916 resultados para THE EMERGENCY SERVICES CALL CENTER


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The past four decades have witnessed an explosive growth in the field of networkbased facility location modeling. This is not at all surprising since location policy is one of the most profitable areas of applied systems analysis in regional science and ample theoretical and applied challenges are offered. Location-allocation models seek the location of facilities and/or services (e.g., schools, hospitals, and warehouses) so as to optimize one or several objectives generally related to the efficiency of the system or to the allocation of resources. This paper concerns the location of facilities or services in discrete space or networks, that are related to the public sector, such as emergency services (ambulances, fire stations, and police units), school systems and postal facilities. The paper is structured as follows: first, we will focus on public facility location models that use some type of coverage criterion, with special emphasis in emergency services. The second section will examine models based on the P-Median problem and some of the issues faced by planners when implementing this formulation in real world locational decisions. Finally, the last section will examine new trends in public sector facility location modeling.

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Abstract OBJECTIVE To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR) in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. METHOD A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. RESULTS The majority of nurses reported that the high number of professionals in the scenario (75.5%), the lack of harmony (77.6%) or stress of any member of staff (67.3%), lack of material and/or equipment failure (57.1%), lack of familiarity with the emergency trolleys (98.0%) and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1%) are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. CONCLUSION The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.

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L’objectiu dels Serveis Intel·ligents d’Atenció Ciutadana (SAC) és donar resposta a les necessitats d'informació dels ciutadans sobre els serveis i les actuacions del municipi i, per extensió, del conjunt del serveis d'interès ciutadà. Des que l’ iSAC s’ha posat en funcionament, periòdicament s’analitzen les consultes que es fan en el sistema i el grau de satisfacció que la ciutadania té d’aquest servei. Tot i que en general les valoracions són satisfactòries s’ha observat que actualment aquest sistema té un buit, hi ha un ampli ventall de respostes que, de moment, l’iSAC no és capaç de resoldre, i possiblement el 010, el call center del servei d’atenció ciutadana, tampoc. Algunes de les cerques realitzades marxen molt de l’àmbit municipal i és l’experiència de la mateixa ciutadania la que pot oferir un millor resultat. És per aquest motiu que ha sorgit la necessitat de crear wikiSAC. Eina que te com a principals objectius que: poder crear, modificar i eliminar el contingut d’una pàgina de forma interactiva de manera fàcil i ràpida a través d’un navegador web; controlar els continguts ofensius i malintencionats; conservar un historial de canvis; incentivar la participació ciutadana i aconseguir que aquest sigui un lloc on els ciutadans preguntin, suggereixin i opinin sobre temes relacionats amb el seu municipi i aconseguir que els ciutadans es sentin més integrats amb el funcionament de l’administració, col∙laborant en les tasques d’informació i atenció ciutadana

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Legislatively Mandated Report. Iowa Code §8A.224 – “The department shall submit an annual report not later than January 31 to the members of the General Assembly and the Legislative Services Agency of the activities funded by and expenditures made from the revolving fund during the preceding fiscal year.

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This paper investigates the effects of Spain s large recent immigration wave on thelabor supply of highly skilled native women. We hypothesize that female immigration led to an increase in the supply of affordable household services, such as housekeeping and child or elderly care. As a result, i) native females with high earnings potential were able to increase their labor supply, and ii) the effects were larger on skilled women whose labor supply was heavily constrained by family responsibilities. Our evidence indicates that over the last decade immigration led to an important expansion in the size of the household services sector and to an increase in the labor supply of women in high-earning occupations (of about 2 hours per week). We also find that immigration allowed skilled native women to return to work sooner after childbirth, to stay in the workforce longer when having elderly dependents in the household, and to postpone retirement. Methodologically, we show that the availability of even limited Registry data makes it feasible to conduct the analysis using quarterly household survey data, as opposed to having to rely on the decennial Census.

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Effect of Citrus floral extracts on the foraging behavior of the stingless bee Scaptotrigona pectoralis (Dalla Torre). Stingless bees have an important role as pollinators of many wild and cultivated plant species in tropical regions. Little is known, however, about the interaction between floral fragrances and the foraging behavior of meliponine species. Thus we investigated the chemical composition of the extracts of citric (lemon and orange) flowers and their effects on the foraging behavior of the stingless bee Scaptotrigona pectoralis. We found that each type of flower has its own specific blend of major compounds: limonene (62.9%) for lemon flowers, and farnesol (26.5%), (E)-nerolidol (20.8%), and linalool (12.7%) for orange flowers. In the foraging experiments the S. pectoralis workers were able to use the flower extracts to orient to the food source, overlooking plates baited with hexane only. However, orange flower extracts were seemingly more attractive to these worker bees, maybe because of the particular blend present in it. Our results reveal that these fragrances are very attractive to S. pectoralis, so we can infer that within citric orchards they could be important visitors in the study area; however habitat destruction, overuse of pesticides and the competitive override by managed honeybees might have put at risk their populations and thus the ecological services they provide to us.

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Osteoporosis is a serious worldwide epidemic. Increased risk of fractures is the hallmark of the disease and is associated with increased morbidity, mortality and economic burden. FRAX® is a web-based tool developed by the Sheffield WHO Collaborating Center team, that integrates clinical risk factors, femoral neck BMD, country specific mortality and fracture data and calculates the 10 year fracture probability in order to help health care professionals identify patients who need treatment. However, only 31 countries have a FRAX® calculator at the time paper was accepted for publication. In the absence of a FRAX® model for a particular country, it has been suggested to use a surrogate country for which the epidemiology of osteoporosis most closely approximates the index country. More specific recommendations for clinicians in these countries are not available. In North America, concerns have also been raised regarding the assumptions used to construct the US ethnic specific FRAX® calculators with respect to the correction factors applied to derive fracture probabilities in Blacks, Asians and Hispanics in comparison to Whites. In addition, questions were raised about calculating fracture risk in other ethnic groups e.g., Native Americans and First Canadians. In order to provide additional guidance to clinicians, a FRAX® International Task Force was formed to address specific questions raised by physicians in countries without FRAX® calculators and seeking to integrate FRAX® into their clinical practice. The main questions that the task force tried to answer were the following: The Task Force members conducted appropriate literature reviews and developed preliminary statements that were discussed and graded by a panel of experts at the ISCD-IOF joint conference. The statements approved by the panel of experts are discussed in the current paper.

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The purpose of this paper is to highlight the mobile services developed by the Rector Gabriel Ferraté Library (BRGF) of the Universitat Politècnica de Catalunya (UPC Barcelona Tech) in Barcelona, Spain.We hope this paper will be of use to other libraries exploring new technologies for communicating and delivering their services to users at a time when mobile services are an emerging topic in librarianship and information science literature. By setting out the successive steps involved in the as yet unfinished process of building our mobile services portfolio, we aim to offer a detailed picture of the mobile services and features offered by a university library from a case study perspective.The main topics to be discussed include:- The BRGF’s mobile website, including the information available, its interactivecapabilities and the services it provides to its users.- The mobile-friendly version of UPCommons (the UPC Library Service’s institutionalrepositories).- The UPC Library Service’s mobile OPAC.- The mobile version of u-win (BRGF’s videogame service).- The use of QR codes to deliver information to mobile devices.- Text message notifications.Additional topics for discussion include:- The library’s organisation and the organisational concepts that underpin andmake possible its technological developments (including mobile).- BRGF’s concern regarding the reduction of investment in the development of mobile services.- The criteria and tools used to guide the library’s decisions regarding thedesign and orientation of current and future mobile services.- How mobile services can help to improve the image of the library as a leadingtechnology site.- Selected mobile features that BRGF plans to offer in the near future.Ultimately, this paper aims to delineate the effectiveness and potential of deliveringlibrary services by the preferred means of communication of a new generation of studentsand teachers.

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The emergency medicine appears more and more as a transversal discipline, leaning on specific competences regularly updated with evidence-based medicine concepts. This selection of recent articles presents an update on frequent conditions, including the place of neuroimaging for patients with seizures or minor head injuries, the management of acute cocaine intoxications, the diagnosis of aortic dissections, or the management of cardiopulmonary arrest. The primary care physician will find elements of diagnostic or therapeutic strategies. This selection reflects the dynamism of emergency medicine.

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Iowa’s four Mental Health Institutes (MHIs), located in Cherokee, Clarinda, Independence and Mount Pleasant, provide critical access to quality acute psychiatric care for Iowa’s adults and children needing mental health treatment, and provide specialized mental health related services. The specialized services include substance abuse treatment, dual diagnosis treatment for persons with mental illness and substance addiction, psychiatric medical institution for children (PMIC), and long-term psychiatric care for the elderly (geropsychiatric).

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In the emergency situation, preoperative patient work-up for cardio-vascular surgery is quite different from the elective setting. We have analyzed a consecutive series of 5576 cases out of which 823 underwent emergency procedures (14.8%). The most frequent problems requiring emergent intervention were peripheral vascular (186 cases; 22.6% of the emergent procedure), followed by coronary artery disease (156 cases; 19.0%), thoracic aortic aneurysms (86 cases; 10.4%), abdominal aortic aneurysms (54 cases; 6.6%), congenital heart disease (36 cases: 4.4%), heart and heart lung transplantation (31 cases; 3.8%), problems with cardiac rythm (25 cases: 3.0%), and others (267 cases: 32.4%). Classification by proportion of urgent procedures with reference to elective operations shows a different picture. As a matter of fact transplantations were always emergency procedures (100%), whereas repair of aortic dissections type A and B was an emergency procedure in 81.5%. Emergency thoracic and abdominal aortic aneurysm repair accounted for 30% and 20% respectively and the corresponding proportion for peripheral vascular surgery is 19%. However, emergency surgery for acute coronary ischemia, valvular and congenital heart disease accounted for somewhat less than 10% for each group of these pathologies. Systematic pre-operative diagnostic work-up is a recognized tool for procedure related risk assessment and superior management of diseases. However, hemodynamic instability and other time related events correlated with negative outcome, are the main driving forces for accelerated diagnostic pathways

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Legislation passed during the 2010 legislative session required a study of ways to streamline state-funded library operations and services. The Iowa Library Association was asked to lead this endeavor and named a committee to carry out the study. The study resulted in the development of a plan for reorganization, which is outlined in the Iowa Library Services Reorganization Report. The Iowa Library Reorganization Committee was representative of the Library Services Areas, the State Library of Iowa, and public libraries of all sizes from all around the state. The president of the Iowa Library Association and the State Librarian also served as members of the Committee. The report was submitted to members of the Iowa legislature on November 1, 2010.

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Papillary fibroelastomas (PFE) are benign endocardial masses and generally originate from the cardiac valves, while PFE arising from the ascending thoracic aorta are an uncommon clinical finding. We report the case of a 78-year-old female who presented to the emergency department with an acute ST segment elevation myocardial infarction. Urgent coronary angiography showed no significant coronary artery obstructive disease but left ventriculography revealed the presence of a highly mobile mass located in the proximal portion of the ascending thoracic aorta. We postulated that the clinical symptoms were caused by embolization from the aortic mass and surgical excision of the peduncle was performed. Histopathological examination revealed a PFE with thrombotic material. Nowadays, surgical excision of PFE remains, the treatment of choice for symptomatic patients with excellent short- and long-term results but recurrence of PFE following surgical excision has not been reported.

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Modeling of water movement in non-saturated soil usually requires a large number of parameters and variables, such as initial soil water content, saturated water content and saturated hydraulic conductivity, which can be assessed relatively easily. Dimensional flow of water in the soil is usually modeled by a nonlinear partial differential equation, known as the Richards equation. Since this equation cannot be solved analytically in certain cases, one way to approach its solution is by numerical algorithms. The success of numerical models in describing the dynamics of water in the soil is closely related to the accuracy with which the water-physical parameters are determined. That has been a big challenge in the use of numerical models because these parameters are generally difficult to determine since they present great spatial variability in the soil. Therefore, it is necessary to develop and use methods that properly incorporate the uncertainties inherent to water displacement in soils. In this paper, a model based on fuzzy logic is used as an alternative to describe water flow in the vadose zone. This fuzzy model was developed to simulate the displacement of water in a non-vegetated crop soil during the period called the emergency phase. The principle of this model consists of a Mamdani fuzzy rule-based system in which the rules are based on the moisture content of adjacent soil layers. The performances of the results modeled by the fuzzy system were evaluated by the evolution of moisture profiles over time as compared to those obtained in the field. The results obtained through use of the fuzzy model provided satisfactory reproduction of soil moisture profiles.

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State general fund revenue estimates are generated by the Iowa Revenue Estimating Conference (REC). The REC is comprised of the Governor or their designee, the Director of the Legislative Services Agency, and a third person agreed upon by the other two members. The REC meets periodically, generally in October, December, and March/April. The Governor and the Legislature are required to use the REC estimates in preparing the state budget.