River Camel SAP Final Plan

This is the River Camel Salmon Action Plan Final document produced by the Environment Agency in 2002. This final Salmon Action Plan (SAP) for the River Camel catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Camel salmon stock. The actions presented within this Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. An attempt has been made to cost these actions, identify possible sources of funding and to provide a timescale for action. This Action Plan aims to promote long term collaboration and co-operation between the Agency and other interested parties to effectively and efficiently manage the stock of salmon on the River Camel.

River Fowey SAP Final Plan

This is the River Fowey Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Fowey catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Fowey salmon stock. The actions presented within this final Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. The main objective of the Fowey SAP therefore, is to maintain, improve and develop the Fowey salmon stocks to a sustainable level that, on the basis of historic catch records, the catchment can clearly support. Although the Fowey is passing its conservation limit, the consultees felt very strongly that there were two major factors limiting the salmon stock of the River Fowey- the overgrazing of Bodmin Moor and the use of the catchment for water supply by South West Water.

River Lynher SAP Final Plan

This is the River Lynher Salmon Action Plan Final document produced by the Environment Agency in 1999. This final Salmon Action Plan (SAP) for the River Lynher catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Lynher salmon stock. The actions presented within this final Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. The River Lynher salmon stock has suffered two periods of spawning target failure within the past ten years. This assessment can only be estimated and in this case is likely to be dependent on river flow and the availability of salmon to the rods as only rod catch is used in the compliance assessment.

River Plym SAP Final Plan

This is the River Plym Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Plym catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Lynher salmon stock. These issues and actions follow on from the detailed analysis of the catchment, which is presented in the River Plym SAP Consultation document.The actions presented within this final Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. The main objective of the River Plym SAP therefore, is to maintain, improve and develop the River Plym salmon stocks to a sustainable level that, on the basis of historic catch records, the catchment can clearly support. The River Plym has failed to pass its conservation limit since 1996, and the consultees felt very strongly that there were three major factors limiting the salmon stock of the River Plym.

River Tavy SAP Final Plan

This is the River Tavy Salmon Action Plan Final document produced by the Environment Agency in 2000. This final Salmon Action Plan (SAP) for the River Tavy catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Tavy salmon stock. The actions presented within this Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. An attempt has been made to cost these actions, identify possible sources of funding and to provide a timescale for action. This Action Plan aims to promote long term collaboration and co-operation between the Agency and other interested parties to effectively and efficiently manage the stock of salmon on the River Tavy.

River Yealm SAP Final Plan

This is the River Yealm Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Yealm catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Yealm salmon stock. The actions presented within this Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. An attempt has been made to cost these actions, identify possible sources of funding and to provide a timescale for action. The main objective of the River Yealm SAP is to maintain, improve and develop the River Yealm salmon stocks to a sustainable level that, on the basis of historic catch records, the catchment can clearly support.

The Rivers Avon & Erme SAP Final Plan

This is the Rivers Avon & Erme Salmon Action Plan Final document produced by the Environment Agency in 2004. The Rivers Avon and Erme Salmon Action Plan (SAP) has been produced after consideration of feedback from public consultation. The final plan provides a list of the agreed issues and actions for the next five years to maintain and improve the salmon stocks and fisheries of both rivers. Efforts have been made to identify possible sources of funding, partners and timescales. It indicates how the plan will be managed, including the process for reviewing stock status, issues, actions and progress. Low marine survival is currently a major factor limiting the numbers of salmon returning to spawn in both the Avon and the Erme. Actions to improve the accessibility of spawning areas and to maximise the productivity of spawning and nursery habitats are seen as priorities, which should help to offset the low marine survival. The quality of the information available to assess salmon stocks is recognised as a limiting factor in the management of salmon fisheries. The SAP aims also to promote long term collaboration between the Agency and other interested parties in managing the salmon stocks and fisheries of the Avon and the Erme.

The River Axe SAP Final Plan

This is the River Axe Salmon Action Plan Final document produced by the Environment Agency in 2004. The River Axe Salmon Action Plan (SAP) has been produced after consideration of feedback from public consultation. The final plan provides a list of the agreed issues and actions for the next five years to maintain and improve the salmon stock of the River Axe. Efforts have been made to identify possible sources of funding, partners and timescales. It indicates how the plan will be managed, including the process for reviewing stock status, issues, actions and progress. Low marine survival is currently a major factor limiting salmon stocks throughout the United Kingdom. However, on the River Axe the freshwater environment is still the main factor limiting the recovery of the salmon stock. Most of the adults returning to the Axe at present are probably derived from hatchery reared smolts, although there has been some natural reproduction in recent years. Juvenile populations in the Yarty indicate that this is a tributary where salmon have started to re-establish a self-sustaining population. Actions to improve the quality of the freshwater environment, both in terms of water quality and sedimentation, are seen as the top priorities, and are required to allow the Axe to support a self-sustaining salmon population.

The River Dart SAP Final Plan

This is the River Dart Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Dart catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Dart salmon stock. The low marine survival (likely to be below 10%) is possibly to be the main cause for the River Dart salmon stock non-compliance with its conservation limit. Actions protecting smolts and maximising spawning activity of returning adults are seen as priorities to contribute to mitigate the low marine survival. Also the lack of information on salmon stock and its habitat is recognised as one main factor limiting the better management of salmon fisheries. Efforts will be focused on gaining more knowledge and improving modelling techniques. The actions presented in this document are perceived as those required to address the important issues and factors limiting the salmon stock. This SAP aims also to promote long term collaboration between the Agency and other interested parties in managing the River Dart salmon stock and fisheries.

The River Exe SAP Final Plan

This is the River Exe Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Exe catchment has been produced after consideration of feedback from external consultation. The actions presented within this Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. An attempt has been made to cost these actions, identify possible sources of funding and to provide a timescale for action. This SAP aims also to promote long term collaboration between the Agency and other interested parties in managing the River Exe salmon stock and fisheries. The River Exe salmon population is currently judged to be passing its Conservation Limit. However, its apparent declining trend in egg deposition in the recent years and the high uncertainty in its stock assessment suggest the following actions as priorities: actions promoting good land management, maximising salmon natural spawning activity and protecting smolts throughout the Exe catchment. Also, the lack of information on salmon stocks and its habitat quality and availability is recognised as the main factor limiting the better management of salmon fisheries. The actions presented in this document are perceived as those required to address the important issues and factors limiting the salmon stock.

The River Lyn SAP Final Plan

This is the River Lyn Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Lyn catchment has been produced after consideration of feedback from external consultation. It provides a list of the agreed issues and actions for the next five years to maintain and improve the River Lyn salmon stock. The actions presented within this Salmon Action Plan clarify the important issues and factors currently limiting the salmon stock on the river. The resolution of these issues should ensure that a sustainable salmon population will be maintained for future generations. An attempt has been made to cost these actions, identify possible sources of funding and to provide a timescale for action. This SAP aims also to promote long term collaboration between the Agency and other interested parties in managing the River Lyn salmon stock and fisheries.

The River Taw SAP Final Plan

This is the River Taw Salmon Action Plan Final document produced by the Environment Agency in 2000. This final Salmon Action Plan (SAP) for the River Taw catchment has been produced after consideration of feedback from external consultation. The SAP provides a list of the issues and actions which were agreed for a five-year programme to maintain and improve the River Taw salmon stock. Some of these actions have already been delivered before finalising the SAP, but others have yet to be addressed. An attempt has been made to estimate the cost of the actions, identify possible sources of funding and the timescale under which they will be dealt with. The Taw salmon stock is currently failing to meet its spawning target. However, there was a period of compliance in the 1990s following a decade of failure through the 1980s. The freshwater environment of the Taw has improved in recent years. The actions presented in this SAP are perceived as those that are required to address, as far as possible, the important issues and factors currently limiting the salmon stock on the river. This SAP aims to promote long term collaboration between the Agency and other interested parties in managing the River Taw salmon stock and fisheries.

The River Teign SAP Final Plan

This is the River Teign Salmon Action Plan Final document produced by the Environment Agency in 2003. This final Salmon Action Plan (SAP) for the River Teign catchment has been produced after consideration of feedback from external consultation. This final plan provides a list of the agreed issues and actions for the next five years to maintain and improve the River Teign salmon stock. An attempt has been made to cost these actions, identify possible sources of funding, partners and the timescale under which they will be dealt with. It indicates how the plan will be managed, i.e., implemented and reviewed, and, summarises progress of on-going actions. The low marine survival (likely to be below 10%) is possibly the main cause for the River Teign salmon stock non-compliance with its conservation limit. Actions protecting smolts and maximising spawning activity of returning adults are seen as priorities to contribute to offset the low marine survival. This SAP aims also to promote long term collaboration between the Agency and other interested parties in managing the River Teign salmon stock and fisheries.

The River Torridge SAP Final Plan

This is the River Torridge Salmon Action Plan Final document produced by the Environment Agency in 2000. This final Salmon Action Plan (SAP) for the River Torridge catchment has been produced after consideration of feedback from external consultation. The SAP provides a list of the issues and actions which were agreed for a five-year programme to maintain and improve the River Torridge salmon stock. Some of these actions have already been delivered before finalising the SAP, but others have yet to be addressed. An attempt has been made to estimate the cost of the actions, identify possible sources of funding and the timescale under which they will be dealt with. The Torridge salmon stock has declined dramatically since the 1960s and is currently failing to meet the spawning target. The decline in the spring fish component has accounted largely for the overall decrease in stocks. The reasons for the decline are not fully understood, but the spring fish problem is recognised as a national issue. The rate of survival over the marine phase has reduced in recent years for both the grilse and multi-sea winter (MSW) components. This is undoubtedly a contributory factor, which may now constrain stocks to lower levels than have existed historically. Agricultural pollution is recognised as one of the main factors limiting freshwater production. This SAP aims to promote long term collaboration between the Agency and other interested parties in managing the River Torridge salmon stock and fisheries.

Avaliação do potencial da Telemedicina em Cuidados Paliativos no câncer avançado

Este estudo avaliou o potencial da Telemedicina como suporte complementar a assistência ambulatorial na monitoração de sintomas em pacientes com câncer avançado. Foram acompanhados 12 pacientes do ambulatório do Núcleo de Cuidados Paliativos do Hospital Universitário Pedro Ernesto (NCP-HUPE) de janeiro de 2011 a agosto de 2013. Mensalmente foram feitas consultas ambulatoriais pela médica e equipe multidisciplinar. Neste intervalo, os pacientes do domicilio, através de seus computadores pessoais se conectaram ao Laboratório de TeleSSaúde UERJ pelo serviço de webconferências interagindo com a mesma médica assistente do ambulatório. Os pacientes também tiveram acesso à médica por celular e email. A cada entrevista (presencial e remota) foi aplicada a Escala de Avaliação de Sintomas de Edmonton [Edmonton Symptom Assessment System (ESAS)], e coletado outros dados quanto a outras queixas biopsicossociais e espirituais, agravos à saúde, qualidade de áudio e vídeo da conexão, avaliação dos familiares com a Telemedicina e interferência da Telemedicina quanto ao local do óbito do paciente. Houve dificuldade na seleção dos pacientes, pois o HUPE é um hospital público cuja população assistida tem, caracteristicamente, baixa escolaridade, nível socioeconômico restrito e pouca habilidade com informática. O tempo médio de acompanhamento foi de 195 dias (DP 175,11; range: 11-553 dias). Todos receberam diagnóstico de câncer avançado e tinham dificuldades com locomoção. Sem dúvidas, a ESAS favoreceu a comunicação dos sintomas com os profissionais de saúde; porém, condições clínicas e controle dos sintomas singulares, avaliados em momentos distintos e sujeitos a influências diversas, impedem conclusões em relação às pretensas vantagens. Acompanhamento clínico, detecção de agravos à saúde e de sintomas físicos, psicossociais e espirituais foram possíveis de ser observados pela Telemedicina, confirmados e medicados nas consultas presenciais. A conexão para webconferência foi estabelecida por familiares, pois nenhum paciente operava computadores. O óbito domiciliar ocorreu em 41,67% e todos, mesmo os óbitos hospitalares, receberam suporte à distância do NCP. Durante o estudo foram feitos 305 contatos: 110 consultas presenciais a pacientes e familiares e 195 por Telemedicina (77 webconferências, 38 telefonemas e 80 emails). Todos os familiares referiram satisfação com o suporte oferecido. A Telemedicina permitiu maior acesso ao sistema de saúde (maior número de contatos), reduziu a busca por serviços de emergência, ajudou o controle dos sintomas e proporcionou orientações e segurança aos familiares. Este suporte favoreceu intervenções precoces e proativas e assistência continuada até o óbito. A Telemedicina demonstrou ser um bom adjuvante na monitoração e gerenciamento de sintomas de pacientes em cuidados paliativos em domicílio, não substituindo, mas complementando a assistência presencial.