6 research outputs found
The potentials, threats and challenges in sustainable development of Penang National Park
No full textThe Penang National Park (PNP) is recognized as an initiative of sustainable development of the Penang State Government. Since the gazettement of the young Penang National Park about 8 years ago, much have yet to be done to fully realize its potentials. These include growing into a world class ecotourism site in tandem with the UNESCO heritage status of Georgetown, to develop into a world class research center, to create sustainable income as a socio-economic contributor to local communities, and to showcase the success of a national park within a highly urbanized island. However, there are threats to PNP such as development pressures due to land scarcity, encroachment of urban and agricultural land use into the park, illegal developments, and apathetic attitude amongst local visitors which have created many environmental issues, problematic solid waste pollution, and infrastructure construction in the park. All these threats need to be addressed in order to ensure sustainable development of the PNP. The challenges include having political will, creating an effective awareness and environmental education system for all stakeholders, develop a sustainable management plan, environmentally-friendly infrastructure, and focusing on ecotourism rather than mass tourism in the PNP
The potentials, threats and challenges in sustainable development of Penang National Park
No full textThe Penang National Park (PNP) is recognized as an initiative of sustainable development of the Penang
State Government. Since the gazettement of the young Penang National Park about 8 years ago, much
have yet to be done to fully realize its potentials. These include growing into a world class ecotourism
site in tandem with the UNESCO heritage status of Georgetown, to develop into a world class research
center, to create sustainable income as a socio-economic contributor to local communities, and to
showcase the success of a national park within a highly urbanized island. However, there are threats to
PNP such as development pressures due to land scarcity, encroachment of urban and agricultural land
use into the park, illegal developments, and apathetic attitude amongst local visitors which have created
many environmental issues, problematic solid waste pollution, and infrastructure construction in the
park. All these threats need to be addressed in order to ensure sustainable development of the PNP. The
challenges include having political will, creating an effective awareness and environmental education
system for all stakeholders, develop a sustainable management plan, environmentally-friendly
infrastructure, and focusing on ecotourism rather than mass tourism in the PN
Characteristics of water quality of rivers related to land-use in Penang Island Malaysia
No full textPotentials, Threats and Challenges in Managing Natural Heritage in the Penang National Park
No full textPenang is one of the most developed and highly urbanised states in Malaysia with very little remaining forests. The Penang National Park (PNP) was gazetted in 2003 with only 1200 hectares. It is one of the smallest national parks in the world, but the park is rich in natural heritage such as pristine rainforest, rich biodiversity, white sandy beaches, crystal clear sea, clean rivers, a meromictic lake and a scenic natural environment. However, many threats to the PNP are identified, including encroachment from farming, tourism development, environmental pollution, over-collection of plants and animals, poaching, ineffective management, poor enforcement and the lack of stakeholders\u27 involvement. The challenges in managing the PNP include addressing all the mentioned threats. Although not a straight forward and easy task, the threats can be reduced via a holistic and integrated management approach, careful planning and expert guidance, strict monitoring of development and enforcement, and active involvement of all stakeholders via empowerment. The park can also be developed into a nature education centre for students and used as a natural laboratory for research and data collection. On the whole, integrated environmental planning and management of the PNP with a focus on ecotourism will lead to sustainable development and ensure the park remains a lasting natural heritage area
36-month clinical outcomes of patients with venous thromboembolism: GARFIELD-VTE
No full textBackground: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.Methods: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.Findings: A total of 6582 (61.6 %) patients had DVT alone, 4097 (38.4 %) had PE +/- DVT. At baseline, 98.1 % of patients received anticoagulation (AC) with or without other modalities of therapy. The proportion of patients on AC therapy decreased over time: 87.6 % at 3 months, 73.0 % at 6 months, 54.2 % at 12 months and 42.0 % at 36 months. At 12-months follow-up, the incidences (95 % confidence interval [CI]) of all-cause mortality, recurrent VTE and major bleeding were 6.5 (7.0-8.1), 5.4 (4.9-5.9) and 2.7 (2.4-3.0) per 100 person-years, respectively. At 36-months, these decreased to 4.4 (4.2-4.7), 3.5 (3.2-2.7) and 1.4 (1.3-1.6) per 100 person-years, respectively. Over 36-months, the rate of all-cause mortality and major bleeds were highest in patients treated with parenteral therapy (PAR) versus oral anti-coagulants (OAC) and no OAC, and the rate of recurrent VTE was highest in patients on no OAC versus those on PAR and OAC. The most frequent cause of death after 36-month follow-up was cancer (n = 565, 48.6 %), followed by cardiac (n = 94, 8.1 %), and VTE (n = 38, 3.2 %). Most recurrent VTE events were DVT alone (n = 564, 63.3 %), with the remainder PE, (n = 236, 27.3 %), or PE in combination with DVT (n = 63, 7.3 %).Interpretation: GARFIELD-VTE provides a global perspective of anticoagulation patterns and highlights the accumulation of events within the first 12 months after diagnosis. These findings may help identify treatment gaps for subsequent interventions to improve patient outcomes in this patient population
Incidence and predictors of post-thrombotic syndrome in patients with proximal DVT in a real-world setting: findings from the GARFIELD-VTE registry
No full text<jats:title>Abstract</jats:title><jats:p>Although substantial progress has been made in the pathophysiology and management of the post-thrombotic syndrome (PTS), several aspects still need clarification. Among them, the incidence and severity of PTS in the real world, the risk factors for its development, the value of patient’s self-evaluation, and the ability to identify patients at risk for severe PTS. Eligible participants (n = 1107) with proximal deep-vein thrombosis (DVT) from the global GARFIELD-VTE registry underwent conventional physician’s evaluation for PTS 36 months after diagnosis of their DVT using the Villalta score. In addition, 856 patients completed a Villalta questionnaire at 24 months. Variable selection was performed using stepwise algorithm, and predictors of severe PTS were incorporated into a multivariable risk model. The optimistic adjusted c-index was calculated using bootstrapping techniques. Over 36-months, 27.8% of patients developed incident PTS (mild in 18.7%, moderate in 5.7%, severe in 3.4%). Patients with incident PTS were older, had a lower prevalence of transient risk factors of DVT and a higher prevalence of persistent risk factors of DVT. Self-assessment of overall PTS at 24 months showed an agreement of 63.4% with respect to physician’s evaluations at 36 months. The severe PTS multivariable model provided an optimistic adjusted c-index of 0.68 (95% CI 0.59–0.77). Approximately a quarter of DVT patients experienced PTS over 36 months after VTE diagnosis. Patient’s self-assessment after 24 months provided added value for estimating incident PTS over 36 months. Multivariable risk analysis allowed good discrimination for severe PTS.</jats:p>
