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In: La revue administrative: histoire, droit, société, Heft 2, S. 66-76
ISSN: 0035-0672
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In: La revue administrative: histoire, droit, société, Heft 2, S. 66-76
ISSN: 0035-0672
In: Natural hazards and earth system sciences: NHESS, Band 12, Heft 3, S. 639-649
ISSN: 1684-9981
Abstract. An analysis of the cloud-to-ground discharges (CGD) over Portugal is carried out using data collected by a network of sensors maintained by the Portuguese Meteorological Institute for 2003–2009 (7 yr). Only cloud-to-ground flashes are considered and negative polarity CGD are largely dominant. The total number of discharges reveals a considerable interannual variability and a large irregularity in their distribution throughout the year. However, it is shown that a large number of discharges occur in the May–September period (71%), with a bimodal distribution that peaks in May and September, with most of the lightning activity recorded in the afternoon (from 16:00 to 18:00 UTC). In spring and autumn the lightning activity tends to be scattered throughout the country, whereas in summer it tends to be more concentrated over northeastern Portugal. Winter generally presents low lightning activity. Furthermore, two significant couplings between the monthly number of days with discharges and the large-scale atmospheric circulation are isolated: a regional forcing, predominantly in summer, and a remote forcing. In fact, the identification of daily lightning regimes revealed three important atmospheric conditions for triggering lightning activity: regional cut-off lows, cold troughs induced by remote low pressure systems and summertime regional low pressures at low-tropospheric levels combined with a mid-tropospheric cold trough.
This study is part of the PROACTIVA 1-2 (2009-2012) and MARPROF-CV (2010-2014) projects, in the framework of the Canary Islands Government and UE PCT MAC 2007-2013 programmes respectively. Research has mainly focused on the stock assessment of the striped soldier shrimp, Plesionika edwardsii (Brandt, 1851), because it has shown moderate to high levels of fishing yield and abundances compatible with the development of a new sustainable fishery in the Cape Verde Islands.
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This study is part of the PROACTIVA 1-2 (2009-2012) and MARPROF-CV (2010-2014) projects, in the framework of the Canary Islands Government and UE PCT MAC 2007-2013 programmes respectively. Research has mainly focused on the stock assessment of the striped soldier shrimp, Plesionika edwardsii (Brandt, 1851), because it has shown moderate to high levels of fishing yield and abundances compatible with the development of a new sustainable fishery in the Cape Verde Islands.
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Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3–8 across 10 European countries. Data on 47,099 children were obtained from prospective birth cohort studies across 10 European countries. We calculated cohort-specific prevalence difference in asthma outcomes using the relative index of inequality (RII) and slope index of inequality (SII). Results from all countries were pooled using random-effects meta-analysis procedures to obtain mean RII and SII scores at the European level. Final models were adjusted for child sex, smoking during pregnancy, parity, mother's age and ethnicity. The higher the score the greater the magnitude of relative (RII, reference 1) and absolute (SII, reference 0) inequity. The pooled RII estimate for asthma risk across all cohorts was 1.46 (95% CI 1.26, 1.71) and the pooled SII estimate was 1.90 (95% CI 0.26, 3.54). Of the countries examined, France, the United Kingdom and the Netherlands had the highest prevalence's of childhood asthma and the largest inequity in asthma risk. Smaller inverse associations were noted for all other countries except Italy, which presented contradictory scores, but with small effect sizes. Tests for heterogeneity yielded significant results for SII scores. Overall, offspring of mothers with a low level of education had an increased relative and absolute risk of asthma compared to offspring of high-educated mothers. ; All phases of this study were supported by a European Union's Seventh Framework Programme grant, 278350, as part of The Determinants to Reduce Health Inequity Via Early Childhood, Realising Fair Employment, and Social Protection (DRIVERS) research programme. The Czech ELSPAC Study (CZ-ELSPAC) was supported by the Ministry of Education of the Czech Republic: CETOCOEN plus project (CZ02101/00/00/15_003/0000469) and RECETOX Research Infrastructure (LM2015051). The Northern Finland Birth Cohort (FI-NFBC8586) received financial support from the Academy of Finland; Biocenter, University of Oulu, Finland; the European Commission EUROBLCS, Framework 5 Award QLG1-CT-2000-01643); EU FP7 EurHEALTHAgeing-277849; the Medical Research Council, UK (PrevMetSyn/SALVE); and the MRC Centenary Early Career Award. The Amsterdam Born Children and their Development Study (NLABCD) received funding from the Netherlands Organization for Health Research and Development (ZonMw) Grant (TOP, 40-00812-98-11010). The All Babies in Southeast Sweden Study (SE-ABIS) has received financial support from the Juvenile Diabetes Research Foundation, Swedish Child Diabetes Foundation (Barndiabetesfonden), The Research Council of South-east Sweden (FORSS), Swedish Research Council K2005-72X-11242-11A, and ALF/County Council of O ̈stergo ̈tland. The INMA study was funded in part by grants from the European Union (FP7-ENV-2011-282957 and HEALTH.2010.2.4.5-1), Spain (Instituto de Salud Carlos III and The Ministry of Health), the Conselleria de Sanitat of the Generalitat Valenciana, department of Health of the Basque Government, the Provincial Government of Gipuzkoa, and the Generalitat de Catalunya-CIRIT. Family and Children of Ukraine (UA-FCOU) study was supported by US NIH Fogarty International Center and National Academy of Medical Sciences of Ukraine. KML is funded by a Medical Research Council UK doctoral training studentship.
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Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
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Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
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