5 research outputs found

    Biophysical and economic models for assessing impacts of change on grazingland ecosystems Modelos biofísicos e econômicos para avaliar impactos de mudanças no ecossistema pastagem nativa

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    PHYGROW, a hydrologic-based forage simulation model, was parameterized to represent a typical South Texas ranch engaged in the production of cattle and meat goats with an indigenous population of white-tailed deer. Forage production and associated stocking rates for two cattle:goat ratios were simulated with POPMIX for 20 years. Two ten-year weather scenarios, one representing normal conditions (30% drought years) and one representing dryer weather conditions (50% drought years) were analyzed. Management decision rules (ASPC) were developed for the region to produce estimates of annual animal production and operating costs for the enterprises on each of the four scenarios. These performance and cost data were then used as input into FLIPSIM, a firm level income and policy simulator, along with relevant product and input price data for the region. Integration of modeled results produced useful information showing the socioeconomic consequences for a typical South Texas firm impacted by alternative climatic conditions and management strategies.<br>Um modelo de simulação de produção de forragem (PHYGROW), foi parametrizado para representar uma fazenda típica no Sul do Texas envolvida com a produção de bovinos, caprinos e de animais silvestres (cervo). A produção de forragem e as taxas de lotação associadas a bovinos e caprinos foram simuladas com POPMIX para o período de 20 anos. Dois períodos de dez anos, um representando condições normais de tempo (30% da série de anos secos) e outro representando condições de tempo mais secos (50%) foram analisados. Foram desenvolvidas regras de decisão de manejo (ASPC) para a região visando estimar a produção anual dos animais e custo operacional para as atividades em cada um dos quatro cenários. Os dados de performance animal e de custo foram então usados como input no FLIPSIM, um simulador de renda e de estratégias de manejo a nível de fazenda, juntamente com dados relevantes de produtos e preços para a região do estudo. A integração dos modelos produziu informações úteis e serviu para mostrar as conseqüências socioeconômicas das diferentes condições climáticas e de alternativas estratégias de manejo para uma fazenda típica no Sul do Texas

    Safety of hospital discharge before return of bowel function after elective colorectal surgery

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    Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P &lt; 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

    Safety of hospital discharge before return of bowel function after elective colorectal surgery

    No full text
    © 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients
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