Using participatory multi-criteria assessments for assessing disaster risk reduction measures

This paper introduces a participatory Multi-Criteria Assessment (MCA) methodology developed through the Resilience Increasing Strategies for Coasts – Toolkit (RISC-KIT) project and implemented in nine case studies in Europe. The purpose of the MCA was to bridge the disciplinary divide between engineering sciences and social sciences, facilitate the communication and dissemination of local coastal risk assessments and Disaster Risk Reduction (DRR) measures' evaluation to a broad range of actors. The process addressed the importance of integrating scientific knowledge with stakeholders’ knowledge to understand and assess the possible social, political and economic implications of different DRR measures, which could foster or hinder successful implementation. The paper discusses the methodological aspects and implementation of the approach which included visualizing risk reduction of DRR measures using paper-based cards to support interaction and negotiation among participants to select preferred strategic alternatives (SA), and a participatory MCA where stakeholders evaluated the SA against three (self-weighted) criteria: feasibility, acceptability and sustainability

An assessment of potential improvements in social capital, risk awareness, and preparedness from digital technologies

Contributions to social capital, risk awareness, and preparedness constitute the parameters against which applications of digital technologies in the field of disaster risk management should be tested. We propose here an evaluation of four of these: mobile positioning data, social media crowdsourcing, drones, and satellite imaging, with an additional focus on acceptability and feasibility. The assessment is carried out through a survey disseminated among stakeholders. The frame of the analysis also grants the opportunity to investigate to what extent different methodologies to aggregate and evaluate the results, i.e., the Criteria Importance Through Criteria Correlation (CRITIC) model, the (Euclidean)-distance Criteria Importance Through Criteria Correlation (dCRITIC) model, the entropy model, the mean weight model, and the standard deviation model, may influence the preference of one technology over the others. We find that the different assumptions on which these methodologies rely deliver diverging results. We therefore recommend that future research adopt a sensitivity analysis that considers multiple and alternatives methods to evaluate survey results.</p

Predictive Models for the Diagnostic of Human Visceral Leishmaniasis in Brazil

Visceral leishmaniasis (VL) is a neglected tropical disease endemic to 65 countries, including Brazil, where the disease frequently occurs in remote locations and treatment is often performed on the basis of clinical suspicion. Predictive models based on scoring systems could be a helpful tool for the clinical management of VL. Based on clinical signs and symptoms, and five different serological tests of 213 patients with parasitologically confirmed (cases) and 119 with clinical suspicion of VL but with another confirmed etiology (non-cases), twelve prediction models using logistic regression and classification and regression trees (CART) for VL diagnosis were developed. The model composed of the clinical-laboratory variables and the rk39 rapid test showed the best performance in both logistic regression and CART (Sensitivity of 90.1% and specificity ranging from 97.2–97.4%). The scoring system is simple and based on the clinical-laboratory findings that are easily available in most clinical settings. The results suggest that those models might be useful in locations where access to available diagnostic methods is difficult, contributing to more efficient and more rational allocation of healthcare resources

3066 consecutive Gamma Nails. 12 years experience at a single centre

<p>Abstract</p> <p>Background</p> <p>Fixation of trochanteric hip fractures using the Gamma Nail has been performed since 1988 and is today well established and wide-spread. However, a number of reports have raised serious concerns about the implant's complication rate. The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other obvious advantages, when this implant is employed.</p> <p>Through access to a uniquely large patient data base available, which is available for analysis of trochanteric fractures; we have been able to evaluate the performance of the Gamma Nail over a twelve year period.</p> <p>Methods</p> <p>3066 consecutive patients were treated for trochanteric fractures using Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l'Orthopedie (CTO), Strasbourg, France. These patients were retrospectively analysed. Information on epidemiological data, intra- and postoperative complications and patients' outcome was retrieved from patient notes. All available radiographs were assessed by a single reviewer (AJB).</p> <p>Results</p> <p>The results showed a low complication rate with the use of the Gamma Nail. There were 137 (4.5%) intraoperative fracture-related complications. Moreover 189 (6.2%) complications were detected postoperatively and during follow-up. Cut-out of the lag screw from the femoral head was the most frequent mechanical complication (57 patients, 1.85%), whereas a postoperative femoral shaft fracture occurred in 19 patients (0.6%). Other complications, such as infection, delayed healing/non-union, avascular femoral head necrosis and distal locking problems occurred in 113 patients (3.7%).</p> <p>Conclusions</p> <p>The use of the Gamma Nail in trochanteric hip fractures is a safe method with a low complication rate. In particular, a low rate of femoral shaft fractures was reported. The low complication rate reported in this series can probably be explained by strict adherence to a proper surgical technique.</p

Towards improved adaptation action in Europe: Policy recommendations from the UNCHAIN project

Policymakers can make adaptation "smarter" by using the Impact Chain approach to analyse both conventional local climate risks and lesser well-known transboundary climate risks. • Policymakers should embrace uncertainties by applying a reflect-then-act rather than the predict-then-act approach; by including socioeconomic scenarios for a range of possible developments, from likely to unanticipated; and by ensuring transparency in communications. Below we summarize our policy-relevant insights and recommendations for the European Commission and EU member states