30 research outputs found

    A review of injury epidemiology in the UK and Europe: some methodological considerations in constructing rates

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    <p>Abstract</p> <p>Background</p> <p>Serious injuries have been stated as a public health priority in the UK. However, there appears to be a lack of information on population-based rates of serious injury (as defined by a recognised taxonomy of injury severity) at national level from either official statistics or research papers. We aim to address this through a search and review of literature primarily focused within the UK and Europe.</p> <p>Methods</p> <p>The review summarizes research papers on the subject of population based injury epidemiology published from 1970 to 2008. We examined critically methodological approaches in measuring injury incident rates including data sources, description of the injury pyramid, matching numerator and denominator populations as well as the relationship between injury and socioeconomic status.</p> <p>Results</p> <p>National representative rates come from research papers using official statistics sources, often focusing on mortality data alone. Few studies present data from the perspective of an injury pyramid or using a standardized measure of injury severity, i.e. Injury Severity Score (ISS). The population movement that may result in a possible numerator – denominator mismatch has been acknowledged in five research studies and in official statistics. The epidemiological profile shows over the past decades in UK and Europe a decrease in injury death rates. No major trauma population based rates are available within well defined populations across UK over recent time periods. Both fatal and non-fatal injury rates occurred more frequently in males than females with higher rates in males up to 65 years, then in females over 65 years. Road traffic crashes and falls are predominant injury mechanisms. Whereas a straightforward inverse association between injury death rates and socio-economic status has been observed, the evidence of socioeconomic inequalities in non-fatal injuries rates has not been wholly consistent.</p> <p>Conclusion</p> <p>New methodological approaches should be developed to deal with the study design inconsistencies and the knowledge gaps identified across this review. Trauma registries contain injury data from hospitals within larger regions and code injury by Abbreviated Injury Scale enabling information on severity; these may be reliable data sources to improve understanding of injury epidemiology.</p

    Technology and devices for liquid pressure pipeline interventions in livestock farms

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    This technology is used when performing interventions on pipelines through which fluid under pressure is conveyed, in order to extend new networks, or branches, repair damage to pipes, install heat measuring systems, meter water consumption for billing, without interruption of utilities to consumers connected upstream of the point of intervention. Implementing the new technology is based on two devices: tight drilling-cutting device for the pressure pipeline and clogging device of the pressure pipeline. Both devices are successively mounted on a base block, whose boss is welded on the top generator of the pressure pipes, at the point of intervention. Currently, interventions on liquid pressure pipes, regardless their purpose, involve closure of the tower at the nearest point where there are isolation gates, hard to handle or broken, sometimes located in inaccessible places. The technology of intervention presented may be applied on under pressure pipe networks being in static or dynamic operational mode for operational pressures of max. 6 bar and standard nominal diameters of 65, 80, 100, 125, 150 and 200 mm. After performing tests was chosen the obturator with constant thickness of the wall for its constructive simplicity in the conditions in which the operational requirements are fulfilled. The tests demonstrated that the obturator accomplishes its role of interrupting water flow through the pipe in dynamic operational mode at 6 bar, if the pressure from inside it has a value of 10 bar. Application of this new technology has a direct effect on quality of life, allowing elimination of interruptions in drinking water supply utilities, domestic hot water or heat

    Layered Composites Based on Recycled PET/Functionalized Woven Flax Fibres

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    Extended Abstract Plastic waste is generated by a variety of sources including packaging, automotive, consumer goods, electrical and electronics industries, leading to a significant growth in the volume of waste and the impetuous need to reduce it The paper aims at developing new layered composite materials based on recycled thermoplastic polymer (PETpolyethylene terephthalate) from the food industry reinforced with woven flax fiber functionalized with nano (micro) particles of titanium or alumina and testing the composite in terms of physico-mechanical (tensile strength, bending, shock, etc.), morphological (SEM), structural (FTIR), and thermal (Vicat) properties. Based on this technology, the new composite will exhibit improved physical, mechanical and thermal properties, as well as resistance to mold attack. In this regard, in the first stage, the surface of flax fibers were chemically modified using aluminum (AlCl3), and titanium (titanium butoxide) precursors followed by precipitation. The woven flax whose surface was functionalized with nano (micro) alumina or TiO2 particles were subsequently used to obtain layered composite materials. Layered composite materials were obtained by alternating functionalized / not functionalized woven flax fiber with sheets made from recycled PET. The recycled PET sheets and layered composites based on recycled PET and functionalized / not functionalized woven flax fiber were obtained by press molding using an electrical press at the following optimum parameters: plate temperature -254ÂșC, preheating time -8 min; pressing time -2 min; cooling time -15 min; pressing force -100 kN. Special attention must be paid to the pre-drying process (at 100-110ÂșC) to remove adsorbed water. In the absence of the pre-drying operation, the resulting sheets exhibit holes, porosity and discontinuities, making them unusable for the development of layered composite materials. Physical, mechanical and thermal analyses results for specimens of layered composite materials based on recycled PET / functionalised woven flax fiber show significantly improved values compared with the control samples obtained from recycled PET / not functionalized flax fiber. Improved mechanical and thermal properties are due to links developed at the woven flax fiber / polymer phase interphase. Results have also been confirmed by SEM, while the degree of adhesion and the interpenetration of polymer phase / woven flax fiber are superior in the case of composites made of functionalized flax fibers in comparison with the unfunctionalized ones

    The Northwick Park Therapy Dependency Assessment scale:a psychometric analysis from a large multicentre neurorehabilitation dataset

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    Purpose: To assess the internal reliability, construct and concurrent validity and responsiveness of the Northwick Park Therapy Dependency Assessment (NPTDA) scale. Method: A cohort of 2505 neurorehabilitation patients submitted to the UK Rehabilitation Outcomes Collaborative database. Cronbach’s coefficient-α was used to assess internal reliability and factor analysis (FA) to assess construct validity. We compared NPTDA scores at admission and discharge to determine responsiveness. Results: Coefficient-α for the whole scale was 0.74. The exploratory FA resulted in a four-factor model (Physical, Psychosocial, Discharge planning and Activities) that accounted for 43% of variance. This model was further supported by the confirmatory FA. The final model had a good fit: root-mean-square error of approximation of 0.069, comparative fit index/Tucker–Lewis index of 0.739/0.701 and the goodness of fit index of 0.909. The NPTDA scores at admission and discharge were significantly different for each of the factors. Expected correlations were seen between the admission scores for the NPTDA, the Rehabilitation Complexity Scale (r = 0.30, p < 0.01) and the Functional Independence Measure (r = −0.25, p < 0.01). Conclusions: The scale demonstrated acceptable internal reliability and good construct and concurrent validity. NPTDA may be used to describe and quantify changes in therapy inputs in the course of a rehabilitation programme. IMPLICATIONS FOR REHABILITATION: The Northwick Park Therapy Dependency Assessment (NPTDA) is designed as a measure therapy intervention, which reflects both quantitative and qualitative aspects of the inputs provided (including staff time and the different types of intervention) during inpatient rehabilitation. The scale demonstrated acceptable internal reliability and good construct and concurrent validity. NPTDA is responsive to change in the therapy inputs provided during neurorehabilitation between admission and discharge

    Functional outcomes and efficiency of rehabilitation in a national cohort of patients with guillain - barré syndrome and other inflammatory polyneuropathies

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    To describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies.186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-BarrĂ© Syndrome (n = 118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n = 15 (8.1%) or critical illness neuropathy (n = 32 (17.2%)).Cohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: 'low' (NPDS<10), 'medium' (NPDS 10-24) and 'high' (NPDS ≄ 25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community.The mean rehabilitation length of stay was 72.2 (sd = 66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (ÂŁ1049 per week (SD ÂŁ994)), so that overall they were the most cost-efficient to treat.Patients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients

    Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type:a descriptive study

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    BACKGROUND: Acute myocardial infarction (AMI) type is an important distinction to be made in both clinical and health care research context, as it determines the treatment of the patient as well as affecting outcomes. The aim of the paper was to determine the feasibility of distinguishing AMI type, either ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI), using ICD10 codes. METHODS: We carried out a retrospective descriptive analysis of hospital administrative data on AMI emergency patients in England, for financial years 2000/1 to 2009/10. We used the performance of an angioplasty procedure on the same day and on the same or next day of hospital admission as a proxy for STEMI. RESULTS: Among the ICD10 AMI subcategories, there were inconsistent trends, with some of the codes exhibiting a gradual decline (such as I21.0 Acute transmural myocardial infarction of anterior wall, I21.1 Acute transmural myocardial infarction of inferior wall, I22.0 Subsequent myocardial infarction of anterior wall and I22.1 Subsequent myocardial infarction of inferior wall) and other codes an increase (in particular I21.9 Acute myocardial infarction, unspecified and I22.9 Subsequent myocardial infarction of unspecified site). With the exception of the codes I21.4 Acute subendocardial myocardial infarction, I21.9 Acute myocardial infarction, unspecified, I22.8 Subsequent myocardial infarction of other sites and I22.9 Subsequent myocardial infarction of unspecified site, all the other AMI subcategories appear to have undergone a significant increase in the number of angioplasty procedures performed the same or the next day of hospital admission from around 2005/6. There appear to be difficulties in accurately identifying the proportion of STEMI/NSTEMI by sole reliance on ICD10 codes. CONCLUSIONS: We suggest as the best sets of codes to select STEMI cases I21.0 to I21.3, I22.0, I22.1 and I22.8; however, without any further adaptations, ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type
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