Can we be certain about future land use change in Europe? A multi-scenario, integrated-assessment analysis.

The global land system is facing unprecedented pressures from growing human populations and climatic change. Understanding the effects these pressures may have is necessary to designing land management strategies that ensure food security, ecosystem service provision and successful climate mitigation and adaptation. However, the number of complex, interacting effects involved makes any complete understanding very difficult to achieve. Nevertheless, the recent development of integrated modelling frameworks allows for the exploration of the co-development of human and natural systems under scenarios of global change, potentially illuminating the main drivers and processes in future land system change. Here, we use one such integrated modelling framework (the CLIMSAVE Integrated Assessment Platform) to investigate the range of projected outcomes in the European land system across climatic and socio-economic scenarios for the 2050s. We find substantial consistency in locations and types of change even under the most divergent conditions, with results suggesting that climate change alone will lead to a contraction in the agricultural and forest area within Europe, particularly in southern Europe. This is partly offset by the introduction of socioeconomic changes that change both the demand for agricultural production, through changing food demand and net imports, and the efficiency of agricultural production. Simulated extensification and abandonment in the Mediterranean region is driven by future decreases in the relative profitability of the agricultural sector in southern Europe, owing to decreased productivity as a consequence of increased heat and drought stress and reduced irrigation water availability. The very low likelihood (< 33% probability) that current land use proportions in many parts of Europe will remain unchanged suggests that future policy should seek to promote and support the multifunctional role of agriculture and forests in different European regions, rather than focusing on increased productivity as a route to agricultural and forestry viability.

Presence of human non-polio enterovirus and parechovirus genotypes in an Amsterdam hospital in 2007 to 2011 compared to national and international published surveillance data: a comprehensive review.

Enteroviruses (EV) and human parechoviruses (HPeV) are endemic worldwide. These infections are a constant cause of hospitalisation and severe disease, predominantly in young children and infants. Coordinated monitoring and surveillance are crucial to control these infections. We have monitored EV and HPeV epidemiology in Amsterdam from 2007 to 2011 with real-time RT-PCR and direct genotyping, facilitating highly sensitive surveillance. Moreover, we conducted a literature survey of existing surveillance data for comparison. Only 14 studies were identified. While HPeV1 was most frequently detected in Amsterdam, EV-B viruses dominated nationally and internationally. Furthermore, the top 10 strains detected differed yearly and per study. However, detection and typing methods were too varied to allow direct comparison and comprehension of the worldwide distribution and circulation patterns of the different genotypes. This limited a direct response to anticipate peaks. Uniform European monitoring programmes are essential to aid prediction of outbreaks and disease management.

Comparing childhood leukaemia treatment before and after the introduction of a parental education programme in Indonesia.

SETTING: Previously, treatment and the results of treatment for childhood acute lymphoblastic leukaemia (ALL) in Indonesia differed significantly between poor and prosperous patients. Poor patients received less individual attention from oncologists and access to parental education and donated chemotherapy was lacking. INTERVENTION: A structured parental education programme for both poor and prosperous parents was introduced in January 2004 to improve access to parental education and donated chemotherapy. The programme consisted of a video presentation, an information booklet, DVD, audiocassette, a statement-of-understanding for donated chemotherapy, and a complaints procedure. Informed consent was also sought. OBJECTIVE: Our study compared childhood ALL treatment outcome before and after the introduction of the parental education programme. DESIGN: The medical records of 283 children with ALL diagnosed before (1997-2002; n = 164) and after (2004-2006; n = 119) the introduction of the education programme were reviewed. Data on treatment results and parental socioeconomic status were collected. RESULTS: After the introduction of the education programme, treatment refusal decreased (from 14% to 2%) and event-free survival increased (from 13% to 29%) significantly among poor patients. Treatment dropout increased (from 0% to 13%) significantly among prosperous patients. Overall, toxic death (from 23% to 36%) increased significantly, but there was no significant difference in event-free survival. CONCLUSIONS: After introduction of the programme, treatment refusal decreased and event-free survival increased significantly among poor families. However, improved knowledge, skills and communication are still required to combat the high rates of toxic death and treatment dropout. Treatment intensity should be accompanied by improved supportive care.