1,721,270 research outputs found
Poesie cromatico-materiche di Pietro G. Pantaleo
No full textPresentazione critica a corredo della mostra personale di Pietro G. Pantaleo ( Latiano, Palazzo Imperiali, 5-15 ottobre 2008). La produzione artistica contemporanea dell'artista Pietro G. Pantaleo ( Palese , 1956
NEW FRONTIERS OF TRIAGE: EXPERIMENTATION OF THE “FAST-TRACK” PATHS. ANALYSIS OF ORGANIZATIONAL OUTCOMES, COSTS AND PROCESSES
No full textBackground: about 53,300 patients are visited per
year at the First Aid service of St. Paul’s Hospital,
Milan. The major activity (85%) occurs from 7 a.m. to
9 p.m., encompassing the activities and prolonging
the Wait Times before the call. In order to shorten
Wait Times we realized that fast nursing paths called
“fast-tracks” should be established as implemented in
Tuscany and Emilia Romagna.
Aim: to measure the impact on efficiency of the fasttrack
system in the treatment of patients with ophthalmologic,
dermatological and ear, nose and throat
health disorders.
Methods: comparison of the activity from 8 a.m. to 4
p.m. in the First Aid service of St. Paul hospital, Milan,
in the periods September 2010/2011 (fast-tracks activated)
and September 2009/2010.
Exclusion criteria: patients with major health issues
(color code yellow and red) or with preferential
access (obstetrics, pediatric, orthopedic and trauma).
Data obtained from the SW “first-aid”, and analysed
with SW-free OPENEPI. We used the Student’s t-test
for independent samples, significance level set at 0.05.
Results: analysis per code of access did not register an
increasing number of admissions according to color
codes, except for patients with white codes (from 214
to 614), and green codes (from 5.606 to 6.508) in the
period observed, while yellow and red codes did not
vary significantly.
Analysis per length of Wait Times: the introduction of
the fast-track system, demonstrated on the whole, a
reduction of Wait Times. This decrease was statistically
significant (200 minutes) for the white codes, despite
the increased number of admissions (p <0.001),
and for the green codes (55 minutes) (p <0.001). Wait
Time was thus reduced by19 minutes for the yellow
codes and 4 minutes for the red ones (p= 0.99).Cost Analysis of white codes (paying a ticket): with
patients paying a 25 ticket, the mean cost estimated
is 11.65 per patient visited in the First Aid service,
with the hospital earning about 13.25 per patient.
Shorter Wait Times for patients given white codes
reduced the number of people leaving the hospital
(2,663 vs. 4,043). We estimated net proceeds of
3,174 only during the month of June 2011.
Conclusions: the activation of the fast track system
has significantly reduced Wait Times for the less severe
patients. Further investigations are needed to assess
the economic impact in the mid/long-terms.
References
• Anchisi R, Benci L, Benci A et al. NurseTriage. Milan: Mc
Graw- Hill; 2000
• Raimondi M. Triage. In Raimondi M. Prehospital Trauma
Care. Arianna Editrice; 2003: 141-50
• Di Pietro G, De Blasio E, Diani A, et al. Prehospital Triage
at the poly-emergency and maxi-emergency areas.
Prehospital Trauma Care Basic Framework. Prehospital
Trauma Approach and Treatment following the Italian
Resuscitation Council guidelines. Milan: Italian
Resuscitation Council;2003: 81-3
• Benci L. Professional practice in specific operating situations.
In Benci L. Juridical Aspects of the Nursing profession.
Elements of healthcare legislation. 4th ed. Milan Mc
Graw-Hill; 2005: 96-103GFT-Group Triage Training.
Nursing Triage. McGraw-Hill Italy, Milan 2005
Vitamin D supplementation in fractured patient: how, when and why
Full text linkVitamin D, through its action on calcium metabolism, is essential for bone physiology. It’s also required in a wide range of biological systems to act modulating the proliferation and inducing terminal differentiation of a variety of normal cells. Actually vitamin
D deficiency can impact muscle function and increases fall risk in elderly, while severe vitamin D deficiency (< 30 nmol/L) is common in patients with fragility fractures. Vitamin D and calcium supplementation, in addition to antiosteoporosis treatment after surgery or conservative treatment, can ensure optimal recovery and survival, especially in hip fractured patient
A Parallel Implementation of a Spectral Multi-Domain Solver for Incompressible Navier-Stokes Equations
No full textUn piano per Firenze. Conversazione con Gianfranco Di Pietro, Pietro Giorgieri e Angelo Sampieri
No full text
Urban planning vs. Agricultural production: A study on the Po Valley
Full text linkAt a time when wars and pandemics have disrupted the world order and deeply damaged
international agreements, more people are talking about the energy and food independence of the
nation-states. It is clear that the achievement of these objectives will not be rapid, but it is also
clear that land use must take account of these important aspects. The over-dimensioning of the
settled areas presents illogically in almost all municipal urban planning plans regardless of their
geographical location, demographic dynamics, and values of the administered territory; it certainly
constitutes an obstacle to effective land use. The work presented here aims to analyze the effects on
agricultural production of the transformations envisaged by the plans of the provinces of Modena
and Reggio nell’Emilia, while also providing solutions that could promote the sustainability of the
interventions planned in these areas of high agri-food value
Neuropsychiatric disorders in hip fracture patients
No full textHip fractures in elderly patients are a major health problem in the industrialised world. Italy records more than 85,000 hip fractures/year; 77% of these occur in women, 79% of whom are aged over 75 years (data from Italian Health Ministry discharge records for 2005).Hip fractures generate 30% of overall hospitalisation costs. It is calculated that, in the over-65s alone, the annual cost of fractures exceeds 1 billion euros.The incidence of this disease is increasing constantly, and it is predicted that by 2030 there will be around 750,000 new cases in Europe each year (data from Italian Health Ministry discharge records for 2006).This is an extremely interesting phenomenon, not only from the economic and organisational perspectives, but also as regards the profile of healthcare required, given that hip fractures are often associated with a worsening of quality of life and increased mortality.Elderly fracture patients generally have comorbidities that need to be assessed before and after surgery. Recommendations for the care of these patients include: early surgical intervention, use of prophylactic antibiotics and thromboembolic prophylaxis, good control of perioperative pain to improve ambulation, prevention of malnutrition, urinary tract management, osteoporosis management and the promotion of early mobilisation to improve functional recovery; it is also necessary to detect and manage delirium and other cognitive disorders in order to reduce the risk of complications and of institutionalisation.Neuropsychiatric disorders such as dementia and delirium increase the mortality of these patients in the six months following hip fracture, while depression can have a negative effect on functional outcome and survival in the longer term. Delirium in hip fracture patients seems to be different from that observed in other types of patient, showing a different clinical course.Delirium is a frequent post-operative complication in elderly patients treated for hip fracture. Several fundamental factors have been identified in the genesis of this comorbidity. The use of psychotropic drugs in the preoperative period seems to significantly increase the risk of developing postoperative delirium.Hyperactive delirium, characterised by increased pyschomotor activity, agitation and behavioural disturbances, is the delirium subtype most often encountered in patients with proximal femur fractures.In short, cognitive and mood disorders in elderly hip fracture patients are associated with an increased risk of poor functional outcome and of reduced survival. Therefore, identification and treatment of these conditions is central to a correct therapeutic approach to the fragile elderly patient with hip fractur
Land Use Changes and Ecosystem Services: The Case Study of the Abruzzo Region Coastal Strip
Full text linkConsistent and optimized territorial planning, imply the use of numerous variables aimed at improving life quality and reduction of environmental impacts. The resilience of the territory to climate change threats is strongly linked to its progressive transformation. This fact is extremely evident in coastal systems, which are intrinsically fragile systems due to their high environmental value and strong anthropogenic pressure. The existing tools and techniques provide to outline future transformation effects through the scenarios analysis. This work has the objective to evaluate the effects of land use changes in the territory of the Abruzzo coast. The conversion from natural soils to artificial uses has a significant impact on several ecosystem services. The regulation services considered in this work are flood regulation, carbon storage and sequestration, and habitat for biodiversity. The first is directly connected to soil sealing which determines a reduction of water infiltration with the consequent overloading of the existing sewerage systems. The quantitative evaluation is made using the concept of surface runoff coefficient. Instead, the estimation of the last two ecosystem services has been made using InVEST (Integrated Valuation of Ecosystem Services and Tradeoffs) models, specifically the Carbon Storage and Sequestration model and the Habitat Quality model. The results show that Land Use Changes (2012–2018) caused a potential increase of 10% in runoff and an annual Carbon Sequestration loss estimated at about € 820,000
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