Environmental Risk Assessments as Input to a Decision-Making Process: Examples From a Barents Sea Project

2019 ◽  
Author(s):  
Eric Ford ◽  
Hans Petter Lohne ◽  
Jon Tømmerås Selvik
Keyword(s):  
Decision Making ◽  
Environmental Risk ◽  
Barents Sea ◽  
Risk Assessments ◽  
Decision Making Process

SP9.1.2 Sarcopenia and myosteatosis predict thirty-day emergency laparotomy mortality [The FrOGS study]

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Samantha Body ◽  
Marjolein Ligthart ◽  
James Ward ◽  
Philip H Pucher ◽  
Nathan Curtis ◽  
...  
Keyword(s):  
Decision Making ◽  
Body Composition ◽  
Emergency Surgery ◽  
Risk Assessments ◽  
Muscle Quality ◽  
Emergency Laparotomy ◽  
Decision Making Process ◽  
Shared Decision ◽  
Charlson Score ◽  
Poor Outcomes

Abstract Aims Sarcopenia (low muscle mass - SM) and myosteatosis (low muscle quality - SM-RA) are associated with poor outcomes after elective cancer surgery. Body composition parameters have not been explored in emergency surgery and may offer additive value to risk prediction scores. This multicentre study assessed the association of body composition and survival after emergency laparotomy. Methods A retrospective longitudinal cohort of 674 patients, across 10 hospitals in southern England were recruited (NCT03534765). All patients underwent emergency laparotomy, fulfilling NELA criteria, between August 2016 and November 2017. Pre-operative CTs were blindly analysed using L3 slices, assessing SM and SM-RA. Regression analysis was used to assess associations of body composition and 30-day mortality. Results Six hundred and ten patients were included [283(46%) men, median(IQR) age 71 years (57-79)]. P-POSSUM and NELA predicted mortality was 7% and 4.5% respectively, with a length of stay of 15 days (9-24), 30-day mortality of 7.8% and 1-year mortality of 18.9%. Significant univariate associations between 30-day mortality and age (OR1.04 (1.02-1.07);p=0.001), Charlson score (OR 6.84 (1.64-28.55);p=0.008), P-POSSUM (OR 1.03 (1.02-1.05);p<0.001, NELA mortality (OR 1.06 (1.04-1.08);p<0.001), SM (OR 0.98 (0.97-0.99);p=0.003 and SM-RA (OR 0.93 (0.9-0.96);p<0.001. Significant multivariate associations between 30-day mortality and NELA (OR 1.05 (1.03-1.07); p < 0.001, P-POSSUM (OR 1.03 (1.01-1.04); p < 0.001, SM-RA (OR 0.94 (0.9-0.97); p < 0.001. Conclusions Sarcopenia and myosteatosis are associated with increased mortality in patients undergoing emergency surgery. Body composition should be considered as an objective adjunct to traditional risk assessments, further informing the shared-decision making process around emergency surgery.

scholarly journals Introduction to the Concepts and Use of ERA Acute

2021 ◽  
pp. 1-19
Author(s):  
Cathrine Stephansen ◽  
Anders Bjørgesæter ◽  
Odd Willy Brude ◽  
Ute Brönner ◽  
Tonje Waterloo Rogstad ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Oil Spill ◽  
Environmental Risk ◽  
Marine Mammals ◽  
Input Data ◽  
Risk Assessments ◽  
Management Decision ◽  
Management Decision Making ◽  
Norwegian Continental Shelf

AbstractIntroducing the main concepts of ERA Acute, this chapter describes the overall framework and purpose of the methodology. ERA Acute is a recently developed oil spill risk assessment (OSRA) methodology for quantification of oil spill impacts and risk (Environmental Risk Assessment, ERA). It covers four environmental compartments; sea surface (seabirds, turtles, marine mammals), water column (fish eggs/larvae), shoreline and seafloor (species and habitats) using continuous impact functions and introduces the Resource Damage Factor (RDF). The methodology depends on external oil spill modelling and input data related to the presence and vulnerability of Valued Ecosystem Components (VECs). ERA Acute is developed to provide an improvement over the currently used “MIRA” method on the Norwegian Continental Shelf (NCS) and is better suited for risk management, decision-making and analyses from screening studies to full environmental risk assessments.

AAC Decision-Making and Mobile Technology: Points to Ponder

2014 ◽  
Vol 23 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Mary Ann Abbott ◽  
Debby McBride
Keyword(s):  
Decision Making ◽  
Mobile Technology ◽  
Communication System ◽  
Augmentative And Alternative Communication ◽  
Evaluation Process ◽  
Decision Making Process ◽  
Alternative Communication ◽  
Ipod Touch ◽  
Feature Match

The purpose of this article is to outline a decision-making process and highlight which portions of the augmentative and alternative communication (AAC) evaluation process deserve special attention when deciding which features are required for a communication system in order to provide optimal benefit for the user. The clinician then will be able to use a feature-match approach as part of the decision-making process to determine whether mobile technology or a dedicated device is the best choice for communication. The term mobile technology will be used to describe off-the-shelf, commercially available, tablet-style devices like an iPhone®, iPod Touch®, iPad®, and Android® or Windows® tablet.

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