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This study examines the direct and indirect impacts of climate change to the tourism sector on the islands of New Providence and adjacent Paradise Island in the Bahamas. The assessment was carried out by conducting a geospatial analysis of tourism establishments at risk using Geographic Information Systems (GIS). We combined the geospatial analysis with publicly available databases to assess the integrated climate-related impacts pertaining to a Small Island Developing State (SIDS) economy. Our study estimated that many tourism properties currently lie in a storm surge zone and the extent of properties at risk increases with a future scenario of a 1 m rise in sea level. While sea level rise (SLR) by itself only threatens a small number of properties, when combined with weak (Category 1), moderate (Category 3) and strong (Category 5) storms the resulting coastal flooding impacts 34%, 69%, and 83% of the tourism infrastructure (hotels and resorts), respectively. In addition to flooding, properties are also susceptible to coastal erosion with 28% of the total hotels and resorts on the two islands being situated within 0-50 m and 60% of the tourism infrastructure within 0-100 m of the coastline. Considering the economic importance of the sector, the potential impacts on the tourism infrastructure will cause significant losses in revenue and employment for the two islands. Furthermore, the majority of the tourism on these islands is beach-based and visitor expenditures will decline due to their vulnerability. These losses will have far-reaching social-economic consequences for the Bahamas. Our findings reveal a need for integrated coastal zone management that incorporates tourism management strategies with adaptation measures to deal with climate change.

Emergency urologic conditions are relatively common, albeit rarely life threatening, there is often a need for prompt and expedient management in order to avert severe or permanent morbidities. This study aimed to evaluate the spectrum of Urologic emergencies and interventions offered in a tertiary hospital in Nigeria.

We retrospectively reviewed the records of patients who were managed in our institution for emergency urologic conditions over a period of 6years (2011-2017). The data extracted included; the demographic information, diagnosis and the treatment offered. The data obtained were analyzed using SPSS version 20. Data were displayed using mean +/- standard deviation and percentages.

The records of a total of 681 patients were retrieved and they span across almost all ages with age range or 2-90years. Urinary retention was the commonest emergency seen, accounting for 51.7% of the patients. Testicular torsion was the next most common (10%), others are bilateral ureteric obstruction and priapism with 5.4% and 5.3% respectively. Suprapubic cystostomy (SPC) was the commonest operative procedure performed (37.6%). The age range for patients with urinary retention was 3-90years, though the peak incidence was in the 7th decade (37.3%). Patients with testicular torsion were young adults between the ages of 11 and 44years.

Urinary retention was the commonest urologic emergency followed by testicular torsion. Though urethral catheterization was successful in most patients urinary retention, making it the commonest procedure. SPC was the commonest emergency operative procedure performed. Other emergencies occurred sporadically.

Urinary retention was the commonest urologic emergency followed by testicular torsion. selleck compound Though urethral catheterization was successful in most patients urinary retention, making it the commonest procedure. SPC was the commonest emergency operative procedure performed. Other emergencies occurred sporadically.

Endotracheal intubation by direct laryngoscopy is a mainstay of advanced airway management performed both in the prehospital environment and in the Emergency Department. Many factors may affect the quality of view during direct laryngoscopy, one of them being the visual acuity (VA) of the intubator under these demanding conditions. While some individual variation in VA is to be expected in younger populations, VA naturally deteriorates in older populations particularly beyond the age of 40years. This study aimed to describe VA in a younger (

=19) and an older (≥40years of age,

=20) cohort of intubators at baseline and during simulated adult laryngoscopy, and to compare VA between these two age cohorts.

A baseline near VA test was done using a Sloan Early Treatment Diabetic Retinopathy Study (EDTRS) near vision chart at 40cm under ambient indoor light. Participants in both age cohorts were then requested to perform laryngoscopy using an airway simulator at 40cm viewing distance and again at a viewing distance.

Increased age was associated with a significant reduction in VA at baseline and during laryngoscopy, which can be partially compensated for by adjusting viewing distance. Although it is currently unknown to what extent this age-related reduction of VA might negatively affect time to place an endotracheal tube or success of placement under direct vision, older intubators should be aware of this effect and consider specialized corrective eyewear in order to maintain an adequate level of VA.

Increased age was associated with a significant reduction in VA at baseline and during laryngoscopy, which can be partially compensated for by adjusting viewing distance. Although it is currently unknown to what extent this age-related reduction of VA might negatively affect time to place an endotracheal tube or success of placement under direct vision, older intubators should be aware of this effect and consider specialized corrective eyewear in order to maintain an adequate level of VA.

Adverse events (AE) are a common occurrence in healthcare systems; however, the frequency of AEs occurring in South Africa and especially Emergency Departments (ED) is unknown. The aims of this study were to describe the frequency of AEs experienced by Healthcare providers (HCP) and the frequency of formal reporting thereafter over a 12-month period.

A cross sectional descriptive study was performed amongst HCPs at Helen Joseph Hospital and Chris Hani Baragwanath Academic Hospital EDs. The questionnaire incorporated ED relevant AEs using the South African National Procedural Manual for Patient Safety Incident Reporting and Learning.

The questionnaires from 51 doctors and 49 nurses were analysed. All HCPs experienced >10 AEs over 1year. Nurses were 21 times more likely than doctors to report >10 AEs (p<0.001). Twenty four percent of AEs experienced were deemed to be minor, very minor or not adverse.

There are low levels of formal AE reporting, especially amongst doctors, within Johannesburg Academic EM Departments despite large numbers of AEs experienced.