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Article: Coordinating climate change adaptation across levels of government: the gap between theory and practice of integrated adaptation strategy processes

Clar, Christoph

Journal of environmental planning and management. 2019 Oct. 15, v. 62, no. 12

2019

Abstract: Policymakers at different government levels develop integrated adaptation strategy processes (ASPs), which are supposed to prepare a particular region, country or municipality for the impacts of climate change. The adaptation literature suggests that ... ...

Abstract	Policymakers at different government levels develop integrated adaptation strategy processes (ASPs), which are supposed to prepare a particular region, country or municipality for the impacts of climate change. The adaptation literature suggests that coordination of these efforts promises comprehensive climate change adaptation, because it allows making use of synergies and avoiding maladaptation. Nonetheless, we lack evidence about the coordination of multiple levels and its potential to actually facilitate climate change adaptation. Based on an examination of 14 integrated ASPs, the author asks how they interact with each other, if they reconcile the priorities of other levels, and if they are an adequate tool for coordinating climate change adaptation. The study reveals a considerable gap between theory and practice. It demonstrates that the call for coordination is not reflected in current adaptation policy and questions whether (more) coordination is what we need to be better prepared for the impacts of climate change.
Keywords	climate change ; collective action ; environmental policy
Language	English
Dates of publication	2019-1015
Size	p. 2166-2185.
Publishing place	Routledge
Document type	Article
ZDB-ID	2000921-5
ISSN	1360-0559 ; 0964-0568
ISSN (online)	1360-0559
ISSN	0964-0568
DOI	10.1080/09640568.2018.1536604
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Occupational injuries in orthopedic and trauma surgeons in Austria.

Clar, Clemens / Koutp, Amir / Leithner, Andreas / Leitner, Lukas / Puchwein, Paul / Vielgut, Ines / Sadoghi, Patrick

Archives of orthopaedic and trauma surgery

2024 Volume 144, Issue 3, Page(s) 1171–1178

Abstract: Background: The aim of this study was to investigate the frequency and type of injuries during the career of orthopedic and trauma surgeons in Austria. The hypothesis was that the percentage of occupational injuries among orthopedic and trauma surgeons ... ...

Abstract	Background: The aim of this study was to investigate the frequency and type of injuries during the career of orthopedic and trauma surgeons in Austria. The hypothesis was that the percentage of occupational injuries among orthopedic and trauma surgeons aligns with the incidence reported in the United States, thus indicating the need for a workplace prevention program. Methods: A web-based survey was created to collect all necessary data and was sent to all orthopedic and trauma surgeons in Austria via e-mail. Relevant parameters included the surgeons' age, work experience, severity of pain, type of injury, and current pain. Descriptive and explorative statistical analysis was performed. Results: A web-based survey was sent to 1122 board-certified orthopedic surgeons and residents in Austria via e-mail. In total, the response rate was 135 (12%). Seventy-two surgeons (54%) had suffered from one or more occupational injuries during their career. We detected a significant raise of occupational injuries related to the work life duration in which operations were performed and the prevalence of injuries. Most injuries of surgeons were reported between 21 and 30 years of their professional life. According to the frequency at different locations, the distribution in descending order was 25% with injuries of the hand, 22% of finger(s), 12% of the foot, 10% of the spine, 2% of the neck, 3% of the head, and 2% of the abdomen. A causality of incapacity to work through injuries at the workplace was given as 4%. Four percent stated a sick leave of at least 3 weeks. In 7% of the facilities, there was no optimization of preventive measures following an occupational injury. We found no correlation of injuries and resident status. Conclusion: Orthopedic surgeons in Austria show a high incidence of occupational injuries in line with the findings of colleagues from the United States. The impact on the health system consists of absenteeism in the workplace of highly specialized health service providers as well as the incapacity to work of a high quality, highly trained workforce of at least 4%. With more preventive measures and more attention and care in the rehabilitation phase after such injuries, a positive effect could be achieved. We believe that residents should be specifically trained on how to avoid such injuries.
MeSH term(s)	Humans ; United States ; Occupational Injuries/epidemiology ; Occupational Injuries/etiology ; Austria/epidemiology ; Orthopedics ; Surgeons ; Orthopedic Surgeons ; Pain
Language	English
Publishing date	2024-01-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-024-05200-0
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Article: Infant Mortality and Life Expectancy: The Inequitable Loss of Potential Life.

Williams-DeVane, ClarLynda

North Carolina medical journal

2023 Volume 83, Issue 5, Page(s) 318–321

Abstract: Differences in life expectancy between racial and other subgroups of the population indicate inequities in the community. There are both societal and physical factors-including racism, poverty, and access to care-that must be resolved to increase and ... ...

Abstract	Differences in life expectancy between racial and other subgroups of the population indicate inequities in the community. There are both societal and physical factors-including racism, poverty, and access to care-that must be resolved to increase and equalize life expectancy and decrease the infant mortality rate.
MeSH term(s)	Infant ; Humans ; Infant Mortality ; Life Expectancy ; Poverty ; Mortality
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	422795-5
ISSN	0029-2559
ISSN	0029-2559
DOI	10.18043/ncm.83.5.318
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Article ; Online: A CASE OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS (ABPA) IN A CHILD: RESPONSE TO DUPILUMAB.

Meneses, Jaime V / Clar, Miriam / Bracamonte, Stephanie C / Gómez, Elisa / Martín, Aranzazu / Borja, Jesús / Galindo, Pedro A

The journal of allergy and clinical immunology. In practice

2024

Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2024.04.018
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Article ; Online: The LCT 13910 C/T polymorphism as a risk factor for osteoporosis, has no impact on metastatic bone disease in breast cancer.

Clar, H / Renner, W / Krippl, P / Leithner, A / Gruber, G / Langsenlehner, T / Hofmann, G / Yazdani-Biuki, B / Clar, V / Windhager, R / Langsenlehner, U

Breast cancer research and treatment

2008 Volume 112, Issue 2, Page(s) 363–365

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms/genetics ; Bone Neoplasms/secondary ; Breast Neoplasms/genetics ; Breast Neoplasms/pathology ; Disease-Free Survival ; Female ; Genotype ; Humans ; Lactose/metabolism ; Middle Aged ; Neoplasm Metastasis ; Osteoporosis/genetics ; Polymorphism, Genetic ; Risk Factors
Chemical Substances	Lactose (J2B2A4N98G)
Language	English
Publishing date	2008-11
Publishing country	Netherlands
Document type	Letter
ZDB-ID	604563-7
ISSN	1573-7217 ; 0167-6806
ISSN (online)	1573-7217
ISSN	0167-6806
DOI	10.1007/s10549-007-9863-6
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Article ; Online: Restoring tibial obliquity for kinematic alignment in total knee arthroplasty: conventional versus patient-specific instrumentation.

Smolle, Maria Anna / Koutp, Amir / Clar, Clemens / Leitner, Lukas / Leithner, Andreas / Sadoghi, Patrick

Archives of orthopaedic and trauma surgery

2023 Volume 143, Issue 9, Page(s) 5867–5872

Abstract: Introduction: In total knee arthroplasty (TKA), tibial obliquity-restoration using kinematic alignment (KA) poses a major difference to conventional mechanical alignment. This study aimed at analysing the accuracy of conventional instrumentation (CI) ... ...

Abstract	Introduction: In total knee arthroplasty (TKA), tibial obliquity-restoration using kinematic alignment (KA) poses a major difference to conventional mechanical alignment. This study aimed at analysing the accuracy of conventional instrumentation (CI) versus patient-specific instrumentation (PSI) to restore anatomic tibial obliquity measured by the medial proximal tibial angle (MPTA) on conventional X-rays. Materials and methods: One-hundred patients were randomized to receive CI (n = 50) or PSI (n = 50) for TKA. Further 100 patients received CI without randomisation, resulting in 200 patients in total (127 women, mean age: 70.7 (range: 48-90 years). Pre- and postoperative X-rays were measured twice by two observers with a 2-week break in-between. Inter- and intraclass correlations were calculated and postoperative tibial obliquity compared to preoperative anatomy. Results: In 150 patients with CI, no case with tibial obliquity-deviation greater than 2° was found, whilst 21.3% (n = 32) and 0.7% (n = 1) of cases and had a deviation of 0°-1°, and 1°-2°, respectively. In the remaining 78.0% (n = 117), tibial obliquity was restored. In 50 patients with PSI, no single case with a deviation greater than 1° was found. Sixty percent (n = 30) had a deviation of 0°-1°. In the remaining 40.0% (n = 20), no deviation from preoperative measurements was found. Consequently, CI resulted in a significantly smaller change in tibial obliquity from preoperative to postoperative than PSI (p < 0.001). Inter- and intra-class correlations showed a substantial agreement (any ICC > 0.90). Conclusion: Both conventional and patient-specific instrumentation revealed adequate results with respect to restoring tibial obliquity in kinematically aligned TKA, with conventional instrumentation achieving superior results.
MeSH term(s)	Humans ; Female ; Aged ; Arthroplasty, Replacement, Knee/methods ; Biomechanical Phenomena ; Osteoarthritis, Knee/surgery ; Tibia/surgery ; Radiography ; Knee Joint/diagnostic imaging ; Knee Joint/surgery ; Knee Prosthesis
Language	English
Publishing date	2023-03-20
Publishing country	Germany
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-04845-7
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Article ; Online: Development of application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers.

Leitner, Lukas / Hauer, Georg / Rasic, Laura / Clar, Clemens / Leithner, Andreas / Sadoghi, Patrick

Archives of orthopaedic and trauma surgery

2023 Volume 144, Issue 2, Page(s) 855–859

Abstract: Purpose: The aim was to compare total knee arthroplasty (TKA) between countries with regard to epidemiologic data and surgical technique by the use of worldwide registers and compare findings with a previous report after one decade.: Methods: A ... ...

Abstract	Purpose: The aim was to compare total knee arthroplasty (TKA) between countries with regard to epidemiologic data and surgical technique by the use of worldwide registers and compare findings with a previous report after one decade. Methods: A systematic search was carried out in November 2022 and compared to previous reports from 2010. We extracted data regarding implanted TKAs, patients' age distribution, procedure types, fixation and revision rates. After identification of 28 national arthroplasty registers, 8of them, namely Australia, Canada, Denmark, England and Wales, New Zealand, Norway, Scotland and Sweden, offered sufficient data and were included in final analysis. Results: A large variation was found in the annual number of implantations per 100,000 inhabitants with a range from 77 to 210.2 (mean 132.8). The fixation type varied strongly as well, e.g. over 95% of totally cemented TKAs in Sweden versus 61.2% cemented fixation in Denmark. Another significant difference was the use of patellar resurfacing in TKA, ranging from 47.3% (Canada) using a patellar button in TKA to less than 5% (Sweden). Within the period of one decade, the mean overall number of annual implantations increased (10%), whilst relative number of revisions decreased, the use of cemented TKA decreased from 87 to 74%, and the use of patella button remained largely inhomogeneous. Conclusion: Comparison of arthroplasty registers revealed large differences regarding the annual number of primary TKAs per inhabitant as well as primary TKA procedure types with an increase of annual implantations, decrease of relative number of revisions, and a decrease of the use of cemented systems over the period of one decade.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee/methods ; Prosthesis Failure ; Reoperation ; Registries ; Knee Prosthesis ; Treatment Outcome
Language	English
Publishing date	2023-10-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-05089-1
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Article: Transformation of zinc oxide nanoparticles in synthetic lung fluids.

Hatch, Avery C / Peloquin, Derek / Kumbar, Amar S / Luxton, Todd P / Clar, Justin G

Journal of nanoparticle research : an interdisciplinary forum for nanoscale science and technology

2022 Volume 24, Issue 8, Page(s) 153

Language	English
Publishing date	2022-07-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2017013-0
ISSN	1572-896X ; 1388-0764
ISSN (online)	1572-896X
ISSN	1388-0764
DOI	10.1007/s11051-022-05527-y
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Article ; Online: WITHDRAWN: Iodine supplementation for preventing iodine deficiency disorders in children.

Angermayr, Lucia / Clar, Christine

The Cochrane database of systematic reviews

2018 Volume 11, Page(s) CD003819

Abstract: Background: Iodine deficiency is the main cause of potentially preventable mental retardation in childhood, as well as causing goitre and hypothyroidism in people of all ages. It is still prevalent in large parts of the world.: Objectives: To assess ... ...

Abstract	Background: Iodine deficiency is the main cause of potentially preventable mental retardation in childhood, as well as causing goitre and hypothyroidism in people of all ages. It is still prevalent in large parts of the world. Objectives: To assess the effects of iodine supplementation overall, and of different forms and dosages of iodine supplementation separately, in the prevention of iodine deficiency disorders in children. Search methods: The Cochrane Library, MEDLINE, EMBASE and reference lists, databases of ongoing trials and the Internet were searched. Selection criteria: We included randomised controlled trials and prospective controlled trials not using randomisation of iodine supplementation in children living in areas of iodine deficiency. Data collection and analysis: Two reviewers did the initial data selection and quality assessment of trials independently. As the studies identified were not sufficiently similar and not of sufficient quality, we did not do a meta-analysis but summarised the data in a narrative format. Main results: Twenty-six prospective controlled trials were related to our question, assessing a total of 29613 children. Twenty of them were classified as being of low quality, six of moderate quality. Most studies used iodised oil as a supplement, but other supplements were also used. The intervention groups were compared to a non-supplemented control group, different doses or different forms of iodine supplementation.There was a clear tendency towards goitre reduction with iodine supplementation; this was significant in several studies. Significant differences in physical development were not seen, except in one study. Results for differences in cognitive and psychomotor measures were mixed, with only few studies showing a positive intervention effect. One study suggested that infant mortality was lowered after iodine supplementation.Most studies showed a significant increase in urinary iodine excretion and levels recommended by the WHO were reached in most cases after supplementation. Thyroid-stimulating hormone (TSH) levels were significantly reduced in one study. In 1.8% of the children investigated, adverse effects were found, most of them were minor and transient. Authors' conclusions: Despite most of the included studies being of low quality, the results suggest that iodine supplementation, especially iodised oil, is an effective means of decreasing goitre rates and improving iodine status in children. Indications of positive effects on physical and mental development and mortality were seen, although results were not always significant. Adverse effects were generally minor and transient. Insufficient evidence was available on non-oil supplements. High quality controlled studies investigating relevant long term outcome measures are needed to address the question of the best form of iodine supplementation in different population groups and settings.
MeSH term(s)	Child ; Congenital Hypothyroidism/prevention & control ; Controlled Clinical Trials as Topic ; Dietary Supplements/adverse effects ; Goiter/prevention & control ; Humans ; Iodates/administration & dosage ; Iodine/administration & dosage ; Iodine/adverse effects ; Iodine/deficiency ; Iodized Oil/administration & dosage ; Myxedema/prevention & control ; Potassium Compounds/administration & dosage ; Potassium Iodide/administration & dosage ; Sodium Chloride, Dietary/administration & dosage
Chemical Substances	Iodates ; Potassium Compounds ; Sodium Chloride, Dietary ; Potassium Iodide (1C4QK22F9J) ; Iodized Oil (8001-40-9) ; Iodine (9679TC07X4)
Language	English
Publishing date	2018-11-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD003819.pub3
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Book ; Online: Interferone und Natalizumab in der Behandlung der multiplen Sklerose (MS)

Clar, Christine / Velasco-Garrido, Marcial / Gericke, Christian A.

(Schriftenreihe health technology assessment ; 77)

2008

Author's details	Christine Clar ; Marcial Velasco-Garrido ; Christian Gericke
Series title	Schriftenreihe health technology assessment ; 77
Collection
Language	German
Size	VII, 177 S.
Edition	1. Aufl.
Publisher	DIMDI
Publishing place	Köln
Publishing country	Germany
Document type	Book ; Online
HBZ-ID	HT016018882
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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