Large Catchment Area Research Articles

Urban stormwater runoff pollutant loadings: GIS land use classification vs. sample-based predictions.

Cities are growing worldwide with an increase in stormwater quantity and decrease in quality, negatively impacting receiving water bodies. The characterization of stormwater is difficult given its high variability and the typically numerous outfalls to be monitored. However, loadings can be estimated via models and validated using actual outfall monitoring. This study determined stormwater pollutant loadings predicted using eight land-use classifications (i.e., a 'desktop' study) and via an outfall sampling regime (i.e., a 'monitoring' study) for seven stormwater catchment areas in Saskatoon, SK, Canada, where stormwater typically releases directly into the South Saskatchewan River. Pollutants considered were total suspended solids (TSS), chemical oxygen demand (COD), metals, and polycyclic aromatic hydrocarbons. Catchment areas were dominated by single-family residential (39%) and green areas (17%). The largest catchment area, Preston Crossing, was the major source of the predicted annual loadings, such as TSS at 550,000kg and COD at 265,000kg. For comparison, the sampled-based estimated loadings for TSS and COD were 362,700kg and 652,700kg, respectively. Differences between the average predicted and actual estimations ranged from 29 to 156% for the eight pollutants considered, with averages for the summed pollutants in each catchment area ranging from 48 to 130%. Overall, the assessment and monitoring of stormwater outfalls are needed for the determination of impacts of loadings on the environment and for the subsequent development and implementation of treatment technologies.

Inpatient Addiction Medicine Consultation Service Impact on Post-discharge Patient Mortality: a Propensity-Matched Analysis.

Inpatient addiction medicine consultation services (AMCS) have grown rapidly, but there is limited research of their impact on patient outcomes. To examine whether AMCS is associated with all-cause mortality and hospital utilization post-discharge. This was a propensity-score-matchedcase-control study from 2018 to 2020. The intervention group included patients referred to the AMCS from October 2018 to March 2020. Matched control participants included patients hospitalized from October 2017 to September 2018 at an urban academic hospital with a large suburban and rural catchment area. The effect of treatment was estimated as the difference between the proportion of subjects experiencing the event (7-day and 30-day readmission, emergency department visits, and mortality within 90 days) for each group in the matched sample. There were 711 patients in the intervention group and 2172 patients in the control group. The most common substance use disorders among the intervention group were primary alcohol use disorder (n=181; 25.5%) and primaryopioid use disorder (n=175, 24.6%) with over a third with polysubstance use (n=257, 36.1%). Intervention patients showed a reduction in 90-day mortality post-hospital discharge (average treatment effect [ATE]: -2.35%, 95% CI: -3.57, -1.13; p-value <0.001) compared to propensity-matched controls. We found a statistically significant reduction in 7-day hospital readmission by 2.15% (95% CI: -3.65, -0.65; p=0.005) and a nonsignificant reduction in 30-day readmission (ATE: -2.38%, 95% CI: -5.20, 0.45; p=0.099). There was a statistically significant increase in 30-day emergency department visits (ATE: 5.32%, 95% CI: 2.19, 8.46; 0.001) compared to matched controls. There was a reduction in 90-day all-cause mortality for the AMCS intervention group compared to matched controls, although the impact on hospital utilization was mixed. AMCS are systems interventions that are effective tools to improve patient health and reduce all-cause mortality.

Insights into Preservation of Blood Biomarkers in Biobank Samples.

Insights into Preservation of Blood Biomarkers in Biobank Samples.

Does intercity rail station placement matter? Expansion of the node-place model to identify station location impacts on Amtrak ridership

The node-place model has been used in previous studies to categorize urban transit rail stations, and to study impacts on transit station ridership. Similar studies have not been performed for intercity rail station ridership. This study uses the node-place model to examine the station-level factors affecting station ridership on the Amtrak network in the United States. The local factors include measures of the node and place quality of each station. The node-place model is expanded to include accessibility, an important consideration for the large catchment areas of intercity rail. Measures and indices defining each node-place-accessibility category are constructed and analyzed in two groups of Amtrak stations. A multivariate regression is used to determine the effects of each measure and category on the station ridership. The results indicate that the quality of place and accessibility for stations significantly impact station ridership for both groups of Amtrak stations. The findings contribute to a better understanding of the drivers of intercity rail ridership; the resulting insights could be used to improve service and development planning for intercity rail networks.

Identifying suitable sites for rainwater harvesting using GIS &amp; Multi – Criteria Decision Making techniques in Badghis Province of Afghanistan

In Afghanistan, about 1/3 (12.5 mln) of the total population have no access to stable water supplies such as groundwater extraction, stream flow diversion, and reservoir storage. In areas with limited water sources, rainwater harvesting (RWH) can improve the availability of potable water. Due to RWH flexibility and applying different criteria, it can be used in various settings, making RWH a viable option for local communities. Within this study, suitable RWH sites were identified based on modern technological approaches (GIS and Multi-Criteria Decision Making (MCDM)) considering different biophysical criteria selected according to the requirements of the target area environment. The Analytical Hierarchy Process (AHP), Weighted Linear Combination (WLC) Model and hydrology tools were used as MCDM and GIS-based decisions, respectively. The proposed methodology was implemented in the target area of 11,772 km2. The obtained land suitability map was divided into five (5) RWH zones: highly suitable (7.84% of the total area), suitable (21.85%), moderately suitable (31.15%), marginally suitable (27.85%), and not suitable (11.31%). The research results show that highly suitable and suitable sites (3,495.47 km2) are located in mountainous zones with good elevation potential, proper valley shapes, and large catchment areas. RWH practices in these areas can be considered as renewable and sustainable alternatives to water demand saturation. In addition to being a solution in terms of providing water to water-scarce areas, RWH installations represent a good climate change response and water resource management means.

Pilot study of home phototherapy for neonatal jaundice monitored in maternity ward during the enforced Italy-wide COVID-19 national lockdown.

In Italy, where neonatal jaundice treatment is required, it is largely carried out in hospitals. However, it is possible to safely administer home phototherapy (HPT). We report our pilot center’s experience of HPT and its potential benefits during the COVID-19-enforced national lockdown. This is an observational study performed at the Policlinic Abano Terme, a suburban hospital that covers a large catchment area near the Euganean Hills in Northeast Italy with around 1000 deliveries per year. HPT was started after regular nursery discharge, and the mothers brought the neonates back to the hospital maternity ward each day to check infants’ bilirubin levels, weight, and general state of health, until it was deemed safe to stop. The efficacy of HPT in bilirubin reduction, hospital readmission rates, and parental satisfaction were evaluated. Thirty infants received HPT. In 4 of these infants, HPT was associated with total serum bilirubin (TSB) between 75 and 95th percentile (high-intermediate-risk zone) and in 26 infants HPT was associated with TSB > 95th percentile (high-risk zone) of the Bhutani nomogram. Among these 30 infants, 27 (90%) completed the HPT with a progressive decrease of TSB levels with 4 neonates requiring a second course and 3 infants requiring a third course of 24-h HPT. Three (10%) neonates failed HPT and were readmitted after one 24-h phototherapy course. No abnormalities of breastfeeding, body weight (defined as > 10% decrease), temperature, nor COVID infections were detected following HPT consultation in the neonatal ward. Home treatment efficacy with varying degrees of parental satisfaction occurred in all but 3 cases that involved difficulties with the equipment and inconsistent lamp manipulation practices.Conclusion: Our pilot study suggests that HPT for neonatal jaundice can be carried out effectively and with parental satisfaction as supported by daily back bilirubin monitoring in the maternity ward during the enforced COVID-19 national lockdown in Italy. What is Known:• No high-quality evidence is currently available to support or refute the practice of phototherapy in patients’ own homes.What is New:• Phototherapy can be delivered at home in a select group of infants and could be an ideal option if parents are able to return with their infants to the hospital maternity ward for daily follow-up.• It can be as effective as inpatient phototherapy and potentially helps in delivering family-centered care.

AN EFFECTIVENESS OF STRATEGIC LAND DEVELOPMENT ON SEWERAGE PLANNING AND LAND SERVICES IN INDAH WATER KONSORTIUM SDN BHD

The higher demanding factor for residential and commercial units has seen an increasing number of STP maintained by IWK every year. This increasing number of STP has forced IWK to incur increased operating and maintenance costs. With a limited number of employees and a large catchment area, it has raised several issues and problems such as the issue of encroachment into the STP land. To overcome the issues and problems, strategic land development is needed where it is also a method in achieving sustainable development. This study used a qualitative method by analyzing the current work procedures or guidelines and government documents used by IWK such as the Federal Constitution of Malaysia, National Land Code, and Malaysian Sewerage Industry Guidelines. The findings of the study found that the function of IWK in sewerage land management for public STP and the former STP site is quite limited. Thus, a new procedure or guidelines need to be developed to improve these weaknesses. Based on the land issues faced by IWK, it shows that the strategic land development will be able to help IWK in the planning stages in the future effectively. While sustainable development can be achieved by IWK using a combination between the new land management model and GIS application. This new land management model needs to be combined and should include all the existing procedures or guidelines and be controlled by one unit only. GIS as the most powerful tool today seen can help IWK to manage all the matter related sewerage lands, such as finding the decommissioned STP site, selecting the new location for the Regional STP project, and selection of the new alignment for a property connection project. Indirectly, it can help IWK to reduce the cost of operation and maintenance, sewerage land issues, environmental issues, and others.

Abstract 11667: Factors Associated With No-Show and Cancellations at Adult Congenital Heart Disease Clinic

Introduction: Many adults with congenital heart disease (ACHD) do not regularly access cardiology care; this has been associated with adverse outcomes. Clinic no-shows and cancellations limit access to care, and identify a population in need of intervention to improve engagement with care. We investigated factors associated with no-shows and cancellations in our academic ACHD clinic which draws from a large catchment area in Oregon, Washington, Idaho and California. Methods: The electronic medical record was queried to identify individuals ≥ 18 years of age with a scheduled appointment in the ACHD clinic from 2017-2020. Demographic and scheduling characteristics were recorded. Multivariate logistic regression was used to test for an association between variables and either no-show or patient-initiated cancellation. Results: Our sample included 7616 scheduled visits, and 4191 (55.0%) were completed. There were 332 (4.4%) no-shows and 1320 were canceled by the patient (17.3%). Factors associated with an increased risk of no-show to clinic were Medicaid (OR=1.86 (95% CI: 1.39, 2.49), p&lt;0.001), prior no-show (OR per 1% increase in prior no-show rate 1.13 (95% CI: 1.13, 1.45), p&lt;0.001), and an appointment at an off-site clinic (OR 2.16 (95% CI: 1.32, 3.45), p=0.002). Factors associated with an increased risk of a cancellation were in-person vs. virtual visits (OR 1.89 (95% CI 1.44, 2.53), p&lt;0.001) and being an established patient (OR 1.38 (95% CI 1.17, 1.63), p&lt;0.001). Patient age, day of the week, and appointment time were not associated with no-shows or cancellations. Discussion: Medicaid insurance, prior no-show, and off-site clinics are associated with a higher risk of no-show to ACHD clinic. As ACHD remains a limited resource, and lack of ACHD follow-up is associated with adverse events, limiting no-shows and canceled visits is an important goal. This study identifies a high-risk population which may benefit from targeted interventions to improve access to care.

Impact of the State-mandated Stay-at-home Order for the COVID-19 Pandemic on an Academic Level I Trauma Center with a Large Rural Catchment Area

Impact of the State-mandated Stay-at-home Order for the COVID-19 Pandemic on an Academic Level I Trauma Center with a Large Rural Catchment Area

Loneliness in older adult mental health services during the COVID-19 pandemic and before: Associations with disability, functioning and pharmacotherapy.

ObjectivesLoneliness is associated with psychiatric morbidity. Restrictions placed on the population during the first COVID‐19 lockdown may have disproportionately affected older adults, possibly through increasing loneliness. We sought to investigate this by examining loneliness in referrals to mental health of older adults (MHOA) services during the first UK COVID‐19 lockdown.MethodsReferrals to MHOA services from a large South London catchment area were identified for the 16‐week period of the UK lockdown starting in March 2020 and for the corresponding period in 2019. A natural language processing algorithm identified loneliness in the patients' records. We applied logistic regression models adjusted for age, gender, ethnicity and diagnosis, to examine associations of loneliness in the study population.Results1991 referrals were identified, 56.9% of whom were female, with a mean age of 77.9 years. Only 26.9% occurred during the 2020 lockdown, but with a higher prevalence of loneliness (22.0 vs. 17.7%, p = 0.028). In the whole sample, loneliness was associated with non‐accidental self‐injury (Odds ratio [OR]: 1.65), depressed mood (OR: 1.73), psychotic symptoms (OR: 1.65), relationship problems (OR: 1.49), problems with daytime activities (OR: 1.36), and antidepressant use (OR: 2.11). During lockdown, loneliness was associated with non‐accidental self‐injury (OR: 2.52), problem drinking or drug‐taking (OR 2.33), and antidepressant use (OR 2.10).ConclusionsLoneliness is associated with more severe symptoms of affective illness, worse functional problems and increased use of antidepressant medication in older adults. During lockdown, loneliness in referrals to MHOA services increased and was associated with increased risk‐taking behaviour. Loneliness is a potential modifiable risk factor for mental illness, and efforts to minimise it in older adults should be prioritised as we emerge from the pandemic.

CALCULATING EVAPOTRANSPIRATION FOR THE LAKE LADOGA CATCHMENT AREA

The paper evaluates the possibility of calculating evapotranspiration and gross primary production using a coupled biophysical Penman-Monteith-Leuning model for large catchment areas. In particular, the paper considers the application of the Penman-Monteith-Leuning model for the Lake Ladoga catchment. The theoretical foundations of the model,its flowchart, and the possibility of accessing it through the interface of the cloud platform for the analysis and processing of geospatial data Google Earth Engine are outlined. The model uses MODIS satellite images as input data, from which it receives the properties of the underlying surface. For meteorological data, the model uses the reanalysis model GLDAS. The land cover is classified according to the IBCG classification. Based on the Penman-Monteith-Leuning model, maps of the geospatial distribution of evapotranspiration and its constituent components (vegetation transpiration, soil evaporation, interception from vegetation canopy) and gross primary production in the Lake Ladoga catchment were obtained. The results indicate that evapotranspiration and gross primary production were the greatest in the south of the Lake Ladoga catchment, in areas of mixed forests. For the period from July 2002 to December 2017, there was no significant change in gross primary production, evapotranspiration and its components. For all components of evapotranspiration and gross primary production, seasonality associated with the growing season in the region is observed. The model outputs are consistent with the data on evaporation reported by other authors. The Penman-Monteith-Leuning model is hence fit for application to the Lake Ladoga catchment. The results of the study can be used for efficient water management, in particular for the reclamation of agricultural land in the study area.

The #FeesMustFall protests in South Africa: Exploring first-year students’ experiences at a peri-urban university campus

Students experienced unique challenges in transitioning to their first-year during the FeesMustFall (#FMF) protest actions. It is important to examine students’ first-year adjustment experiences amidst study disruptions to ensure better outcomes of first-year study experiences. The impact of protest actions on the economy, higher education institutions (HEIs) and the individual student may be harmful when not managed effectively. The current study aims to clarify the first-year experience to explore how South African first-year students enrolled at a peri-urban university campus experienced the #FMF protest actions. The peri-urban university campus serves a large rural catchment area. Using the Mmogo-method® and unstructured individual interviews, researchers gathered in-depth experiences of fifteen participants who provided insight into their subjective experiences of their first-year transitions during the #FMF movement. Thematic analysis resulted in four themes: Clashes between students and police or campus security; the impact of protest actions on students’ lives; psychological experiences of trauma and physical harm; and student attitudes towards and needs in times of crisis. The study uncovered the experiences of first-year students at a peri-urban campus. The knowledge gathered could aid universities to develop proactive measures to minimize the impact of the protest actions or disruptions on the institution itself, students and stakeholders involved.

The Water Balance of Wet Grassland Sites with Shallow Water Table Conditions in the North-Eastern German Lowlands in Extreme Dry and Wet Years

In recent years, Germany has experienced an increasing number of extreme wet and dry years. In the North German lowlands, wet grassland sites with shallow water table conditions are widespread landscape elements. They are characterized by a special water and nutrient balance that reacts very sensitively to changes in the hydrological system. Studies on evapotranspiration (ETa) and the development of groundwater levels were carried out at two typical wet grassland sites with shallow water table conditions. A weighable groundwater lysimeter system in the Spreewald wetland (SPW) and an eddy covariance station in Havelländisches Luch (HL) were used to measure ETa. The results show that even these shallow water table sites cannot sufficiently meet the vegetation’s water demands in extreme dry conditions. The groundwater levels drop to values deeper than 1 m below the surface. As a result, water supply to the vegetation is temporarily limited. The mean crop coefficients (Kc) of these wet grassland sites reach values of 1.1 in the vegetation period with a sufficient water supply, but drop to around 0.8 in dry years when the water supply is limited. Areas with small catchment areas, such as HL, are more seriously affected by the dry meteorological conditions than areas with sufficient inflows from larger catchment areas, such as SPW.

Potential raw material sources for the production of lithic artefacts in western Central Europe – GIS-data for the Rhineland, Westphalia, and the Benelux countries

Since July 2013, the project D4 of the Collaborative Research Centre 806 at the University of Cologne has dealt with the Mesolithic in western Germany. During the first phase of this research, the primary tasks were to establish a regional chronology for the Middle Stone Age on the one hand, and the mapping of all known sites in the Rhineland and Westphalia regarding the different Mesolithic phases on the other. Since July 2017, the project has focused on mobility, cultural exchange, and human-environment interactions during the Final Palaeolithic, Mesolithic, and Neolithic in Central Europe. Due to the poor conditions of preservation, numerous Palaeolithic and Mesolithic assemblages only contain lithic artefacts. Communication networks and mobility patterns of the hunter-gatherer groups can be deduced from the raw material of these finds for a considerable number of sites. Apart from pottery, lithic artefacts and their resources also illustrate the social and economic networks during the Neolithic. The raw material of knapped artefacts and their potential geological sources offer important information relating to the project's goals.A map of the potential raw material sources for knapped artefacts in comparison with the archaeological finds is the basis for any suggestion about mobility patterns and communication networks. In general, information on geological lithic sources and the archaeological inventories in western Central Europe is far more detailed than for other regions. These data and all the information gathered on lithic raw material sources for western Germany and the Benelux countries allow us to provide a GIS-database using the software QGIS in the form of several maps and data tables with geological and archaeological information as well as detailed descriptions and references.One important result of this paper addresses the reconstruction of lithic raw material catchment areas. Three examples from younger Mesolithic sites show that the more precise petrographic method for identifying lithic raw materials results in much larger catchment areas than traditional macroscopic identification, leading to new considerations for estimating population densities during the later Middle Stone Age.

ЭКОЛОГИЧЕСКОЕ СОСТОЯНИЕ Р. ЗИМНЯЯ ЗОЛОТИЦА В ЗОНЕ ОПОСРЕДОВАННОГО ВОЗДЕЙСТВИЯ ГОРНО-ОБОГАТИТЕЛЬНОГО КОМБИНАТА

Introduction. Medium rivers play an important role in the environment: draining the large catchment area, they determine the water content and quality as well as hydrological conditions in large watercourses. The joint effect of such factors as the small size of these rivers and human activity disturbs the balance of ecosystems, thus increasing the vulnerability of the rivers. Significant negative changes tend to occur faster and stronger in river valleys. Our aim was to study the ecological state of the Zimnyaya Zolotitsa River ecosystem in the area of the indirect impact of wastewater from the mining and processing plant in the Lomonosov diamond field. Methods. In the course of the study, we used the standard methods for determining the main biogenic elements and oil hydrocarbons. Results. The paper provides data on the content of biogenic elements in water, pH value, dissolved oxygen and mineralization, as well as the content of oil hydrocarbons in water and bottom sediments. Conclusion. As a result of the studies, it was found that in the summer observation period, the concentrations of phosphorus, nitrogen and silicon salts as well as oil hydrocarbons did not exceed the maximum allowable values for fishery reservoirs.

Assessing DNA rates for new referrals in older adults

AimsTo assess DNA rates for initial assessment medical appointments offered for new referrals within an Older Adults CMHT.To establish any correlation between waiting time and DNA rates.To establish if the initial appointments offered were in keeping with the National guidelines (18 weeks) and our local Trust policy (1-4 weeks).BackgroundIn the Uk 15% of adults 60 and above suffer from a mental disorder. Despite the increasing mental health burden, analysis indicate that a quarter of mental health trust received less investment from 2017 to 2018. Financial pressures have also increased appointment waiting time. The NHS has stated that by 2023 there will be a 4-week waiting time for older adult mental health services. Current national guidelines state that initial referrals should be seen within 18 weeks.MethodThis is a retrospective audit looking at all first time referrals to an Older Adult CMHT in East Birmingham. 110 patients were included in this audit. Factors recorded included age, gender, reason for referral, waiting time for appointment, and whether this complies with guidelines.Electronic patients' notes (RIO) were used for data collection.ResultOut of 110 new referrals 11 were not offered any appointments. Out of the remaining 99, 13 cancelled and 8 did not attend.In total, 78 attended the initial appointment offered, out of which 77 were seen within 18 weeks as per national guidelines. 43 patients were seen within the 4-week period (trust policy). 1 patient was offered an appointment at 19 weeks and 3 days from the referral date. The patients who did not attend their appointments were followed up except for one, to find out the reasons of the DNA. This included 2 (physically unwell), 1 (unaware of appointment), 1 (refused), 1 (forgot), 1 (couldn't get to clinic), 1 (asthma attack). Another appointment was offered to those who could attend.ConclusionThere was no significant correlation between a longer waiting time and an increased DNA rate for first appointments. Even though the time for an initial appointment was within the NHS guidelines, only 56% of the appointments met our Trust's policy of a 4 week wait.When discussing the results with the relevant team it was clear that a number of factors affected the waiting time including: number of available clinicians and a large catchment area.

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

BackgroundTelemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We compared both adolescent and caregiver (parent or guardian) attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness.MethodsThis qualitative research study analyzed transcribed structured telephone interviews with both 11–18 year-old pediatric nephrology patients and their caregivers and performed a quantitative analysis of patient demographics, disease factors and distance to tertiary center vs. telemedicine center.ResultsThe study was conducted in a medium-sized tertiary pediatric nephrology centre with a large catchment area of over 0.5 million square kilometers and 629,000 children and adolescents under 18 years of age. Eleven dyads of adolescents and caregivers were enrolled. Five adolescents were male. The mean age of the adolescents was 14.4 ± 2.5 years (range 11.2–18.0). The median distance to our tertiary center was 191 km (range 110–1378 km). Four adolescents lived more than 500 km from our tertiary center. The 11 adolescents had a total of 334 in person visits (mean 30 ± 25) and 86 telemedicine visits (mean 8 ± 7). A ratio of 2:1 telemedicine to in-person visits was favored; with caregivers more in favor of remote care than adolescents. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by adolescents and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by adolescents. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for adolescents with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits. Adolescents with more complex conditions preferred in-person visits.ConclusionsIndiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially among adolescents). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.

CORR Insights®: Is There an Association Between Bundled Payments and "Cherry Picking" and "Lemon Dropping" in Orthopaedic Surgery? A Systematic Review.

CORR Insights®: Is There an Association Between Bundled Payments and "Cherry Picking" and "Lemon Dropping" in Orthopaedic Surgery? A Systematic Review.

Potencial de aproveitamento de água pluvial para fins não potáveis na Universidade do Estado do Pará

A captação de água pluvial é uma maneira viável de otimizar o uso dos recursos hídricos e estimular o desenvolvimento sustentável. O objetivo deste artigo é determinar o potencial de economia de água no Bloco I da Universidade do Estado do Pará (UEPA). Para isso, o estudo foi realizado com a aplicação do Netuno, um software computacional para análise da água de chuva que concede o potencial de economia de água para fins menos nobres para cada volume de reservatório. Dados diários de precipitação num período de 31 anos (1987-2017) foram considerados, bem como área de captação de 543,55 m², número de usuários e demandas de água para fins não nobres e pluviais. A demanda de água total foi de 30L/estudante.dia; as demandas de água de chuva foram tomadas como uma porcentagem da demanda de água para fins menos nobres, considerou-se 40% e 100%. Os resultados indicaram potenciais de economia de água para fins menos nobres de 23,21% e 33,19%, e volumes de reservatórios ideais de 19.250L e 18.750L. A Universidade do Estado do Pará-Marabá/PA possui potencial favorável de aproveitamento de água de chuva como forma de economia da água fornecida pelo sistema de abastecimento da Universidade, devido aos altos índices pluviométricos e grandes áreas de captação, entretanto, o dimensionamento do tanque de armazenamento de água pluvial deve ser realizado de acordo para cada situação específica, de forma a avaliar a viabilidade do projeto.

Televascular consultation is one answer to rural vascular surgery shortage

Telemedicine provides an opportunity for virtual consultation between physicians and patients in remote locations. We sought to evaluate whether telemedicine consultation for vascular surgery can replace direct visits for patients in remote areas. Patients undergoing telemedicine consultation from 2014–2019 at the Veterans Affairs Medical Center (VAMC) with a large rural catchment area, were reviewed. Primary outcomes included diagnosis, type and number of telemedicine visits, and types of surgical procedures scheduled after initial visit. 574 patients participated in 708 out-patient telemedicine consultations conducted by four vascular surgeons and two advanced practitioners. Visits took place at 21 clinics across Minnesota (n = 305), North Dakota (n = 96), South Dakota (n = 82), Wisconsin (n = 20), and Iowa (n = 2) with an average distance of 159 miles from the VAMC. There were 429 (75%) new patient visits and 279 (25%) follow-ups. After initial telemedicine consultation, 236 (55%) patients were booked for procedures. Telemedicine is feasible for vascular surgery consultation and increases patient convenience with decreased overall travel expense and wait time. Telemedicine can be a viable solution to the shortage of vascular surgeons in the rural United States.