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1.
Ann Emerg Med ; 82(3): e97-e105, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37596031

RESUMO

Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure, challenges with timely access to a mental health professional, the nature of a busy ED environment, and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.


Assuntos
Transtornos do Comportamento Infantil , Emergências , Transtornos Mentais , Humanos , Masculino , Feminino , Criança , Adolescente , Transtornos Mentais/terapia , Serviços Médicos de Emergência , Transtornos do Comportamento Infantil/terapia , Pessoal de Saúde , Serviços de Saúde Mental
2.
J Fish Biol ; 102(2): 492-503, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36451613

RESUMO

Little is known about manta ray population size, structure and connectivity in the Philippines. In collaboration with dive operators, non-governmental organizations and authorities, sightings of manta rays were collated into a single national database. Using in-water photographs and videos gathered through citizen science and dedicated research efforts, this study compiled sightings between 2004 and 2020, showing 22 separate sites throughout the archipelago with manta rays present. A total of 392 individual reef manta rays (Mobula alfredi) and 107 oceanic manta rays (Mobula birostris) were identified from the collected footage. Four specific sites in the provinces of Masbate and Palawan together hosted 89% of all identified individuals and accounted for 95% of sightings, highlighting these areas are key aggregation sites. This study also reports the movements of M. birostris within the Philippines, based on photo-identification of three individuals moving 150 km between Cebu and Masbate. Despite the growing number of recreational divers in Daanbantayan and San Jacinto, an 80% decline in M. birostris sightings was observed at these sites. To ensure effective future conservation, it is recommended that efforts focus on the identification and protection of manta ray hotspots and migratory corridors, the creation of a sustainable tourism framework and, most important, the implementation of mitigation strategies to reduce fisheries interactions.


Assuntos
Elasmobrânquios , Rajidae , Animais , Filipinas , Oceanos e Mares , Pesqueiros
3.
J Emerg Nurs ; 49(5): 703-713, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37581617

RESUMO

Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure, challenges with timely access to a mental health professional, the nature of a busy ED environment, and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.


Assuntos
Serviços Médicos de Emergência , Transtornos Mentais , Humanos , Criança , Adolescente , Emergências , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Serviço Hospitalar de Emergência , Ideação Suicida
4.
J Emerg Nurs ; 48(6): 652-665, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36208980

RESUMO

This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting" and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department has frequent workflow interruptions, multiple care transitions, and barriers to effective communication. In addition, the high volume of patients, high decision density under time pressure, diagnostic uncertainty, and limited knowledge of patients' history and preexisting conditions make the safe care of critically ill and injured patients even more challenging. It is critical that all emergency departments, including general emergency departments who care for the majority of ill and injured children, understand the unique safety issues related to children. Furthermore, it is imperative that all emergency departments practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This policy statement outlines the recommendations necessary for emergency departments to minimize pediatric medical errors and to provide safe care for children of all ages.


Assuntos
Serviços Médicos de Emergência , Pediatria , Criança , Humanos , Estados Unidos , Segurança do Paciente , Serviço Hospitalar de Emergência , Tratamento de Emergência
5.
J Fish Biol ; 98(3): 881-885, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33161579

RESUMO

Little is known about the reproductive ecology of the whale shark Rhincodon typus. On 15 March 2020, a free-swimming neonate whale shark was found in the shallow, coastal waters of Donsol, Philippines. The total length of the male shark was 60 cm, falling within the species known size-at-birth. This is the third occurrence of neonatal whale sharks reported in the area, and coupled with the occurrence of juveniles and adults, and anecdotal mating and precopulatory behaviour reported herein, the importance of the site for this endangered species is highlighted.


Assuntos
Ecossistema , Espécies em Perigo de Extinção , Reprodução/fisiologia , Tubarões/fisiologia , Animais , Masculino , Filipinas , Natação
6.
Prehosp Emerg Care ; 24(2): 175-179, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31854223

RESUMO

This is a joint policy statement from the American Academy of Pediatrics, American College of Emergency Physicians, Emergency Nurses Association, National Association of Emergency Medical Services Physicians, and National Association of Emergency Medical Technicians on pediatric readiness in emergency medical services systems.


Assuntos
Serviços Médicos de Emergência/organização & administração , Pediatria/organização & administração , Qualidade da Assistência à Saúde , Criança , Humanos , Sociedades Médicas , Estados Unidos
7.
J Fish Biol ; 97(4): 1247-1251, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32671837

RESUMO

Cleaning interactions are essential for healthy marine ecosystem communities. This study reports the first documentation of the whale shark Rhincodon typus cleaning behaviour in the Indo-West Pacific by two wrasse species, the blue-streak cleaner wrasse Labroides dimidiatus and the moon wrasse Thalassoma lunare in Cebu, Philippines. This study documented 36 cleaning interactions with 14 individual whale sharks. The cleaning interactions appear opportunistic rather than targeted by the sharks, unlike that observed in other species of elasmobranchs. Further work should focus on understanding the drivers of these unique cleaning interactions.


Assuntos
Perciformes/fisiologia , Tubarões/fisiologia , Simbiose , Animais , Organismos Aquáticos/fisiologia , Ecossistema , Oceano Pacífico , Filipinas
12.
Ann Emerg Med ; 64(1): 102-5, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24951421

RESUMO

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report.


Assuntos
Morte , Serviço Hospitalar de Emergência , Mortalidade Hospitalar , Política Organizacional , Relações Profissional-Família , Luto , Criança , Medicina de Emergência/educação , Humanos , Pediatria/educação , Guias de Prática Clínica como Assunto , Assistência Terminal
13.
Ann Emerg Med ; 64(1): e1-17, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24951422

RESUMO

The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED.


Assuntos
Morte , Serviço Hospitalar de Emergência , Mortalidade Hospitalar , Política Organizacional , Relações Profissional-Família , Humanos
14.
J Emerg Nurs ; 45(1): 2-3, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30616762
15.
J Emerg Nurs ; 40(4): e83-e101, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24998719

RESUMO

The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED.


Assuntos
Luto , Morte , Serviço Hospitalar de Emergência , Pediatria/métodos , Relações Profissional-Família , Adolescente , Autopsia , Criança , Pré-Escolar , Mortalidade Hospitalar , Humanos , Lactente , Recém-Nascido , Política Organizacional , Ressuscitação , Obtenção de Tecidos e Órgãos
16.
J Emerg Nurs ; 40(4): 301-4, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24998713

RESUMO

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report.


Assuntos
Morte , Emergências , Medicina de Emergência , Serviço Hospitalar de Emergência , Política Organizacional , Pediatria , Criança , Humanos , Relações Profissional-Família
18.
BMJ Open Respir Res ; 11(1)2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38653506

RESUMO

Chronic obstructive pulmonary disease (COPD) is a multisystem disease, and many patients have multiple conditions. We explored multimorbidity patterns that might inform intervention planning to reduce health-care costs while preserving quality of life for patients. Literature searches up to February 2022 revealed 4419 clinical observational and comparative studies of risk factors for multimorbidity in people with COPD, pulmonary emphysema, or chronic bronchitis at baseline. Of these, 29 met the inclusion criteria for this review. Eight studies were cluster and network analyses, five were regression analyses, and 17 (in 16 papers) were other studies of specific conditions, physical activity and treatment. People with COPD more frequently had multimorbidity and had up to ten times the number of disorders of those without COPD. Disease combinations prominently featured cardiovascular and metabolic diseases, asthma, musculoskeletal and psychiatric disorders. An important risk factor for multimorbidity was low socioeconomic status. One study showed that many patients were receiving multiple drugs and had increased risk of adverse events, and that 10% of medications prescribed were inappropriate. Many patients with COPD have mainly preventable or modifiable multimorbidity. A proactive multidisciplinary approach to prevention and management could reduce the burden of care.


Assuntos
Progressão da Doença , Multimorbidade , Doença Pulmonar Obstrutiva Crônica , Humanos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade de Vida , Fatores de Risco
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