849 resultados para Triage Scales


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It is argued that existing polar prediction systems do not yet meet users’ needs; and possible ways forward in advancing prediction capacity in polar regions and beyond are outlined. The polar regions have been attracting more and more attention in recent years, fuelled by the perceptible impacts of anthropogenic climate change. Polar climate change provides new opportunities, such as shorter shipping routes between Europe and East Asia, but also new risks such as the potential for industrial accidents or emergencies in ice-covered seas. Here, it is argued that environmental prediction systems for the polar regions are less developed than elsewhere. There are many reasons for this situation, including the polar regions being (historically) lower priority, with less in situ observations, and with numerous local physical processes that are less well-represented by models. By contrasting the relative importance of different physical processes in polar and lower latitudes, the need for a dedicated polar prediction effort is illustrated. Research priorities are identified that will help to advance environmental polar prediction capabilities. Examples include an improvement of the polar observing system; the use of coupled atmosphere-sea ice-ocean models, even for short-term prediction; and insight into polar-lower latitude linkages and their role for forecasting. Given the enormity of some of the challenges ahead, in a harsh and remote environment such as the polar regions, it is argued that rapid progress will only be possible with a coordinated international effort. More specifically, it is proposed to hold a Year of Polar Prediction (YOPP) from mid-2017 to mid-2019 in which the international research and operational forecasting community will work together with stakeholders in a period of intensive observing, modelling, prediction, verification, user-engagement and educational activities.

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The degree to which habitat fragmentation affects bird incidence is species specific and may depend on varying spatial scales. Selecting the correct scale of measurement is essential to appropriately assess the effects of habitat fragmentation on bird occurrence. Our objective was to determine which spatial scale of landscape measurement best describes the incidence of three bird species (Pyriglena leucoptera, Xiphorhynchus fuscus and Chiroxiphia caudata) in the fragmented Brazilian Atlantic forest and test if multi-scalar models perform better than single-scalar ones. Bird incidence was assessed in 80 forest fragments. The surrounding landscape structure was described with four indices measured at four spatial scales (400-, 600-, 800- and 1,000-m buffers around the sample points). The explanatory power of each scale in predicting bird incidence was assessed using logistic regression, bootstrapped with 1,000 repetitions. The best results varied between species (1,000-m radius for P. leucoptera; 800-m for X. fuscus and 600-m for C. caudata), probably due to their distinct feeding habits and foraging strategies. Multi-scale models always resulted in better predictions than single-scale models, suggesting that different aspects of the landscape structure are related to different ecological processes influencing bird incidence. In particular, our results suggest that local extinction and (re)colonisation processes might simultaneously act at different scales. Thus, single-scale models may not be good enough to properly describe complex pattern-process relationships. Selecting variables at multiple ecologically relevant scales is a reasonable procedure to optimise the accuracy of species incidence models.

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Background Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. Methods A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. Results The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. Conclusions Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.

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We review the scaling properties of few-body observables near the critical conditions for binding, with particular attention to light exotic nuclei, molecules and ultracold atoms.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The play operator has a fundamental importance in the theory of hysteresis. It was studied in various settings as shown by P. Krejci and Ph. Laurencot in 2002. In that work it was considered the Young integral in the frame of Hilbert spaces. Here we study the play in the frame of the regulated functions (that is: the ones having only discontinuities of the first kind) on a general time scale T (that is: with T being a nonempty closed set of real numbers) with values in a Banach space. We will be showing that the dual space in this case will be defined as the space of operators of bounded semivariation if we consider as the bilinearity pairing the Cauchy-Stieltjes integral on time scales.

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DNA-based studies have been one of the major interests in conservation biology of endangered species and in population genetics. As species and population genetic assessment requires a source of biological material, the sampling strategy can be overcome by non-destructive procedures for DNA isolation. An improved method for obtaining DNA from fish fins and scales with the use of an extraction buffer containing urea and further DNA purification with phenol-chloroform is described. The methodology combines the benefits of a non-destructive DNA sampling and its high efficiency. In addition, comparisons with other methodologies for isolating DNA from fish demonstrated that the present procedure also becomes a very attractive alternative to obtain large amounts of high-quality DNA for use in different molecular analyses. The DNA samples, isolated from different fish species, have been successfully used on random amplified polymorphic DNA (RAPD) experiments, as well as on amplification of specific ribosomal and mitochondrial DNA sequences. The present DNA extraction procedure represents an alternative for population approaches and genetic studies on rare or endangered taxa.

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Biological control of Diatraea saccharalis is regarded as one of the best examples of successful classical biological control in Brazil. Since the introduction of the exotic parasitoid, Cotesia flavipes, from Pakistan at the beginning of the 1970s, decrease in D. saccharalis infestation in sugarcane fields has been attributed to the effectiveness of this agent. Recently, the native Tachinidae fly parasitoids (Lydella minense and Paratheresia claripalpis) have also been implicated in this success. However, quantitative data confirming the actual contribution of these agents to the control of D. saccharalis are rather limited. The purpose of this study was to investigate the dynamics of the interactions between D. saccharalis and its parasitoids, emphasizing the temporal patterns of parasitism. To investigate this question, a large data set comprising information collected from two sugarcane mills located in the state of São Paulo, Brazil (Barra and Sao Joao sugarcane mills), was analysed. Basically, the data set contained monthly information about the number of D. saccharalis larvae and their parasitoids in each sample (man-hour per sample), the sugarcane varieties cultivated, the age of the sugarcane plants (only at the Sao Joao sugarcane mill) as well as the sugarcane cut at sampling time. The data were collected from March 1984 to March 1997 and from May 1982 to December 1996 for the Barra and Sao Joao sugarcane mills, respectively. Temporal inverse density-dependent parasitism was predominant for both parasitoid species with respect to all spatial scales. Although the temporal pattern of parasitism was not directly density dependent, it was evident that the tachinids and C. flavipes presented positive numerical responses according to variations in D. saccharalis densities through time.

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The well-known correlations of low-energy three and four-nucleon observables with a typical three-nucleon scale (e.g., the Tjon line) is extended to light nuclei and nuclear matter. Evidence for the scaling between light nuclei binding energies and the triton one are pointed out. We argue that the saturation energy and density of nuclear matter are correlated to the triton binding energy. The available systematic nuclear matter calculations indicate a possible band structure representing these correlations. (c) 2006 Elsevier B.V. All rights reserved.

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In this study I propose an epistemological discussion of multiple spatio-temporal scales in neuroscience. Are such scales merely convenient levels of description of structure and function, or do they correspond to irreducible levels of brain organization? What criteria should we employ in order to reduce one level to another, or to identify levels that are not reducible to others? Should we think of these criteria as based on empirical and/or theoretical reasons? Beginning with an empirical criterion - the necessity of different experimental methodologies for the measurement of different phenomena in the same system - I summarize spatial and temporal scales currently used in neuroscience and discuss the possibility of a more general theoretical criterion. I conclude that multiscaling should be recognized as a central concept in the epistemology of neuroscience.

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This paper offers a geographical perspective on the way in which health regions have been defined and established in São Paulo as part of overall Brazilian health policy. To accomplish this, I first situate the Brazilian case in the international debate over the regionalization of health services. Second, I examine health regionalization in the case of São Paulo and show how the process is dynamic and complex, involving geographical scales that go well beyond the administrative boundaries of Brazilian municipalities.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The biological control of Diatraea saccharalis is regarded as one of the best examples of successful classical biological control in Brazil. Since the introduction of the exotic parasitoid, Cotesia flavipes, the decrease in D. saccharalis infestation in sugarcane fields has been attributed to the effectiveness of this agent. Native Tachinidae fly parasitoids (Lydella minense and Paratheresia claripalpis) have also been implicated in the success. Quantitative data confirming the actual contribution of these agents to the control of D. saccharalis are, however, rather scant. The purpose of this study was to investigate the spatial pattern of parasitism of these parasitoids in D. saccharalis populations at two large spatial scales (fields and zones). To investigate this subject, a large data set comprising information collected from a sugarcane mill located in the state of São Paulo, Brazil (São João sugarcane mill) was analysed. When regressions between the proportion parasitism against host density were computed, the percentage of significant regressions with either a positive or a negative slope was very small at both spatial scales for both parasitoid species. Regressing the densities of tachinid-parasitized hosts against host densities per field showed that these parasitoids presented a 'moderate aggregative' response to host densities, as 53.33% of the regressions were positively significant. Cotesia flavipes was 'weakly aggregated' on host densities at the field level, because only 33.33% of the regressions were positively significant. At the zone level, neither aggregative nor spatial proportion parasitism responses were evident for either parasitoid species due to the small percentage of significant regressions computed.