Why the US Should Adopt a Universal Health Care Coverage Program - eScholarship
Notice bibliographique
Résumé
The California Journal of Emergency Medicine V:3, Jul-Sep 2004 Page 59 between practitioners, it is not surprising that their recommendations will also vary. We additionally suggest that the very nature of a telephone survey to determine PCC recommendations could artificially highlight any differences, when, in fact, clinical practice is more consistent. C ONCLUSION Considerable variation exists among the recommendations given by PCCs in the United States and Canada regarding the management of pediatric benzocaine exposures. The general consensus among our survey respondents was that: 1) the need for observation or any interventions is related to the estimated ingested dose, 2) patients evaluated in a healthcare facility should receive some kind of gastrointestinal decontamination, 3) patients should be observed for several hours (between 2 to 4 hours), 4) the primary signs to observe for are cyanosis, respiratory distress, and altered level of consciousness, 5) arterial blood gas sampling should be obtained on cyanotic patients, even if asymptomatic, and 6) antidotal treatment with methylene blue should be given for methemoglobin levels at or above 20%. R EFERENCES 1. Spiller HA, Revolinski DH, Winter ML, Weber JA, Gorman SE. Multi-center retrospective evaluation of oral benzocaine exposure in children. Vet Hum Toxicol 2000;42:228-31. 2. Curry S. Methemoglobinemia. Ann Emerg Med 3. Guertler AT, Pearce WA. A prospective evaluation of benzocaine associated methemoglobinemia in human beings. Ann Emerg Med 1994;24:626-30. 4. Rodriguez LF, Smolik LM, Zbehlik AJ. Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature. Ann Pharmacother 1994;28:643-9. 5. POISINDEX ® System: POISINDEX ® Editorial Staff: Benzocaine (Management/Treatment Protocol). In: Klasco RK (Ed): POISINDEX ® System. Thomson MICROMEDEX, Greenwood Village, Colorado. 6. Lagutchik MS, Mundie TG, Martin DG. Methemoglobinemia induced by a benzocaine-based topically administered anesthetic in eight sheep. J Am Vet Med Assoc 1992;201:1407-10. 7. Juurlink DN, McGuigan MA. Gastrointestinal decontamination for enteric-coated aspirin overdose: what to do depends on who you ask. J Toxicol Clin Toxicol CaJEM PRO/CON This is a forum for the discussion of controversial topics in emergency medicine. Views expressed in this series are those of the discussants and may not reflect those of the editors. We asked, “should the United States adopt a universal health care coverage system?” Why the US Should Adopt a Universal Health Care Coverage Program Lance Brown, MD, MPH, FAAEM Chief, Division of Pediatric Emergency Medicine Associate Professor of Emergency Medicine and Pediatrics Loma Linda University Medical Center and Children’s Hospital Loma Linda, California LBROWNMD@aol.com There has been increasing interest in the development of universal health care coverage in the United States. 1- The most prominent of these calls has come from a recent Institute of Medicine (IOM) report calling for universal health care coverage in the United States by 2010. 4 There are several key points made in this report that are clearly worth consideration. Over a series of five reports, the IOM Committee on Consequences of Uninsurance made the following conclusions: 4 • The number of uninsured individuals under age 65 is large, growing, and has persisted even during periods of strong economic growth. • Uninsured children and adults do not receive the care they need; they suffer from poorer health and development, and are more likely to die early than are those with coverage. • Even one uninsured person in a family can put the financial stability and health of the whole family at risk. • A community’s high uninsured rate can adversely affect the overall health status of the community, its health care institutions and providers, and the access of its residents to certain services. • The estimated value across the population in healthy years of life gained by providing health insurance
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,034 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,003 | 0,005 |
| Science ouverte | 0,002 | 0,004 |
| Intégrité de la recherche | 0,008 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,048 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».