ZONAS INUNDÁVEIS E QUANTIFICAÇÃO DO RISCO DE INUNDAÇÃO EM MEIOS URBANOS: ESTUDO EM COIMBRA

As inundações urbanas são, hoje em dia, um tema bastante atual em praticamente todos os países e, em particular, em zonas muito urbanizadas. Os danos por elas causados são, frequentemente, bastante graves, o que se afigura serem necessárias medidas preventivas para evitar, quando possível, ou mitigar esses eventos. A crescente urbanização e, eventualmente, as alterações climáticas recentes apresentam um forte contributo para os eventos de inundações em zonas urbanas. Associados às preocupações inerentes às inundações, surgem os mapas de risco, os quais classificam determinada zona, quando atingida por uma inundação, consoante as consequências sofridas. Em 2007, a União Europeia publicou a Diretiva 2007/60/CE que prevê, para todos os Estados-Membros, o dever de elaborarem mapas de risco de inundação. Assim, este artigo tem como objetivo a elaboração de mapas de zonas inundáveis e mapas de risco de inundação para a Zona Central de Coimbra, Portugal. Com esse propósito, simularam-se eventos pluviométricos com diferentes períodos de retorno e, com base nos resultados, elaboraram-se os referidos mapas. Através da sua elaboração, verificou-se que estes proporcionavam uma indicação clara de quais as zonas e os edifícios mais sujeitos a sofrerem maiores prejuízos em caso de inundação

How to Improve the Biological Quality of Urban Streams? Reviewing the Effect of Hydromorphological Alterations and Rehabilitation Measures on Benthic Invertebrates

Urbanisation alters the natural hydromorphology of streams, affecting aquatic communities and ecological quality. Increasing efforts have been put into the rehabilitation of urban streams due to their importance for urban sustainability. Despite these efforts, many projects fail to achieve the improvement of aquatic communities. This study aims to provide specific recommendations to enhance the biological rehabilitation of urban streams by reviewing: (i) the impacts of urbanisation and climate change on urban stream hydrology, (ii) the responses of invertebrate assemblages to alterations in the hydrology and morphology of streams, and (iii) the hydromorphological rehabilitation measures applied to streams and their effect on invertebrate communities. This review found that commonly employed measures of habitat heterogeneity enhancement (such as the addition of meanders, boulders, and artificial riffles) are not enough to improve invertebrate communities. On the other hand, the most effective measures are those leading to the re-establishment of natural hydrological patterns and good water quality. Ultimately, an integrated ecohydrological approach that considers the entire watershed and its interactions between ecosystems and anthropological activities is the key to managing and rehabilitating urban streams

ZONAS INUNDÁVEIS E QUANTIFICAÇÃO DO RISCO DE INUNDAÇÃO EM MEIOS URBANOS: ESTUDO EM COIMBRA

Normal 0 21 false false false MicrosoftInternetExplorer4 As inundações urbanas são, hoje em dia, um tema bastante atual em praticamente todos os países e, em particular, em zonas muito urbanizadas. Os danos por elas causados são, frequentemente, bastante graves, o que se afigura serem necessárias medidas preventivas para evitar, quando possível, ou mitigar esses eventos. A crescente urbanização e, eventualmente, as alterações climáticas recentes apresentam um forte contributo para os eventos de inundações em zonas urbanas. Associados às preocupações inerentes às inundações, surgem os mapas de risco, os quais classificam determinada zona, quando atingida por uma inundação, consoante as consequências sofridas. Em 2007, a União Europeia publicou a Diretiva 2007/60/CE que prevê, para todos os Estados-Membros, o dever de elaborarem mapas de risco de inundação. Assim, este artigo tem como objetivo a elaboração de mapas de zonas inundáveis e mapas de risco de inundação para a Zona Central de Coimbra, Portugal. Com esse propósito, simularam-se eventos pluviométricos com diferentes períodos de retorno e, com base nos resultados, elaboraram-se os referidos mapas. Através da sua elaboração, verificou-se que estes proporcionavam uma indicação clara de quais as zonas e os edifícios mais sujeitos a sofrerem maiores prejuízos em caso de inundação. <!--[endif] --

Hydraulic and water quality modelling of urban drainage systems

As inundações urbanas estão se tornando cada vez mais frequentes, de tal forma que a União Europeia publicou a Diretiva 2007/60/CE no sentido de mitigar as consequências relacionadas com este fenômeno e de impor limites à concentração de poluentes nas águas pluviais. O objetivo deste artigo foi apresentar uma modelação dos sistemas de drenagem em situação de inundações, baseada no software da United States Environmental Protection Agency (EPA), Storm Water Management Model (SWMM), em que o estudo de caso é analisar um sistema de drenagem urbana unitário, inserido na Zona Central de Coimbra, em Portugal. Recorrendo à metodologia Automatic Overland Flow Delineation (AOFD) para a geração de uma rede de drenagem superficial e implementando-a no SWMM, obteve-se um modelo de drenagem dual, que permite a análise do escoamento em situação de inundações, incluindo o controle de escoamento entre a superfície e a rede de coletores e a modelação da qualidade da água à superfície. Este modelo permite quantificar a carga poluente à superfície, relativamente ao parâmetro de sólidos suspensos totais, para um evento de precipitação extrema.Urban floods are becoming more frequent. Thus, the European Union published the Directive 2007/60/CE to mitigate costs related with this phenomenon and to impose limits on the concentration of pollutants in pluvial water. The purpose of this study was to present the modelling of drainage systems in flood situations, based on the software of the United States Environmental Protection Agency (EPA), the Storm Water Management Model (SWMM), in which the study case is to analyze a unitary urban drainage system of Zona Central catchment in Coimbra, Portugal. By using the Automatic Overland Flow Delineation (AOFD) methodology for the generation of a superficial drainage network and implementing it in the SWMM, it was obtained a dual drainage model that allows the flow analysis in flood conditions, including flow control between the surface and collectors network and also modeling of water quality at the surface. This model allows quantifying the pollution load at the surface, relatively to the parameter of total suspended solids, for any extreme rainfall event

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p&lt;0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p&lt;0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit