920 resultados para National Triage Scale
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produced by the Metropolitan Area Planning Council GIS Lab.
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'Reproduced with permission from Environmental Health Perspectives'
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The 1992 Maastricht Treaty introduced the concept of European Union citizenship. All citizens of the 28 EU member states are also EU citizens through the very fact that their countries are members of the EU. Acquired EU citizenship gives them the right to free movement, settlement and employment across the EU, the right to vote in European elections, and also on paper the right to consular protection from other EU states' embassies when abroad. The concept of citizenship in Europe – and indeed anywhere in the world – has been evolving over the years, and continues to evolve. Against this time scale, the concept of modern citizenship as attached to the nation-state would seem ephemeral. The idea of EU citizenship therefore does not need to be regarded as a revolutionary phenomenon that is bound to mitigate against the natural inclination of European citizens towards national identities, especially in times of economic and financial crises. In fact, the idea of EU citizenship has even been criticised by some scholars as being of little substantive value in addition to whatever rights and freedoms European citizens already have. Nonetheless the ‘constitutional moment’ that the Maastricht Treaty achieved for the idea of EU citizenship has served more than just symbolic value – the EU’s Charter of Fundamental Rights is now legally binding, for instance. The idea of EU citizenship also put pressure on the Union and its leaders to address the perceived democratic deficit that the EU is often accused of. In attempts to cement the political rights of EU citizens, the citizens’ initiative was included in Lisbon Treaty allowing citizens to directly lobby the European Commission for new policy initiatives or changes.
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The 1992 Maastricht Treaty introduced the concept of European Union citizenship. All citizens of the 28 EU member states are also EU citizens through the very fact that their countries are members of the EU. Acquired EU citizenship gives them the right to free movement, settlement and employment across the EU, the right to vote in European elections, and also on paper the right to consular protection from other EU states' embassies when abroad. The concept of citizenship in Europe – and indeed anywhere in the world – has been evolving over the years, and continues to evolve. Against this time scale, the concept of modern citizenship as attached to the nation-state would seem ephemeral. The idea of EU citizenship therefore does not need to be regarded as a revolutionary phenomenon that is bound to mitigate against the natural inclination of European citizens towards national identities, especially in times of economic and financial crises. In fact, the idea of EU citizenship has even been criticised by some scholars as being of little substantive value in addition to whatever rights and freedoms European citizens already have. Nonetheless the ‘constitutional moment’ that the Maastricht Treaty achieved for the idea of EU citizenship has served more than just symbolic value – the EU’s Charter of Fundamental Rights is now legally binding, for instance. The idea of EU citizenship also put pressure on the Union and its leaders to address the perceived democratic deficit that the EU is often accused of. In attempts to cement the political rights of EU citizens, the citizens’ initiative was included in Lisbon Treaty allowing citizens to directly lobby the European Commission for new policy initiatives or changes.
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A wide variety of different socially motivated organisations perform exceptional feats in alleviating societal ills using creativity and entrepreneurial spirit in their quest to scale their social impact. Their focus is seldom limited to one specific region – instead they strive to benefit the largest possible number of people, thereby often transcending national borders. After all, societal issues usually don’t stop at a countries’ borders – why then should good ideas and impactful concepts aimed at solving these issues? For many socially motivated organisations, the goal of disseminating their social impact remains a solemn wish due to lacking experience and know-how of how to plan and conduct systematic scaling.
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A classic T-cell phenotype in systemic lupus erythematosus (SLE) is the downregulation and replacement of the CD3ζ chain that alters T-cell receptor signaling. However, genetic associations with SLE in the human CD247 locus that encodes CD3ζ are not well established and require replication in independent cohorts. Our aim was therefore to examine, localize and validate CD247-SLE association in a large multiethnic population. We typed 44 contiguous CD247 single-nucleotide polymorphisms (SNPs) in 8922 SLE patients and 8077 controls from four ethnically distinct populations. The strongest associations were found in the Asian population (11 SNPs in intron 1, 4.99 × 10(-4) < P < 4.15 × 10(-2)), where we further identified a five-marker haplotype (rs12141731-rs2949655-rs16859085-rs12144621-rs858554; G-G-A-G-A; P(hap) = 2.12 × 10(-5)) that exceeded the most associated single SNP rs858554 (minor allele frequency in controls = 13%; P = 4.99 × 10(-4), odds ratio = 1.32) in significance. Imputation and subsequent association analysis showed evidence of association (P < 0.05) at 27 additional SNPs within intron 1. Cross-ethnic meta-analysis, assuming an additive genetic model adjusted for population proportions, showed five SNPs with significant P-values (1.40 × 10(-3) < P< 3.97 × 10(-2)), with one (rs704848) remaining significant after Bonferroni correction (P(meta) = 2.66 × 10(-2)). Our study independently confirms and extends the association of SLE with CD247, which is shared by various autoimmune disorders and supports a common T-cell-mediated mechanism.
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Objectives To determine the face and content validity of items for measuring safe medication practices in Portuguese hospitals. Methods 128 items were drafted from content analysis of existing questionnaires and the literature, employing preferred terms of the WHO International Classification for Patient Safety (Portuguese version). A two-round e-Delphi was convened, using a purposive multidisciplinary panel. Hospital-based experts were asked to rate the relevance of items on a 7-point Likert scale and to comment on their clarity and completeness. Results The response rate was similar in both rounds (70.3% and 73.4%, respectively). In the first round 91/128 (71.1%) items reached the predefined level of positive consensus. In the second round 23 additional items reached positive consensus, as well as seven items newly derived by the panel. Conclusions Most items have face and content validity, indicating relevance and clarity, and can be included in a future questionnaire for measuring safe medication practices in Portuguese hospitals.
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Simple clinical scores to predict large vessel occlusion (LVO) in acute ischemic stroke would be helpful to triage patients in the prehospital phase. We assessed the ability of various combinations of National Institutes of Health Stroke Scale (NIHSS) subitems and published stroke scales (i.e., RACE scale, 3I-SS, sNIHSS-8, sNIHSS-5, sNIHSS-1, mNIHSS, a-NIHSS items profiles A-E, CPSS1, CPSS2, and CPSSS) to predict LVO on CT or MR arteriography in 1085 consecutive patients (39.4 % women, mean age 67.7 years) with anterior circulation strokes within 6 h of symptom onset. 657 patients (61 %) had an occlusion of the internal carotid artery or the M1/M2 segment of the middle cerebral artery. Best cut-off value of the total NIHSS score to predict LVO was 7 (PPV 84.2 %, sensitivity 81.0 %, specificity 76.6 %, NPV 72.4 %, ACC 79.3 %). Receiver operating characteristic curves of various combinations of NIHSS subitems and published scores were equally or less predictive to show LVO than the total NIHSS score. At intersection of sensitivity and specificity curves in all scores, at least 1/5 of patients with LVO were missed. Best odds ratios for LVO among NIHSS subitems were best gaze (9.6, 95 %-CI 6.765-13.632), visual fields (7.0, 95 %-CI 3.981-12.370), motor arms (7.6, 95 %-CI 5.589-10.204), and aphasia/neglect (7.1, 95 %-CI 5.352-9.492). There is a significant correlation between clinical scores based on the NIHSS score and LVO on arteriography. However, if clinically relevant thresholds are applied to the scores, a sizable number of LVOs are missed. Therefore, clinical scores cannot replace vessel imaging.
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The geological overview map was compiled from 15 geological maps (1 : 25,000) and is based on Jacobs et al. 1996. The topographic basemaps were adapted from unpublished 1:250,000 provisional topographic maps, Institut f. Angewandte Geodäsie, Frankfurt, 1983. Part of the contour lines are from Radarsat (Liu et al. 2001).
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Mode of access: Internet.
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Includes bibliographical references
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Description based on: 1913/1914.
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Mode of access: Internet.
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Mode of access: Internet.
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Mode of access: Internet.