A Smart Grid for the city of Rome: A Cost Benefit Analysis

In this work, the JRC applies its Smart Grid CBA methodology to a full-scale project rather than only to a small-size demonstrative one. To this end, the JRC and ACEA - one of Italy’s biggest Distribution System Operators (DSOs), in charge of managing the distribution system of Rome - teamed up to study the merits of deploying Smart Grid technologies (preliminarily tested in a pilot project) in a big city like the Italian capital, hosting several million electricity users. The ACEA Smart Grid Pilot Project (named "Malagrotta" after the area where pilot solutions were first realised) is the starting point for this study, as it displays many of the characteristics of emerging Smart Grids projects and interconnects several diversified generation facilities (like biogas, waste-to-electricity and PV plants) and consumption centres. This study illustrates the outcome of the application of the JRC Cost Benefit Analysis (CBA) to a) the ACEA Smart Grids pilot project; and b) the planned deployment of Smart Grid technologies (tested in the ACEA Smart Grids pilot project) to the whole of the city of Rome. The CBA is conducted from both the private investor’s and the societal perspective, in order to assess whether scaling up the Smart Grid pilot project benefits the distribution operator and the citizens. Finally, this report shows how the JRC's CBA methodology can be effectively used to assess the financial and economic viability of real Smart Grids projects and help the investment decisions of DSOs.JRC.F.3-Energy Security, Systems and Marke

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely