Emergency medicine : open access最新文献

{"title":"The Training needs of the Manager of Allied Health Professions","authors":"L. Antonelli","doi":"10.4172/2165-7548.1000387","DOIUrl":"https://doi.org/10.4172/2165-7548.1000387","url":null,"abstract":"Background: Since its establishment under Italian law 251/2000, the role of the head of health professions has felt the need to develop and expand managerial skills. Despite the existence of training courses for general managers of health companies, studies on the professional development of the Italian NHS management and management training of NHS managers, attention has not yet focused on technical health professions. A study on the real training needs would allow the design of ad hoc routes, aimed at the professional growth of this role. Objective: The aim of this research is to explore the training needs of the manager of technical health professions, so that the results can be used to design a managerial course for those who seek to or already cover this role. Materials, Methods and Sample: The survey was conducted in the period between March and July 2017 and involved a representative sample of 20 health professionals from the diagnostic technical area (15 managers, 3 organizational positions, 2 coordinators) from Central-Northern Italy. The survey method used was an online questionnaire, made of 70 questions divided into 3 areas: personal data, skills and training-innovation. Before the interview was held, the consultation of a focus group from two hospitals in Rome made it possible to analyze the profile of the manager and how training could contribute to its development. Results: The study shows the need for managerial training in blended mode, or mixed, with frontal lessons and technical-practical lessons, conducted by managers and trainers. The course must take place over several years, in the autumn and spring months, in outdoor and indoor settings. The issues that must be addressed are those related to management and organization, analysis techniques and problem solving, legislative aspects and teamwork. Furthermore, it shows a great interest in participating in courses across multiple areas, disciplines and professions and in meetings between managers from different sectors, such as industrial or healthcare, of national and European realities. Conclusion and Discussion: The research data constitutes a considerable resource for those who want to invest in a management training such that the managers of the technical health professions can become an added value to the system, contributing to the achievement of the objectives of the NHS.","PeriodicalId":90158,"journal":{"name":"Emergency medicine : open access","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79544917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalists at Emergency Department Can Improve the Effectiveness of Pre-hospitalized Patients Care","authors":"Chun-Minn Yang, Tzu-Chieh Weng, Huirong Lin, Chien-Chin Hsu, Kao-chang Lin","doi":"10.4172/2165-7548.1000390","DOIUrl":"https://doi.org/10.4172/2165-7548.1000390","url":null,"abstract":"Introduction: The hospitalists care model (HOS) was performed in the United States (US) since 1996, with good evidence in patients care, saved medical expenses, and improved patient satisfaction. It was applied to Taiwan since 2009 setting at wards with similar efficacy in care quality. The first implementation at emergency department (ED) in a medical center in southern Taiwan was undertaken since 2012 to care all the pre-hospitalized patients at ED.Purpose: To observe weather this pivotal HOS model at ED worked functioning with good outcomes for patients care, shortened waiting time for hospitalization, reduced mortality, and increased patient satisfaction compared to previously.Methods: A pilot approach with eight internal attending physicians as a team (Holistic Care Unit-HCU) at observation room nearby ED to care all patients for hospitalization referred by emergency physicians. Parameters were estimated including waiting time, mortality rate, and patient satisfaction, etc., with a proper statistical analysis used for significance.Results: The waiting time for admission declined 17.3% (p=0.017), overstayed (> 48 hours at ED) declined from 7.83% to 4.91% (p=0.087) before and after HOS setting. The mortality rate decreased 50% with statistically significant (p=0.008) by 24-hour HCU care during pre-hospitalized period. The satisfaction (very satisfied, satisfied) to physician attitude, disease explanation, symptom relief and overall care quality using 5-point Likert scale was 99.1%, 92.8%, 92.0% and 95.3% respectively in total 427 subjects.Conclusion: Our first-shot HOS model at ED improved patients care quality, lessened waiting time and mortality, and increased satisfaction. It is the creative experience at ED as similar outcome in care quality as at wards. Although it was the only one medical center database, it deserved further research to realize the evidence of improvement.","PeriodicalId":90158,"journal":{"name":"Emergency medicine : open access","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78116100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Work-related Injuries and Exposures amongst Paramedics and Emergency Medical Technicians: A Literature Review","authors":"Naif Harthi, Pauline Rachman","doi":"10.4172/2165-7548.1000388","DOIUrl":"https://doi.org/10.4172/2165-7548.1000388","url":null,"abstract":"Objectives: To identify work-related injuries and exposures amongst paramedics and emergency medical technicians, along with their consequences, injury events, and the factors that cause them.Methods: A computerised online literature search for papers published on or after 2013 was conducted on the following databases: AMED, CINAHL, EMBASE, MEDLINE, Delphis, NIHR Journals Library, ProQuest Dissertations & Theses AI all the papers were rated as yielding either moderate or low-quality evidence.Conclusions: Musculoskeletal injuries are a common occupational injury that can lead to work dissatisfaction, lost workdays, limitations following injuries, and the end of a career. They are caused by: body motion, exposure to harmful substances, accidents during ambulance operations, violence, or slips, trips and falls. Contributory factors include: a lack of expectancy, improper reactions to unexpected situations, inadequate concentration, inexperience, poor fitness, rushing, partner problems, the negative actions of other personnel, low salaries, multiple-jobs, long tours, lack of breaks, ambulance design, a lack of reporting, and weather conditions. These should all be considered when developing preventive solutions. The following recommendations were therefore made: identifying risk factors, holding regular meetings between supervisors and ambulance workers, enhancing the safety culture, following recent safety guidelines and policies, increasing safety awareness, developing positive relationships with other personnel, improving ambulances, improving reporting processes, and using reported data as the basis for further research and training.","PeriodicalId":90158,"journal":{"name":"Emergency medicine : open access","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80914882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Headache after Delivery, a Misleading Presentation of Sheehan's Syndrome: A Case Report","authors":"R. Varutti, Fabio Rosa, T. Setti, M. Fracas, Mariateresa Casarotto, Y. Leykin, F. Bassi","doi":"10.4172/2165-7548.1000389","DOIUrl":"https://doi.org/10.4172/2165-7548.1000389","url":null,"abstract":"Post dural puncture is one of the most common causes of postpartum headache. Other causes are benign primary headache disorders (migraine, tension-type headache) and secondary headache disorders such as stroke, ischaemia or pituitary apoplexy and venous sinus thrombosis. Headache in the new mother after delivery, mandates a differential diagnosis because it is not appropriate to focus only on the most common diseases, such as post dural puncture headache. In this report we discuss a case of postpartum headache with delayed cause diagnosis in complicated labour and delivery.","PeriodicalId":90158,"journal":{"name":"Emergency medicine : open access","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82095361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gathering Medicine: Is Pneumococcal Vaccination Useful to Prevent Pneumonia in Elderly Pilgrims to Mecca?","authors":"C. Hamouda, H. Naija","doi":"10.4172/2165-7548.1000391","DOIUrl":"https://doi.org/10.4172/2165-7548.1000391","url":null,"abstract":"Introduction: The Hajj pilgrimage in Mecca is an annual mass gathering event with high risk of infectious diseases.Method: In this short communication we try to check clinical evidence comforting pneumococcal vaccination to prevent pneumonia in elderly pilgrims to Mecca.Results and Discussion: Current medical researches focused on microorganism portage and pathogens responsible of epidemic infectious diseases. In this context, and since the epidemic meningitides declared among Mecca pilgrims in 1987, vaccination procedures were developed. However recommendations for prevention of respiratory tract infection, mostly faired when Influenza H1N1 or Middle East Coronavirus are suspected, are still under health professional expectations.Conclusion: Since many countries published clinical expert reports, we recommend an international clinical survey to provide evidence based practice of pneumococcal vaccination for elderly pilgrims to Mecca.","PeriodicalId":90158,"journal":{"name":"Emergency medicine : open access","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75348214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcriptional Regulation of the Group IIA Secretory Phospholipase A2 Gene by C/EBP<i>δ</i> in Rat liver and its Relationship to Hepatic Gluconeogenesis during Sepsis.","authors":"Rei-Cheng Yang,&nbsp;Chin Hsu,&nbsp;Tzu-Ying Lee,&nbsp;Kung-Kai Kuo,&nbsp;Shou-Mei Wu,&nbsp;Yen-Hsu Chen,&nbsp;Mei-Ling Ho,&nbsp;Xing-Hai Yao,&nbsp;Chia-Hsiung Liu,&nbsp;Maw-Shung Liu","doi":"10.4172/2165-7548.1000151","DOIUrl":"https://doi.org/10.4172/2165-7548.1000151","url":null,"abstract":"<p><strong>Background: </strong>The present study was undertaken to test hypothesis that altered transcription of secretory Phospholipase A2 (sPLA2) gene in rat liver is regulated by CCAAT/enhancer binding protein δ (C/EBPδ), and to assess its relationship to hepatic gluconeogenesis during the progression of sepsis.</p><p><strong>Methods: </strong>Sepsis was induced by Cecal Ligation and Puncture (CLP). Experiments were divided into three groups, control, early sepsis (9 h after CLP), and late sepsis (18 h after CLP).</p><p><strong>Results: </strong>DNA mobility and super shift assays reveal that C/EBP complexes in the liver consisted of at least three isoforms: C/EBPα, C/EBPβ, and C/EBPδ; and various C/EBP isoforms were capable of interacting with each other. Hepatocyte transfection experiments demonstrate that under normal conditions, binding of C/EBPδ to sPLA2 gene enhanced sPLA2 promoter activity and the binding resulted in an increase in hepatic gluconeogenesis. Under pathological conditions such as sepsis, binding of C/EBPδ to sPLA2 promoter increased during early and late phases of sepsis, and the increases in C/EBPδ binding correlated with increases in sPLA2 mRNA abundance and sPLA2 protein levels. Under otherwise the identical experimental conditions, hepatic gluconeogenesis was reduced during early and late phases of sepsis and the sepsis-induced reductions in liver gluconeogenesis were aggravated by binding of C/EBPδ to sPLA2 gene.</p><p><strong>Conclusions: </strong>These results link C/EBPδ binding to altered sPLA2 promoter, and to hepatic gluconeogenesis under normal and pathological conditions. It is suggested that C/EBPδ-sPLA2- hepatic gluconeogenesis may function as a signalling axis affecting glucose homeostasis during the progression of sepsis.</p>","PeriodicalId":90158,"journal":{"name":"Emergency medicine : open access","volume":"3 ","pages":"151"},"PeriodicalIF":0.0,"publicationDate":"2013-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7548.1000151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32513936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}