Total Number Of Attendances Research Articles

Primary care medical brigades in the Parish of San Mateo in the province of Esmeraldas: a strategy for corporate social responsibility

Introduction: the medical health care brigades are a strategy to address the health problems of communities from a perspective of social construction, in which people are recognized as subjects of rights and key actors in the process of building with solid foundations through the establishment of strategic alliances with companies committed to corporate social responsibility that allow the strengthening of governance processes to develop a culture of quality that promotes the sustained improvement of the provision of health services. Method: this study has a cross-sectional and descriptive approach, from the registration of a database in Excel with the total number of attendances and anonymized data of the direct beneficiaries of the project. Results: a total of 915 residents of the communities of Tabete, La Victoria, Timbre Commune, Tatica and Cantonal Seat of the San Mateo parish of the city and province of Esmeraldas benefited, achieving a total of 1059 visits in general or family medicine, obstetrics and dentistry, from which the 10 main morbidities of the beneficiaries were obtained, the most prevalent being intestinal parasitosis without other specification with 60 %. atopic dermatitis with 25 % and acute vaginitis with 21 %. Primary essential hypertension, acute rhinopharyngitis, type 2 diabetes mellitus with other specified complications, urinary tract infection of unspecified site, acute tonsillitis and other gastroenteritis and colitis of infectious origin account for less than 10 % each. Conclusions: corporate social responsibility strategies through medical brigades are a mechanism to highlight and reaffirm the concept of improving health care gaps, which allows the participation of the community in health promotion and prevention and minimizes the occurrence of chronic non-communicable and communicable diseases and their sequelae

A multi-faceted intervention to improve screening of erectile dysfunction for men with diabetes mellitus in public health clinics: A pilot study.

Erectile dysfunction (ED) is common in men with diabetes and is associated with coronary artery disease and psychological distress. However, discussion of ED in primary care consultations is uncommon. Interventions, such as audit and feedback, mandate of management, and workshop on men's sexual health, have been proposed to improve ED screening in public health clinics. This study aimed to pilot test a multi-faceted intervention to increase ED screening among men with diabetes and to improve knowledge and confidence in ED screening among primary healthcare providers (PHPs). We conducted an interrupted time-series quasi-experimental study with PHPs at public health clinics in Perak, Malaysia from February 2019 to February 2020. Doctors, nurses, and assistant medical officers involved in diabetes care were recruited. The intervention was conducted between July and September 2019 and comprised two phases: audit and feedback, and mandate from management (phase 1), and an interactive face-to-face workshop (phase 2). The primary outcome measure was monthly ED screening rate, and the data were retrieved from health records and the clinical diabetes registry. The PHPs completed a questionnaire on ED knowledge and confidence in ED screening before and after the workshop. The total number of attendances by patients with diabetes was 50,325 during the study period, of which 21,413 were by men. A total of 30 PHPs participated in the training workshop: 7 (23.3%) doctors, 12 (40%) medical assistants, and 11 (36.7%) nurses. The mean duration of employment at a health clinic was 7 ± 5 years. The majority of the participants were male (56.7%), Malay (80%), married (76.7%), and had no experience with working in a urology department (76.7%). There was a significant improvement in the mean knowledge score (39.0 ± 11.4 vs. 63.6 ± 6.2, p<0.001) and median confidence level in ED screening from 2 (IQR 2-3) to 4 (IQR 4-4) after the workshop (p<0.001). After phase 1, the rate of ED screening increased from a baseline of between 10.3% (February 2019) and 12.7% (June 2019) before intervention to between 15% (July 2019) and 18.9% (September 2019) and was maintained between 18% (October 2019) and 17.9% (December 2019) after phase 2. Subsequently, the ED screening rate declined from 14.6% (January 2020) to 10.9% (February 2020). This study found that audit and feedback with mandate from management increased ED screening and detection rate. The workshop improved the participants' knowledge and confidence in ED screening but did not further increased ED screening. The improved practice was sustained for 6 months after the intervention, while the detection rate of ED persisted. We propose regular audit and feedback with mandate from management to sustain the practice of ED screening in men with diabetes.

Caracterização das ocorrências do serviço de Atendimento Móvel de Urgência – SAMU

Esse artigo buscou caracterizar as ocorrências do Serviço de Atendimento Móvel de Urgência e Emergência por meio da pesquisa quantitativa, realizada com dados arquivados no Sistema de Informação do serviço. A amostragem selecionada correspondeu a quantidade de ocorrências atendidas nos meses de setembro à dezembro de 2019, e de janeiro à abril de 2020. A quantidade total de atendimentos no período de 2020 (6.158) foi bem próxima ao apresentado em 2019 (6.160). A média geral de atendimentos em 2019 e 2020 foi de 1.540 ocorrências. Em 2019 a USA apresentou a média de 258 atendimentos, da USB 1.197 e a motolância 45. A prevalência de atendimentos em 2020 realizados pela USB obteve a média 1.271, a USA 228 e a motolância 40. As ocorrências clínicas foram prevalentes em relação as outras naturezas. Porém, ressalta- se a incidência significativa dos serviços prestados às vítimas de acidente de trânsito, às vítimas de queda e aos pacientes internados que necessitaram de transferência inter-hospitalar.

Alcohol-related attendances in French emergency departments in 2017

Abstract Background France is one of the leading countries in terms of daily alcohol consumption per inhabitant. Alcohol is a major concern for emergency department (ED) since it accounts for a large part of their resources and increases behavior problems resulting in violence against staff. Individual information of French ED attendances registered in OSCOUR network are daily collected by Santé publique France, the French Public Health Agency. This study aims at describing alcohol-related ED attendances (ARA) in 2017 in France. Methods The OSCOUR network included 677 ED in 2017 recording 92% of national attendances. ARA were identified through the main and associated medical diagnoses coded by physicians using ICD10. The study considered acute alcohol intoxication, dependence syndrome/withdrawal state, other mental disorders and intoxications due to alcohol, chronic complications and intentional self-poisoning by alcohol. The number of ARA was analyzed by age group, gender and region. Results 1.4% of total attendances were associated to alcohol consumption (202,184 attendances) in 2017. 68% of ARA were due to acute alcohol intoxication and 14% for dependence syndrome/withdrawal state. The highest proportions of ARA were observed for people aged 40-59 yo and 18-24 yo, particularly for women. Regions of North and West metropolitan France and La Réunion Island had the highest proportion of ARA among the total number of attendances. Conclusions The part of ARA in France is consistent with figures provided in international studies using similar data. This proportion is similar with proportion of major public health issues like influenza, that represented 1% of the total ED attendances from November 2016 to February 2017 and reached 1.8% in January (month of the epidemic peak). Consequences of alcohol use represent a heavy burden for ED and the health system in France. This is all the more true as ARA are underestimated due to the low coding rate of associated medical diagnosis in ED. Key messages 1.4% of total French ED attendances were associated to alcohol consumption in 2017. This proportion is close to the proportion of influenza attendances in ED.

Popular Theatre - Highbrow or Lowbrow

For 13 years, from 1851 to 1864, Ibsen worked full time at the Norwegian theatres in Bergen and Christiania (Oslo) as a stage director and theatre manager. Ibsen’s period in the theatre and the repertory he staged have seldom enjoyed much attention in schol­arly research. The reason for this has been that the repertory Ibsen staged has been seen as vulgar and lowbrow, and Ibsen’s period in the theatre has almost unani­mously been seen as a waste of time. The general understanding has been that Ibsen’s development as an artist had been much faster if he had been working with a highbrow repertory of serious drama.Contrary to this established opinion I will contribute to the discussion of popular theatre as highbrow or lowbrow by presenting the production A Caprice (En Kaprice) by Erik Bøgh, staged by Henrik Ibsen at the Norwegian Theatre in Christiania (Oslo). It premi­ered 7 September 1859 and then ran for another thirty-five performances during the 1859-60 season. The total number of attendances was more than 30.000. In relation to the population of the town of 42.000, it was about 2/3 or 67%. This is the by far largest box-office success in Norwegian theatre history. No wonder that Ibsen scholars gener­ally have understood A Caprice as the ultimate example of the unholy trade Ibsen was forced into as a theatre manager. According to Michael Meyer Ibsen for the only time in his life “rebuked for truckling to the box-office” (Meyer 1971, 166). The contemporary criticism in Morgenbladet (Nr. 278, 9.10.1859) claimed that Ibsen was declining the Norwe­gian Theatre in Christiania into a kind of amusement ground for the lower classes.I will, however, present A Caprice as the summit of Ibsen’s theatrical career and under­line that both this and other dance productions staged by Ibsen in this period, were not at all amusement for the lower classes but on the contrary important expressions of his artistic creativity and development – and actually a highbrow performance presented for an upper class audience.

The impact of the Lisbon Football Derby on the profile of emergency department admissions.

Variations in emergency department admissions have been reported to happen as a result of major sports events. The work presented assessed changes in volume and urgency level of visits to a major Emergency Department in Lisbon during and after the city's football derby. Volume of attendances and patient urgency level, according to the Manchester Triage System, were retrospectively analyzed for the 2008-2011 period. Data regarding 24-hour periods starting 45 minutes before kick-off was collected, along with data from similar periods on the corresponding weekdays in the previous years, to be used as controls. Data samples were organized according to time frame (during and after the match), urgency level, and paired accordingly. A total of 14 relevant periods (7 match and 7 non-match) were analyzed, corresponding to a total of 5861 admissions. During the match time frame, a 20.6% reduction (p = 0.06) in the total number of attendances was found when compared to non-match days. MTS urgency level sub-analysis only showed a statistically significant reduction (26.5%; p = 0.05) in less urgent admissions (triage levels green-blue). Compared to controls, post-match time frames showed a global increase in admissions (5.6%; p = 0.45), significant only when considering less urgent ones (18.9%; p = 0.05). A decrease in the total number of emergency department attendances occurred during the matches, followed by a subsequent increase in the following hours. These variations only reached significance among visits triaged green-blue. During major sports events an overall decrease in emergency department admissions seems to take place, especially due to a drop in visits associated with less severe conditions.

PB7 Does more mean less? The impact of increased consultant numbers on ED admission rates

Objectives and BackgroundThe College of Emergency Medicine has recommended an expansion of the consultant workforce; this is intended to improve patient care, patient safety, cost efficiency and further the development...

Rapid access cardiology--a nine year review

Rapid access cardiology clinics provide a rapid assessment and evaluation of patients with suspected chest pain, heart failure or cardiac arrhythmia. Longitudinal data regarding the attendances and clinical diagnoses at rapid access clinics is lacking and may provide insight into their efficiency and role in providing a comprehensive referral service for primary care. Data regarding total number of attendances and diagnoses were retrospectively analysed from databases collated by nurse specialists and physicians undertaking rapid access clinics at Charing Cross Hospital between April 2002 and March 2011. A total of 12 000 patients were seen over the 9-year time period. Demand for Rapid Access Chest Pain Clinic and Rapid Access Arrhythmia Clinic has shown a steady rise since 2007 whereas attendances at Rapid Access Heart Failure Clinic have remained constant. The proportion of patients diagnosed with significant cardiac disease across all rapid access clinics has not changed significantly. The most commonly diagnosed arrhythmia was atrial fibrillation (15% of all attendances). Referrals have increased to our service which suggests that demand for a rapid access cardiology service remains high and the proportion of patients diagnosed with significant cardiac disease has remained constant. Despite considerable motivation towards providing primary based care this has not occurred in our local area and we believe this shows that our model, based in secondary care to be both efficient and accessible to local GPs and patients.

Case management of patients who frequently present to a Scottish emergency department

Aims:To assess whether case management of frequent attenders to the emergency department (ED) reduces subsequent attendances made by these patients.Methods:Patients who attended the ED 10 times or more over a...

Interpreter Services in An Inner City Teaching Hospital: A 6-Year Experience

Being able to communicate effectively with patients is essential not only from a medicolegal standpoint but more importantly from clinical governance perspectives. Issues such as informed consent and patient choice within the NHS are currently being highlighted; for these to be available to patients, their language requirements are paramount. An audit was performed by the Linkworkers office at the Central Manchester & Manchester Children's Hospital NHS (CMMC) Trust on the total number of attendances and refusals per language in the period 1998-2003. In the CMMC Trust, Urdu/Punjabi, Bengali, Cantonese, Somali, Arabic and French represent the majority of the workload, comprising almost 80% of cases in 2003. In the same year, an increase in demand for languages of Eastern European countries became evident. Finding interpreters for these languages even via agencies can be extremely difficult. If the current trend continues, requirement for these services will increase exponentially. For this demand to be met adequately these issues must be kept at the forefront of NHS planning.

Reducing utilisation of hospital services by case management: a randomised controlled trial

A 12-month randomised controlled trial was conducted in Hong Kong to evaluate the effectiveness of case management provided to a group of home-dwelling, frail elderly patients (control group: n = 47; intervention group: n = 45) in terms of utilisation of hospital services by these patients. Significant reductions (significance at P </= 0.05) in mean total number of hospital bed-days (P < 0.001), mean total episodes of hospital admissions (P < 0.001), and mean total number of attendances at the outpatient department (P < 0.05) were observed when the baseline and post-intervention differences between the intervention and control groups were compared. The study demonstrated that utilisation of hospital services could be significantly reduced when a group of elderly patients and their caregivers received timely interventions and appropriate services through case management services.

Association of severe asthma attacks with weather, pollen, and air pollutants.

The association between exacerbations of asthma and weather or air pollution is not well understood. The relationships between visits to the emergency room for asthma attacks and the meteorological, aerobiological, and chemical characteristics of the outdoor air have been evaluated. The number of daily attendances for asthma attacks at the emergency room of Oulu University Central Hospital was recorded over one year together with daily meteorological readings (temperature, humidity, barometric pressure, rainfall), levels of air pollutants (nitrogen dioxide (NO2), sulphur dioxide (SO2), hydrogen sulphide (H2S), total suspended particles (TSP)), and pollen counts (birch, alder, pine, willow, total pollen). The relationship between the number of attendances and the measured variables was then analysed by multiple regression and stepwise discriminant analysis. The total number of attendances during the year was 232, with lower figures in summer and higher in winter. No association was found between visits for asthma attacks and airborne pollen levels or meteorological factors except for temperature, which had a low inverse correlation with attendance. The most significant correlations were found between asthma visits and the levels of NO2; those for SO2, TSP, and H2S were also significant. Intercorrelations between SO2 and temperature or NO2 and between temperature and TSP or NO2 were also found, but only NO2 correlated significantly with attendances after standardisation for temperature. Increased levels of pollutants, especially NO2, were associated with attacks of asthma, but the explanation for this is unclear. Air pollen levels were not associated with asthma attacks and only temperature among the meteorological factors had a small association with asthma.