RESUMO
Aim of this paper is to analyze the tools and working methods, used in the Lazio Region, to assess organizational appropriateness in the context of Inpatient Rehabilitation Facilities, and the results obtained. It illustrates also the regional experiences of Veneto and Lombardia, which characterized by dynamism and originality in an attempt to overcome the obvious place for the critical assessment of this area of care.
Assuntos
Eficiência Organizacional , Pacientes Internados , Avaliação de Resultados em Cuidados de Saúde , Centros de Reabilitação/organização & administração , Humanos , Itália , Guias de Prática Clínica como Assunto , Garantia da Qualidade dos Cuidados de Saúde , Regionalização da Saúde/organização & administração , Centros de Reabilitação/legislação & jurisprudência , Estudos RetrospectivosRESUMO
Violence and aggression in health care settings is an ill-defined and under-reported problem. Early risk assessment, adequate training and information of health care workers, and specific monitoring tools (such as the Violent Incident Form, VIF) are necessary for risk management.
Assuntos
Exposição Ocupacional , Violência , Local de Trabalho , Feminino , Humanos , Exposição Ocupacional/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Violência/estatística & dados numéricosRESUMO
Often in Occupational Medicine doctors misunderstand or underestimate the occupational psychologic discomfort forms deriving from "transverse risks" of organizational kind. In this communication is shortly described a our study with in a "call center". We explain the several kinds of psychologic discomfort which we have here recognized and studied. We show, at last, some of job's organization modifications rose from the first outcome of our study.
Assuntos
Doenças Profissionais/diagnóstico , Estresse Psicológico/diagnóstico , Humanos , ItáliaRESUMO
In patients undergoing bone marrow transplantation cryptococcosis is rarely encountered. We report a fatal case of Cryptococcus meningitis in a 12-year-old girl with acute lymphoblastic leukemia (ALL) in second remission who had a transplant from a human leukocyte antigen (HLA)-identical unrelated bone marrow donor. The conditioning regimen was thiotepa, cyclophosphamide, and total body irradiation (TBI); graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A, methotrexate, and antilymphocyte globulin (ALG). The patient experienced stage III GVHD responsive to high-dose corticosteroids. On day +54 a thrombotic microangiopathy occurred. On day +64 neurological status worsened; a brain computed tomographic (CT) scan showed hyperdense lesions suggesting fungal infection. Detection of cryptococcal antigen by latex agglutination was positive but India ink stain and culture were negative. Despite treatment with amphotericin B, 5-flucytosine, and granulocyte-macrophage colony-stimulating factor, the patient died 13 days after the diagnosis.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Meningite Criptocócica/etiologia , Trombose/etiologia , Trombose/fisiopatologia , Criança , Evolução Fatal , Feminino , Teste de Histocompatibilidade , Humanos , Meningite Criptocócica/fisiopatologia , Microcirculação/patologia , Doadores de Tecidos , Transplante HomólogoRESUMO
Los riesgos psicosociales se están constituyendo en una de las principales causas de alteración de la salud en los puestos de trabajo. En los últimos años, el "riesgo relacional o interpersonal" - mobbing - se ha ido incrementando debido a los cambios macroeconómicos y por el cambio en la tipología del trabajo y en los riesgos laborales derivados. Cada trabajador, independientemente de las características de su propia personalidad y del propio carácter, puede ser objeto de acoso moral. Los primeros efectos derivados del mobbing son observables sobre la salud de la víctima que, casi siempre, después de un intervalo variable, se altera con manifestaciones en la esfera neuropsíquica, Las consecuancias sociales pueden ser devastadoras. El costo del mobbing no se limita a los aspectos individuales, sino que se refleja generalmente a nivel de la empresa. La gestión del fenómeno de mobbing es multidisciplinaria. A nivel asistencial, el rol del médico del trabajo, del psiquiatra y del psicólogo son interdependientes y deben por lo tanto ser integrados en una estructura funcional unitaria...