scholarly journals Multi-criteria analysis in the health area: selection of the most appropriate triage system for the emergency care units in natal

Author(s):  
Deyse Gillyane Gomes Camilo ◽  
Ricardo Pires de Souza ◽  
Talita Dias Chagas Frazão ◽  
João Florêncio da Costa Junior
2006 ◽  
Vol 23 (12) ◽  
pp. 906-910 ◽  
Author(s):  
J Roukema ◽  
E W Steyerberg ◽  
A van Meurs ◽  
M Ruige ◽  
J van der Lei ◽  
...  

2006 ◽  
Vol 41 (3) ◽  
pp. 283-295 ◽  
Author(s):  
Renaud Quilbé ◽  
Alain N. Rousseau ◽  
Pierre Lafrance ◽  
Jacinthe Leclerc ◽  
Mohamed Amrani

Abstract Numerous models have been developed over the last decades to simulate the fate of pesticides at the watershed scale. Based on a literature review, we inventoried thirty-six models categorized as management, research, screening or multimedia models, each of them having specific strengths and weaknesses. Given this large number of models, it may be difficult for potential users (stakeholders or scientists) to find the most suited one with respect to their needs. To help in this process, this paper proposes a pragmatic approach based on a multi-criteria analysis. Selection criteria are defined following the user's needs and classified in five classes: modelling characteristics, output variables, model applicability, possibilities to simulate best management practices (BMPs) and ease of use. The relative importance of each criterion is quantified by a weight and the total score of a model is calculated by adding the resulting weights of satisfied criteria. This selection framework is illustrated with a case study that consists in selecting a model to develop water quality standards at the watershed scale with respect to the implementation of BMPs. This resulted in the selection of three models: BASINS, SWAT and GIBSI.


1997 ◽  
Vol 41 (2) ◽  
pp. 260-265 ◽  
Author(s):  
P. SUOMINEN ◽  
R. KORPELA ◽  
M. KUISMA ◽  
T. SILFVAST ◽  
K. T. OLKKOLA

2019 ◽  
Vol 41 (1) ◽  
pp. 40606 ◽  
Author(s):  
Lillian Maria Baggio ◽  
Luciano Aparecido Panagio ◽  
Fabiana Guillen Moreira Gasparin ◽  
Daniele Sartori ◽  
Maria Antonia Pedrine Colabone Celligoi ◽  
...  

Cardiovascular diseases associated with thrombosis are one of the main causes of death all around the world. Urokinase, streptokinase, and tissue plasminogen activator are the major thrombolytic agents used to treat thrombosis. However, the fact that these agents have several side effects and high prices has driven the search for safer and more economically viable compounds for the treatment of cardiovascular diseases. Thus, the aim of this study was to evaluate the potential of fungi isolated from industrial effluents to produce fibrino(geno)lytic enzymes. The selection of the protease-producing strains showed that only the BF20 strain was able to produce proteolytic halos in milk agar. This strain identified as belonging to the genus Penicillium was cultivated in submerged fermentation. Different media composition were tested to evaluate proteolytic activity, and the results showed that the medium containing 0.1% yeast extract and 1% skim milk, pH 5.0, present higher azocaseinolytic activity (0.24 U mL-1 min.-1). This sample also showed the ability to degrade fibrinogen and fibrin after 15 and 120 min. of incubation, respectively. These results indicate that the BF20 strain has a thrombolytic potential, effectively degrading fibrinogen and fibrin, having great application in the health area.


Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 101
Author(s):  
Anne Craveiro Brøchner ◽  
Lars Grassmé Binderup ◽  
Caroline Schaffalitzky de Muckadell ◽  
Søren Mikkelsen

The “morning morality effect”—the alleged phenomenon that people are more likely to act in unethical ways in the afternoon when they are tired and have less self-control than in the morning—may well be expected to influence prehospital anaesthesiologist manning mobile emergency care units (MECUs). The working conditions of these units routinely entail fatigue, hunger, sleep deprivation and other physical or emotional conditions that might make prehospital units predisposed to exhibit the “morning morality effect”. We investigated whether this is in fact the case by looking at the distribution of patient transports to hospital with and without physician escort late at night at the end of the shift as a surrogate marker for changing thresholds in ethical behaviour. All missions over a period of 11 years in the MECU in Odense were reviewed. Physician-escorted transports to hospital were compared with non-physician-escorted transports during daytime, evening, and night-time (which correlates with time on the 24 h shifts). In total, 26,883 patients were transported to hospital following treatment by the MECU. Of these, 27.4% (26.9%–27.9%) were escorted to the hospital. The ratio of patient transports to hospital with and without physician escort during the three periods of the day did not differ (p = 1.00). We found no evidence of changes in admission patterns over the day. Thus, no evidence of the expected “morning morality effect” could be found in a prehospital physician-manned emergency care unit.


2019 ◽  
Vol 72 (suppl 1) ◽  
pp. 143-150
Author(s):  
Patrícia Madalena Vieira Hermida ◽  
Eliane Regina Pereira do Nascimento ◽  
Maria Elena Echevarría-Guanilo ◽  
Selma Regina de Andrade ◽  
Ângela Maria Blatt Ortiga

ABSTRACT Objective: To describe the facilities and difficulties of the counter-referral of an Emergency Care Unit in Santa Catarina State. Method: Descriptive, qualitative study, with the participation of three nurses and 17 physicians. The data were collected through a semi-structured interview and analyzed using the Discourse of the Collective Subject technique. For the theoretical basis, the Política Nacional de Atenção às Urgências (National Policy of Emergency Care) and the Rede de Atenção às Urgências (Network of Care to the Emergencies) was used. Results: The facilities of the counter-referral correspond to the strategies of communication with the Primary Care: embracement; good interpersonal relationships; and electronic medical record network. The difficulties are related to the deficiencies of Primary Care and specialized services, such as the insufficient number of physicians and the delay in scheduling consultations and more complex exams. Final considerations: The difficulties highlighted indicate significant challenges of the local health system in the search for integration between emergency care points.


2018 ◽  
Vol 71 (suppl 2) ◽  
pp. 811-817 ◽  
Author(s):  
Giovana Aparecida de Souza Scolari ◽  
Leidyani Karina Rissardo ◽  
Vanessa Denardi Antoniassi Baldissera ◽  
Lígia Carreira

ABSTRACT Objective: to understand the conception of the elderly and their caregivers about the accessibility to health mediated by the service in Emergency Care Units. Methodo: a qualitative study conducted with 25 elderly patients and caregivers at Emergency Care Units in a city of Paraná, using Grounded Theory as a methodological reference. Results: According to the participants, the resources available in these services guarantee medical consultation and provide access to exams and medicines. Such resources have attracted patients and caused excess demand, which implies a set of compromising factors for the quality of care in these services. Final considerations: Investments in the restructuring of the care network, especially in primary care, with an increase in the number of consultations and the creation of a bond, can contribute to the emergency care units achieving the goal of access to qualified assistance to the elderly population.


2016 ◽  
Vol 35 (2) ◽  
pp. 118-131 ◽  
Author(s):  
Mónica Veloza-Gómez ◽  
Lucy Muñoz de Rodríguez ◽  
Claudia Guevara-Armenta ◽  
Sandra Mesa-Rodríguez

Purpose: Explore what spiritual care means to nurses who work in emergency care units. Design and Method: Nine nursing professionals from an emergency care unit at a private health institution affiliated with the Universidad de La Sabana participated in this descriptive qualitative study. Nonparticipant observation, field notes, and in-depth interviews with a question guide were used to collect the data, which were analyzed by means of content analysis. Results: Three themes and their corresponding subthemes were identified with respect to the significance of spiritual care: (1) interpretation of spiritual care, (2) the patient and the family in spiritual care, and (3) the role of the nurse in spiritual care. Conclusions: These findings provide a deeper understanding of spiritual care in terms of its significance. They also acknowledge its importance to nursing practice in emergency care units. The significance of spiritual care is based on theoretical, scientific, and humanistic points of reference (the discipline of nursing) that strengthen the therapeutic relationship between the patient/family–nurse dyad. The study also offers evidence for holistic nursing practice that requires theoretical-academic, administrative, and assistance support.


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