Emergency department presentations in palliative care patients : a retrospective cohort study

Objectives: To map the patient journey for individuals known to palliative care presenting to the emergency department (ED). Methods: A linked dataset from the CUREd database and palliative care services in a region in the North of England was used. The study describes day and time of presentations, events occurring in the ED, mode of leaving the department and length of hospital admissions for presentations occurring within 90 days of a contact with palliative care. Findings were compared with the wider population in the CUREd database. Results: A significant proportion of individuals known to palliative care (29.4%) presented to the ED. Presentations typically occurred in working hours. Most presented by ambulance (84.4%) and were admitted to hospital (75.1%); these observations persisted across age groups. Most presentations involved investigations (88.5%) and/or treatment (84.1%). Conclusions: Palliative patients exhibit significant use of the ED; some have the potential to benefit from attendances, but there is a minority for whom ED is unlikely to have improved their care. Advance care planning and communication between services are important for empowering those who stand to benefit from ED, while ensuring appropriate care is planned for those who prefer to avoid presenting

Tool kits for the Sustainable Management of Ghana’s Riverine Biodiversity: an Overveiw

The Darwin Initiative funded project Tool kits for the Sustainable Management of Ghana’s Riverine Biodiversity was a collaboration between the Centre for African Wetlands at the University of Ghana, various units of the University of Ghana and the Ghana Wildlife Society. The project also involved collaborators from Burkina Faso, Nigeria, Cote d’Ivoire, Togo and Benin. The project aimed to address the impediments that remain for Ghana (and its neighbouring countries) in applying the Ecosystem Approach (EA) to riverine wetland management and the delivery of the Convention on Biodiversity (CBD). Priority needs were identified as taxonomic capacity building, a contemporary assessment of the status of aquatic biodiversity in Ghana, the development of practical management tools for rivers and increased engagement of stakeholders in decision-making together with an enhanced environmental awareness throughout Ghanaian society. These were addressed in this project by regional and local staff training, reporting on the current status of aquatic communities, the production of educational and taxonomic resources for a range of users, the development of a set of nested indicators of ecosystem health adapted for use at various levels, and the production of a policy document outlining the means of applying the EA in the management of Ghana’s rivers

Synthesis and characterization of Sn‑doped TiO2 flm for antibacterial applications

Simple sol–gel method has been exploited to deposit Sn-doped TiO2 thin flms on glass substrates. The resultant coatings were characterized by X-ray difraction (XRD), UV–visible techniques (UV–Vis), Fourier transform infrared spectroscopy (FTIR), and photoluminescence analysis (PL). The XRD pattern reveals an increase in crystallite size of the prepared samples with the increasing doping concentration. A decrease in doping concentrating resulted in the decrease in bandgap values. The diferent chemical bonds on these flms were identifed from their FTIR spectra. The photoluminescence analysis shows an increase in the emission peak intensity with increasing dopant concentration, and this can be attributed to the efect created due to surface states. The prepared samples were tested as antibacterial agent toward both Gram-positive and Gram-negative bacteria like S.aureus (Staphylococcus aureus) and E.coli (Escherichia coli), respectively. The size of the inhibition zones indicates that the sample shows maximum inhibitory property toward E.coli when compared to S.aureus

An Aluminum/Graphite Battery with Ultra-High Rate Capability

A high-performance Al/graphite battery has been investigated, employing a natural graphite cathode (NG) and 1-ethyl-3-methylimidazolium chloride (EMIMCl):AlCl3 as electrolyte. The employed graphite is characterized by excellent reversibility as revealed by electrochemical tests and ex-situ XRD. The Al/EMIMCl:AlCl3/NG battery showed extraordinary performance in terms of rate capability, and cycle life. The cell delivered a capacity of 110 mAh g−1 at lower current values, retaining 90 % and 60 % of the capacity employing a current of 20 A g−1 and 50 A g−1, respectively (i. e., a complete charge-discharge cycle in 35 and 9 seconds, respectively). Furthermore, the cycling test performed using a current of 20 A g−1 revealed an extremely long calendar life of half million of cycles. The practical applicability of the investigated Al/graphite system has been ascertained; this involved estimating the energy efficiency as a function of current rate and carefully calculating the practical energy densities that can be obtained from the system

Characteristics of Li-ion micro batteries fully batch fabricated by micro-fluidic MEMS packaging

A cost-effective and reliable technology allowing extreme miniaturization of batteries into glass chips and electronic packages has been developed, employing a dispense-print process for battery electrodes and liquid electrolyte. Lithium-ion micro-batteries (active area 6 × 8 mm2, 0.15–0.3 mAh) with interdigitated electrodes were fabricated, tested and finally compared with the traditional battery architecture of stacked electrodes. Commercial graphite and lithium titanate anode as well as layered nickel cathode materials were used. All the processes for the micro-battery fabrication were established during this work; in particular the micro fluidic electrolyte filling process that allows simultaneous electrolyte supply to all cells on a planar substrate. Electrode mass reproducibility was sufficient for adequate electrode balancing. Current capability similar to the conventional face-to-face electrode configuration was achieved with interdigital electrodes that can be fabricated much easily on a substrate level. The cells were successfully cycled; several 100 cycles can be achieved. Additional results of life-time characteristics and electrochemical impedance spectroscopy are presented as well. These rechargeable micro-batteries can be used for future extremely miniaturized electronic products

High-throughput battery materials testing based on test cell arrays and dispense/jet printed electrodes

A cost effective and reliable technology for the fabrication of electrochemical test-cell arrays for battery materials research, based on batch-fabricated glass micro packages was developed and tested. Jet dispensing was investigated for the first time as a process for fabricating battery electrode arrays and separators and compared to micro dispense printing. The process shows the reproducibility over the whole range of investigated materials and battery cell structures that is required for battery materials research. Such setup gives rise to a significantly improved reliability and reproducibility of electrochemical experiments. Cost-effective fabrication of our test chips by batch processing allows for their single-use in electrochemical experiments, thereby preventing contamination issues due to repeated use as in conventional laboratory test cells. In addition, the integration of micro pseudo reference electrodes is demonstrated. Thus, the test cell array together with the developed electrode/electrolyte deposition technology provide a highly efficient tool for speedy combinatorial and high throughput testing of battery materials on a system level (full cell tests). Experimental results are shown for the microfabrication of lithium-ion test cells with help of several electrode and binder materials. The influence of jetting parameters on electrode lateral dimensions and thickness, reproducibility of the electrode mass as well as the use of integrated micro-reference electrodes for impedance spectroscopy and cyclic voltammetry measurements in micro cells are presented in detail