scholarly journals Impact of COVID-19 lockdowns on hospital presentations and admissions in the context of low community transmission: evidence from time series analysis in Melbourne, Australia

2021 ◽  
pp. jech-2021-217010
Author(s):  
Taya A Collyer ◽  
George Athanasopoulos ◽  
Velandai Srikanth ◽  
Ravindranath Tiruvoipati ◽  
Chris Matthews ◽  
...  
Keyword(s):  
Health Service ◽  
Catchment Area ◽  
Historical Data ◽  
Forecasting Methods ◽  
Triage Category ◽  
Life Threatening ◽  
Community Transmission ◽  
The Impact ◽  
Second Wave ◽  
Acute Admissions

BackgroundMelbourne, Australia, successfully halted exponential transmission of COVID-19 via two strict lockdowns during 2020. The impact of such restrictions on healthcare-seeking behaviour is not comprehensively understood, but is of global importance. We explore the impact of the COVID-19 pandemic on acute, subacute and emergency department (ED) presentations/admissions within a tertiary, metropolitan health service in Melbourne, Australia, over two waves of community transmission (1 March to 20 September 2020).MethodsWe used 4 years of historical data and novel forecasting methods to predict counterfactual hospital activity for 2020, assuming absence of COVID-19. Observed activity was compared with forecasts overall, by age, triage category and for myocardial infarction and stroke. Data were analysed for all patients residing in the health service catchment area presenting between 4 January 2016 and 20 September 2020.ResultsED presentations (n=401 805), acute admissions (n=371 723) and subacute admissions (n=15 676) were analysed. Substantial departures from forecasted presentation levels were observed during both waves in the ED and acute settings, and during the second wave in subacute. Reductions were most marked among those aged >80 and <18 years. Presentations persisted at expected levels for urgent conditions, and ED triage categories 1 and 5, with clear reductions in categories 2–4.ConclusionsOur analyses suggest citizens were willing and able to present with life-threatening conditions during Melbourne’s lockdowns, and that switching to telemedicine did not cause widespread spill-over from primary care into ED. During a pandemic, lockdowns may not inhibit appropriate hospital attendance where rates of infectious disease are low.

scholarly journals A seven week observational analysis of clinical activities in a North Italian orthopaedic hospital during the second wave of SARS-CoV-2 pandemic: far from usual volumes, but different from the first wave

2021 ◽  
Author(s):  
Luigi Zagra ◽  
Martina Faraldi ◽  
Mauro Andreata ◽  
Immacolata Ottaiano ◽  
Giuseppe Basile ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Service ◽  
Elective Surgery ◽  
Activity Levels ◽  
Hospital Budget ◽  
Observational Analysis ◽  
Orthopaedic Hospital ◽  
Second Wave ◽  
Acute Admissions

Abstract Purpose We previously described the radical changes occurred in an orthopaedic hospital in Milan (Italy) during the first SARS-CoV-2 pandemic outbreak. Currently, during the second wave, the situation is still far from normality. Here we describe the changes that took place, and are still ongoing, in the clinical practice. Methods Number and type of admissions, outpatients activity, ER and urgent procedures in SARS-CoV-2 negative and positive patients have been analyzed over seven weeks (October 26th–December 13th, 2020) and compared with the correspondent period in 2019 and the same timeframe during the first wave (February 24th–April 10th). Results 2019 vs. 2020: Overall admissions decreased by 39.8%; however, while admissions for elective surgery dropped by 42.0%, urgent surgeries increased by 117.0%. Rehabilitation admissions declined by 85.2%. White and green priority ER consultations declined by 41.6% and 52.0%, respectively; yellow and red increased by 766.7% and 400.0%, respectively. Second vs. first wave: Overall admissions increased by 58.6% with a smoother decrement in weekly admissions than during the first wave. Disparity of acute admissions vs. rehabilitation expanded: Acute cases increased by 63.6% while rehabilitation cases decreased by 8.7%. Admissions to triage procedures increased by 72.3%. Conclusions Activity levels are far from normality during the second COVID-19 wave. Elective surgery and outpatients-related activities are still strongly limited compared to 2019 while the number of urgent cases treated increased consistently. SARS-CoV-2 positive emergencies are slightly higher than during the first wave. These important changes are expected to impact on health service and hospital budget for long.

The Impact of Terrorism on Construction Industry in Iraq

2015 ◽  
Vol 3 (2) ◽  
pp. 69-84
Author(s):  
Wadhah Amer Hatem ◽  
Samiaah M. Hassen Al-Tmeemy
Keyword(s):  
Construction Industry ◽  
Construction Projects ◽  
Historical Data ◽  
Terrorist Attacks ◽  
Construction Sector ◽  
Statistical Procedures ◽  
Qualitative Approaches ◽  
Suicide Attacks ◽  
The Face ◽  
The Impact

     Suicide attacks, bombings, explosions became the part of daily life in Iraq. Consequently, the threat of terrorism put the Iraqi construction sector in the face of unique and unusual challenges that not seen on other countries. These challenges can have extensive impact on construction projects. This paper seeks to examine the impact of the terrorist attacks on construction industry and determine the extent to which the impact of terrorism on construction projects in terms of cost, schedule, and quality. This study adapted quantitative and qualitative approaches to collect data using questionnaire survey and interviews, as well as historical data. The study focused on projects that have been the target of terrorist strikes in Diyala governorate. A variety of statistical procedures were employed in data analysis. The results revealed the extent to which terrorist attacks impact construction projects in terms of cost, time, and quality. The results of this study will enhance the awareness of all construction parties to the impact of the terrorist attacks against construction projects. Eventually, this can develop a risk management assessment and assist contractors to properly protect projects and buildings to minimize injuries and fatalities in the event of terrorism.

Alteraciones sistémicas y metabólicas producidas por lesión medular

2019 ◽  
Vol 1 (1) ◽  
pp. 59-75
Author(s):  
Gabriel Guízar Sahagún
Keyword(s):  
Spinal Cord ◽  
Daily Living ◽  
Autonomic Function ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Cord Injury ◽  
Life Threatening ◽  
The Impact

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.

Gendered Impact of Corruption in Healthcare Service Delivery in Nigeria

2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Yetunde A. Aluko
Keyword(s):  
Service Delivery ◽  
Public Hospitals ◽  
Public Health Care ◽  
Women's Voices ◽  
Medical Supplies ◽  
Poor Women ◽  
Level Information ◽  
Life Threatening ◽  
Threatening Situation ◽  
The Impact

This paper supports the hypothesis that corruption and non-delivery of services in key sectors such as health have gender-specific poverty consequences. The study utilized qualitative micro-level information about the structures of corruption and its impact on poor women. Respondents expressed their perceptions on the occurrence of corrupt practices in public health care system and its wider impact on society. The findings revealed that the impact of corruption is felt disproportionately by women and the poor, who are most dependent on public services, and have no alternative even when facing corrupt practices in a life threatening situation, such as complicated birth delivery. Pregnant women denied access to doctors tended to deliver at home, which increased the likelihood of complications and maternal and child mortality. Medical supplies meant for public hospitals are sold to private clinics who charge more for drugs and supplies. There is need to strengthen sectoral oversight mechanisms and transparency as well as increase women’s voices in service delivery.

The management of Hemorrhoidal Disease by Dearterialization and Mucopexy.

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica De Simone ◽  
Francesco Litta ◽  
Angelo Parello ◽  
Paola Campennì ◽  
Raffaele Orefice ◽  
...  
Keyword(s):  
Postoperative Management ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Probe ◽  
Minimally Invasive Surgical ◽  
Bowel Movements ◽  
Excessive Strain ◽  
Life Threatening ◽  
Hemorrhoidal Prolapse ◽  
The Impact

: Several minimally invasive surgical procedures have been recently developed to treat hemorrhoids without any excision. About 25 years ago, a non-excisional procedure providing doppler-guided ligation of the hemorrhoidal arteries has been proposed - named “hemorrhoidal dearterialization”. The original technique has been modified over the years, and indications were expanded. In particular, a plication of the redundant and prolapsing mucosa/submucosa of the rectum (named “mucopexy”) has been introduced to treat hemorrhoidal prolapse, without excision of the hemorrhoidal piles. At present, the THD® Doppler procedure is one of the most used techniques to treat hemorrhoids. Aim of this technique is to realize a target dearterialization, using a Doppler probe with the final purpose to reduce the arterial overflow to the hemorrhoidal piles. In case of associated hemorrhoidal prolapse, a mucopexy is performed together with Doppler-guided dearterialization. The entity and circumferential extension of the hemorrhoidal prolapse guides the mucopexy, which can be considered tailored to a single patient; the dearterialization should be considered mandatory. Advantages of this surgical technique are the absence of serious and life-threatening postoperative events, chronic complications, and limited recurrence risks. The impact of the procedure on the anorectal physiology is negligible. However, a careful postoperative management is mandatory to avoid complications and to guarantee an improved long-term outcome. Therefore, regular physiologic bowel movements, excessive strain at the defecation and strong physical activity are advisable.

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals The Global Registry for Hereditary Angioedema due to C1-Inhibitor Deficiency

2021 ◽  
Author(s):  
Andrea Zanichelli ◽  
Henriette Farkas ◽  
Laurance Bouillet ◽  
Noemi Bara ◽  
Anastasios E. Germenis ◽  
...  
Keyword(s):  
Hereditary Angioedema ◽  
Rare Condition ◽  
C1 Inhibitor ◽  
C1 Inhibitor Deficiency ◽  
Therapeutic Decisions ◽  
Life Threatening ◽  
Enhance Patient Care ◽  
Electronic Support ◽  
The Impact ◽  
Global Registry

AbstractHereditary angioedema (HAE) is a rare condition, mostly due to genetic deficiency of complement C1 inhibitor (C1-INH). The rarity of HAE impedes extensive data collection and assessment of the impact of certain factors known to affect the course of this disabling and life-threatening disease. Establishing a global registry could assist to overcome such issues and provides valuable patient data from different countries. The HAE Global Registry is a disease-specific registry, with web-based electronic support, where data are provided by physicians and patients through a dedicated application. We collected data between January 1, 2018, and August 31, 2020. Data on 1297 patients from 29 centers in 5 European countries were collected. At least one attack was recorded for 497 patients during the study period. Overall, 1182 patients were diagnosed with HAE type 1 and 115 with type 2. At the time of database lock, 389 patients were taking long-term prophylactic medication, 217 of which were on danazol. Most recorded attacks affected the abdomen, were generally moderate in severity, and occurred in patients who were not on prophylactic treatment (70.6%, 6244/8848). The median duration of attacks was 780 min (IQR 290–1740) in patients on prophylactic medication and 780 min (IQR 300–1920) in patients not on continuous prophylactic medication. In conclusion, the establishment of a registry for C1-INH-HAE allowed collection of a large amount of data that may help to better understand the clinical characteristics of this disease. This information may enhance patient care and guide future therapeutic decisions.

scholarly journals Volatility Modeling: An Overview of Equity Markets in the Euro Area during COVID-19 Pandemic

Mathematics ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1212
Author(s):  
Pierdomenico Duttilo ◽  
Stefano Antonio Gattone ◽  
Tonio Di Di Battista
Keyword(s):  
Stock Market ◽  
Euro Area ◽  
Risk Premium ◽  
Stock Markets ◽  
Market Volatility ◽  
Stock Market Volatility ◽  
Volatility Modeling ◽  
The Impact ◽  
Second Wave ◽  
Daily Returns

Volatility is the most widespread measure of risk. Volatility modeling allows investors to capture potential losses and investment opportunities. This work aims to examine the impact of the two waves of COVID-19 infections on the return and volatility of the stock market indices of the euro area countries. The study also focuses on other important aspects such as time-varying risk premium and leverage effect. This investigation employed the Threshold GARCH(1,1)-in-Mean model with exogenous dummy variables. Daily returns of the euro area stock markets indices from 4th January 2016 to 31st December 2020 has been used for the analysis. The results reveal that euro area stock markets respond differently to the COVID-19 pandemic. Specifically, the first wave of COVID-19 infections had a notable impact on stock market volatility of euro area countries with middle-large financial centres while the second wave had a significant impact only on stock market volatility of Belgium.

scholarly journals The impact of the Covid-19 pandemic on adult diagnostic neuroradiology in Europe

2021 ◽  
Author(s):  
Marion Smits ◽  
M. W. Vernooij ◽  
N. Bargalló ◽  
A. Ramos ◽  
T. A. Yousry
Keyword(s):  
Online Courses ◽  
Mental Wellbeing ◽  
Personal Protection Equipment ◽  
Work Training ◽  
Healthcare Crisis ◽  
Area Of Concern ◽  
Media Channels ◽  
The Impact ◽  
Second Wave ◽  
Diagnostic Neuroradiology

Abstract Purpose The purpose of this survey was to understand the impact the Covid-19 pandemic has or has had on the work, training, and wellbeing of professionals in the field of diagnostic neuroradiology. Methods A survey was emailed to all ESNR members and associates as well as distributed via professional social media channels. The survey was held in the summer of 2020 when the first wave had subsided in most of Europe, while the second wave was not yet widespread. The questionnaire featured a total of 46 questions on general demographics, the various phases of the healthcare crisis, and the numbers of Covid-19 patients. Results One hundred sixty-seven responses were received from 48 countries mostly from neuroradiologists (72%). Most commonly taken measures during the crisis phase were reduction of outpatient exams (87%), reduction of number of staff present in the department (83%), reporting from home (62%), and shift work (54%). In the exit phase, these measures were less frequently applied, but reporting from home was still frequent (33%). However, only 22% had access to a fully equipped work station at home. While 81% felt safe at work during the crisis, fewer than 50% had sufficient personal protection equipment for the duration of the entire crisis. Mental wellbeing is an area of concern, with 61% feeling (much) worse than usual. Many followed online courses/congresses and considered these a viable alternative for the future. Conclusion The Covid-19 pandemic substantially affected the professional life as well as personal wellbeing of neuroradiologists.

Has tourism driven house prices in Germany? Time-varying evidence since 1870

2021 ◽  
pp. 135481662110088
Author(s):  
Sefa Awaworyi Churchill ◽  
John Inekwe ◽  
Kris Ivanovski
Keyword(s):  
World War Ii ◽  
Historical Data ◽  
House Prices ◽  
Housing Prices ◽  
Time Varying ◽  
Data Set ◽  
Time Series Modelling ◽  
The Impact ◽  
Tourism Flows ◽  
Non Parametric

Using a historical data set and recent advances in non-parametric time series modelling, we investigate the nexus between tourism flows and house prices in Germany over nearly 150 years. We use time-varying non-parametric techniques given that historical data tend to exhibit abrupt changes and other forms of non-linearities. Our findings show evidence of a time-varying effect of tourism flows on house prices, although with mixed effects. The pre-World War II time-varying estimates of tourism show both positive and negative effects on house prices. While changes in tourism flows contribute to increasing housing prices over the post-1950 period, this is short-lived, and the effect declines until the mid-1990s. However, we find a positive and significant relationship after 2000, where the impact of tourism on house prices becomes more pronounced in recent years.

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