| 1. |
- Aad, G., et al.
(author)
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- 2010
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swepub:Mat__t
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| 2. |
- Aad, G., et al.
(author)
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- 2010
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swepub:Mat__t
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| 3. |
- Tabiri, S, et al.
(author)
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- 2021
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swepub:Mat__t
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| 4. |
- Bravo, L, et al.
(author)
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- 2021
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swepub:Mat__t
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| 5. |
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| 6. |
- Bousquet, Jean, et al.
(author)
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Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology
- 2019
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In: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 143:3, s. 864-879
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Journal article (peer-reviewed)abstract
- Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
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| 7. |
- Menditto, Enrica, et al.
(author)
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Adherence to treatment in allergic rhinitis using mobile technology : The MASK Study
- 2019
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In: Clinical and Experimental Allergy. - : WILEY. - 0954-7894 .- 1365-2222. ; 49:4, s. 442-460
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Journal article (peer-reviewed)abstract
- Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC <= 1.25), 51 (4.23%) were partly adherent (MPR >= 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.
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| 8. |
- Cossarizza, A., et al.
(author)
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Guidelines for the use of flow cytometry and cell sorting in immunological studies (second edition)
- 2019
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In: European Journal of Immunology. - : Wiley. - 0014-2980 .- 1521-4141. ; 49:10, s. 1457-1973
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Journal article (peer-reviewed)abstract
- These guidelines are a consensus work of a considerable number of members of the immunology and flow cytometry community. They provide the theory and key practical aspects of flow cytometry enabling immunologists to avoid the common errors that often undermine immunological data. Notably, there are comprehensive sections of all major immune cell types with helpful Tables detailing phenotypes in murine and human cells. The latest flow cytometry techniques and applications are also described, featuring examples of the data that can be generated and, importantly, how the data can be analysed. Furthermore, there are sections detailing tips, tricks and pitfalls to avoid, all written and peer-reviewed by leading experts in the field, making this an essential research companion.
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| 9. |
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| 10. |
- Bousquet, J, et al.
(author)
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Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies
- 2020
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In: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 10:1, s. 58-
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Journal article (peer-reviewed)abstract
- There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.
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| 11. |
- Bousquet, J., et al.
(author)
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Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)
- 2016
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In: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 6:1, s. 1-18
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Research review (peer-reviewed)abstract
- Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.
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| 12. |
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| 13. |
- Bousquet, J., et al.
(author)
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Building Bridges for Innovation in Ageing : Synergies between Action Groups of the EIP on AHA
- 2017
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In: The Journal of Nutrition, Health & Aging. - : Springer Nature. - 1279-7707 .- 1760-4788. ; 21:1, s. 92-104
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Journal article (peer-reviewed)abstract
- The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Ramenghi, U., et al.
(author)
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Diamond-Blackfan anaemia in the Italian population
- 1999
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In: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 104:4, s. 841-8
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Journal article (peer-reviewed)abstract
- Diamond-Blackfan anaemia (DBA) is a congenital disease characterized by defective erythroid progenitor maturation: 30% of patients have congenital malformations. The link between these malformations and defective erythropoiesis is unclear: a defect in a molecule acting both on embryo development and haemopoiesis has been proposed. Inheritance is autosomal dominant in most familial cases, but recessive families have also been reported. Many cases are sporadic. A DBA locus has been mapped on chromosome 19q13.2 (Gustavsson et al, 1997), but several families unlinked to this locus have also been reported (Gustavsson et al, 1998). This paper presents clinical, epidemiological and molecular data for DBA in the Italian population. Segregation analysis of 19q markers in patients with DBA showed exclusion of this locus in 5/12 families with inherited DBA. There was evidently locus heterogeneity for DBA in this population. A new microdeletion was identified in one patient. Other families, in which DBA segregates concordantly with the 19q critical region, suggest incomplete penetrance and expressivity of the DBA gene.
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| 19. |
- Bousquet, J. Jean, et al.
(author)
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Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases
- 2019
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In: Clinical and Translational Allergy. - : BMC. - 2045-7022. ; 9
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Research review (peer-reviewed)abstract
- Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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| 20. |
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| 21. |
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| 22. |
- Aradi, Daniel, et al.
(author)
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Platelet function testing in acute cardiac care - is there a role for prediction or prevention of stent thrombosis and bleeding?
- 2015
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In: Thrombosis and Haemostasis. - 0340-6245 .- 2567-689X. ; 113:2, s. 221-230
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Journal article (peer-reviewed)abstract
- The role of platelet function testing in acute coronary syndrome patients undergoing percutaneous coronary intervention remains controversial despite the fact that high platelet reactivity is an independent predictor of stent thrombosis and emerging evidence suggests also a link between low platelet reactivity and bleeding. In this expert opinion paper, the Study Group on Biomarkers in Cardiology of the Acute Cardiovascular Care Association and the Working Group on Thrombosis of the European Society of Cardiology aim to provide an overview of current evidence in this area and recommendations for practicing clinicians.
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| 23. |
- Bousquet, Jean, et al.
(author)
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ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice
- 2021
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In: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:1, s. 168-190
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Research review (peer-reviewed)abstract
- Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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| 24. |
- Clason, Caroline C., et al.
(author)
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Modelling the transfer of supraglacial meltwater to the bed of Leverett Glacier, Southwest Greenland
- 2015
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In: The Cryosphere. - : Copernicus GmbH. - 1994-0416 .- 1994-0424. ; 9:1, s. 123-138
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Journal article (peer-reviewed)abstract
- Meltwater delivered to the bed of the Greenland Ice Sheet is a driver of variable ice-motion through changes in effective pressure and enhanced basal lubrication. Ice surface velocities have been shown to respond rapidly both to meltwater production at the surface and to drainage of supraglacial lakes, suggesting efficient transfer of meltwater from the supraglacial to subglacial hydrological systems. Although considerable effort is currently being directed towards improved modelling of the controlling surface and basal processes, modelling the temporal and spatial evolution of the transfer of melt to the bed has received less attention. Here we present the results of spatially distributed modelling for prediction of moulins and lake drainages on the Leverett Glacier in Southwest Greenland. The model is run for the 2009 and 2010 ablation seasons, and for future increased melt scenarios. The temporal pattern of modelled lake drainages are qualitatively comparable with those documented from analyses of repeat satellite imagery. The modelled timings and locations of delivery of meltwater to the bed also match well with observed temporal and spatial patterns of ice surface speed-ups. This is particularly true for the lower catchment (< 1000 m a.s.l.) where both the model and observations indicate that the development of moulins is the main mechanism for the transfer of surface meltwater to the bed. At higher elevations (e.g. 1250-1500 m a.s.l.) the development and drainage of supraglacial lakes becomes increasingly important. At these higher elevations, the delay between modelled melt generation and subsequent delivery of melt to the bed matches the observed delay between the peak air temperatures and subsequent velocity speed-ups, while the instantaneous transfer of melt to the bed in a control simulation does not. Although both moulins and lake drainages are predicted to increase in number for future warmer climate scenarios, the lake drainages play an increasingly important role in both expanding the area over which melt accesses the bed and in enabling a greater proportion of surface melt to reach the bed.
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| 25. |
- Clift, Roland, et al.
(author)
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The Challenges of Applying Planetary Boundaries as a Basis for Strategic Decision-Making in Companies with Global Supply Chains
- 2017
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In: Sustainability. - : MDPI AG. - 2071-1050. ; 9:2
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Journal article (peer-reviewed)abstract
- The Planetary Boundaries (PB) framework represents a significant advance in specifying the ecological constraints on human development. However, to enable decision-makers in business and public policy to respect these constraints in strategic planning, the PB framework needs to be developed to generate practical tools. With this objective in mind, we analyse the recent literature and highlight three major scientific and technical challenges in operationalizing the PB approach in decision-making: first, identification of thresholds or boundaries with associated metrics for different geographical scales; second, the need to frame approaches to allocate fair shares in the 'safe operating space' bounded by the PBs across the value chain and; third, the need for international bodies to co-ordinate the implementation of the measures needed to respect the Planetary Boundaries. For the first two of these challenges, we consider how they might be addressed for four PBs: climate change, freshwater use, biosphere integrity and chemical pollution and other novel entities. Four key opportunities are identified: (1) development of a common system of metrics that can be applied consistently at and across different scales; (2) setting 'distance from boundary' measures that can be applied at different scales; (3) development of global, preferably open-source, databases and models; and (4) advancing understanding of the interactions between the different PBs. Addressing the scientific and technical challenges in operationalizing the planetary boundaries needs be complemented with progress in addressing the equity and ethical issues in allocating the safe operating space between companies and sectors.
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| 26. |
- Cowie, MR, et al.
(author)
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Clinical applications of B-type natriuretic peptide (BNP) testing
- 2003
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In: European Heart Journal. - 0195-668X .- 1522-9645. ; 24:19, s. 1710-1718
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Journal article (peer-reviewed)abstract
- Many claims have been made in recent years regarding the utility of plasma B-type natriuretic peptide (BNP) concentration measurements in the diagnosis, risk stratification and monitoring of patients with heart failure. This paper summarizes the current evidence and provides guidance for practising clinicians. Overall, plasma BNP testing appears to be of most value in the diagnostic arena, where it is likely to improve the performance of non-specialist physicians in diagnosing heart failure. In clinical practice, BNP testing is best used as a 'rule out' test for suspected cases of new heart failure in breathless patients presenting to either the outpatient or emergency care settings, it is not a replacement for echocardiography and full cardiological assessment, which will be required for patients with an elevated BNP concentration. Although work is ongoing in establishing the 'normal' values of BNP, heart failure appears to be highly unlikely below a plasma concentration of 100 pg/ml. However, as BNP levels rise with age and are affected by gender, comorbidity and drug therapy, the plasma BNP measurement should not be used in isolation from the clinical context.
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| 27. |
- Galland, Olivier, et al.
(author)
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Application of open-source photogrammetric software MicMac for monitoring surface deformation in laboratory models
- 2016
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In: Journal of Geophysical Research - Solid Earth. - 2169-9313 .- 2169-9356. ; 121:4, s. 2852-2872
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Journal article (peer-reviewed)abstract
- Quantifying deformation is essential inmodern laboratorymodels of geological systems. This paper presents a new laboratory monitoring method through the implementation of the open-source software MicMac, which efficiently implements photogrammetry in Structure-from-Motion algorithms. Critical evaluation is provided using results from two example laboratory geodesy scenarios: magma emplacement and strike-slip faulting. MicMac automatically processes images fromsynchronized cameras to compute time series of digital elevation models (DEMs) and orthorectified images of model surfaces. MicMac also implements digital image correlation to produce high-resolution displacements maps. The resolution of DEMs and displacement maps corresponds to the pixel size of the processed images. Using 24 MP cameras, the precision of DEMs and displacements is similar to 0.05mm on a 40 x 40 cm surface. Processing displacement maps with Matlab (R) scripts allows automatic fracturemapping on themonitored surfaces. MicMac also offers the possibility to integrate 3-Dmodels of excavated structures with the corresponding surface deformation data. The high resolution and high precision of MicMac results and the ability to generate virtual 3-D models of complex structures make it a very promising tool for quantitative monitoring in laboratory models of geological systems.
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| 28. |
- Jenull, Sabrina, et al.
(author)
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The histone chaperone HIR maintains chromatin states to control nitrogen assimilation and fungal virulence
- 2021
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In: Cell Reports. - : Elsevier BV. - 2211-1247. ; 36:3
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Journal article (peer-reviewed)abstract
- Adaptation to changing environments and immune evasion is pivotal for fitness of pathogens. Yet, the underlying mechanisms remain largely unknown. Adaptation is governed by dynamic transcriptional re-programming, which is tightly connected to chromatin architecture. Here, we report a pivotal role for the HIR histone chaperone complex in modulating virulence of the human fungal pathogen Candida albicans. Genetic ablation of HIR function alters chromatin accessibility linked to aberrant transcriptional responses to protein as nitrogen source. This accelerates metabolic adaptation and increases the release of extracellular proteases, which enables scavenging of alternative nitrogen sources. Furthermore, HIR controls fungal virulence, as HIR1 deletion leads to differential recognition by immune cells and hypervirulence in a mouse model of systemic infection. This work provides mechanistic insights into chromatin-coupled regulatory mechanisms that fine-tune pathogen gene expression and virulence. Furthermore, the data point toward the requirement of refined screening approaches to exploit chromatin modifications as antifungal strategies.
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| 29. |
- Krychtiuk, Konstantin A., et al.
(author)
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Biomarkers of coagulation and fibrinolysis in acute myocardial infarction : a joint position paper of the Association for Acute Cardio Vascular Care and the European Society of Cardiology Working Group on Thrombosis
- 2021
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In: European Heart Journal. - : Oxford University Press. - 2048-8726 .- 2048-8734. ; 10:3, s. 343-355
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Research review (peer-reviewed)abstract
- The formation of a thrombus in an epicardial artery may result in an acute myocardial infarction (AMI). Despite major advances in acute treatment using network approaches to allocate patients to timely reperfusion and optimal antithrombotic treatment, patients remain at high risk for thrombotic complications. Ongoing activation of the coagulation system as well as thrombin-mediated platelet activation may both play a crucial role in this context. Whether measurement of circulating biomarkers of coagulation and fibrinolysis could be useful for risk stratification in secondary prevention is currently not fully understood. In addition, measurement of such biomarkers could be helpful to identify thrombus formation as the leading mechanism for AMI. The introduction of biomarkers of myocardial injury such as high-sensitivity cardiac troponins made rule-out of AMI even more precise. However, elevated markers of myocardial injury cannot provide proof of a type 1 AMI, let alone thrombus formation. The combined measurement of markers of myocardial injury with biomarkers reflecting ongoing thrombus formation might be helpful for the fast and correct diagnosis of an atherothrombotic type 1 AMI. This position paper gives an overview of the current knowledge and possible role of biomarkers of coagulation and fibrinolysis for the diagnosis of AMI, risk stratification, and individualized treatment strategies in patients with AMI.
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| 30. |
- Mattsson, Tobias
(author)
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The dynamic emplacement of felsic magma in the upper crust
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Felsic magma intrudes earth’s upper crust through a variety of mechanisms. Magma intrusion growth and shape have mainly been explained in terms of host rock properties and intrusion depth, while considering the magma as an overpressurised fluid. However, volcanologists view a magma as a rheologically evolving fluid, which affects the magma flow in volcanic conduits. This thesis seeks to explore intrusion dynamics during magma emplacement by taking both the magma and the host rock into account. The first part of the thesis investigates the emplacement of the Sandfell laccolith/cryptodome, the Cerro Bayo cryptodome and the Mourne granite pluton. Both cryptodomes grew initially by inflation, which resulted in contact-parallel magma flow. Later during the emplacement, the rim of the intrusions viscously stalled as indicated by brecciation and fracturing in the intrusion rims, which then forced them to grow vertically. Our observations suggest that rheological changes in the magma during intrusion growth may control the shape of the cryptodomes/laccoliths. Previously proposed emplacement mechanisms of the Mourne Mountains granite pluton were tested by investigating host-rock deformation and the surrounding contact-metamorphic aureole. The aureole displays contact-metamorphic segregations that were later deformed by brecciation and shearing. The consistent regional fracture patterns in the pluton roof indicate that it was not widely domed, while the north-eastern wall of the pluton was deflected parallel to the strike of the contact. These observations suggest that multiple mechanisms emplaced the pluton, involving both floor subsidence and deflection of the roof and wall.The last part of the thesis studies the magma plumbing system to the Holuhraun 2014-15 eruption with mineral and whole-rock geochemistry and thermobarometry. The Holuhraun eruption was accompanied by subsidence in the Bárðarbunga caldera but occurred in the Askja volcanic system. Our results show that the Holuhraun eruption was fed from a vertically extensive magma plumbing system in the Bárðarbunga volcanic system.The works of this thesis highlight that felsic magma emplacement in the upper crust involves multiple and dynamic mechanisms that control the growth and shape of the intrusion and that the interplay between magma and host-rock properties needs to be considered.
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| 31. |
- McIntosh, Jennifer, et al.
(author)
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A case study of polypharmacy management in nine European countries : implications for change management and implementation
- 2018
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:4
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Journal article (peer-reviewed)abstract
- BACKGROUND: Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained.METHODS: Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases.RESULTS: Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation.CONCLUSION: Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.
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| 32. |
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| 33. |
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| 34. |
- Muschitiello, Francesco, et al.
(author)
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Enhanced ice sheet melting driven by volcanic eruptions during the last deglaciation
- 2017
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In: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 8
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Journal article (peer-reviewed)abstract
- Volcanic eruptions can impact the mass balance of ice sheets through changes in climate and the radiative properties of the ice. Yet, empirical evidence highlighting the sensitivity of ancient ice sheets to volcanism is scarce. Here we present an exceptionally well-dated annual glacial varve chronology recording the melting history of the Fennoscandian Ice Sheet at the end of the last deglaciation (similar to 13,200-12,000 years ago). Our data indicate that abrupt ice melting events coincide with volcanogenic aerosol emissions recorded in Greenland ice cores. We suggest that enhanced ice sheet runoff is primarily associated with albedo effects due to deposition of ash sourced from high-latitude volcanic eruptions. Climate and snow-pack mass-balance simulations show evidence for enhanced ice sheet runoff under volcanically forced conditions despite atmospheric cooling. The sensitivity of past ice sheets to volcanic ashfall highlights the need for an accurate coupling between atmosphere and ice sheet components in climate models.
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| 35. |
- Pearce, Danni M., et al.
(author)
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The glacial geomorphology of upper Godthabsfjord (Nuup Kangerlua) in southwest Greenland
- 2018
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In: Journal of Maps. - : Taylor & Francis. - 1744-5647. ; 14:2, s. 45-55
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Journal article (peer-reviewed)abstract
- The Greenland Ice Sheet (GrIS) is known to have experienced widespread retreat over the last century. Information on outlet glacier dynamics, prior to this, are limited due to both a lack of observations and a paucity of mapped or mappable deglacial evidence which restricts our understanding of centennial tomillennial timescale dynamics of the GrIS. Here we present glacial geomorphological mapping, for upper Godthabsfjord, covering 5800km(2) at a scale of 1:92,000, using a combination of ASTER GDEM V2, a medium-resolution DEM (error <10m horizontal and <6m vertical accuracy), panchromatic orthophotographs and ground truthing. This work provides a detailed geomorphological assessment for the area, compiled as a single map, comprising of moraines, meltwater channels, streamlined bedrock, sediment lineations, ice-dammed lakes, trimlines, terraces, gullied sediment and marine limits. Whilst some of the landforms have been previously identified, the new information presented here improves our understanding of ice margin behaviour and can be used for future numerical modelling and landform dating programmes.Data also form the basis for palaeoglaciological reconstructions and contribute towards understanding of the centennial to millennial timescale record of this sector of the GrIS.
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| 36. |
- Schofield, J. Edward, et al.
(author)
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Pushing the Limits : Palynological Investigations at the Margin of the Greenland Ice Sheet in the Norse Western Settlement
- 2022
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In: Environmental Archaeology. - : Routledge. - 1461-4103 .- 1749-6314. ; 27:2, s. 228-242
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Journal article (peer-reviewed)abstract
- This paper presents two high-resolution pollen records dating to ?AD 1000?1400 that reveal the impacts of Norse colonists on vegetation and landscape around a remote farmstead in the Western Settlement of Greenland. The study is centred upon a ?centralised farm? (ruin group V53d) in Austmannadalen, near the margin of the Greenland Ice Sheet (64?13?N, 49?49?W). The climate is low arctic and considered marginal in terms of its suitability for the type of pastoral agriculture that the Norse settlers introduced. The data reveal that at a short distance (?500?m) from the farm buildings, the palynological ?footprint? for settlement becomes extremely indistinct, the only clear palaeoenvironmental evidence for a human presence being elevated levels of microscopic charcoal. This contrasts with the Eastern Settlement, where a strong palynological signature for Norse landn?m is evident, from the local (individual farm) through to the regional (landscape) scale. The palynological data from Austmannadalen, and the Western Settlement more generally, imply that farming occurred at very low intensity. This aligns with ideas that promote the importance of hunting, and trade in valuable Arctic commodities (e.g. walrus ivory), ahead of a search for new pasture as the dominant motivation driving the Norse settlement of this region.
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