A cross-sectional profile and outcome assessment of adult patients triaged away from Steve Biko Academic Hospital emergency unit

BACKGROUND : Overcrowding is a global problem in emergency medicine. This study examined an approach to this problem at a central hospital. METHODS : A prospective observational study was done to provide a cross-sectional profile of patients triaged away from the emergency unit (EU) and to evaluate their outcome by telephonic survey. RESULTS : 549 patients were triaged away during the study period. There was no significant difference in the number of male and female patients in the sample. Female patients were significantly younger than males (p = 0.0399). The most common complaint was abdominal pain followed by extremity complaints. Females complained more of abdominal pains (OR 1.87, 95% CI [1.13–3.12]; p 0.0094), and males had more extremity complaints (OR 2.42, 95% CI [1.45–4.09]; p = 0.0003). Only 42 patients were available for telephonic follow-up; 66% of them received care on the same day at another treatment facility. No patients who were available for follow-up had died due to their presenting complaint or needed to be referred back. CONCLUSIONS : The typical patient triaged away was a 40-year-old female from the hospital’s referral area with abdominal pain. This study indicated that the method of triage may be safe to determine which patients can be diverted from a central hospital to a lower level of care. There were various limitations to this study; hence, the findings of this study should be interpreted with caution.http://medpharm.tandfonline.com/loi/ojfp20am201

Epidemiology of lobomycosis-like disease in bottlenose dolphins <i>Tursiops</i> spp. from South America and southern Africa

We report on the epidemiology of lobomycosis-like disease (LLD), a cutaneous disorder evoking lobomycosis, in 658 common bottlenose dolphins Tursiops truncatus from South America and 94 Indo-Pacific bottlenose dolphins T. aduncus from southern Africa. Photographs and stranding records of 387 inshore residents, 60 inshore non-residents and 305 specimens of undetermined origin (inshore and offshore) were examined for the presence of LLD lesions from 2004 to 2015. Seventeen residents, 3 non-residents and 1 inshore dolphin of unknown residence status were positive. LLD lesions appeared as single or multiple, light grey to whitish nodules and plaques that may ulcerate and increase in size over time. Among resident dolphins, prevalence varied significantly among 4 communities, being low in Posorja (2.35%, n = 85), Ecuador, and high in Salinas, Ecuador (16.7%, n = 18), and Laguna, Brazil (14.3%, n = 42). LLD prevalence increased in 36 T. truncatus from Laguna from 5.6% in 2007-2009 to 13.9% in 2013-2014, albeit not significantly. The disease has persisted for years in dolphins from Mayotte, Laguna, Salinas, the Sanquianga National Park and Bahía Málaga (Colombia) but vanished from the Tramandaí Estuary and the Mampituba River (Brazil). The geographical range of LLD has expanded in Brazil, South Africa and Ecuador, in areas that have been regularly surveyed for 10 to 35 yr. Two of the 21 LLD-affected dolphins were found dead with extensive lesions in southern Brazil, and 2 others disappeared, and presumably died, in Ecuador. These observations stress the need for targeted epidemiological, histological and molecular studies of LLD in dolphins, especially in the Southern Hemisphere

A cross-sectional profile and outcome assessment of adult patients triaged away from Steve Biko Academic Hospital emergency unit

BACKGROUND : Overcrowding is a global problem in emergency medicine. This study examined an approach to this problem at a central hospital. METHODS : A prospective observational study was done to provide a cross-sectional profile of patients triaged away from the emergency unit (EU) and to evaluate their outcome by telephonic survey. RESULTS : 549 patients were triaged away during the study period. There was no significant difference in the number of male and female patients in the sample. Female patients were significantly younger than males (p = 0.0399). The most common complaint was abdominal pain followed by extremity complaints. Females complained more of abdominal pains (OR 1.87, 95% CI [1.13–3.12]; p 0.0094), and males had more extremity complaints (OR 2.42, 95% CI [1.45–4.09]; p = 0.0003). Only 42 patients were available for telephonic follow-up; 66% of them received care on the same day at another treatment facility. No patients who were available for follow-up had died due to their presenting complaint or needed to be referred back. CONCLUSIONS : The typical patient triaged away was a 40-year-old female from the hospital’s referral area with abdominal pain. This study indicated that the method of triage may be safe to determine which patients can be diverted from a central hospital to a lower level of care. There were various limitations to this study; hence, the findings of this study should be interpreted with caution.http://medpharm.tandfonline.com/loi/ojfp20am201

Using Non-linear Models for a Complexity Approach to Psychological Well-being

non-linearity, complexity sciences, adolescence, psychological well-being, satisfaction with life as a whole,