Comparison of drug prescribing before and during the COVID-19 pandemic: A cross-national European study.

PURPOSE: The COVID-19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe. METHODS: We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID-19 pandemic with the preceding 3 years. RESULTS: In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID-19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID-19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from -39.4% in Romagna to -14.2% in Scotland) and nasal preparations (from -34.4% in Lithuania to -5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia. CONCLUSIONS: The findings from this first European cross-national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas.

Utilization of Crushed Pavement Blocks in Concrete: Assessment of Functional Properties and Environmental Impacts.

Production of concrete is connected to extensive energy demands, greenhouse gases production or primary sources depletion. Reflecting current economical, social, or environmental trends, there is strong pressure on mitigation these requirements and impacts. The exploitation of secondary- or waste materials in production processes has therefore a great potential which is not related solely to binders but also to fillers. In this light, this paper aims at thorough investigations of concrete mixtures with crushed concrete pavements as partial or full replacement of natural coarse aggregates. The research combines experimental techniques to quantify the influence of the substitution on basic physical, mechanical, and heat/moisture transport/storage parameters. The experimental data obtained are further exploited as input data for computational prediction of coupled heat and moisture transport to assess the influence of the aggregates substitution on hygrothermal performance of the built-in concretes. In the last step, the environmental impacts are assessed. Since the changes in the hygrothermal performance were found to be insignificant (i), the compressive strength were improved by up to 25% (ii) and most of the environmental impact indicators were decreased (iii) at the same time, the findings of the research presented predeterminate such a reuse strategy to wider application and use.

Functional Properties of SAP-Based Humidity Control Plasters.

The application of materials with high moisture storage capacity close to the interior surface presents a prospective passive method for improving indoor relative humidity conditions. In this paper, lime-cement plasters containing three different types of superabsorbent polymers (SAPs) in varying dosages are introduced and their mechanical, hygric, and thermal characteristics are analyzed in a relation to microstructure. The experimental results show a significant effect of both SAP amount and chemical composition on all functional properties of studied plasters. The incorporation of 1.5% of SAP may induce up to 2.5 better moisture buffering, thus significantly improving the passive humidity control capability. Considering overall functional parameters of SAP-modified plasters, the dosage of 1 wt.% can thus be viewed as a rational compromise between the moisture storage capability and mechanical properties. The obtained wide sets of parameters can be utilized directly as input data of computational models suitable for the assessment of the interior microclimate of residential and administrative buildings.

Service life assessment of historical building envelopes constructed using different types of sandstone: a computational analysis based on experimental input data.

Service life assessment of three historical building envelopes constructed using different types of sandstone is presented. At first, experimental measurements of material parameters of sandstones are performed to provide the necessary input data for a subsequent computational analysis. In the second step, the moisture and temperature fields across the studied envelopes are calculated for a representative period of time. The computations are performed using dynamic climatic data as the boundary conditions on the exterior side of building envelope. The climatic data for three characteristic localities are experimentally determined by the Czech Hydrometeorological Institute and contain hourly values of temperature, relative humidity, rainfalls, wind velocity and direction, and sun radiation. Using the measured durability properties of the analyzed sandstones and the calculated numbers of freeze/thaw cycles under different climatic conditions, the service life of the investigated building envelopes is assessed. The obtained results show that the climatic conditions can play a very significant role in the service life assessment of historical buildings, even in the conditions of such a small country as the Czech Republic. In addition, the investigations reveal the importance of the material characteristics of sandstones, in particular the hygric properties, on their service life in a structure.