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1.  The future of the Amazon: new perspectives from climate, ecosystem and social sciences 
The potential loss or large-scale degradation of the tropical rainforests has become one of the iconic images of the impacts of twenty-first century environmental change and may be one of our century's most profound legacies. In the Amazon region, the direct threat of deforestation and degradation is now strongly intertwined with an indirect challenge we are just beginning to understand: the possibility of substantial regional drought driven by global climate change. The Amazon region hosts more than half of the world's remaining tropical forests, and some parts have among the greatest concentrations of biodiversity found anywhere on Earth. Overall, the region is estimated to host about a quarter of all global biodiversity. It acts as one of the major ‘flywheels’ of global climate, transpiring water and generating clouds, affecting atmospheric circulation across continents and hemispheres, and storing substantial reserves of biomass and soil carbon. Hence, the ongoing degradation of Amazonia is a threat to local climate stability and a contributor to the global atmospheric climate change crisis. Conversely, the stabilization of Amazonian deforestation and degradation would be an opportunity for local adaptation to climate change, as well as a potential global contributor towards mitigation of climate change. However, addressing deforestation in the Amazon raises substantial challenges in policy, governance, sustainability and economic science. This paper introduces a theme issue dedicated to a multidisciplinary analysis of these challenges.
doi:10.1098/rstb.2008.0011
PMCID: PMC2367686  PMID: 18267894
tropical forest; deforestation; climate change; fire; Amazonia; Brazil
2.  Setting standards of prescribing performance in primary care: use of a consensus group of general practitioners and application of standards to practices in the north of England. 
BACKGROUND: There is considerable variation in prescribing, and existing standards against which primary care prescribing is routinely judged consist largely of local or national averages. There is thus a need for more sophisticated standards, which must be widely applicable and have credibility among the general practice profession. AIM: A study aimed to develop a range of criteria of prescribing quality, to set standards of performance for these criteria, and apply these standards to practices. METHOD: A consensus group consisting of eight general practitioners and a resource team was convened to develop and define criteria and set standards of prescribing performance using prescribing analyses and cost (PACT) data. The standards were applied to 1992-93 prescribing data from all 518 practices in the former Northern Regional Health Authority. RESULTS: The group developed criteria and set numeric standards for 13 aspects of prescribing performance in four areas: generic prescribing, prescribing within specific therapeutic groups, drugs of limited clinical value and standards based on prescribing volume. Except for generic prescribing, standards for individual criteria were achieved by between 9% and 34% of practices. For each criterion, a score was allocated based on whether the standard was achieved or not. Total scores showed considerable variation between practices. The distribution of scores was similar between fundholding and non-fundholding practices, and also between dispensing and non-dispensing practices. CONCLUSION: Using a consensus group of general practitioners it is possible to agree criteria and standards of prescribing performance. This novel approach offers a professionally driven method for assessing the quality of prescribing in primary care.
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PMCID: PMC1239506  PMID: 8745847

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