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- Ademuyiwa, Adesoji O., et al.
(author)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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- Dale, Virginia H., et al.
(author)
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Status and prospects for renewable energy using wood pellets from the southeastern United States
- 2017
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In: Global Change Biology Bioenergy. - : Wiley-Blackwell. - 1757-1693 .- 1757-1707. ; 9:8, s. 1296-1305
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Journal article (peer-reviewed)abstract
- The ongoing debate about costs and benefits of wood-pellet based bioenergy production in the southeastern United States (SE USA) requires an understanding of the science and context influencing market decisions associated with its sustainability. Production of pellets has garnered much attention as US exports have grown from negligible amounts in the early 2000s to 4.6 million metric tonnes in 2015. Currently, 98% of these pellet exports are shipped to Europe to displace coal in power plants. We ask, 'How is the production of wood pellets in the SE USA affecting forest systems and the ecosystem services they provide?' To address this question, we review current forest conditions and the status of the wood products industry, how pellet production affects ecosystem services and biodiversity, and what methods are in place to monitor changes and protect vulnerable systems. Scientific studies provide evidence that wood pellets in the SE USA are a fraction of total forestry operations and can be produced while maintaining or improving forest ecosystem services. Ecosystem services are protected by the requirement to utilize loggers trained to apply scientifically based best management practices in planning and implementing harvest for the export market. Bioenergy markets supplement incomes to private rural landholders and provide an incentive for forest management practices that simultaneously benefit water quality and wildlife and reduce risk of fire and insect outbreaks. Bioenergy also increases the value of forest land to landowners, thereby decreasing likelihood of conversion to nonforest uses. Monitoring and evaluation are essential to verify that regulations and good practices are achieving goals and to enable timely responses if problems arise. Conducting rigorous research to understand how conditions change in response to management choices requires baseline data, monitoring, and appropriate reference scenarios. Long-term monitoring data on forest conditions should be publicly accessible and utilized to inform adaptive management.
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- Englund, Oskar, et al.
(author)
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Multifunctional perennial production systems for bioenergy: performance and progress
- 2020
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In: Wiley Interdisciplinary Reviews. - : Wiley. - 2041-8396 .- 2041-840X.
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Journal article (peer-reviewed)abstract
- As the global population increases and becomes more affluent, biomass demands for food and biomaterials will increase. Demand growth is further accelerated by the implementation of climate policies and strategies to replace fossil resources with biomass. There are, however, concerns about the size of the prospective biomass demand and the environmental and social consequences of the corresponding resource mobilization, especially concerning impacts from the associated land-use change. Strategically integrating perennials into landscapes dominated by intensive agriculture can, for example, improve biodiversity, reduce soil erosion and nutrient emissions to water, increase soil carbon, enhance pollination, and avoid or mitigate flooding events. Such ?multifunctional perennial production systems? can thus contribute to improving overall land-use sustainability, while maintaining or increasing overall biomass productivity in the landscape. Seven different cases in different world regions are here reviewed to exemplify and evaluate (a) multifunctional production systems that have been established to meet emerging bioenergy demands, and (b) efforts to identify locations where the establishment of perennial crops will be particularly beneficial. An important barrier towards wider implementation of multifunctional systems is the lack of markets, or policies, compensating producers for enhanced ecosystem services and other environmental benefits. This deficiency is particularly important since prices for fossil-based fuels are low relative to bioenergy production costs. Without such compensation, multifunctional perennial production systems will be unlikely to contribute to the development of a sustainable bioeconomy.
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- Englund, Oskar, 1982
(author)
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On Sustainability of Biomass for Energy and the Governance Thereof
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Due to concerns about climate change, energy security, and resource scarcity, non- renewable resources are increasingly being displaced by biomass. As with most human activities, the production of biobased products can be associated with negative impacts. Primarily, this relates to the biomass supply systems, i.e., agriculture and forestry, which currently are major causes of biodiversity loss and degradation of ecosystem services. Developing sustainable production systems when transitioning from non-renewable resources to biomass is imperative. This thesis aims to clarify the meaning of sustainability in the context of biomass for bioenergy, and contribute to our understanding of how different forms of governance can promote sustainably sourced biomass for bioenergy. The thesis is based on five appended papers: Paper I analyses to what extent, where, and under what conditions oil palm for biodiesel in Brazil can be produced profitably, and what risks and opportunities that can be associated with introducing large-scale oil palm production in Brazil. Paper II lays the foundation for understanding how new biomass production can be introduced into landscapes while supporting rather than compromising the ability of the landscape to supply other ecosystem services. Paper III describes different forms of governance and shows how these can play different roles in promoting sustainable bioenergy in different countries. Paper IV focuses on how short rotation coppice production systems are affected by EU policy and how different governance forms can assist in adapting production systems to conform to the corresponding sustainability requirements. Finally, Paper V assesses how sustainability certification (private governance) addresses biodiversity conservation and contributes to our understanding of possible improvements.
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- Naylor, Mary D, et al.
(author)
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Advancing Alzheimer's disease diagnosis, treatment, and care: recommendations from the Ware Invitational Summit.
- 2012
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In: Alzheimer's & dementia : the journal of the Alzheimer's Association. - : Wiley. - 1552-5279. ; 8:5, s. 445-52
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Journal article (peer-reviewed)abstract
- To address the pending public health crisis due to Alzheimer's disease (AD) and related neurodegenerative disorders, the Marian S. Ware Alzheimer Program at the University of Pennsylvania held a meeting entitled "State of the Science Conference on the Advancement of Alzheimer's Diagnosis, Treatment and Care," on June 21-22, 2012. The meeting comprised four workgroups focusing on Biomarkers; Clinical Care and Health Services Research; Drug Development; and Health Economics, Policy, and Ethics. The workgroups shared, discussed, and compiled an integrated set of priorities, recommendations, and action plans, which are presented in this article.
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