Assessing urban system vulnerabilities to flooding to improve resilience and adaptation in spatial planning

Fluvial, pluvial and coastal flooding are the most frequent and costly natural hazard. Cities are social hubs and life in cities is reliant on a number of services and functions such as housing, healthcare, education and other key daily facilities. Urban flooding can cause significant disruption to these services and wider impacts on the population. These impacts may be short or long with a variably spatial scale: urban systems are spatially distributed and the nature of this can have significant effects on flood impacts. From an urban-planning perspective, measuring this disruption and its consequences is fundamental in order to develop more resilient cities. Whereas the assessment of physical vulnerabilities and direct damages is commonly addressed, new methodologies for assessing the systemic vulnerability and indirect damages at the urban scale are required. The proposed systemic approach recognizes the city as a collection of sub-systems or functional units (such as neighborhoods and suburbs), interconnected through the road network, providing key daily services to inhabitants (e.g., healthcare facilities, schools, food shops, leisure and cultural services). Each city is part of broader systems—which may or may not match administrative boundaries—and, as such, needs to be connected to its wider surroundings in a multi-scalar perspective. The systemic analysis, herein limited to residential households, is based on network-accessibility measures and evaluates the presence, the distribution among urban units and the redundancy of key daily services. Trying to spatially sketch the existence of systemic interdependences between neighborhoods, suburbs and municipalities, the proposed method highlights how urban systemic vulnerability spreads beyond the flooded areas. The aim is to understand which planning patterns and existing mixed-use developments are more flood resilient, thereby informing future urban development and regeneration projects. The methodology has been developed based on GIS and applied to an Italian municipality (Noale) in the metropolitan area of Venice, NE Italy

Oral ondansetron versus domperidone for symptomatic treatment of vomiting during acute gastroenteritis in children: multicentre randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Vomiting in children with acute gastroenteritis (AG) is not only a direct cause of fluid loss but it is also a major factor of failure of oral rehydration therapy (ORT). Physicians who provide care to paediatric patients in the emergency department (ED) usually prescribe intravenous fluid therapy (IVT) for mild or moderate dehydration when vomiting is the major symptom. Thus, effective symptomatic treatment of vomiting would lead to an important reduction in the use of IVT and, consequently, of the duration of hospital stay and of frequency of hospital admission. Available evidence on symptomatic treatment of vomiting shows the efficacy of the most recently registered molecule (ondansetron) but a proper evaluation of antiemetics drugs largely used in clinical practice, such as domperidone, is lacking.</p> <p>Objectives</p> <p>To compare the efficacy of ondansetron and domperidone for the symptomatic treatment of vomiting in children with AG who have failed ORT.</p> <p>Methods/Design</p> <p>Multicentre, double-blind randomized controlled trial conducted in paediatric EDs. Children aged from 1 to 6 years who vomiting, with a presumptive clinical diagnosis of AG, and without severe dehydration will be included. After the failure of a initial ORS administration in ED, eligible children will be randomized to receive: 1) ondansetron syrup (0,15 mg/Kg of body weight); 2) domperidone syrup (0,5 mg/Kg of body weight); 3) placebo. The main study outcome will be the percentage of patients needing nasogastric or IVT after symptomatic oral treatment failure, defined as vomiting or fluid refusal after a second attempt of ORT. Data relative to study outcomes will be collected at 30 minute intervals for a minimum of 6 hours. A telephone follow up call will be made 48 hours after discharge. A total number of 540 children (i.e. 180 patients in each arm) will be enrolled.</p> <p>Discussion</p> <p>The trial results would provide evidence on the efficacy of domperidone, which is largely used in clinical practice despite the lack of proper evaluation and a controversial safety profile, as compared to ondansetron, which is not yet authorized in Italy despite evidence supporting its efficacy in treating vomiting. The trial results would contribute to a reduction in the use of IVT and, consequently, in hospital admissions in children with AG. The design of this RCT, which closely reflect current clinical practice in EDs, will allow immediate transferability of results.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01257672">NCT01257672</a></p

Cognitive Behavior Therapy for Anxious Adolescents: Developmental Influences on Treatment Design and Delivery

Anxiety disorders in adolescence are common and disruptive, pointing to a need for effective treatments for this age group. Cognitive behavior therapy (CBT) is one of the most popular interventions for adolescent anxiety, and there is empirical support for its application. However, a significant proportion of adolescent clients continue to report anxiety symptoms post-treatment. This paper underscores the need to attend to the unique developmental characteristics of the adolescent period when designing and delivering treatment, in an effort to enhance treatment effectiveness. Informed by the literature from developmental psychology, developmental psychopathology, and clinical child and adolescent psychology, we review the ‘why’ and the ‘how’ of developmentally appropriate CBT for anxious adolescents. ‘Why’ it is important to consider developmental factors in designing and delivering CBT for anxious adolescents is addressed by examining the age-related findings of treatment outcome studies and exploring the influence of developmental factors, including cognitive capacities, on engagement in CBT. ‘How’ clinicians can developmentally tailor CBT for anxious adolescents in six key domains of treatment design and delivery is illustrated with suggestions drawn from both clinically and research-oriented literature. Finally, recommendations are made for research into developmentally appropriate CBT for anxious adolescents

Formalization of the classification pattern: Survey of classification modeling in information systems engineering

Formalization is becoming more common in all stages of the development of information systems, as a better understanding of its benefits emerges. Classification systems are ubiquitous, no more so than in domain modeling. The classification pattern that underlies these systems provides a good case study of the move towards formalization in part because it illustrates some of the barriers to formalization; including the formal complexity of the pattern and the ontological issues surrounding the ‘one and the many’. Powersets are a way of characterizing the (complex) formal structure of the classification pattern and their formalization has been extensively studied in mathematics since Cantor’s work in the late 19th century. One can use this formalization to develop a useful benchmark. There are various communities within Information Systems Engineering (ISE) that are gradually working towards a formalization of the classification pattern. However, for most of these communities this work is incomplete, in that they have not yet arrived at a solution with the expressiveness of the powerset benchmark. This contrasts with the early smooth adoption of powerset by other Information Systems communities to, for example, formalize relations. One way of understanding the varying rates of adoption is recognizing that the different communities have different historical baggage. Many conceptual modeling communities emerged from work done on database design and this creates hurdles to the adoption of the high level of expressiveness of powersets. Another relevant factor is that these communities also often feel, particularly in the case of domain modeling, a responsibility to explain the semantics of whatever formal structures they adopt. This paper aims to make sense of the formalization of the classification pattern in ISE and surveys its history through the literature; starting from the relevant theoretical works of the mathematical literature and gradually shifting focus to the ISE literature. The literature survey follows the evolution of ISE’s understanding of how to formalize the classification pattern. The various proposals are assessed using the classical example of classification; the Linnaean taxonomy formalized using powersets as a benchmark for formal expressiveness. The broad conclusion of the survey is that (1) the ISE community is currently in the early stages of the process of understanding how to formalize the classification pattern, particularly in the requirements for expressiveness exemplified by powersets and (2) that there is an opportunity to intervene and speed up the process of adoption by clarifying this expressiveness. Given the central place that the classification pattern has in domain modeling, this intervention has the potential to lead to significant improvements.The UK Engineering and Physical Sciences Research Council (grant EP/K009923/1)

A systematic review of parental involvement in cognitive behavioural therapy for adolescent anxiety disorders

Anxiety disorders are common among adolescents and lead to poor long-term outcomes. Cognitive Behavioural Therapy (CBT) is an evidenced-based intervention for adolescent anxiety disorders, but little is known about whether and how parents should be involved. This systematic review evaluated how parents have been involved and associated treatment outcomes in studies of CBT for adolescent anxiety disorders. Electronic systematic searches were conducted in PsycINFO, Embase, CINAHL, Medline, AMED databases, to identify studies investigating CBT for adolescent anxiety disorder(s) that included parents in treatment. Twenty-three studies were identified. Parents were involved in treatment in a number of different ways: by attending separate parent sessions, joint parent-adolescent sessions, or both, or through provision of a workbook while attending some adolescent sessions. Content varied but was most typically aimed at the parent developing an understanding of core CBT components and skills to help them manage their adolescent’s anxiety and avoidance. Treatment outcomes indicate that CBT with parental involvement is an effective intervention for adolescent anxiety disorders, however it is not possible to draw conclusions regarding whether parental involvement (generally or in any particular form) enhances treatment outcomes. Poor reporting and methodological issues also limit the conclusions. Further research is required to identify whether there are particular types of parental involvement in CBT that bring clinical benefits to adolescents with anxiety disorders generally, as well as in particular circumstances

Conditions Favoring Biomechanically Driven Cv Co-occurrence In Lexicons

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)After having received serious consideration in the 1990s, the hypothesis that biomechanics is phonologized into probabilistic phonotactics subsided for methodological difficulties, while related child language studies gained ground. This paper aims at restoring the original adult language orientation of the discussion of biomechanically driven consonant vowel co-occurrence. It presents new, detailed evidence on two languages, British English and Brazilian Portuguese, where there is clear lexical support for two CV co-occurrence biases attributable to biomechanics: a trend for the combination of corona! consonants with front vowels, and a trend against the combination of dorsal consonants with front vowels. It also shows that such biases are stronger under conditions that complicate speech planning. The analysis uses log-linear modeling in conjunction with other statistical techniques to assure comparability with previous studies and reliability of multiple comparisons. Low overall effect sizes indicate that biomechanically driven CV biases only weakly affect free combination. However, under such complicating conditions as repetition or lack of stress combined with occlusion/obstruence in initial position, effect sizes grow and significant factor interactions emerge, suggesting that such biases help simplify speech planning. Revisiting the phonologization of biomechanics hypothesis with today's tools supports it sufficiently to justify further pursuit and search for explanations. (C) 2015 Elsevier Ltd. All rights reserved.557895CNPq [311154/2009-3]Brazilian National Research Council (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq