scholarly journals From paper to practice: an initial approach to implementation of the environmental monitoring plan for fish farming proposed by JACUMAR

2018 ◽  
Vol 82 (1) ◽  
pp. 27 ◽  
Author(s):  
Elena Martinez-Garcia ◽  
Victoria Fernandez-Gonzalez ◽  
Felipe Aguado-Giménez ◽  
José Luis Sánchez-Lizaso ◽  
Pablo Sanchez-Jerez

The Spanish National Advisory Board of Mariculture (JACUMAR) developed an initiative to unify methodologies between the regions of Spain, in which they proposed the implementation of site-specific “Environmental Monitoring Plans” (EMPs). In this study, we tested the feasibility of an EMP on a fish farm in the Mediterranean Sea. The methods and tools proposed in the EMP are highly useful for environmental monitoring of aquaculture. However, spatial heterogeneity figured prominently in a univariate analysis with environmental variables and a multivariate analysis of polychaete assemblages. This variability may be due to habitat patchiness, and may therefore be solved by an improved experimental design, e.g. by adding replications for increasing statistical power. Multivariate analysis of polychaete assemblages provided accurate information about the quality of the sediment. This information could also be improved using ecological data about key polychaete families in order to avoid misleading results. Thus, the JACUMAR EMP has proved useful in providing precise information about the ecological status of marine benthic habitats, meeting the requirements of current European Directives. However, we suggest that some modifications may be required in order to account for possible misleading thresholds for environmental quality standards, spatial heterogeneity and increasing power analyses.

2019 ◽  
Vol 130 (5) ◽  
pp. 1692-1698 ◽  
Author(s):  
Mitchell P. Wilson ◽  
Andrew S. Jack ◽  
Andrew Nataraj ◽  
Michael Chow

OBJECTIVEReadmission to the hospital within 30 days of discharge is used as a surrogate marker for quality and value of care in the United States (US) healthcare system. Concern exists regarding the value of 30-day readmission as a quality of care metric in neurosurgical patients. Few studies have assessed 30-day readmission rates in neurosurgical patients outside the US. The authors performed a retrospective review of all adult neurosurgical patients admitted to a single Canadian neurosurgical academic center and who were discharged to home to assess for the all-cause 30-day readmission rate, unplanned 30-day readmission rate, and avoidable 30-day readmission rate.METHODSA retrospective review was performed assessing 30-day readmission rates after discharge to home in all neurosurgical patients admitted to a single academic neurosurgical center from January 1, 2011, to December 31, 2011. The primary outcomes included rates of all-cause, unplanned, and avoidable readmissions within 30 days of discharge. Secondary outcomes included factors associated with unplanned and avoidable 30-day readmissions.RESULTSA total of 184 of 950 patients (19.4%) were readmitted to the hospital within 30 days of discharge. One-hundred three patients (10.8%) were readmitted for an unplanned reason and 81 (8.5%) were readmitted for a planned or rescheduled operation. Only 19 readmissions (10%) were for a potentially avoidable reason. Univariate analysis identified factors associated with readmission for a complication or persistent/worsening symptom, including age (p = 0.009), length of stay (p = 0.007), general neurosurgery diagnosis (p < 0.001), cranial pathology (p < 0.001), intensive care unit (ICU) admission (p < 0.001), number of initial admission operations (p = 0.01), and shunt procedures (p < 0.001). Multivariate analysis identified predictive factors of readmission, including diagnosis (p = 0.002, OR 2.4, 95% CI 1.4–5.3), cranial pathology (p = 0.002, OR 2.7, 95% CI 1.4–5.3), ICU admission (p = 0.004, OR 2.4, 95% CI 1.3–4.2), and number of first admission operations (p = 0.01, OR 0.51, 95% CI 0.3–0.87). Univariate analysis performed to identify factors associated with potentially avoidable readmissions included length of stay (p = 0.03), diagnosis (p < 0.001), cranial pathology (p = 0.02), and shunt procedures (p < 0.001). Multivariate analysis identified only shunt procedures as a predictive factor for avoidable readmission (p = 0.02, OR 5.6, 95% CI 1.4–22.8).CONCLUSIONSAlmost one-fifth of neurosurgical patients were readmitted within 30 days of discharge. However, only about half of these patients were admitted for an unplanned reason, and only 10% of all readmissions were potentially avoidable. This study demonstrates unique challenges encountered in a publicly funded healthcare setting and supports the growing literature suggesting 30-day readmission rates may serve as an inappropriate quality of care metric in neurosurgical patients. Potentially avoidable readmissions can be predicted, and further research assessing predictors of avoidable readmissions is warranted.


Author(s):  
Kazuki Ishikawa ◽  
Tsuneo Yamashiro ◽  
Takuro Ariga ◽  
Takafumi Toita ◽  
Wataru Kudaka ◽  
...  

Abstract Purpose Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones. Materials and Methods For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures. Results Posttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P < 0.05–0.01 across sites, except for the ilium and the ischium). Although DVH parameters were also significantly associated with fractures in univariate analysis, only CT densities were significantly associated with fractures in multivariate analysis. Conclusion Pretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.


2021 ◽  
Vol 2 (1) ◽  
pp. 32-46
Author(s):  
Desy Murdiatama ◽  
Ahmad Rifai ◽  
Indah Anggraeni

Service quality and patient satisfaction are the two most important things in Community Health Center (puskesmas) services. This study aims to see the effect of the quality of health services on outpatient satisfaction at Langsa Timur Public Health Center, Langsa City in 2020. This type of research is a quantitative research which is an analytical survey with a cross sectional study approach. The population in this study were 2,116 people. A sample of 95 people using the Slovin formula. The analysis used is univariate analysis, bivariate analysis with chi-square test and multivariate analysis with linear regression test, measuring instruments used questionnaires and data processing using computerized with a significance level of P-Sign <0.05. The results of this study are based on the results of univariate analysis, as many as 64 people were dissatisfied and 31 people were satisfied. The results of multivariate analysis showed that physical evidence and responsiveness had an influence on patient satisfaction and physical evidence was dominant. The conclusion of this study is that there is an effect of physical evidence and responsiveness on outpatient satisfaction at Langsa Timur Public Health Center, Langsa City.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gun Woo Kang ◽  
Seoung Gyu Kim ◽  
In Hee Lee ◽  
Ki Sung Ahn

Abstract Background and Aims The mortality of patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) is higher than the general population. And it is well known that quality of life (QOL) falls immediately after receiving HD. However, studies on the relationship between reduced QOL and mortality in HD patients were very rare. This study aims to observe the correlation between impaired QOL and mortality in HD patients and to identify risk factors that affect mortality. Method The study included 160 patients with ESRD undergoing HD during over 3 months. The QOL was evaluated using WHO Quality of Life-BREF (WHOQOL-BREF). The WHOQOL-BREF instrument comprises 26 items, which measure the following four domains: physical health (domain 1), psychological health (domain 2), social relationships (domain 3), and environment (domain 4). Univariate analysis was used to determine the relationship between comorbidities, sex, age, laboratory findings, and QOL and mortality in HD patients. Multivariate analysis was performed by cox proportional hazard regression. Expected survival at 5 and 10 years was determined by two-sample t-tests. Results The mean age was 58.1 years old. 95 patients (59.7%) received HD due to diabetes mellitus. 42 patients (26.4%) had been diagnosed with coronary heart disease. In univariate analysis, age, coronary heart disease, malignancy, comorbidities, and blood calcium level were positively correlated with mortality. In particular, the domain 1 and 2 of WHOQOL-BREF were negatively associated with mortality. The mean scores of domain 1 and 2 was 18.2±5.2 and 15.9±4.5 for survivors and 15.5±5.7 and 13.7±4.9 for deaths. Multivariate analysis identified the age, comorbidity, serum calcium, and domain 1 of WHOQOL-BREF were independent risk factors for mortality (Table 1). Additionally, predicting 5- and 10- year survival, mortality was correlation with older age, higher Charlson Comorbidity Index, lower serum calcium, and lower domain 1 of WHOQOL-BREF (Table 2). Conclusion The impaired QOL of patients with ESRD undergoing HD was closely related to mortality. In particular, low QOL in physical health domain significantly increased mortality. Therefore, in order to improve the survival of HD patients, we should be considered about QOL as well as medical problems


2021 ◽  
Vol 4 ◽  
Author(s):  
Victor Hugo Salinas Camarillo ◽  
Javier Carmona-Jiménez ◽  
Nelida Abarca ◽  
Jonas Zimmermann ◽  
Demetrio Mora

In central Mexico, streams flow from mountain protected areas at high elevations, i.e. abive 2,400 m a.s.l., being exposed to different human activities along their course. The main human threats of these aquatic ecosystems include the presence of hydraulic infrastructure (e.g. canals and dams), the construction of bridges or roads, fish farming, agriculture, livestock, unregulated tourism or irregular human settlements, resulting in nutrient enrichment, organic pollution and low hydromorphological quality. Diatoms, widely recognized as valuable indicators of environmental conditions, offer a unique opportunity to assess the ecological quality of the streams in and around this megacity, as they respond directly and sensitively to specific physical, chemical and biological changes. To conduct ecological assessment, the composition of diatom communities has traditionally been characterized by morphological methods and most recently by environmental DNA (eDNA) metabarcoding. However, the diatom communities of only a few of these streams in the Basin of Mexico have been characterized morphologically at low resolution light microscopy (LM), and no eDNA-based studies have been conducted yet. In this context, our aims are to 1) implement morphological and eDNA metabarcoding methods for the identification and quantification of epilithic diatoms and to assess their seasonal and spatial response in three peri-urban mountain streams from the Basin of Mexico, and 2) develop a metric to assess and monitor the ecological quality in these streams. For this purpose, we characterized a) the physical, environmental and hydro-morphological conditions related to ecosystem quality, and b) the diatom diversity and community structure of nine sites per stream (27 sites). The sites include headwaters, as well as middle and lower reaches with different land-use and anthropologic pressures, and were investigated over three hydrological periods, i.e. post-rainy, dry-cold and dry-warm. Species identification was first conducted under LM and scanning electron microscopy (SEM), and is currently been done by eDNA metabarcoding of the V4 region of the 18S rRNA gene and a fragment of the chloroplast marker rbcL. Our study has resulted in 520 infrageneric taxa identified by LM and SEM, the largest diversity ever found for freshwater diatoms of Mexico. From this data, we found a clear environmental gradient from almost pristine conditions towards heavily polluted states as the streams enter the city. These changes are well reflected by variations in the diatom community structure, as revealed by the Diatom Ecological Quality Index (DEQI), newly developed to evaluate the ecological quality of the streams in and around this megacity.


2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 520-520
Author(s):  
Cassia R Griswold ◽  
Erin B. Bailey ◽  
Jessica Campaign Mauser ◽  
Kenneth M. Boucher ◽  
Neeraj Agarwal ◽  
...  

520 Background: The Khorana score is the primary tool utilized to predict VTE risk in patients with cancer. This score incorporates primary cancer site, pretreatment hematologic parameters, and body mass index. GCT are considered high-risk for VTE. However, risk factors for VTE not included in the Khorana Score have been reported for GCT including retroperitoneal lymph node (RPLN) size, elevated LDH, and poor risk disease. Methods: A retrospective chart review was conducted to correlate known VTE risk factors with VTE incidence in male patients with GCT undergoing first-line chemotherapy. Variables included venous access type, RPLN size, LDH, chemotherapy regimen, procedure history, cancer stage and histology, Khorana risk factors, and pertinent demographics. VTE and superficial vein thrombosis (SVT) events that occurred within 1 month prior through 6 months after start of chemotherapy were recorded. Fisher’s Exact test was used for univariate analysis and logistic regression for multivariate analysis of the relationship between predictors and thrombosis. P-values are two-sided at an alpha level of 0.05. Results: 47 patients with GCT were identified. 12 VTE occurred (overall incidence 25.5%), 11 in patients with central lines (39.3% incidence) and 1 with a peripheral line (5.3% incidence). SVT were observed in 5 patients with peripheral lines compared to 1 patient with a central line (26.3% vs. 3.6%). Central line access was the primary variable associated with VTE risk in both univariate and multivariate analysis (p=0.01 and p=0.03, respectively). Conclusions: Venous access type is a significant but modifiable factor that can be targeted to reduce VTE risk. Due to small sample size there is limited statistical power to detect potentially meaningful differences in known risk factors. If validated, these results may identify specific patients to be treated with prophylactic anticoagulation. [Table: see text]


2020 ◽  
Vol 60 (13) ◽  
pp. 1654
Author(s):  
Vasiliki Gkarane ◽  
Paul Allen ◽  
Nigel P. Brunton ◽  
Rufielyn S. Gravador ◽  
Noel A. Claffey ◽  
...  

Context Diet is one the most important pre-slaughter factors that potentially influences meat quality, but its effect on flavour quality remains equivocal. Aim The aim of the present study was to investigate the effect of diet composition on the flavour and sensory quality of meat from Texel × Scottish Blackface ram lambs. Methods Groups of 11 lambs were assigned to one of the following four dietary treatments for 54 days before slaughter: a concentrate containing barley, maize and soybean (C treatment); C supplemented with a saturated fat source (Megalac®); C supplemented with protected linseed oil; a by-product-based diet containing citrus pulp, distillers grain and soybean. Samples of cooked M. longissimus thoracis et lumborum were subjected to volatile analysis involving solid-phase microextraction followed by gas chromatography–mass spectrometry and to sensory analysis performed by a trained panel. Key results Univariate analysis of volatile data and sensory data showed few differences due to dietary treatments. However, multivariate analysis of the volatile data, and to a lesser extent the sensory profile data, showed potential to discriminate between lamb meat samples, on the basis of the different dietary treatments. Conclusions The inclusion of certain dietary ingredients in the diets of lambs to enhance the nutritional profile of lamb meat (through increasing n-3 fatty acid content) or to reduce feed-formulation costs (through the use of by-products) has minor effects on sensory quality but permits some discrimination between dietary treatments following the application of multivariate analysis. Implications The application of the findings is in allowing lamb producers to use alternative feed types without affecting the sensory quality of lamb negatively, but with the potential to discriminate lamb meat on the basis of its dietary background.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ting Yu ◽  
Xiaoxue Shen ◽  
Miaomiao Li ◽  
Meifeng Wang ◽  
Lin Lin

Aim. To evaluate the short-term efficacy of biofeedback therapy (BFT) for dyssynergic defecation (DD) and to explore the predictors of the efficacy of BFT. Methods. Clinical symptoms, psychological state, and quality of life of patients before and after BFT were investigated. All patients underwent lifestyle survey and anorectal physiology tests before BFT. Improvement in symptom scores was considered proof of clinical efficacy of BFT. Thirty-eight factors that could influence the efficacy of BFT were studied. Univariate and multivariate analysis was conducted to identify the independent predictors. Results. Clinical symptoms, psychological state, and quality of life of DD patients improved significantly after BFT. Univariate analysis showed that efficacy of BFT was positively correlated to one of the 36-item Short-Form Health Survey terms, the physical role function (r=0.289; P=0.025), and negatively correlated to the stool consistency (r=−0.220; P=0.032), the depression scores (r=−0.333; P=0.010), and the first rectal sensory threshold volume (r=−0.297; P=0.022). Multivariate analysis showed depression score (β = −0.271; P=0.032) and first rectal sensory threshold volume (β = −0.325; P=0.013) to be independent predictors of BFT efficacy. Conclusion. BFT improves the clinical symptoms of DD patients. Depression state and elevated first rectal sensory threshold volume were independent predictors of poor outcome with BFT.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 491.1-492
Author(s):  
L. D. Fajardo Hermosillo

Background:Rheumatoid Arthritis (RA) is a disabling chronic inflammatory disease that shows an unpredictable and severe clinical course [1]. Global assessment, functional status and disease activity of patients with RA can be influenced also by non-inflammatory factors as concomitant presence of fibromyalgia (FM) [1,2]. FM occur up to 20% in RA patients, who present chronic widespread pain, fatigue and cognitive symptoms that impacts achieving a complete disease remission, having more comorbidities, bearing a higher medical cost and finally exhibiting a worse quality of life [1,3,4]. Range of manifestations of FM varies according ethnical and cultural differences between patients [1]. Here is presented the impact of fibromyalgia in Mexican patients with RA.Objectives:To determinate the frequency and factors associated to fibromyalgia in Mexican RA patients.Methods:624 patients with RA that fulfilled ACR/EULAR 2010 criteria (≥18 years) from a Mexican population recruited from 2012 to 2020 were examined. Patients with or without presence of FM diagnosed by ACR 2010/2011 criteria were included. Demographic factors, clinical features, disease activity measured using DAS28 (Disease Activity Score 28-joint counts), functional status evaluated by HAQ (Health Assessment Questionnaire), comorbidities and pharmacologic treatments were explored for RA patients with and without FM. Charlson’s comorbidity index (CCI) was used to analyze comorbidities. Chi-square, Student´s-t, U Mann-Whitney tests were performed by univariate analysis and logistic regression was executed by multivariate analysis adjusted for age and gender. Statistical tests were conducted at 5% level of significance.Results:Of 624 patients with RA 88.8% were women. The mean age [standard deviation (SD)] was 55.0 (12.3) years. The mean of time at onset of RA (SD) was 11.2 (9.1) years. A total of 311(49.8%) patients had FM; of them 91.6% were women and the mean age (SD) was 54.5 (12.2) years. In the univariate analysis RA patients with FM were more likely to be older and smokers, have seropositive RA, higher body mass index and longer time at onset of RA, show worse functional status by HAQ and more radiographic progression, present more extra-articular and Sicca manifestations, exhibit increased demand of hip and knee arthroplasty, also reveal a higher frequency of comorbidities including depression, osteoporosis and type 2 diabetes mellitus, besides to use a greater number of disease-modifying anti-rheumatic drugs (DMARDs), more biologic agents and higher doses of corticosteroids. Also, CCI was higher in RA patients with FM. Nevertheless, no differences were found for RA disease activity in both groups. In multivariate analysis, higher score of CCI (OR 1.21, 95% CI 1.01–1.44, p=0.037) remained significant in RA patients with FM.Conclusion:This study suggests that RA patients from Mexico have high prevalence of the FM. Those with FM have a worse functional status, a higher frequency and score of comorbidities that impact in a reduction of their quality of life. On the other hand, no differences were found for RA disease activity in both groups. However, these observations must be confirmed in larger and prospective studies.References:[1]Zhao SS et al. Best Pract Res Clin Rheumatol. 2019;33(3):101423;[2]Duffield SJ et al. Rheumatology (Oxford). 2018;57(8):1453;[3]Kim H et al. Arthritis Care Res (Hoboken) 2017;69(12):1871;[4]Salaffi Fet al. Rheumatol Int. 2017;37(12):2035.Disclosure of Interests:None declared


Author(s):  
Ekaterina Grinberg

In two parts of the article, more than 70 errors and violations of the Biotechnics of artificial breeding of Pacific salmon in salmon hatcheries are collected and summarized, which lead to an immediate or delayed deterioration of the quality of reared fry and a decrease in their survival rate. Deviations from the biological basis of fish farming are shown and possible consequences of such errors or violations are predicted. In the first part of the article (#7,2020) there were General errors (throughout the entire fish-breeding process), as well as violations of Biotechnics during the work with producers, collecting eggs and preparing them for incubation, in the second part-violations of Biotechnics during the incubation of eggs, holding pre-larvae, rearing and release of young. Their correction, prevention or minimization of consequences will significantly improve the quality of sexual products and offspring from producers, increase the linear and weight gain of juveniles during rearing, improve the coefficient of feed payment, reduce the time of rearing, improve the epizootic situation by developing immunity in fry and mobilizing other protective reactions of their body, significantly reduce waste at all stages of the production process, increasing survival by 10–15%. In conclusion, it is noted that the first and most important condition for an efficient salmon hatchery is the creation of optimal environmental conditions at each stage of the production process. The second condition is strict compliance with the Biotechnics of artificial salmon breeding and the complex of veterinary and sanitary, fish-breeding and meliorative and therapeutic and preventive measures. The third is the availability of competent specialists who regularly improve their skills in accredited Universities to implement, control and manage the first two conditions.


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