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    10 research outputs found

    Green Thoughts, Green Futures: Planning for Energy Efficient Cities

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    More than 50% of all people globally are living in cities today. Enhancing the sustainability and efficiency of urban energy systems isthus of high priority for global sustainable development. A transition towards Energy Smart Cities calls for technological, innovative, behavioural and structural capacities – in other words a holistic approach to city planning.For this reason, the PLEEC project – "Planning for Energy Efficient Cities" – funded by the EU Seventh Framework Programme has applied an integrative approach to achieve the sustainable, energy-efficient, smart city. By coordinating strategies and combining best practices, PLEEC has developed a general model for energy efficiency and sustainable city planning. By connecting scientific excellence and innovative enterprises in the energy sector with ambitious and well‐organized cities, the project aimed to reduce energy use in Europe in the near future and will therefore be an important tool contributing to the EU's 20‐20‐20 targets.The main project outcomes were individual Energy Efficiency Action Plans for the six “PLEEC cities” on how to improve their energy efficiency in a strategic and holistic way. In order to make this knowledge available to further European cities the project developed a general model on energy efficiency and sustainable urban planning – accessible through an online model website
    TU Delft Repository

    Combining Soil Erosion Modeling with Connectivity Analyses to Assess Lateral Fine Sediment Input into Agricultural Streams

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    Soil erosion causes severe on- and off-site effects, including loss of organic matter, reductions in soil depth, sedimentation of reservoirs, eutrophication of water bodies, and clogging and smothering of spawning habitats. The involved sediment source-mobilization-delivery process is complex in space and time, depending on a multiplicity of factors that determine lateral sediment connectivity in catchment systems. Shortcomings of soil erosion models and connectivity approaches call for methodical improvement when it comes to assess lateral sediment connectivity in agricultural catchments. This study aims to (i) apply and evaluate different approaches, i.e., Index of Connectivity (IC), the Geospatial Interface for Water Erosion Prediction Project (GeoWEPP) soil erosion model, field mapping and (ii) test a connectivity-adapted version of GeoWEPP (i.e., “GeoWEPP-C”) in the context of detecting hot-spots for soil erosion and lateral fine sediment entry points to the drainage network in a medium-sized (138 km2) agricultural catchment in Austria, further discussing their applicability in sediment management in agricultural catchments. The results revealed that (a) GeoWEPP is able to detect sub-catchments with high amount of soil erosion/sediment yield that represent manageable units in the context of soil erosion research and catchment management; (b) the combination of GeoWEPP modeling and field-based connectivity mapping is suitable for the delineation of lateral (i.e., field to stream) fine sediment connectivity hotspots; (c) the IC is a useful tool for a rapid Geographic Information System (GIS)-based assessment of structural connectivity. However, the IC showed significant limitations for agricultural catchments and functional aspects of connectivity; (d) the process-based GeoWEPP-C model can be seen as a methodical improvement when it comes to the assessment of lateral sediment connectivity in agricultural catchments.© 2019 by the author

    Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery

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    Background. The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods. We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results. A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a threefold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failureto- rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions. Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries
    Maastricht University Research Portal

    Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

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    Nestle Health Sciences
    Crossref
    IRIS UniSR (’Università Vita-Salute San Raffaele)
    UNIL IRIS | Institutional Research Information System
    Ghent University Academic Bibliography
    Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna
    ZORA
    Archivio istituzionale della ricerca - Università di Ferrara
    Queen Mary Research Online
    White Rose Research Online
    Utrecht University Repository
    George Washington University: Health Sciences Research Commons (HSRC)

    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study

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    Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London
    Crossref
    Online Research @ Cardiff
    University of Groningen
    UNIL IRIS | Institutional Research Information System
    Ghent University Academic Bibliography
    Institutional Repository Universiteit Antwerpen
    VBN (Videnbasen) Aalborg Universitets forskningsportal
    The University of Manchester - Institutional Repository
    Queen Mary Research Online
    St George's Online Research Archive

    Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery.

    Author
    Publication venue
    Publication date
    Field of study
    No full text
    Background: The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods: We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results: A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a three-fold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failure-to-rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions: Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries
    University of Groningen
    UNIL IRIS | Institutional Research Information System
    The University of Manchester - Institutional Repository
    Queen Mary Research Online
    George Washington University: Health Sciences Research Commons (HSRC)
    Crossref
    Online Research @ Cardiff
    Ghent University Academic Bibliography
    Institutional Repository Universiteit Antwerpen
    St George's Online Research Archive

    Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group

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    Funded by Nestle Health Sciences through an unrestricted research grant, by a National Institute for Health Research Professorship held by R.P., and sponsored by Queen Mary University of London
    Aberdeen University Research
    University of Groningen
    Archivio istituzionale della ricerca - Università dell'Insubria
    Open Repository and Bibliography - Liège
    George Washington University: Health Sciences Research Commons (HSRC)
    Archivio istituzionale della Ricerca - Università degli Studi di Parma
    Ghent University Academic Bibliography
    Oxford University Research Archive
    Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna
    University of Melbourne Institutional Repository
    Monash University Research Portal
    Southampton (e-Prints Soton)
    UNIL IRIS | Institutional Research Information System
    PEARL (Univ. of Plymouth)
    Spiral - Imperial College Digital Repository
    The University of Manchester - Institutional Repository
    Queen Mary Research Online
    Repositório da Unidade Local de Saúde São José
    UQ eSpace (University of Queensland)
    Maastricht University Research Portal
    UCL Discovery
    St George's Online Research Archive
    Swepub

    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study

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    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational stud
    DRO Deakin Research Online

    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study

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    AIMS: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level. METHODS: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals. RESULTS: 2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]). CONCLUSIONS: Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk
    The Francis Crick Institute

    Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

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    This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London
    University of Birmingham Research Portal
    UNIL IRIS | Institutional Research Information System
    Archivio istituzionale della ricerca - Università dell'Insubria
    FreiDok plus
    Open Repository and Bibliography - Liège
    The University of Manchester - Institutional Repository
    Queen Mary Research Online
    Repositório da Unidade Local de Saúde São José
    George Washington University: Health Sciences Research Commons (HSRC)
    HKU Scholars Hub
    UQ eSpace (University of Queensland)
    Crossref
    Archivio istituzionale della Ricerca - Università degli Studi di Parma
    Ghent University Academic Bibliography
    UCL Discovery
    Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna
    Utrecht University Repository
    Archivio della ricerca- Università di Roma La Sapienza
    Explore Bristol Research
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