Working document of the 14th Global Meeting of the Regional Seas Conventions and Action Plans

Report of the 8th Global Meeting of the Regional Seas

This report summarises ten actions being undertaken in the sub?region to improve air quality. In selecting these ten actions, consideration was given to their replicability, global appropriateness to address particular air pollution challenges and potential impact. For more details, please refer to the methodology document.

目的了解中国吸烟者的戒烟意愿,为制定有效健康干预措施提供依据。方法通过系统检索中英文数据库,设定文献的纳入与排除标准,整理公开发表的吸烟者戒烟意愿文献。运用Stata 14.0软件进行数据处理。结果共计纳入16篇文献。meta分析结果显示,31.8%(95%CI:29.7%～42. 4%)的吸烟者愿意戒烟。亚组分析结果显示,西部地区、男性吸烟者、家庭与单位无吸烟限制以及无戒烟经历的吸烟者戒烟意愿较为消极,是今后控烟工作的重点关注人群。结论我国吸烟者戒烟意愿较低。应针对重点人群的不同特点,采取不同形式的健康教育,提升吸烟者的戒烟意愿。

The objective of this systematic literature review is to examine the impact of interventions to improve cardiovascular disease healthcare provided to people living in rural areas. Systematic electronic searches were conducted in Medline, CINAHL, Embase, Scopus, and Web of Knowledge in July 2018. We included clinical trials assessing the effectiveness of interventions to improve cardiovascular disease healthcare in rural areas. Study eligibility assessment, data extraction, and critical appraisal were undertaken by two reviewers independently. We identified 18 trials (18 interventions). They targeted myocardial infarction (five interventions), stroke (eight), and heart failure (five). All the interventions for myocardial infarction were based on organizational changes (e.g. implementation of mobile coronary units). They consistently reduced time to treatment and decreased mortality. All the interventions for heart failure were based on the provision of patient education. They consistently improved patient knowledge and self-care behaviour, but mortality reductions were reported in only some of the trials. Among the interventions for stroke, those based on the implementation of telemedicine (tele-stroke systems or tele-consultations) improved monitoring of stroke survivors; those based on new or enhanced rehabilitation services did not consistently improve mortality or physical function; whereas educational interventions effectively improved patient knowledge and behavioural outcomes. In conclusion, a number of different strategies (based on enhancing structures and providing patient education) have been proposed to improve cardiovascular disease healthcare in rural areas. Although available evidence show that these interventions can improve healthcare processes, their impact on mortality and other important health outcomes still remains to be established.

Management of Mercury and Mercury-Containing Waste

OBJECTIVES: Mental health disorders are highly prevalent among university students. Universities could be an optimal setting to provide evidence-based care through the Internet. As part of the World Mental Health International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of Internet-based interventions for university students' mental health. METHOD: A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, and PsycINFO) for randomized trials examining psychological interventions for the mental health (depression, anxiety, stress, sleep problems, and eating disorder symptoms), well-being, and functioning of university students was performed through April 30, 2018. RESULTS: Forty-eight studies were included. Twenty-three studies (48%) were rated to have low risk of bias. Small intervention effects were found on depression (g = 0.18, 95% confidence interval [CI; 0.08, 0.27]), anxiety (g = 0.27, 95% CI [0.13, 0.40]), and stress (g = 0.20, 95% CI [0.02, 0.38]). Moderate effects were found on eating disorder symptoms (g = 0.52, 95% CI [0.22-0.83]) and role functioning (g = 0.41, 95% CI [0.26, 0.56]). Effects on well-being were non-significant (g = 0.15, 95% CI [-0.20, 0.50]). Heterogeneity was moderate to substantial in many analyses. After adjusting for publication bias, effects on anxiety were not significant anymore. DISCUSSION: Internet interventions for university students' mental health can have significant small-to-moderate effects on a range of conditions. However, more research is needed to determine student subsets for which Internet-based interventions are most effective and to explore ways to increase treatment effectiveness.

文章立足于循证科学的视角和方法,以"基于当前可得的最佳证据"为基本原则,沿着从理论驱动到数据驱动的经济学方法演化路径,对从前古典时期到现代经济学各个理论发展时期的经济学证据演化进行了梳理,构建了主要包括证据来源、证据生产、证据评价等环节的循证经济学全证据链框架。研究发现,循证科学的理念始终贯穿于经济学证据的演化历史之中;大数据时代的经济学"最佳证据"是一个广义、多源的各种最佳证据集合;大数据时代,经济学证据从理论驱动走向数据驱动,证据链得到优化升级,最终助推经济学研究范式的转变与循证经济学的发展。

新兴技术推动下的信息流正以前所未有的速度冲击着传统的教育学,而以实证研究为导向的循证教育实践运动为信息的合理、高效流转提供了更为科学、严谨的研究理念、框架和方法。文章主要探索了循证教育学的信息流转模式、过程以及产生的效应等内容。研究认为:学科的科学化推进以及教育与信息的深度融合需求共同促成了循证教育学的发展;循证教育学的信息流转无论从证据来源、循证框架还是循证方法来看都为深度学习的发生创造了条件;循证教育学为信息流转提供了方向;循证教育学的信息流转引发了重新思考"理解"、创造开放性问题、变革教育结构等方面的效应。

方兴未艾的互联智能大数据时代,引爆了传统法学领域内科学研究与法治决策内外部关系的重构,使得法学学术范式的转型与法治决策流程的再造变得迫在眉睫。如何认识法治决策与决策证据尤其是循证证据之间的关系及两者的历史流变;如何实现大数据时代决策证据的规范有效转化,法循证学方法又如何扬长避短地发挥其应有的功能等问题,就成了明确法循证学内涵与外延后业界需着力思考和解决的问题。文章以决策证据的循证使用/消费为核心,为法循证学方法在汉语法学与法治实践中的运用初步总结出一个能够与传统法学方法实现功能衔接的学科新工具,描摹出一个由浅入深、色谱递进的法循证学方法领地,概括出一个基本的法循证学方法使用流程。

绩效信息的供给与使用是提升政府绩效管理有效性的重要前提,但目前的政府绩效信息管理却困难重重。文章认为,循证科学的证据管理思想能够为优化政府绩效信息的供给与使用提供重要的方法论支持。文章通过厘清证据与绩效信息的转化逻辑,构建了循证视角下的政府绩效信息管理框架,利用证据管理思想优化了政府绩效信息管理的流程。循证方法在政府绩效信息管理不同阶段的应用将有助于突破信息供给与使用的现实困境。

目的评价临床路径在心脏瓣膜置换术后患者健康教育中的应用效果。方法通过计算机检索Cochrane Library、PubMed、EMBASE、CBM、中国知网(CNKI)、万方数据知识服务平台、中国科技期刊数据库等国内外数据库,检索临床路径在心脏瓣膜置换术后患者健康教育中应用效果的随机对照实验,采用Cochrane协作网提供的RevMan5. 3软件对所提取的资料进行统计分析。结果最终纳入文献7篇,共806例研究对象,Meta分析结果显示:健康教育路径有助于改善心脏瓣膜置换术后患者对健康教育知识掌握的情况(Z=6. 32,P <0. 01)、提高健康教育满意度(Z=4. 55,P <0. 01)、提高治疗依从性(Z=2. 79,P <0. 01)、减少并发症的发生(Z=2. 44,P <0. 05)、缩短ICU治疗时间(Z=7. 30,P <0. 01)。结论临床路径应用于心脏瓣膜置换术后患者健康教育中的效果优于传统健康教育。

Full report in English

OBJECTIVE: To determine whether patients have better outcomes when exercise instructions are provided using multimedia approaches compared with verbal or written instructions. DATA SOURCES: Electronic databases (MEDLINE, EMBASE, CINAHL, and PsychInfo) searched up to October 2018. STUDY SELECTION: Randomized controlled trials exploring exercise-based interventions for health conditions, and comparing instructions provided using multimedia approaches with conventional verbal or written instructions. RESULTS: Fourteen trials from seven countries were included, with a total of 2156 participants. Diagnoses included orthopaedic, neurological, pulmonary, cardiac, and women's health conditions. A meta-analysis of three trials (140 participants) provided very low-quality evidence that multimedia exercise instructions may be more effective than written instructions in improving exercise adherence (standardized mean difference (SMD) 0.60, 95% confidence interval (CI) -0.06 to 1.25). Two of nine trials that could not be included in the meta-analysis for adherence due to heterogeneity reported that multimedia exercise instructions were more effective than written instructions in improving exercise adherence. Four other meta-analyses (three trials each) found low- to high-quality evidence that provision of exercise instructions using multimedia is no more beneficial than paper-based instructions for patient-related outcomes of pain intensity (SMD 0.09, 95% CI -0.47 to 0.28); uptake of physical activity (SMD 0.07, 95% CI -0.08 to 0.23); or physical (SMD 0.21, -0.21 to 0.64) or emotional (SMD 0.16, 95% CI -0.04 to 0.36) domains of health-related quality of life. CONCLUSION: Multimedia approaches to exercise instruction may result in increased adherence compared with instructions provided in written or verbal format, but there is insufficient evidence to determine whether this results in improved patient outcomes.

The pilot Global Assessment of Laboratories Analysing Mercury was organized in summer 2018 (August-October) as a first round of the global proficiency test. Participation was by invitation only and invitees were selected from the Mercury Laboratory Databank organized by UN Environment, Chemicals and Health Branch. There were 80 laboratories invited, 42 laboratories from 29 countries registered for the global assessment and 38 laboratories from 28 countries worldwide delivered results. Test materials for total mercury analyses used included three matrices: (i) test solution of analytical standards and (ii) naturally contaminated samples of biota: (a) fish samples, and (b) human scalp hair samples. Total mercury was analysed in all test samples and results provided by laboratories are shown in this report. No matrix was compulsory in this pilot laboratory assessment, therefore there was no full participation in analyses of individual matrices. Almost 90% of all laboratories analysed the standard solution and 80% of the delivered results presented satisfactory z-score. Lower amount, 84% of all laboratories analysed biota sample (fish) and almost 85% were with satisfactory z-scores outcome. 73.7% laboratories analysed human scalp hair and there were 82% of satisfactory z-scores outcome. It is quite encouraging to see a good agreement of reported data with reference values for the individual test samples provided by both developed and developing countries.

The Global Pact portal aims at providing existing information and material on international environmental law in an easily accessible manner. This portal is presented in an interactive format where users can: Access complementary courses and material on environmental law, including foundational environmental law courses developed under the InforMEA portal and which have been expanded/updated for this portal; Read a report to be submitted by the UN Secretary General that identifies and assesses possible gaps in international environmental law and environment-related instruments; Contact environmental law experts through the contact tab with questions related to the substance of the above report or to the activities of the ad hoc open‑ended working group established by resolution 72/277 “Towards a Global Pact for the Environment”; Find news on environmental law from around the world; Learn from a glossary of key terms in international environmental law.

In its Five Year Progress Report, the Climate Technology Centre & Network announces that 137 technology solutions have been delivered or are under way in 79 countries. 2,500 people have been trained and over 10 million tonnes of CO₂-eq. are expected to be reduced per year with the completion of the mitigation-related projects. With an original investment of $40 million USD, the CTCN’s technical assistance has leveraged $670 million USD in anticipated funding for developing countries’ technology implementation.

We support development of legal and institutional frameworks and build capacities of participating countries to meet the core obligations of the Nagoya Protocol.

The summary presents SBU's position based on the pilot study, and a brief description of the findings in the pilot study. If a pilot study shows that the topic is not suitable for any of the SBU product types, the process ends.

Presentation material