scholarly journals E-Bike Injuries: Experience from an Urban Emergency Department—A Retrospective Study from Switzerland

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sylvana Papoutsi ◽  
Luca Martinolli ◽  
Christian Tasso Braun ◽  
Aristomenis K. Exadaktylos
Keyword(s):  
Emergency Department ◽  
Healthy Lifestyle ◽  
Low Cost ◽  
Hospital Setting ◽  
Time Period ◽  
Electric Bicycle ◽  
Rapid Transition ◽  
The Mean ◽  
Increasing Demand ◽  
Human Powered

Background. Between 2005 and 2012, annual sales of E-bikes in Switzerland increased from 1,792 to 52,941. This continuous and rapid transition from human-powered bicycles to an electric bicycle technology may indicate the increasing demand for low-cost transportation technology in combination with a healthy lifestyle.Material and Methods. In the present study, from April 2012 to September 2013, we retrospectively analysed E-bike accidents treated in the Emergency Department of our hospital by focusing on the following parameters: age, gender, time, period, and cause of the accident, as well as injury and outcome.Results. Patients were predominantly male. The mean age of injured E-cyclists was 47.5 years. The main causes of injury were self-accident. Most injuries were to the head/neck. The mean ISS was 8.48. The outcome showed that 9 patients were treated as outpatients, 9 were inpatients, and 5 patients were kept in the Intensive Care Unit (ICU). Only six patients underwent surgery (S).Discussion. This is the first attempt to evaluate E-bike injuries in Switzerland in an acute hospital setting. Since there is increasing popular preference for E-bikes as means of transportation and injuries to the head or neck are prevalent among E-cyclists, the hazard should not to be underestimated.

scholarly journals Effect of COVID-19 outbreak on emergency department attendances in an Italian academic hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poletto ◽  
G Perri ◽  
F Malacarne ◽  
B Bianchet ◽  
A Doimo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Phase ◽  
Mainland China ◽  
Hospital Setting ◽  
Academic Hospital ◽  
Significant Difference ◽  
Before And After ◽  
Life Threatening ◽  
The Mean ◽  
Critical Patients

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.

scholarly journals Intravenous versus oral paracetamol in a UK ambulance service: a case control study

2020 ◽  
Vol 5 (1) ◽  
pp. 1-6
Author(s):  
Karl Charlton ◽  
Matthew Limmer ◽  
Hayley Moore
Keyword(s):  
Pain Score ◽  
Acute Pain ◽  
Rating Scale ◽  
Hospital Setting ◽  
Numeric Rating Scale ◽  
Time Period ◽  
Intravenous Paracetamol ◽  
Common Causes ◽  
The Mean ◽  
Clinically Significant

Objectives: To determine the effectiveness of intravenous versus oral paracetamol (acetaminophen) in the management of acute pain in the out-of-hospital setting.Methods: We extracted ambulance electronic patient care records for all patients who received 1 g intravenous paracetamol throughout January 2019, and case matched these by sex and age with consecutive patients who received 1 g oral paracetamol over the same time period. Eligible for inclusion were all patients aged ≥ 18 who received 1 g paracetamol for acute pain and who were transported to the emergency department (ED). The primary outcome was the mean reduction in pain score using the numeric rating scale (NRS), with a reduction of 2 or more accepted as clinically significant.Results: 80 care records were eligible for analysis; 40 patients received intravenous and 40 patients received oral paracetamol. The mean age of both groups was 54 years (± 3 years) and 67.5% (n = 54) were female. Patients receiving intravenous paracetamol had a clinically significant mean (SD) improved pain score compared to those receiving oral paracetamol, 2.02 (1.64) versus 0.75 (1.76), respectively [p = 0.0013]. 13/40 (32.5%) patients who received intravenous paracetamol saw an improved pain score of ≥ 2 compared to 8/40 (20%) who received oral paracetamol. No patients received additional analgesia or reported any adverse symptoms. Abdominal pain, infection and trauma were the most common causes of pain in both groups.Conclusion: Our study suggests that intravenous paracetamol is more effective than oral paracetamol when managing acute pain in the out-of-hospital setting. Our findings support further investigation of the role of paracetamol in paramedic practice using more robust methods.

Back to basics: an audit of measurement of infant growth at presentation to hospital

2015 ◽  
Vol 39 (5) ◽  
pp. 539 ◽  
Author(s):  
Lesley Alison Williams ◽  
Robert S. Ware ◽  
Peter S. W. Davies
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Nutritional Status ◽  
Head Circumference ◽  
Growth And Development ◽  
Low Cost ◽  
Hospital Setting ◽  
Infant Growth ◽  
Anthropometric Measures ◽  
Paediatric Hospital

Objectives Infants who present or are admitted to hospital with illness or with inadequate growth and development are those most at risk of decreased nutritional status. However, not all infants who present or are admitted to hospital have their growth assessed. The aim of the present study was to identify how frequently anthropometric measurements were documented in charts of infants presenting and/or admitted to a tertiary paediatric hospital. Methods A systematic random sample of hospital charts of infants who had presented to the emergency department between 1 July 2011 and 30 June 2012 was audited retrospectively for the presence of appropriate documentation of measurement. Results In all, 465 charts were audited, representing 10% of infants who presented to the emergency department in the year. The frequency of anthropometric measures was: birthweight 103 (22%), presentation weight 275 (59%), length 8 (2%), head circumference 15 (3%), percentiles 27 (6%) and body mass index score 1 (0%). Age of the infant was significantly associated with recording of birthweight. There were no significant relationships found between gender, socioeconomic status, gestational age, delivery type and recording of diagnosis and birthweight. Conclusions Infant measurements were not recorded on many occasions. Assessment of growth as a marker of illness or nutritional deficit has been poorly assessed in this group. This is a missed opportunity to assess infant growth in this population, which has been found to be at risk of decreased nutritional status. Identification and treatment of growth deficits are a cost-effective method of optimising infant health worldwide. What is known about this topic? Infants who present or are admitted to hospital with illness or with inadequate growth and development are those most at risk of decreased nutritional status. What does this paper add? Not all infants who present or are admitted to hospital have their growth assessed. What are the implications for practitioners? It is important in a paediatric setting to identify who is responsible for measuring and recording infant growth. Measurement of weight, height and head circumference is a basic, low-cost method of measuring infant growth in the hospital setting.

scholarly journals Synthesis, Structure and Diffusion Pathways of Fast Lithium-Ion Conductors in the Polymorphs α- and β-Li8SnP4

2021 ◽  
Author(s):  
Thomas F Fässler ◽  
Stefan Strangmüller ◽  
Henrik Eickkhoff ◽  
Wilhelm Klein ◽  
Gabriele Raudaschl-Sieber ◽  
...  
Keyword(s):  
High Performance ◽  
Low Cost ◽  
Lithium Ion ◽  
Conducting Materials ◽  
Increasing Demand ◽  
Battery Technology ◽  
Lithium Ion Conductors ◽  
And Diffusion ◽  
Ion Conductors

The increasing demand for a high-performance and low-cost battery technology promotes the search for Li+-conducting materials. Recently, phosphidotetrelates and aluminates were introduced as an innovative class of phosphide-based Li+-conducting materials...

scholarly journals Personal Exposure Assessment to Wi-Fi Radiofrequency Electromagnetic Fields in Mexican Microenvironments

2021 ◽  
Vol 18 (4) ◽  
pp. 1857
Author(s):  
Raquel Ramirez-Vazquez ◽  
Jesus Gonzalez-Rubio ◽  
Isabel Escobar ◽  
Carmen del Pilar Suarez Rodriguez ◽  
Enrique Arribas
Keyword(s):  
Risk Perception ◽  
Electromagnetic Fields ◽  
Personal Exposure ◽  
Wireless Internet ◽  
European Cities ◽  
Radiofrequency Electromagnetic Fields ◽  
Time Period ◽  
The Mean ◽  
Personal Exposure Assessment ◽  
Study Participants

In recent years, personal exposure to Radiofrequency Electromagnetic Fields (RF-EMF) has substantially increased, and most studies about RF-EMF with volunteers have been developed in Europe. To the best of our knowledge, this is the first study carried out in Mexico with personal exposimeters. The main objective was to measure personal exposure to RF-EMF from Wireless Fidelity or wireless Internet connection (Wi-Fi) frequency bands in Tamazunchale, San Luis Potosi, Mexico, to compare results with maximum levels permitted by international recommendations and to find if there are differences in the microenvironments subject to measurements. The study was conducted with 63 volunteers in different microenvironments: home, workplace, outside, schools, travel, and shopping. The mean minimum values registered were 146.5 μW/m2 in travel from the Wi-Fi 2G band and 116.8 μW/m2 at home from the Wi-Fi 5G band, and the maximum values registered were 499.7 μW/m2 and 264.9 μW/m2 at the workplace for the Wi-Fi 2G band and the Wi-Fi 5G band, respectively. In addition, by time period and type of day, minimum values were registered at nighttime, these values being 129.4 μW/m2 and 93.9 μW/m2, and maximum values were registered in the daytime, these values being 303.1 μW/m2 and 168.3 μW/m2 for the Wi-Fi 2G and Wi-Fi 5G bands, respectively. In no case, values exceeded limits established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Of the study participants (n = 63), a subgroup (n = 35) answered a survey on risk perception. According to these results, the Tamazunchale (Mexico) population is worried about this situation in comparison with several European cities; however, the risk perception changes when they are informed about the results for the study.

scholarly journals Utility-Scale PV-Battery versus CSP-Thermal Storage in Morocco: Storage and Cost Effect under Penetration Scenarios

Energies ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4675
Author(s):  
Ayat-allah Bouramdane ◽  
Alexis Tantet ◽  
Philippe Drobinski
Keyword(s):  
Storage Capacity ◽  
Low Cost ◽  
Thermal Storage ◽  
Solar Pv ◽  
Storage Duration ◽  
Maximum Cost ◽  
Pv Inverter ◽  
The Mean ◽  
Mean Variance Portfolio ◽  
Utility Scale

In this study, we examine how Battery Storage (BES) and Thermal Storage (TES) combined with solar Photovoltaic (PV) and Concentrated Solar Power (CSP) technologies with an increased storage duration and rental cost together with diversification would influence the Moroccan mix and to what extent the variability (i.e., adequacy risk) can be reduced; this is done using recent (2013) cost data and under various penetration scenarios. To do this, we use MERRA-2 climate reanalysis to simulate hourly demand and capacity factors (CFs) of wind, solar PV and CSP without and with increasing storage capabilities—as defined by the CSP Solar Multiple (SM) and PV Inverter Loading Ratio (ILR). We adjust these time series to observations for the four Moroccan electrical zones over the year 2018. Our objective is to maximize the renewable (RE) penetration and minimize the imbalances between RE production and consumption considering three optimization strategies. We analyze mixes along Pareto fronts using the Mean-Variance Portfolio approach—implemented in the E4CLIM model—in which we add a maximum-cost constraint to take into account the different rental costs of wind, PV and CSP. We propose a method to calculate the rental cost of storage and production technologies taking into account the constraints on storage associated with the increase of SM and ILR in the added PV-BES and CSP-TES modules, keeping the mean solar CFs fixed. We perform some load bands-reduction diagnostics to assess the reliability benefits provided by each RE technology. We find that, at low penetrations, the maximum-cost budget is not reached because a small capacity is needed. The higher the ILR for PV, the larger the share of PV in the mix compared to wind and CSP without storage is removed completely. Between PV-BES and CSP-TES, the latter is preferred as it has larger storage capacity and thus stronger impact in reducing the adequacy risk. As additional BES are installed, more than TES, PV-BES is favored. At high penetrations, optimal mixes are impacted by cost, the more so as CSP (resp., PV) with high SM (resp., ILR) are installed. Wind is preferably installed due to its high mean CF compared to cost, followed by either PV-BES or CSP/CSP-TES. Scenarios without or with medium storage capacity favor CSP/CSP-TES, while high storage duration scenarios are dominated by low-cost PV-BES. However, scenarios ignoring the storage cost and constraints provide more weight to PV-BES whatever the penetration level. We also show that significant reduction of RE variability can only be achieved through geographical diversification. Technological complementarity may only help to reduce the variance when PV and CSP are both installed without or with a small amount of storage. However, the diversification effect is slightly smaller when the SM and ILR are increased and the covariances are reduced as well since mixes become less diversified.

scholarly journals Economic Burden of Colorectal Cancer: A Case of Fars, Iran

2021 ◽  
Vol 28 ◽  
pp. 107327482110099
Author(s):  
Abdosaleh Jafari ◽  
Peyman Mehdi Alamdarloo ◽  
Mehdi Dehghani ◽  
Peivand Bastani ◽  
Ramin Ravangard
Keyword(s):  
Colorectal Cancer ◽  
Economic Burden ◽  
Purchasing Power Parity ◽  
Annual Cost ◽  
Low Cost ◽  
Direct Costs ◽  
Fars Province ◽  
Power Parity ◽  
Medical Sciences ◽  
The Mean

Among cancers, colorectal cancer is the third most common cancer in the world and the fourth leading cause of cancer deaths worldwide. Some studies have shown that the incidence of colorectal cancer is increasing in Iran and in Fars province. The present study aimed to determine the economic burden of colorectal cancer in patients referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences in 2019 from the patients’ perspective. This is a partial economic evaluation and a cost-of-illness study conducted cross-sectionally in 2019. All the patients with colorectal cancer who had been referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences, and had medical records were studied through the census method (N = 96). A researcher-made data collection form was used to collect the cost data. The prevalence-based and bottom-up approaches were also used in this study. The human capital approach was applied to calculate indirect costs. The mean annual cost per patient with colorectal cancer in the present study was $10930.98 purchasing power parity (PPP) (equivalent to 5745.29 USD), the main part of which was the medical direct costs (74.86%). Also, among the medical direct costs per patient, the highest were those of surgeries (41.7%). In addition, the mean annual cost per patient with colorectal cancer in the country was $ 116917762 PPP (equivalent to 61451621.84 USD) in 2019. Regarding the considerable economic burden of colorectal cancer and in order to reduce the costs, these suggestions can be made: increasing the number of specialized beds through the cooperation of health donors, establishing free or low-cost accommodation centers for patients and their companions near the medical centers, using the Internet and cyberspace technologies to follow up the treatment of patients, and increasing insurance coverage and government drug subsidies on drug purchase.

Labour-use Efficiency of Assam Gramin Vikash Bank: Branch- and District-level Analysis

2021 ◽  
pp. 232102222110243
Author(s):  
Mohuya Deb Purkayastha ◽  
Joyeeta Deb ◽  
Ram Pratap Sinha
Keyword(s):  
Efficiency Score ◽  
Significant Variable ◽  
Data Envelopment ◽  
Tobit Regression ◽  
Second Stage ◽  
Time Period ◽  
Use Efficiency ◽  
The Mean ◽  
The Impact ◽  
Observation Period

The present study estimated labour-use efficiency of 48 branches of Assam Gramin Vikash Bank at its branch level, covering three districts of Barak Valley, which falls under Silchar region of the bank for the time period from 2010–2011 to 2017–2018. The study applied data envelopment analysis for estimating labour-use efficiency. In the second stage, the study applied censored Tobit regression for determining the impact of several contextual variables on efficiency. The study reveals that the mean labour-use efficiency score of the selected branches is 76% when averaged for the in-sample branches over the observation period. Results of the Tobit regression identified cluster 2 and total business of the branches as the significant factors for determining efficiency and the number of employees as a significant variable influencing inefficiency. JEL Classifications: G2, G20, G21, J3

Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

1993 ◽  
Vol 18 (1) ◽  
pp. 115-118 ◽  
Author(s):  
J. STEVENSON ◽  
I. W. R. ANDERSON
Keyword(s):  
Emergency Department ◽  
Complete Resolution ◽  
Wound Care ◽  
Duration Of Treatment ◽  
Mean Delay ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
The Mean ◽  
Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

741 Manipulation and Reduction of Paediatric Forearm Fractures in The Emergency Department Using Intranasal Diamorphine and Entonox

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Kapoor ◽  
A Valand ◽  
J Dartnell
Keyword(s):  
Emergency Department ◽  
Patient Discharge ◽  
General Anaesthetic ◽  
Forearm Fractures ◽  
Distal Radial Fractures ◽  
Access To Treatment ◽  
Early Access ◽  
The Mean ◽  
Salter Harris

Abstract Background Paediatric forearm fractures are commonly encountered in Trauma and Orthopaedics. Currently most forearm fractures are manipulated in theatre the following day, increasing resource burden and delays in management. The aim of this project was to introduce guidelines to reduce fractures in the Emergency Department (ED) using intranasal Diamorphine and Entonox. Method 197 cases were identified over a 6-month period in 2018 and 2019. 74 distal radial fractures and 123 mid shaft forearm fractures were analysed. Fractures with an intact periosteal hinge or a Salter Harris type 2 were reduced in ED. The pre manipulation and post manipulation radiographs were compared with particular attention to the post reduction angles. Results 67% of fractures were reduced in the correct setting. A number of fractures reduced in ED required re-manipulation or internal fixation. Overall, there was a 56% reduction in patients undergoing general anaesthetic. There was a reduction in the mean length of stay from 36 hours to 3.5 hours. Conclusions Intranasal Diamorphine and Entonox offer a safe method for managing paediatric forearm fractures in ED. Implementation of this method facilitates early access to treatment and early patient discharge. Manipulation in ED offers significant financial savings and reduces demands on the Trauma Theatres.

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