Journal articles on the topic 'Medical service events'
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Zagorodny, G. M., and E. N. Pinchuk. "Organization of medical caremajor sporting events." Sports medicine: research and practice 12, no. 1 (August 15, 2022): 16–24. http://dx.doi.org/10.47529/2223-2524.2022.1.12.
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Organization of medical support for major international events is one of the major challenges for organizers. There is no single supranational detailed normative act yet.Objective: to analyze the existing national and international regulatory framework for the regulation of medical support for competitions with the subsequent formation of a general algorithm and uniform requirements.Materials and methods: analysis of literature data and personal experience.Results: The authors set out the general principles of organizing medical support for sports events based on an analysis of their own experience and recommendations of international organizations. The basic principles have been tested at a number of major sporting events and are practice-oriented. The preparation of the regulations should be based on the normative act of the international federation for the sport, adjusted taking into account national legislation and the scale of the sporting event being held and our own experience in holding such events. The practical significance of the work is the proposed scheme for organizing medical care at a sports facility. The number of medical teams and medical centers at each sports facility is determined by the organizers of the sports event in accordance with the approved national and international rules; the equipment of medical services is determined by the regulations of the Ministry of Health.Conclusion: Medical regulations should contain general provisions, principles of health protection of athletes, implementation of anti-doping rules, compliance with safety measures at the facility. Requirements for the medical service of the competition for the personnel, facility, medical center of the arena, special conditions for ensuring the competition, interaction with the doping control services; maintenance of accounting and reporting documentation are allocated in a separate detailed chapter. A special place and training in practical skills should be given to the algorithm of actions in case of emergencies.
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Zayas-Cabán, Gabriel, Mark E. Lewis, Matthew Olson, and Samuel Schmitz. "Emergency medical service allocation in response to large-scale events." IIE Transactions on Healthcare Systems Engineering 3, no. 1 (January 2013): 57–68. http://dx.doi.org/10.1080/19488300.2012.762816.
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Enstone, Joanne E., Martin C. J. Wale, Jonathan S. Nguyen-Van-Tam, and James C. G. Pearson. "Adverse medical events in British service personnel following anthrax vaccination." Vaccine 21, no. 13-14 (March 2003): 1348–54. http://dx.doi.org/10.1016/s0264-410x(02)00690-4.
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Taylor, Benjamin B., Edward R. Marcantonio, Odelya Pagovich, Alexander Carbo, Margaret Bergmann, Roger B. Davis, David W. Bates, Russell S. Phillips, and Saul N. Weingart. "Do Medical Inpatients Who Report Poor Service Quality Experience More Adverse Events and Medical Errors?" Medical Care 46, no. 2 (February 2008): 224–28. http://dx.doi.org/10.1097/mlr.0b013e3181589ba4.
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Cash, Rebecca E., Jeremiah Kinsman, Remle P. Crowe, Madison K. Rivard, Mark Faul, and Ashish R. Panchal. "Naloxone Administration Frequency During Emergency Medical Service Events — United States, 2012–2016." MMWR. Morbidity and Mortality Weekly Report 67, no. 31 (August 10, 2018): 850–53. http://dx.doi.org/10.15585/mmwr.mm6731a2.
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Williams, Lindsy N., Cynthia M. Sweeney, and Jeffrey W. Britton. "Medication events on a tertiary neurology inpatient service." Journal of Clinical Neuroscience 21, no. 1 (January 2014): 51–54. http://dx.doi.org/10.1016/j.jocn.2013.04.012.
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Jones, Tracie. "Collaborative Relationships for Mass Gathering Events." Prehospital and Disaster Medicine 34, s1 (May 2019): s109. http://dx.doi.org/10.1017/s1049023x19002280.
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Introduction:Electronic Dance Music events (EDMs) are complex mass gatherings and given published rates of illnesses, injuries, and hospitalizations, these events can place an additional burden on local health care services. Accordingly, during the planning process for EDMs many stakeholders are involved; however, local hospitals, a key part of the medical safety plan, are often excluded. In this case report, it is posited that the involvement of local hospital(s) and the resulting integration of on-site and acute-care service provision during an event, ultimately reduces the burden placed on local hospitals.Methods:Case report; synthesis of published literature.Results:A 25,000 person per day, two-day mass gathering EDM event trialed a model of collaborative planning with a local community hospital. Planning included the identification of a hospital liaison, pre-event teleconferences between event staff, contracted and public medical response teams, emergency management teams, harm reduction practitioners, public health, and hospital personnel. Throughout the collaborative planning process, vital information was shared in order to optimize patient continuity of care and streamline the transition of care from site medical response to an acute care setting. Outcomes included the prevention of unnecessary transfers to the hospital; however, those patients who required transfer had their initial treatment started prior to leaving the venue. Further, collaborative planning also contributed to improved bidirectional data sharing to better understand the impact on the local hospital of the event, including transfers from the onsite medical team as well as transports from the community and self-presentations for care.Discussion:The collaboration of onsite medical and hospital teams improved the delivery of essential medical care to the patrons of the event and added a layer to the safety planning process essential to mass gathering events.
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Bortolin, Michelangelo, Marco Ulla, Alessia Bono, Enrico Ferreri, Mariano Tomatis, and Sergio Sgambetterra. "Holy Shroud Exhibition 2010: Health Services During a 40-Day Mass-Gathering Event." Prehospital and Disaster Medicine 28, no. 3 (March 21, 2013): 239–44. http://dx.doi.org/10.1017/s1049023x13000216.
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AbstractIntroductionMass-gathering events require varying types and amounts of medical resources to deal with patient presentations as well as careful planning for environmental health management. The Holy Shroud Exhibition was hosted in Torino, Italy, between April and May 2010. The venue was a unique mass-gathering event which lasted several weeks. It was held in a limited area in the center of the city and it was attended by a large and heterogeneous population. A dedicated Health Care Service was created for the event.MethodsThis study is a retrospective analysis of clinical presentations of patients who were managed by the Medical Services during the event. The main study outcomes included Patient Presentation Rate (PPR), type of injuries and illnesses, and the Transport to Hospital Rate (TTHR).ResultsThe PPR and TTHR were both low (0.27 and 0.039 respectively). The majority of patients presented with low severity codes and no sudden cardiac death (SCD) or cardiac arrest occurred. Cardiac and trauma emergencies were most frequent categories of presentation. A number of pediatric patients (19.37%) were treated by the event Medical Service. Approximately two million persons participated in the 40-day event.ConclusionThe experience for this 40-day event supported having an on-site, organized, dedicated Medical Service that decreased overcrowding of the local Emergency Medical System and hospitals. It is recommended that, for such events, there be recruitment of emergency physicians with experience in mass-gathering events, recruitment of pediatricians, and training for professionals during the planning process.BortolinM, UllaM, BonoA, FerreriE, TomatisM, SgambetterraS. Holy Shroud Exhibition 2010: health services during a 40-day mass-gathering event. Prehosp Disaster Med. 2013;28(3):1-6.
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Miller, Anastasia. "Emergency medical service personnel injury and fatality in the United States." Journal of Epidemiological Research 4, no. 2 (May 23, 2018): 9. http://dx.doi.org/10.5430/jer.v4n2p9.
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Introduction: Emergency Medical Services (EMS) personnel comprise an intricate part of the public safety net in the US. The purpose of this study was to synthesize data sources to understand the major workplace dangers facing EMS providers. Methods: This study examined four data sources: The BLS Census of Fatal Occupational Injuries (CFOI), BLS Survey of Occupational Injuries and Illnesses (SOII), Firefighter Fatalities and Statistics from USFA, and the EMS Voluntary Event Notification Tool (E.V.E.N.T.). Characteristics of the most common causes of injury and fatalities were described and compared. Results: SOII reports covered 13 years and 64,780 nonfatal reported cases. COFI covered 12 years and 149 fatalities. 111 fatalities from the USFA dataset who had been identified as EMS in some manner in their rank between 2003-2016 were inspected. 21 cases where a firefighter died in the course of providing EMS/patient care were also identified and discussed. All events submitted to E.V.E.N.T. were read and categorized. 214 events were identified as near-miss EMS provider injuries and included in the study. Conclusions: The biggest mortal threat to private EMS personnel is vehicular incidents. Among firefighters/EMTs Heart Attacks was the most common nature of death. The biggest nonfatal concerns are violence, slips, trips, and falls, and overexertion in addition to vehicular incidents. Most violent events were the result of a patient with a Temporarily Altered Mental Status. There is clearly a need for further research to develop evidence-based methods and policies to reduce injury and death in EMS personnel from an agency level.
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Hick, John L., Ralph J. Frascone, Katherine Grimm, Merle Hillman, Jayne Griffith, Michael Hogan, Rebecca Trotsky-Sirr, and Jane Braun. "Health and Medical Preparedness and Response to the 2008 Republican National Convention." Disaster Medicine and Public Health Preparedness 3, no. 4 (December 2009): 224–32. http://dx.doi.org/10.1097/dmp.0b013e3181c5b4a8.
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ABSTRACTObjective: National security special events occur yearly in the United States. These events require comprehensive advance planning for health and medical contingencies in addition to law enforcement concerns. The planning for and impact of the Republican National Convention (RNC) on the City of St Paul and the Minneapolis–St Paul metropolitan area is described.Methods: Descriptive analysis of events was provided by the authors based on their planning and operational experiences. Daily data were gathered from area hospitals, emergency medical services agencies, the National Weather Service, federal medical teams, and the Minnesota Department of Health to capture the impact of the RNC on emergency department activity, nonemergency surgery, emergency medical services run volumes, patient visits to onsite and offsite medical clinics, and general hospital occupancy in the metropolitan area.Results: There were no epidemiological signal events. Weather was not extreme. Confrontations between protestors and law enforcement resulted in frequent use of riot-control agents. Protestors sought medical care from “street medics” and their affiliated free clinics in preference to usual medical facilities. Emergency departments close to the event venue reported decreased patient volumes. Hospitals close to the venue reported significantly decreased nonemergency surgical case volumes. Local hospitals implemented access controls and in 1 case, shut down ventilation systems due to riot-control agent deployment in the streets outside. Emergency medical services volumes were near average, with the exception of St Paul Fire Department on the day of a major protest march.Conclusions: Planning and operational response for the RNC consumed large amounts of time and resources. The RNC had minimal patient impact on the health care system and in fact caused significant volume decreases at hospitals proximate to the venue. Although contingencies available for a mass casualty event were not needed, they must continue to be available for all such events. Health and medical preparedness and funding is not adequately detailed in the planning framework for national security special events, and this should be a focus for future events. (Disaster Med Public Health Preparedness. 2009;3:224–232)
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Kade, Kristy A., Kathryn H. Brinsfield, Richard A. Serino, Elena Savoia, and Howard K. Koh. "Emergency Medical Consequence Planning and Management for National Special Security Events After September 11: Boston 2004." Disaster Medicine and Public Health Preparedness 2, no. 3 (October 2008): 166–73. http://dx.doi.org/10.1097/dmp.0b013e318184556e.
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ABSTRACTThe post-September 11 era has prompted unprecedented attention to medical preparations for national special security events (NSSE), requiring extraordinary planning and coordination among federal, state, and local agencies. For an NSSE, the US Secret Service (USSS) serves as the lead agency for all security operations and coordinates with relevant partners to provide for the safety and welfare of participants. For the 2004 Democratic National Convention (DNC), designated an NSSE, the USSS tasked the Boston Emergency Medical Services (BEMS) of the Boston Public Health Commission with the design and implementation of health services related to the Convention. In this article, we describe the planning and development of BEMS’ robust 2004 DNC Medical Consequence Management Plan, addressing the following activities: public health surveillance, on-site medical care, surge capacity in the event of a mass casualty incident, and management of federal response assets. Lessons learned from enhanced medical planning for the 2004 DNC may serve as an effective model for future mass gathering events. (Disaster Med Public Health Preparedness. 2008;2:166–173)
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Bushmanov, A., I. Galstyan, V. Solov'ev, and M. Konchalovsky. "Lessons for Health Service: the Chernobyl Accident and the COVID-19 Pandemic." Medical Radiology and radiation safety 65, no. 3 (August 1, 2020): 79–84. http://dx.doi.org/10.12737/1024-6177-2020-65-3-79-84.
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Purpose: The article is devoted to the analysis of organizational measures to overcome the medical consequences of two large-scale events: the Chernobyl accident on 26.04.1986 and the COVID-19 pandemic.
Results: A comparison of the causes, key factors, numbers affected and involved in these events persons, and the availability of the source of knowledge about the clinical picture, diagnosis, prevention and treatment of diseases, developing as a result of radiation exposure and the virus SARS-Cov-2. The article considers the availability of special medical institutions, the infectability of medical workers, the presence of long-term consequences for the health of victims and for the economy.
Conclusions: In the development of such catastrophic events, an important role should be played by 1) Timely and adequate information to the population. 2) It is necessary to have a sufficient number of beds that can be repurposed in accordance with the needs and provided with appropriate equipment to support the vital functions of the body. 3) Planned training of qualified medical personnel should be carried out. 4) It is necessary to have stocks of emergency drugs close to the institutions where it is possible to receive victims.
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Tippett, Elizabeth. "Medical Advice from Lawyers." American Journal of Law & Medicine 41, no. 1 (March 2015): 7–48. http://dx.doi.org/10.1177/0098858815591508.
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This study examined the medical information contained in a sample of television ads soliciting consumers for lawsuits against drug and medical device manufactures. Almost all such ads involved drugs or devices that have not been recalled and remain on the market. These ads raise important public health questions because they may influence the prospective medical decisions of viewers.The ads contained extensive descriptions of serious adverse events associated with the drugs or devices but almost uniformly failed to disclose information relating to the likelihood of such events. They also failed to effectively advise viewers to consult a doctor.Results also identified a subset of ads that mimicked public service announcements, claiming to be a “medical alert” “consumer alert” or “FDA warning” at the start of the ad. Most such ads did not disclose the attorney source of the advertising until the final few seconds.
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Mills, Ellen, Vicki Hume, and Kathy Stiller. "Increased allied health services to general and acute medical units decreases length of stay: comparison with a historical cohort." Australian Health Review 42, no. 3 (2018): 327. http://dx.doi.org/10.1071/ah16220.
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Objective The present study evaluated the effect of an initiative to fund increased allied health (AH) services, enabling increased days and both volume and scope of AH services, for general medical in-patients in the Central Adelaide Local Health Network for a 6-month trial period. Methods A quasi-experimental mixed-methods study was undertaken involving general medical in-patients at two acute tertiary-referral public hospitals with a prospective (December 2015–May 2016) and historical comparison (December 2014–May 2015) cohort. Outcome measures compared between the two cohorts included hospital length of stay (LOS), occupied bed-days, adverse events and AH service data. Results After implementation of increased AH services, there were significant decreases in the median (interquartile range) of both hospital LOS (from 7.2 (7.0–8.0) to 6.5 (6.1-6.7) days; P = 0.006) and occupied bed-days (from 5295.0 (5200.0–5622.3) to 4662.5 (4335.8–4744.3) bed-days per month; P = 0.004). There was no significant change in weekend discharges or adverse events. AH services increased, with the median number of referrals seen by AH professionals per month, occasions of AH service and AH intervention time per month increasing by 17%, 45% and 43% respectively after implementation, along with a faster response time to referrals. Conclusions Increased levels of AH staffing to general medical in-patients were associated with a significant reduction in hospital LOS and occupied bed-days. What is known about the topic? AH services are an important component in the delivery of safe, effective and efficient health care to hospitalised patients. There is little evidence specifically investigating the effect of increased AH services for general medical patients in an acute hospital setting. What does this paper add? This study provides new evidence demonstrating that increasing AH services to general medical in-patients within two acute tertiary-referral public hospitals decreased hospital LOS and occupied bed-days, without an increase in adverse events. What are the implications for practitioners? A funding initiative to enable increased AH services to general medical in-patients significantly reduced hospital LOS and occupied bed-days. These findings will be of considerable interest to other healthcare centres, particularly those where AH levels are below benchmark figures.
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Wu, Wilson C. S., and Andrew P. Schachat. "Transfer from Ophthalmology to Another Service is a Marker of High Risk Medical Events." Ophthalmic Surgery, Lasers and Imaging Retina 22, no. 1 (January 1991): 7–9. http://dx.doi.org/10.3928/1542-8877-19910101-04.
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Lund, Adam, and Sheila Turris. "The Event Chain of Survival in the Context of Music Festivals: A Framework for Improving Outcomes at Major Planned Events." Prehospital and Disaster Medicine 32, no. 4 (March 20, 2017): 437–43. http://dx.doi.org/10.1017/s1049023x1700022x.
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AbstractDespite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs).The authors hypothesized that one approach to minimizing this fragmentation may be to create a framework to “connect the dots,” or join together the many silos of professionals responsible for safety, security, health, and emergency planning at MPEs. Adapted from the well-established literature regarding the management of cardiac arrests, both in and out of hospital, the “chain of survival” concept is applied to the disparate groups providing services that support event safety in the context of music festivals. The authors propose this framework for describing, understanding, coordinating and planning around the integration of safety, security, health, and emergency service for events. The adapted Event Chain of Survival contains six interdependent links, including: (1) event producers; (2) police and security; (3) festival health; (4) on-site medical services; (5) ambulance services; and (6) off-site medical services.The authors argue that adapting and applying this framework in the context of MPEs in general, and music festivals specifically, has the potential to break down the current disconnected approach to event safety, security, health, and emergency planning. It offers a means of shifting the focus from a purely reactive stance to a more proactive, collaborative, and integrated approach. Improving health outcomes for music festival attendees, reducing gaps in planning, promoting consistency, and improving efficiency by reducing duplication of services will ultimately require coordination and collaboration from the beginning of event production to post-event reporting.LundA, TurrisSA. The Event Chain of Survival in the context of music festivals: a framework for improving outcomes at major planned events. Prehosp Disaster Med. 2017;32(4):437–443.
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King, Kevan, Hannah E. Davis, Robin Moorman-Li, Kelsey J. Cook, and Nathan D. Seligson. "Development of a Campus-Wide Community Service Initiative during a Pandemic." Pharmacy 10, no. 3 (April 19, 2022): 47. http://dx.doi.org/10.3390/pharmacy10030047.
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Community service serves as a major aspect of pharmacy education; however, coronavirus disease 2019 (COVID-19) represented a significant disruption to student involvement. The College of Pharmacy student council, which serves as the local student government organization for the University of Florida College of Pharmacy, Jacksonville campus, developed a community service initiative to offer more consistent opportunities for students to participate in community service events, while adapting to COVID-19 restrictions. A retrospective, qualitative review of this initiative demonstrates the potential value of this model. Prior to this initiative, students relied on individual student organizations to provide service opportunities to their members. This excluded portions of the student body and led to sparse and inconsistent events, with limited variation in the types of service events available. Furthermore, de-centralized planning of service opportunities increased the difficulty of ensuring that COVID-19 safety restrictions were followed appropriately. This initiative resulted in 39 students logging over 200 service hours through nine events in the first seven months after its development. Despite the challenges presented by the COVID-19 pandemic, our centralized initiative serves as a model for improving community service involvement.
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Reilly, Michael J., David Markenson, and Charles DiMaggio. "Comfort Level of Emergency Medical Service Providers in Responding to Weapons of Mass Destruction Events: Impact of Training and Equipment." Prehospital and Disaster Medicine 22, no. 4 (August 2007): 297–303. http://dx.doi.org/10.1017/s1049023x00004908.
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AbstractBackground:Numerous studies have suggested that emergency medical services (EMS) providers areill-prepared in the areas of training and equipment for response to events due to weapons of mass destruction(WMD) and other public health emergencies (epidemics, etc.).Methods:A nationally representative sample of basic and paramedic EMS providers in the United States wassurveyed to assess whether they had received training in WMD and/or public health emergencies as part of their initial provider training and as continuing medical education within the past 24 months. Providers also were surveyed as to whether their primary EMS agency had the necessary specialty equipment to respond to these specific events.Results:More than half of EMS providers had some training in WMD response. Hands-on training was associated with EMS provider comfort in responding to chemical, biological, and/or radiological events and public health emergencies (odds ratio (OR) = 3.2, 95% confidence interval (CI) 3.1, 3.3). Only 18.1% of providers surveyed indicated that their agencies had the necessary equipment to respond to a WMD event. Emergency medical service providers who only received WMD training reported higher comfort levels than those who had equipment, but no training.Conclusions:Lack of training and education as well as the lack of necessary equipment to respond to WMD events is associated with decreased comfort among emergency medical services providers in responding to chemical, biological, and/or radiological incidents. Better training and access to appropriate equipment may increase provider comfort in responding to these types of incidents.
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Carli, Pierre, Caroline Telion, and David Baker. "Terrorism in France." Prehospital and Disaster Medicine 18, no. 2 (June 2003): 92–99. http://dx.doi.org/10.1017/s1049023x00000820.
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AbstractFrance has experienced two waves of major terrorist bombings since 1980. In the first wave (1985–1986), eight bombings occurred in Paris, killing 13 and injuring 281. In the second wave (1995–1996), six bombings occurred in Paris and Lyon, killing 10 and injuring 262. Based on lessons learned during these events, France has developed and improved a sophisticated national system for prehospital emergency response to conventional terrorist attacks based on its national emergency medical services (EMS) system, Service d' Aide Medicale Urgente (SAMU). According to the national plan for the emergency medical response to mass-casualty events (White Plan), the major phases of EMS response are: (1) alert; (2) search and rescue; (3) triage of victims and provision of critical care to first priority victims; (4) regulated dispatch of victims to hospitals; and (5) psychological assistance.Following the 1995 Tokyo subway sarin attack, a national plan for the emergency response to chemical and biological events (PIRATOX) was implemented. In 2002, the Ministries of Health and the Interior collaborated to produce a comprehensive national plan (BIOTOX) for the emergency response to chemical, biological, radiological, and nuclear events. Key aspects of BIOTOX are the prehospital provision of specialized advance life support for toxic injuries and the protection of responders in contaminated environments. BIOTOX was successfully used during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak in France.
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Bigouette, John Paul, Erin C. Owen, Jonathan Greenleaf, Stanley L. James, and Nicholas L. Strasser. "Injury Surveillance and Evaluation of Medical Services Utilized During the 2016 Track and Field Olympic Trials." Orthopaedic Journal of Sports Medicine 6, no. 12 (December 1, 2018): 232596711881630. http://dx.doi.org/10.1177/2325967118816300.
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Background: Injury surveillance systems have been implemented at world championships, yet no previous work has determined the burden of injuries during the United States Track and Field Olympic Trials. Additionally, the type of medical service providers utilized throughout the meet has not been reported, leaving it unclear whether optimal staffing needs are being met. Purpose: To describe the incidence of injuries presenting to the medical team at the 2016 US Track and Field Olympic Trials (Eugene, Oregon) by event type and competitor demographics. Study Design: Descriptive epidemiology study. Methods: A retrospective review was performed of all documented injuries and treatments recorded from June 28 through July 10, 2016. Descriptive statistics and the prevalence of newly incurred injuries were calculated for registered athletes and nonathlete (ie, support) staff. The incidence of acute injuries was analyzed for registered athletes, as stratified by athlete sex and event type. Results: A total of 514 individuals were seen during the trials: 89% were athletes and 11% were supporting staff. Physicians treated 71 injuries and 14 illnesses. Of diagnosed injuries, 85% (n = 60) occurred among athletes, with hamstring strains (16.7%, n = 10) being the most prevalent. A mean of 124 medical services (median, 137; interquartile range, 65.5-179.5) were provided each day of the trials. Among medical services, 41.8% were attributed to massage therapists for athletes, while chiropractic services were the most utilized service (47.1%) by the support staff. There was an overall incidence of 59.7 injuries per 1000 registered athletes, with jumpers (109.4 per 1000) and long-distance athletes (90.4 per 1000) being the most commonly seen athletes. Conclusion: Throughout the trials, athletes participating in jumping and long-distance events were the most commonly seen by physicians, creating the potential need for an increase in staffing of physicians during meet periods when these events occur. The provided medical services appeared to follow the number of athletes competing during the trials and the need for recovery treatments after competition. Findings from this study should inform future strategy for staffing and policy development at Olympic Trials and other elite-level track and field events in the United States.
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Nortje, Charl, Craig B. Roberts, and André T. Möller. "Judgement of Risk in Traumatized and Nontraumatized Emergency Medical Service Personnel." Psychological Reports 95, no. 3_suppl (December 2004): 1119–28. http://dx.doi.org/10.2466/pr0.95.3f.1119-1128.
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This study investigated the hypothesis that posttraumatic stress is associated with a judgement of risk bias, defined as an overestimation of the likelihood of the occurrence of adverse events, as proposed by information-processing theories of posttraumatic stress disorder. Emergency medical service personnel with high PTSD symptomatology ( n = 27) and without PTSD symptoms ( n = 74) completed the PTSD Symptom Scale: Self-report version, the Work Experiences Questionnaire, the Beck Depression Inventory, and an Event Probability Questionnaire. Analysis showed that individuals with high PTSD symptomatology exhibited significantly more judgement of risk bias, that this cognitive bias was towards a wider range of threats than those involving only the threat of external harm, and that intrusion was its best predictor.
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Lin, Li-Wei, Hsiao-Yu Lin, Chien-Yeh Hsu, Hsiao-Hsien Rau, and Ping-Ling Chen. "Effect of weather and time on trauma events determined using emergency medical service registry data." Injury 46, no. 9 (September 2015): 1814–20. http://dx.doi.org/10.1016/j.injury.2015.02.026.
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Lum, Diane J., Patricia A. Ross, Martin A. Bishop, Michelle L. Caetano, Rohil Malpani, and Michael B. Streiff. "Evaluation of a Standardized Perioperative Management Protocol in the Adult Hematology Anticoagulation Management Service." Annals of Pharmacotherapy 51, no. 12 (July 5, 2017): 1077–83. http://dx.doi.org/10.1177/1060028017719505.
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Background: In North America, 250,000 patients on vitamin K antagonists require surgical procedures each year. Temporary interruption of oral anticoagulation and perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin are recommended by the American College of Chest Physicians 2012 for select patients. Objectives: The study objectives are to evaluate adherence and nonadherence to the Johns Hopkins clinic guidelines for perioperative management of anticoagulation and identify bleeding or thromboembolic events during perioperative management of anticoagulation. Methods: This is a retrospective study of patients who required perioperative management of anticoagulation for an invasive procedure from May 2009 to March 2014. Individualized perioperative anticoagulation management plans were prospectively developed for each patient according to the standardized Johns Hopkins perioperative bridging recommendations and documented in the medical record. Adherence to these standardized Johns Hopkins clinic guidelines, the incidence of thromboembolic events, and bleeding and adverse events during perioperative management were retrieved from the medical record. Results: In 294 perioperative management cases, there was 1 (0.3%) thromboembolism, 3 (1%) major bleeds, and 21 (7%) minor bleeds. One patient experienced facial swelling after starting enoxaparin. There was no difference in thromboembolic (0 vs 1, P = 1.00), major (1 vs 2, P = 1.00), or minor bleeding (14 vs 7, P = 1.00) events in patients managed by providers who were adherent to guidelines when compared with providers who were nonadherent. Conclusion: Our study shows that using a standardized guideline for perioperative management of anticoagulation to inform but not to dictate clinical practice leads to low rates of both thromboembolism and bleeding.
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Gogu, Madalina-Cristina. "Developing emergency medical transportation services for a turbulent future." Global Journal of Sociology: Current Issues 8, no. 1 (May 9, 2018): 13–21. http://dx.doi.org/10.18844/gjs.v8i1.3401.
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AbstractThe purpose of the emergency medical transportation services is to save human life, irrespective of political, economical, social or military situation in which the people, seeking help, find themselves in. The direction towards which the populations health is heading, is unsure due to the lack of drinkable water, quality food, access to medical care, pollution, stress, new viruses, economic, social, political and military problems, terrorism, fires, floods, earthquakes and other events and processes with a high risk for human health. The objective of the paper presents the challenges that citizens and the emergency medical transportation service will face, in terms of a turbulent future; and the necessity of applying the principles of adaptive management and the analysis of the possibility of applying those principles in emergency medicine using analytical, theoretical and comparative methods. The result shows that the emergency medical transportation services will cope with the uncertainties and the challenges of a turbulent future.
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O’Donnell, Elen, Bridget Honan, Simon Quilty, and Rebecca Schultz. "The Effect of Heat Events on Prehospital and Retrieval Service Utilization in Rural and Remote Areas: A Scoping Review." Prehospital and Disaster Medicine 36, no. 6 (November 2, 2021): 782–87. http://dx.doi.org/10.1017/s1049023x21001163.
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AbstractIntroduction:It is well-established that heatwaves increase demand for emergency transport in metropolitan areas; however, little is known about the impact of heat events on demand for prehospital retrieval services in rural and remote areas, or how heatwaves are defined in this context.Inclusion Criteria:Papers were eligible for inclusion if they reported on the impact of a heat event on the activity of a prehospital and retrieval service in a rural or remote area.Methods:A search of PubMed, Cochrane, Science Direct, CINAHL, and Google Scholar databases was undertaken on August 18, 2020 using search terms related to emergency medical transport, extreme heat, and rural or remote. Data relevant to the impact of heat on retrieval service activity were extracted, as well as definitions of extreme heat.Results:Two papers were identified, both from Australia. Both found that heat events increased the number of road ambulance call-outs. Both studies used the Excess Heat Factor (EHF) to define heatwave periods of interest.Conclusions:This review found almost no primary literature on demand for prehospital retrieval services in rural and remote areas, and no data specifically related to aeromedical transport. The research did recognize the disproportionate impact of heat-related increase in service demand on Australian rural and regional health services. With the effects of climate change already being felt, there is an urgent need for more research and action in this area.
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Lucey, Thomas A., Jeffrey M. Hawkins, and Duane M. Giannangelo. "U.S. History Interpretations of Pre-Service and In-Service Teachers." Social Studies Research and Practice 4, no. 1 (March 1, 2009): 42–55. http://dx.doi.org/10.1108/ssrp-01-2009-b0004.
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Teachers’ understandings of content affect their abilities to develop creative instructional strategies for learning. The authors investigated understandings of United States history among a convenience sample of pre-service and in-service teachers enrolled in social studies methods and multicultural education courses at two institutions of higher learning. They employed a 30-item survey concerning events and topics from all 10 United States historical eras, involving both conventional and revisionist interpretations. The authors found very low percentages of correct responses. Respondents taking more history courses generally answered more items correctly. White students answered more revisionist items correctly than underrepresented students. The findings are generally consistent with previous interpretations of pre-service and in-service teachers’ United States history understandings. The authors provide suggestions for teacher preparation and future research.
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Farrar, Emma. "Cystic fibrosis newborn screening." Morecambe Bay Medical Journal 5, no. 6 (October 1, 2007): 158–61. http://dx.doi.org/10.48037/mbmj.v5i6.409.
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CYSTIC FIBROSIS - Ethical issues at two extremes
Emma Farrar and Jemma Smith worked as medical students with consultant paediatrician Clare Peckham at a time when services for cystic fibrosis were undergoing a transformation. Clare herself is leading the local service development. Neonatal screening for cystic fibrosis started in the North West on 1 October 2007.
The right of a child to be involved in decision making concerning his or her future has recently been affirmed by the General Medical Council. These events provide the backdrop to two timely articles on the ethical issues involved in the management of a difficult illness.
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KHISAMIEV, RUSTEM SH, DILYA R. SULTANOVA, RASHID Il KHALITOV, VIKTOR V. FROLOV, and NAIL B. AMIROV. "DEPARTMENTAL MEDICAL SERVICE OF THE MINISTRY OF INTERNAL AFFAIRS OF THE RUSSIAN FEDERATION IS 100 YEARS OLD." Bulletin of Contemporary Clinical Medicine 14, no. 5 (October 2021): 7–13. http://dx.doi.org/10.20969/vskm.2021.14(5).7-13.
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The article reflects the historical aspects of the development of the medical service of the Ministry of Internal Affairs of the Republic of Tatarstan. The operation of the unit, including the functioning of all subdivisions, is described. The organization of activities on medical service provision at large-scale sporting events of international level is disclosed. The strategic goals of the institution and directions for increasing the quality and availability of medical care in the near future are determined. The article also gives a set of preventive measures taken by the medical unit in the fight against a new coronavirus infection.
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Lund, Adam, Sheila A. Turris, and Ron Bowles. "Conceptualizing the Impact of Special Events on Community Health Service Levels: An Operational Analysis." Prehospital and Disaster Medicine 29, no. 5 (September 4, 2014): 525–31. http://dx.doi.org/10.1017/s1049023x14000880.
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AbstractMass gatherings (MG) impact their host and surrounding communities and with inadequate planning, may impair baseline emergency health services. Mass gatherings do not occur in a vacuum; they have both consumptive and disruptive effects that extend beyond the event itself. Mass gatherings occur in real geographic locations that include not only the event site, but also the surrounding neighborhoods and communities. In addition, the impact of small, medium, or large special events may be felt for days, or even months, prior to and following the actual events. Current MG reports tend to focus on the events themselves during published event dates and may underestimate the full impact of a given MG on its host community.In order to account for, and mitigate, the full effects of MGs on community health services, researchers would benefit from a common model of community impact. Using an operations lens, two concepts are presented, the “vortex” and the “ripple,” as metaphors and a theoretical model for exploring the broader impact of MGs on host communities. Special events and MGs impact host communities by drawing upon resources (vortex) and by disrupting normal, baseline services (ripple). These effects are felt with diminishing impact as one moves geographically further from the event center, and can be felt before, during, and after the event dates. Well executed medical and safety plans for events with appropriate, comprehensive risk assessments and stakeholder engagement have the best chance of ameliorating the potential negative impact of MGs on communities.LundA, TurrisSA, BowlesR. Conceptualizing the impact of special events on community health service levels: an operational analysis. Prehosp Disaster Med. 2014;29(5):1-7.
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İsmayıl oğlu Rzayev, Taleh. "Opportunities for cooperation between Germany and Azerbaijan in the field of “Medical Tourism”." SCIENTIFIC WORK 65, no. 04 (April 23, 2021): 241–43. http://dx.doi.org/10.36719/2663-4619/65/241-243.
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Development cooperation between Germany and Azerbaijan continues to develop relations in the field of medical tourism, as well as in many areas of tourism. This cooperation serves to further increase the opportunities in the field of medical tourism between the two countries and seeks to strengthen German-Azerbaijani medical tourism cooperation. The German healthcare system has a strong international reputation for its quality, and the medical technology and treatment options available in Germany are at the most modern level. For these reasons, it is important for Azerbaijan to benefit from German medical tourism practice and to study the available medical technology and treatment options. Conferences, events and scientific discussions are held between Germany and Azerbaijan to ensure the long-term development of this cooperation. Such events are very important in increasing the awareness of health workers and developing internship opportunities between the two countries. In accordance with the topic of the article, research has been conducted in the field of medical tourism in Germany, and the existing purposeful opinions and ideas on the application of new projects to Azerbaijan have been included the topic. Key words: Medical tourism, high medical service, Health Clinic, Senior Expert Services, Ms. Heike Muskel, German-Azerbaijani Business Forum, German health system
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Ahluwalia, Manmeet S., Kimberly Klein, Boris W. Kuvshinoff, Francisco J. Hernandez-Ilizaliturri, Gregory Wilding, Judy L. Smith, and Minoo Battiwalla. "Improving Compliance with Guidelines for Venous Thromboembolism (VTE) Prophylaxis Significantly Reduces VTE Events." Blood 112, no. 11 (November 16, 2008): 1288. http://dx.doi.org/10.1182/blood.v112.11.1288.1288.
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Abstract Background: Venous thromboembolism (VTE) is reported in about five percent of patients with malignancy and is often associated with serious clinical outcomes such as major infarction, hemorrhage and death. The prevalence rates of malignancy-related VTE is most likely underestimated, in part because of the frequent presence of confounding risk factors, such as advanced age, prolonged immobilization, surgical procedures, and chemotherapeutic regimens. Occurrence of VTE can increase the likelihood of death for cancer patients by 2- to 8-fold. Prophylactic anticoagulation therapy and mechanical prophylaxis is recommended for all inpatients with a diagnosis of active malignancy. Mechanical prophylaxis alone is recommended for patients if contraindication to anticoagulation therapy exists. Roswell Park Cancer Institute (RPCI), a Comprehensive Cancer Center with 24,000 active patients under its care, initiated an Institute-Wide Quality Improvement Initiative in 2006 to improve the rates of VTE prophylaxis for all adult inpatient admissions. The objectives were to improve compliance with national guidelines on VTE prophylaxis and to reduce future VTE events in our patient population. Methods: VTE prophylaxis based on National Comprehensive Cancer Network (NCCN) guidelines was instituted on all Medical services. Surgical services followed guidelines in accordance with NCCN and Surgical Best Practice and published standards. Mandatory physician order entry forms including computerized physician order entry were implemented. VTE awareness and staff education was promoted via informational materials, field in-services and seminars. In order to track compliance, manual audits of patient charts were performed every 3 months. Results: Results: Initial surveys revealed 61% compliance with guidelines on the medicine service and 86% on the surgical services. Overall institute-wide VTE Prophylaxis compliance improved from 80% to 95% following implementation of the initiative (shown in table 1). This has resulted in a decrease in VTE incidence from 0.39% in the last quarter of 2006 when the initiative was launched to 0.13% and 0.08% seen in the first and second quarters of 2008 respectively (P<0.0001). The actual events dropped from 40 in the last quarter of 2006 to 14 events and 10 events in the first and the second quarter of 2008 respectively. The greatest benefit was seen in reduction in outpatient VTE and on the medical services. Conclusions: Implementation of our VTE Prophylaxis Initiative resulted in improved compliance with national guidelines at RPCI and has resulted in a highly significant and clinically relevant reduction of VTE in our vulnerable patient population. Table 1: Institute Compliance rate on VTE prophylaxis 2006 2007 2008 Compliance Q4 Q1 Q2 Q3 Q4 Q1 Q2 Medical Services 61% 78% 86% 95% 96% 90% 90% Surgical Service 86% 92% 98% 98% 97% 97% 100% Institute-Wide 80.40% 86.80% 93.60% 96.60% 96.50% 94.60% 95.4% Table 2: VTE events 2006 2007 2008 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 # VTE/Quarter 31 30 40 40 38 29 34 17 14 10 # Admission/Outpatients 10439 11518 10367 10298 10230 11072 10815 11852 10887 13234 % 0.30% 0.26% 0.39% 0.39% 0.37% 0.26% 0.31% 0.14% 0.13% 0.08%
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Gottrich, Ronald W. "Public Health/Government Service as an Alternate Practice of Pharmacy." Journal of Pharmacy Practice 2, no. 2 (April 1989): 77–82. http://dx.doi.org/10.1177/089719008900200204.
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Public health and governmental service are discussed as alternate forms of the practice of pharmacy. The author discusses his employment with the Illinois Department of Public Health in the areas of drug product selection, drug, medical device, and cosmetic establishment inspections, and long-term care. Aspects of the author's employment as consultant pharmacist for the state Medicaid program are related. Events leading to the author's selection of the field of public health pharmacy practice are described. The benefits of a pharmacy education in this field, rewards and frustrations of government employment, and the future prospects for public health pharmacy are highlighted.
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Li, Xiaobing, Qinglin Hu, and Abbey Gregg. "An integrated spatio-temporal analysis of emergency medical service response characteristics for stroke events across Alabama." Journal of Transport & Health 20 (March 2021): 101018. http://dx.doi.org/10.1016/j.jth.2021.101018.
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DiGiacomo, Michelle, Patricia M. Davidson, Joyce Davison, Louise Moore, and Penny Abbott. "Stressful life events, resources, and access: key considerations in quitting smoking at an Aboriginal Medical Service." Australian and New Zealand Journal of Public Health 31, no. 2 (April 2007): 174–76. http://dx.doi.org/10.1111/j.1753-6405.2007.00037.x.
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Dey, Subhashish. "The Importance of Health Insurance in the Various Insurance Sectors in India: A Review." International Journal of Industrial Marketing 7, no. 1 (November 20, 2022): 31. http://dx.doi.org/10.5296/ijim.v7i1.20485.
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The pressure of competitive and dynamic markets has contributed to the provision of these services. A booming financial market holds the interest of most of the Indian today. The banks are no longer the means of saving money and taking loans but they have turned into one stop any financial need by a common man. For banks seeking to improve their performance, developing offers to attract mass affluent customers may be the key to raising their profile and reducing their cost-to income ratios. Each banking institution must weigh the economics of such a move and determine whether there is demand for such service in its market. Insurance is a finance service for collecting the savings of public and providing them with risk coverage. It reimbursement in a situation of loss, The risk may be certain events like death, retirement, pension, education, marriage etc. or uncertain events like theft, accident, fire, ill-health, etc. Insurance is pooling of risks, when the concepts of insurance to arises, a pre-payment of some type is required. Today, there is insurance for many aspects of daily living: Business, Auto, Health, Life and Travel. The health insurance is one of the very important products for various types of insurance products. In this study we are analysis the various types of health insurance policy effects on the human life.
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Bowley, Douglas M., N. Davis, M. Ballard, L. Orr, and J. Eddleston. "Military assistance to the civil authority: medical liaison with the Manchester clinicians after the Arena bombing." BMJ Military Health 166, no. 2 (July 16, 2018): 76–79. http://dx.doi.org/10.1136/jramc-2018-000944.
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UK Defence Medical Services’ personnel have experienced an intense exposure to patients injured during war over the last decade and a half. As some bitter lessons of war surgery were relearned and innovative practices introduced, outcomes for patients impr oved consistently as experience accumulated. The repository of many of the enduring lessons learnt at the Role 4 echelon of care remain at the Queen Elizabeth Hospital Birmingham (QEHB), with the National Health Service and Defence Medical Services personnel who treated the returning casualties. On 22 May 2017, a terrorist detonated an improvised explosive device at the Manchester Arena, killing 22 and wounding 159 people. In the aftermath of the event, QEHB was requested to provide support to the Manchester clinicians and teleconferencing and then two clinical visits were arranged. This short report describes the nature of the visits, outlines the principles of Military Aid to the Civil Authority and looks to the future role of the Defence Medical Services in planning and response to UK terrorism events.
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Machado-Alba, Jorge E., Edwar A. Cardona-Trejos, Yudy Lorena Delgado-Pascuaza, Daniel R. Torres-Bahamon, and Alfredo Portilla. "Adverse events associated with medical devices in patients at different clinics and hospitals in Colombia." Journal of Patient Safety and Risk Management 24, no. 6 (September 25, 2019): 245–50. http://dx.doi.org/10.1177/2516043519878994.
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Background The use of medical technology may result in damage to patients. The aim was to determine which adverse events and adverse incidents related to medical–surgical devices were most frequently observed in patients seen at 65 health service providers, clinics and hospitals in Colombia. Methods Retrospective study describing reports of adverse events or incidents related to medical devices between 2014 and 2017. From the database of reports, all cases were identified and classified by the type of device, causes and time of identification of the event. Results The devices that were most frequently reported as having events or adverse incidents were those belonging to the vascular access category, with 45.2% of cases, followed by surgical equipment, with 20.2%. The causes of the events or adverse incidents were most often failures of the mechanical components, at 50.6%, followed by manufacturing defects, at 28.7%. The professionals who reported these issues most frequently were nurses, who did so in 33.1% of the cases. A total of 86.8% of the reports were non-serious adverse events, and the failure was identified at the time of device use in 72.8% of the cases. Conclusions Preventive approaches to events and adverse events related to medical devices can mostly be resolved through stricter quality control measures.
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Gardiner, Fergus, and E. C. Gardiner. "Similarities between military and medical service: stigma of seeking mental health assistance." BMJ Military Health 166, no. 3 (May 16, 2018): 181–82. http://dx.doi.org/10.1136/jramc-2018-000975.
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Studies have identified that there are many barriers to treatment of mental health illnesses in military populations, including the negative-associated stigma. One such barrier includes perceptions of weakness, leading to concerns about leadership and competency and being seen as malingering. Furthermore, similarities can be seen in civilian health professionals, where concerns of negative perceptions can limit reporting and treatment of mental health illnesses. Despite the frequency of stressful events, military and health professionals do not become immune to stress and are often ill prepared to cope with acute stressors that can often build on each other until emotional exhaustion and/or crisis point. Even with targeted internal programmes, the stigma of seeking mental health assistance in the military and medicine is poor and is believed to contribute to poor outcomes, such as the potential of increased suicide prevalence.
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Penney, June C. "The Evolution of a Medical School Curriculum in Death and Dying." Journal of Palliative Care 3, no. 2 (June 1987): 14–18. http://dx.doi.org/10.1177/082585978700300205.
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A medical school curriculum in “Death and Dying” evolved through a number of catalysts. A study demonstrated medical students’ reactions to human dissection and their responses led to a design for an “Orientation to Human Dissection.” These events, other simultaneous catalysts, and the resulting curriculum in Death and Dying are described. Evaluation of the course, types of elective studies, and a memorial service are discussed.
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Tsukuda, Hiroshi, Tomohiro Suzumura, Kimio Yonesaka, and Masahiro Fukuoka. "Care cycle on advanced cancer: Reforming a value-based system." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20682-e20682. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20682.
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e20682 Background: In Japan, reconstruction of medical service system for cancer patients is urgent necessity. On medical service system, economist Michael E. Porter and Elizabeth Olmsted Teisberg advocated that value in health care is determined in addressing the patient's particular medical condition over the full cycle of care. In our facility, we adopted their concept to our cancer care system. Methods: In our facility, the cancer care team conducted by medical oncologists provides the best value across the full span of care services. In order to manage our care delivery value chain (CDVC) for advanced cancer, we innovated 'Annshin Card' system. 'Annshin means comfort in Japan. This card functions as a key among the patients, home nursing teams and us. We analyzed 772 patients from the tumor registry of our hospital from 7/12/2010 to 12/31/2012. The following factors were evaluated: (1) the overall incidence rate of emergency visit among patients with an 'Annshin cards', (2) the length of hospitalization and the rate of mortality at our palliative care unit (PCU) as hospitalizing indicators and (3) the medical profession income and expenditure rate as an indicator of cost-benefit. Results: (1) Of 772 patients, 419 patients were adopted 'Annshin card' system. Among patients with an 'Annshin card', the overall incidence rate of an emergency visit was 2.0 visits per 100 patients per month (/100/month). (2) Of 772 patients, 411 patients have been hospitalized in PCU and 748 events of hospitalization to PCU occurred. On 748 events, the average length of hospitalization was 19.8 [ 0-263 ] days; leaving hospital mortality was 274 events (36.6%). (3) On the medical profession income and expenditure rate, before vs. after launching our system, 85.3% vs. 95.8%, respectively. Conclusions: Our CDVC for advanced cancer not only reduced the emergency visit rate, but improved the indicators of hospitalization. Furthermore this system brought cost-benefit. We suppose that the concept of care cycles is effective for cancer patient management.
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Iddrisu, Inusah D., Akwasi Anyanful, and Samuel V. Nuvor. "Incidence of adverse events after discharge from a secondary hospital in northern Ghana." International Journal Of Community Medicine And Public Health 6, no. 6 (May 27, 2019): 2341. http://dx.doi.org/10.18203/2394-6040.ijcmph20192295.
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Background: Adverse events involve unintended injuries or complications resulting in death, disability, harm or prolonged hospital stay that arise from health care management. This paper aims at giving insight into the incidence, types and severity of adverse events after hospital discharge in the context of the management/care patients received from the hospital.Methods: A descriptive cohort study design was used in a secondary hospital in Ghana. The study population involved patients discharged from the medical, surgical and emergency wards of the Hospital. A total of 206 patients were recruited through a consecutive sampling technique.Results: The findings revealed an adverse events rate of 25.7%. The study also identified adverse events related to medications to be the leading type of adverse events recorded after discharge from the hospital. There were 3.9% death rate among participants 21 days after discharge from the hospital. The study revealed that adverse events usually occur after discharge from the hospitals which differ in several forms and in severity.Conclusions: These, therefore offer nurses and other service providers an opportunity to target the areas for improvement of services.
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Gottrich, Ronald W. "Public Health/State Government Service as an Alternate Practice of Pharmacy." Journal of Pharmacy Practice 9, no. 4 (August 1996): 268–75. http://dx.doi.org/10.1177/089719009600900407.
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Public health and governmental service are discussed as alternate forms of the practice of pharmacy. The author discusses his employment with the Illinois Department of Public Health in the areas of drug product selection, drug, medical device, and cosmetic establishment inspections, and long-term care. Aspects of the author's former employment as consultant pharmacist for the state Medicaid program are related. Events leading to the author's selection of the field of public health pharmacy practice are described. The benefits of a pharmacy education in this field, rewards and frustrations of government employment, and the future prospects for public health pharmacy are highlighted.
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Locke, Christy, Susan L. Ravnan, Rajul Patel, and James A. Uchizono. "Reduction in Warfarin Adverse Events Requiring Patient Hospitalization After Implementation of a Pharmacist-Managed Anticoagulation Service." Pharmacotherapy 25, no. 5 (May 2005): 685–89. http://dx.doi.org/10.1592/phco.25.5.685.63582.
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Gerwell, K., K. E. Pruiksma, M. S. Brock, A. L. Peterson, F. A. Carrizales, A. Brundige, D. J. Taylor, et al. "0399 The MSSA: A Novel Instrument to Assess Sleep and Sleep Disturbances in Military Men and Women." Sleep 43, Supplement_1 (April 2020): A152—A153. http://dx.doi.org/10.1093/sleep/zsaa056.396.
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Abstract Introduction Military personnel experience unique stressors (e.g., deployments, shift work, family separation) which can cause sleep disturbances. However, little is known regarding the general sleep quality of military personnel and how it changes throughout their service, what types of stressors precipitate sleep disturbances, and how this differs among military men and women. We present findings from a new self-report measure, the Military Service Sleep Assessment (MSSA), which was designed to assess (1) current primary problems with sleep, (2) sleep quality throughout military service (3) life events that may have impacted their sleep and (4) the specific events which most effected sleep. Methods A total of 69 military personnel (22 women and 47 men) completed the MSSA and 49 also completed a diagnostic polysomnogram (PSG). Chi-square tests were run to differences in responses between men and women. Results No significant differences were found between men and women. In general, sleep quality progressively decreased over a participant’s military career from 3 to 2 on a 5-point Likert scale (1=low, 5=high). For those with at least one deployment (n=52), 73% reported that deployment and 54% reported that a redeployment (return from deployment) negatively impacted sleep quality for 3 months. Women reported that permanent change of station (PCS) negatively impacted their sleep more frequently than men (36% vs. 28%). The reported events that most significantly impacted sleep quality were deployment, military service other than deployment and trauma. Conclusion The MSSA is a novel instrument that can be used to increase understanding of sleep disturbances in military men and women which can inform prevention and treatment strategies. This measure is being used to systematically evaluate the factors which may precipitate or perpetuate sleep disturbances in military men and women such as military service-associated factors, training, deployment history, changing stations, and exposure to trauma or other stressful life events. Support This study is supported by the Defense Health Agency, Defense Medical Research and Development Program, Clinical Research Intramural Initiative for Military Women’s Health.
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SINGH, PRABHSIMRANJOT, Osama Abu-Shawer, Amanda Brito, Eric Yenulevich, Shilpa Grover, Raja-Elie E. Abdulnour, Nicole R. LeBoeuf, et al. "Multidisciplinary team management for high grade immune-related adverse events (irAEs): A single center experience." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e15076-e15076. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e15076.
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e15076 Background: Immune checkpoint inhibitors (ICIs) are increasingly used in the management of cancer. High grade irAEs are uncommon but can be severe and require hospital admission. There is an urgent need for early identification and triage of patients with irAEs in order to improve their management and outcomes. Methods: We established Immunotherapy toxicity (ITOX) team as the first in nation inpatient service at DFCI and Brigham and Women's Hospital (BWH) along with our partners at Massachusetts General Hospital (MGH) that is specifically devoted to mitigating irAEs. The ITOX service is consistent of 2 PAs and a medical oncology attending with an expertise in immunotherapy. The service utilizes algorithms that are modified from the ASCO and NCCN guidelines by our medical subspecialty experts at BWH. The service uses a multi-disciplinary approach with around the hour consulting service from experts in the field including GI, pulmonary, endocrinology and others. We leveraged EPIC to triage patients who are admitted to BWH and have ever received or currently on immune checkpoint inhibitors (ICIs). The daily list generated by EPIC is then curated manually by a PA to identify patients with potential irAEs. Results: A total of 138 patients with high grade irAEs were admitted to BWH between June 2018 and June 2019. Seventy percent of the 201 irAEs- related admissions were to ITOX service (70% accuracy in triaging). Most common irAEs was colitis (31%), pneumonitis (28%) and hepatitis (13%) which is consistent with the most common reported irAEs due to ICIs. Eighty five percent of the patients had grade 3 irAEs and 15% were admitted with life threatening grade 4 adverse events. About half of the patient had received ICI monotherapy; 33% received combination of ICI and non-ICI (chemotherapy or targeted therapy) and 17% received combination of ICIs. Most patients responded to steroids and only 9% had steroid-refractory irAEs requiring other immunosuppressive agents. The average length of stay for irAEs-related admission was 11 days with readmission rate of 26% within a year. Over 50 patients consented for tissue and blood biospecimen collection at the time of toxicity. Conclusions: We demonstrated the feasibility of empowering EMR to accurately triage patients with suspected irAEs to the ITOX service that is supported by institution developed guidelines and specialists. Our model is adaptable in major academic centers and can have major impact on quality improvement and future research studies that can be conducted in this unique setting.
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NOGUEIRA, Wanessa S., Lunara T. SILVA, Mércia P. PROVIN, Rita G. AMARAL, Tatyana M. FERREIRA, and Ana C. MODESTO. "Adverse drug events: description of an active search process in a teaching hospital of the Sentinela Network." Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde 12, no. 1 (March 24, 2021): 602. http://dx.doi.org/10.30968/rbfhss.2021.121.0602.
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Objective: To describe the implementation of an active search service for adverse drug events (ADE) in a teaching hospital in the Midwest region of Brazil. Method: Observational sectional study conducted at the Pharmacovigilance Service in a University hospital in the Midwest Region of Brazil, from March to August/2019. All patients admitted to a medical clinic unit were included and those who did not find medical records were excluded. A work process structured in six stages was elaborated: 1) elaboration of a list of triggers through literature review; 2) elaboration of a list of patients whose previously selected triggers appeared; 3) visiting the wards and reviewing medical records; 4) validation of ADE; 5) notification of ADE to Agência Nacional de Vigilância Sanitária; 6) registration of information in databases. Results: The Positive Predictive Value (PPV) of each tracker was calculated individually and globally. The relative and absolute frequency of ADE was calculated as to the type, description and the drug involved. A total of 479 searches were made in the period and the frequency of ADE was 7.48%. The global triggers PPV was 0.04. The trigger with the best performance was promethazine (1.00), followed by the Activated Partial Thromboplastin Time (0.67). Regarding the identified ADE, it was observed that most of the time, 24.14% were related to infusion reactions. It was observed that 53.85% of the drugs involved in ADE were high alert medications. Conclusion: It was observed that the implementation of an active search service for ADE in hospitals that do not have the support of an electronic medical record system is feasible to be performed. It was also observed a high frequency of ADE and that the active search guided by triggers allows to identify events that otherwise could not be identified.
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Suriya, Dr S., and Nivetha S. "Design of UML Diagrams for WEBMED - Healthcare Service System Services." EAI Endorsed Transactions on e-Learning 8, no. 1 (February 1, 2023): e5. http://dx.doi.org/10.4108/eetel.v8i1.3015.
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Healthcare service has huge demand these days as it really helps in managing a hospital or a medical office. The scope of Healthcare service systems is increasing by each day and it is true for the entire world. Some of these solutions include improved awareness about Healthcare services and health policies. The objective of this system is to provide medical assistance to people instantly with the help of technology. This system eradicates the cultural sensitivity that prevails in many hospitals and improvises the quality of medical assistance. The captivating features of this system are online doctor, medicines at doorstep, bulletin of awareness. The users can also navigate and choose among various insurance schemes that are displayed.Unified Modeling language (UML) is a standardized modeling language enabling developers to specify, visualize, construct and document artifacts of a software system. It uses graphic notation to create visual models of software systems. This paper contains the UML diagrams for better understanding of the system with the help of Star UML tool.Usecase diagrams are used during the analysis phase of a project to identify system functionalities. Class diagram represents the static view of an application.The class diagrams are the only UML diagrams, which can be mapped directly with object-oriented languages.Activity diagram is an important behavioral diagram in UML diagram to describe dynamic aspects of the system. Activity diagram is essentially an advanced version of flow chart that modeling the flow from one activity to another activity.The state machine diagram shows the different states of an entity and focuses more on how it responds to various events by changing from one state to another. Statechart diagram is used to capture the dynamic aspect of a system. State machine diagrams are used to represent the behavior of an application. The sequence diagram focuses on the messages that are passed during an interaction in a time based perspective.A Communication diagram models the interactions between objects or parts in terms of sequenced messages. It describes both the static structure and dynamic behavior of a system. Component diagrams are used to model the physical aspects of a system. It does not describe the functionality of the system but it describes the components used to make those functionalities. Deployment Diagram is a type of diagram that specifies the physical hardware on which the software system will execute. It also determines how the software is deployed on the underlying hardware. UML is a modeling language used by software developers.UML can be used to develop diagrams and provide users with ready-to-use, expressive modeling examples. Some UML tools generate program language code from UML.UML can be used for modeling a system independent of a platform language. UML is a graphical language for visualizing, specifying, constructing, and documenting information about software-intensive systems.UML gives a standard way to write a system model, covering conceptual ideas.
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Sleffel, Justin. "Organisational structural predictors of ambulance crashes: an analysis." Journal of Paramedic Practice 13, no. 12 (December 2, 2021): 493–99. http://dx.doi.org/10.12968/jpar.2021.13.12.493.
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Objective: This study investigated the association between three organisational structural factors—organisational type, organisation status (staffing model), and level of service—and ambulance crash rates. The null hypothesis was that there would be no difference in ambulance crash rates during response or transport between any of the three factors. Methods: A cross-sectional design with a sample drawn from the 2019 National Emergency Medical Services Information System dataset was used to examine the relationship between these systems-level factors and ambulance crashes. After applying inclusion criteria, a sample of 2207 cases was drawn and analysed using the χ2 test of association and multiple logistic regression. Results: There was a statistically significant but small association between level of service and ambulance crashes during transport, using the χ2 test of association (P<0.05). Emergency medical technician (EMT)-level services had lower crash rates and paramedic-level services had higher rates than expected. There was no statistically significant association between organisational type or organisational status and ambulance crashes during either the response or transport phase of an emergency medical service (EMS) call, using the χ2 test of association (P>0.05). Of the two logistic regression models performed, only EMT-level services had a statistically significant association with ambulance crashes during transport (P<0.05; OR 0.208 [0.050, 0.866]). Conclusion: The organisational structural factors examined in this study failed to explain most of the variance in ambulance crash rates. However, EMT-level services were associated with lower rates of ambulance crashes than paramedic level services. EMS healthcare administrators and researchers should continue to explore potentially modifiable factors to reduce the incidence of these events and promote positive social change by reducing the risk of injury to patients, EMS workers and the public at large.
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Feldacker, Caryl, Aaron F. Bochner, Vernon Murenje, Batsirai Makunike-Chikwinya, Marrianne Holec, Sinokuthemba Xaba, Shirish Balachandra, et al. "Timing of adverse events among voluntary medical male circumcision clients: Implications from routine service delivery in Zimbabwe." PLOS ONE 13, no. 9 (September 7, 2018): e0203292. http://dx.doi.org/10.1371/journal.pone.0203292.
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Mann, N. Clay, Ellen MacKenzie, and Cheryl Anderson. "Public Health Preparedness for Mass-Casualty Events: A 2002 State-by-State Assessment." Prehospital and Disaster Medicine 19, no. 3 (September 2004): 245–55. http://dx.doi.org/10.1017/s1049023x00001849.
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AbstractIntroduction:The ongoing threat of a terrorist attack places public agencies under increasing pressure to ensure readiness in the event of a disaster. Yet, little published information exists regarding the current state of readiness, which would allow local and regional organizations to develop disaster preparedness plans that would function seamlessly across service areas. The objective of this study is to characterize state-level disaster readiness soon after September 2001 and correlate readiness with existing programs providing an organized response to medical emergencies.Methods:During the first quarter of 2002, a cross-sectional survey assessing five components of disaster readiness was administered in all 50 states. The five components of disaster readiness included: (1) statewide disaster planning; (2) coordination; (3) training; (4) resource capacity; and (5) preparedness for biological/chemical terrorism.Results:Most states reported the presence of a statewide disaster plan (94%), but few are tested by activation, (48%) and still fewer contain a bioterrorism component (38%). All states have designated disaster operations centers (100%), but few states have an operating communications system linking health and medical resources (36%). Approximately half of states offer disaster training to medical professionals; about 10% of states require the training. Between 22–48% of states have various contingency plans to treat victims when service capacity is exceeded. Biochemical protective equipment for health professionals is lacking in all but one state, and only 10% of states indicate that all hospitals have decontamination capabilities. States with a functioning statewide trauma system were significantly more likely to possess key attributes of a functioning disaster readiness plan.Conclusion:These findings suggest that disaster plans are prevalent among states. However, key programs and policies were noticeably absent. Communication systems remain fragmented and adequate training programs and protective equipment for health personnel are markedly lacking. Statewide trauma systems may provide a framework upon which to build future medical disaster readiness capacity.