scholarly journals Recent Changes in Hydroclimatic Patterns over Medium Niger River Basins at the Origin of the 2020 Flood in Niamey (Niger)

Water ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 1659
Author(s):  
Giovanni Massazza ◽  
Maurizio Bacci ◽  
Luc Descroix ◽  
Mohamed Housseini Ibrahim ◽  
Edoardo Fiorillo ◽  
...  
Keyword(s):  
Rainfall Runoff ◽  
Current Period ◽  
River Bed ◽  
Reduction Strategies ◽  
Extreme Hydrological Events ◽  
Niger River ◽  
Maximum Flows ◽  
Hydrometric Station ◽  
Risk Reduction Strategies ◽  
Hydroclimatic Trends

Niamey, the capital of Niger, is particularly prone to floods, since it is on the banks of the Niger River, which in its middle basin has two flood peaks: one in summer (the red flood) and one in winter (the black flood). In 2020, the Niger River in Niamey reached its all-time highest levels following an abundant rainy season. On the other hand, the floods in Niamey have been particularly frequent in the last decade, a symptom of a change in hydroclimatic behaviour already observed since the end of the great droughts of the 1970s and 1980s and which is identified with the name of Sahelian Paradox. This study, starting from the analysis of the 2020 flood and from the update of the rating curve of the Niamey hydrometric station, analyses the rainfall–runoff relationship on the Sahelian basins of the Medium Niger River Basin (MNRB) that are at the origin of the local flood. The comparative analysis of runoffs, annual maximum flows (AMAX) and runoff coefficients with various rainfall indices calculated on gridded datasets allowed to hydroclimatically characterise the last decade as a different period from the wet one before the drought, the dry one and the post-drought one. Compared to the last one, the current period is characterised by a sustained increase in hydrological indicators (AMAX +27%) consistent with the increase in both the accumulation of precipitation (+11%) and the number (+51%) and magnitude (+54%) of extreme events in the MNRB. Furthermore, a greater concentration of rainfall and extremes (+78%) in August contributes to reinforcing the red flood’s positive anomalies (+2.23 st.dev in 2020). The study indicates that under these conditions the frequency of extreme hydrological events in Niamey will tend to increase further also because of the concurrence of drivers such as river-bed silting and levee effects. Consequently, the study concludes with the need for a comprehensive flood-risk assessment on the Niamey city that considers both recent hydroclimatic trends and urbanisation dynamics in flood zones hence defining the most appropriate risk-reduction strategies.

The Role of Revascularisation in Patients Undergoing Non-cardiac Surgery

2010 ◽  
Vol 5 (1) ◽  
pp. 104
Author(s):  
Daniel S Menees ◽  
Eric R Bates ◽  
◽  
Keyword(s):  
Cardiac Surgery ◽  
Prediction Models ◽  
Cardiovascular Complications ◽  
Weight Of Evidence ◽  
Beta Blockade ◽  
Cardiac Morbidity ◽  
Increased Risk ◽  
Reduction Strategies ◽  
Artery Disease ◽  
Risk Reduction Strategies

Coronary artery disease (CAD) affects millions of US citizens. As the population ages, an increasing number of people with CAD are undergoing non-cardiac surgery and face significant peri-operative cardiac morbidity and mortality. Risk-prediction models can be used to help identify those patients at increased risk of peri-operative cardiovascular complications. Risk-reduction strategies utilising pharmacotherapy with beta blockade and statins have shown the most promise. Importantly, the benefit of prophylactic coronary revascularisation has not been demonstrated. The weight of evidence suggests reserving either percutaneous or surgical revascularisation in the pre-operative setting for those patients who would otherwise meet independent revascularisation criteria.

scholarly journals Hazards of Risk: Identifying Plausible Community Wildfire Disasters in Low-Frequency Fire Regimes

Forests ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 934
Author(s):  
Andy McEvoy ◽  
Becky K. Kerns ◽  
John B. Kim
Keyword(s):  
Risk Reduction ◽  
Low Frequency ◽  
Fire Regimes ◽  
Cascade Range ◽  
Private Land ◽  
Wildfire Risk ◽  
Location Data ◽  
Reduction Strategies ◽  
Community Exposure ◽  
Risk Reduction Strategies

Optimized wildfire risk reduction strategies are generally not resilient in the event of unanticipated, or very rare events, presenting a hazard in risk assessments which otherwise rely on actuarial, mean-based statistics to characterize risk. This hazard of actuarial approaches to wildfire risk is perhaps particularly evident for infrequent fire regimes such as those in the temperate forests west of the Cascade Range crest in Oregon and Washington, USA (“Westside”), where fire return intervals often exceed 200 years but where fires can be extremely intense and devastating. In this study, we used wildfire simulations and building location data to evaluate community wildfire exposure and identify plausible disasters that are not based on typical mean-based statistical approaches. We compared the location and magnitude of simulated disasters to historical disasters (1984–2020) in order to characterize plausible surprises which could inform future wildfire risk reduction planning. Results indicate that nearly half of communities are vulnerable to a future disaster, that the magnitude of plausible disasters exceeds any recent historical events, and that ignitions on private land are most likely to result in very high community exposure. Our methods, in combination with more typical actuarial characterizations, provide a way to support investment in and communication with communities exposed to low-probability, high-consequence wildfires.

scholarly journals Descriptive Epidemiology of Rescue-Related Fatal Drowning in Turkey

2021 ◽  
Vol 18 (12) ◽  
pp. 6613
Author(s):  
Ali Işın ◽  
Adnan Turgut ◽  
Amy E. Peden
Keyword(s):  
Public Health ◽  
Retrospective Study ◽  
Relative Risk ◽  
Confidence Interval ◽  
Descriptive Epidemiology ◽  
Death Registry ◽  
Public Health Threat ◽  
Reduction Strategies ◽  
Media Reports ◽  
Risk Reduction Strategies

Drowning is a public-health threat and a leading cause of injury-related death. In Turkey, drowning results in 900 fatalities annually, and the rate is rising. As data on rescue-related drowning are scarce, this retrospective study explores the epidemiology of fatal drowning among rescuers in Turkey. As there are no routinely collected death registry data on drowning in Turkey, data were sourced from media reports of incidents between 2015 and 2019. Rescuer fatalities were analysed by age, sex, activity prior to rescue, location, incident day of week and season, and place of death. Statistical analyses comprised X2 tests of significance (p < 0.05) and calculation of relative risk (95% confidence interval) using fatality rates. In total, 237 bystander rescuers drowned (90% male; 35% 15–24 years). In 33% of cases, the primary drowning victim (PDV) was successfully rescued, while in 46% of cases the rescue resulted in multiple drowning fatalities (mean = 2.29; range 1–5 rescuers). Rescues were more likely to be successful in saving the PDV if undertaken at the beach/sea (X2 = 29.147; p < 0.001), while swimming (X2 = 12.504; p = 0.001), or during summer (X2 = 8.223; p = 0.029). Risk of bystander rescue-related fatal drowning was twice as high on weekdays compared to on weekends (RR = 2.04; 95%CI: 1.56–2.67). While bystanders play an important role in reducing drowning, undertaking a rescue is not without risk and can lead to multiple drowning incidents. Training in rescue and resuscitation skills (especially the prioritization of non-contact rescues) coupled with increasing awareness of drowning risk, are risk-reduction strategies which should be explored in Turkey.

Prevention of Breast Cancer (Part II): Risk Reduction Strategies

2010 ◽  
Vol 28 (10) ◽  
pp. 1070-1077 ◽  
Author(s):  
Maria Tria Tirona ◽  
Rajesh Sehgal ◽  
Oscar Ballester
Keyword(s):  
Breast Cancer ◽  
Risk Reduction ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Prevention Of Breast Cancer

Impact of the New York State Prescription Drug Monitoring Program (IStop) on chronic pain management by primary care providers

2021 ◽  
Vol 17 (1) ◽  
pp. 39-54
Author(s):  
Josiah D. Strawser, MD ◽  
Lauren Block, MD, MPH
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Risk Reduction ◽  
New York State ◽  
Monitoring Program ◽  
Primary Care Providers ◽  
Care Providers ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

Objective: To explore the impact of the New York State Prescription Drug Monitoring Program (IStop) on the self-reported management of patients with chronic pain by primary care providers.Design: Mixed-methods study with survey collection and semistructured interviews.Setting: Multiple academic hospitals in New York.Participants: One hundred and thirty-six primary care providers (residents, fellows, attendings, and nurse practitioners) for survey collection, and eight primary care clinicians (residents, attending, and pharmacist) for interviews. Interventions: Introduction of IStop.Main outcome measure(s): Change in usage of four risk reduction strategies (pain contracts, urine tests, monthly visits, and co-management) as reported by primary care providers for patients with chronic pain.Results: After the introduction of IStop, 25 percent (32/128) of providers increased usage of monthly visits, 28 percent (36/128) of providers increased usage of pain management co-management with other healthcare providers, and 46 percent (60/129) of providers increased usage of at least one of four risk reduction strategies. Residents indicated much higher rates of change in risk reduction strategies due to IStop usage; increasing in the use of monthly visits (32 vs. 13 percent, p = 0.02) and co-management (36 vs. 13 percent, p = 0.01) occurred at a much higher rate in residents than attending physicians. Interview themes revealed an emphasis on finding opioid alternatives when possible, the need for frequent patient visits in effective pain management, and the importance of communication between the patient and provider to protect the relationship in chronic pain management.Conclusions: After the introduction of IStop, primary care providers have increased usage of risk reduction strategies in the care of chronic pain patients.

Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position

2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Rare Complication ◽  
Patient Positioning ◽  
Sensory Innervation ◽  
Plexus Brachialis ◽  
Clinical Anatomy ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Endometriosis Surgery

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.

Infant fatality patterns in shared sleep: keys to intervention strategies?

2021 ◽  
Vol 65 (1) ◽  
pp. 1322-1326
Author(s):  
Dorothy Ann Drago ◽  
Carol Pollack-Nelson ◽  
Sarah Beth Newens
Keyword(s):  
Cause Of Death ◽  
Potential Risk ◽  
Intervention Strategies ◽  
Consumer Product Safety Commission ◽  
Time Period ◽  
Reduction Strategies ◽  
Sleep Environment ◽  
Risk Reduction Strategies ◽  
The U.S ◽  
Age And Sex

This study examines infant fatalities that occurred while sharing a sleep surface. Fatality data reported to the U.S. Consumer Product Safety Commission (CPSC) during the time period January, 2013 through December, 2017 and involving infants through age 10 months were reviewed. 1,587 Cases were analyzed on the following variables: infant age and sex; sleep environment by product; cause of death; fatality pattern; and breastfeeding, where it was mentioned. 97% Of deaths were due to some form of asphyxia. Adult beds were associated with 78% of shared sleep fatalities, and the primary fatality pattern was overlay (35.4%)/probable overlay (8.8%). Infants <3 months made up 65% of fatalities. The data reflect that bedsharing continues, despite AAP guidelines to the contrary, and that overlay is the primary hazard pattern to be addressed. This paper discusses potential risk reduction strategies that may reduce the potential for overlay fatalities.

scholarly journals Evaluation of flood risk reduction strategies through combinations of interventions

2018 ◽  
Vol 12 (S2) ◽  
Author(s):  
Erik C. Berchum ◽  
William Mobley ◽  
Sebastiaan N. Jonkman ◽  
Jos S. Timmermans ◽  
Jan H. Kwakkel ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Flood Risk ◽  
Reduction Strategies ◽  
Flood Risk Reduction ◽  
Risk Reduction Strategies

scholarly journals Inadequate stakeholder management and its effect on a coherent sinkhole risk management strategy: The case of the Merafong Local Municipality, South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Tshepo Moshodi ◽  
Christo Coetzee ◽  
Kristel Fourie
Keyword(s):  
Risk Management ◽  
Risk Reduction ◽  
Community Involvement ◽  
Stakeholder Management ◽  
Current Status ◽  
Community Stakeholders ◽  
Management Processes ◽  
Reduction Strategies ◽  
Local Municipality ◽  
Risk Reduction Strategies

The Merafong Local Municipality (MLM) has historically suffered financial and human losses because of the presence of dolomite and the consequent formation of sinkholes. There is a great need for the MLM to address the risk posed by sinkholes to ensure the continued safety of communities. However, as the risk is so pervasive, the MLM needs to coordinate their risk reduction strategies with a wide array of stakeholders in the municipality. Efficient stakeholder management is thus crucial if the sinkhole risk is to be addressed appropriately. This article reviews the current status of stakeholder management in the MLM as it pertains to the formulation of a holistic sinkhole risk reduction strategy. Findings indicate that there are serious deficiencies in the MLM’s stakeholder management relating to key risk management processes such as community involvement in risk management structures, disaster risk assessment, training and awareness, and early warning and response. Improved stakeholder management could be characterised by the following factors: improved two-way communication between the municipality and community stakeholders, fostering a relationship based upon trust and equality amongst stakeholders, participation by a wide array of stakeholder groups affected by the sinkhole risk and a mutual commitment by all stakeholders to address the risk. These factors could contribute to enhancing current and future sinkhole risk reduction strategies.

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