Poverty Reduction Strategy Papers (PRSPs) represent the World Bank and the International Monetary Fund’s (IMF) most recent initiative for reducing the plight of the poor. This paper examines whether ...the PRSPs for Liberia, Afghanistan and Haiti follow World Bank guidance on health. The health data, analysis and strategy content of the three PRSPs are assessed with respect to the ‘Health, Nutrition and Population’ chapter of the World Bank’s PRSP Sourcebook. This guidance states that PRSPs should include: health data on the poor and a clear analysis showing the determinants of ill health and pro-poor health strategies. Unfortunately, none of the PRSPs analysed comply with the guidance and, consequently, do not adequately portray the health situation within their countries. Thus health is not given a high priority in the PRSP process and is seemingly low on the agenda of both poor country governments and the International Financial Institutions (IFIs). If the situation for the world’s poorest people is to improve, health and the right to health need to be promoted within PRSPs.
The absence of contaminants in the hydrogen delivered at the hydrogen refuelling station is critical to ensure the length life of FCEV. Hydrogen quality has to be ensured according to the two ...international standards ISO 14687–2:2012 and ISO/DIS 19880-8. Amount fraction of contaminants from the two hydrogen production processes steam methane reforming and PEM water electrolyser is not clearly documented. Twenty five different hydrogen samples were taken and analysed for all contaminants listed in ISO 14687-2. The first results of hydrogen quality from production processes: PEM water electrolysis with TSA and SMR with PSA are presented. The results on more than 16 different plants or occasions demonstrated that in all cases the 13 compounds listed in ISO 14687 were below the threshold of the international standards. Several contaminated hydrogen samples demonstrated the needs for validated and standardised sampling system and procedure. The results validated the probability of contaminants presence proposed in ISO/DIS 19880-8. It will support the implementation of ISO/DIS 19880-8 and the development of hydrogen quality control monitoring plan. It is recommended to extend the study to other production method (i.e. alkaline electrolysis), the HRS supply chain (i.e. compressor) to support the technology growth.
•No contaminants above ISO 14687-2 threshold in H2 from SMR with PSA.•No contaminants above ISO 14687-2 threshold in H2 from PEMW with TSA.•Impact of TSA on contaminants from PEMW electrolyser.•Sampling contamination may lead to false positive.•Probability of contaminants presence in line with real hydrogen samples.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective
We developed a national survey to assess the changes implemented by respiratory departments across England in response to the first wave of the COVID‐19 pandemic.
Methods
An online survey ...was sent to the respiratory clinical leads in 132 NHS trusts in England. The survey was open between 10 August 2020 and 25 September 2020.
Results
Fifty‐three responses (42%) are included in our results.
The total number of non‐critical care led Level 2 beds (requiring care for single organ failure—capable of managing continuous positive airways pressure, CPAP) increased by 159% at peak COVID activity from levels prior to COVID‐19. CPAP was used solely in side‐rooms in 9% of sites, and 57% and 31% of sites used CPAP in closed bays and closed wards, respectively.
Fifteen sites (28%) reported shortages of non‐vented non‐invasive ventilation (NIV) masks and 12 sites (23%) CPAP machines. There was regional variation.
Conclusions
The number of beds capable of managing patients requiring CPAP increased significantly. We found deviations from previous standards of care, which likely reflects the pressure faced by hospitals in managing patients with COVID‐19. The regional variation in equipment shortages suggests moving resources between regions may have been beneficial.
We developed a national survey to assess the changes implemented by respiratory departments across England in response to the first wave of the COVID‐19 pandemic. The number of beds capable of managing patients requiring CPAP increased significantly. We found deviations from previous standards of care which likely reflects the pressure faced by hospitals in managing patients with COVID‐19.
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Impurities in carbon dioxide can affect several aspects of the carbon capture and storage process, including storage capacity, rock erosion, accuracy of flow meters, and toxicity of potential leaks. ...There is an industry need for guidance on performing purity analysis before carbon dioxide is transported and stored. This paper reviews selected reports that specifically provide threshold amount fraction limits for impurities in carbon dioxide for the purpose of transport and storage, with rationales for these limits. A carbon dioxide purity specification is provided (including threshold amount fractions of impurities) on the basis of the findings, as well as recommendations on further work required to develop a suitable gas metrology infrastructure to support these measurements including primary reference materials, sampling methods, and instruments for performing purity analysis. These recommendations provide important guidance to operators and gas analysis laboratories for performing quality assurance.
We describe our experience of rigid bronchoscopy and endobronchial intervention at a single tertiary centre over a 12-year period. All rigid bronchoscopy procedures between July 2008 and July 2020 ...(inclusive) were reviewed. All procedures were performed in cardiothoracic theatres by a designated team under general anaesthesia. 2135 rigid bronchoscopies were performed on 1301 patients aged between 18 and 93 years. Complications occurred in 24 (1.12%) procedures. There was one fatality (0.05%). Haemorrhage >100mls occurred in seven (0.33%) all of which were successfully managed endobronchially. Ten procedures (0.5%) were complicated by pneumothorax and an intercostal drain was required for eight. Five patients required intensive care admission post operatively, all of whom were subsequently discharged from hospital. One patient had stent migration. To the best of our knowledge, this is amongst the largest single centre collection of data available for endobronchial intervention using rigid bronchoscopy. We show that rigid bronchoscopy is a safe and effective procedure when performed in a high-volume specialist centre with designated lists involving a specialist multidisciplinary team.
A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this ...study was to investigate the extent of variation in COVID-19 outcomes between National Health Service (NHS) hospital trusts and regions in England using data from March–July 2020.
This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. Patients aged ≥ 18 years who had a diagnosis of COVID-19 during a hospital stay in England that was completed between March 1st and July 31st, 2020 were included. In-hospital mortality was the primary outcome of interest. In secondary analysis, critical care admission, length of stay and mortality within 30 days of discharge were also investigated. Multilevel logistic regression was used to adjust for covariates.
There were 86,356 patients with a confirmed diagnosis of COVID-19 included in the study, of whom 22,944 (26.6%) died in hospital with COVID-19 as the primary cause of death. After adjusting for covariates, the extent of the variation in-hospital mortality rates between hospital trusts and regions was relatively modest. Trusts with the largest baseline number of beds and a greater proportion of patients admitted to critical care had the lowest in-hospital mortality rates.
There is little evidence of clustering of deaths within hospital trusts. There may be opportunities to learn from the experience of individual trusts to help prepare hospitals for future case-surges.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Lung cancer is one of the commonest malignancies worldwide and necessitates both early and personalised treatment. A key requirement is histological sampling with immunohistochemistry obtained ...usually from percutaneous biopsy. Conventionally thoracic biopsies are performed using CT guidance, but more recently, there has been development of physician led ultrasound biopsy for pleural lesions. Contrast-enhanced ultrasound (CEUS) has been increasingly used in interventional procedures and is able to offer benefits for thoracic biopsies including improving lesional visualisation and characterisation, targeting viable tissue and avoiding critical vascular structures as well as evaluating for the presence of post-procedural complications. This educational review aims to benefits of the role of CEUS in thoracic biopsies.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
To meet carbon emissions reduction targets heat and transport need to be decarbonised. Hydrogen is being considered as a flexible energy vector that could play an important part in this endeavour. ...With demonstration projects on the rise it is crucial to identify suitable odorants to ensure, safety regulations are met and public acceptance gained. Specifically, this work investigates the use of sulphur based odorants currently in use in the UK and Europe, alongside sulphur-free and experimental ones, for use in a 100% hydrogen gas demonstration network in the UK. Gas samples odorised with five different odorants are analysed to determine odour detection threshold, the odour intensity, its hedonic tone and character. The tests are performed by an accredited laboratory following EU standards. The results show that four odorants meet requirements as stenching agents for use in UK gas distribution network, whilst one, 5-ethylidene-2-norbornene, fails to demonstrate an unpleasant odour.
•Four odorants currently in use appear suitable for a hydrogen network.•5-ethylidene-2-norbornene does not illicit an unpleasant odour.•Tested odorants are intense enough to be detected as a result of a gas leak.•Tested odorants display between 4 and 9 odour characters, making them distinctive.•Pleasantness or unpleasantness tends to increase with increasing intensity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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