Incorporating stakeholders' preferences into a multi-criteria framework for planning large-scale Nature-Based Solutions.

Hydro-meteorological risks are a growing issue for societies, economies and environments around the world. An effective, sustainable response to such risks and their future uncertainty requires a paradigm shift in our research and practical efforts. In this respect, Nature-Based Solutions (NBSs) offer the potential to achieve a more effective and flexible response to hydro-meteorological risks while also enhancing human well-being and biodiversity. The present paper describes a new methodology that incorporates stakeholders' preferences into a multi-criteria analysis framework, as part of a tool for selecting risk mitigation measures. The methodology has been applied to Tamnava river basin in Serbia and Nangang river basin in Taiwan within the EC-funded RECONECT project. The results highlight the importance of involving stakeholders in the early stages of projects in order to achieve successful implementation of NBSs. The methodology can assist decision-makers in formulating desirable benefits and co-benefits and can enable a systematic and transparent NBSs planning process.

Effects of oral zinc supplementation on patients with noise-induced hearing loss associated tinnitus: A clinical trial.

BACKGROUND: Zinc plays a vital antioxidant role in human metabolism. Recent studies have demonstrated a correlation between noise-induced hearing loss (NIHL) and oxidative injury; however, no investigation has focused specifically on the subgroup of NIHL associated tinnitus patients. We aimed to evaluate the effectiveness of zinc supplementation in treating NIHL associated tinnitus. METHODS: Twenty patients with tinnitus and a typical NIHL audiogram (38 ears) were included in this study. Another 20 healthy subjects were used as the control group. A full medical history assessment was performed, and each subject underwent an otoscopic examination, basic audiologic evaluation, distortion product otoacoustic emissions (DPOAEs), tinnitus-match testing, Tinnitus Handicap Inventory (THI) and serum zinc level analyses. After 2 months of treatment with zinc, all tests were repeated. RESULTS: There was a significant difference between pretreatment and post-treatment within the tinnitus group (73.6 vs. 84.6 µg/dl). The pre- and post-treatment difference in serum zinc was significantly higher in the young group (≦50 years) compared to the old group (19.4 ± 11.4 vs. 2.6 ± 9.2 µg/dl, respectively; p = 0.002). There were no statistically significant differences in hearing thresholds, speech reception thresholds, or tinnitus frequency and loudness results before and after treatment. In addition, 17 patients (85%) showed statistically significant improvement of THI-total scores post-treatment, from 38.3 to 30 (p = 0.024). CONCLUSIONS: Zinc oral supplementation elevated serum zinc levels, especially in younger patients. THI scores improved significantly following zinc treatment in patients with NIHL associated tinnitus. However, no improvements in objective hearing parameters were observed.