RESUMO
Introduction of 'One Queue' to our paediatric emergency department (PED)-changing to a single-stream triage destination in PED to improve patient flow, clinician experience and team cohesion.
Assuntos
Serviço Hospitalar de Emergência , Triagem , Criança , HumanosRESUMO
Although a great deal of paediatric consultations are not urgent, doctors in training spend so much time providing service for acute conditions that they spend little time focusing on outpatient work before they become a consultant. Engaging clinicians in the managerial aspects of providing clinical care is a key to improving outcomes, and this article addresses these aspects of the outpatient consultation from referral to discharge. We aim to provide doctors in training with a tool to use during their training and their first few years as a consultant, to think about how outpatient work is organised and how it can be improved to maximise patient experience. The non-urgent consultation varies across the world; this article is aimed to be relevant to an international audience.
Assuntos
Pacientes Ambulatoriais , Alta do Paciente/normas , Pediatria/educação , Pediatria/normas , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Médicos , Reino Unido , Estados UnidosRESUMO
Pressure and temperature are important environmental variables that influence living systems. However, while they vary over a considerable range on Earth and other planets, it has hardly been addressed how straightforwardly and to what extent cellular life can acquire resistance to extremes of these parameters within a defined genomic context and a limited number of generations. Nevertheless, this is a very pertinent question with respect to the penetration of life in allegedly inhospitable environments. In this study, directed evolution was used to reveal the potential of the nonsporulating and mesophilic model bacterium Escherichia coli to develop the ability to survive exposure to high temperature or pressure. While heat resistance could only marginally be increased, our data show that piezoresistance could readily and reproducibly be extended into the GPa range, thereby greatly exceeding the currently recognized maximum for growth or survival.
