Mitigation Of Harm Research Articles

Trends in biodiversity and habitat quantification tools used for market-based conservation in the United States.

Market‐based conservation mechanisms are designed to facilitate the mitigation of harm to and conservation of habitats and biodiversity. Their potential is partly hindered, however, by the quantification tools used to assess habitat quality and functionality. Of specific concern are the lack of transparency and standardization in tool development and gaps in tool availability. To address these issues, we collected information via internet and literature searchers and through conversations with tool developers and users on tools used in U.S. conservation mechanisms, such as payments for ecosystem services (PES) and ecolabel programs, conservation banking, and habitat exchanges. We summarized information about tools and explored trends among and within mechanisms based on criteria detailing geographic, ecological, and technical features of tools. We identified 69 tools that assessed at least 34 species and 39 habitat types. Where tools reported pricing, 98% were freely available. More tools were applied to states along the U.S. West Coast than elsewhere, and the level of tool transferability varied markedly among mechanisms. Tools most often incorporated conditions at numerous spatial scales, frequently addressed multiple risks to site viability, and required 1–83 data inputs. Most tools required a moderate or greater level of user skill. Average tool‐complexity estimates were similar among all mechanisms except PES programs. Our results illustrate the diversity among tools in their ecological features, data needs, and geographic application, supporting concerns about a lack of standardization. However, consistency among tools in user skill requirements, incorporation of multiple spatial scales, and complexity highlight important commonalities that could serve as a starting point for establishing more standardized tool development and feature‐incorporation processes. Greater standardization in tool design may expand market participation and facilitate a needed assessment of the effectiveness of market‐based conservation.

A comparison of the photolytic and photocatalytic degradation of fluvastatin

Fluvastatin, a commonly used cholesterol-lowering drug, has attracted considerable attention because of its adverse effects on human beings. Photolysis and ZnIn2S4 photocatalysis of fluvastatin under UV–Vis irradiation were compared based on analysis of reactive oxygen species (ROS), degradation pathways, and toxicity evaluation. The removal rates of fluvastatin by photolysis and photocatalysis were 71.07% and 99.79%, respectively. Photolytic degradation of fluvastatin was conducted in the absence of ROS, whereas O2− played a vital role and OH played an auxiliary role during the photocatalytic process. The photolytic degradation of fluvastatin was achieved through cleavage of the CC, CN, and CC bonds. Because of the limited photon energy, photolytic products with stable structure did not decompose easily, which resulted in chemical oxygen demand (COD) removal rate of the photolytic system only 15.62%. The photocatalytic degradation of fluvastatin was achieved through direct cleavage of the chemical bonds under the synergistic oxidation of O2− and OH, and the hydroxylation reaction under OH attack. The COD removal rate of the photocatalytic system reached 43.05%. The photocatalytic samples were slightly less toxic than fluvastatin, whereas the photolytic samples were more toxic than fluvastatin. Therefore, the toxicity of the photolytic samples was significantly higher than that of the photocatalytic samples. Photocatalysis was an effective way for mitigation and elimination of harm of statins to the environment than photolysis.

Intraoperative Adverse Events in Abdominal Surgery: What Happens in the Operating Room Does Not Stay in the Operating Room.

We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. The relationship between iAEs and postoperative clinical outcomes remains largely unknown. The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration". Each chart flagged during the initial screen was then manually reviewed to confirm whether an iAE occurred. Univariate then multivariable logistic regression models were constructed to assess the independent impact of iAEs on 30-day mortality, 30-day morbidity, and prolonged (≥7 days) postoperative LOS, controlling for preoperative/intraoperative variables (eg, age, comorbidities, ASA, wound classification), procedure type (eg, laparoscopic vs open, intestinal, foregut, hepatopancreaticobiliary vs abdominal wall procedure), and complexity (eg, adhesions; relative value units). Propensity score analyses were conducted with each iAE patient matched with 5 non-iAE patients. Sensitivity analyses were performed. A total of 9288 cases were included; 183 had iAEs. Most iAEs consisted of bowel (44%) or vessel (29%) injuries and were addressed intraoperatively (92%). In multivariable analyses, iAEs were independently associated with increased 30-day mortality [OR = 3.19, 95% confidence interval (CI) 1.52-6.71, P = 0.002], 30-day morbidity (OR = 2.68, 95% CI 1.89-3.81, P < 0.001), and prolonged postoperative LOS (OR = 1.85, 95% CI 1.27-2.70, P = 0.001). Postoperative complications associated with iAEs included deep/organ-space surgical site infection (OR = 1.94, 95% CI 1.20-3.14), P = 0.007), sepsis (OR = 2.14, 95% CI 1.32-3.47, P = 0.002), pneumonia (OR = 2.18, 95% CI 1.11-4.26, P = 0.023), and failure to wean ventilator (OR = 3.88, 95% CI 2.17-6.95, P < 0.001). Propensity score matching confirmed these findings, as did multiple sensitivity analyses. iAEs are independently associated with substantial increases in postoperative mortality, morbidity, and prolonged LOS. Quality improvement efforts should focus on iAE prevention, mitigation of harm after iAEs occur, and risk/severity-adjusted iAE tracking and benchmarking.

Modelling Equitable and Reasonable Water Sharing in Transboundary Rivers: the Case of Sirwan-Diyala River

There are over 260 transboundary river and lake basins in the world that many of them are facing great challenges of water sharing between riparian countries concerned. The 1997 UN Watercourses Convention, entered into force in 2014, includes articles and factors on water sharing which have not been completely used for modelling of the basins yet. In this paper, legal aspects (i.e. Articles 5, 6, 7 and 10 of the Convention) are integrated with a technical approach for water allocation in transboundary rivers. For this purpose, a new conceptual model is developed for quantification of the Convention provisions concerning equitable and reasonable water sharing. The method is applied to the Sirwan-Diyala transboundary river shared by Iran and Iraq. Some indicators are developed and quantified for determination of water shares of the riparian countries and different scenarios considering extreme and equal weights of the factors are defined. The basin is simulated by WEAP model to evaluate effects of the scenarios on up- and downstream of the basin. Five demand management alternatives comprising increasing of irrigation efficiency and eliminating second cultivation are proposed as appropriate measures for elimination or mitigation of possible significant harm. The proposed technical-legal approach paves the way for enhancing bargaining potentials of the riparian countries and increasing their cooperation to achieve a win-win solution in using waters of transboundary rivers.

Heimlich valve orientation error leading to radiographic tension pneumothorax: analysis of an error and a call for education, device redesign and regulatory action

Medical errors are commonly multifactorial, with adverse clinical consequences often requiring the simultaneous failure of a series of protective layers, termed the Swiss Cheese model. Remedying and preventing future medical...

After the Green Rush? Biodiversity Offsets, Uranium Power and the ‘Calculus of Casualties’ in Greening Growth

Biodiversity offsets are part of a new suite of biodiversity conservation instruments designed to mitigate the impacts of economic developments on species, habitats and ecosystems. Led by an international collaboration of representatives from companies, financial institutions, governments and non-governmental organizations (NGOs), the Business and Biodiversity Offsets Programme (BBOP) of the market-oriented Forest Trends group, has created a global framework through which principles and standards for biodiversity offsets are being established. These enable the apparently unavoidable harm caused by development to be exchanged for investment in conservation activities both at different geographical locations and in the future. Offsets can also be traded via bespoke markets for environmental conservation indicators. Given a globalizing ‘green economy’ discourse that conservation can be a profitable enterprise if guided by market-based mechanisms and the entwining of ecological with economic spheres, biodiversity offsets are becoming key to current entrepreneurial interest in biodiversity conservation. The ‘green rush’ of my title refers to both this interest in conservation activities that can be marketized, and to an associated appetite in business and financial sectors for incorporating biodiversity offsets as part of a strategy for ‘greening’ the environmental harm caused by developments. I illustrate the uses to which biodiversity offsets are being put, through a case study connecting the extraction of uranium in Namibia for the generation of nuclear power in the UK. Biodiversity offsets are invoked to satisfy requirements for off-site mitigation of environmental harm at points of both extraction and ‘consumption’ of uranium in this case. I highlight some of the (anti-)ecological assumptions guiding calculations of complex ecological assemblages so that they can become biodiversity offsets, and draw attention to the intensified distributions of new environmental values with which biodiversity offsets may be associated.

Preventing Obstetric Fistulas in Low-Resource Countries

An obstetric fistula is classically regarded as an "accident of childbirth" in which prolonged obstructed labor leads to destruction of the vesicovaginal/rectovaginal septum with consequent loss of urinary and/or fecal control. Obstetric fistula is highly stigmatizing and afflicted women often become social outcasts. Although obstetric fistula has been eliminated from advanced industrialized nations, it remains a major public health problem in the world's poorest countries. Several million cases of obstetric fistula are currently thought to exist in sub-Saharan Africa and south Asia. Although techniques for the surgical repair of such injuries are well known, it is less clear which strategies effectively prevent fistulas, largely because of the complex interactions among medical, social, economic, and environmental factors present in those countries where fistulas are prevalent. This article uses the Haddon matrix, a standard tool for injury analysis, to examine the factors influencing obstetric fistula formation in low-resource countries. Construction of a Haddon matrix provides a "wide angle" overview of this tragic clinical problem. The resulting analysis suggests that the most effective short-term strategies for obstetric fistula prevention will involve enhanced surveillance of labor, improved access to emergency obstetric services (particularly cesarean delivery), competent medical care for women both during and after obstructed labor, and the development of specialist fistula centers to treat injured women where fistula prevalence is high. The long-term strategies to eradicate obstetric fistula must include universal access to emergency obstetric care, improved access to family planning services, increased education for girls and women, community economic development, and enhanced gender equity. Successful eradication of the obstetric fistula will require the mobilization of sufficient political will at both the international and individual country levels to ensure that adequate resources are devoted to this problem and that maternal health becomes a high priority on national political agendas. Obstetricians & Gynecologists and Family Physicians. After participating in this CME activity, physicians should be better able to apply the Haddon matrix, a tool commonly used for injury analysis, to the field of obstetrics and gynecology; analyze the problem of obstructed labor and obstetric fistula formation in low-resource countries using the Haddon matrix, and implement possible strategies for the prevention of obstetric fistulas and the mitigation of harm in cases of obstructed labor that arise from the use of the Haddon matrix.

Brazilian registered nurses’ perceptions and attitudes towards adverse events in nursing care: a phenomenological study

To describe the perceptions and attitudes of registered nurses (RNs) towards adverse events (AEs) in nursing care. The professionals' subjective perspectives should be taken into account for the prevention of AEs in care settings. Schütz's social phenomenology was developed. Interviews were conducted with nine Intensive Care Unit RNs. The following five descriptive categories emerged: (1) the occurrence of AEs is inherent to the human condition but provokes a feeling of insecurity, (2) the occurrence of AEs indicates the existence of failures in health care systematization, (3) the professionals' attitudes towards AEs should be permeated by ethical principles; (4) the priority regarding AEs should be the mitigation of harm to patients, and (5) decisions regarding the communication of AEs were determined by the severity of the error. The various subjective perspectives related to the occurrence of AEs requires a health care systematization with a focus on prevention. Ethical behaviour is essential for the patients' safety. Activities aimed at the prevention of AEs should be integrated jointly with both the professionals and the health care institution. A culture of safety, not punishment, and improvement in the quality of care provided to patients should be priorities.

Allocating Ecological Space

Liberals have long been committed to two axiomatic claims about freedom: that the exercise of control within one’s private space epitomizes individual liberty, and that each person must be free to define and pursue the good life for themselves. Together, these claims form a conception of freedom as autonomy (from the Greek Auto-Nomos, giving law to oneself), conceptualized as a personal space in which each can act according to one’s own view of the good, free from external constraint. Liberal theories of justice have embraced such claims about autonomy, defining justice in terms that recognize sovereignty within one’s personal space and protect individuality. John Rawls’s primary goods, 1 Ronald Dworkin’s resources, 2 and Amartya Sen’s capabilities approach 3 all focus on instrumental goods within a metric of egalitarian justice, allowing individuals full control over their personal spaces of autonomy while maintaining the bases for interpersonal comparison that distributive justice requires. This spatial conception of liberty has dominated liberal thought at least since J. S. Mill’s observation that “the only freedom which deserves the name, is that of pursuing our own good in our own way, so long as we do not attempt to deprive others of theirs, or impede their efforts to attain it.” 4 Here, Mill not only defines individual liberty in terms of autonomy, but he also specifies its limits: each of us should be free to pursue our own ideas about the good within our own space, bounded only by the space of others, where our acts infringe upon their autonomy. 5 If this autonomous space is to play the role that Mill and other liberals have long assumed, it must be sufficiently large to allow for a wide range of actions and choices, allowing each to express their individuality without encountering the limits that Mill mentions and the constraints on action that they entail. If almost everything that I do impedes others from pursuing the good in their way—harming them directly, limiting their opportunities, or otherwise infringing upon their space—then my personal space becomes vanishingly small, and my liberty but a trivial abstraction. This spatial conception of freedom is challenged by analyses emerging from the ecological crisis, which offer competing accounts of personal space with quite different implications for the exercise of individual autonomy. 6 Given ecological limits, aggregate ecological space 7 (i.e., life-supporting natural resource-based goods and services, conceived in spatial terms) is finite and threatened by current patterns of over-appropriation, yielding imperatives to fairly allocate that space among various claimants, present and future. Uninhibited autonomy, as construed above, is not sustainable, justifying significant limits on both personal space and

Mitigation of patient harm from testing errors in family medicine offices: a report from the American Academy of Family Physicians National Research Network

Objectives:Little research has focused on preventing harm from errors that occur in primary care. We studied mitigation of patient harm by analysing error reports from family physicians’ offices.Methods:The data for...

Climate variability and El Niño Southern Oscillation: implications for natural coastal resources and management

The El Nino Southern Oscillation (ENSO) significantly influences marine ecosystems and the sustained exploitation of marine resources in the coastal zone of the Humboldt Current upwelling system. Both its warm (El Nino: EN) and cold (La Nina: LN) phase have drastic implications for the ecology, socio-economy and infrastructure along most of Pacific South America. Local artisanal fisheries, which especially suffer from the effects of EN, represent a major part for the domestic economy of Chile and Peru and in consequence a huge amount of published and unpublished studies exists aiming at identifying effects of EN and LN. However, most processes and underlying mechanisms fostering the ecology of organisms along Pacific South America have not been analyzed yet and for the marine realm most knowledge is traditionally based on rather descriptive approaches. We herein advocate that small-scale comparative and interdisciplinary process studies work as one possible solution to understand better the variability observed in EN/LN effects at local scale. We propose that differences in small-scale impacts of ENSO along the coast rather than the macro-ecological and oceanographic view are essential for the sustainable management of costal ecosystems and the livelihood of the people depending on it. Based on this, we summarize the conceptual approach from the EU-funded International Science and Technology Cooperation (INCO) project “Climate variability and El Nino Southern Oscillation: Implications for Natural Coastal Resources and Management (CENSOR)” that aims at enhancing the detection, compilation, and understanding of EN and LN effects on the coastal zone and its natural resources. We promote a multidisciplinary avenue within present international funding schemes, with the intention to bridge the traditional gap between basic and applied coastal research. The long-term aim is an increased mitigation of harm caused by EN as well as a better use of beneficial effects, with the possibility to improve the livelihood of human coastal populations along Pacific South America and taking differences between local socio-economic structures of the countries affected by EN into consideration. The success of such an approach however, does finally rely upon a willingness of the recourse users and the various political and economic stakeholders involved to taking on the message as part of sustainable management strategies.

Legal Regulation of Sexual Harassment in Ireland: a Critical Evaluation

‘The legal treatment of sexual harassment in the workplace has produced difficult challenges for anti-discrimination law wherever this phenomenon has been recognised. In Ireland a large body of decisions on this issue has been built up over the last decade. Although an increasingly sympathetic approach to the problems involved can be discerned in decisions made in this period, the limitations inherent in liberal legal ideology persist. These are rooted in the tendency of the law to treat socially contingent, gendered power structures as natural, and in the enduring strength of the division between the public and private spheres. Issues such as employer responsibility, employee mitigation of harm, same-sex sexual harassment, and the analysis of evidence in sexual cases illustrate these limitations. This article points to some improvements which might be made in gender equality laws to deal with such issues while acknowledging that the effect of law is to regulate rather than prohibit sexual harassment in t...