294 research outputs found

    A modelling tool for capacity planning in acute and community stroke services

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    Background: Mathematical capacity planning methods that can take account of variations in patient complexity, admission rates and delayed discharges have long been available, but their implementation in complex pathways such as stroke care remains limited. Instead simple average based estimates are commonplace. These methods often substantially underestimate capacity requirements. We analyse the capacity requirements for acute and community stroke services in a pathway with over 630 admissions per year. We sought to identify current capacity bottlenecks affecting patient flow, future capacity requirements in the presence of increased admissions, the impact of co-location and pooling of the acute and rehabilitation units and the impact of patient subgroups on capacity requirements. We contrast these results to the often used method of planning by average occupancy, often with arbitrary uplifts to cater for variability. Methods: We developed a discrete-event simulation model using aggregate parameter values derived from routine administrative data on over 2000 anonymised admission and discharge timestamps. The model mimicked the flow of stroke, high risk TIA and complex neurological patients from admission to an acute ward through to community rehab and early supported discharge, and predicted the probability of admission delays. Results: An increase from 10 to 14 acute beds reduces the number of patients experiencing a delay to the acute stroke unit from 1 in every 7 to 1 in 50. Co-location of the acute and rehabilitation units and pooling eight beds out of a total bed stock of 26 reduce the number of delayed acute admissions to 1 in every 29 and the number of delayed rehabilitation admissions to 1 in every 20. Planning by average occupancy would resulted in delays for 1 in every 5 patients in the acute stroke unit. Conclusions: Planning by average occupancy fails to provide appropriate reserve capacity to manage the variations seen in stroke pathways to desired service levels. An appropriate uplift from the average cannot be based simply on occupancy figures. Our method draws on long available, intuitive, but underused mathematical techniques for capacity planning. Implementation via simulation at our study hospital provided valuable decision support for planners to assess future bed numbers and organisation of the acute and rehabilitation services. <br/

    Testing the ecosystem service cascade framework for Atlantic salmon

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    Aligning nature protection with human well-being for the UN Sustainable Development Goals implies that conservation monitoring should indicate the sustainability of ecosystem services (ES). Here we test the value of the ES cascade framework using national, multi-decadal data for an iconic freshwater fish, the Atlantic salmon Salmo salar. For the first time, we assemble all long-term monitoring data for England and Wales along the ES cascade for this species from resource to benefit: juvenile density to measure the biological resource, returning adult numbers to measure potential ES use, and rod catches and angling effort as measures of actual ES use. We aimed to understand how the ES cascade framework reconciled conservation with ES sustainability targets. Only some linkages along the ES cascade could be evidenced: in catchments where juveniles declined, rod catches also generally decreased, but angling effort declined everywhere irrespective of the biological resource trends. We suggest that i) programmes focused on juvenile monitoring provide an early-warning system for ES provision as well as nature conservation, ii) the ES cascade framework can reconcile nature conservation and ES sustainability if monitoring efforts link biological resources fully to the ES, and ES monitoring explicitly relates biological resources to human use

    Global Mangrove Extent Change 1996–2020:Global Mangrove Watch Version 3.0

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    Mangroves are a globally important ecosystem that provides a wide range of ecosystem system services, such as carbon capture and storage, coastal protection and fisheries enhancement. Mangroves have significantly reduced in global extent over the last 50 years, primarily as a result of deforestation caused by the expansion of agriculture and aquaculture in coastal environments. However, a limited number of studies have attempted to estimate changes in global mangrove extent, particularly into the 1990s, despite much of the loss in mangrove extent occurring pre-2000. This study has used L-band Synthetic Aperture Radar (SAR) global mosaic datasets from the Japan Aerospace Exploration Agency (JAXA) for 11 epochs from 1996 to 2020 to develop a long-term time-series of global mangrove extent and change. The study used a map-to-image approach to change detection where the baseline map (GMW v2.5) was updated using thresholding and a contextual mangrove change mask. This approach was applied between all image-date pairs producing 10 maps for each epoch, which were summarised to produce the global mangrove time-series. The resulting mangrove extent maps had an estimated accuracy of 87.4% (95th conf. int.: 86.2–88.6%), although the accuracies of the individual gain and loss change classes were lower at 58.1% (52.4–63.9%) and 60.6% (56.1–64.8%), respectively. Sources of error included misregistration in the SAR mosaic datasets, which could only be partially corrected for, but also confusion in fragmented areas of mangroves, such as around aquaculture ponds. Overall, 152,604 km2 (133,996–176,910) of mangroves were identified for 1996, with this decreasing by -5245 km2 (-13,587–1444) resulting in a total extent of 147,359 km2 (127,925–168,895) in 2020, and representing an estimated loss of 3.4% over the 24-year time period. The Global Mangrove Watch Version 3.0 represents the most comprehensive record of global mangrove change achieved to date and is expected to support a wide range of activities, including the ongoing monitoring of the global coastal environment, defining and assessments of progress toward conservation targets, protected area planning and risk assessments of mangrove ecosystems worldwide

    The Grizzly, September 15, 2016

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    Board Chair Marcon Resigns Amid Controversy • Meet the Interim Board Chair • Black Girl Dangerous Comes to Speak at Ursinus • Student Work Hits the Stage • A Creative Approach to Raising Awareness • Opinions: Choose the America You Wish to be a Part of ; Students\u27 Guide to Weekends at Reimert • Field Hockey Off to a Hot Start, Looking for Redemption • You Bend \u27Em, We Mend \u27Em: The Life of an Athletic Trainerhttps://digitalcommons.ursinus.edu/grizzlynews/1648/thumbnail.jp

    The Grizzly, November 10, 2016

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    Ursinus Picks New Dean / VPAA after Months-Long Search • Innovation and Discovery Center Breaks New Ground • Q&A with Anupy Singla • International Perspective: Chinese Teaching Assistant Embraces the Freedom to be Herself in the U.S. • U-Speak Talk to Explore Under-Represented Voices • Women Entrepreneurs Share Stories of Success • Opinions: Offensive Costumes are Micro-aggressions; UC Needs In-Person Activism to Make Progress • Wrestling Looks to Win it All in 2016-2017 • Field Hockey Tops Conference Once Againhttps://digitalcommons.ursinus.edu/grizzlynews/1655/thumbnail.jp

    Populations of high-value predators reflect the traits of their prey

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    The extent to which prey traits combine to influence the abundance of predators is still poorly understood, particularly for mixed predators in sympatry and in aquatic ecosystems. In this study, we characterise prey use and distribution in iconic bird (grey wagtails and Eurasian dippers) and fish species (brown trout and Atlantic salmon) to assess whether prey traits could predict populations of these four riverine predators. Specifically, we hypothesised that: 1) prey key traits would predict predator populations more effectively than 2) diversity of prey traits, 3) the taxonomic abundance or richness of prey (known as traditional or mass‐effect types of biodiversity) or 4) the prevailing environmental conditions. Combined predator population sizes were predicted better by a few key traits – specifically those revealing prey habitat use, size and drifting behaviour – than by prey diversity or prey trait diversity or environmental conditions. Our findings demonstrate that the complex relationships between prey assemblages and multiple predator species can be represented mechanistically when the key prey traits that govern encounter and consumption rates are identified. Given their apparent potential to reveal trophic relationships, and to complement more traditional measures of prey abundance, we advocate further development of trait‐based approaches in predator–prey research

    The Grizzly, September 28, 2016

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    Campus Safety Takes Safety Initiatives • Poet Comes to UC • ESL Program Promotes Community Between Students and Staff • New Club Aims to Get Money Out of Politics • Shakespeare in the Summer of Love • Family Day Branches Out • Opinions: Let\u27s (Finally) Talk About Sex Addiction; Frank Ocean\u27s Blonde was Worth Waiting For • Ursinus Men\u27s and Women\u27s Cross Country Team Off to a Hot Start • Rare Breed: The Two-Sport Athletehttps://digitalcommons.ursinus.edu/grizzlynews/1650/thumbnail.jp

    The Grizzly, September 8, 2016

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    Marcon Under Fire for Controversial Tweets • First-Year Class Smaller Than Usual • Ursinus Offers Gateway to Success • Ursinus\u27 Students Mourn the Loss of Beloved Wawa • History Department Welcomes New Professor • Student Researchers Spend Summer with NASA • Opinions: Ostrum to Marcon: Let\u27s Work Toward Inclusion; Students Happily Embrace Changes to Wismer • Spike! Ursinus Volleyball is Back in Action! • The Bears and the Bisonhttps://digitalcommons.ursinus.edu/grizzlynews/1647/thumbnail.jp

    The Grizzly, October 13, 2016

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    Annual Safety Report Released • Ma Tones Brings Music to Collegeville • Come to Me Campaign Raises Awareness • International Perspective: French TA Excited to Learn What it\u27s Really Like to Live in the U.S. • Students Unite for Worker Justice • Partnership in Politics • Opinions: New Face of Change: A Defense of Millennials; Students Need to Understand Consent • UC Athletes Give Back to Their Community • Rafter Tackles Milestonehttps://digitalcommons.ursinus.edu/grizzlynews/1652/thumbnail.jp
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