Comparing oil based ointment versus standard practice for the treatment of moderate burns in Greece: a trial based cost effectiveness evaluation

<p>Abstract</p> <p>Background</p> <p>The local treatment of burn wounds has long been a subject of debate. The objective of this study was to compare the cost and the effectiveness of Moist Exposed Burn Ointment -MEBO versus a combination of <it>povidone iodine </it>plus <it>bepanthenol </it>cream for partial thickness burns.</p> <p>Methods</p> <p>The study was carried out in the Burn Center of a state hospital in Athens, Greece. 211 patients needing conservative therapy were prospectively selected according to the depth of the burn wound. The treatment was allocated according to the Stratified Randomization Design. The outcomes measured were mean cost of in-hospital stay, rate of complications, time of 50% wound healing, pain scores, in hospital stay diminution. We have adopted a societal perspective.</p> <p>Results</p> <p>In the total groups MEBO presented lower cost, (although not significantly different: p = 0.10) and better effectiveness. The data suggest that MEBO is the dominant therapy for superficial partial burn wound with significantly lower costs and significantly higher effectiveness due to a lesser time of recovery and consequently lower time of hospitalization and follow-up. MEBO presented similar percentages of complications with the comparator, lower pain levels and smaller time of no healthy appearance of the burn limits for superficial partial thickness burns.</p> <p>Conclusions</p> <p>The data suggested that topical application of MEBO may be considered for further investigation as a potential first-line treatment modality for superficial partial thickness burns.</p> <p>Trial registration</p> <p>The trial has been registered on the International Standard Randomised Controlled Trial Number Register (ISRCTN) and given the registration number <a href="http://www.controlled-trials.com/ISRCTN74058791">ISRCTN74058791</a>.</p

Contribution of emissions to concentrations: The TAGGING 1.0 submodel based on the Modular Earth Submodel System (MESSy 2.52)

Questions such as “what is the contribution of road traffic emissions to climate change?” or “what is the impact of shipping emissions on local air quality?” require a quantification of the contribution of specific emissions sectors to the concentration of radiatively active species and air-quality-related species, respectively. Here, we present a diagnostics package, implemented in the Modular Earth Submodel System (MESSy), which keeps track of the contribution of source categories (mainly emission sectors) to various concentrations. The diagnostics package is implemented as a submodel (TAGGING) of EMAC (European Centre for Medium-Range Weather Forecasts – Hamburg (ECHAM)/MESSy Atmospheric Chemistry). It determines the contributions of 10 different source categories to the concentration of ozone, nitrogen oxides, peroxyacytyl nitrate, carbon monoxide, non-methane hydrocarbons, hydroxyl, and hydroperoxyl radicals ( =  tagged tracers). The source categories are mainly emission sectors and some other sources for completeness. As emission sectors, road traffic, shipping, air traffic, anthropogenic non-traffic, biogenic, biomass burning, and lightning are considered. The submodel obtains information on the chemical reaction rates, online emissions, such as lightning, and wash-out rates. It then solves differential equations for the contribution of a source category to each of the seven tracers. This diagnostics package does not feed back to any other part of the model. For the first time, it takes into account chemically competing effects: for example, the competition between NOx, CO, and non-methane hydrocarbons (NMHCs) in the production and destruction of ozone. We show that the results are in-line with results from other tagging schemes and provide plausibility checks for concentrations of trace gases, such as OH and HO2, which have not previously been tagged. The budgets of the tagged tracers, i.e. the contribution from individual source categories (mainly emission sectors) to, e.g., ozone, are only marginally sensitive to changes in model resolution, though the level of detail increases. A reduction in road traffic emissions by 5 % shows that road traffic global tropospheric ozone is reduced by 4 % only, because the net ozone productivity increases. This 4 % reduction in road traffic tropospheric ozone corresponds to a reduction in total tropospheric ozone by  ≈  0.3 %, which is compensated by an increase in tropospheric ozone from other sources by 0.1 %, resulting in a reduction in total tropospheric ozone of  ≈  0.2 %. This compensating effect compares well with previous findings. The computational costs of the TAGGING submodel are low with respect to computing time, but a large number of additional tracers are required. The advantage of the tagging scheme is that in one simulation and at every time step and grid point, information is available on the contribution of different emission sectors to the ozone budget, which then can be further used in upcoming studies to calculate the respective radiative forcing simultaneously.Aircraft Noise and Climate Effect

The role of the general dental practitioner in managing patients who self-harm.

There has been a reported increase in the incidence of self-harm within the United Kingdom. This is of great concern, as a number of studies have shown self-harm to be a major risk factor to completed suicide. However, the identification of self-harm provides an opportunity for support and treatment. Mental health is an area that often receives little attention in the undergraduate dental curriculum. Yet dental practitioners, as healthcare professionals, need to be vigilant for any risk factors or signs of mental illness among their patients and make appropriate onward referrals. The purpose of this article is to examine the current evidence and aspects of self-harm, particularly in young adults and adolescents that are relevant within a dental settling