A new global landslide dam database (RAGLAD) and analysis utilizing auxiliary global fluvial datasets

To address the current data and understanding knowledge gap in landslide dam inventories related to geomorphological parameters, a new global-scale landslide dam dataset named River Augmented Global Landslide Dams (RAGLAD) was created. RAGLAD is a collection of landslide dam records from multiple data sources published in various languages and many of these records we have been able to precisely geolocate. In total, 779 landslide dam records were compiled from 34 countries/regions. The spatial distribution, time trend, triggers, and geomorphological characteristic of the landslides and catchments where landslide dams formed are summarized. The relationships between geomorphological characteristics for landslides that form river dams are discussed and compared with those of landslides more generally. Additionally, a potential threshold for landslide dam formation is proposed, based on the relationship of landslide volume to river width. Our findings from our analysis of the value of the use of additional fluvial datasets to augment the database parameters indicate that they can be applied as a reliable supplemental data source, when the landslide dam records were accurately and precisely geolocated, although location precision in smaller river catchment areas can result in some uncertainty at this scale. This newly collected and supplemented dataset will allow the analysis and development of new relationships between landslides located near rivers and their actual propensity to block those particular rivers based on their geomorphology.

Directions and Extent of Flows Changes in Warta River Basin (Poland) in the Context of the Efficiency of Run-of-River Hydropower Plants and the Perspectives for Their Future Development

This paper presents changes in the flow of 14 rivers located in the Warta River basin, recorded from 1951 to 2020. The Warta is the third-longest river in Poland. Unfortunately, the Warta River catchment area is one of the most water-scarce regions. It hosts about 150 hydropower plants with a capacity of up to 5 kW. The catchment areas of the 14 smaller rivers selected for the study differ in location, size, land cover structure and geological structure. The paper is the first study of this type with respect to both the number of analyzed catchments, the length of the sampling series and the number of analyzed flow characteristics in this part of Europe. The analysis of changes in the river flows was performed with reference to low minimum, mean and maximum monthly, seasonal and annual flows. Particular attention was paid to 1, 3, 7, 30 and 90-day low flows and durations of the flows between Q50 and Q90%. In addition, the duration of flows between Q50 and Q90% were analysed. Analysis of the direction and extent of particular flow types was performed by multitemporal analysis using the Mann–Kendall (MK) and Sen (S) tests. The analysis of multiannual flow sequences from the years 1951–2020 showed that the changes varied over the time periods and catchments. The most significant changes occurred in the low flows, while the least significant changes occurred in the high flows. From the point of view of the operation of the hydropower sector, these changes may be unfavourable and result in a reduction in the efficiency of run-of-river hydropower plants. It was established that local factors play a dominant role in the shaping of river flows in both positive and negative terms, for the efficiency of the hydropower plants.

Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland

Background: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional population. Prior research has identified 11 specific program components of FIT in Germany. In this paper we aim at assessing the applicability of these components to the Polish context and at comparatively analysing FIT implementation in Poland and Germany.Methods: Qualitative interviews about the applicability of the 11 FIT-specific components were conducted with the program managers of the Polish FIT models (n = 19). Semi-quantitative data on the FIT-specific components were then collected in 19 Polish and 10 German FIT models. We assessed the grading of each component, their overall degree of implementation and compared them between the two countries. In all study hospitals, structural and statistical parameters of service delivery were collected and compared.Results: The qualitative results showed that the German FIT-specific components are in principle applicable to the polish context. This allowed the comparative assessment of components grading and degree of implementation, which showed only subtle discrepancies between German and Polish FIT models. The little discrepancies point to specific aspects of care such as home treatment, peer support, and cooperation with non-clinical and social welfare institutions that should be further integrated in the components' definition.Conclusions: The specific program components of FIT as first defined from the German experience, serves as a powerful tool to measure, and evaluate implementation of integrated psychiatric care both within and between health systems.

Plant invasions in riparian areas of the Middle Danube Basin in Serbia

Riparian areas experience strong invasion pressures worldwide and represent important points of spread for invasive alien plants (IAPs) in the European mainland. The Danube Basin is a well-known point of high plant invasion levels. Given that the middle part of the Danube Basin is critically understudied and the general lack of data for Serbia, the study aimed to provide an insight into the spatial patterns of plant invasions in the riparian areas of Serbia (Middle Danube Basin area). A total of 250 field sites, distributed along 39 rivers (nine catchment areas) and six canal sections, were studied during a four-year period (2013–2016) for the presence and abundance of IAPs. At the landscape scale, we studied distribution patterns of IAPs, differences in invasion levels in different catchment areas and between rivers and canals. At the local scale, we investigated how the proximity to roads/railway lines, housing areas, different land-use types (primarily agriculture), and dominant vegetation on site related to invasion patterns. Of the 26 studied IAPs, those with a well-known weedy behavior, long history of cultivation and strong affinity for riparian areas prevailed in the study area. Riparian zones of the Danube catchment exhibited the highest invasion levels in terms of IAPs richness and abundance, followed by the catchment areas of the Timok, Sava and Zapadna Morava rivers. Surprisingly, the Danube-Tisa-Danube canal network had the lowest invasion level. At the local scale, agriculture in proximity of the field site and dominant vegetation on site were observed as significant predictors of the invasion level. On the other hand, proximity to roads/railway lines and housing areas was not related to the invasion level. Finally, our study provides the first systematic overview of IAPs’ distribution data for riparian areas of the Middle Danube Basin in Serbia, which could provide a basis for long-term monitoring of IAPs and development of future management plans.

Authorship Correction: Effect of Door-to-Door Screening and Awareness Generation Activities in the Catchment Areas of Vision Centers on Service Use: Protocol for a Randomized Experimental Study (Preprint)

UNSTRUCTURED A vision center (VC) is a significant eye care service model to strengthen primary eye care services. VCs have been set up at the block level, covering a population of 150,000-250,000 in rural areas in North India. Inadequate use by rural communities is a major challenge to sustainability of these VCs. This not only reduces the community’s vision improvement potential but also impacts self-sustainability and limits expansion of services in rural areas. The current literature reports a lack of awareness regarding eye diseases and the need for care, social stigmas, low priority being given to eye problems, prevailing gender discrimination, cost, and dependence on caregivers as factors preventing the use of primary eye care. Our organization is planning an awareness-cum-engagement intervention—door-to-door basic eye checkup and visual acuity screening in VCs coverage areas—to connect with the community and improve the rational use of VCs. In this randomized, parallel-group experimental study, we will select 2 VCs each for the intervention arm and the control arm from among poor, low-performing VCs (ie, walk-in of ≤10 patients/day) in our 2 operational regions (Vrindavan, Mathura District, and Mohammadi, Kheri District) of Uttar Pradesh. Intervention will include door-to-door screening and awareness generation in 8-12 villages surrounding the VCs, and control VCs will follow existing practices of awareness generation through community activities and health talks. Data will be collected from each VC for 4 months of intervention. Primary outcomes will be an increase in the number of walk-in patients, spectacle advise and uptake, referral and uptake for cataract and specialty surgery, and operational expenses. Secondary outcomes will be uptake of refraction correction and referrals for cataract and other eye conditions. Differences in the number of walk-in patients, referrals, uptake of services, and cost involved will be analyzed. Background work involved planning of interventions and selection of VCs has been completed. Participant recruitment has begun and is currently in progress. Through this study, we will analyze whether our door-to-door intervention is effective in increasing the number of visits to a VC and, thus, overall sustainability. We will also study the cost-effectiveness of this intervention to recommend its scalability. ClinicalTrials.gov NCT04800718; https://clinicaltrials.gov/ct2/show/NCT04800718

Environmental spreading of clinically relevant carbapenem-resistant gram-negative bacilli: the occurrence of blaKPC-or-NDM strains relates to local hospital activities

Background Aquatic matrices impacted by sewage may shelter carbapenem-resistant (CR) Gram-negative bacilli (GNB) harboring resistance genes of public health concern. In this study, sewage treatment plants (STPs) servicing well-defined catchment areas were surveyed for the presence of CR-GNB bearing carbapenemase genes (blaKPC or blaNDM). Results A total of 325 CR-GNB were recovered from raw (RS) and treated (TS) sewage samples as well as from water body spots upstream (UW) and downstream (DW) from STPs. Klebsiella-Enterobacter (KE) group amounted to 116 isolates (35.7%). CR-KE isolates were recovered from TS, DW (35.7%) and RS samples (44.2%) (p = 0.001); but not from UW samples. KE isolates represented 65.8% of all blaKPC or blaNDM positive strains. The frequency of blaKPC-or-NDM strains was positively associated with the occurrence of district hospitals located near STPs, as well as with the number of hospitalizations and of sewer connections serviced by the STPs. blaKPC-or-NDM strains were recovered from ST samples in 7 out of 14 STPs, including four tertiary-level STPs; and from 6 out of 13 DW spots whose RS samples also had blaKPC-or-NDM strains. Conclusions Clinically relevant GNB bearing blaKPC-or-NDM resist sewage treatments and spread into environmental aquatic matrices mainly from STPs impacted by hospital activities.

Impact of introducing capacity-based mental health legislation on the use of community treatment orders in Norway: case registry study

Background In 2017, a capacity-based criterion was added to the Norwegian Mental Health Act, stating that those with capacity to consent to treatment cannot be subjected to involuntary care unless there is risk to themselves or others. This was expected to reduce incidence and prevalence rates, and the duration of episodes of involuntary care, in particular regarding community treatment orders (CTOs). Aims The aim was to investigate whether the capacity-based criterion had the expected impact on the use of CTOs. Method This retrospective case register study included two catchment areas serving 16% of the Norwegian population (aged ≥18). In total, 760 patients subject to 921 CTOs between 1 January 2015 and 31 December 2019 were included to compare the use of CTOs 2 years before and 2 years after the legal reform. Results CTO incidence rates and duration did not change after the reform, whereas prevalence rates were significantly reduced. This was explained by a sharp increase in termination of CTOs in the year of the reform, after which it reduced and settled on a slightly higher leven than before the reform. We found an unexpected significant increase in the use of involuntary treatment orders for patients on CTOs after the reform. Conclusions The expected impact on CTO use of introducing a capacity-based criterion in the Norwegian Mental Health Act was not confirmed by our study. Given the existing challenges related to defining and assessing decision-making capacity, studies examining the validity of capacity assessments and their impact on the use of coercion in clinical practice are urgently needed.

Regional variations in lumbar spine surgery in Finland

Introduction The regional variation in spine surgery rates has been shown to be large both within and between countries. This variation has been reported to be less in studies from countries with spine registers. The aim of this study was to describe the regional variation in lumbar spine surgery in Finland. Materials and methods This is a retrospective register study. Data from the Finnish National Hospital Discharge Register (NHDR) were used to calculate and compare the rates of lumbar disc herniation (LDH), decompression, and fusion surgeries in five University Hospital catchment areas, covering the whole Finnish population, from January 1, 1997, through December 31, 2018. Results A total of 138,119 lumbar spine operations (including LDH, decompression, and fusion surgery) were performed in Finland between 1997 and 2018. The regional differences in the rate of LDH surgery were over fourfold (18 vs. 85 per 100,000 person years), lumbar decompression surgery over threefold (41 vs. 129 per 100,000 person years), and lumbar fusion surgery over twofold (14 vs. 34 per 100,000 person years) in 2018. The mean age of the patients increased in all regions during the study period. Conclusions In Finland, the regional variations in spine surgeries were vast. In a country with a publicly funded healthcare system, this finding was surprising. The recently created national spine register may serve to shed more light on the reasons for this regional variation.

Coexistence of Lobelia dortmanna and Cladium mariscus, an ecological and paleobotanical study

Lobelia dortmanna L. (Lobeliaceae family) is an indicator species that is predominantly found in oligotrophic and acidic lakes. They are mainly distributed in northwestern Europe. Their occurrence in Poland is highly threatened by the increasing grade of human activity and environmental eutrophication; however, new sites of Lobelia were discovered in the last few decades, for example, in Lake Krzywce Wielkie situated in Bory Tucholskie National Park (BTNP), Poland. The existence of Lobelia in this lake was unexpected because Cladium mariscus was also found in the lake. Cladium has different ecological demands and is regarded as a species typical of calcareous habitats where calcium is found in abundance in the substrate. To explain the coexistence of both species in Krzywce Wielkie, pollen analysis of organic sediments was performed for four short cores collected from the littoral zone of the lake and for one long deep-water core. Additionally, macrofossil analysis was done for all the short cores. Pollen analysis revealed the existence of Cladium from the early Holocene period up to the present time. Pollen and seeds of Lobelia were found to be present since the beginning of the 20th century. Development of L. dortmanna and Myriophyllum alterniflorum populations and a decrease in the number of aquatic macrophytes in the eutrophic water indicate oligotrophication of water. This process started following the construction of drainage canal and the consequent water level decrease. This situation can be attributed to the abandonment of the agricultural areas adjoining the lake, which causes a decrease in the inflow of nutrients into the lake. Development of pine forest and establishment of BTNP enabled the protection and conservation of the surrounding catchment areas, thus restricting the potential eutrophication of the habitats.