How financial mechanisms can incentivize provision of ecosystem services from land restoration: A systematic review protocol.

The current food chain both contributes to, and is affected by, climate change. While GHG emissions and emissions to water and soil are a problem for the whole food chain, the majority of such emissions and the major solutions to them can be found in the farming and land use sector. The farming system needs to reduce its greenhouse-gas emissions and adapt its supply chain to cope with climate change. A broad variety of payment tools have been proposed to motivate farmers and landowners to take certain actions to reduce greenhouse gas emissions and encourage the protection or restoration of natural resources. The protocol described here (OSF preregistration https://doi.org/10.17605/OSF.IO/STGQ6) outlines the methodology for a systematic review to explore how financial mechanisms such as green bonds can provide incentives to agri-food sector to support environmental sustainability and ecosystem service delivery through land-use change. Our primary research question is: how do financial mechanisms incentivize land restoration? Studies will be categorized according to the types of financial mechanisms, their characteristics, methods of land restoration and their impact on mitigating agri-food footprint. The results are expected to increase our understanding about the design of financing tools currently used to accelerate nature restoration. Moreover, they will inform us about the effectiveness of deploying such tools on rural communities, food companies and landowners.

Technologic advances in the assessment and management of obstructive sleep apnoea beyond the apnoea-hypopnoea index: a narrative review.

Obstructive sleep apnoea (OSA) is a growing and serious worldwide health problem with significant health and socioeconomic consequences. Current diagnostic testing strategies are limited by cost, access to resources and over reliance on one measure, namely the apnoea-hypopnoea frequency per hour (AHI). Recent evidence supports moving away from the AHI as the principle measure of OSA severity towards a more personalised approach to OSA diagnosis and treatment that includes phenotypic and biological traits. Novel advances in technology include the use of signals such as heart rate variability (HRV), oximetry and peripheral arterial tonometry (PAT) as alternative or additional measures. Ubiquitous use of smartphones and developments in wearable technology have also led to increased availability of applications and devices to facilitate home screening of at-risk populations, although current evidence indicates relatively poor accuracy in comparison with the traditional gold standard polysomnography (PSG). In this review, we evaluate the current strategies for diagnosing OSA in the context of their limitations, potential physiological targets as alternatives to AHI and the role of novel technology in OSA. We also evaluate the current evidence for using newer technologies in OSA diagnosis, the physiological targets such as smartphone applications and wearable technology. Future developments in OSA diagnosis and assessment will likely focus increasingly on systemic effects of sleep disordered breathing (SDB) such as changes in nocturnal oxygen and blood pressure (BP); and may also include other factors such as circulating biomarkers. These developments will likely require a re-evaluation of the diagnostic and grading criteria for clinically significant OSA.

Risk and Planning in Agriculture: How Planning on Dairy Farms in Ireland Is Affected by Farmers' Regulatory Focus.

This article examines how planning on dairy farms is affected by farmers' motivation. It argues that farmers' choice of expansion strategies can be specified in terms of risk decision making and understood as either prevention-focused or promotion-focused motivation. This relationship was empirically examined using mediated regression analyses where promotion/prevention focus was the independent variable and its effect on total milk production via planned expansion strategies was examined. The results indicate that promotion focus among farmers has an indirect effect on farm expansion via planning strategies that incur greater risk to the farm enterprise. Regulatory focus on the part of farmers has an influence on farmers' planning and risk management activities and must be accounted for in the design and implementation of policy and risk management tools in agriculture.

Health policy and the policymaking system: A case study of primary care in Ireland.

In 2001 the Irish government published a reforming policy intended to modernise and expand the delivery of primary care in Ireland. Fifteen years later, the Irish health system remains beset by problems indicative of a fragmented and underdeveloped primary care system. This case study examines the formation and implementation of the 2001 primary care policy and identifies key risk categories within the policymaking process itself that inhibited the timely achievement of policy objectives. Our methodology includes a directed content analysis of the policy formation and implementation documents and the influencing academic literature, as well as semi-structured interviews with key personnel involved in the process. We identify three broad risk categories - power, resources and capability - within the policymaking process that strongly influenced policy formation and implementation. We additionally show that the disjoint between policy formation and policy implementation was a contested issue among those involved in the policy process and provided space for these risks to critically undermine Ireland's primary care policy.

A portable automated assessment tool for sleep apnea using a combined Holter-oximeter.

STUDY OBJECTIVES: Resource limitations have raised interest in portable monitoring systems that can be used by specialist sleep physicians as part of an overall strategy to improve access to the diagnosis of sleep apnea. This study validates a combined electrocardiogram and oximetry recorder (Holter-oximeter) against simultaneous polysomnography for detection of sleep apnea. DESIGN: Prospective study. SETTING: A dedicated sleep disorders unit. PARTICIPANTS: 59 adults presenting for evaluation of suspected sleep apnea. INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: An automated algorithm previously developed for sleep apnea detection was applied to the electrocardiogram and oximetry measurements. The algorithm provides (a) epoch-by-epoch estimates of apnea occurrence and (b) estimates of overall per-subject AHI. Using separate thresholds of AHI > or =15 and AHI <5 for defining clinically significant and insignificant sleep apnea, sensitivity, specificity, and likelihood ratios, conditional on positive or negative (but not indeterminate) test results were used to assess agreement between the proposed system and polysomnography. Sensitivity of 95.8% and specificity of 100% was achieved. Positive and negative likelihood ratios were >20 and 0.04 respectively, with 16.7% of subjects having intermediate test results (AHI 5-14/h). Regardless ofAHI, 85.3% of respiratory events were correctly annotated on an epoch-by-epoch basis. AHI underestimation bias was 0.9/h, and the antilogs of log-transformed limits of agreement were 0.3 and 2.7. Correlation between estimated and reference AHI was 0.95 (P <0.001). CONCLUSION: Combined Holter-oximeter monitoring compares well with polysomnography for identifying sleep apnea in an attended setting and is potentially suitable for home-based automated assessment of sleep apnea in a population suspected of having sleep apnea.

Contemporary terrorism: risk perception in the London options market.

Previous studies have a demonstrated a linkage between terrorist attacks and the operation of financial markets. This article focuses on terrorist events carried out over the last five years and examines how they have been perceived among participants on the London financial market. Data from the London options market suggest a high degree of sensitivity to these events. We argue that this sensitivity reveals a vulnerability in the financial markets should the recent trends in terrorist activity continue.