858 resultados para disaster triage


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Restocking is a favoured option in supporting livelihoods after a disaster. With the depletion of local livestock populations, the introduction of new species and breeds will clearly affect biodiversity. Nevertheless, the impact of restocking on Animal Genetic Resources has been largely ignored. The aim of this paper, therefore, is to examine the consequences of restocking on biodiversity via a simple model. Utilising a hypothetical project based on cattle, the model demonstrates that more than one-third of the population was related to the original restocked animals after three generations. Under conditions of random breed selection, the figure declined to 20 per cent. The tool was then applied to a donor-led restocking project implemented in Bosnia-Herzegovina. By restocking primarily with Simmental cattle, the model demonstrated that the implementation of a single restocking project is likely to have accelerated the decline of the indigenous Busa breed by a further nine per cent. Thus, greater awareness of the long-term implications of restocking on biodiversity is required.

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Restocking is a favoured option in supporting livelihoods after a disaster. With the depletion of local livestock populations, the introduction of new species and breeds will clearly affect biodiversity. Nevertheless, the impact of restocking on Animal Genetic Resources has been largely ignored. The aim of this paper, therefore, is to examine the consequences of restocking on biodiversity via a simple model. Utilising a hypothetical project based on cattle, the model demonstrates that more than one-third of the population was related to the original restocked animals after three generations. Under conditions of random breed selection, the figure declined to 20 per cent. The tool was then applied to a donor-led restocking project implemented in Bosnia-Herzegovina. By restocking primarily with Simmental cattle, the model demonstrated that the implementation of a single restocking project is likely to have accelerated the decline of the indigenous Buşa breed by a further nine per cent. Thus, greater awareness of the long-term implications of restocking on biodiversity is required.

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Two sources of bias arise in conventional loss predictions in the wake of natural disasters. One source of bias stems from neglect of accounting for animal genetic resource loss. A second source of bias stems from failure to identify, in addition to the direct effects of such loss, the indirect effects arising from implications impacting animal-human interactions. We argue that, in some contexts, the magnitude of bias imputed by neglecting animal genetic resource stocks is substantial. We show, in addition, and contrary to popular belief, that the biases attributable to losses in distinct genetic resource stocks are very likely to be the same. We derive the formal equivalence across the distinct resource stocks by deriving an envelope result in a model that forms the mainstay of enquiry in subsistence farming and we validate the theory, empirically, in a World-Society-for-the-Protection-of-Animals application

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Attributed to human-mediated dispersal, a species of the Anopheles gambiae complex invaded northeastern Brazil in 1930. This event is considered unique among the intercontinental introductions of disease vectors and the most serious one: ""Few threats to the future health of the Americas have equalled that inherent in the invasion of Brazil, in 1930, by Anopheles gambiae."" Because it was only in the 1960s that An. gambiae was recognized as a species complex now including seven species, the precise species identity of the Brazilian invader remains a mystery. Here we used historical DNA analysis of museum specimens, collected at the time of invasion from Brazil, and aimed at the identification of the Brazilian invader. Our results identify the arid-adapted Anopheles arabiensis as being the actual invading species. Establishing the identity of the species, in addition to being of intrinsic historical interest, can inform future threats of this sort especially in a changing environment. Furthermore, these results highlight the potential danger of human-mediated range expansions of insect disease vectors and the importance of museum collections in retrieving historical information.

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Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed: 1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED? 2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)? 3. How valid is each triage scale in predicting hospitalization and hospital mortality? A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted. We found ED triage scales to be supported, at best, by limited and often insufficient evidence. The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other scales. Two of the scales yielded limited scientific evidence, and one scale yielded insufficient evidence, on which to assess the risk of early death or hospitalization in patients assigned to the two lowest triage levels on a 5-level scale (validity).

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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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http://digitalcommons.colby.edu/atlasofmaine2008/1020/thumbnail.jpg

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Natural disasters can cause extensive damage to communities and infrastructure. The state of Maine is fairly lucky because natural disasters are relatively infrequent. Maine does, however, experience earthquakes, flooding, hurricanes, and landslides. Certain areas of the state are more prone to experience natural disaster than others. Using GIS analysis, we are analyzing natural disaster hotspots in Maine to determine if there is a statistically significant relationship between natural disaster susceptibility and socioeconomic variables including income and population.

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http://digitalcommons.winthrop.edu/dacusfocus/1023/thumbnail.jpg