There you will have to solve the puzzle with the plates in order to get the reward. There is a piggy bank in the left corner of the room itself, catch it. Enemies may be waiting for you at the turn, deal with them. The next box will be there.įrom the dead end, exit again to the right and go into the next passage. Walk right along the corridor and at the first turn turn right again. You will find a chest in the upper right corner of the room right behind the tables. The treasure will be waiting for you to the right of the teleporter. You can already find 10 treasure chests in this location. The chest will be waiting for you in the middle of the arc platform. To get the last treasure in this zone, turn around to the east and go to the circular platform, along the way you will encounter a monster. The chest will be waiting for you on the right side on the central round platform. When the corridor turns left, you will see a treasure chest.Īfter that, teleport to the Atrium on the first floor. Next, you need to go east along the corridor around the perimeter of the floor. The treasure will be right on the right side of the door. In the next room on the right, you will have to attack Piggy Bank. Now it will be necessary to go along the corridor in a southerly direction. You can also learn more about the solution from the guide on triple authentication. To get to the treasure, you will need to solve a puzzle with colorful bridges, defeating several enemies along the way. Go back to the Outer Control Room and go into the easternmost room. There, you need to activate plates of Unearthly material to get to the chest. Deal with the enemies waiting there to gain access to the reward. Go through the open door into the next room. A monster will be waiting for you in front of the door. Teleport to the Outer Control Room on the ground floor. To overcome the abyss behind which the treasure is located, it is necessary to solve the riddle again. To get the last chest on the second floor, turn 180 degrees. On the right side of the platform, a monster will be waiting for you, which you need to defeat in order to get to the chest. There, at the bottom of the circle, you will see the following container. There, near the wall you will find a chest. Turn right and go to the very end of the corridor. To get through the second gap, you need to solve the riddle. Immediately to the left you will find treasures.įurther along the bridge, go north. Go back to the fast travel point and exit the safe zone in a northwest direction this time. A chest will be waiting for you on the right side of it. From the teleporter, go into the room in the southeast direction. Head to the Special Purpose Laboratory on the second floor. 10 of them will be marked on the interactive map this time. On the left side of the room you can find the last treasure chest. He is quite strong, so after defeating him, you will receive not an ordinary chest, but a deluxe chest. There you will first see the enemy in the very center. Clear the passage and enter the new room. How to open the door located further in the passage and get the chest and other rewards, we told in separate guide.īefore entering the room where the last chests will be waiting for you, you will encounter several monsters. The chest will be waiting for you on the right side, very close to the entrance. If you still have it closed, then you need to start Arlan's mission “Road of Rebirth”. To find these jewels, you will need to go to the right northern corridor. Right in the center you will find the next treasure. Go further down the corridor and enter the room. If suddenly you could not defeat Pig, and she ran away, then just exit and enter the game again, the creature will be in place again. To get a reward, you need to attack her and deal with three opponents. Behind one of the turns you will see the Piggy Bank of Space. Teleport back to the Reception Center and go to the left northern corridor. On the left side of the elevator next to the greenhouse you will find the next chest. There, next to the plants, you will see a new chest of jewels. Return to the first floor and go under the right stairs. Treasures will be waiting for you on the right side of the room closer to the far corner. There you will be able to enter the room located on the western side of the zone. Next, go up the nearby stairs to the second floor. There will be a chest on the other side of it. After that, turn south and go around the wall directly in front of you. Use the teleport located in the Reception Center. Please note that only 8 of them are listed on the interactive map. There are a total of 10 chests you can find in this location. How to unlock the Real Player achievement.
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It is suggested that the visits by FVs may be unnecessary improving patient education and developing safety netting pathways might help to reduce these visits. In addition, visiting a familiar doctor might improve patient satisfaction and patient outcomes. Therefore, preventing repeated visits by FVs or channeling FVs to another healthcare path might also reduce total health care costs. It was found that 31% of the cost of all pediatric ED patients was made by the FVs consisting of only 8% of the patients. In the Netherlands, visiting an ED is 2.5 times as expensive as visiting a pediatrician and almost 8 times as expensive as visiting the GP. Īpart from ED overload, visiting the ED is an expensive form of receiving care. The high number of visits made by FVs may partially contribute to ED crowding. Therefore, a small group of patients accounts for a large number of visits, making them frequent visitors (FV). Of all ED visitors, a subgroup of patients frequently seeks medical attention at the ED. In the Netherlands, the ED visiting rate is reported to be 115 visits per 1000 inhabitants with 1 out of 5 below 18 years old or younger. Patients can either visit the ED at their own initiative (self-referral) by out of hospital emergency services or referred by a previous (emergent) health care contact from either primary or secondary care. The emergency department (ED) is an important location where patients of all ages receive acute medical care. If these data are used for other research questions, users are requested to notify the senior author ( or by contacting PlosOne.įunding: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: A minimum anonymized database to reproduce the analyses is available through the supporting information file 6. Received: JAccepted: DecemPublished: January 27, 2022Ĭopyright: © 2022 Vrijlandt et al. PLoS ONE 17(1):Įditor: Biswadev Mitra, Monash University School of Public Health and Preventive Medicine, AUSTRALIA We identified the presence of a comorbidity (non-complex CD HR 1.66 1.52–1.81 and complex CD HR 2.00 1.84–2.16) as determinants with the highest hazard for a return visit.Ĭitation: Vrijlandt SEW, Nieboer D, Zachariasse JM, Oostenbrink R (2022) Characteristics of pediatric emergency department frequent visitors and their risk of a return visit: A large observational study using electronic health record data. Overall, FVs presented at the ED more often because of an infection (41.3%) compared to non-FVs (27.4%), either associated or not with the body system affected by the CD. At visit-level, frequent visits were more often initiated by self-referral and were more often related to medical problems (compared to trauma’s). At patient-level, FVs were younger and more often suffered from chronic diseases (CDs). Our study population of 10,209 children with 16,397 ED visits contained 500 FVs (4.9%) accounting for 3,481 visits (21.2%). Risk factors for a recurrent ED visit were determined using a Prentice Williams and Peterson gap time cox-based model. Descriptive analysis of the study cohort at patient- and visit-level were performed. Children with 4 or more ED visits within 365 days were classified as FVs. Data of all children aged 0–18 years visiting the ED of a university hospital in the Netherlands between 20 were included in this observational study based on routine data extraction. |
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