Degree Of Urgency Research Articles

Impact of Regional integration on Trade and Economic Cooperation – a key study of Georgia and Azerbaijan

The South Caucasus is a unique small and densely populated region in the southern part of the Caucasus. It consists of three independent states - Georgia, Azerbaijan and Armenia. Georgia is actively engaged in the Peaceful Neighborhood Initiative in the South Caucasus and strives to deepen political and economic relations with the countries in the region based on sovereign interests. In these processes, strengthening mutually beneficial, trust-based cooperation with the Republic of Azerbaijan is of special interest to Georgia. After the collapse of the Union of Soviet Socialist Republics (USSR) and the regaining of independence by Georgia and Azerbaijan, a completely new phase of diplomatic relations began between the two countries which grew into a strategic partnership. Territorial proximity and the establishment of diplomatic relations have prompted the dynamic development of trade and economic relations between the two countries, which increases the degree of urgency of the study. The presented paper focuses on the priority areas of trade and economic cooperation between Georgia and Azerbaijan. However, at the present stage economics and politics are so closely interrelated that it is impossible to draw a line between them. Therefore, in order to achieve the purpose of the paper, the first chapter focuses on the development of diplomatic relations between the two countries, while the following chapters study trade and economic cooperation between Georgia and Azerbaijan and analyze the development of bilateral cooperation in trade in services; in addition, the trade intensity index is calculated; the importance of investments from Azerbaijan in the Georgian economy is assessed; the transnational energy and transport projects proposed by the Georgian and Azerbaijani governments are discussed; and the growing role of Georgia as trade and transport hub in the Caucasus in both the offshore and onshore components of these projects is assessed. It is noted that trade and economic relations have growing dynamics and show readiness to further develop cooperation. In addition, some suggestions that will be helpful for Georgia to increase the scale of cooperation with Azerbaijan and assist deepening the involvement of the two countries in the world integration processes are proposed. We believe that the paper will enhance further research and discussion on trade and economic cooperation between Georgia and Azerbaijan and, most importantly, ensure support for this kind of cooperation.

A creeping crisis when an urgent crisis arises: The reprioritization of plastic pollution issues during COVID‐19

AbstractSingle‐use plastics (SUPs) are increasingly polluting terrestrial, coastal, and marine habits, contributing to the creeping “plastic crisis.” The COVID‐19 pandemic provided a window of opportunity for decision makers to change the degree of urgency and responsiveness to this crisis and for policy entrepreneurs and industry who are against reducing plastic consumption to influence decision makers to change their position on various plastic‐related issues. Hygiene/health concerns have been used as a justification by governments and industry to increase the use of SUPs resulting in a reversal in, or a reprioritization of, policy decisions. Through the Multiple Streams Framework (MSF), I examine how creeping crises become secondary to urgent crises through agenda setting that is influenced and leveraged by policy entrepreneurs. I explore examples of such plastic policy decisions finding that they have been politically driven and influenced by entrepreneurs and industry rather than being primarily based on health concerns.Related ArticlesDiaz‐Kope, Luisa, and John C. Morris. 2022. “Why Collaborate? Exploring the Role of Organizational Motivations in Cross‐sector Watershed Collaboration.” Politics & Policy 50(3): 516–39. https://doi.org/10.1111/polp.12470.Gerlach, John David, Laron K. Williams, and Colleen E. Forcina. 2013. “The Science‐Natural Resource Policy Relationship: How Aspects of Diffusion Theory Explain Data Selection for Making Biodiversity Management Decisions.” Politics & Policy 41(3): 326–54. https://doi.org/10.1111/polp.12017.Neill, Katharine A., and John C. Morris. 2012. “A Tangled Web of Principals and Agents: Examining the Deepwater Horizon Oil Spill through a Principal–Agent Lens.” Politics & Policy 40(4): 629–56. https://doi.org/10.1111/j.1747‐1346.2012.00371.x.

Risk Factors for Severe Postoperative Complications after Oncologic Right Colectomy: Unicenter Analysis.

Background and Objectives: This study aimed to investigate the potential risk factors for severe postoperative complications after oncologic right colectomy. Materials and Methods: All consecutive patients with right colon cancer who underwent right colectomy in our department between 2016 and 2021 were retrospectively included in this study. The Clavien-Dindo grading system was used to evaluate postoperative complications. Univariate and multivariate logistic regression analyses were used to investigate risk factors for postoperative severe complications. Results: Of the 144 patients, there were 69 males and 75 females, with a median age of 69 (IQR 60-78). Postoperative morbidity and mortality rates were 41.7% (60 patients) and 11.1% (16 patients), respectively. The anastomotic leak rate was 5.3% (7 patients). Severe postoperative complications (Clavien-Dindo grades III-V) were present in 20 patients (13.9%). Univariate analysis showed the following as risk factors for postoperative severe complications: Charlson score, lack of mechanical bowel preparation, level of preoperative proteins, blood transfusions, and degree of urgency (elective/emergency right colectomy). In the logistic binary regression, the Charlson score (OR = 1.931, 95% CI = 1.077-3.463, p = 0.025) and preoperative protein level (OR = 0.049, 95% CI = 0.006-0.433, p = 0.007) were found to be independent risk factors for postoperative severe complications. Conclusions: Severe complications after oncologic right colectomy are associated with a low preoperative protein level and a higher Charlson comorbidity index.

The Risk Map of Cross-Regional Cultural Heritage: From a Perspective of Slow Degradation

The Cross-Regional Cultural Heritage (CRCH) is a continuous, large-spanned, and comprehensive system with a large number and diversity of components. To support the integrated conservation of CRCH, an analytical approach with simple structure and easy operation is needed. Therefore, this paper aims to conduct risk maps to interpret, understand, and manage the slow degradation of built heritage in the daily environment. The hazard factors of slow degradation in the environment are extracted and translated into meteorological data for mapping with the Geographic Information Systems (GIS). A risk map to evaluate the risk level of the heritage is obtained by overlapping the vulnerability and hazard factors. With the case study of the Chinese Eastern Railway (CER), the risk maps revealed the risk condition and spatial distribution pattern of CRCH, based on which a network-connected working platform is developed, and suggestions for solutions are proposed. In terms of the operational plan for conservation works, the graded architectural risk sections are delineated. The priority and extent of intervention are proposed according to the degree of urgency and preventive conservation measures can be implemented in advance by using weather forecast data. In terms of social management strategy, through a level-by-level penetration education model, the social awareness of heritage conservation can be cultivated, the technical methods for restoration and maintenance will be trained, and the operating system for monitoring and inspection can be established. Relevant stakeholders, such as government officials, experts, users, and visitors can participate together in the preventive conservation process of the heritage.

Studies of first‐aid medical stations by flow simulation of damaged patients by the earthquake part 2: Investigation based on the area scale of disaster base hospitals by predicting the number of patients affected by a northern Tokyo Bay earthquake

AbstractBased on a simulation of casualties potentially affected by a Northern Tokyo Bay earthquake, we examined the limits and possibilities of medical relief activities and building space at disaster base hospitals. Considering casualty numbers over time, we determined details about the overall space required to deal with affected patients based on degree of urgency and ascertained the needs of each area. We found that the yellow area (for high‐risk patients) was relatively large; however, it was also found that affected patients remained and continued to accumulate in the red (critical) area for some time after the disaster.

An optimization method for evacuation guidance under limited visual field

In the emergency under smoke or gas, the visual field of pedestrians is limited, unreasonable evacuation guidance methods will affect the efficiency of evacuation, and even cause evacuation failure in serious cases. Therefore, the optimized evacuation guidance strategy is investigated in this study. First, a distance factor is introduced to modify the follow-up behavior of pedestrians, which solves the problem of leaders being blocked by pedestrians. Then, a reward grid-based leader initial position optimization method is proposed to ensure the safe guidance of pedestrians. By considering the density and distance factors comprehensively, the leader’s position is theoretically available by calculation. Finally, a leader exit selection strategy based on evacuation urgency degree is proposed. The leaders select exits in order of evacuation urgency degree, thus ensuring a more balanced exit utilization. The simulation results show that the proposed model can improve the safety of evacuation, and reduce the evacuation time.

Truthful Online Double Auctions for Mobile Crowdsourcing: An On-Demand Service Strategy

Double auctions play a pivotal role in stimulating active participation of a large number of users comprising both task requesters and workers in mobile crowdsourcing. However, most existing studies have concentrated on designing offline two-sided auction mechanisms and supporting single-type tasks and fixed auction service models. Such works ignore the need of dynamic services and are unsuitable for large-scale crowdsourcing markets with extremely diverse demands (i.e., types and urgency degrees of tasks required by different requesters) and supplies (i.e., task skills and online durations of different workers). In this article, we consider a practical crowdsourcing application with an on-demand service strategy. Especially, we innovatively design three online service models, namely, online single-bid single-task (OSS), online single-bid multiple-task (OSM), and online multiple-bid multiple-task (OMM) models to accommodate diversified tasks and bidding demands for different users. Furthermore, to effectively allocate tasks and facilitate bidding, we propose a truthful online double auction mechanism for each service model based on the McAfee double auction. By doing so, each user can flexibly select auction service models and corresponding auction mechanisms according to their current interested tasks and online duration. To illustrate this, we present a three-demand example to explain the effectiveness of our on-demand service strategy in realistic crowdsourcing applications. Moreover, we theoretically prove that our mechanisms satisfy truthfulness, individual rationality, budget balance, and consumer sovereignty. Through extensive simulations, we show that our mechanisms can accommodate the various demands of different users and improve social utility, including platform utility and average user utility.

Umbilical Cord Prolapse: Revisiting its Definition and Management

(Am J Obstet Gynecol. 2021;225:357–366) Umbilical cord prolapse is an uncommon condition but is associated with high perinatal mortality, with higher rates in low-income countries. It has an incidence from 1 to 6 per 1000 pregnancies. There are still many questions around umbilical cord prolapse. This review aimed to address variations in the definition and classification, the degree of urgency in delivery when umbilical cord prolapse is present, and the efficacy of maneuvers used to relieve cord compression before delivery.

La dépression aux urgences psychiatriques : une expérience quotidienne

Depression is the most common psychiatric disorder in the general population, and emergency room visits for depression have been increasing for several years. In addition, the Covid-19 pandemic may lead to an explosion of psychiatric emergency room visits for this reason, with an overall prevalence of anxiety and depression that appears to be increasing since 2020. The Centre Psychiatrique d’Orientation et d’Accueil is a regional psychiatric emergency service located in Paris which records approximately 10,000 consultations per year. Among these consultations, the main symptoms are those of depression (depressive ideations, anxiety) and nearly 40 % are diagnosed with mood disorders, including depression. The management of the patient in the emergency room is based on a global evaluation, which should not be limited to the psychiatric interview. In the best case, and if compatible with the organization of the service, an initial evaluation by the nursing reception staff determines the context of the arrival of the patient, the reason and the degree of urgency of the consultation can thus be assessed from the outset. The request for care can come from the patient themself, but also from family and friends who are worried about a decline in the patient's previous condition. The consultation may also be triggered by the intervention of emergency services, particularly in the case of attempted suicide or agitation. The context of arrival, the environment, and the patient's entourage must be taken into account in order to achieve an optimal orientation. Particular attention must be paid to the first episodes (elimination of a differential diagnosis, screening for a possible bipolar disorder). The existence of an external causal factor or a comorbid personality disorder should not trivialize the consultation and lead to a faulty diagnosis of a characterized depressive episode. Drug treatment in the emergency room is usually symptomatic (anxiolytic treatment with benzodiazepines or neuroleptics, depending on the situation), and outpatient referral should always be preferred. Therapeutic adaptations can then be considered. The decision to hospitalize must always be justified, and consent for care must be rigorously evaluated. It is almost always necessary to take the patient's entourage into account as well as the potential support of the patient by the entourage. All these elements must be recorded in the file. Suicide risk assessment must be systematic for all patients consulting psychiatric emergencies, and the use of the RUD (Risk, Urgency, Dangerousness) grid can be useful. Any decision to release a patient with suicidal tendencies must be made strictly following certain conditions:a rapid psychiatric re-evaluation of the crisis, with for example the proposal of a post-emergency consultation, a supportive entourage, accepted symptomatic treatment. The registration of the suicidal patient in a monitoring system such as VigilanS can also be beneficial and reduce the risk of recidivism.

Study the Biaxial creep of continuous polymer fiber composites

Creep is the slow continuous change in the dimensions of the engineering piece during the service. The study of the creep is one of the very important things in order to avoid the disasters that occur as a result of changing the dimensions. Since we are studying creep and its effect on engineering parts in various fields in which polymer or composite materials are used, and among these areas is the use of polymers and composite materials in dams, then we must choose polymeric materials carefully so that these materials must have special properties in terms of strength and rigidity. In order to meet the required requirements in terms of properties, we chose high-density polyethylene because it has several properties, including its high degree of urgency as well as high inter molecular force, but this material alone does not meet all requirements because the polymer alone is not considered a successful material. High-density carbon fiber and we got a composite material with excellent properties that are much better than high-density polyethylene alone.

Unit’s Heterogeneity and System Differentiation: The Logic of U.S.-China Relations' Transition

In this paper, Unit Heterogeneity and the Degree of system differentiation are considered as the independent variables to explain the differential characteristics of the international structure, which lead to a differentiated interaction mode between hegemon and other rising powers. Then the paper further argues that globalization and nuclear deterrence lead to dynamic changes in system differentiation, and the heterogeneity between rising power and hegemonic power in geographical objectives, strategic culture, ideology, and polity are the conditions that hegemon must refer to when positioning the nature of rising power and interacting with rising power. However, the logic of power distribution is implied in the degree of system differentiation, and the author finds that in the process of globalization promoted by the hegemon if the relative power of rising powers becomes unconstrained, the hegemon will slow down globalization and suppress rising powers instead. The degree of urgency relates not only to power distribution but also to unit heterogeneity. Therefore, the paper distinguished four patterns in terms of great powers’ competition: duopoly competition in orderly anarchy status, alliance management in rigid hierarchy status, the dual-track embedded competition in loose hierarchy status, and quasi-perfect competition in chaotic anarchy status. In the end, the article verified the common modes of great power interaction, which are reflected in the competition between the U.S. and the USSR, differing interests between hegemon and allies inside the hegemon alliance, and U.S.-China competition.

Non Linear Healing

Non-Linear Healing is a minifilm that makes tangible and visible the reality of healing as a continual process, rather than a target that must be reached. The film features visuals from a dozen personal journals spanning the years 2014 to 2020. In the background, audio recordings of different entries overlap with varying degrees of intensity, urgency, and volume. Those varying degrees allow for the non-linearity of healing to be felt through the sense of movement created when the recordings lull to softer volumes, to make some readings more audible than others. Below, is an adaptation of this minifilm, which has been reproduced for print form. The adaption includes a short media curation text and video stills placed strategically to convey the spirit of the film. Additionally, multiple listening and speed typing sessions were used to create a transcript that could adequately capture the auditory experience. This transcript is included in sync with the video stills. Click here to watch the minifilm.

A Reverse Order Hierarchical Integrated Scheduling Algorithm Considering Dynamic Time Urgency Degree of the Process Sequences

Aiming at the general integrated scheduling problem of tree-structured complex single-product machining and assembling, a reverse order hierarchical integrated scheduling algorithm (ROHISA) is proposed by considering the dynamic time urgency degree (TUD) of process sequences (PSs). The strategy of process sorting is put forward, and the TUD of PS is defined. The process tree is reversed using leaf alignment, and according to the order from leaf to root, the scheduling order of leaf nodes in the same layer is determined layer by layer according to the TUD values of the PSs to which the leaf nodes belong. In turn, the sorted leaf nodes in each layer are stored in a corresponding layered array (LA). Finally, the elements in each LA are reversed, and the LAs’ arranging order is reversed. A reverse order hierarchical scheduling strategy is proposed. Starting from the root node, every LA is taken as a unit to conduct trial scheduling each time. Under the condition of meeting the craft constraints, a set of quasi-scheduling schemes of same-layer processes (QSSSLP) is obtained, and the one with the minimum end time is selected from it as the scheduling scheme of the same layer processes (SSSLP). If it is not unique, the QSSSLP that machines all the same layer processes (SLP) as early as possible is selected. The research shows that the ROHISA optimizes the integrated scheduling results of single-product manufacturing enterprises and improves its production efficiency.

Business track diplomacy: 4ocean effort in mitigation of plastic waste in Bali waters area

Environmental issues have become one of the global problems with a high degree of urgency. The province of Bali is one of the absolute highlights with evidence of a poor water quality index. In studying international relations, global problems can be solved through diplomatic instruments by interested countries. Uniquely, footage of phenomena in the field shows that there are non-governmental actors, namely business people, trying to solve environmental problems to lead to world peace. This study aims to examine 4Ocean's efforts to mitigate plastic waste in the waters of Bali. The author uses business track diplomacy to analyze the actions of 4Ocean. As a result, several measures have realized 4Ocean's efforts to carry out business line diplomacy in mitigating plastic pollution in Bali's waters. First, 4Ocean has sought to implement a sound business model by turning profits into reforestation operations. Second, 4Ocean has carried out plastic pollution operations in Bali as a whole, including river, coastal, and ocean operations. Third, 4Ocean has attempted to validate environmentally friendly products with B Corp, GOTS, and Green Circle Certified certifications.

Formation of the strength of pelletized multiphase dicalcium silicate sinter

To ensure the comprehensive use of mineral raw materials and the widespread use of waste instead of minerals, it is necessary to deepen the search and scientific substantiation of the relevant reserves. The main waste of alumina production is red mud (RM), which has a complex chemical composition with the main content of iron oxide, which makes it possible to use the sludge in ferrous metallurgy as an additive to increase the strength of iron ore pellets. The degree of urgency of this task is quite high, since RM and iron ore raw materials of domestic and foreign deposits have their own specifics and give different strengthening effects. The nature of the hardening of the agglomerate with the addition of RM is based on the stabilization of the dicalcium silicate present in the pellet structure. A technique has been developed for the mechanism of formation of the multiphase sinter strength and a laboratory setup has been created that makes it possible to obtain a sample on a platinum loop at heat treatment temperatures of 1400 C with subsequent testing of stability and strength. The method of hardening mechanism takes into account the temperature level, shape and size of the obtained sample. The effect of calcium ferrite mineralizer on the stabilization of dicalcium silicate depending on its content in the charge was studied. It was determined that calcium ferrite in the amount of 10–15 % sharply accelerates the synthesis of dicalcium silicate. When recalculating the composition of a stable sinter to the composition of a fluxed pellet, at least 1.5–2.0 % of RM is required to achieve the stability of β-dicalcium silicate. The quality of the sinter, its stabilization or spontaneous crumbling were determined visually during the cooling of the sinter, the completeness of the crumbling process was determined by sieve analysis of the decomposition product.

Designing the temporary dental clinic in the Covid-19 global pandemic

Covid-19 pandemic has directed hospitals to concentrate services for patients who are positive or still in undefined status. Some countries are even forced to build temporary structures or utilize multifunctional buildings such as sports/public halls. On the other hand, hospitals still have to keep performing other routine services and this becomes a challenge for them. When global attention nowadays focuses more on how hospitals serve the Covid-19 cases, this research proposes another side of healthcare service needed by people in the pandemic, which is the dental clinic. The spread of Covid-19 through droplets puts both dental patients and practitioners at risk target of Covid-19 transmission. Therefore, particular standards and protocols are mandatory to be deployed. A prototype design of the temporary dental clinic is the main output from this research. The main objective is to provide service for the community without being afraid of contracting the pandemic as the clinic will be isolated from the regular hospital buildings. To achieve this objective, this research employed three approaches for the methodology. It was started with the desk study to review references on recent technology of temporary building structures. Followed by the online questionnaire using the Google platform distributed to 206 registered dental practitioners in Aceh, in collaboration with the Indonesian Dental Association, Aceh Province, Indonesia. The questionnaire collected the data related to the needs, standards, procedures, and dental service protocols under the Covid-19 pandemic as the main reference for the design process. The last approach was gathering feedback from dentists and international architects who are experts in building science and technology. This was done through a series of pre-design reviews. This research has a high degree of urgency globally, including Saudi Arabia, which is also impacted by the Covid-19 pandemic. It is also in line with Saudi Vision 2030 to enhance the standard quality and sustainability of healthcare services. The prototype design proposed in this research does not only contribute to the Covid-19 pandemic in particular but also post-Covid scenarios or other possible global pandemics in the future.

Traditional Beliefs and Practices in Masquerading: Effutu Context

The study elevates the masquerading culture of Effutu masquerade and examines its functionalism of the traditional beliefs and practices associated with the masquerading culture in Winneba, Central Region of Ghana. The study employed a descriptive research tool under the qualitative research approach through ethnographic inquiry, which aimed at collecting data to unearth these traditional beliefs and practices of the Effutu masquerade. The study used unstructured interviews, photographs, and direct observation as the form of instrumentations to elicit information from the federation, some members, and leaders of the various masquerade groups in Winneba. The data was analyzed using descriptive and interpretative phenomenological (IPA) analysis tools. It was revealed that the Effutu masquerade culture possessed traditional beliefs and practices that were shrouded in religious, socioeconomic and aesthetic contexts. Functionalism in Effutu masquerade culture was seen as a repository for a critical reflection of the visual culture that promotes Ghana’s tradition and cultural values. The study concludes that the Effutu masquerade, irrespective of its distrust, contains elements of cultural richness and important traditional values that demonstrate a degree of philosophical urgency.

Assessment of the Magnitude and Risk Factors of Post Spinal Relevant Hemodynamics Associated with Caesarean Section in Bahirdar University Hospital, Northwest Ethiopia, 2020

Background: Maternal hemodynamics is a common clinical problem for caesarean section under spinal anesthesia. The main objective of this study was to determine magnitude of post spinal hemodynamics and factors associated with relevant maternal hypotension during caesarean section. Materials and Methods: This cross-sectional clinical study was conducted among 143 pregnant mothers who underwent caesarean section from January 29 to April 15, 2020. Simple random sampling technique was conducted with fulfilling the inclusion criteria. Maternal hemodynamic changes and the severity were assessed within 60 minutes after spinal injection. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) of parturient were recorded during the perioperative period. These times of recording were including the admission to operating room (preanaesthetic baseline), immediately after anesthesia (displayed as 0 time), and minutes of 3, 5, 15, 20, 25, 30, 35, and 60 after spinal injection. Results: The incidence of relevant maternal hypotension was 55.9 %. From these, 31patients (21.7%) were connected with sever hypotension. There was a highly significant relationship to sensory block height above T4, at 10 minutes of post spinal anesthesia P < 0.001 (AOR= 5.340; 95% CI: 2.235 - 12.762), Elective degree of urgency involved P_ 0.038 (AOR=0.207; 95% CI: 0.047 - 0.918) and Dose of local anesthetic more than 2.5 ml or > 12.5 mg of bupivacaine, P_0.001 (AOR= 7.815; 95% CI: 2.338 – 26.12). Conclusion and Recommendation: Lowering the intrathecal dose of spinal anesthesia seems to be a useful technique to reduce the incidence of hypotension and better preserves maternal hemodynamic stability. The study showed that the incidence of relevant hypotension will increase when the analgesic block level become higher than T4 dermatome within 10 minutes. Depending on the degree of urgency, a parturient with an emergency base for caesarean delivery may be a useful tool to predict relevant hypotension during spinal anesthesia. The hospital management and responsible clinicians of GUH need to minimize the incidence of post spinal relevant hypotension by adquate preotimization and taking to account avaliable options.

Visits to the Pediatric Emergency Department for Eye Conditions Before and During the COVID-19 Pandemic.

IntroductionThe use of the emergency department (ED) has been increasing, and many visits occur for non-urgent conditions. A similar trend was found among adult visits to the ED for ocular conditions. In this study we analyzed the impact of sociodemographic factors, presentation timing, and the COVID-19 pandemic on pediatric ED (PED) encounters for ophthalmologic conditions. It is important to identify the multifold factors associated with overutilization of the ED for non-urgent conditions. Caring for these patients in an outpatient clinical setting is safe and effective and could decrease ED crowding; it would also prevent delays in the care of other patients with more urgent medical problems and lower healthcare costs.MethodsWe retrospectively reviewed electronic health records of PED ocular-related encounters at two children’s hospitals before (January 2014–May 2018) and during the COVID-19 pandemic (March 2020–February 2021). Encounters were categorized based on the International Classification of Diseases codes into “emergent,” “urgent,” and non-urgent” groups. We analyzed associations between sociodemographic factors and degrees of visit urgency. We also compared visit frequencies, degrees of urgency, and diagnoses between pre-pandemic and pandemic data.ResultsPre-pandemic ocular-related PED encounters averaged 1,738 per year. There were highly significant sociodemographic associations with degrees of urgency in PED utilization. During the 12-month pandemic timeframe, encounter frequency contracted to 183. Emergent visits decreased from 21% to 11%, while the proportions of urgent and non-urgent encounters were mostly unchanged. The most common pre-pandemic urgent diagnosis was corneal abrasion (50%), while visual disturbance was most common during the pandemic (92%). During both time periods, eye trauma was the most frequent emergent encounter and conjunctivitis was the most common non-urgent encounter.ConclusionSociodemographic factors may be associated with different types of PED utilization for ocular conditions. Unnecessary visits constitute major inefficiency from a healthcare-systems standpoint. The marked decrease in PED utilization and differing proportions of ocular conditions encountered during the pandemic may reflect a decrease in incidence of many of those conditions by social distancing; these changes may also reflect altered parental decisions about seeking care.

The accuracy of nurse-led triage of adult patients in the emergency centre of urban private hospitals.

Background: Triage is applied in emergency centres (ECs) to assign degrees of urgency to illnesses or injuries to decide in which order to treat patients, especially when there are many patients or casualties, facilitating the allocation of scarce medical resources. A triage nurse determines triage priority by assessing patients using an established triage tool with specific criteria. The South African Triage Scale is widely used in South African ECs. Although the South African Triage Scale has been adopted and implemented in both private and public healthcare ECs in South Africa, few studies have assessed the accuracy of nurse-led triage in private ECs.Aim: To determine the accuracy of nurse-led triage in ECs in urban, private hospitals.Methods: A quantitative, descriptive, retrospective study was done. Three private hospitals with similar average patient volumes were purposively selected. We sampled the nursing notes as follows: 1) we stratified nursing notes by nurse qualification and then 2) for each category of nurse we stratified nursing notes according to triage priority level and 3) then systematically randomly selected the recommended number of notes from each triage priority level for each nurse category. We retrospectively audited 389 EC nursing notes to determine the accuracy of nurse-led triage. For each note, we independently applied the South African Triage Scale, and then determined agreement between our score and the score determined by the triage nurse.Results: We recorded 342 triage errors, consisting of triage early warning scores (TEWS) errors (n = 168), discriminator errors (n = 97) and additional investigation errors (n = 77). Overall agreement between the triage nurses and our scores was 71.7% (n = 279). Triage errors (n = 110) consisted of 3.9% (n = 15) over-triage errors and 24.4% (n = 95) under-triage errors. The highest level of agreement was between our scores and the scores of the emergency trained registered nurses (85%) and enrolled nursing assistants (78%).Conclusion: In South African ECs, the South African Triage Scale is not always correctly applied, which can lead to almost a quarter (24.4%) of cases being under-triaged and not receiving timeous care. Our results suggest that emergency trained registered nurses are well equipped to be triage nurses, and that this skill should be developed in South African nursing curricula.