| 1. |
- Thomas, HS, et al.
(författare)
-
- 2019
-
swepub:Mat__t
|
|
| 2. |
|
|
| 3. |
- Drake, TM, et al.
(författare)
-
Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
-
Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
-
Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Lavers, David A., et al.
(författare)
-
A Vision for Hydrological Prediction
- 2020
-
Ingår i: Atmosphere. - : MDPI AG. - 2073-4433. ; 11:3
-
Tidskriftsartikel (refereegranskat)abstract
- IMproving PRedictions and management of hydrological EXtremes (IMPREX) was a European Union Horizon 2020 project that ran from September 2015 to September 2019. IMPREX aimed to improve society's ability to anticipate and respond to future extreme hydrological events in Europe across a variety of uses in the water-related sectors (flood forecasting, drought risk assessment, agriculture, navigation, hydropower and water supply utilities). Through the engagement with stakeholders and continuous feedback between model outputs and water applications, progress was achieved in better understanding the way hydrological predictions can be useful to (and operationally incorporated into) problem-solving in the water sector. The work and discussions carried out during the project nurtured further reflections toward a common vision for hydrological prediction. In this article, we summarized the main findings of the IMPREX project within a broader overview of hydrological prediction, providing a vision for improving such predictions. In so doing, we first presented a synopsis of hydrological and weather forecasting, with a focus on medium-range to seasonal scales of prediction for increased preparedness. Second, the lessons learned from IMPREX were discussed. The key findings were the gaps highlighted in the global observing system of the hydrological cycle, the degree of accuracy of hydrological models and the techniques of post-processing to correct biases, the origin of seasonal hydrological skill in Europe and user requirements of hydrometeorological forecasts to ensure their appropriate use in decision-making models and practices. Last, a vision for how to improve these forecast systems/products in the future was expounded, including advancing numerical weather and hydrological models, improved earth monitoring and more frequent interaction between forecasters and users to tailor the forecasts to applications. We conclude that if these improvements can be implemented in the coming years, earth system and hydrological modelling will become more skillful, thus leading to socioeconomic benefits for the citizens of Europe and beyond.
|
|
| 7. |
|
|
| 8. |
- Titley, H. A., et al.
(författare)
-
Key Factors Influencing the Severity of Fluvial Flood Hazard from Tropical Cyclones
- 2021
-
Ingår i: Journal of Hydrometeorology. - : American Meteorological Society. - 1525-755X .- 1525-7541. ; 22:7, s. 1801-1817
-
Tidskriftsartikel (refereegranskat)abstract
- Knowledge of the key drivers of the severity of river flooding from tropical cyclones (TCs) is vital for emergency preparedness and disaster risk reduction activities. This global study examines landfalling TCs in the decade from 2010 to 2019 to identify those characteristics that influence whether a storm has an increased flood hazard. The highest positive correlations are found between flood severity and the total precipitation associated with the TC. Significant negative correlations are found between flood severity and the translation speed of the TC, indicating that slower-moving storms that rain over an area for longer tend to have higher flood severity. Larger and more intense TCs increase the likelihood of having a larger area affected by severe flooding but not its duration or magnitude, and it is found that the fluvial flood hazard can be severe in all intensity categories of TC, including those of tropical storm strength. Catchment characteristics such as antecedent soil moisture and slope also play a role in modulating flood severity, and severe flooding is more likely in cases in which multiple drivers are present. The improved knowledge of the key drivers of fluvial flooding in TCs can help to inform research priorities to help with flood early warning, such as increasing the focus on translation speed in model evaluation and impact-based forecasting. Significance Statement Knowing ahead of landfall which TCs are likely to lead to significant river flooding will help those responsible for emergency planning make appropriate decisions to minimize loss of life and property. We compare 280 TCs and find that the cases with slow-moving, large, and intense cyclones, affecting areas with wet antecedent conditions, have the highest likelihood of experiencing widespread flooding. Slower-moving storms also have an increased risk of longer and more extreme floods. Our results show the importance of considering aspects such as the speed of forward movement along the whole flood early warning chain, from model evaluation and development, through to warning design and communication, to better inform forecast-based action prior to TC landfall.
|
|
