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The paper aims at enriching the knowledge of the application of lean management (LM) in emergency department (ED), structuring the methodology for implementing LM projects and summarizing the relevant dimensions of LM adoption in ED.

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature review has been performed, extracting a database of 34 papers. To answer the research purpose, a descriptive and content analyses have been carried out.

The descriptive analysis demonstrates that the dealt topic is worldwide emerging and multidisciplinary as it arouses interest by medical and engineering communities. Despite the heterogeneity in the adopted methodology, a framework can be grasped from the literature review. It points out the phases and activities, the tools and techniques and the enablers to be considered for guiding the developing of LM project in ED.

This paper provides a comprehensive overview on how to adopt LM in ED, contributing to fill in the gap emerged in the literature. From a practical perspective, this paper provides healthcare managers with a synthesis of the best managerial practices and guidelines in developing a LM project in ED.

The consumption of rice that contains high levels of inorganic arsenic may cause human health risk. This study aims to determine As species concentrations, particularly iAs, in raw rice in Ho Chi Minh (HCM) City and its health risks.

A total of 60 polished raw composite samples of rice were purchased from traditional markets and supermarkets in HCM City. All samples were analyzed by HPLC-ICPMS for As species determination.

Mean concentrations of inorganic arsenic in all samples, which were purchased from supermarket and traditional market, were 88.8 µg/kg and 80.6 µg/kg, respectively. Overall, inorganic arsenic level was 84.7 µg/kg and contributed the highest proportion of arsenic species in rice with 67.7%. The proportion profiles for arsenic species were: As (III) (60 %); dimethylarsinic acid (32.2 %); As (V) (7.7 %) and methylarsonic acid (0.1 %). Inorganic arsenic level in raw rice was below the recommendation of World Health Organization. Using the benchmark dose recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), all exposure doses were lower than BMDL05. However, as the doses ranged from 3.0 to 8.6 of Margin of Exposure (MOE), the health risk of iAs from rice consumption remains public health concern.

The study results report on the surveillance data of the presence of inorganic arsenic in raw rice products, which are available in the supermarkets and traditional markets, and its health risk to consumers in a metropolitan city in Vietnam.

This study explored the experiences of Irish emergency medical services (EMS) first responders during the first nationwide restrictions to curb the spread of COVID-19.

A systematic literature review (SLR) of research into healthcare workers' and first responders' experiences during the COVID-19 and 2003 SARS pandemics was performed. The SLR informed the content of an online questionnaire distributed via the Irish Pre-Hospital Emergency Care Council to 2,092 first responders on its live register. Data analysis used both descriptive and content analysis.

EMS first responders faced many challenges including PPE quality, training on its use, issues with decontamination facilities, and organisational effectiveness. Emotional challenges included the anxiety experienced, the impact on families, and ethical dilemmas confronted related to patient care. Positive findings also emerged, such as first responders' dedication to working through the pandemic, collegiality, and the community goodwill displayed.

While investigations of the impact of the COVID-19 pandemic on healthcare workers have been undertaken globally, studies focussing exclusively on the experiences of EMS first responders have been rare. This study addressed this knowledge gap, providing an insight into the challenges and successes experienced by first responders and identifying opportunities for learning that can be applied to future public health emergencies.