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- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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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.
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- Schulze, E D, et al.
(författare)
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The European carbon balance. Part 4: integration of carbon and other trace-gas fluxes
- 2010
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Ingår i: GLOBAL CHANGE BIOLOGY. - : Blackwell Publishing Ltd. - 1354-1013 .- 1365-2486. ; 16:5, s. 1451-1469
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Forskningsöversikt (refereegranskat)abstract
- Overviewing the European carbon (C), greenhouse gas (GHG), and non-GHG fluxes, gross primary productivity (GPP) is about 9.3 Pg yr-1, and fossil fuel imports are 1.6 Pg yr-1. GPP is about 1.25% of solar radiation, containing about 360 x 1018 J energy - five times the energy content of annual fossil fuel use. Net primary production (NPP) is 50%, terrestrial net biome productivity, NBP, 3%, and the net GHG balance, NGB, 0.3% of GPP. Human harvest uses 20% of NPP or 10% of GPP, or alternatively 1 parts per thousand of solar radiation after accounting for the inherent cost of agriculture and forestry, for production of pesticides and fertilizer, the return of organic fertilizer, and for the C equivalent cost of GHG emissions. C equivalents are defined on a global warming potential with a 100-year time horizon. The equivalent of about 2.4% of the mineral fertilizer input is emitted as N2O. Agricultural emissions to the atmosphere are about 40% of total methane, 60% of total NO-N, 70% of total N2O-N, and 95% of total NH3-N emissions of Europe. European soils are a net C sink (114 Tg yr-1), but considering the emissions of GHGs, soils are a source of about 26 Tg CO2 C-equivalent yr-1. Forest, grassland and sediment C sinks are offset by GHG emissions from croplands, peatlands and inland waters. Non-GHGs (NH3, NOx) interact significantly with the GHG and the C cycle through ammonium nitrate aerosols and dry deposition. Wet deposition of nitrogen (N) supports about 50% of forest timber growth. Land use change is regionally important. The absolute flux values total about 50 Tg C yr-1. Nevertheless, for the European trace-gas balance, land-use intensity is more important than land-use change. This study shows that emissions of GHGs and non-GHGs significantly distort the C cycle and eliminate apparent C sinks.
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