scholarly journals The Role of the Emergency Department in Protecting the Hospital as a Critical Infrastructure in the Corona Pandemic Strategies and Experiences of a Rural Sole Acute-Care Clinic

2020 ◽  
Author(s):  
Stefan O. Kortuem ◽  
Dirk Becker ◽  
Hans-Juergen Ott ◽  
Hans-Peter Schlaudt
Keyword(s):  
Emergency Department ◽  
Critical Infrastructure ◽  
Early Stage ◽  
Short Term ◽  
Care Clinic ◽  
Appropriate Treatment ◽  
Patient Pathways ◽  
Strategic Element ◽  
First Contact

Background. The Klinikum Hochrhein is responsible as a regional sole provider for the acute and emergency medical treatment of more than 170.000 people. Against the background of the pandemic spread of SARS-CoV-2 with expected high patient inflows and at the same time endangering one's own infrastructure due to intraclinical transmissions, the hospital management defined the maintenance of one's functionality as a priority protection objective in the pandemic. An essential strategic element was a very short-term restructuring of the Emergency Department with the objectives of reducing the number of cases within the clinic, detecting COVID-19 cases as sensitively as possible and separating the patient pathways at an early stage. Methods. The present work is a retrospective analysis of the processes and structures established in the Emergency Department between 27 March 2020 and 20 May 2020. In addition, a retrospective descriptive evaluation of the epidemiological and clinical data of the patients is carried out at the time of first contact during the period mentioned above. Results. After establishing a pre-triage with structured algorithms, all confirmed COVID-19 cases were identified before entering the clinic and assigned to an appropriate treatment pathway. Unprotected entry into hospital structures or nosocomial infections were not observed, although almost 35% of patients with confirmed infection were admitted due to other symptom complexes or injuries. 201 inpatient patients were initially isolated without COVID-19 being confirmed. The number of cases in the Emergency Department was 39% lower than the previous year's period, thus avoiding crowding. Discussion. The reduction in the number of cases was strategically intended and is primarily the result of a restrictive indication of in-clinical treatment but supported by a decline in emergency consultations that can be noticed anyway. The proportion of false positive triage results is probably dependent on epidemiological activity and was accepted for safety reasons as sufficient resources were available for isolation. Conclusion. Short-term organizational, spatial and procedural restructuring of the Emergency Department has enabled the clinic to achieve its goal of managing the pandemic. The algorithms we developed are particularly well suited to guarantee the desired level of safety in the case of a high pre-test probability.

How Social Ventures Grow: Understanding the Role of Philanthropic Grants in Scaling Social Entrepreneurship

2020 ◽  
pp. 000765032097343
Author(s):  
Saurabh A. Lall ◽  
Jacob Park
Keyword(s):  
Human Capital ◽  
Social Entrepreneurship ◽  
Early Stage ◽  
Institutional Logics ◽  
Short Term ◽  
Data Set ◽  
Positive Effects ◽  
Debt Finance ◽  
Social Ventures

Although early-stage finance is critical to the growth of most ventures, it is even more important for social ventures as they face the challenges of balancing their social and commercial objectives. Drawing on institutional logics and signaling theory, this study uses a panel data set of 3,401 nascent social ventures to investigate the important role philanthropic grant funding plays in the organizational and financial development of social ventures. We find mixed results, with positive effects on employment and subsequent access to debt finance, but no effects on revenues and access to equity. Our findings connect these theories by suggesting philanthropic grants provide social ventures with flexibility to invest in human capital without pushing them to pursue short-term financial objectives, and that receiving a philanthropic grant provides a signal that is interpreted differently by debt and equity financiers. These findings are especially relevant as funders increasingly use grants to support social entrepreneurship.

scholarly journals The value of hospital data for covid-19 pandemic surveillance and planning

2021 ◽  
Author(s):  
Douglas G Manuel ◽  
Carl van Walraven ◽  
Alan J Forster
Keyword(s):  
Critical Infrastructure ◽  
Hospital Data ◽  
Short Term ◽  
Data Infrastructure ◽  
Admission Data ◽  
Public Health Information ◽  
Care Capacity ◽  
Source Of Information

Hospital data for covid-19 surveillance, planning and modelling are challenging to find well into the pandemic. Data for new covid-19 admissions are particularly challenging to find. Accurate hospital data are the best source of information for short-term forecasts of health care capacity, and they improve long-term covid-19 models that are typically based on cases. We describe the role of hospital data for studying covid-19, why admission data are hard to find, and how improved data infrastructure can meet surveillance and planning needs over the next year. Critical infrastructure includes a well-maintained list of patients hospitalized with covid-19 that is integrated with public health information systems.

scholarly journals The diagnostic process of covıd-19 in the emergency department: laboratory and ımaging methods

2020 ◽  
Vol 66 (suppl 2) ◽  
pp. 58-64
Author(s):  
Fatih Guneysu ◽  
Yusuf Yurumez ◽  
Ertugrul Guclu ◽  
Mehmet Koroglu ◽  
Alper Karacan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Inflammatory Markers ◽  
Reference Range ◽  
Early Stage ◽  
Diagnostic Process ◽  
Rt Pcr ◽  
Significant Difference ◽  
Laboratory Results ◽  
Novel Coronavirus

SUMMARY OBJECTIVES The 2019 Novel coronavirus disease puts a serious burden on the health system. Therefore, the detection of particularly serious patients at an early stage is extremely important in terms of controlling the outbreak and improving the prognosis. We investigated the role of inflammatory markers studied in patients suspected of COVID-19 at an emergency department in predicting PCR and CT results. METHODS This retrospective study was carried out with 133 patients who were admitted between 13 March and 1st April 2020 with suspicion of COVID-19. The patients were divided into four groups according to CT and RT-PCR results and evaluated. RESULTS Considering all patients, no specific findings were found in the hematological and biochemical values of patients in the laboratory analyses. Although all of the results remained within the reference range, there was a significant difference in white blood cell, neutrophil, platelet, and lymphocyte values when the groups were compared [p = 0.000; p = 0.004; p = 0.022; p = 0.023]. CONCLUSION Laboratory is not specific enough in the pre-diagnosis. In addition, this result does not alter with PCR or CT positivity. However, minimal changes observed in laboratory results may be partially guiding in patients in whom both PCR and CT are positive.

Role of affect in short-term memory for paired associates.

1968 ◽  
Vol 78 (3, Pt.1) ◽  
pp. 494-501 ◽  
Author(s):  
Calvin F. Nodine ◽  
James H. Korn
Keyword(s):  
Short Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Paired Associates

Update regarding anemia in heart failure

Medic ro ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Roxana Marcela Sânpălean ◽  
Dorina Nastasia Petra
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Multidisciplinary Team ◽  
Significant Proportion ◽  
Life Quality ◽  
Lower Number ◽  
Nutritional Deficiencies ◽  
Cardiac Morbidity ◽  
Appropriate Treatment

Heart failure (HF) is a burden for the healthcare system. The incidence will increase significantly due to the aging of po­pu­la­tion, which is associated with multiple comorbidities. Ane­mia and iron deficiency are common in patients with HF, their etiology being often multifactorial. The screening for anemia and iron deficiency is recommended as soon as pos­si­ble. There are often no targeted investigations, therefore a significant proportion of cases are underdiagnosed. The ma­nagement of patients may focus on identifying and correcting the cause. Anemia can occur due to nutritional deficiencies, infla­m­mation, renal failure, bone marrow dysfunction, neuro­hor­mo­nal activity, treatment and hemodilution. The appropriate the­ra­py for the patients with anemia and HF will contribute to the improvement of life quality. The only recommended iron product is ferric carboxymalose administered by in­tra­venous infusion. Under the appropriate treatment, the pa­tients showed an increase in effort tolerance, with an im­prove­ment in symptomatology and a lower number of hos­pi­ta­li­za­tion days. The management of these cases is handled by a multidisciplinary team consisting of a general prac­ti­tio­ner, a cardiologist and other specialists if the patient has other comorbidities. The role of the general practitioner is essential, as he can perform proper screening, prevention and management, developed by a multidisciplinary team, in order to reduce the cardiac morbidity and mortality.  

The capacity of short term memory from an evolutionary perspective

2019 ◽  
Author(s):  
Majid Manoochehri
Keyword(s):  
Short Term Memory ◽  
Memory Span ◽  
Critical Role ◽  
Experimental Studies ◽  
Cognitive System ◽  
Evolutionary Approach ◽  
Evolutionary Perspective ◽  
Short Term ◽  
Term Memory

Memory span in humans has been intensely studied for more than a century. In spite of the critical role of memory span in our cognitive system, which intensifies the importance of fundamental determinants of its evolution, few studies have investigated it by taking an evolutionary approach. Overall, we know hardly anything about the evolution of memory components. In the present study, I briefly review the experimental studies of memory span in humans and non-human animals and shortly discuss some of the relevant evolutionary hypotheses.

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