Work analysis in emergency neurological department of University Hospital Split in one-year period

Prenapučenost odjela hitne službe rastući je problem u hitnim službama diljem svijeta. Cilj našeg istraživanja bio je utvrditi stupanj opterećenosti Hitnoga neurološkog prijema (HNP) Kliničkoga bolničkog centra (KBC) Split, utvrditi najučestalije razloge dolaska i procijeniti njihovu opravdanost. Napravili smo retrospektivnu analizu svih bolesnika pregledanih u našem HNP-u tijekom jednogodišnjeg razdoblja. U tom periodu pregledano je ukupno 8.146 pacijenata, u prosjeku 22 bolesnika na dan. Najučestaliji razlog dolaska je bio moždani udar (1.822 bolesnika – 22%), ali više od polovice pregledanih pacijenata procijenjeni su kao ne-hitni bolesnici i upućeni su na daljnju ambulantnu obradu. Čak 1.616 pacijenata prezentiralo se sa (sub)akutnim tegobama vratnog i leđnog dijela kralježnice. Ovim istraživanjem dokazali smo preopterećenost HNP-a i postojanje vrlo velikog broja ne-hitnih bolesnika u hitnom prijemu. Smatramo da bi bolja edukacija bolesnika, ali i liječnika obiteljske medicine i hitne medicine trebala pomoći u rješavanju ove problematike.Overcrowding of emergency departments all over the world has been recognised as one of the growing problems. The aim of our investigation was to determine the level of overcrowding in the neurological emergency room of the University Hospital Centre Split. This is a retrospective analysis of all patients that were examined in our emergency reception during the one-year period. We examined 8146 patients (around 22 patients per day). The main reason of their arrival was stroke (1,822 patients – 22%) but more than half of the patients were judged as non- urgent and they were sent to outpatient treatment. A total of 1,616 patients presented to the emergency department with (sub)acute complaints of cervical or lumbar spine. With this investigation we proved that there is a problem of overcrowding in our neurological emergency room and the existence of a very large number of non-urgent patients. We believe that better education of patients and doctors could be the solution of this problem

Air pollution trends in the EMEP region between 1990 and 2012

The present report synthesises the main features of the evolution over the 1990-2012 time period of the concentration and deposition of air pollutants relevant in the context of the Convention on Long-range Transboundary Air Pollution: (i) ozone, (ii) sulfur and nitrogen compounds and particulate matter, (iii) heavy metals and persistent organic pollutants. It is based on observations gathered in State Parties to the Convention within the EMEP monitoring network of regional background stations, as well as relevant modelling initiatives. Joint Report of: EMEP Task Force on Measurements and Modelling (TFMM), Chemical Co-ordinating Centre (CCC), Meteorological Synthesizing Centre-East (MSC-E), Meteorological Synthesizing Centre-West (MSC-W)

The EMEP Intensive Measurement Period campaign, 2008-2009: characterizing carbonaceous aerosol at nine rural sites in Europe

Carbonaceous aerosol (total carbon, TCp) was source apportioned at nine European rural background sites, as part of the European Measurement and Evaluation Programme (EMEP) Intensive Measurement Periods in fall 2008 and winter/spring 2009. Five predefined fractions were apportioned based on ambient measurements: elemental and organic carbon, from combustion of biomass (ECbb and OCbb) and from fossil-fuel (ECff and OCff) sources, and remaining non-fossil organic carbon (OCrnf), dominated by natural sources.OCrnf made a larger contribution to TCp than anthropogenic sources (ECbb, OCbb, ECff, and OCff) at four out of nine sites in fall, reflecting the vegetative season, whereas anthropogenic sources dominated at all but one site in winter/spring. Biomass burning (OCbb + ECbb) was the major anthropogenic source at the central European sites in fall, whereas fossil-fuel (OCff + ECff) sources dominated at the southernmost and the two northernmost sites. Residential wood burning emissions explained 30 %-50 % of TCp at most sites in the first week of sampling in fall, showing that this source can be the dominant one, even outside the heating season. In winter/spring, biomass burning was the major anthropogenic source at all but two sites, reflecting increased residential wood burning emissions in the heating season. Fossil-fuel sources dominated EC at all sites in fall, whereas there was a shift towards biomass burning for the southernmost sites in winter/spring.Model calculations based on base-case emissions (mainly officially reported national emissions) strongly underpredicted observational derived levels of OCbb and ECbb outside Scandinavia. Emissions based on a consistent bottom-up inventory for residential wood burning (and including intermediate volatility compounds, IVOCs) improved model results compared to the base-case emissions, but modeled levels were still substantially underestimated compared to observational derived OCbb and ECbb levels at the southernmost sites.Our study shows that natural sources are a major contributor to carbonaceous aerosol in Europe, even in fall and in winter/spring, and that residential wood burning emissions are equally as large as or larger than that of fossil-fuel sources, depending on season and region. The poorly constrained residential wood burning emissions for large parts of Europe show the obvious need to improve emission inventories, with harmonization of emission factors between countries likely being the most important step to improve model calculations for biomass burning emissions, and European PM2.5 concentrations in general.This work was supported by the Co-operative Programme for Monitoring and Evaluation of the Long-range Transmission of Air pollutants in Europe (EMEP) under UNECE, the European Union Seventh Framework Programme (FP7/2007–2013) under the ACTRIS project (grant agreement no. 262254), and the European Union Seventh Framework Programme (FP7/2007–2013) under the ECLIPSE project (grant agreement no. 282688). Computer time for EMEP model runs was supported by the Research Council of Norway through the NOTUR project EMEP (NN2890K), and this work was also supported by the Swedish Strategic Research Project MERGE (http://www.merge.lu.se; last access: 23 March 2019). We are grateful to the Laboratory of Ion Beam Physics of ETH Zurich for providing the accelerator mass spectrometer MICADAS for 14C measurements. We thank ECMWF and http://met.no (last access: 23 March 2019) for granting access to ECMWF analysis data. Hugo Denier van der Gon and Jeroen Kuenen from TNO are acknowledged for useful discussions and data concerning OM emissions

Long-term sulphate and inorganic nitrogen mass balance budgets in European ICP Integrated Monitoring catchments (1990–2012)

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The EMEP Intensive Measurement Period campaign, 2008–2009: characterizing carbonaceous aerosol at nine rural sites in Europe

Carbonaceous aerosol (total carbon, TCp) was source apportioned at nine European rural background sites, as part of the European Measurement and Evaluation Programme (EMEP) Intensive Measurement Periods in fall 2008 and winter/spring 2009. Five predefined fractions were apportioned based on ambient measurements: elemental and organic carbon, from combustion of biomass (ECbb and OCbb) and from fossil-fuel (ECff and OCff) sources, and remaining non-fossil organic carbon (OCrnf), dominated by natural sources. OCrnf made a larger contribution to TCp than anthropogenic sources (ECbb, OCbb, ECff, and OCff) at four out of nine sites in fall, reflecting the vegetative season, whereas anthropogenic sources dominated at all but one site in winter/spring. Biomass burning (OCbb + ECbb) was the major anthropogenic source at the central European sites in fall, whereas fossil-fuel (OCff + ECff) sources dominated at the southernmost and the two northernmost sites. Residential wood burning emissions explained 30 %–50 % of TCp at most sites in the first week of sampling in fall, showing that this source can be the dominant one, even outside the heating season. In winter/spring, biomass burning was the major anthropogenic source at all but two sites, reflecting increased residential wood burning emissions in the heating season. Fossil-fuel sources dominated EC at all sites in fall, whereas there was a shift towards biomass burning for the southernmost sites in winter/spring. Model calculations based on base-case emissions (mainly officially reported national emissions) strongly underpredicted observational derived levels of OCbb and ECbb outside Scandinavia. Emissions based on a consistent bottom-up inventory for residential wood burning (and including intermediate volatility compounds, IVOCs) improved model results compared to the base-case emissions, but modeled levels were still substantially underestimated compared to observational derived OCbb and ECbb levels at the southernmost sites. Our study shows that natural sources are a major contributor to carbonaceous aerosol in Europe, even in fall and in winter/spring, and that residential wood burning emissions are equally as large as or larger than that of fossil-fuel sources, depending on season and region. The poorly constrained residential wood burning emissions for large parts of Europe show the obvious need to improve emission inventories, with harmonization of emission factors between countries likely being the most important step to improve model calculations for biomass burning emissions, and European PM2.5 concentrations in general.JRC.C.5-Air and Climat

Trace metal budgets for forested catchments in Europe – Pb, Cd, Hg, Cu and Zn

Input/output budgets for cadmium (Cd), lead (Pb) and mercury (Hg) in the years 1997 monitored and determined for 14 small forest-covered catchments across Europe as part of the Integrated Monitoring program on the effects of long-range pollutants on ecosystems. Metal inputs were considered to derive from bulk deposition, throughfall and litterfall. Outputs were estimated from run-off values. Litterfall plus throughfall was taken as a measure of the total deposition of Pb and Hg (wet+dry) on the basis of evidence suggesting that, for these metals, internal circulation is negligible. The same is not true for Cd. Excluding a few sites with high discharge, between 74 and 94 % of the input Pb was retained within the catchments; significant Cd retention was also observed. High losses of Pb (>1.4 mgm (>0.15 mgm Central European sites with high water discharge. All other sites had outputs below or equal to 0.36 and 0.06 mgm Almost complete retention of Hg, 86 was reported in the Swedish sites. These high levels of metal retention were maintained even in the face of recent dramatic reductions in pollutant loads.–2011 were−2year−1) and Cd−2year−1) were observed in two mountainous−2year−1, respectively, for the two metals.–99 % of input