The STRIPassistant: a Digital Tool to Optimize Polypharmacy

The Structured Tool to Reduce Inappropriate Prescribing (STRIP) is a method to perform a medication review. Part of this method is the pharmaceutical analysis that is digitalized into the STRIPassistant (demo: www.ephor.eu). The effectiveness and time-efficiency of the STRIPassistant will be presented.

A revised L-band radio-brightness sensitivity to extreme winds under tropical cyclones: The 5 year SMOS-Storm database

Five years of SMOS L-band brightness temperature data intercepting a large number of tropical cyclones (TCs) are analyzed. The storm-induced half-power radio-brightness contrast (ΔI) is defined as the difference between the brightness observed at a specific wind force and that for a smooth water surface with the same physical parameters. ΔI can be related to surface wind speed and has been estimated for ~ 300 TCs that intercept with SMOS measurements. ΔI, expressed in a common storm-centric coordinate system, shows that mean brightness contrast monotonically increases with increased storm intensity ranging from ~ 5 K for strong storms to ~ 24 K for the most intense Category 5 TCs. A remarkable feature of the 2D mean ΔI fields and their variability is that maxima are systematically found on the right quadrants of the storms in the storm-centered coordinate frame, consistent with the reported asymmetric structure of the wind and wave fields in hurricanes. These results highlight the strong potential of SMOS measurements to improve monitoring of TC intensification and evolution. An improved empirical geophysical model function (GMF) was derived using a large ensemble of co-located SMOS ΔI, aircraft and H*WIND (a multi-measurement analysis) surface wind speed data. The GMF reveals a quadratic relationship between ΔI and the surface wind speed at a height of 10 m (U10). ECMWF and NCEP analysis products and SMOS derived wind speed estimates are compared to a large ensemble of H*WIND 2D fields. This analysis confirms that the surface wind speed in TCs can effectively be retrieved from SMOS data with an RMS error on the order of 10 kt up to 100 kt. SMOS wind speed products above hurricane force (64 kt) are found to be more accurate than those derived from NWP analyses products that systematically underestimate the surface wind speed in these extreme conditions. Using co-located estimates of rain rate, we show that the L-band radio-brightness contrasts could be weakly affected by rain or ice-phase clouds and further work is required to refine the GMF in this context.

Age-Dependent Fragility and Life-Cycle Cost Analysis of Timber and Steel Distribution Poles Subjected to Hurricanes

Power distribution systems are susceptible to extreme damage from natural hazards especially hurricanes. Hurricane winds can knock down distribution poles thereby causing damage to the system and power outages which can result in millions of dollars in lost revenue and restoration costs. Timber has been the dominant material used to support overhead lines in distribution systems. Recently however, utility companies have been searching for a cost-effective alternative to timber poles due to environmental concerns, durability, high cost of maintenance and need for improved aesthetics. Steel has emerged as a viable alternative to timber due to its advantages such as relatively lower maintenance cost, light weight, consistent performance, and invulnerability to wood-pecker attacks. Both timber and steel poles are prone to deterioration over time due to decay in the timber and corrosion of the steel. This research proposes a framework for conducting fragility analysis of timber and steel poles subjected to hurricane winds considering deterioration of the poles over time. Monte Carlo simulation was used to develop the fragility curves considering uncertainties in strength, geometry and wind loads. A framework for life-cycle cost analysis is also proposed to compare the steel and timber poles. The results show that steel poles can have superior reliability and lower life-cycle cost compared to timber poles, which makes them suitable substitutes.

Hazard Mitigation Element Quality in Coastal Comprehensive Plans in a State with Strong Requirements for Hazard Mitigation Plan Elements

This dissertation examines the quality of hazard mitigation elements in a coastal, hazard prone state. I answer two questions. First, in a state with a strong mandate for hazard mitigation elements in comprehensive plans, does plan quality differ among county governments? Second, if such variation exists, what drives this variation? My research focuses primarily on Florida’s 35 coastal counties, which are all at risk for hurricane and flood hazards, and all fall under Florida’s mandate to have a comprehensive plan that includes a hazard mitigation element. Research methods included document review to rate the hazard mitigation elements of all 35 coastal county plans and subsequent analysis against demographic and hazard history factors. Following this, I conducted an electronic, nationwide survey of planning professionals and academics, informed by interviews of planning leaders in Florida counties. I found that hazard mitigation element quality varied widely among the 35 Florida coastal counties, but were close to a normal distribution. No plans were of exceptionally high quality. Overall, historical hazard effects did not correlate with hazard mitigation element quality, but some demographic variables that are associated with urban populations did. The variance in hazard mitigation element quality indicates that while state law may mandate, and even prescribe, hazard mitigation in local comprehensive plans, not all plans will result in equal, or even adequate, protection for people. Furthermore, the mixed correlations with demographic variables representing social and disaster vulnerability shows that, at least at the county level, vulnerability to hazards does not have a strong effect on hazard mitigation element quality. From a theory perspective, my research is significant because it compares assumptions about vulnerability based on hazard history and demographics to plan quality. The only vulnerability-related variables that appeared to correlate, and at that mildly so, with hazard mitigation element quality, were those typically representing more urban areas. In terms of the theory of Neo-Institutionalism and theories related to learning organizations, my research shows that planning departments appear to have set norms and rules of operating that preclude both significant public involvement and learning from prior hazard events.

Cultural identity in landscape architecture, renovation of Managua's lakeside

This thesis examines a design approach in landscape architecture in which cultural and historical values are reinterpreted in a contemporary urban environment. The site of this project is located in Managua's lakeside area, which was destroyed by hurricane Mitch in 1998. The lakeside area has been an attraction to Managua's residents because of its beautiful views and fresh breezes. The majority of Nicaragua's population is of indigenous descent; however, Managua's urban environment is predominantly of European influence. The pre-Columbian heritage of Nicaraguans is hidden in their cultural expressions, such as the names of places and religious rituals. This project provides a new lakeside area for Managua in which cultural identity in landscape architecture is represented in the use of the site and in a rescue of Managua's residents' pride in their pre-Columbian heritage. The lakeside renovation was planned using pre-Columbian design methodology and vocabulary to create a functional and environmentally sens~velandscape.

Climate Change Adaptation Case Study: Benefit-Cost Analysis of Coastal Flooding Hazard Mitigation

The damage Hurricane Sandy caused had far-reaching repercussions up and down the East Coast of the United States. Vast coastal flooding accompanied the storm, inundating homes, businesses, and utility and emergency facilities. Since the storm, projects to mitigate similar future floods have been scrutinized. Such projects not only need to keep out floodwaters but also be designed to withstand the effect that climate change might have on rising sea levels and increased flood risk. In this study, we develop an economic model to assess the costs and benefits of a berm (sea wall) to mitigate the effects of flooding from a large storm. We account for the lifecycle costs of the project, which include those for the upfront construction of the berm, ongoing maintenance, land acquisition, and wetland and recreation zone construction. Benefits of the project include avoided fatalities, avoided residential and commercial damages, avoided utility and municipal damages, recreational and health benefits, avoided debris removal expenses, and avoided loss of function of key transportation and commercial infrastructure located in the area. Our estimate of the beneficial effects of the berm includes ecosystem services from wetlands and health benefits to the surrounding community from a park and nature system constructed along the berm. To account for the effects of climate change and verify that the project will maintain its effectiveness over the long term, we allow the risk of flooding to increase over time. Over our 50-year time horizon, we double the risk of 100- and 500-year flood events to account for the effects of sea level rise on coastal flooding. Based on the economic analysis, the project is highly cost beneficial over its 50-year timeframe. This analysis demonstrates that climate change adaptation investments can be cost beneficial even though they mitigate the impacts of low-probability, high-consequence events.

Executive order no. 2016-38

This executive order by Governor Nikki R. Haley rescinds the evacuation provisions for Georgetown and Horry counties as set forth in Executive Order 2016-32.

Executive order no. 2016-37

This executive order by Governor Nikki R. Haley rescinds the evacuation provisions for Beaufort and Jasper counties as set forth in Executive Orders 2016-31 and 2016-33, effective at 6:30 PM, October 9, 2016.

Executive order no. 2016-26

This executive order by Governor Nikki R. Haley declares that a State of Emergency exists in South Carolina. She directs that the South Carolina Emergency Operations Plan be placed into effect and directs that all prudent preparations be taken at the individual, local, and state levels to protect against the possible effects of Hurricane Matthew.

Executive order no. 2016-27

This executive order by Governor Nikki R. Haley order a mandatory evacuation of all healthcare facilities, licensed by the Department of Health and Environmental Control and located in the designated evacuation zones in certain lowcountry counties.

Executive order no. 2016-29

This executive order by Governor Nikki R. Haley declares schools and government offices to be closed in certain counties beginning Wednesday, October 5, 2016 in order to support evacuation operations and mass transportation of the public with critical transportation needs due to Hurricane Matthew..

Executive order no. 2016-30

This executive order by Governor Nikki R. Haley orders a mandatory evacuation of all healthcare facilities, licensed by the Department of Health and Environmental Control and located in the designated evacuation zones in certain counties due to Hurricane Matthew.

Executive order no. 2016-31

This executive order by Governor Nikki R. Haley has declared a State of Emergency and orders an evacuation of all persons located in certain coastal counties due to Hurricane Matthew.