Patients with severe intracerebral hemorrhage (ICH) often suffer from impaired capacity and rely on surrogates for decision-making. Restrictions on visitors within healthcare facilities during the ...pandemic may have impacted care and disposition for patient with ICH. We investigated outcomes of ICH patients during the COVID-19 pandemic compared to a pre-pandemic period.
We conducted a retrospective review of ICH patients from two sources: (1) University of Rochester Get With the Guidelines database and (2) the California State Inpatient Database (SID). Patients were divided into 2019-2020 pre-pandemic and 2020 pandemic groups. We compared mortality, discharge, and comfort care/hospice. Using single-center data, we compared 30-day readmissions and follow-up functional status.
The single-center cohort included 230 patients (n = 122 pre-pandemic, n = 108 pandemic group), and the California SID included 17,534 patients (n = 10,537 pre-pandemic, n = 6,997 pandemic group). Inpatient mortality was no different before or during the pandemic in either cohort. Length of stay was unchanged. During the pandemic, more patients were discharged to hospice in the California SID (8.4% vs. 5.9%, p<0.001). Use of comfort care was similar before and during the pandemic in the single center data. Survivors in both datasets were more likely to be discharged home vs. facility during the pandemic. Thirty-day readmissions and follow-up functional status in the single-center cohort were similar between groups.
Using a large database, we identified more ICH patients discharged to hospice during the COVID-19 pandemic and, among survivors, more patients were discharged home rather than healthcare facility discharge during the pandemic.
The purpose of reporting on selected cases is to increase the recognition and treatment of mechanical joint dysfunction (restrictions in movement at the joint level) in pediatric patients.
The ...selected cases demonstrate a variety of clinical outcomes that are possible using manual therapy to improve mechanical joint dysfunction and chronic pain. The techniques used for these patents were performed by a physical therapist without formal manual therapy training to encourage more physical therapists to use manual therapy as an intervention to improve outcomes in pediatric patients.
The hands-on treatment used to treat mechanical joint dysfunction improved participation and function in children of various ages with a variety of clinical issues.
: Recognizing and treating mechanical joint restrictions that interfere with active movement in children may result in decreased pain and improved motor skills, balance, self-regulation, sleep hygiene, and social interactions. Clinicians should consider manual therapy as an intervention strategy for pediatric patients with mechanical joint restrictions.
Late one Saturday night -- Dec 12, 2015 -- on the outskirts of Paris while sitting in the chilly prefabricated buildings of a repurposed airport known as Le Bourget, the world's climate change ...negotiators watched as a new climate agreement was gavelled into existence. This new, legally binding agreement known as the Paris Agreement, effectively set the world onto a new, climate-focused development path. Human-induced climate change is acknowledged to be the greatest challenge facing our society and economy. The excessive and unsustainable use of fossil fuels and destruction of the earth's natural ecosystems have resulted in greenhouse gases which enter the atmosphere and trap heat, thereby driving an increase in global average temperatures. Climate change has been classified as a super-wicked problem -- in other words, a global environmental problem for which the time available to find a solution is rapidly decreasing and where our irrational discounting of the impacts pushes the required responses and associated costs into the future.
Climate change is a severe global threat. Research on climate change and vulnerability to natural hazards has made significant progress over the last decades. Most of the research has been devoted to ...improving the quality of climate information and hazard data, including exposure to specific phenomena, such as flooding or sea-level rise. Less attention has been given to the assessment of vulnerability and embedded social, economic and historical conditions that foster vulnerability of societies. A number of global vulnerability assessments based on indicators have been developed over the past years. Yet an essential question remains how to validate those assessments at the global scale. This paper examines different options to validate global vulnerability assessments in terms of their internal and external validity, focusing on two global vulnerability indicator systems used in the WorldRiskIndex and the INFORM index. The paper reviews these global index systems as best practices and at the same time presents new analysis and global results that show linkages between the level of vulnerability and disaster outcomes. Both the review and new analysis support each other and help to communicate the validity and the uncertainty of vulnerability assessments. Next to statistical validation methods, we discuss the importance of the appropriate link between indicators, data and the indicandum. We found that mortality per hazard event from floods, drought and storms is 15 times higher for countries ranked as highly vulnerable compared to those classified as low vulnerable. These findings highlight the different starting points of countries in their move towards climate resilient development. Priority should be given not just to those regions that are likely to face more severe climate hazards in the future but also to those confronted with high vulnerability already.
Display omitted
•Internal and external validation is crucial for global vulnerability assessments.•Vulnerability of WRI and INFORM index partially explains mortality and economic losses.•Hazard mortality is 15 times higher in most compared to least vulnerable countries.•Vulnerability shows different starting points towards climate resilient development.
Planning for the Future of Urban Biodiversity NILON, CHARLES H.; ARONSON, MYLA F. J.; CILLIERS, SAREL S. ...
BioScience/Bioscience,
04/2017, Letnik:
67, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Cities represent considerable opportunities for forwarding global biodiversity and sustainability goals. We developed key attributes for conserving biodiversity and for ecosystem services that should ...be included in urban-planning documents and reviewed 135 plans from 40 cities globally. The most common attributes in city plans were goals for habitat conservation, air and water quality, cultural ecosystem services, and ecological connectivity. Few plans included quantitative targets. This lack of measurable targets may render plans unsuccessful for an actionable approach to local biodiversity conservation. Although most cities include both biodiversity and ecosystem services, each city tends to focus on one or the other. Comprehensive planning for biodiversity should include the full range of attributes identified, but few cities do this, and the majority that do are mandated by local, regional, or federal governments to plan specifically for biodiversity conservation. This research provides planning recommendations for protecting urban biodiversity based on ecological knowledge.
Conserving and restoring biodiversity is central to the achievement of the Sustainable Development Goals. The need to curb biodiversity loss through the mainstreaming of biodiversity considerations ...within land-use planning is consistently highlighted in global biodiversity assessments intended for policymakers and practitioners. We present a Global South local government-led examination of the mainstreaming of biodiversity issues within a biodiversity hotspot area. Here, we evaluated the four-decade-long evolution in open space planning in Durban, South Africa, in response to shifting urbanisation, governance and policy/legislative contexts. We assessed the role of science in responding to contextual changes, the need for champions, and key institutional interventions undertaken to embed a biodiversity function within local government. In addition, we investigated how biodiversity concerns have been incorporated into land-use planning applications via the city’s environmental planning function. We provide evidence of the advancement of mainstreaming biodiversity concerns within local government processes, institutional functions, and land-use decision-making. This has been achieved through effective and sustained leadership; the use of science and scientific information in advancing the policy and legislative environment and building political support by responding to shifting governance contexts; investment in institutional scientific capacity and generating scale-appropriate biodiversity information. Learnings from this paper may be useful for other local governments addressing biodiversity loss through land-use planning processes, by identifying critical investment areas that may shorten the time required for effective mainstreaming.
Abstract
Objective
Mechanical ventilation (MV) has a complex interplay with the pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH). We aim to provide a review of the physiology of MV in ...patients with aSAH, give recommendations based on a systematic review of the literature, and highlight areas that still need investigation.
Data sources
PubMed was queried for publications with the Medical Subject Headings (MeSH) terms “mechanical ventilation” and “aneurysmal subarachnoid hemorrhage” published between January 1, 1990, and March 1, 2020. Bibliographies of returned articles were reviewed for additional publications of interest.
Study selection
Study inclusion criteria included English language manuscripts with the study population being aSAH patients and the exposure being MV. Eligible studies included randomized controlled trials, observational trials, retrospective trials, case-control studies, case reports, or physiologic studies. Topics and articles excluded included review articles, pediatric populations, non-aneurysmal etiologies of subarachnoid hemorrhage, mycotic and traumatic subarachnoid hemorrhage, and articles regarding tracheostomies.
Data extraction
Articles were reviewed by one team member, and interpretation was verified by a second team member.
Data synthesis
Thirty-one articles met the inclusion criteria for this review.
Conclusions
We make recommendations on oxygenation, hypercapnia, PEEP, APRV, ARDS, and intracranial pressure monitoring.
Objective
This research sought to bring awareness to positive communication skills and social components that may be helpful with closing the persistent academic achievement gap between White and ...Black students in junior high school and high school. In underserved Black American populations it is often believed that parents have little communication concerning the need for educational attainment; however, there is some research to explain that Black American parents participate in much communication with their children pertaining to academic well-being.
Methods
Questionnaires were distributed to 167 adolescents, ages 11–19 years old, in sixth through twelfth grades. Once data were collected, we completed moderated-mediation analyses using the bootstrapping technique in Process.
Results
We found support for self-efficacy and social skills as mediators in the relationship between parent–adolescent communication (PAC) and academic performance. However, the findings were conditional for moderators, grade level and household make up. Results for self-efficacy and social skills were mixed for junior high school and high school in the relationship between PAC and academic performance. Furthermore, single parent homes revealed low amounts of self-efficacy and social skills as expected in the moderated-mediation.
Conclusion
Implications for the study suggest more direct PAC in the Black American community surrounding self-efficacy, social skills and academic performance in order to promote academic success.
Conference of the Parties (COP), a meeting of all the nation states who have signed and ratified the United Nations Framework Convention on Climate Change's, serves as a meeting of the parties to the ...associated Kyoto Protocol. COP18 in Doha very clearly illustrated that the international climate negotiating process is now being held hostage to the domestic ambitions of national governments. Local governments have long recognised that there is very little point in waiting for national governments to negotiate a grand climate deal, and that it is necessary for those working at the coal face in the world's cities to ensure that there is real progress in tackling the climate change challenge. It is critical that cities and their local governments remain active and engaged players on the global climate stage. Their economic power, share of the population and ability to act decisively means that the rebirth of the era of city-states is not improbable.
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