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PubMed2000

Radon in Wisconsin.

Owners of about 15% to 20% of the homes in Wisconsin have tested their indoor air for the carcinogenic gas radon. Five percent to 10% of homes have year-average main-floor radon levels that exceed the US Environmental Protection Agency (EPA) exposure guideline, and they are found in most regions of the state. Attempting to retroactively seal foundations to keep radon from the ground out of a home is largely ineffective. However, a soil-depressurization radon mitigation system is highly effective for existing houses, and new homes can easily be built radon-resistant. As the number of homeowners obtaining needed repairs increases, significant lung cancer risk reduction is being achieved in a voluntary, non-regulatory setting. In coming years, as radon in community drinking water supplies becomes regulated under the federal 1996 Safe Drinking Water Act, the "multimedia" option of the act may result in additional attention to mitigation of radon in indoor air.

Carcinogens, Environmental↗
PubMed2001

TP-10 (AVANT Immunotherapeutics).

AVANT Immunotherapeutics is developing TP-10, a recombinant soluble complement receptor type 1 (sCR1), for the potential treatment of reperfusion injury (following surgery, ischemic disease and organ transplantation), organ rejection, acute inflammatory injury to the lungs and autoimmune diseases [348669]. TP-10 has been awarded Orphan Drug status from the FDA for the prevention and reduction of adult respiratory distress syndrome (ARDS) and as a treatment for infants undergoing cardiac surgery [180849], [359588]. A placebo-controlled phase II trial, conducted at approximately 30 sites in the US and involving approximately 600 adult patients undergoing cardiac surgery utilizing cardiopulmonary bypass, was initiated in November 2000. This safety and efficacy study was designed to assess the ability of TP-10 to mitigate the injury to the heart, brain and other organs that occurs when patients are placed on cardiopulmonary bypass circuits, thus potentially improving postoperative outcomes [391437]. In September 2000, the company was planning a double-blind, placebo controlled phase IIb trial in infants undergoing cardiac surgery; AVANT expected to initiated in 30 infants in January 2001 [395086]. The data from this trial will enable the company to further define its clinical endpoints before inititating a pivotal phase III trial in 2001 [382529]. A phase I/II trial of TP-10 involving 15 infants, under 12 months of age, undergoing cardiac surgery for congenital heart defects was initiated by the company in September 1999. The trial will evaluate the ability of TP-10 to mitigate the injury to the heart and other organs when patients are placed on cardiopulmonary bypass circuits [340602]. Enrollment was complete by January 2000 [352458]. Phase I safety trials of TP-10, including studies in adult patients at risk for adult respiratory distress syndrome (ARDS), adult patients with first-time myocardial infarction (heart attack), and pediatric patients undergoing cardiac surgery demonstrated that TP-10 is well tolerated. However, after completion, in December 1997, of a phase IIa trial in nine patients with ARDS, AVANT decided to cease development for this indication. TP-10 was licensed to Novartis AG for use in xeno- and allotransplantation in July 1999. Extensive animal studies have shown TP-10 to have potential in a wide variety of complement-mediated conditions, including organ transplantation, multiple sclerosis, rheumatoid arthritis and lupus [238093]. Early work demonstrated favorable results in animal models of reperfusion injury [180849] and hyperacute xenograft rejection in guinea pig to rat and pig to primate organ transplants [191552]. AVANT has received Notices of Allowance (July 1998) from the USPTO for three separate patent applications covering pharmaceutical compositions of TP-10, methods of purification and methods of certain TP-10 glycoforms for treating diseases or disorders resulting from inappropriate complement activation [291776]. In January 1999, the company was awarded US-05856297 which covers pharmaceutical compositions of TP-10. US-05856300 was also awarded covering compositions and methods of producing the drug [312267].

Acute-Phase Reaction↗
PubMed2001

[Discussion on some basic problems in design of wetland ecosystem].

The design of wetland ecosystem is the key and fundament in wetland restoration and mitigation. In recent years, it has been frequently applied to the proper construction of wetlands. The paper first reviews the concept of wetland ecosystem design, as well as the basis of ecological engineering, and then presented the basic principles in the design of wetland ecosystem. Some major ecological indicators including hydrology, chemical, substrate, soil and biotic indicators were also discussed, and some reference values for ecological indicators were presented. On the base of the designing purposes, three major types in the wetland design were analysed. They include constructing wetlands for wastewater treatment, for mitigation wetlands, and for controlling flooding and non-point source pollution.

Ecosystem↗
PubMedDate not supplied

Managing the workforce reduction: hospital CEO perceptions of organizational dysfunction.

Over the past few years many nations have undertaken activities aimed at restructuring and reengineering their health system as a means of achieving greater cost effectiveness and consumer responsiveness. Most efforts at reforming healthcare delivery have been accompanied by the downsizing of healthcare organizations. Organizations that are undergoing decline or significant workforce contractions are widely believed to experience a number of negative or dysfunctional attributes as a consequence of reductions in, or redeployments of, their labor force. For organizations undergoing planned workforce reductions, much speculation has been made in an attempt to identify a set of "best practices" that have the potential to mitigate the dysfunctional consequences associated with large permanent reductions in the workforce. This article explores the relationships among workforce-reduction practices and perceptions of organizational dysfunction in a large sample of Canadian hospitals. Results of the analysis suggest that the application of certain "progressive" workforce-reduction practices preceding, during, and subsequent to the downsizing process may play an important role in mitigating some of these dysfunctional organizational consequences. This research provides some evidence to suggest that how a workforce reduction is carried out may have a greater effect on organizational effectiveness than either the magnitude or severity of the overall workforce reduction.

Attitude of Health Personnel↗
PubMed2002

On the minimum cost of an evolutionary strategy response to environment stress.

Two revised drafts about a simple evolution trade-off function studied by Mitchell(Mitchell, 2000) were put up first. Considering the complex of the environment, or the nonlinear interaction of the environment and species, we put up two new cost functions: [formula: see text] In the first case, if the environment is adverse to species (a > 0), the region of low-stress which is more suitable for the intolerant species is very small, and at the same environment stress z, the tolerant species will pay the more cost than it will paid in the normal environment. However the tolerant species will pay more cost but low strategies in the environment of a < 0 than that it will paid in the environment of a = 0 or a > 0. In the second case, the results showed that the greater the stress of the environment is, or the more complex the environment is, the lower cost the intolerant species will pay in the region of z < 1. In order to exist or to evolve from an environment of high-stress, the organisms must possess a higher u, or a better means of mitigating of the stress of environment. Meanwhile in the region d > 1, when d decrease, the intolerant species will pays more lower cost of exploiting a habitat in the low-stress environment while the tolerant one will pays more lower cost in the high-stress environment. This means that scale d describes the selection character of the species system in the evolution process, the smaller the d(d < 1) is, the better the selection or the mitigation the system will possesses.

Adaptation, Physiological↗
PubMed1988

Aubuku v. The State, 29 July 1987.

The Supreme Court of Justice of Papua New Guinea in this case set out guidelines for sentencing in rape convictions. These guidelines follow principles expressed in the English Court of Appeal decision R. vs. Billam (1986). They are as follows: "1) the offence is a serious crime which is to be punished by an immediate punitive custodial sentence other than in wholly exceptional circumstances; 2) for rape committed by an adult without any aggravating or mitigating features, a figure of five years should be taken as the starting point; 3) for rape committed by two or more persons acting together, or by a person who has broken into or otherwise gained access to a place where the victim is living, or by a person who is in a position of responsibility towards the victim, or by a person who abducts the victim and holds her captive, the starting point should be eight years; 4) for rape committed as part of a concerted campaign, where the accused represents more than an ordinary danger, a sentence of 15 years or more may be appropriate; 5) for rape committed in circumstances which manifest perverted or psychopathic tendencies or gross personality disorder, and where if the accused is likely, if at large, to remain a danger, a life sentence will not be inappropriate; 6) where any one or more of the following aggravating factors are present, the sentence should be substantially higher than the suggested starting point; a) violence over and above the force necessary to commit rape, b) use of a weapon to frighten or wound the victim, c) the rape is repeated, d) the rape has been carefully planned, e) the accused has previous convictions for rape or other serious offenses of a sexual or violent kind, f) the victim is subjected to further sexual indignities or perversions, g) the victim is either very old or very young, h) the effect upon the victim, whether physical or mental; and 7) matters which may be relevant to mitigation include: a) a plea of guilty, b) the age of the defendant, and c) the degree of involvement of the defendant in the planning and carrying into effect of the crime, but do not include d) the fact that the victim may be considered to have exposed herself to the danger by acting imprudently, and e) the previous sexual experience of the victim."

Behavior↗
PubMed1987

Smith v. Gore, 13 April 1987.

After undergoing a failed tubal ligation and giving birth to a healthy child, the plaintiff brought a wrongful pregnancy suit against physicians, a university hospital, and a manufacturer of a sterilization technique seeking damages for emotional distress, loss of income, expenses of rearing a child to the age of majority, and punitive damages. The Supreme Court of Tennessee held that all damages were recoverable except those for the expenses of rearing the child. It ruled that the costs of rearing a normal, healthy child lay with the parents under both statutory and common law. It also held that there was no duty to mitigate damages by having an abortion or placing the child for adoption. In 1987 the Supreme Courts of Kansas and Oklahoma also rejected claims for the expenses of raising a healthy child whose birth resulted from a failed sterilization. (Johnston v. Elkins, 1 May 1987 [736 P.2d 935]; Morris v. Sanchez, 10 November 1987, corrected 17 November 1987 [746 P.2d 184]). In making its ruling, the Supreme Court of Oklahoma also held that there was no duty to mitigate damages in such a case. In addition, the Appellate Court of Illinois, First District, Second Division, held that a woman who became pregnant after being sterilized could not recover because she did not show that, had she been informed that there was a 1 percent chance of the sterilization failing, she would not have chosen to be sterilized anyway (Marshall v. University of Chicago Hospitals and Clinics, 29 December 1987 [520 N.E.2d 740]).

Americas↗
PubMed2002

Normal accidents: human error and medical equipment design.

High-risk systems, which are typical of our technologically complex era, include not just nuclear power plants but also hospitals, anesthesia systems, and the practice of medicine and perfusion. In high-risk systems, no matter how effective safety devices are, some types of accidents are inevitable because the system's complexity leads to multiple and unexpected interactions. It is important for healthcare providers to apply a risk assessment and management process to decisions involving new equipment and procedures or staffing matters in order to minimize the residual risks of latent errors, which are amenable to correction because of the large window of opportunity for their detection. This article provides an introduction to basic risk management and error theory principles and examines ways in which they can be applied to reduce and mitigate the inevitable human errors that accompany high-risk systems. The article also discusses "human factor engineering" (HFE), the process which is used to design equipment/ human interfaces in order to mitigate design errors. The HFE process involves interaction between designers and endusers to produce a series of continuous refinements that are incorporated into the final product. The article also examines common design problems encountered in the operating room that may predispose operators to commit errors resulting in harm to the patient. While recognizing that errors and accidents are unavoidable, organizations that function within a high-risk system must adopt a "safety culture" that anticipates problems and acts aggressively through an anonymous, "blameless" reporting mechanism to resolve them. We must continuously examine and improve the design of equipment and procedures, personnel, supplies and materials, and the environment in which we work to reduce error and minimize its effects. Healthcare providers must take a leading role in the day-to-day management of the "Perioperative System" and be a role model in promoting a culture of safety in their organizations.

Accidents↗
PubMed2003

Detoxification on top of enhanced, diamine-extended glutaraldehyde fixation significantly reduces bioprosthetic root calcification in the sheep model.

BACKGROUND AND AIM OF THE STUDY: Increased concentrations of glutaraldehyde (GA), diamine-extension (DA) of crosslinks and subsequent extraction of excess GA all reduce bioprosthetic calcification in the subdermal rat model. The study aim was to demonstrate the combined effect of all three treatments in a circulatory sheep model. METHODS: Two fixation treatments were used for GA detoxification (urazole in acetate buffer, 0.1 M; pH 4.5; 37 degrees C; 7 days): (i) conventional 0.2% GA fixation (4 degrees C; 7 days); and (ii) enhanced 3.0% GA fixation (4 degrees C; 2 days, followed by a DA interim step; 100 mM L-lysine; 37 degrees C; 2 days, followed by GA; 3.0%; 37 degrees C; 5 days). Entire porcine root prostheses were implanted in the distal aortic arch of young sheep for 12 weeks (n = 5 per group). Non-detoxified 0.2% GA-treated roots served as controls (n = 5). Calcium analysis was based on atomic absorption spectrophotometry; morphology was assessed using light and transmission electron microscopy. RESULTS: Detoxification alone resulted in an 83% reduction of leaflet calcification (p = 0.086), but achieved only 23% (p = 0.145) and 12% (p = 0.362) mitigation of calcification in aortic wall and sinus tissue, respectively. When combined with DA-enhanced 3% GA fixation, detoxification led to a 95% reduction in leaflet calcification (p = 0.057), followed by 79% in sinus (p = 0.003) and 79% in aortic wall tissue (p = 0.0003). Morphologically, detoxification primarily affected leaflets and the subadventitial layer of aortic wall tissue, whereas enhanced fixation seemed to affect all structures. CONCLUSION: It was shown in a circulatory sheep model that a combination of DA-enhanced fixation with an extraction process of excess GA leads to a distinct mitigation of leaflet and aortic wall calcification.

Animals↗
PubMed2002

[Study on the effects of telephone counseling for family caregivers of demented patients].

PURPOSE: The purposes of this study were to clarify the impact of telephone counseling on the actual state of family caregivers of demented patients, and to investigate strategies of public health care for such caregivers. METHODS: We classified 206 counseling cases, including 103 cases in 1999 and 103 cases through mid-2000, using several checklists, and analyzed date with the chi 2 test. RESULTS: 1) The most common symptom of demented patients was "forgetfulness." (106 cases) 2) 87 caregivers (42.2%) lived separately from demented patients, and in 60 cases the caregivers were daughters. 3) 104 caregivers suffered from stress because of caregiving difficulties, 89 (43.2%) having "emotional difficulties in caregiving," 33 (16.0%) "social difficulties with caregiving," 28 (13.6%) "physical difficulties with caregiving," and 8 (3.9%) "financial difficulties." While 102 caregivers (49.5%) reported no caregiving difficulties. 42 (40.4%) belonged to more than two of the listed categories. 4) The greatest concern of caregivers was "how to care for senile patients' mental symptoms." followed by "whether suffering from dementia" in 36 cases, "how to use welfare services" in 35, "whether the doctor should be consulted" in 30, and "expression of emotion" in 30 cases. The caregivers for whom "expression of emotion was an issue" had emotional, social and physical caregiving difficulties, prompting the contact for telephone counseling. 5) Public health nurses who had been working for more than 10 years tended to deal with the caregivers' "emotional caregiving difficulties" (P = 0.05). There were no differences regarding other items. CONCLUSIONS: 1) The results suggest that living apart, especially for daughters, has an effect on caregiving with senile patients if the number of family caregivers is reduced. In the future, we should consider ways to support families living apart from senile patients. 2) The results also reveal that caregivers of senile patients have emotional, social and physical caregiving difficulties. Therefore, a necessity for support of caregivers' emotional and physical health maintenance, and provision of community education is indicated. 3) Caregivers can talk more freely on the telephone than face-to-face, and get help when senile patients' symptoms are in the early stages. Therefore, it is possible to mitigate caregiving difficulties by intervening in their problems before these become serious and entrenched. 4) Telephone counseling gives caregivers the opportunity to express their emotions. Therefore, it can be expected to mitigate caregiving difficulties through appropriate targets of their expressed concerns.

Aged↗
PubMed2003

Compassion satisfaction, compassion fatigue, and critical incident stress management.

This study examines the potential for compassion satisfaction, compassion fatigue, and burnout in a sample of persons attending a workshop on Prevention of Compassion Fatigue at an international conference of providers of Critical Incident Stress Management (CISM) services. In the study, more than half (58%) of the respondents reported experiencing psychological reactions after providing CISM services, including an array of behavioral, emotional, cognitive, and physical symptoms of psychological stress. Forty percent of respondents were found to have moderate, high, or extremely high risk for compassion fatigue. At the same time, 89% of respondents were found to have a good, high, or extremely high potential for compassion satisfaction, and 87% were found to be at extremely low risk for burnout. The results appear to indicate that, while the CISM practitioners recognize the stress associated with their work (as reflected in the reported symptoms), the work provides significant rewards (as measured by compassion satisfaction) that outweigh the stress and mitigate against burnout. Likewise, while 40% tested positive for compassion fatigue (or secondary traumatic stress) as a result of their empathy with CISM recipients, the rewards of the work again appear to mitigate the negative effects of the work. Implications for future research and practice are presented.

Adult↗
PubMed2002

Disaster epidemiology: prudent public health practice in the Pacific Islands.

Natural or technological disasters may strike a community at any time, causing death, disability, illness and material destruction. Loss of human life, healthcare costs associated with disaster-related injuries and illnesses, pain and suffering, economic loss from destruction of homes, commercial enterprises and public structures are some of the myriad ways in which the impact of the disaster may be felt by the community. Disaster managers seek to prevent, mitigate and prepare for disasters during the pre-impact phase. If and when a disaster occurs, they seek to provide timely, appropriate and effective response, relief and rehabilitation services. Disaster epidemiology arose out of a need to apply objective descriptive and analytic tools to the field of disaster management in order to improve its reievance, effectiveness, and efficiency. The table illustrates the types of studies that can be undertaken during each phase of disaster management. During the pre-impact phase vulnerability and community hazards analyses can provide useful information to public health officials responsible for prevention and mitigation of potential disasters. Epidemiologic surveys of the disaster-affected area to assess the nature and the impact of the disaster are crucial during the impact phase since the information is valuable to public health, paramedical, and medical staff in tailoring their response and relief efforts. Post-impact retrospective and prospective epidemiologic studies can assistwith the establishment of appropriate rehabilitation services. They can also serve as pre-disaster exercises since results and conclusions from these studies can help disaster managers in planning the resources needed for future disasters. Finally, there is a need for surveillance of disaster-related or emergency-related illnesses, injuries and deaths during all three phases so that baseline data is readily available for comparison during or after the disaster occurs. See Table 1.

Disaster Planning↗
PubMed2003

Integrated environmental impact assessment: a Canadian example.

The Canadian federal process for environmental impact assessment (EIA) integrates health, social, and environmental aspects into either a screening, comprehensive study, or a review by a public panel, depending on the expected severity of potential adverse environmental effects. In this example, a Public Review Panel considered a proposed diamond mining project in Canada's northern territories, where 50% of the population are Aboriginals. The Panel specifically instructed the project proposer to determine how to incorporate traditional knowledge into the gathering of baseline information, preparing impact prediction, and planning mitigation and monitoring. Traditional knowledge is defined as the knowledge, innovations and practices of indigenous and/or local communities developed from experience gained over the centuries and adapted to local culture and environment. The mining company was asked to consider in its EIA: health, demographics, social and cultural patterns; services and infrastructure; local, regional and territorial economy; land and resource use; employment, education and training; government; and other matters. Cooperative efforts between government, industry and the community led to a project that coordinated the concerns of all interested stakeholders and the needs of present and future generations, thereby meeting the goals of sustainable development. The mitigation measures that were implemented take into account: income and social status, social support networks, education, employment and working conditions, physical environments, personal health practices and coping skills, and health services.

American Indian or Alaska Native↗
PubMed2003

[Factors influencing CH4 emissions from a permanently flooded rice field during rice growing period].

Permanently flooded rice fields are the rice fields which emit the largest amount of CH4 in China. A 6-years (1995-2000) measurement carried out in a permanently flooded rice field in Chongqing, China showed that draining floodwater in winter and planting upland crops, either winter wheat or rape, instead of fallow under flooded conditions not only stopped CH4 emission during the winter season, but also mitigated CH4 emission during following rice growing period. CH4 emission could also be mitigated by ridge-cultivation. By using the results obtained from 1998-2000, statistical analysis indicated a significant relationship between the mean CH4 emission over the rice growing period and averaged soil moisture in winter season, which explained 56% of the variation of the CH4 emissions among the years and treatments. The averaged soil moisture (0-20 cm) in winter season and soil temperature (5 cm) over the rice growing period explained 78% of the variation. The significance of soil moisture in winter season in CH4 emission during the following rice growing period was further demonstrated by a lysimeter experiment. The relationships implied that the precipitation during non-rice growing period, which dominates soil moisture at a large spatial scale, and the soil temperature during the rice growing period would be the main factors controlling the annual variation of CH4 emissions from rice fields.

Methane↗
PubMedDate not supplied

Receptor strategies in pancreatitis.

A variety of receptors on pancreatic acinar and duct cells regulate both pancreatic exocrine secretion and intracellular processes. These receptors are potential sites of action for therapeutic agents in the treatment of pancreatitis. Cholecystokinin (CCK) receptor antagonists, which may reduce the level of metabolic "stress" on acinar cells, have been shown to mitigate the severity of acute pancreatitis in a number of models. Not all studies have shown a benefit, however, and differences may exist between different structural classes of antagonists. Because increased pancreatic stimulation due to loss of feedback inhibition of CCK has been proposed to contribute to the pain of some patients with chronic pancreatitis, CCK receptor antagonists could also be of benefit in this setting. Somatostatin and its analogs diminish pancreatic secretion of water and electrolytes and have been effective in treating pancreatic fistulas and pseudocysts. These agents are also being evaluated for their ability to reduce pain in chronic pancreatitis (perhaps by reducing ductal pressure by diminishing secretory volume) and mitigating the severity of acute pancreatitis (possibly by reducing the metabolic load on acinar cells). Recently described secretin receptor antagonists may also have therapeutic value as a means of selectively inhibiting pancreatic secretion of water and electrolytes.

Animals↗
PubMedDate not supplied

Human exposure to pollutants in Poland.

Serious environmental problems caused by decades of mismanagement of Poland's natural resources have been brought to light in recent years. All environmental media--air, water, food, and soil--have been burdened with toxic chemicals. Some environmental problems are so severe that the sources of pollution and the mitigation techniques needed are obvious, requiring no further research, but rather common sense, monies, and determination to implement the necessary controls and mitigation procedures. This paper will not address these obvious cases. Rather it will address that spectrum of environmental problems which requires a better understanding of public health risk in order to develop effective risk management strategies. Because these problems are numerous and monies limited, policy makers will need to set priorities both for research projects and control options. Using environmental concentration data presently available from Poland (especially for air), the paper will estimate human exposures, will point out research and monitoring needs, and hopefully, will lend credence to the concept that environmental policies and risk reduction strategies will be most effective if the Total Human Exposure Concept is used as the guiding scientific principle in risk assessment and management programs.

Air Pollutants↗
PubMed2004

[Application of pseudotyped lentivirus-mediated double suicide genes to allogeneic bone marrow transplantation in mice].

OBJECTIVE: To explore the feasibility and efficiency of cytosine deaminase (CD)/thymidine kinase (TK) gene-modified donor T cells used in allogeneic bone marrow transplantation (allo-BMT) as an approach to mitigate GVHD without compromising engraftment. METHODS: The pseudotyped lentivirus vectors containing CD and TK double suicide genes were transfected with lipofectine to donor T cells. Lethally irradiated 615 leukemia mice were transplanted with BALB/c bone marrow plus CD(+)TK(+)T cells. GVHD prophylaxis was by administration of ganciclovir (GCV) and 5-Fluoride cytosine (5-FC). RESULTS: The pseudotyped lentivirus-mediated gene transfer system could efficiently transfer CD and TK double suicide genes into donor T cells. Administration of GCV and 5-FC to the mice could markedly potentiate the CFU-S and CFU-GM yields and raise the number of peripheral white blood cells. 1 x 10(7) CD(+)TK(+) allogeneic T cells caused GVHD of a similar magnitude and time course to that of fresh, naive T cells after allo-BMT. Administration of GCV and 5-FC in mice received CD(+)TK(+)T cells reduced the severity of GVHD and resulted in significantly longer survival as compared with non-administration mice, and the effect was stronger than that of administration of GCV or 5-FC alone. CONCLUSION: Administration of CD + TK gene-modified donor T cells to recipient in allo-BMT might be an approach to mitigate GVHD without compromising alloengraftment.

Animals↗
PubMed2004

The negative impacts of human activities in the eastern African region: an international waters perspective.

The complex interactions between human activities and the environment at the interface of land and water is analyzed with a focus on the Somali Current (East Africa), and Indian Ocean Island States, subregions of the Global International Waters Assessment (GIWA). These 2 subregions contain some of the world's richest ecosystems, including the high biodiversity forests of Madagascar and the diverse coastal habitats of the eastern African coast. These ecosystems support local communities and national and regional economies. Current and future degradation of these systems, from water basins to continental shelves, affects the livelihoods and sustainability of the countries in the region, and long-term efforts to reduce poverty. The assessments determined that pollution and climate change are the primary environmental and social concerns in the Islands of the Indian Ocean, while freshwater shortage and unsustainable exploitation of fisheries and other living resources are the primary environmental and social concerns in East Africa. The GIWA approach, through assessing root causes of environmental concerns, enables the development of policy approaches for mitigating environmental degradation. This paper explores policy frameworks for mitigating the impacts, and reducing the drivers, of 3 environmental concerns--freshwater shortage; solid waste pollution; and climate change--addressing social and institutional causes and effects, and linking the subregions to broad international frameworks. The common theme in all 3 case studies is the need to develop integrated ecosystem and international waters policies, and mechanisms to manage conflicting interests and to limit threats to natural processes.

Climate↗