BackgroundThis paper crystallises the experience developed by the pan-European PALANTE Consortium in dealing with the generation of relevant evidence from heterogeneous eHealth services for patient empowerment in nine European Regions. The European Commission (EC) recently funded a number of pan-European eHealth projects aimed at empowering European patients/citizens thus transforming the traditional patient/citizen role in the management of their health (e.g., PALANTE, SUSTAIN, CARRE, HeartCycle, Empower). However, the heterogeneity of the healthcare systems, of the implemented services and of the target patients, the use of ad-hoc definitions of the salient concepts and the development of small-size experiences have prevented the dissemination of “global” results and the development of cumulative knowledge. The main challenge has been the generation of large-scale evidence from heterogeneous small-size experiences.DiscussionThree lessons have been collectively learnt during the development of the PALANTE project, which involves 9 sites that have implemented different eHealth services for empowering different typologies of patients. These lessons have been refined progressively through project meetings, reviews with the EC Project Officer and Reviewers. The paper illustrates the ten steps followed to develop the three lessons.The first lesson learnt is about how EC-funded projects should develop cumulative knowledge by avoiding self-crafted measures of outcome and by adopting literature-grounded definitions and scales. The second lesson learnt is about how EC-funded projects should identify ambitious, cross-pilot policy and research questions that allow pooling of data from across heterogeneous experiences even if a multi-centre study design was not agreed before. The third lesson learnt is about how EC-funded projects should open their collections of data and make them freely-accessible to the scientific community shortly after the conclusion of the project in order to guarantee the replicability of results and conclusions.SummaryThe three lessons might provide original elements for fuelling the ongoing debate about the capability of the EC to develop evidence-based policies by pooling evidence from heterogeneous, local experiences.
Tree survival is a performance metric for urban forestry initiatives, and an understanding of the factors that influence mortality can help managers target resources and enhance survival. Furthermore, urban tree planting investments depend on tree survival to maximize ecosystem services. In this literature review, we categorized factors commonly associated with urban tree mortality and summarized mortality rates published in 56 studies, focusing on studies of trees along streets, in yards, and in landscaped parks. Study designs included quantitative field monitoring of uneven-aged tree populations and tracking planting cohorts of even-aged trees, as well as qualitative analyses. Annual mortality rates ranged from 0.6 to 68.5% for cohort studies and 0 to 30% for repeated inventories of uneven-aged trees. The 1st, 2nd, and 3rd quartiles of annual mortality were 2.8 to 3.8%, 4.4 to 6.5%, and 7.1 to 9.3% for planting cohorts, and 1.6%, 2.3 to 2.6%, and 3.0 to 3.3% for repeated inventories of uneven-aged trees (ranges reflect studies that reported a range for the time period or mortality rate). For cohort studies, annual mortality tended to be highest during the first five years after planting. The most commonly cited biophysical factors associated with mortality were taxa (15 articles), tree size/age (13 articles), and site characteristics (12 articles). The most commonly cited human-related factors were stewardship, maintenance, and vandalism (15 articles). More long-term studies are needed to investigate how site characteristics influence mortality, including rarely examined soil and microclimate characteristics. Future research should also examine institutional structures related to mortality outcomes, as well as parcel-level sociodemographic factors and resident behaviors.
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