Design with nature : a proposed model for coastal settlements in Australia adapting to climate change and extreme weather events

The Australian coast is rich in history and is scattered with coastal settlements amongst a contrasting landscape with infinite visual and ecological diversity. These attributes provide the opportunity to create sustainable and resilient settlements, linking the wholeness of a place to the foundation of living in harmony with nature. On the contrary the coastal regions of Australia are facing dynamic changes of population growth including the looming impact of a changing climate. Acknowledging these challenges, the Australian Government highlighted that one of the key requirements for a sustainable future is to establish sustainable settlements that are resilient against the impacts of climate change. Recent government studies and reports highlighted various possible impacts to the Australian coast and regional settlements due to sea level rise with associated coastal recession, extreme weather events, flooding, and prolonged heat waves. Various adaptation frameworks are proposed to deal with this issue, but very few consider the relationship between ecological systems and human built environments. The resilience planning of settlements must consider the co-evolution of human and nature under future climate effects. This paper is thus seeking answers to the question: How can the theoretical principles of Design with Nature (McHarg, 1967) and The Nature of Order (Alexander, 1980) provide for input to a adaptation model for settlements along the coast? Reflecting on a literature review of these two well established theories, the author select key principles from both as input to a ecological design based adaptation model for coastal settlements, which establishes a system of unfolding steps to create sustainable communities that connect with the landscape, and are resilient against future impacts of change.

The Victorian bushfires and extreme weather events : media coverage, crisis and communication

The 2009 'Black Saturday' Victorian bushfires claimed the lives of 173 people and have become known as the worst fire event in Australian history. Victoria has been at the centre of two other significant Australian fire disasters - 'Black Friday' in 1939 and the 1983 'Ash Wednesday' fires in south-eastern Australia that claimed the lives of 47 people in Victoria. As media scholar and commentator Michael Gawenda has noted, the media not only report an 'event' - like the Victorian bushfires or the tsunami in the South Pacific - but in a sense create and define it. Print and electronic media coverage of extreme weather events therefore raises a multitude of issues about the media's role in serving the community before, during and after a crisis, while also trying to produce the best possible reportage in a competitive industry undergoing dramatic change. This issue of MIA provides a venue for critical, empirical engagement with media coverage and representation, and the role of journalism and journalists in reporting national and international bushfires, tsunamis, hurricanes and other extreme weather events, with a special focus on the 2009 Victorian bushfires. Its goal is to address the ramifications of an industry in flux - indeed, some may say crisis - driven by technological advances, staff reductions and media organisations under financial pressure, and to explore the ways in which such extreme weather events have impacted media practices and policy

Deleuze's neo-leibnizianism, events and the logic of sense's 'static ontological genesis'

In The Logic of Sense, Deleuze effectively argues that two types of relation between events govern their ‘evental’ or ‘ideal play’, and ultimately underlie determined substances, that is, worldly individuals and persons. Leibniz calls these relations ‘compossibility’ and ‘incompossibility’. Deleuze calls them ‘convergence’ and ‘divergence’. This paper explores how Deleuze appropriates and extends a number of Leibnizian concepts in order to ground the idea that events have ontological priority over substances ‘all the way down’.

The missing evidence: a systematic review of patients' experiences of adverse events in health care

PURPOSE: Preventable patient harm due to adverse events (AEs) is a significant health problem today facing contemporary health care. Knowledge of patients' experiences of AEs is critical to improving health care safety and quality. A systematic review of studies of patients' experiences of AEs was conducted to report their experiences, knowledge gaps and any challenges encountered when capturing patient experience data. DATA SOURCES: Key words, synonyms and subject headings were used to search eight electronic databases from January 2000 to February 2015, in addition to hand-searching of reference lists and relevant journals. STUDY SELECTION: Titles and abstracts of publications were screened by two reviewers and checked by a third. Full-text articles were screened against the eligibility criteria. DATA EXTRACTION: Data on design, methods and key findings were extracted and collated. RESULTS: Thirty-three publications demonstrated patients identifying a range of problems in their care; most commonly identified were medication errors, communication and coordination of care problems. Patients' income, education, health burden and marital status influence likelihood of reporting. Patients report distress after an AE, often exacerbated by receiving inadequate information about the cause. Investigating patients' experiences is hampered by the lack of large representative patient samples, data over sufficient time periods and varying definitions of an AE. CONCLUSION: Despite the emergence of policy initiatives to enhance patient engagement, few studies report patients' experiences of AEs. This information must be routinely captured and utilized to develop effective, patient-centred and system-wide policies to minimize and manage AEs.

Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery

CONTEXTO E OBJETIVO: Associações significativas entre cirurgia do abdome superior e eventos pulmonares do período perioperatório foram investigadas em pacientes com condições pulmonares pré-operatórias submetidos a anestesia geral. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo cujos dados foram retirados de banco de dados obtidos prospectivamente de forma protocolada, de 1 de janeiro de 1999 a 31 de dezembro de 2004, em hospital universitário terciário. MÉTODOS: Estudados 3107 pacientes com mais de 11 anos, American Society of Anesthesiologists (ASA) I, II, III, com cirurgia de abdome superior sob anestesia geral, enviados à sala de recuperação. Condições pré-operatórias analisadas por regressão logística foram: idade, sexo, estado físico ASA, insuficiência cardíaca congestiva, asma, doença pulmonar obstrutiva crônica, insuficiência respiratória e hábito de fumar. Os resultados estudados, ou variáveis dependentes, incluíram eventos intra- e pós-operatórios: broncoespasmo, hipoxemia, hipercapnia, intubação prolongada e secreção de vias aéreas. RESULTADOS: Dos 3.107 pacientes: 1.540 eram homens, 1.649 mulheres, tinham média de 48 anos, 1088 ASA I, 1402 ASA II, 617 ASA III, com insuficiência cardíaca havia 80, asma, 82, doença pulmonar obstrutiva, 122, insuficiência respiratória, 21, hábito de fumar, 428. Pela regressão logística, sexo feminino (p < 0.001), idade maior que 70 anos (p < 0.01), hábito de fumar (p < 0.001) e doença pulmonar obstrutiva crônica (p < 0.02) influenciaram significativamente o desenvolvimento de eventos pulmonares, principalmente hipoxemia e broncospasmo, em ambos os períodos, mas não nos mesmos pacientes. Asma e insuficiência cardíaca não se associaram com eventos pulmonares na sala de recuperação. CONCLUSÃO: em cirurgia do abdome superior sob anestesia geral, sexo feminino, idade maior que 70 anos, hábito de fumar e doença pulmonar obstrutiva crônica foram fatores de risco independentes para a ocorrência de eventos pulmonares intra- e pós-operatórios.

The frequency of pharmacological pain relief in university neonatal intensive care units

Objective: To evaluate the use of drugs to relieve the pain of invasive procedures newborn infants cared for at a university hospital NICU. Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of the hospitalized newborn infants; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration. Factors associated with the use of analgesia in this cohort of patients were studied by multiple linear regression using SPSS 8.0. Results: Ninety-one newborn infants were admitted to the NICU during the study period (1,025 patient-days). Only 25% of the 1,025 patient-days received systemic analgesia. No specific drugs were administered to relieve acute pain during any of the following painful events: arterial punctures, venous, capillary and lumbar punctures or intubations. For chest tube insertion, 100% of newborn infants received specific analgesia. For the insertion of central catheters 8% of the newborn infants received painkillers. Only nine of the 17 newborn infants that underwent surgical procedures received any analgesic dosage during the postoperative period. For 93% of patients under analgesia the drug of choice was fentanyl. The presence of mechanical ventilation increased the chance of newborn infants receiving painkillers by 6.9 times and the presence of chest tube increased this chance by five times. Conclusion: It is necessary to train health professionals in order to bridge the gap between scientific knowledge regarding newborn infant pain and clinical practice. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Analysis of extreme events in the Caribbean 1990-2008

This study presents an analysis of extreme events in the Caribbean subregion for the period 1990 to 2008, and forms part of a similar, wider study focused on the Latin America and the Caribbean region (Central America and South America being the other two subregional components). It explores the economic costs of climate change through an examination of adaptation costs to extreme events. ECLAC, through its Subregional Headquarters for the Caribbean, is pleased to have been able to undertake this study with the financial support of DFID and to have ensured its successful execution in collaboration with technical expertise from the University of the West Indies.

The reasons of the nursing staff to notify adverse events

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

Effects of a synthetic gonadotrophin-releasing hormone agonist, leuprolide, on rut-associated events in male red deer

This study examined the effectiveness of leuprolide, a gonadotrophin-releasing hormone agonist, in suppressing rut-associated events in farmed male red deer. In mid-January (~6 weeks before the rut period in the southern hemisphere) adult red deer (Cervus elaphus scoticus) stags that had been allocated to three groups (n = 10 per group) received leuprolide, administered subcutaneously in a 90-day release formulation, at zero (control), low (22.5 mg) or high (45 mg) doses. Following treatment with leuprolide there was evidence of suppression of mean plasma luteinising hormone concentration that was significant (P < 0.05) at 9 weeks. Mean plasma testosterone concentration of all three groups rose following treatment, then declined prematurely in the low- and high-dose leuprolide-treated groups, so that it was significantly (P < 0.05) suppressed (0.66 ± 0.29 and 2.0 ± 0.88 ng mL–1, low and high dose respectively) in early April when the peak value (9.0 ± 1.94 ng mL–1) was recorded from control stags. A reduction in mean liveweight occurred in all three groups through February–April and this did not differ among treatments. However, a corresponding reduction in mean body condition score was greater in the control stags (P < 0.05). There was little effect of leuprolide treatment on aggressive behaviours, but it lowered roaring frequency in the latter period of the rut. The results indicate that this gonadotrophin-releasing hormone agonist has potential for application in the deer farming industry to suppress undesirable effects of the rut.

Probabilistic Envelope Curves for Extreme Rainfall Events - Curve Inviluppo Probabilistiche per Precipitazioni Estreme

A regional envelope curve (REC) of flood flows summarises the current bound on our experience of extreme floods in a region. RECs are available for most regions of the world. Recent scientific papers introduced a probabilistic interpretation of these curves and formulated an empirical estimator of the recurrence interval T associated with a REC, which, in principle, enables us to use RECs for design purposes in ungauged basins. The main aim of this work is twofold. First, it extends the REC concept to extreme rainstorm events by introducing the Depth-Duration Envelope Curves (DDEC), which are defined as the regional upper bound on all the record rainfall depths at present for various rainfall duration. Second, it adapts the probabilistic interpretation proposed for RECs to DDECs and it assesses the suitability of these curves for estimating the T-year rainfall event associated with a given duration and large T values. Probabilistic DDECs are complementary to regional frequency analysis of rainstorms and their utilization in combination with a suitable rainfall-runoff model can provide useful indications on the magnitude of extreme floods for gauged and ungauged basins. The study focuses on two different national datasets, the peak over threshold (POT) series of rainfall depths with duration 30 min., 1, 3, 9 and 24 hrs. obtained for 700 Austrian raingauges and the Annual Maximum Series (AMS) of rainfall depths with duration spanning from 5 min. to 24 hrs. collected at 220 raingauges located in northern-central Italy. The estimation of the recurrence interval of DDEC requires the quantification of the equivalent number of independent data which, in turn, is a function of the cross-correlation among sequences. While the quantification and modelling of intersite dependence is a straightforward task for AMS series, it may be cumbersome for POT series. This paper proposes a possible approach to address this problem.