International journal of environmental research and public health
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Int J Environ Res Public Health · Sep 2019
Factors Associated with Preventable Emergency Department Visits for Nontraumatic Dental Conditions in the U.S.
This study was designed to examine national trends and evaluate social determinants of health that were associated with the provision of dental services in emergency rooms in the United States between 2007 and 2014. A pooled cross-sectional database of emergency department (ED) visits combined the 2007-2014 waves of the Nationwide Emergency Department Sample. A total of 3,761,958 ED visits with dental conditions were extracted and the principal diagnosis was identified. ⋯ Patients in all other age groups were more likely to seek care in an ED for NTDCs relative to those 65 years of age or older. Multiple strategies are required to reduce the use of EDs for routine dental care. This approach will require an interprofessional dialogue and solutions that reduce barriers to receiving dental care.
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Int J Environ Res Public Health · Sep 2019
Analysis of the Local Agenda 21 in Madrid Compared with Other Global Actions in Sustainable Development.
Over the last two decades, numerous towns have been involved in the Local Agenda 21 program in Spain, which is founded on social participation. In the wake of this initiative, the recent promotion of the new Spanish Urban Agenda by the national government seeks to implement the 2030 Agenda in municipalities nationwide. This research aims to examine the Local Agenda 21 process by using Madrid as a case study to determine the lessons learned to enable the effective application of the new Spanish Urban Agenda. ⋯ Social, institutional, economic, and environmental dimensions of sustainable development were not equally considered by the plans, being the first two aspects the most predominant. Social engagement hardly reached 0.44% of the registered population. The contribution of all action plans to the sustainable development of Madrid was not assessed due to the absence of indicators in the program.
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Int J Environ Res Public Health · Sep 2019
Comparative Study Clinical TrialComparison of Frailty Screening Instruments in the Emergency Department.
Early identification of frailty through targeted screening can facilitate the delivery of comprehensive geriatric assessment (CGA) and may improve outcomes for older inpatients. As several instruments are available, we aimed to investigate which is the most accurate and reliable in the Emergency Department (ED). We compared the ability of three validated, short, frailty screening instruments to identify frailty in a large University Hospital ED. ⋯ Based upon the CGA, 58% were frail and the most accurate instrument for separating frail from non-frail was the PRISMA-7 (AUC 0.88; 95% CI:0.83-0.93) followed by the CFS (AUC 0.83; 95% CI:0.77-0.88), and the ISAR (AUC 0.78; 95% CI:0.71-0.84). The PRISMA-7 was statistically significantly more accurate than the ISAR (p = 0.008) but not the CFS (p = 0.15). Screening for frailty in the ED with a selection of short screening instruments, but particularly the PRISMA-7, is reliable and accurate.
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Int J Environ Res Public Health · Sep 2019
Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009-2017.
A few studies have explored the association between meteorological factors and hand, foot, and mouth disease (HFMD) with inconsistent results. Besides, studies about the effects of air pollutants on HFMD are very limited. ⋯ Temperature, relative humidity, sunshine duration, rainfall, ozone and NO2 were significantly associated with HFMD, and such effects varied with gender age and childcare patterns. These findings highlight the need for more prevention effort to the vulnerable populations and may be helpful for developing an early environment-based warning system for HFMD.
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Int J Environ Res Public Health · Sep 2019
Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas.
Implementation of environmental cleaning and disinfection has been shown to reduce the incidences of healthcare-associated infections. The effect of an enhanced strategy for terminal room disinfection, applying the pulsed xenon-based ultraviolet light no-touch disinfection systems (PX-UVC) after the current standard operating protocol (SOP) was evaluated. In a teaching hospital, the effectiveness in reducing the total bacterial count (TBC) and in eliminating high-concern microorganisms was assessed on five high-touch surfaces in different critical areas, immediately pre- and post-cleaning and disinfection procedures (345 sampling sites). ⋯ According to the hygienic standards proposed by the Italian Workers Compensation Authority, 9 of 80 (11%) surfaces in operating rooms showed TBC ≥15 CFU/24 cm2 after the SOP, while all samples were compliant applying the SOP plus PX-UVC disinfection. Clostridium difficile (CD) spores and Klebsiella pneumoniae (KPC) were isolated only after the SOP. The implementation of the standard cleaning and disinfection procedure with the integration of the PX-UVC treatment had effective results in both the reduction of hygiene failures and in control environmental contamination by high-concern microorganisms.