios that fulfil these criteria are characterised by greater coverage of the available mitigation levers than those scenarios that exceed at least one of the high upper bounds. When excluding the two scenarios that exceed the SR1.5 carbon budget for limiting global warming to 1.5 °C, this subset of 1.5 °C scenarios shows a range of 15–22 Gt CO2 (16–22 Gt CO2 interquartile range) for emissions in 2030. For the year of reaching net zero CO2 emissions the range is 2039–2061 (2049–2057 interquartile range)

The Development of Practice Recommendations for Drug-Disease Interactions by Literature Review and Expert Opinion

Background Drug-disease interactions negatively affect the benefit/risk ratio of drugs for specific populations. In these conditions drugs should be avoided, adjusted, or accompanied by extra monitoring. The motivation for many drug-disease interactions in the Summary of Product Characteristics (SmPC) is sometimes insufficiently supported by (accessible) evidence. As a consequence the translation of SmPC to clinical practice may lead to non-specific recommendations. For the translation of this information to the real world, it is necessary to evaluate the available knowledge about drug-disease interactions, and to formulate specific recommendations for prescribers and pharmacists. The aim of this paper is to describe a standardized method how to develop practice recommendations for drug-disease interactions by literature review and expert opinion. Methods The development of recommendations for drug-disease interactions will follow a six-step plan involving a multidisciplinary expert panel (1). The scope of the drug-disease interaction will be specified by defining the disease and by describing relevant effects of this drug-disease interaction. Drugs possibly involved in this drug-disease interaction are selected by checking the official product information, literature, and expert opinion (2). Evidence will be collected from the official product information, guidelines, handbooks, and primary literature (3). Study characteristics and outcomes will be evaluated and presented in standardized reports, including preliminary conclusions on the clinical relevance and practice recommendations (4). The multidisciplinary expert panel will discuss the reports and will either adopt or adjust the conclusions (5). Practice recommendations will be integrated in clinical decision support systems and published (6). The results of the evaluated drug-disease interactions will remain up-to-date by screening new risk information, periodic literature review, and (re)assessments initiated by health care providers. Actionable Recommendations The practice recommendations will result in advices for specific DDSI. The content and considerations of these DDSIs will be published and implemented in all Clinical Decision Support Systems in the Netherlands. Discussion The recommendations result in professional guidance in the context of individual patient care. The professional will be supported in the decision making in concerning pharmacotherapy for the treatment of a medical problem, and the clinical risks of the proposed medication in combination with specific diseases

The Development of Practice Recommendations for Drug-Disease Interactions by Literature Review and Expert Opinion

Background: Drug-disease interactions negatively affect the benefit/risk ratio of drugs for specific populations. In these conditions drugs should be avoided, adjusted, or accompanied by extra monitoring. The motivation for many drug-disease interactions in the Summary of Product Characteristics (SmPC) is sometimes insufficiently supported by (accessible) evidence. As a consequence the translation of SmPC to clinical practice may lead to non-specific recommendations. For the translation of this information to the real world, it is necessary to evaluate the available knowledge about drug-disease interactions, and to formulate specific recommendations for prescribers and pharmacists. The aim of this paper is to describe a standardized method how to develop practice recommendations for drug-disease interactions by literature review and expert opinion. Methods: The development of recommendations for drug-disease interactions will follow a six-step plan involving a multidisciplinary expert panel (1). The scope of the drug-disease interaction will be specified by defining the disease and by describing relevant effects of this drug-disease interaction. Drugs possibly involved in this drug-disease interaction are selected by checking the official product information, literature, and expert opinion (2). Evidence will be collected from the official product information, guidelines, handbooks, and primary literature (3). Study characteristics and outcomes will be evaluated and presented in standardized reports, including preliminary conclusions on the clinical relevance and practice recommendations (4). The multidisciplinary expert panel will discuss the reports and will either adopt or adjust the conclusions (5). Practice recommendations will be integrated in clinical decision support systems and published (6). The results of the evaluated drug-disease interactions will remain up-to-date by screening new risk information, periodic literature review, and (re)assessments initiated by health care providers. Actionable Recommendations: The practice recommendations will result in advices for specific DDSI. The content and considerations of these DDSIs will be published and implemented in all Clinical Decision Support Systems in the Netherlands. Discussion: The recommendations result in professional guidance in the context of individual patient care. The professional will be supported in the decision making in concerning pharmacotherapy for the treatment of a medical problem, and the clinical risks of the proposed medication in combination with specific diseases

Climate change: the necessary, the possible and the desirable Earth League climate statement on the implications for climate policy from the 5th IPCC Assessment

The development of human civilisations has occurred at a time of stable climate. This climate stability is now threatened by human activity. The rising global climate risk occurs at a decisive moment for world development. World nations are currently discussing a global development agenda consequent to the Millennium Development Goals (MDGs), which ends in 2015. It is increasingly possible to envisage a world where absolute poverty is largely eradicated within one generation and where ambitious goals on universal access and equal opportunities for dignified lives are adopted. These grand aspirations for a world population approaching or even exceeding nine billion in 2050 is threatened by substantial global environmental risks and by rising inequality. Research shows that development gains, in both rich and poor nations, can be undermined by social, economic and ecological problems caused by human-induced global environmental change. Climate risks, and associated changes in marine and terrestrial ecosystems that regulate the resilience of the climate system, are at the forefront of these global risks. We, as citizens with a strong engagement in Earth system science and socio-ecological dynamics, share the vision of a more equitable and prosperous future for the world, yet we also see threats to this future from shifts in climate and environmental processes. Without collaborative action now, our shared Earth system may not be able to sustainably support a large proportion of humanity in the decades ahead

Patient safety in Dutch primary care: a study protocol

<p>Abstract</p> <p>Background</p> <p>Insight into the frequency and seriousness of potentially unsafe situations may be the first step towards improving patient safety. Most patient safety attention has been paid to patient safety in hospitals. However, in many countries, patients receive most of their healthcare in primary care settings. There is little concrete information about patient safety in primary care in the Netherlands. The overall aim of this study was to provide insight into the current patient safety issues in Dutch general practices, out-of-hours primary care centres, general dental practices, midwifery practices, and allied healthcare practices. The objectives of this study are: to determine the frequency, type, impact, and causes of incidents found in the records of primary care patients; to determine the type, impact, and causes of incidents reported by Dutch healthcare professionals; and to provide insight into patient safety management in primary care practices.</p> <p>Design and methods</p> <p>The study consists of three parts: a retrospective patient record study of 1,000 records per practice type was conducted to determine the frequency, type, impact, and causes of incidents found in the records of primary care patients (objective one); a prospective component concerns an incident-reporting study in each of the participating practices, during two successive weeks, to determine the type, impact, and causes of incidents reported by Dutch healthcare professionals (objective two); to provide insight into patient safety management in Dutch primary care practices (objective three), we surveyed organizational and cultural items relating to patient safety. We analysed the incidents found in the retrospective patient record study and the prospective incident-reporting study by type of incident, causes (Eindhoven Classification Model), actual harm (severity-of-outcome domain of the International Taxonomy of Medical Errors in Primary Care), and probability of severe harm or death.</p> <p>Discussion</p> <p>To estimate the frequency of incidents was difficult. Much depended on the accuracy of the patient records and the professionals' consensus about which types of adverse events have to be recognized as incidents.</p

Innovations for Sustainability: Pathways to an efficient and post-pandemic future

3rd Report prepared by The World in 2050 initiativ