1,721,016 research outputs found
Heatwaves And Emergency Departments in Italy (HEAT-ED IT) : strategies to identify determinants of overload and mitigate impact
Full text linkDue to global warming and climate change, periods of unusual heat called heatwaves are increasing in frequency and intensity, pose an important risk for population health and are associated with an increased demand for emergency care. This overload on prehospital emergency medicine (PHEM) and emergency departments (EDs) during heatwaves has been retrospectively confirmed, but evidence on how to mitigate this effect still needs to be provided. This PhD project aimed at finding the factors causing PHEM and ED overload during heatwaves using qualitative methods. First, an online Delphi study included 15 experts in emergency medicine, disaster medicine, or public health. Thirty-one statements were obtained after content analysis. The experts agreed on 18 statements, mostly focusing on the input section of patient processing and identifying stakeholders, the population, and primary care as targets of potential interventions. Since the re-sults of the Delphi study mainly dealt with the ED, a multicentric study using semi-structured interviews was performed to shed light on PHEM systems. Thirteen PHEM doctors and nurses working in Veneto region, Northern Italy, were interviewed. After content analysis, their perspectives were categorized in: perception of heatwaves; clinical impact of heatwaves; social factors and heatwaves; heatwaves and emergency medical service (EMS). According to the interviewees, the strain on EMS during heatwaves may be partially reduced by interventions targeting vulnerable populations, primary care, social networks, and education and information. Specific actions could fol-low the surge science principles of staff, stuff, structure, and system to help policymakers improve EMS surge capacity planning, preparedness, and response against heatwaves. Overall, these findings could be used in the future to implement heat-health action plans and reduce emergency care dysfunction during heatwaves
Chest ultrasound integrated teaching of respiratory system physiology to medical students. A first experience.
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Intravascular access routes while wearing personal protective equipment: are we close to the bone or not?
Full text linkUltrasound-based lectures on cardiovascular physiology and reflexes for medical students.
Full text link Ultrasound has become a widely used diagnostic technique. While its role in patient evaluation is well known, its utility during preclinical courses such as anatomy and physiology is becoming increasingly recognized. The aim of the present study was to assess the feasibility/utility of integrating ultrasound-based sessions into conventional undergraduate medical school programs of physiology of the cardiovascular system and cardiovascular reflexes and to evaluate student perceptions of an ultrasound-based didactic session. Second-year medical students enrolled in the University of Padova attended a didactic session during which basic concepts regarding ultrasound instrumentation, image production, and spatial orientation were presented. Five anatomic sectors (the heart, aorta, neck vessels, inferior vena cava, and femoral veins) were then examined on a volunteer. Student perceptions of the images that were projected, the usefulness of the presentation, and the reproducibility of the experience were assessed at the end of the lecture with an anonymous questionnaire consisting of positive and negative items that were rated using a 5-point Likert scale and with two questions. One hundred eleven students attended the lecture; 99% of them found it very interesting, and none considered it boring or a waste of time. More than 96% thought it helped them to gain a better comprehension of the subject and would recommend it to a colleague. In conclusion, as ultrasound has been found to be a valuable resource for the teaching of physiology of the cardiovascular system and cardiovascular reflexes, efforts should be made to integrate ultrasound sessions into the traditional human physiology curriculum. </jats:p
Role of health simulation centres in the COVID-19 pandemic response in Italy: a national study
Full text linkINTRODUCTION: The COVID-19 pandemic has dramatically affected the Italian health systems and drastically impacted healthcare workers’ daily routine and training. Simulation is an efficient tool to provide medical education, especially in the case of incoming public health emergencies. This study investigated the role and activities of Italian simulation centres (SCs) during the acute phase of the COVID-19 pandemic. METHODS: The population was identified through a web search. The directors of Italian SCs were contacted via email and then enrolled. A structured interview was created, internally validated and administrated by phone to participants. RESULTS: Following the government’s ordinance, 37 (88.37%) SCs had to be closed to the public. Twenty (46.51%) SCs organised in situ simulation while 7 (16.28%) of them organised simulation inside the centre. Twenty-three (53.49%) SCs resorted to telematic modalities to provide training about COVID-19 and 21 (48.84%) of them for other training. Up to date, 13 SCs are still closed to the public. CONCLUSIONS: Italy has been severely hit by COVID-19, with differences between the regions. Almost all the SCs were closed, with only a few delivering training. The SCs took advantage of emergent technologies to create new ways to train people safely. Unfortunately, nearly one-fourth of Italian SCs have not reopened yet. The evolution of the COVID-19 epidemic calls for reconsideration about training activities including adequate safety measures implemented for all individuals involved
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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