The Team Is Not Okay: Violence in Emergency Departments Across Disciplines in a Health System.

INTRODUCTION: Healthcare workers, particularly those in the emergency department (ED), experience high rates of injuries caused by workplace violence (WPV). OBJECTIVE: Our goal was to establish the incidence of WPV among multidisciplinary ED staff within a regional health system and assess its impact on staff victims. METHODS: We conducted a survey study of all multidisciplinary ED staff at 18 Midwestern EDs encompassing a larger health system between November 18-December 31, 2020. We solicited the incidence of verbal abuse and physical assault experienced and witnessed by respondents over the prior six months, as well as its impact on staff. RESULTS: We included responses from 814 staff (24.5% response rate) for final analysis with 585 (71.9%) indicating some form of violence experienced in the preceding six months. A total of 582 (71.5%) respondents indicated experiencing verbal abuse, and 251 (30.8%) indicated experiencing some form of physical assault. All disciplines experienced some type of verbal abuse and nearly all experienced some type of physical assault. One hundred thirty-five (21.9%) respondents indicated that being the victim of WPV has affected their ability to perform their job, and nearly half (47.6%) indicated it has changed the way they interact with or perceive patients. Additionally, 132 (21.3%) indicated experiencing symptoms of post-traumatic stress, and 18.5% reported they have considered leaving their position due to an incident. CONCLUSION: Emergency department staff suffer violence at a high rate, and there is no discipline that is spared. As health systems seek to prioritize staff safety in violence-prone areas such as the ED, it is imperative to recognize that the entire multidisciplinary team is impacted and requires targeted efforts for improvement in safety.

[An epidemic of dengue fever in a department of paediatrics: report on 58 cases in Lamentin (Martinique)]. / Une épidémie de dengue dans un service de pédiatrie. A propos de 58 cas au Lamentin (Martinique).

UNLABELLED: Dengue fever is caused by a virus transmitted by an Aedes mosquito, and infects 80 million people in the world annually. 30 000 case fatality of Dengue hemorrhagic fever are estimated each year. The disease, endemo-epidemic in the inter-tropical area, is a public health problem. PATIENTS AND METHODS: An epidemic of dengue fever occurred in Martinique, French department of the Caribbean, in 2001-2002. This work was a clinical and epidemiologic study of dengue and dengue hemorrhagic fever in 58 children. RESULTS: Three children (5%) developed a hemorrhagic dengue, and 13 subjects (24%) presented at least with one hemorrhagic sign. Symptoms were polymorphous, certain forms were only myalgic; the main reason for consultation was the fever (89%). The principal characteristics were a leucopenia (56%) associated with a neutropenia (80%), a thrombocytopenia (54%), a hepatic cytolysis (66%) and sometimes a muscular cytolysis (9/15) and a increase in the ferritinemia (16/27). No death was noted. CONCLUSION: The treatment of the dengue is above all preventive, it consists in the antivector fight.

[Seasonal variations of lipids and arterial pressure]. / Variación estacional de lípidos y presión arterial.

BACKGROUND: The presence of a seasonal variation in serum lipids and blood pressure is often described in the literature. METHODS: With the aim of analyzing this seasonal influence blood pressure and lipid (total cholesterol and cholesterol corresponding to different lipoprotein, triglycerides and AI and B apolipoprotein families) values were studied over 12 months in 36 normotense healthy males (mean age 36 +/- 6 years), a third of whom presented diverse base lipid alterations. A variance analysis of the relative intraindividual values (to study monthly differences) was carried out and a Student's t test was performed for the absolute values and grouped into two periods (summer and winter) and according to two categories (normal and hyperlipemic). RESULTS: No significant modification was observed in any of the parameters studied with the exception of the intrapersonal variation coefficient of the triglycerides which was significantly higher in the hyperlipemic individuals. CONCLUSIONS: In the population studied no seasonal modification was observed in blood pressure or different lipid concentrations analyzed. The slight variation of temperature observed and the elevated sunstroke in Spain in addition to the youth of the population studied may explain the lack of seasonal variation.

[Study of preventive activity and health promotion in a primary care center]. / Estudio de la actividad de prevención y promoción de la salud en un centro de atención primaria.

The present study was undertaken in our center to investigate the application level of the criteria from the Program of Preventive Activities and Health Promotion (PAPPS) for the adult population of the SEMFYC, before the implementation of any specific activity. We carried out a simple random sampling (310 clinical records) and we registered their application for risk subpopulations. The most relevant results were as follows: screening for hypercholesterolemia 41.4%, for hypertension 27.2%, for smoking habits 45.8%, for chronic alcohol abuse 35.2%, and for obesity 13.6%. Those corresponding to women program and vaccinations were poor, except for influenza vaccination (39.7%). We evaluate the small preventive activity and its low effectiveness, which is related to the lack of protocols, of an adequate population ranging and of integrated approach. We conclude that there is a need for protocol approach and a population-oriented program of preventive activity, with an adequate recording system. We expect to achieve these goals by the adscription of the EAP to PAPPS.

AIDS stigma combinations in a sample of Puerto Rican health professionals: qualitative and quantitative evidence

The HIV/AIDS epidemic continues to impact Puerto Rico and the Caribbean region with growing numbers of cases each year. The stigma that surrounds the epidemic has harmful implications on the health of people living with the disease and public health in general, fostering health deterioration and new infections. When this stigma emanates from health professionals it can severely hinder access to health services, which are crucial for those living with the virus. Still, AIDS stigma has been previously explored among this population as a separate phenomenon from other pre-existing stigmas. This has yielded a limited perspective on the complexity of how AIDS stigma is manifested. In light of this limitation, the main objectives of this study were: 1) to document AIDS stigma among a sample of Puerto Rican health professionals and health professionals in training and 2) to explore the combination of other stigmas (sexism, homophobia, and negative attitudes towards drug users) with that associated to HIV/AIDS. Through an exploratory design, using a mixed method approach (qualitative in-depth interviews and quantitative questionnaires), we explored the objectives in a sample of 501 health professionals and health professionals in training. The results evidenced the combinations of other stigmas with that of HIV/AIDS. Homophobia yielded the strongest correlation and was the best predictor of AIDS stigma. These results evidence the need to develop interventions to reduce AIDS stigma and its combinations among this population.