57 research outputs found

    Some considerations on coastal processes relevant to sea level rise

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    The effects of potential sea level rise on the shoreline and shore environment have been briefly examined by considering the interactions between sea level rise and relevant coastal processes. These interactions have been reviewed beginning with a discussion of the need to reanalyze previous estimates of eustatic sea level rise and compaction effects in water level measurement. This is followed by considerations on sea level effects on coastal and estuarine tidal ranges, storm surge and water level response, and interaction with natural and constructed shoreline features. The desirability to reevaluate the well known Bruun Rule for estimating shoreline recession has been noted. The mechanics of ground and surface water intrusion with reference to sea level rise are then reviewed. This is followed by sedimentary processes in the estuaries including wetland response. Finally comments are included on some probable effects of sea level rise on coastal ecosystems. These interactions are complex and lead to shoreline evolution (under a sea level rise) which is highly site-specific. Models which determine shoreline change on the basis of inundation of terrestrial topography without considering relevant coastal processes are likely to lead to erroneous shoreline scenarios, particularly where the shoreline is composed of erodible sedimentary material. With some exceptions, present day knowledge of shoreline response to hydrodynamic forcing is inadequate for long-term quantitative predictions. A series of interrelated basic and applied research issues must be addressed in the coming decades to determine shoreline response to sea level change with an acceptable degree of confidence. (PDF contains 189 pages.

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

    Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

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    Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

    Comparison of a mid-shelf wave hindcast to ADCP-measured directional spectra and their transformation to shallow water

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    In conducting a cross-shelf wave transformation experiment off the Atlantic coast of north Florida, a unique opportunity was exploited in which an Acoustic Doppler Current Profiler (ADCP) instrument was installed 30 km offshore at the exact location of one of the archive-nodes of a WAM-like wave hindcast model (OWI3G). A second ADCP was installed 550 m from shore. Approximately 53 days of directional wave spectra collected with the two ADCPs are used to (a) locally test the reliability of a subsequent update of the hindcast, (b) document the loss in energy as the waves crossed the broad, relatively shallow continental shelf between the two instruments, (c) test the ability of the SWAN (Gen2) nearshore wave transformation model to replicate the measurements taken in shallow water when driven by the offshore ADCP spectra, and (d) reassess the spectral transformation results when the offshore hindcast is used as input. In addition to direct comparison of the time series of frequency spectra and the directional distribution of energy, typical spectral parameters are each subjected to standard error tests. Results indicate that the offshore hindcast performs well in replicating significant wave height, fairly well for mean period, but not as reliably for peak period. Directional spreading in deeper water is generally well-represented, although vector mean direction is not, and is believed due to the proximity of the coast to the hindcast node. The nearshore model requires an order-of-magnitude reduction in bed roughness from its default value before agreement in wave energy at the nearshore ADCP can be achieved. Outcomes of the error tests for the hindcast-driven versus the ADCP-driven nearshore results (after roughness calibration) are quite similar, but nevertheless indicate that transformed wave period, wave direction, and directional spreading require improvement

    The longshore transport enigma and analysis of a 10-year record of wind-driven nearshore currents

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    Previous analysis of a 10-year record of nearshore directional wave spectra collected with an Acoustic Doppler Current Profiler (ADCP) installed outside the surf zone in Melbourne Beach, Florida, unexpectedly revealed that the long-term average wave-induced radiation stress (Sxy) was nearly balanced between northerly and southerly forcing. More than 4 years of wind data collected at the site with a directional anemometer also showed a nearly balanced net longshore wind stress. However, shoreline offsets at nearby jettied inlets clearly indicate a predominant north-to-south net sediment transport. This enigma was investigated by analyzing the nearshore currents measured by the ADCP, and examining their correlation with the wind and incident waves. Significant correlation was found between the depth-averaged wind-driven longshore current and the incident wave conditions; e.g., the average energy-based significant wave height mo is typically larger (0.95 m) when the current is directed to the south than when the current is directed to the north (0.73 m). Guided by the classic Coastal Engineering Research Center (CERC) formula for longshore sediment transport, it is found that is significantly more correlated with southerly directed longshore currents (r = 0.47) than northerly currents (r = 0.21). Also, if a storm is defined as whenever Hmo exceeds 1.75 m, 40% of this time, the mean wave direction is out of the northeast quadrant, 33% is from the southeast, and 27% approaches shore-normal. Additionally, during storms, a stronger correlation between Sxy is found with southerly directed wind-driven currents (r = 0.51) than with northerly directed currents (r = 0.32). These findings indicate that net longshore sediment transport may in fact be heavily influenced by the correlation of the local wind with the waves, a feature not included in traditional longshore sediment transport formulas

    Evaluating the Impact of Beach Nourishment on Surfing: Surf City, Long Beach Island, New Jersey, U.S.A.

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    Utilizing the Cornell University Long and Intermediate WAVE (COULWAVE) Boussinesq wave model, the effect of the construction of a conventional beach nourishment project in Surf City, New Jersey, on the quality of the local surf break is examined in detail. A 20-year-long nearshore synthetic wave record is first developed for use in creating a monthly wave climate almanac so that typical seasonal effects on surf-break quality can be objectively portrayed. The wave model is then run with preconstruction bathymetric conditions, and with three postconstruction surveys performed in subsequent months. Construction of the nourishment project was found to affect the quality of the surf break adversely by (1) compression of the surf zone, (2) an increase in the occurrence of closeouts, (3) a shift in breaker type toward collapsing breakers, particularly during high tide, and (4) an increase in wave reflectioncfindings that are in agreement with anecdotal testimony offered by local surfers. On the basis of modeling results conducted using the sequential postconstruction surveys and the wave almanac, it appears to have required nominally 21-22 months for the surf-break quality to return to preproject conditions. A paradigm shift in the design and construction of beach nourishment projects in the United States is required if such effects are to be avoided, and several options are offered and discussed
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