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In this work, a risk-based assessment method and benefit-cost analysis to support policy decisions for adapting Australian coastal residential buildings to future coastal inundation hazard is presented. Future coastal inundation is mainly influenced by storm surge and rising sea level. The sea level rises projected by the A1FI, A1B and B1 emissions scenarios developed by the Intergovernmental Panel on Climate Change are considered. The effects of economic and population growth are accounted for by three urban development scenarios: (a) business as usual, (b) urban consolidation and (c) regional development. The adaptation policy actions investigated include a ‘protect’ stance (involving the construction of seawalls), an ‘accommodate’ stance that mandates raising house floors to a certain height (e.g. at heights of 100-year events) and an ‘avoid’ stance that limits new developments in hazardous areas. Policy stances classified as reactive (i.e. action taken after damage being incurred) and anticipatory (i....

Acute renal failure (ARF) is common after cardiac surgery and more frequent after complex cardiac surgery. While the incidence of ARF is increasing after coronary artery bypass graft (CABG) surgery, trends in other forms of cardiac surgery remain unclear. We investigated the trend of ARF in various cardiac procedures and compared patterns using CABG surgery as a reference group. The study population consisted of discharges from the Nationwide Inpatient Sample from 1988 to 2003, grouped according to surgery as: CABG, CABG with mitral valve, CABG with other valve, valve alone, and heart transplant. Standard diagnostic codes were used to identify ARF among discharges. Multivariable regression was used to determine trends in ARF among various procedures with CABG as a reference group. The incidence of ARF increased in all five groups (p < 0.001) over the 16-year period. The ARF incidence was highest in the heart transplant group (17%). Compared to the CABG population, patients following heart transplantation developed ARF at higher rates during the study period. In contrast, while ARF increased over time in other groups, the rates of rise were slower than in CABG patients. Among heart surgery procedures, ARF incidence is highest in heart transplantation. The incidence of ARF is also increasing at a faster rate in this group of patients in contrast to other procedure groups when compared to CABG surgery. The disproportionate increase in ARF burden after heart transplantation is a concern due to its strong association with chronic kidney disease and mortality.

Background: Acute renal failure (ARF) is a frequent complication of coronary artery bypass grafting (CABG) surgery and is strongly associated with perioperative morbidity and mortality. We hypothesized that renal artery stenosis (RAS), causing occult renal ischemia, may be an important factor contributing to development of ARF after CABG surgery. Methods: Preoperative and intraoperative data on 798 consecutive adult patients undergoing CABG surgery with cardiopulmonary bypass from February 1, 1995 to February 1, 1997 (who had also undergone an abdominal aortogram for the evaluation of RAS) were recorded and entered into a computerized database. The development of ARF was defined as a rise in serum creatinine of 1 mg/dL (88.4 µmol/L) above baseline postoperatively. The association between the presence of renal artery stenosis together with preoperative and intraoperative variables and the development of ARF was assessed by multivariate logistic regression. Results: A total of 798 patients underwent isolate...

As it becomes harder to see how the world will keep GHGs in the atmosphere below levels at which global warming of at least 2°C is likely [1], calls for geoengineering approaches to climate managem...