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- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Goni, Maria Fernanda Sanchez, et al.
(författare)
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The ACER pollen and charcoal database : a global resource to document vegetation and fire response to abrupt climate changes during the last glacial period
- 2017
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Ingår i: Earth System Science Data. - : Copernicus GmbH. - 1866-3508 .- 1866-3516. ; 9:2, s. 679-695
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Tidskriftsartikel (refereegranskat)abstract
- Quaternary records provide an opportunity to examine the nature of the vegetation and fire responses to rapid past climate changes comparable in velocity and magnitude to those expected in the 21st-century. The best documented examples of rapid climate change in the past are the warming events associated with the Dansgaard-Oeschger (D-O) cycles during the last glacial period, which were sufficiently large to have had a potential feedback through changes in albedo and greenhouse gas emissions on climate. Previous reconstructions of vegetation and fire changes during the D-O cycles used independently constructed age models, making it difficult to compare the changes between different sites and regions. Here, we present the ACER (Abrupt Climate Changes and Environmental Responses) global database, which includes 93 pollen records from the last glacial period (73-15 ka) with a temporal resolution better than 1000 years, 32 of which also provide charcoal records. A harmonized and consistent chronology based on radiometric dating (C-14, U-234/Th-230, optically stimulated luminescence (OSL), Ar-40/Ar-39-dated tephra layers) has been constructed for 86 of these records, although in some cases additional information was derived using common control points based on event stratigraphy. The ACER database compiles metadata including geospatial and dating information, pollen and charcoal counts, and pollen percentages of the characteristic biomes and is archived in Microsoft Access (TM) at https://doi. org/10.1594/PANGAEA. 870867.
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| 3. |
- Elliott, Sarah, et al.
(författare)
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The legacy of 1300 years of land use in Jamaica
- 2024
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Ingår i: Journal of Island & Coastal Archaeology. - : Taylor & Francis Group. - 1556-4894 .- 1556-1828. ; 19:2, s. 312-343
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Tidskriftsartikel (refereegranskat)abstract
- Despite decades of archaeological research on Jamaica, little is known about how settlers influenced landscape change on the island over time. Here, we examine the impact of human occupation through a multi-proxy approach using phytolith, charcoal, and stratigraphic analyses. White Marl was a continuously inhabited village settlement (ca. 1050-450 cal yrs BP) with large mounded midden areas, precolonial house structures, and human landscape management practices. We have shown that the local vegetation at White Marl was directly affected by human settlement through the use of agroforestry and burning, and suggest that fire was used to modify vegetation. Manioc phytoliths were found throughout human occupation and are broadly associated with increases in evidence for burning, suggesting fire was used to modify the landscape and clear vegetation for crop cultivation. The phytolith assemblages relate to three distinct temporal vegetation phases: (1) the earliest occupation dominated by arboreal vegetation (pre-ca. 870 cal yrs BP); (2) a transition to palm-dominated vegetation (ca. 870-670 cal yrs BP); and (3) the latest occupation representing European colonization associated with a more open, grass-dominated landscape (after ca. 670 cal yrs BP). These transitions occur independent of changes in paleoclimate records, suggesting humans were the dominant driver of vegetation change.
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