scholarly journals The Beirut Port explosion: injury trends from a mass survey of emergency admissions

The Lancet ◽  
2021 ◽  
Vol 398 (10294) ◽  
pp. 21-22
Author(s):  
Hana A Mansour ◽  
Eugenie Bitar ◽  
Youssef Fares ◽  
Assad A Makdessi ◽  
Antoine Maalouf ◽  
...  
Keyword(s):  
Mass Survey ◽  
Emergency Admissions ◽  
Explosion Injury

Ethno-social Situation and Interethnic Relations in Crimea

2019 ◽  
Vol 48 (4) ◽  
pp. 106-119
Author(s):  
Olga V. Kulbachevskaya
Keyword(s):  
Social Situation ◽  
Ethnic Identification ◽  
Mass Survey ◽  
Interethnic Relations ◽  
The Republic ◽  
And Migration ◽  
Interethnic Interaction

Based on the results of a mass survey and free interviews conducted by the author in The Republic of Crimea, the article analyzes the ethnic and social situation on the peninsula. The issues of national and ethnic identification, ethnocultural demands, and migration intentions of the residents of the republic are considered separately. Possible risks in the field of interethnic interaction are assessed, including the effect of an unfavorable social situation on the interethnic relations

scholarly journals Does admission prevalence change after reconfiguration of inpatient services? An interrupted time series analysis of the impact of reconfiguration in five centres

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanne Martin ◽  
Edwin Amalraj Raja ◽  
Steve Turner
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Emergency Admission ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Emergency Admissions ◽  
Series Analysis ◽  
Inpatient Services ◽  
The Impact ◽  
Admission Prevalence

Abstract Background Service reconfiguration of inpatient services in a hospital includes complete and partial closure of all emergency inpatient facilities. The “natural experiment” of service reconfiguration may give insight into drivers for emergency admissions to hospital. This study addressed the question does the prevalence of emergency admission to hospital for children change after reconfiguration of inpatient services? Methods There were five service reconfigurations in Scottish hospitals between 2004 and 2018 where emergency admissions to one “reconfigured” hospital were halted (permanently or temporarily) and directed to a second “adjacent” hospital. The number of emergency admissions (standardised to /1000 children in the regional population) per month to the “reconfigured” and “adjacent” hospitals was obtained for five years prior to reconfiguration and up to five years afterwards. An interrupted time series analysis considered the association between reconfiguration and admissions across pairs comprised of “reconfigured” and “adjacent” hospitals, with adjustment for seasonality and an overall rising trend in admissions. Results Of the five episodes of reconfiguration, two were immediate closure, two involved closure only to overnight admissions and one with overnight closure for a period and then closure. In “reconfigured” hospitals there was an average fall of 117 admissions/month [95% CI 78, 156] in the year after reconfiguration compared to the year before, and in “adjacent” hospitals admissions rose by 82/month [32, 131]. Across paired reconfigured and adjacent hospitals, in the months post reconfiguration, the overall number of admissions to one hospital pair slowed, in another pair admissions accelerated, and admission prevalence was unchanged in three pairs. After reconfiguration in one hospital, there was a rise in admissions to a third hospital which was closer than the named “adjacent” hospital. Conclusions There are diverse outcomes for the number of emergency admissions post reconfiguration of inpatient facilities. Factors including resources placed in the community after local reconfiguration, distance to the “adjacent” hospital and local deprivation may be important drivers for admission pathways after reconfiguration. Policy makers considering reconfiguration might consider a number of factors which may be important determinants of admissions post reconfiguration.

The outcomes of emergency hospital admissions with non-malignant upper gastrointestinal bleeding in England between 2003 and 2015

Endoscopy ◽  
2021 ◽  
Author(s):  
James Rees ◽  
Felicity Evison ◽  
Jemma Mytton ◽  
Prashant Patel ◽  
Nigel Trudgill
Keyword(s):  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Key Management ◽  
Hospital Admissions ◽  
Upper Gastrointestinal Bleeding ◽  
Medical Emergency ◽  
Emergency Admissions ◽  
Co Morbidity ◽  
Standardized Mortality Rate ◽  
Upper Gastrointestinal

Abstract Background Upper gastrointestinal bleeding (UGIB) is a common medical emergency with significant mortality. Despite developments in endoscopic and clinical management, only minor improvements in outcomes have been reported. Methods This was a retrospective cohort study of patients with non-malignant UGIB emergency admissions in England between 2003 and 2015, using Hospital Episode Statistics. Multilevel logistic regression analysis examined the associations with mortality. Results 242 796 patients with an UGIB admission were identified (58.8 % men; median age 70 [interquartile range (IQR) 53 – 81]). Between 2003 and 2015, falls occurred in both 30-day mortality (7.5 % to 7.0 %; P < 0.001) and age-standardized mortality (odds ratio (OR) 0.74, 95 % confidence interval [CI] 0.69 – 0.80; P < 0.001), including from variceal bleeding (OR 0.63, 95 %CI 0.45 – 0.87; P < 0.005). Increasing co-morbidity (Charlson score > 5, OR 2.94, 95 %CI 2.85 – 3.04; P < 0.001), older age (> 83 years, OR 6.50, 95 %CI 6.09 – 6.94; P < 0.001), variceal bleeding (OR 2.03, 95 %CI 1.89 – 2.18; P < 0.001), and a weekend admission (Sunday, OR 1.18, 95 %CI 1.12 – 1.23; P < 0.001) were associated with 30-day mortality. Of deaths at 30 days, 8.9 % were from ischemic heart disease (IHD) and the cardiovascular age-standardized mortality rate following UGIB was high (IHD deaths within 1 year, 1188.4 [95 %CI 1036.8 – 1353.8] per 100 000 men in 2003). Conclusions Between 2003 and 2015, 30-day mortality among emergency admissions with non-malignant UGIB fell by 0.5 % to 7.0 %. Mortality was higher among UGIB admissions at the weekend, with important implications for service provision. Patients with UGIB had a much greater risk of subsequently dying from cardiovascular disease and addressing this risk is a key management step in UGIB.

scholarly journals Origins: Colonies and Statistics

2020 ◽  
Vol 53 (4) ◽  
pp. 735-754
Author(s):  
Barbara Arneil
Keyword(s):  
Indigenous Peoples ◽  
Mentally Ill ◽  
Political Thought ◽  
English Language ◽  
Settler Colonialism ◽  
State Policies ◽  
Mass Survey ◽  
Waste Land ◽  
Key Concepts ◽  
History Of

AbstractIn this address, I examine the lexical, geographic, temporal and philosophical origins of two key concepts in modern political thought: colonies and statistics. Beginning with the Latin word colonia, I argue that the modern ideology of settler colonialism is anchored in the claim of “improvement” of both people and land via agrarian labour in John Locke's labour theory of property in seventeenth-century America, through which he sought to provide an ideological justification for both the assimilation and dispossession of Indigenous peoples. This same ideology of colonialism was turned inward a century later by Sir John Sinclair to justify domestic colonies on “waste” land in Scotland—specifically Caithness (the county within which my own grandparents were tenant farmers). Domestic colonialism understood as “improvement” of people (the “idle” poor and mentally ill and disabled) through engagement in agrarian labour on waste land inside explicitly named colonies within the borders of one's own country was first championed not only by Sinclair but also his famous correspondent, Jeremy Bentham, in England. Sinclair simultaneously coined the word statistics and was the first to use it in the English language. He defined it as the scientific gathering of mass survey data to shape state policies. Bentham embraced statistics as well. In both cases, statistics were developed and deployed to support their domestic colony schemes by creating a benchmark and roadmap for the improvement of people and land as well as a tool to measure the colony's capacity to achieve both over time. I conclude that settler colonialism along with the intertwined origins of domestic colonies and statistics have important implications for the study of political science in Canada, the history of colonialism as distinct from imperialism in modern political thought and the role played by intersecting colonialisms in the Canadian polity.

450 Retrospective Analysis of Surgical Clerk-Ins Within the Acute Receiving Unit: A Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Lee ◽  
A MacLeod ◽  
A Bradley
Keyword(s):  
Royal Infirmary ◽  
Improvement Project ◽  
Out Of Hours ◽  
Emergency Admissions ◽  
Vte Prophylaxis ◽  
Care Services ◽  
Documentation Quality ◽  
Patient Documentation ◽  
Patient Handovers

Abstract Introduction Accurate patient documentation at the ARU is vital to patient safety and ensuring smooth handovers to secondary care services. Because the nature of surgical treatment requires frequent patient handovers, and this increases the risk of miscommunication, we aimed to assess the quality of surgical clerk-ins and identify areas for improvement. Method Emergency admissions at the Dumfries Galloway Royal Infirmary were audited, looking at documentation quality under various clerk-in sections. Data was analysed before presentation to clinical governance. Results When 46 patient clerk-ins were examined, venous thromboembolism (VTE) prophylaxis plans were performed in only 24% of admissions - less than 1 in 4 patients. Comparing out-of-hours and in-hours patient documentation, much higher omission rates were identified in the out-of-hours documentation: in systemic enquiry (42 vs 100%) and family history (31% vs 66%). Conclusions These results brought to attention the effect of hospital admission timing on patient documentation quality, and the lack of VTE prophylaxis planning. In surgery, these plans are key to minimising risk of avoidable thromboembolic complications. A departmental meeting was convened to stress the importance of accurate and comprehensive clerk-ins to ARU doctors. Future audits could explore the factors influencing documentation quality for out-of-hours admissions, and ways to address these issues.

scholarly journals Comparative 4-year risk and type of hospital admission among homeless and housed emergency department attendees: longitudinal study of hospital records in England 2013–2018

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049811
Author(s):  
Charlie Moss ◽  
Matt Sutton ◽  
Sudeh Cheraghi-Sohi ◽  
Caroline Sanders ◽  
Thomas Allen
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Primary Diagnosis ◽  
Secondary Outcome ◽  
Emergency Admissions ◽  
Incident Rate Ratio ◽  
Chronic Angina ◽  
Access To Primary Care ◽  
Incident Rate ◽  
Preventable Admissions

ObjectivesPeople experiencing homelessness are frequent users of secondary care. Currently, there is no study of potentially preventable admissions for homeless patients in England. We aim to estimate the number of potentially preventable hospital admissions for homeless patients and compare to housed patients with similar characteristics.DesignRetrospective matched cohort study.SettingHospitals in England.Participants16 161 homeless patients and 74 780 housed patients aged 16–75 years who attended an emergency department (ED) in England in 2013/2014, matched on the basis of age, sex, ED attended and primary diagnosis.Primary and secondary outcome measuresAnnual counts of admissions, emergency admissions, ambulatory care-sensitive (ACS) emergency admissions, acute ACS emergency admissions and chronic ACS emergency admissions over the following 4 years (2014/2015–2017/2018). We additionally compare the prevalence of specific ACS conditions for homeless and housed patients.ResultsMean admissions per 1000 patients per year were 470 for homeless patients and 230 for housed patients. Adjusted for confounders, annual admissions were 1.79 times higher (incident rate ratio (IRR)=1.79; 95% CI 1.69 to 1.90), emergency admissions 2.08 times higher (IRR=2.08; 95% CI 1.95 to 2.21) and ACS admissions 1.65 times higher (IRR=1.65; 95% CI 1.51 to 1.80), compared with housed patients. The effect was greater for acute (IRR=1.78; 95% CI 1.64 to 1.93) than chronic (IRR=1.45; 95% CI 1.27 to 1.66) ACS conditions. ACS conditions that were relatively more common for homeless patients were cellulitis, convulsions/epilepsy and chronic angina.ConclusionsHomeless patients use hospital services at higher rates than housed patients, particularly emergency admissions. ACS admissions of homeless patients are higher which suggests some admissions may be potentially preventable with improved access to primary care. However, these admissions comprise a small share of total admissions.

scholarly journals Influence of the COVID-19 Pandemic on Dental Emergency Admissions in an Urgent Dental Care Service in North Italy

2021 ◽  
Vol 18 (4) ◽  
pp. 1812 ◽  
Author(s):  
Maria Grazia Cagetti ◽  
Araxi Balian ◽  
Nicole Camoni ◽  
Guglielmo Campus
Keyword(s):  
Retrospective Study ◽  
Dental Care ◽  
Tooth Extraction ◽  
Care Service ◽  
Emergency Admissions ◽  
Exact Test ◽  
Remarkable Increase ◽  
Time Period ◽  
Dental Emergency ◽  
Second Wave

A retrospective study was performed to verify if the number of admissions for urgent dental care in the Urgent Dental Care Service of San Paolo Hospital in Milan (Italy) was directly related to the different phases of the COVID-19 pandemic. Different periods were analyzed: 25 March–5 April 2019 (pre-COVID); 23 March–3 April 2020 (lockdown); 8 June–19 June 2020 (reopening); and November 9–November 20 (second wave). Raw data regarding admissions, diagnoses, and treatments were extracted. Descriptive and bivariate analyses were performed. The survey included 901 admissions, 285 in pre-COVID, 93 during lockdown, 353 in reopening, and 170 in the second wave. In each time period, statistically significant differences were found in the prevalence of each kind of diagnoses (χ2(3) = 20.33 p = 0.01 for endodontic emergencies, χ2(3) = 29.05 p < 0.01 for cellulitis/phlegmon, χ2(3) = 28.55 p < 0.01 for periodontal emergencies, Fisher’s Exact Test p < 0.01 for trauma, and χ2(3) = 59.94 p < 0.01 for all other kinds of diagnosis). A remarkable increase in consultations (+186.36%) and other treatments (+90.63%) occurred during reopening. Tooth extraction was the most frequently delivered treatment, but suffered the largest reduction during lockdown (−79.82%). The COVID-19 pandemic has highly affected dental activity in north Italy, underling the weaknesses of a private dental system in a pandemic scenario.

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