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Corruption has found very fertile ground in the health sector. Many studies demonstrate the negative relationship between sustainability and corruption. However, relatively little is known at this time about how to prevent corruption in healthcare organizations (HCOs), and thus to recover the important sustainability of the entire healthcare system. After noticing this gap in the literature, the authors’ aim in undertaking this study was twofold: first, to analyze the current state of knowledge about how Italian HCOs adopt corruption prevention plans in compliance with the National Plan issued by the National Anti-Corruption Authority; second, to identify some clusters of HCOs which represent different adoption patterns of corruption prevention interventions and to classify these HCOs. For these purposes, the authors studied 68 HCOs along 13 dimensions that characterized the corruption prevention plans. The empirical results showed that the HCOs were not fully compliant with the anti-corruption legislation. At the same time, the authors identified three clusters of HCOs with different patterns of anti-corruption prevention interventions. The clusters that adopted some specific interventions seemed to be more sustainable than others.

The crucial role evaluation can play in the co-development of project design and its implementation will be addressed through the analysis of a case study, the Green Communities (GC) project, funded by the Italian Ministry of Environment within the EU Interregional Operational Program (2007-2013) "Renewable Energy and Energy Efficiency". The project's broader goals included an attempt to trigger a change in Italian local development strategies, especially for mountain and inland areas, which would be tailored to the real needs of communities, and based on a sustainable exploitation and management of the territorial assets. The goal was not achieved, and this paper addresses the issues of how GC could have been more effective in fostering a vision of change, and which design adaptations and evaluation procedures would have allowed the project to better cope with the unexpected consequences and resistances it encountered. The conclusions drawn are that projects should be conceived, designed and carried out as dynamic systems, inclusive of a dynamic and engaged evaluation enabling the generation of feedbacks loops, iteratively interpreting the narratives and dynamics unfolding within the project, and actively monitoring the potential of various relationships among project participants for generating positive social change.

Urea is the most common nitrogen (N) fertilizer in agriculture, due to its cheaper price and high N content. Although the reciprocal influence between NO3- and NH4+ nutrition are well known, urea (U) interactions with these N-inorganic forms are poorly studied. Here, the responses of two tomato genotypes to ammonium nitrate (AN), U alone or in combination were investigated. Significant differences in root and shoot biomass between genotypes were observed. Under AN+U supply, Linosa showed higher biomass compared to UC82, exhibiting also higher values for many root architectural traits. Linosa showed higher Nitrogen Uptake (NUpE) and Utilization Efficiency (NUtE) compared to UC82, under AN+U nutrition. Interestingly, Linosa exhibited also a significantly higher DUR3 transcript abundance. These results underline the beneficial effect of AN+U nutrition, highlighting new molecular and physiological strategies for selecting crops that can be used for more sustainable agriculture. The data suggest that translocation and utilization (NUtE) might be a more important component of NUE than uptake (NUpE) in tomato. Genetic variation could be a source for useful NUE traits in tomato; further experiments are needed to dissect the NUtE components that confer a higher ability to utilize N in Linosa.

In resource-constrained settings, the recovery of nutrients and the production of energy from liquid and solid waste are important. We determined the range and magnitude of potential community health impacts of six solid and liquid waste recovery and reuse business models in Hanoi, Vietnam.We employed a health impact assessment (HIA) approach using secondary data obtained from various sources supplemented with primary data collection. For determining the direction (positive or negative) and magnitude of potential health impacts in the population, a semiquantitative impact assessment was pursued.From a public health perspective, wastewater reuse for inland fish farming, coupled with on-site water treatment has considerable potential for individual and community-level health benefits. One of the business models investigated (i.e. dry fuel manufacturing with agro-waste) resulted in net negative health impacts.In Hanoi, the reuse of liquid and solid waste-as a mean to recover water and nutrients and to produce energy-has considerable potential for health benefits if appropriately managed and tailored to local contexts. Our HIA methodology provides an evidence-based decision-support tool for identification and promotion of business models for implementation in Hanoi.

AbstractRising atmospheric [CO2] and associated climate change are expected to modify primary productivity across a range of ecosystems globally. Increasing aridity is predicted to reduce grassland productivity, although rising [CO2] and associated increases in plant water use efficiency may partially offset the effect of drying on growth. Difficulties arise in predicting the direction and magnitude of future changes in ecosystem productivity, due to limited field experimentation investigating climate and CO2 interactions. We use repeat near‐surface digital photography to quantify the effects of water availability and experimentally manipulated elevated [CO2] (eCO2) on understorey live foliage cover and biomass over three growing seasons in a temperate grassy woodland in south‐eastern Australia. We hypothesised that (i) understorey herbaceous productivity is dependent upon soil water availability, and (ii) that eCO2 will increase productivity, with greatest stimulation occurring under conditions of low water availability. Soil volumetric water content (VWC) determined foliage cover and growth rates over the length of the growing season (August to March), with low VWC (<0.1 m3 m−3) reducing productivity. However, eCO2 did not increase herbaceous cover and biomass over the duration of the experiment, or mitigate the effects of low water availability on understorey growth rates and cover. Our findings suggest that projected increases in aridity in temperate woodlands are likely to lead to reduced understorey productivity, with little scope for eCO2 to offset these changes.

Failure to successfully implement and sustain change over the long term continues to be a major problem in health and social care. Translating evidence into routine clinical practice is notoriously complex, and it is recognised that to implement new evidence-based interventions and sustain them over time, professional behaviour needs to change accordingly. A number of theories and frameworks have been developed to support behaviour change among health and social care professionals, and models of sustainability are emerging, but few have translated into valid and reliable interventions. The long-term success of healthcare professional behavioural change interventions is variable, and the characteristics of successful interventions unclear. Previous reviews have synthesised the evidence for behaviour change, but none have focused on sustainability. In addition, multiple overlapping reviews have reported inconsistent results, which do not aid translation of evidence into practice. Overviews of reviews can provide accessible succinct summaries of evidence and address barriers to evidence-based practice. We aim to compile an overview of reviews, identifying, appraising and synthesising evidence relating to sustained social and healthcare professional behaviour change.We will conduct a systematic review of Cochrane reviews (an Overview). We plan to systematically search the Cochrane Database of Systematic Reviews. We will include all systematic reviews of randomised controlled trials comparing a healthcare professional targeted behaviour change intervention to a standard care or no intervention control group. Two reviewers will independently assess the eligibility of the reviews and the methodological quality of included reviews using the ROBIS tool. The quality of evidence within each comparison in each review will be judged based on the GRADE criteria. Disagreements will be resolved through discussion. Effects of interventions will be systematically tabulated and the quality of evidence used to determine implications for clinical practice and make recommendations for future research.This overview will bring together the best available evidence relating to the sustainability of health professional behaviour change, thus supporting policy makers with decision-making in this field.

AbstractHerbicides inhibiting either aromatic or branched-chain amino acid biosynthesis trigger similar physiological responses in plants, despite their different mechanism of action. Both types of herbicides are known to activate ethanol fermentation by inducing the expression of fermentative genes; however, the mechanism of such transcriptional regulation has not been investigated so far. In plants exposed to low-oxygen conditions, ethanol fermentation is transcriptionally controlled by the ethylene response factors-VII (ERF-VIIs), whose stability is controlled in an oxygen-dependent manner by the Cys-Arg branch of the N-degron pathway. In this study, we investigated the role of ERF-VIIs in the regulation of the ethanol fermentation pathway in herbicide-treated Arabidopsis plants grown under aerobic conditions. Our results demonstrate that these transcriptional regulators are stabilized in response to herbicide treatment and are required for ethanol fermentation in these conditions. We also observed that mutants with reduced fermentative potential exhibit higher sensitivity to herbicide treatments, thus revealing the existence of a mechanism that mimics oxygen deprivation to activate metabolic pathways that enhance herbicide tolerance. We speculate that this signaling pathway may represent a potential target in agriculture to affect tolerance to herbicides that inhibit amino acid biosynthesis.