ABSTRACT
Air pollution is a serious problem in Romania, with the country ranking 13th among the most polluted countries in Europe in the 2021 World Air Quality Report. Despite the recognized impact of pollutants on health, there has been a lack of large-scale studies conducted in Romania. This study investigated the impact of air pollutants on patients with chronic respiratory, cardiovascular, cerebrovascular, or metabolic diseases in Bucharest and its metropolitan area from 20 August 2018 to 1 June 2022. The daily limit values for particulate matter PM10 and PM2.5 were exceeded every month, especially during the cold season, with a decrease during the COVID-19 pandemic restrictions. A significant statistical correlation was found between the monthly average values of PM2.5 and PM10 and hospitalizations for respiratory and cardiovascular diseases. A 10 µg/m3 increase in monthly average values resulted in a 40–60% increase in admissions for each type of pathology, translating to more than 2000 admissions for each pathology for the study period. This study highlights the urgent need for national and local measures to ensure a cleaner environment and enhance public health in Romania according to international regulations. © 2023 by the authors.
ABSTRACT
Learning Objectives: We sought to develop a research escape-hunt to teach EM residents: 1) predictive statistics and diagnostic test characteristics, 2) interpretation of data and statistical analysis, 3) study design, 4) informed consent for research, and 8) the ethical principles guiding research. Introduction: Research and evidence-based medicine are important parts of residency training and the ACGME identifies scholarly activity as a core requirement for EM. EM training programs take a variety of approaches to addressing these requirements and there is not a standard, widely accepted curriculum available. Curricular Design: We considered ways to incorporate active, participatory learning experiences that effectively engage adult learners. Within the CORD community, escape- hunts have demonstrated efficacy for other EM content. An escape-hunt was developed with each station focused on one topic and requiring participants to solve a series of puzzles. Prior to the event, participants reviewed materials covering the content including summary sheets and podcast links. The escape-hunt served as an opportunity to further explore and reinforce the asynchronous content. Faculty members were present to help guide teams through the stations and to answer questions about the content. Teams worked to solve each station with the first team to successfully complete all nine stations winning a prize. A subsequent COVID-impacted event was held the following year utilizing Zoom breakout rooms, demonstrating that this innovation can be successfully implemented both in-person and virtually. Impact: Participants reported high levels of satisfaction (100% (21/21)) and engagement (95% (20/21)) with the activity, increased comfort with the content (91% (19/21)), and demonstrated improvements in knowledge across content areas (91% (19/21)). Participants reported using skills relevant to clinical practice such as 'working as a team,' 'task switching,' 'task delegation,' 'brainstorming,' and 'solving complex problems together.' Challenges exist related to props cost and the time for development;however, we now have a materials bank that can be used in the future and we have successfully implemented a COVID-safe virtual event, demonstrating the adaptability of this format.