Journal articles on the topic 'Medical service trip'
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Franco, Rene, Chirag Desai, William Firth, and Harold M. Szerlip. "Reflections on a Medical Service Trip: Did we do the right thing?" Southwest Respiratory and Critical Care Chronicles 1, no. 4 (September 24, 2013): 60. http://dx.doi.org/10.12746/swrccc.v1i4.95.
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Medical service trips have a long and distinguished history. In the United States,interest in medical outreach trips has grown substantially, as medical schools andnon-governmental organizations support numerous overseas endeavors at an estimatedcost of 250 million dollars a year. Although providing care to those in need is arewarding experience, the question that needs to be answered is whether these tripsdo more harm than good. We describe our experience during a medical service trip toEnsenada, Mexico. We treated over 500 people for numerous problems, but due to thelack of services were not able to monitor or ensure follow-up. Did we do more harmby providing medications that can have serious side effects? Recommendations havebeen developed to help short-term international medical service trips provide the bestoverall experience for the participants and the best care for the patients.
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Christaldi, Joanne, and Jessica R. Bodzio. "Cultural Competence and the Global Role of Dietitians: A Haitian Medical Mission and Inter-Professional, Service-Learning Nutrition Course." Open Nutrition Journal 9, no. 1 (February 27, 2015): 35–41. http://dx.doi.org/10.2174/1876396001509010035.
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As the poorest Western Hemisphere country, Haiti has a long history of health disparity including elevated rates of hypertension, HIV/AIDS, and tuberculosis. In the summer of 2012, a four-week knowledge and skills based course, including a one-week medical mission, was developed to meet the need for medical care in Haiti, and to provide an interprofessional, service-learning environment to enhance students’ cultural competence. A nonprofit volunteer organization that connects healthcare people with a community in need assisted in developing the mission trip. Background on the culture of Haiti, medical education, and development of nutrition education materials were incorporated into the course. Students participated in classroom activities, assisted with development of nutrition education materials, and maintained a reflective journal during the mission trip. Basic nutrition education, nutrition assessment and evaluation, and breastfeeding instruction were provided to Haitian patients. Additionally, students and faculty interacted with each member of the healthcare team; facilitating a greater understanding of an interprofessional approach to medical care. Incorporating a medical mission trip into dietetics education provides an opportunity to increase cultural competence of faculty and students while providing another outlet for students to gain hands-on experience. Interprofessional service-learning further enhances the educational experience and should be considered as a worthwhile educational technique. Programs looking to incorporate such a mission trip into their curriculum can follow a similar scheme of course development.
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Yui, N. D., N. K. Voznesensky, and A. A. Titov. "Modern aspects of improving the reliability of the medical component of the human factor in railway transport." Russian Journal of Occupational Health and Industrial Ecology, no. 9 (March 19, 2020): 823. http://dx.doi.org/10.31089/1026-9428-2019-59-9-823-824.
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The experience of the Sverdlovsk railway in the organization of pre-trip medical examinations using an automated system and software and hardware systems, as well as the ability of the psycho-physiological service in preventing accidents, is presented
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Llorca, Carlos, Joseph Molloy, Joanna Ji, and Rolf Moeckel. "Estimation of a Long-Distance Travel Demand Model using Trip Surveys, Location-Based Big Data, and Trip Planning Services." Transportation Research Record: Journal of the Transportation Research Board 2672, no. 47 (June 21, 2018): 103–13. http://dx.doi.org/10.1177/0361198118777064.
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Long-distance trips are less frequent than short-distance urban trips, but contribute significantly to the total distance traveled, and thus to congestion and transport-related emissions. This paper develops a long-distance travel demand model for the province of Ontario, Canada. In this paper, long-distance demand includes non-recurrent overnight trips and daytrips longer than 40 km, as defined by the Travel Survey for Residents in Canada (TSRC). We developed a microscopic discrete choice model including trip generation, destination choice, and mode choice. The model was estimated using travel surveys, which did not provide data about destination attractiveness and modal level of service. Therefore, a data collection method was designed to obtain publicly available data from the location-based social network Foursquare and from the online trip planning service Rome2rio. In the first case, Foursquare data characterized land uses and predominant activities of the destination alternatives, by the number of user check-ins at different venue types (i.e., ski areas, outdoor or medical activities, etc.). In the second case, the use of Rome2rio data described the modal alternatives for each observed trip. Combining data from travel surveys, Foursquare, and Rome2rio, coefficients of the model were estimated econometrically. It was found that the Foursquare data on number of check-ins at destinations was statistically significant, especially for leisure trips, and improved the goodness of fit compared with models that only used population and employment. Additionally, Rome2rio mode-specific variables were found to be significant for mode choice selection, making the resulting model sensitive to changes in travel time, transit fares, or service frequencies.
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Dainton, Christopher J., and Charlene H. Chu. "Mobile EMR Use for Epidemiological Surveillance on a Medical Service Trip in Honduras: A Pilot Study." E-Health Telecommunication Systems and Networks 05, no. 01 (2016): 1–7. http://dx.doi.org/10.4236/etsn.2016.51001.
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Jimenez, Rosalinda R., and Wendy R. Thal. "Faculty Reflections on International Travel to Reach the Medically Underserved." Creative Nursing 25, no. 2 (May 1, 2019): 138–43. http://dx.doi.org/10.1891/1078-4535.25.2.138.
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One approach to preparing students to engage in culturally diverse health-care settings around the world is to incorporate faculty-led short-term cultural immersion programs in medically underserved nations. This reflective summary analyzes the impact of a faculty-led international health-care trip on students' global health-care experience and needed health-care services in developing countries. A content analysis of the journals of two advanced practice registered nurse (APRN) faculty members was performed to gain perspectives on a trip with undergraduate and graduate nursing students and medical students to a small city in Nicaragua. This article examines the personal and professional growth achieved, and the challenges faced, when managing acute and chronic diseases with limited resources in an unfamiliar country. Themes identified included anxieties of planning, provider versus faculty role, students in action, networking, nurturing behaviors, advocating, and mentoring self-sustainability. Faculty-led international health-care trips both add a needed service to developing countries' health-care needs and offer students the experience of health care from a global perspective.
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Asadi, Hossein, Aghil Habibi Soola, Farhad Gheybati, and Mahnaz Davari. "Time Indices of Prehospital Emergency Services in Ardabil City, Iran, 2020." Health in Emergencies & Disasters Quarterly 6, no. 3 (April 1, 2021): 161–68. http://dx.doi.org/10.32598/hdq.6.3.377.2.
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Background: The role and function of Emergency Medical Service (EMS) in people’s health and the need for continuous evaluation of its function, especially delivering services to the patients, are essential. So, the present study was conducted to determine the time indices of prehospital emergency services in Ardabil City, Iran. Materials and Methods: This study was a retrospective cross-sectional study. Out of all calls recorded in EMS centers of Ardabil in the first 6 months of 2020, 327 calls, which resulted in the patient’s transfer to a hospital, were randomly selected. Then, the required data, including time indices and demographic information, were extracted from EMS forms filled by a medical emergency technician for each mission. The obtained data were analyzed using descriptive statistics, including mean, standard deviation, and inferential statistics, including 1-way analysis of variance and the Chi-square test in SPSS v. 22. Results: In terms of time indices, the average delay time (1.01 minutes), the response time (7.87 minutes), on-scene time (13.81 minutes), transport time (12.53 minutes), the total run time (transport time, response time, and on-scene time) (35.15 minutes), and the round trip time (52.50) had been recorded. According to the Chi-square test, there was a significant relationship between the total run time (transport time, response time, and on-scene time), transport time, round trip time, and the location of the emergency base. Conclusion: EMS time indices were at the desired level. Updating information systems, ambulances, medical equipment, and holding training courses for personnel working in this system can effectively improve time indicators.
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Zakiyah, Qonita, Tedy Murtejo, and Nurul Chayati. "Analysis of generation and attraction in Bogor Regency (Case study: Tenjolaya sub-District, Tamansari sub-District and Tenjolaya sub-District)." astonjadro 12, no. 1 (January 2, 2023): 1. http://dx.doi.org/10.32832/astonjadro.v12i1.4263.
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<p>Tenjolaya Subdistrict, Tamansari Subdistrict, and Ciomas Subdistrict of Bogor District has an area of 61.74 km<sup>2</sup>, divided into 25 villages, and 1 urban-village with those total populations density are 4,819.7 people/km<sup>2</sup>. The increasing population and significant development in the region has increased the movement of traffic flows to and from the region, which is expected to cause some particular problems in traffic congestion on Road segments. This research aims to make the model of the trip generation and the trip attraction caused by land use such as education area, medical, office, lodging, physical fitness center and tourism in the three sub-districts. MKJI 2017 is used as a data processing guideline for the method of calculation of transport analysis. Then use Trip Generation Manual and modelled into SATURN software. Total trip generations from 3 sub-districts of the study area are 4,403.78 trips/hour, and with total trip attractions are 6,165.33 SMP/hour. The design of the transportation modelling equation for Ciomas subdistrict, Tamansari District, and Tenjolaya subdistrict is 21,230 – 0,950 (X). The Model of trip generation and trip attraction has a value of R2 = 0,9687. The level of service is obtained index in the range of A until D, with an average is B, indicating a relatively stable condition. although in some areas, it is still necessary to repair and improve road network infrastructure, and strive for a comfortable and efficient alternative public transport system (time, cost, energy) to transfer people from private vehicles to Public transport.</p>
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Andreatta, Susan, and Jie Hu. "Cross-Cultural Exchange Experiences in China: Medical Anthropology and Community Health Nursing Clinical for Nursing Students." Practicing Anthropology 32, no. 1 (December 25, 2009): 21–25. http://dx.doi.org/10.17730/praa.32.1.01588p10r7p20026.
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As most would say, traveling to China is a trip of a lifetime. With the support of many at UNCG and from various connections in China, we have provided undergraduate students a cultural experience that will be transformative, one that they may be able to use in their profession, in future international travel experiences or when they meet up with others from another country, especially those unable to communicate in English. The short-term study abroad experience incorporated a number of activities both in preparation as well as from the day of departure to completion of the trip. The way the program is arranged is for students to visit three major Chinese cities (Beijing, Wuhan and Shanghai) and engage in service learning while participating in local health care experiences. Undergraduate nursing students complete some of their clinical hours and the anthropology students dip their toes in doing fieldwork in a vast country with a wide range of culture groups, and differing approaches to health care, nutrition, environmental conditions and ideas for solutions to many contemporary problems facing the Chinese people of the twenty first century.
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Evenson, Kelly R., Trent B. Legare, Emily B. Schroeder, Jane H. Brice, Wayne D. Rosamond, and Dexter L. Morris. "Emergency Medical Service Transport Times for Acute Stroke and Myocardial Infarction." Stroke 32, suppl_1 (January 2001): 373. http://dx.doi.org/10.1161/str.32.suppl_1.373-c.
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P188 It is currently recommended by the American Heart Association that both stroke and myocardial infarction (MI) patients be treated with urgency, as time dependent medical therapies are available for both conditions. Since stroke symptoms are often vague, it has been hypothesized that stroke patients may not be treated with the same urgency as MI patients by emergency medical services (EMS). To examine this hypothesis, EMS transport times were examined for both stroke and MI patients who used a paramedic-level, county based EMS system for transportation to a single hospital during 1999. Patients were identified by their hospital discharge diagnosis as stroke (ICD-9 430–438) or MI (ICD-9 410–414). Trip sheets with the corresponding transport times were retrospectively obtained from the 911 center. Thirteen patients with both a stroke and MI discharge diagnosis code were excluded from these analyses, leaving 75 stroke and 127 MI patients. While stroke patients were older than MI patients (median 81.1 vs. 73.3 years, p=0.01), the distribution of gender (56.9% women) and ethnicity (68.3% white) was not significantly different between stroke and MI patients. The use of lights and sirens to the scene (84.4%) and to the hospital (10.6%) also was not significantly different between stroke and MI patients. Mean EMS transport times are presented below in minutes, with the corresponding Wilcoxon rank sum test. In this study, all components of EMS transport times were similar for stroke and MI patients. Multiple linear regression predicting transport times confirmed these results. In this single county, EMS urgency for delivery of care was not different for stroke and MI patients.
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Roldan, Nidya Velasco, Caitlin E. Coyle, Michael Ward, and Jan Mutchler. "IMPACT OF AGING POPULATIONS ON MUNICIPAL EMERGENCY MEDICAL SERVICES." Innovation in Aging 3, Supplement_1 (November 2019): S956. http://dx.doi.org/10.1093/geroni/igz038.3468.
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Abstract The services that residents require from their local governments vary depending on the demographics of their populations. While municipalities have long sought to consider how changes in the young population may impact their school system needs, few systematic considerations have been developed relating to how aging populations may impact municipal service provision. This study aims to address this issue by focusing on demands on emergency services at the municipal level. Using data from the Massachusetts Ambulance Trip Record Information System (MATRIS) we explore the association between emergency medical services (EMS) demand and population age-structure. The data shows an overrepresentation of older people among EMS users. People age 65 and older represent 16% of Massachusetts’ population but account for 31% of the transported emergent calls —e.g., 911 calls— and 60% of the scheduled transports. Results from the OLS regression analysis suggest that communities with larger shares of older residents have significantly higher numbers of EMS calls. The type of community and other age-related community features such as the percentage of older residents living alone and the percentage of older population dually eligible for Medicare and Medicaid are also significantly associated with the number of EMS calls. Contrary to our expectations, other resources available in the community such nursing homes or assisted living facilities were not significantly associated with number of EMS calls. Our research indicates that if growth in the older population occurs as projected, the demand placed on the EMS system by older populations will grow considerably in coming decades.
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Keeves, Jemma, Belinda Gabbe, Sarah Arnup, Christina Ekegren, and Ben Beck. "Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type." International Journal of Environmental Research and Public Health 19, no. 21 (October 28, 2022): 14063. http://dx.doi.org/10.3390/ijerph192114063.
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This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma Registry (VSTR) and Transport Accident Commission (TAC), we identified 1597 people who had sustained transport-related orthopaedic, brain, or spinal cord injuries between 2006 and 2016 that met the study inclusion criteria. The adjusted odds of GP service use for regional participants were 76% higher than for metropolitan participants in the orthopaedic and traumatic brain injury (TBI) groups. People with spinal cord injury (SCI) living in regional areas had 72% lower adjusted odds of accessing mental health, 76% lower adjusted odds of accessing OT services, and 82% lower adjusted odds of accessing physical therapies compared with people living in major cities. People with a TBI living in regional areas on average travelled significantly further to access all post-discharge health services compared with people with TBI in major cities. For visits to medical services, the median trip distance for regional participants was 76.61 km (95%CI: 16.01–132.21) for orthopaedic injuries, 104.05 km (95% CI: 51.55–182.78) for TBI, and 68.70 km (95%CI: 8.34–139.84) for SCI. Disparities in service use and distance travelled to health services exist between metropolitan Melbourne and regional Victoria following serious injury.
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Choi, Yongrok, Zamira Ashurova, and Hyoungsuk Lee. "Sustainable Governance on the Intention of Medical Tourism in Uzbekistan." Sustainability 13, no. 12 (June 18, 2021): 6915. http://dx.doi.org/10.3390/su13126915.
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Medical tourism is a growing niche market with huge potential as the 6th industry of medical services, including an unforgettable trip. Due to these advantages, Uzbekistan hopes to be a leader in central Asia concerning medical tourism. Contrary to this ambitious goal, Uzbekistan patients still prefer going abroad for medical services. Therefore, in order for Uzbekistan to be a hub for medical tourism, the sustainable governance factors of medical tourism need to be found for local patients going overseas. Under this research motivation, this study evaluates how the medical, tourism, and information sharing factors influence behavioral intention based on the structural equation model (SEM) with a random sample of 498 residents in Uzbekistan. Perceived value and behavioral intention are used as a mediating variable and a dependent variable, respectively. The main findings are summarized as follows. First, the medical factor and information sharing are very important factors for behavioral intention, with high coefficient values of 0.399 and 0.516, respectively, while the tourism factor is not influential on the behavioral intention statistically. This implies that Uzbekistani patients do not consider tourism factors as a core condition, instead focusing on the service quality of the medical operation and convenience for foreign patients. Second, in the indirect model, we found that perceived value takes a fully mediating role between medical factors and behavioral intention, while it takes a partially mediating role between information sharing and behavioral intention, implying that strong promotion policies are required for the advantages of tourism and enhanced access to information.
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George, Tracy P., Allison C. Munn, Tiffany A. Phillips, and J. Marty Hucks. "The Use of Tweet-Format Narrative Reflections During a Service-Learning Trip to Appalachia." Online Journal of Rural Nursing and Health Care 20, no. 2 (December 11, 2020): 156–78. http://dx.doi.org/10.14574/ojrnhc.v20i2.633.
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Background: Tweet-format narratives have been used in medical education to capture student experiences. However, there is a lack of research on tweet-format narratives during experiential learning in nursing education.
Purpose: The purpose of this project was to explore the usefulness of tweet-format narratives to capture nursing student experiences and to elicit reflection during a service-learning trip.
Methods: Eight bachelor of science in nursing (BSN) students participated in a service-learning experience to Appalachia. A grounded theory approach with three data collection methods was used to determine the usefulness of tweet-format narratives to facilitate student reflection during the event. A free closed text-messaging app was used to house tweet-format narratives. A focus group session and post-survey were conducted at the conclusion of the trip. Emergent themes from each data collection method were compared and modified using iterative techniques and constant comparison analysis until the data were saturated.
Results: Focus group responses were reflective in nature and included student elaboration about content themes that were previously identified by the tweet-based narratives. Modification of themes resulted in six final themes of improved skills, cultural competence, patient interaction, socioeconomic factors and health, landscape/clinic setting, and impactful shared experiences.
Conclusions: It is important for nursing students to reflect on their experiences during service-learning immersion trips, especially as they relate to underserved rural populations and their unique healthcare scenarios. With the growth of social media, more nursing students are accustomed to communicating in a short, text-based format. The tweet-format narratives in the free closed text-messaging app allowed students to reflect on their experiences through open-ended comments and to communicate with other members of the group. Short text-based narratives can be an effective narrative medicine technique for nursing students participating in service-learning trips in rural areas.
Key words: narrative medicine, rural health, service-learning, technology
DOI: http://doi.org/10.14574/ojrnhc.v20i2.633
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Meidl, Katherine A., Joseph M. Meidl, Laura R. Meidl, and Erik J. Meidl. "Effects of Short–Term Medical Mission Trips to Chiapas, Mexico, on the Religiosity of the Missionaries." Linacre Quarterly 84, no. 2 (May 2017): 115–29. http://dx.doi.org/10.1080/00243639.2016.1268800.
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This study evaluates the effects that short-term, foreign, Catholic medical mission trips had on the religiosity of the United States-based participants. The subjects of this study participated in Catholic medical missions to Chiapas State, Mexico, in 2014 and 2015. Twenty-two of forty-two participants responded to a survey to assess for any changes in their religiosity and associated attitudes and behaviors. The results revealed that participation in the medical mission was associated with a significant increase in non-organizational religious activity, intrinsic religiosity, concern for health disparities and the burden of illness in the developing world, the promotion of further missions, the provision of service and/or monetary aid to the poor in the missionary's local community, and an increased likelihood to discuss the Christian faith in conversations with others. There was no statistically significant association with organizational religious activity or local participation in evangelization activities. Summary This article reports on the changes seen in the religious attitudes and charitable works performed following participation in a short-term medical mission. After serving on a mission trip to Mexico, we found that United States-based missionaries had an increase in their private religious activities, felt closer to God, were more likely to help the poor in their own neighborhoods, and were more likely to discuss their Christian faith than prior to the mission trip. We discuss possible reasons for these changes.
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Tshokey, Tshokey, Ugyen Tshering, Karma Lhazeen, Arpine Abrahamyan, Collins Timire, Bikash Gurung, Devi Charan Subedi, Kencho Wangdi, Victor Del Rio Vilas, and Rony Zachariah. "Performance of an Emergency Road Ambulance Service in Bhutan: Response Time, Utilization, and Outcomes." Tropical Medicine and Infectious Disease 7, no. 6 (May 31, 2022): 87. http://dx.doi.org/10.3390/tropicalmed7060087.
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Background: An efficient ambulance service is a vital component of emergency medical services. We determined the emergency ambulance response and transport times and ambulance exit outcomes in Bhutan. Methods: A cross-sectional study involving real-time monitoring of emergency ambulance deployments managed by a central toll-free (112) hotline (20 October 2021 to 20 January 2022) was carried out. Results: Of 5092 ambulance deployments, 4291 (84%) were inter-facility transfers, and 801 (16%) were for emergencies. Of the latter, 703 (88%) were for non-pregnancy-related emergencies (i.e., medical, surgical, and accidents), while 98 (12%) were for pregnancy-related emergencies. The median ambulance response and patient transport times were 42 (IQR 3–271) and 41 (IQR 2–272) minutes, respectively. The median round-trip distance travelled by ambulances was 18 km (range 1–186 km). For ambulance exit outcomes that were pregnancy-related (n = 98), 89 (91%) reached the health facility successfully, 8 delivered prior to ambulance arrival at the scene or in the ambulance during transport, and 1 had no outcome record. For the remaining 703 non-pregnancy deployments, 29 (4.1%) deployments were deemed not required or refusals, and 656 (93.3%) reached the health facility successfully; 16 (2.3%) died before the ambulance’s arrival at the scene, and 2 (0.3%) were not recorded. Conclusions: This first countrywide real-time operational research showed acceptable ambulance exit outcomes. Improving ambulance response and transport times might reduce morbidities and mortalities further.
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Slover, Gretchen. "A Quantitative Assessment of the Need for Offering Counselling Services to Medical Students attending University of Zambia, School of Medicine." Christian Journal for Global Health 7, no. 2 (June 30, 2020): 93–103. http://dx.doi.org/10.15566/cjgh.v7i2.325.
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Background: This research was birthed in 2017 during a trip to Lusaka, Zambia, with the purpose of offering fourth-year, medical students attending the University of Zambia, School of Medicine, lectures on psychology topics as part of their clinical studies. Students were also offered brief therapy sessions where they could process thoughts and feelings causing them internal struggles. The subject of offering counseling on a regular basis was randomly discussed with the students. From these discussions the need for this research became evident, with the intent of becoming the launching pad to brainstorm the most effective ways of developing a plan to offer counseling services for all medical students attending the University of Zambia School of Medicine.
Methods: An-experimental research design, consisting of completion of a 12-item questionnaire administered by paper and pen. The inclusion criteria were the fourth year, medical students attending the University of Zambia, School of Medicine.
Results: The student responses revealed that most of them had little to no experience with counseling services, but a strong desire for them.
Discussion: The goal of this study was to simply establish a need for an on-campus counseling service, the need of which has been established by the very students who would benefit. With the acceptance of this need, the future plan is to explore the different ways in which this need can be fulfilled with minimal costs to the Medical School Program.
Conclusion: This study is the first step towards identifying the needs of the medical students and sets the ground-work for further research into the specific areas of need and mental health challenges. More specificity in the area of demographics of students will produce a more comprehensive picture of the areas of concentration for the therapists offering services.
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Zhang, Jiawei, Peien Han, Yan Sun, Jingyu Zhao, and Li Yang. "Assessing Spatial Accessibility to Primary Health Care Services in Beijing, China." International Journal of Environmental Research and Public Health 18, no. 24 (December 14, 2021): 13182. http://dx.doi.org/10.3390/ijerph182413182.
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Primary health care has been emphasized as a pillar of China’s current round of health reforms throughout the previous decade. The purpose of this study is to analyze the accessibility of primary health care services in Beijing and to identify locations with a relative scarcity of health personnel. Seven ecological conservation districts, which are relatively underdeveloped, were selected in the study. The Gini coefficient and Lorenz curve, as well as the shortest trip time and modified two-step floating catchment area (M2SFCA) approach, are used to quantify inequalities in primary health care resources and spatial accessibility. The Gini coefficient of primary medical services was calculated as high as 0.705, showing a significant disparity in primary care services. A total of 81.22% of communities reached the nearest primary care institution within 15 min. The average accessibility of primary healthcare services, as measured by the number of health professionals per 1000 population, was 2.34 in the 1715 communities of seven ecological conservation districts. Three hundred and ninety-one communities (22.80%) were identified with relatively low accessibility. More primary health professionals should be allocated to Miyun, Mentougou, and Changping Districts. Overall, the primary healthcare resources were distributed unevenly in most districts. According to our study, expanding primary healthcare institutions, increasing the number of competent health professionals, and enhancing road networks will all be effective ways to increase spatial accessibility and reduce primary healthcare service disparity in Beijing.
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Krisanda, Thomas J., David R. Eitel, Dean Hess, Robert Ormanoski, Robert Bernini, and Nancy Sabulsky. "An Analysis of Invasive Airway Management in a Suburban Emergency Medical Services System." Prehospital and Disaster Medicine 7, no. 2 (June 1992): 121–26. http://dx.doi.org/10.1017/s1049023x00039340.
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AbstractIntroduction:Airway management is the most critical and potentially life-saving intervention performed by emergency medical service (EMS) providers. Invasive airway management often is required in non-cardiac-arrest patients who are combative or otherwise uncooperative. The success of prehospital invasive airway management in this patient population was evaluated.Methods:A retrospective review was undertaken of the records of all such patients requiring endotracheal intubation over a three-year period (1987–1989). The study population included 278 patients enrolled by five advanced life support (ALS) units serving a suburban population of 425,000. Field trip sheets were reviewed for diagnosis, intubation method and success, number of intubation attempts, provider experience, reasons for unsuccessful intubations, and complications.Results:A total of 394 invasive airway management attempts were performed on 278 patients. The overall successful intubation rate was 75% (41 % orotracheal, 52% nasotracheal, 7% other or unknown). The most common diagnoses were COPD and pulmonary edema (30%) and trauma (24%). Experienced providers were successful on the first attempt in 57% of cases compared to 50% by inexperienced providers (p=.24). Multiple intubation attempts were required in 33% of the patients. There was no statistically significant difference in success rates between the orotracheal and nasotracheal methods (p=.51). The most common reason for unsuccessful intubation was altered level of consciousness. Complications occurred with 7% of successful attempts and in 18% of unsuccessful attempts (p<.001). Forty-six percent of the patients who were not intubated successfully in the field and required intubation in the emergency department (ED) received a neuromuscular blocking agent prior to successful intubation.Conclusion:Prehospital providers can intubate a high but improvable proportion of non-cardiac-arrested patients by both the orotracheal and nasotracheal routes. The use of pharmacologic adjuncts to facilitate the prehospital intubation of selected, non-cardiac-arrested patients is a promising adjunct that needs further evaluation.
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Simons, Anne-Sophie, Julie Vercauteren, João Barbosa-Breda, and Ingeborg Stalmans. "Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting." Journal of Clinical Medicine 10, no. 20 (October 19, 2021): 4785. http://dx.doi.org/10.3390/jcm10204785.
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Glaucoma patients require lifelong management, and the prevalence of glaucoma is expected to increase, resulting in capacity problems in many hospital eye departments. New models of care delivery are needed to offer requisite capacity. This review evaluates two alternative schemes for glaucoma care within a hospital, i.e., shared care (SC) and virtual clinics (VCs), whereby non-medical staff are entrusted with more responsibilities, and compares these schemes with the “traditional” ophthalmologist-led outpatient service (standard care). A literature search was conducted in three large bibliographic databases (PubMed, Embase, and Trip), and the abstracts from the prior five annual meetings of the Association for Research in Vision and Ophthalmology were consulted. Twenty-nine were included in the review (14 on SC and 15 on VCs). Patients with low risk of vision loss were considered suitable for these approaches. Among the non-medical staff, optometrists were the most frequently involved. The quality of both schemes was good and improved with the non-medical staff being trained in glaucoma care. No evidence was found on patients feeling disadvantaged by the lack of a doctor visit. Both schemes increased the hospital’s efficiency. Both SC and VCs are promising approaches to tackle the upcoming capacity problems of hospital-based glaucoma care.
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Muller, Luis Antônio, Eneida Rejane Rabelo, Maria Antonieta Moraes, and Karina Azzolin. "Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital." Revista Latino-Americana de Enfermagem 16, no. 1 (February 2008): 52–56. http://dx.doi.org/10.1590/s0104-11692008000100009.
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OBJECTIVE: To identify factors that delay the onset of thrombolysis in patients with acute myocardial infarction (AMI). METHODS: A cohort study was carried out with 146 patients, each diagnosed with AMI and subjected to thrombolytic therapy. The data was extracted from medical records between January 2002 and December 2004. RESULTS: The average age of the studied population was 57.5 ± 9 years, 64.4% were male. The average time between the onset of pain and arrival at the hospital was 254.7 ± 126.6 minutes, 28.1% used an ambulance for the trip to the hospital, the door-to-electrocardiogram time averaged 19.4 ± 7.3 minutes and the door-to-needle time was 51.1 ± 14.9 minutes. There was no significant difference between the time of arrival to the hospital and the method of transportation used (P= 0.81), and those seen by cardiologists and during the nightshift had a reduction in the door-to-needle time, respectively (P=0.014) and (P=0.034). CONCLUSIONS: Study results show that the delay in the search for medical service, and the long time taken from door-to-electrocardiogram and to reach the AMI diagnosis were the factors involved in the delay of thrombolytic treatment.
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Gutor, Ekaterina M., Yuliya A. Tkachenko, Elena A. Zhidkova, and Konstantin G. Gurevich. "Experience of medical support for railway transport workers in the context of a new coronavirus infection." Russian Journal of Occupational Health and Industrial Ecology 61, no. 2 (March 15, 2021): 125–29. http://dx.doi.org/10.31089/1026-9428-2021-61-2-125-129.
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Introduction. The work's relevance is related to the health system's challenges associated with the pandemic of new coronavirus infection. The study aims to explore the experience of organizing the response to the COVID-19 epidemic by the medical service of JSC "Russian Railways" in March-August 2020. Materials and methods. We used the statistical reporting materials of the Ministry of Health of the Russian Federation and JSC "Russian Railways" to analyze the availability of bed fund and medical personnel. The official information of стопкоронавирус.рф website of the Russian Federation is used to analyze the incidence of COVID-19 in the Russian Federation and in the world. To analyze the morbidity of JSC "Russian Railways", we used data from daily monitoring conducted by the company. Results. The incidence of COVID-19 among health care workers in the pre-trip examination rooms of the holding was lower than in the whole of the Russian Federation. The bed fund of JSC "Russian Railways" in terms of 10 thousand people corresponds to the Russian average. The indicators of availability of medical personnel are higher than in the Russian Federation. During the "first wave" of the epidemic, 4 hospitals of Russian Railways were redesigned to provide medical care to patients with COVID-19. Two thousand one hundred twenty medical workers were involved. A total of 3.6 thousand patients with COVID-19 were treated. According to the treatment regimens described in the interim guidelines, the early start of therapy allowed to prevent the development of severe forms and minimize mortality. Russian railways medical institutions participated in the fight against the epidemic in 19 regions of the Russian Federation. 20 PCR laboratories were opened. Conclusions. The activities of Russian railways medical institutions were adequately reformed, which allowed not only to prevent the spread of a new coronavirus infection among the holding's employees.
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Bakhtiari, Leila, and Dimitre Karamanev. "A THEORETICAL OVERVIEW OF COMPRESSED AIR ENERGY STORAGE TECHNOLOGIES AND DEVELOPMENTS." Ecological Engineering and Environment Protection 2022, no. 2/2022 (November 20, 2022): 30–44. http://dx.doi.org/10.32006/eeep.2022.2.3044.
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In our modern world, technological developments on the one hand, and global warming and its consequences, on the other hand, cause us to feel the necessity for reliable, cost-effective, and clean energy. Using renewable energy sources paired with compressed air energy storage can be a good option that meets these expected criteria. Although a compressed air energy storage system (CAES) is clean and relatively cost-effective with long service life, the currently operating plants are still struggling with their low round trip efficiencies. This paper illustrates an up-to-date review of compressed air energy storage systems containing changes in the conventional process to improve performance and increase efficiency. Three main categories of compressed air energy storage technology, diabatic, adiabatic, and isothermal, are analyzed theoretically. In addition, three components of a compressed air energy storage system including compression system, reservoirs, and expansion system are discussed here in detail. The advantages, disadvantages, and the technological readiness of different types of CAES are discussed.
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Hayward, Kelsey, Sabrina H. Han, Alexander Simko, Hector E. James, and Philipp R. Aldana. "Socioeconomic patient benefits of a pediatric neurosurgery telemedicine clinic." Journal of Neurosurgery: Pediatrics 25, no. 2 (February 2020): 204–8. http://dx.doi.org/10.3171/2019.8.peds1925.
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OBJECTIVEThe objective of this study was to examine the socioeconomic benefits to the patients and families attending a regional pediatric neurosurgery telemedicine clinic (PNTMC).METHODSA PNTMC was organized by the Division of Pediatric Neurosurgery of the University of Florida College of Medicine–Jacksonville based at Wolfson Children’s Hospital and by the Children’s Medical Services (CMS) to service the Southeast Georgia Health District. Monthly clinics are held with the CMS nursing personnel at the remote location. A retrospective review of the clinic population was performed, socioeconomic data were extracted, and cost savings were calculated.RESULTSClinic visits from August 2011 through January 2017 were reviewed. Fifty-five patients were seen in a total of 268 initial and follow-up PNTMC appointments. The average round-trip distance for a family from home to the University of Florida Pediatric Neurosurgery (Jacksonville) clinic location versus the PNTMC remote location was 190 versus 56 miles, respectively. The families saved an average of 2.5 hours of travel time and 134 miles of travel distance per visit. The average transportation cost savings for all visits per family and for all families was $180 and $9711, respectively. The average lost work cost savings for all visits per family and for all families was $43 and $2337, respectively. The combined transportation and work cost savings for all visits totaled $223 per family and $12,048 for all families. Average savings of $0.68/mile and $48.50/visit in utilizing the PNTMC were calculated.CONCLUSIONSManaging pediatric neurosurgery patients and their families via telemedicine is feasible and saves families substantial travel time, travel cost, and time away from work.
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Árpád, Balla, and Pelok Benedek-György. "To the memory of Pápai Páriz Ferenc. The „Pax Corporis”, a home medical book for people." Bulletin of Medical Sciences 91, no. 2 (December 1, 2018): 119–24. http://dx.doi.org/10.2478/orvtudert-2018-0015.
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Abstract We present the life, career and memory of Pápai Páriz Ferenc (1649, Dés - 1716, Nagyenyed), professor and rector of the Protestant College of Nagyenyed, the famous Transylvanian humanist, medical doctor, poet, philosopher, church historian, heraldist. He studied in Dés (now Dej, Romania), Gyulafehérvár (now Alba Iulia, Romania), Kolozsvár (now Cluj-Napoca, Romania), Marosvásárhely (now Târgu-Mureş, Romania) and Nagyenyed (now Aiud, Romania). In the spring of 1672 he set off from Nagyenyed for a pedestrian trip abroad. He admired the Treasury in Dresden, and attended medical studies in Leipzig and Heidelberg. He completed his medical studies in Basel. In 1674 he became doctor medicus and was elected member of the board of the medical faculty. He returned to Nagyenyed in 1675. Between 1676 and 1690 he is the physician of the court of the Transylvanian princely couple. In 1678 he got a department in the College of Nagyenyed, extended in 1680 with Greek, physics, natural sciences and medical knowledge departments. Between 1681 and 1715 he was the rector of the College. Above all he cherished peace. He was a versatile writer. His medical book written in Hungarian, the PAX CORPORIS, i.e. “the peace of the body” was printed and published at Kolozsvár in 1690. This was dedicated to the target community: “for the benefit of the stupid poor”, it substituted the physician in the family. The rules of a healthy lifestyle were formulated also. The popularity of the book was proved by those eleven editions we know about. Another great work was the Hungarian-Latin, Latin-Hungarian dictionary (Lőcse, now Levoca, Slovakia, 1708). His memory is kept by a bust and plate in the courtyard of the Protestant College of Nagyenyed. The Hungarian postal service (Magyar Posta) released a stamp on his 350th anniversary. His life, work and importance were appreciated by a number of authors across centuries. An internet search on the terms “Pápai” + “Páriz” + “Ferenc” returns an important number of hits. Many foundations and associations are dedicated to his memory.
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Djebbari, Faouzi, Maciej Tatarczuch, Fotios Panitsas, Grant Vallance, Manuela Sultanova, Jaimal Kothari, Karthik Ramasamy, and Andy Peniket. "Resource implications of bortezomib therapy in a large UK cohort: An evaluation study." Journal of Oncology Pharmacy Practice 25, no. 8 (August 7, 2019): 1995–98. http://dx.doi.org/10.1177/1078155219866500.
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Background Bortezomib is a cornerstone in the management of multiple myeloma. It remains an attractive treatment option because it is efficacious, reasonably well tolerated and easy to administer. However, data on resource implications in the UK for both patients and healthcare providers are limited. Methods We conducted a retrospective study of 127 patients to assess implications of bortezomib therapy on patients and healthcare resources. A patient-episode was defined as a patient attending the chemotherapy day treatment unit solely for bortezomib administration. Data were collected for the duration of therapy as follows: cost of drug calculated using the UK’s bortezomib indicative price as per British National Formulary, cost of drug administration in the chemotherapy day treatment unit calculated using the National Health Service’s schedule of service cost, time from check-in to drug administration, patient travel time and distance calculated using Google maps, and cost of travel. Results Median drug cost and administration cost per patient were £8336 (£2084–£108,368) and £4640 (£290–£15,080), respectively. Median time from check-in to administration was 63 min (range 5–433), median travel time was 90 min (range 8–270) and 80 min (range 8–280) during peak and off-peak periods, respectively. Median return travel distance was 33.4 miles (range 1.2–224) for travel cost per patient per trip was £8.35–£13.20. Conclusions Our real-world resource analysis demonstrated that delivering bortezomib therapy can be associated with significant cost and time implications for patients and healthcare providers. Our study method sets a basis for evaluating resource implications of other novel approaches to myeloma therapy.
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Wong, Alanna, Aidan McParland, and Brodie Nolan. "Identifying causes of delay in interfacility transfer of patients by air ambulance." CJEM 22, S2 (September 2020): S30—S37. http://dx.doi.org/10.1017/cem.2019.444.
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ABSTRACTObjectivesPopulation density can limit the level of care that can be provided in local facilities in Ontario, and as such, patients with severe illnesses often require interfacility transfers to access specialized care. This study aimed to identify causes of delay in interfacility transport by air ambulance in Ontario.MethodsCauses of delay were identified by manual review of electronic patient care records (ePCRs). All emergent interfacility transfers conducted by Ornge, the sole provider of air-based medical transport in Ontario, between January 1, 2016 and December 31, 2016 were included. The ePCRs were reviewed if they met one or more of the following: (1) contained a standardized delay code; (2) contained free text including “delay”, “wait”, or “duty-out”; (3) were above the 75th percentile in total transport time; or (4) were above the 90th percentile in time to bedside, time at the sending hospital, or time to receiving facility.ResultsOur search strategy identified 1,220 ePCRs for manual review, which identified a total of 872 delays. Common delays cited included aircraft refueling (234 delays), waiting for land emergency medical service (EMS) escort (146), and staffing- or dispatch-related issues (124). Other delays included weather/environmental hazards (43); mechanical issues (36); and procedures, imaging, or stabilization (80).ConclusionsSome common causes of interfacility delay are potentially modifiable: better trip planning around refueling and improved coordination with local EMS, could reduce delays experienced during interfacility trips. To better understand causes of delay, we would benefit from improved documentation and record availability which limited the results in this study.
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Endiyono, Endiyono, and M. Hanif Prasetya Adhi. "PELATIHAN EVAKUASI DAN TRANSPORTASI PADA DRIVER AMBULANS LAZIZMU BANYUMAS." Community Services and Social Work Bulletin 1, no. 2 (January 30, 2022): 69. http://dx.doi.org/10.31000/cswb.v1i2.5868.
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Accidents or unwanted events can happen anywhere and anytime. This incident can be a small incident or a disaster involving a large number of sufferers. Those who attempt to provide this help have varying degrees of knowledge ranging from no knowledge to those who may have been trained. There is a golden time between assistance in the field until the victim can get help by medical personnel at a health facility, so this response time must be used properly so that the victim will survive. The speed of evacuation of victims of traffic accidents is one of the important goals in emergency assistance. In a dangerous situation, a rescuer may need to move the patient immediately. In a dangerous situation, it is very important for rescuers to take appropriate, fast and alert action. Ambulance is a specially designed medical transportation that is different from other modes of transportation. The emergency ambulance is designed to be able to handle emergency patients, provide first aid and perform intensive care during the trip to the referral hospital. This activity was carried out by conducting evacuation and transportation training for the Lazizmu Banyumas ambulance driver and the Banyumas ambulance community which was attended by 38 drivers. This training uses lectures, demonstrations and red-emonstration methods on how to evacuate and transport patients. The result of this training is an increase in driver skills in evacuating and transporting patients in accordance with standard operating procedures (SOPs). The impact of this service is to increase the confidence of ambulance drivers in providing first aid in prehospital events.
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Rosamond, Wayne D., Dexter L. Morris, Kelly R. Evenson, Jane H. Brice, and Emily B. Schroeder. "Seeking Help When Strokes Happen: A Study of 911 Tapes." Stroke 32, suppl_1 (January 2001): 324. http://dx.doi.org/10.1161/str.32.suppl_1.324.
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43 Recommendations from the American Stroke Association stress the importance of treating stroke symptoms as medical emergencies and encourages the public to call 911 if they witness or experience a stroke. However, many patients experience delays from onset of symptoms to hospital arrival of 4 to 6 hours. Use of emergency medical service (EMS) is an important link in the chain of recovery. To investigate EMS use, tapes of calls to 911 were evaluated for 93 confirmed stroke cases arriving at the hospital by ambulance in 2 North Carolina counties during 1999. Tapes were transcribed and linked to EMS trip sheets. Seventy-two percent of patients were women, 30% were black, and their mean age was 76 years. Forty-three percent of the calls were placed by medical personnel and 37% by a family member. Only 5 of the 93 calls were made by the patient. In 42 (45%) of calls, the term “stroke” or “cerebrovascular accident” was recorded. In most instances (35 of 42) the term was first used by the caller. A decreased ability to walk or altered mental status were the two most frequently reported symptoms (30% each), followed by breathing difficulty (27%), impaired speech (25%), and muscle weakness (16%). In 78% of the calls, dispatchers sent EMS personnel to the scene at highest priority, with lights and sirens. The median time from dispatch to arrival of EMS personnel on the scene was 7 minutes. The median elapsed time from receiving the 911 call to the patient’s arrival at the hospital was 42 minutes. This study suggests that most 911 calls in these two counties were dispatched with highest priority. While EMS arrived in 7 minutes, it took more than one-half hour from arrival at the scene to reach the hospital. Few calls to 911 were made by the patients themselves. The information from this study will be useful in designing public health strategies to reduce prehospital delay for stroke patients.
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Bhattacharjee, Shuvarthi, Nima Yaghmaei, Cao Tran Le Phuong, and Dinesh Neupane. "Factors influencing the readiness to tackle the burden of ischaemic heart disease in India: a systematic review protocol." BMJ Open 11, no. 8 (August 2021): e047464. http://dx.doi.org/10.1136/bmjopen-2020-047464.
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IntroductionIschaemic heart disease (IHD) is one of the leading causes of death and disease burden in India affecting all age groups. To reduce the deaths and tackle the burden of existing IHD, the government approach has been mostly through the National Health Policy (2017) and National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke. This paper offers a protocol for the systematic review of studies exploring the factors influencing service readiness of the public health system of India to tackle the burden of IHD.Methods and analysisElectronic databases of Embase (Ovid), AMED (Ovid), HMIC (Ovid), BNI (ProQuest), CINAHL (EBSCO), EMCARE (Ovid), PsycINFO (ProQuest), MEDLINE/PubMed and Web of Science (Clarivate Analytics) will be searched till 2020 for primary studies. Grey literature will be accessed through OpenGrey, TRIP Medical, WHO database, MoHFW website, Open Government Data (OGD) Platform of India and Google Scholar (between 2010 and 2020). Primary studies meeting the eligibility criteria and grey literature published in English between 2010 and 2020 will be included. Data will be analysed through a conceptual framework, and the primary outcome will constitute both quantitative and qualitative data. The quality of included studies will be assessed based on study design. Data will be managed on the COVIDENCE platform. All authors will be involved in data extraction, quality appraisal, data synthesis and formulation of the final draft.Ethics and disseminationThis study, being a systematic review, does not involve any clinical trial, primary data collection or empirical study involving humans or animals. Therefore, no ethical permissions were sought by reviewers.PROSPERO registration numberCRD42020219490.
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Lim, Chi Ching, Xiaojuan Chen, Yee Mei Lee, Winnie ZY Teo, Moon Ley Tung, Wee-Joo Chng, and Melissa Ooi. "Feasibility of Advanced Practice Nurse - Led Telehealth Service in Patients with Myeloproliferative Neoplasm in the Community: A Singapore Single-Centre Report." Blood 136, Supplement 1 (November 5, 2020): 18–19. http://dx.doi.org/10.1182/blood-2020-138410.
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Introduction Telehealth is fast becoming a promising alternative service for face-to-face consultation in healthcare to improve access to healthcare in a cost effective manner. An academic medical centre (AMC) piloted a tele-consultation program for patients with myeloproliferative neoplasm (MPN), a disease with an abnormal mutation in the bone marrow leading to overproduction of any combination of white cells, red cells and platelets. The program aimed to demonstrate the feasibility and safety of the use of telehealth in managing patients with MPN. Methods For this program only patients with Essential Thrombocytosis (ET) and Polycythemia Vera (PV) who met the criteria were recruited and enrolled into the program. Workflows, logistics and education materials were developed and briefed to stakeholders prior to the commencement of the program. The program utilised the Advanced Practice Nurses' (APNs) expertise in the haematology unit to support the service. APNs were provided addition training on both clinical practice knowledge and the appropriate use of the telehealth equipment. Data was collected between January and July 2020. Prospective outcome indicators measured were i) correct treatment prescribed according to guidelines; ii) number of emergency visits due to events related to MPN and its complications, iii) deterioration in cardiovascular health (namely hypertension, diabetes mellitus and hyperlipidermia) iv) number of patient visits right-sited to the community and v) barriers and facilitators for the uptake of the program. Results A total of 21 patients with 44 tele-consults over 7 months was captured. Average age of the patients were 70.1 years. Thirteen patients were diagnosed with ET and 8 patients have PV. Only 1 patient was on a combination of hydroxyurea and anagrelide, the rest of the patients were on hydroxyurea. A total of 14 dosage adjustments were made based on patients' complete blood count, and all of patients' blood countsremained stable during the following review. Two venesections were prescribed for patients with PV. None of the patients required ED visit or admission due to events related to MPN and its complications. One patient was referred back to physician earlier due to non-compliance to telehealth review. All patients had their blood pressure reviewed within 1 year. Sixteen patients had fasting glucose/HbA1c within 2 years, and 14 patients had fasting lipid within 2 years. None of the patients required cardiovascular medication titration, thus there is no deterioration in their cardiovascular health since recruitment. For 9 of the telehealth review, patients did their blood tests concurrently with other medical appointments they had at an earlier date, hence saving a separate trip to hospital for blood test. We were also able to consolidate blood tests and reduce repetition for these 9 patients. Only 8 telehealth blood tests were done in the community, largely due to the closure of satellite blood test service during COVID pandemic. There were only 6 home medicine deliveries, largely because many of the patients had collected adequate medications lasting half a year to a year during physical consult with physicians. The MPN telehealth service has right sited a total of 67 hospital visits to the community. We determined the barriers and facilitators to the program are due to patient, physician and workflow factors. Some of our older patients do not own a mobile device, or prefer traditional, physical consultations with physicians. Some physicians are unfamiliar with telehealth referral workflow. Potential facilitators include older, immobile patients with multiple comorbiditieswanting to cut down hospital visits, as well as patients whose work schedule did not permit frequent hospital visits. Conclusions Our results show that utilising APN-led telehealth service is a feasible and safe method to deliver care to patients with myeloproliferative neoplasm in the community. Right-siting of patient care could reduce patient visits to hospitals especially during COVID pandemic. Ongoing challenges include increasing the number of blood test facilities in the community to facilitate blood taking in the community. Other proposed intangible benefits would include improving patients' psychosocial well-being by transiting them to a new normalcy with minimal hospital visits to a haematology centre. There is potential cost- saving as well that will be explored. Disclosures Chng: Janssen: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Novartis: Honoraria; Abbvie: Honoraria; Amgen: Honoraria, Research Funding.
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Barbantan, Ioana, Mihaela Porumb, Camelia Lemnaru, and Rodica Potolea. "Feature Engineered Relation Extraction – Medical Documents Setting." International Journal of Web Information Systems 12, no. 3 (August 15, 2016): 336–58. http://dx.doi.org/10.1108/ijwis-03-2016-0015.
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Purpose Improving healthcare services by developing assistive technologies includes both the health aid devices and the analysis of the data collected by them. The acquired data modeled as a knowledge base give more insight into each patient’s health status and needs. Therefore, the ultimate goal of a health-care system is obtaining recommendations provided by an assistive decision support system using such knowledge base, benefiting the patients, the physicians and the healthcare industry. This paper aims to define the knowledge flow for a medical assistive decision support system by structuring raw medical data and leveraging the knowledge contained in the data proposing solutions for efficient data search, medical investigation or diagnosis and medication prediction and relationship identification. Design/methodology/approach The solution this paper proposes for implementing a medical assistive decision support system can analyze any type of unstructured medical documents which are processed by applying Natural Language Processing (NLP) tasks followed by semantic analysis, leading to the medical concept identification, thus imposing a structure on the input documents. The structured information is filtered and classified such that custom decisions regarding patients’ health status can be made. The current research focuses on identifying the relationships between medical concepts as defined by the REMed (Relation Extraction from Medical documents) solution that aims at finding the patterns that lead to the classification of concept pairs into concept-to-concept relations. Findings This paper proposed the REMed solution expressed as a multi-class classification problem tackled using the support vector machine classifier. Experimentally, this paper determined the most appropriate setup for the multi-class classification problem which is a combination of lexical, context, syntactic and grammatical features, as each feature category is good at representing particular relations, but not all. The best results we obtained are expressed as F1-measure of 74.9 per cent which is 1.4 per cent better than the results reported by similar systems. Research limitations/implications The difficulty to discriminate between TrIP and TrAP relations revolves around the hierarchical relationship between the two classes as TrIP is a particular type (an instance) of TrAP. The intuition behind this behavior was that the classifier cannot discern the correct relations because of the bias toward the majority classes. The analysis was conducted by using only sentences from electronic health record that contain at least two medical concepts. This limitation was introduced by the availability of the annotated data with reported results, as relations were defined at sentence level. Originality/value The originality of the proposed solution lies in the methodology to extract valuable information from the medical records via semantic searches; concept-to-concept relation identification; and recommendations for diagnosis, treatment and further investigations. The REMed solution introduces a learning-based approach for the automatic discovery of relations between medical concepts. We propose an original list of features: lexical – 3, context – 6, grammatical – 4 and syntactic – 4. The similarity feature introduced in this paper has a significant influence on the classification, and, to the best of the authors’ knowledge, it has not been used as feature in similar solutions.
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Wolff, Emily. "Gringita in the Waiting Room: Women's Reproductive Healthcare in Quito, Ecuador." Practicing Anthropology 32, no. 3 (June 26, 2010): 18–22. http://dx.doi.org/10.17730/praa.32.3.6k648p4714250218.
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In August of 2008, I embarked on a three-month field research trip to Quito, Ecuador, a project intended to hone my anthropological research skills. The purpose of my trip was to research women's use and perceptions of health care services, paying special attention to the differences between those receiving public and private care. I gained access to seven clinics and hospitals through my participation in a medical volunteer and shadowing program. I had learned of Child Family Health International (CFHI) at the University of Nebraska-Lincoln campus where they were advertising medical volunteering programs all over the world. While the program had locations in developing countries worldwide, I focused on Latin American countries. With the growing Spanish speaking population in the United States, improving my Spanish seemed like a very practical thing to do.
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Burt, Susan. "Extending the Vision of Short-Term Medical Teams." Journal of Doctoral Nursing Practice 10, no. 2 (2017): 144–48. http://dx.doi.org/10.1891/2380-9418.10.2.144.
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Short-term medical teams (STMTs), serving for a week or two, often do not partner with the local health care system. As a result, nationals receive poor care coordination and duplication of medical services (Green, Green, Scandlyn, & Kestler, 2009). This article offers a care model and collaboration alternatives to support coordinated care. Experience: An STMT composed of 15 health care professionals provided care at a local camp in rural Guatemala. The pre-trip preparation included securing supplies and communicating with another STMT that visits the camp each year. Results: The Guatemala medical team treated 494 patients and dispensed 989 medications. Despite communication with a previous STMT, possible duplication of services occurred with an absence of medical follow-up. Analysis: Evaluation of the STMT’s experience involved analyzing the number of people seen and medications dispensed, reflecting on conversations with local health care providers and patient. Discussion: The STMT’s goal was to provide care to people living in poverty. Unfortunately, team members learned that their unfamiliarity with the local medical system resulted in duplication of services. If sustainable care is to occur, future teams should use a care model and collaborate with the local health care professionals.
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Clements, Jennifer N., Michelle L. Rager, and Emily M. Vescovi. "The Value of Pharmacy Services on a Short-Term Medical Mission Trip: Description of Services and Assessment of Team Satisfaction." Annals of Pharmacotherapy 45, no. 12 (November 8, 2011): 1576–81. http://dx.doi.org/10.1345/aph.1q328.
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Jaques, Cécile, Isabelle De Kaenel, and Alexia Trombert. "Moving the Lausanne medical library to a new location: shaping spaces, tailoring services." Journal of EAHIL 16, no. 2 (June 24, 2020): 18–23. http://dx.doi.org/10.32384/jeahil16389.
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Moving the Lausanne medical library to a new location was the opportunity to investigate how to best support the educational, training, clinical and research needs of both the Medical Faculty and the medical community across all disciplines. Our analysis is based on a tridimensional approach. First, we examine the role of the library as space provider, especially for the students and educational staff. Second, we reflect to what extent we could improve as an online resources provider and trim the print collection. Finally, we underline the importance to position the library as solution provider geared towards clinicians and researchers.
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Tulaib, Lamia F., Akbal O. Salman, and Mazin A. Mohammed. "Innovative Techniques for Attack Detection in Wireless Ad-Hoc Networks." International Journal of Wireless and Ad Hoc Communication 3, no. 1 (2021): 49–58. http://dx.doi.org/10.54216/ijwac.030105.
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As a result of the inherent weaknesses of the wireless medium, ad hoc networks are susceptible to a broad variety of threats and assaults. As a direct consequence of this, intrusion detection, as well as security, privacy, and authentication in ad-hoc networks, have developed into a primary focus of the current study. This body of research aims to identify the dangers posed by a variety of assaults that are often seen in wireless ad-hoc networks and provide strategies to counteract those dangers. The Black hole assault, Wormhole attack, Selective Forwarding attack, Sybil attack, and Denial-of-Service attack are the specific topics covered in this proposed work. In this paper, we describe a trust-based safe routing protocol with the goal of mitigating the interference of black hole nodes while routing in mobile ad-hoc networks. The overall performance of the network is negatively impacted when there are black hole nodes in the route that routing takes. As a result, we have developed a routing protocol that reduces the likelihood that packets would be lost because of black hole nodes. This routing system has been subjected to experimental testing to guarantee that the most secure path will be selected for the delivery of packets between a source and a destination. The invasion of wormholes into wireless networks results in the segmentation of the network as well as a disorder in the routing. As a result, we provide an effective approach for locating wormholes by using ordinal multi-dimensional scaling and round-trip duration in wireless ad hoc networks with either sparse or dense topologies. Wormholes that are linked by both short-route and long-path wormhole linkages may be found using the approach that was given. To guarantee that this ad hoc network does not include any wormholes that go unnoticed, this method is subjected to experimental testing. To fight against selective forwarding attacks in wireless ad-hoc networks, we have developed three different techniques. The first method is an incentive-based algorithm that makes use of a reward-punishment system to drive cooperation among three nodes for forwarding messages in crowded ad-hoc networks. A unique adversarial model has been developed by our team, and inside it, three distinct types of nodes and the activities they participate in are specified. We have demonstrated that the proposed method that is based on incentives prevents nodes from adopting individualistic behaviour, which ensures cooperation in the process of packet forwarding. In the second algorithm, a game theoretic model is proposed that uses non-cooperative game theory to ensure that intermediate nodes in resource-constrained ad-hoc networks faithfully forward packets.
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Davis, Eric A., and Anthony J. Billitier. "The Utilization of Quality Assurance Methods in Emergency Medical Services." Prehospital and Disaster Medicine 8, no. 2 (June 1993): 127–32. http://dx.doi.org/10.1017/s1049023x0004019x.
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AbstractObjective:The concept of the necessity of a good quality assurance (QA) plan for emergency medical services (EMS) is well-accepted; guidelines as how best to achieve this and how current systems operate have not been defined. The purpose of this study was to survey EMS systems to discover current methods used to perform medical control and QA and to examine whether the existence of an emergency medicine residency affected these components.Methods:A survey was mailed in 1989 to the major teaching hospitals associated with all of the emergency medicine residency programs (n = 79) and all other hospitals with greater than 350 beds within the 50 largest United States metropolitan areas (n = 172). If no response was received, a second request was sent in 1990. The survey consisted of questions concerning four general EMS-QA categories: 1) general information; 2) prospective; 3) immediate; and 4) retrospective medical control.Results:Completed surveys were received from 78.5% of residency and 50% of non-residency programs. The majority had an emergency medicine physician as medical director (80.1% vs 61.5%, p = .03). While both residency and non-residency hospitals participated in initial public and prehospital personnel education, academic programs were more likely to be involved in continuing medical education (98.2% vs 82.3%, p = .009). On-line (direct) supervision was more likely to be provided by residency institutions (96.4% vs 81.0%, p = .017) which was provided by a physician in 88.3%. Trip sheet review was utilized by 62.0% of non-residency and 75.5% of residency programs responding, and utilized the paramedic coordinator (44.5% vs 46.1%) or medical director (35.7% vs 34.5 %) primarily.Conclusion:This survey characterizes some of the current methods utilized nationwide in EMS-QA programs. Further research is needed to determine the effectiveness of these various methods, and to develop a model program.
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Sutphin, D., D. Tooke-rawlins, J. Willcox, and J. Muller. "(A186) Edward via College of Osteopathic Medicine (VCOM) Honduras Dengue Outbreak Emergency Response Case Study." Prehospital and Disaster Medicine 26, S1 (May 2011): s52—s53. http://dx.doi.org/10.1017/s1049023x11001828.
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In July 2010, the government of Honduras requested VCOM assistance with a widespread Dengue Outbreak. At the time of the mission trip, over 33,000 Hondurans had been hospitalized for Dengue Fever and a National State of Emergency declared. VCOM sent a team of medical students, faculty and volunteers to answer the call for help. The Honduran government selected five villages where the need for medical attention was greatest. The team provided medical exams, treatment or referral when necessary to approximately 200 patients in each of the five villages. General medical exams were provided in addition to screenings for Dengue Fever and subsequent supportive treatment including oral rehydration salts, Tylenol, vitamins and treatment of complications. National and local strategic partnerships to provide emergency medical response services included the Minister of Health, Minister of Defense, Minister of Transportation and Housing and office of the President of Honduras; Deans of the National and Catholic Medical Schools; President of the Board of Medicine and other governmental and non-governmental offices; Mayors and local officials, and often local media. At Marcala, the Minister of Public Transportation and Housing arrived by Helicopter from Tegucigalpa to greet the VCOM team and patients at the clinic; and at Santa Maria del Real, the Honduran President's son met the team personally. The Honduran support for VCOM's ongoing continuity of health and improved medical care efforts in the country was evident. The trip enhanced the skills and knowledge of participating students and faculty. Student Jenie Sales writes, “I not only enhanced my own clinical experience and knowledge, but I obtained a greater understanding for the people and culture of Honduras.” Student opportunities for reflective learning included case study writing, surveys and evaluations. The successful experience will lead to increased knowledge in the care of patients during a Dengue outbreak.
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Botsman, A., D. Ponkratov, D. Roslavtsev, and M. Pavlov. "EVALUATION OF THE EQUIVALENT TRIP DISTANCE USING MICROMOBILITY AND PUBLIC TRANSIT ACCORDING TO THE TIME CRITERION." Municipal economy of cities 6, no. 173 (December 16, 2022): 199–205. http://dx.doi.org/10.33042/2522-1809-2022-6-173-199-205.
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The advanced direction of improving the transport systems of the cities is to ensure their sustainability. Transport system sustainability directed to provide its operational efficiency, ensures the city residents transportation needs satisfaction with the appropriate level of quality and the least of the travel time costs, contributes to the economic development of the city and reduces the negative environmental impact of the transport. The concept of sustainable urban development involves widespread alternative transportation modes, in particular micromobility. The benefits of micromobility include cost-effectiveness (lack of dependence on fuel), high capacity of the transport infrastructure, environmental friendliness, and positive impact on user’s health. The main factors that affect users' choice to using micromobility are safety, cost, time and effort. The cost level depends on which one vehicle is used, own or hired through a sharing system. Travel time depends on distance and speed, which is related to the type of vehicle, user experience, time of day, weather conditions, etc. Carrying out long-distance micromobility is associated with significant efforts and usually does not provide time savings. However, the joint use of micromobility with transit services at the first-mile and (or) last-mile of the trip can really compete with private cars. The research proposed an analytical equation of determining the rational spheres micromobility trips choice by users according to the time criterion. This equation involves the definitionn of the equivalent trip distance by scheduled passenger transport and micromobility considering the directness of connections by the specified modes. It is assumed that the directness of the micromobility trips is higher than for public transit. It was established that the equivalent trip distance can vary widely, which is due to the different ratio of the micromobility and public transit trips conditions. Further research will be focused on the study of the separate and combined influence of equivalent trip distance factors and establishing the patterns of its change. Keywords: transport system, micromobility, equivalent distance, sharing system, public transit, directness of the connection.
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Yin, Nay Lynn. "Decision Factors in Medical Tourism: Evidence from Burmese Visitors to a Hospital in Bangkok." Journal of Economics and Behavioral Studies 6, no. 2 (February 28, 2014): 84–94. http://dx.doi.org/10.22610/jebs.v6i2.472.
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Medical tourism is a significant factor in Thailand’s economy as the country aims to develop more high value-added activities to escape from the middle income trap. The country has a number of highly advanced private sector hospitals, with western-trained physicians and the legendary service levels provided in Thailand. There are several prime targets for promoting medical tourism, which include the Middle East and South Asia, as well as some western countries, but one which is often ignored is neighboring Myanmar. This country is emerging from military dictatorship and has an unequal society in which there are a number of wealthy individuals unable to find the level of medical service they require in their homeland. Many Burmese people speak English, which is the international language of tourism and medicine. For such people, Thailand is a logical destination in the search for high-quality medical tourism. However, little if any research has been conducted to determine the levels of satisfaction that patients and their carers have received in Thailand and what improvements in service would be required. This paper aims to fill that gap to some extent by reporting on a quantitative survey of 200 Burmese users of a well-known private sector hospital in Bangkok. Their levels of satisfaction are charted and this leads to discussion of the meaning of their visit and its overall impact and benefit.
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Korobko, Ksenia I. "On the Possibility for Carrying Out Procurements for State and Municipal Needs Involving Services of Obligatory Pre-Trip and Post-Trip Medical Examinations of Vehicle Drivers Using Telemedicine Technologies." Jurist 6 (June 10, 2020): 31–35. http://dx.doi.org/10.18572/1812-3929-2020-6-31-35.
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Prieto, José Tomás, Kenneth Scott, Dean McEwen, Laura J. Podewils, Alia Al-Tayyib, James Robinson, David Edwards, Seth Foldy, Judith C. Shlay, and Arthur J. Davidson. "The Detection of Opioid Misuse and Heroin Use From Paramedic Response Documentation: Machine Learning for Improved Surveillance." Journal of Medical Internet Research 22, no. 1 (January 3, 2020): e15645. http://dx.doi.org/10.2196/15645.
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Background Timely, precise, and localized surveillance of nonfatal events is needed to improve response and prevention of opioid-related problems in an evolving opioid crisis in the United States. Records of naloxone administration found in prehospital emergency medical services (EMS) data have helped estimate opioid overdose incidence, including nonhospital, field-treated cases. However, as naloxone is often used by EMS personnel in unconsciousness of unknown cause, attributing naloxone administration to opioid misuse and heroin use (OM) may misclassify events. Better methods are needed to identify OM. Objective This study aimed to develop and test a natural language processing method that would improve identification of potential OM from paramedic documentation. Methods First, we searched Denver Health paramedic trip reports from August 2017 to April 2018 for keywords naloxone, heroin, and both combined, and we reviewed narratives of identified reports to determine whether they constituted true cases of OM. Then, we used this human classification as reference standard and trained 4 machine learning models (random forest, k-nearest neighbors, support vector machines, and L1-regularized logistic regression). We selected the algorithm that produced the highest area under the receiver operating curve (AUC) for model assessment. Finally, we compared positive predictive value (PPV) of the highest performing machine learning algorithm with PPV of searches of keywords naloxone, heroin, and combination of both in the binary classification of OM in unseen September 2018 data. Results In total, 54,359 trip reports were filed from August 2017 to April 2018. Approximately 1.09% (594/54,359) indicated naloxone administration. Among trip reports with reviewer agreement regarding OM in the narrative, 57.6% (292/516) were considered to include information revealing OM. Approximately 1.63% (884/54,359) of all trip reports mentioned heroin in the narrative. Among trip reports with reviewer agreement, 95.5% (784/821) were considered to include information revealing OM. Combined results accounted for 2.39% (1298/54,359) of trip reports. Among trip reports with reviewer agreement, 77.79% (907/1166) were considered to include information consistent with OM. The reference standard used to train and test machine learning models included details of 1166 trip reports. L1-regularized logistic regression was the highest performing algorithm (AUC=0.94; 95% CI 0.91-0.97) in identifying OM. Tested on 5983 unseen reports from September 2018, the keyword naloxone inaccurately identified and underestimated probable OM trip report cases (63 cases; PPV=0.68). The keyword heroin yielded more cases with improved performance (129 cases; PPV=0.99). Combined keyword and L1-regularized logistic regression classifier further improved performance (146 cases; PPV=0.99). Conclusions A machine learning application enhanced the effectiveness of finding OM among documented paramedic field responses. This approach to refining OM surveillance may lead to improved first-responder and public health responses toward prevention of overdoses and other opioid-related problems in US communities.
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Qin, Xiaodi, Haitao Wu, Yifeng Xie, and Xiaofang Zhang. "Lagging behind the Joneses: Relative Deprivation and Household Consumption in Rural China." Agriculture 12, no. 11 (November 14, 2022): 1912. http://dx.doi.org/10.3390/agriculture12111912.
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Based on the Chinese Family Panel Studies (CFPS) 2010–2018, this article investigates how relative deprivation influences household consumption in rural China. High-dimensional fixed-effects (HDFE), the instrumental variable (IV), and causal mediation analysis (CMA) are leveraged to estimate the causal effect and mechanisms. Results show that relative deprivation reduces survival-oriented consumption of food, development-oriented consumption of transportation, telecommunication, and education, as well as enjoyment-oriented of durable goods, and increases survival-oriented consumption of residence and development-oriented consumption of healthcare and medical services. Mechanism analysis indicates that relative deprivation decreases household consumption through the anticipated effect and increases it through a cognitive trap effect. On the whole, the anticipated effect prevails over the cognitive trap effect.
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Heller, Michael, Walt A. Stoy, Larry J. Shuman, Harvey Wolfe, and Chalice A. Zavada. "Effectiveness of Interactive Videodisc Instruction for the Continuing Education of Paramedics." Prehospital and Disaster Medicine 9, no. 3 (September 1994): 165–71. http://dx.doi.org/10.1017/s1049023x00041285.
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AbstractObjectives:To evaluate the effectiveness of interactive videodisc (IVD) instruction of paramedics through the use of computer analysis of trip sheets.Design/Setting:Prospective, controlled, in an urban 9-1-1, paramedic, emergency medical services (EMS) system with total call volume of 62,000/year; 15,000 advanced life support (ALS).Interventions:All 150 paramedics in the system received eight hours of IVD instruction covering five subject areas: 1) airway; 2) head/cervical trauma; 3) chest; 4) shock; and 5) cardiac arrest. Trip sheets from 9,943 runs in the pre-IVD period were subjected to computer analysis, and a compliance score was generated using previously developed algorithms that assigned a weight to each omission and commission. After a nine-month IVD training period, 4,303 cases were collected and analyzed in the post-IVD period. Statistical analyses were made using “Student's“ t-test and Chi-square with alpha set at 0.05.Exclusions:Only those records of adult patients who fit one of the five protocols were eligible for computer analysis. Of the 9,943 cases in the pre-IVD group, 480 (4.8%) were excluded, all due to inadequate data recording by the paramedics. A statistically similar portion, 233 (5.4%) of the 4,303 post-IVD instruction cases were excluded (p = .15).Results:Overall the mean compliance score of the pre-IVD group was 0.65 ±0.19 (±SD). The post-IVD group score was 0.65 ±0.19 (p = 0.99). Analysis of scores for each algorithm also showed no significant differences. This study had an observed power of .94 to detect a difference in compliance as small as 0.030.Conclusion:Eight hours of IVD instruction did not result in improved paramedic performance as judged by computer analysis of trip sheets.
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Susanty, Meredita, Erwin Setiawan, Ade Irawan, and Randi Fermana. "PENDAMPINGAN IMPLEMENTASI TEKNOLOGI UNTUK USAHA PENGANGKUTAN LIMBAH BAHAN BERBAHAYA BERACUN PT. BINA ENVIRO NUSA." Jurnal Terapan Abdimas 7, no. 2 (June 23, 2022): 163. http://dx.doi.org/10.25273/jta.v7i2.12495.
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<p><strong><em>Abstract.</em></strong> <em>The COVID-19 pandemic in 2020 caused an increase in infectious waste from personal protective equipment (PPE) used by the medical team. Infectious waste as hazardous and toxic waste (B3) must be appropriately and correctly handled following applicable laws so that it does not cause soil, water and air pollution. In managing B3 waste, hospitals as waste producers will cooperate with other parties such as B3 waste transport and waste management companies. The increase in the amount of B3 waste that must be transported every two days also increases the volume of work for each party. Monitoring the waste transportation process is critical because several potential problems can occur at this stage. For example, B3 waste disposal is not dumped in proper locations and loss of waste or transportation of waste that does not reach its destination. Various violation cases trigger waste producers to choose established B3 waste carriers rather than the new, small or medium-scale B3 waste carriers. Through this community service activity, Pertamina University collaborates with Small and Medium Enterprises (SMEs) B3 waste carriers in building real-time vehicle location tracking to increase the trust of waste producers toward new SME waste carriers. Thus, it will boost the competitiveness of these SMEs. With this tracking application, waste generators and transporters can check the route taken by transporting vehicles until they arrive at certified waste treatment facilities and monitor vehicle speed so that B3 waste remains safe during the trip. </em></p><p> </p><p><strong>Abstrak.</strong> Pandemik COVID-19 di tahun 2020 menyebabkan peningkatan limbah infeksius dari alat perlindungan diri (APD) yang digunakan tim medis. Limbah infeksius termasuk dalam golongan limbah bahan berbahaya dan beracun (B3) yang proses pengelolaannya harus dilakukan dengan baik dan benar sesuai dengan Undang - Undang yang berlaku, agar tidak menimbulkan pencemaran tanah, air, dan udara. Dalam pengelolaan limbah B3, rumah sakit sebagai penghasil limbah akan bekerjasama dengan pihak-pihak lain seperti perusahaan pengangkut dan/atau pengelola limbah B3. Peningkatan jumlah limbah B3 yang harus diangkut setiap dua hari sekali juga menambah volume pekerjaan setiap pihak. Monitoring pengangkutan limbah B3 merupakan aktivitas yang sangat penting untuk dilakukan, karena adanya potensi masalah yang dapat terjadi misalnya pembuangan limbah B3 tidak di lokasi yang semestinya, hilangnya limbah atau pengangkutan limbah yang tidak sampai ke tujuan. Berbagai temuan dalam pengangkutan limbah mengakibatkan rendahnya kepercayaan penghasil limbah terhadap pengangkut limbah B3 berskala kecil dan menengah, atau yang relatif baru. Melalui kegiatan pengabdian masyarakat ini, Universitas Pertamina bekerjasama dengan pelaku Usaha Kecil dan Menengah (UKM) pengangkutan limbah B3 membangun aplikasi pelacak keberadaan kendaraan pengangkut, untuk meningkatkan kepercayaan penghasil limbah untuk menggunakan jasa pengangkut limbah berskala kecil dan menengah sehingga meningkatkan daya saing UKM tersebut. Dengan adanya aplikasi pelacakan ini, pihak penghasil dan pengangkut limbah dapat memeriksa rute yang dilalui kendaraan pengangkut hingga sampai ke tempat pengolahan yang legal, serta memantau kecepatan kendaraan agar limbah B3 tetap aman selama perjalanan.</p><p> </p><div id="gtx-trans" style="position: absolute; left: -16px; top: 538px;"> </div>
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Москалева, Наталья, and Natal'ya Moskaleva. "IMPROVING THE QUALITY OF TRANSPORT SERVICES FOR LONG-DISTANCE ROAD PASSENGER TRANSPORTATION." Services in Russia and abroad 11, no. 6 (October 26, 2017): 54–66. http://dx.doi.org/10.22412/1995-042x-11-6-5.
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The article justifies the role of self-control by transportation organizations and monitoring by tour operators and insurance companies of the behavior of drivers, their health and technical condition of vehicles. The article reveals the methodology of improving the quality of social services for the public by monitoring the behavior, health of drivers of vehicles and the technical state of vehicles in longdistance, international transport of the population (including tourists). The methodology is aimed at identifying possible dangers, discomfort in the process of providing services to the population and proactive purposeful actions to eliminate or minimize the negative consequences. The methodology contains a set of measures and recommendations that improve the quality of tourism road transportation, and allow car carriers, tour operators and travel agents significantly to reduce financial costs by avoiding traffic accidents through the fault of drivers of car carriers. The author develops and analyzes the concepts of behavior, the health status of drivers of the vehicle, the signs of their manifestation. The methodology includes recommendations for transportation organizations, tour operators (travel agents) for tests of the behavior of vehicle drivers through a «mysterious passenger». The author suggests ways to organize quality control of pre-trip medical examination of drivers. The author recommends for auto carriers introduce measures aimed at maintaining the normal technical condition of vehicles. The practical significance of the study lies in the possibility of implementing the methodology in the work of auto carriers, tour operators, travel agents not only in the Russian Federation, but also the host party abroad.
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Chimonero, Prince. "Sports Injury Risks and Opportunity Costs: The Conspicuous Landscape of Handball among Tertiary Teachers’ Colleges in Zimbabwe." EAST AFRICAN JOURNAL OF EDUCATION AND SOCIAL SCIENCES 2, Issue 3 (July 15, 2021): 17–28. http://dx.doi.org/10.46606/eajess2021v02i03.0099.
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This study explored injury risks associated with sport participation among handball players in Zimbabwean Tertiary Institutions between 2016 and 2019. The study employed a descriptive, prospective cohort design anchored on quantitative methodology and informed by Positivism Philosophy. The population comprised technocrats (coaches, fitness trainers, physiotherapists, psychologists and players) from selected Zimbabwe Teachers’ Colleges Sports Association handball teams. Stratified random sampling was used to select the respondents. Questionnaire was used as data collection tool and IBM SPSS Statistic Version 23 was used for data analysis. Findings revealed critical knowledge-service gaps on sports medicine professionals regarding lack of players’ informational sources on pre-participation medical health-checks as evidence-based practices for addressing activity limitations and risks upon return-to-sport. Ego-oriented administration characteristic of pain-injury paradox environment prevailed with pre-mature ending of players’ rehabilitation routes. Well formulated guideline-inclined preventive injury risk management protocols resonating player-centered medicine approaches that could effectively abate epidemiologic opportunity injury risks and costs were non-existent. Furthermore, regularized in-service professional development clinics lacked. Players’ objective injury records, profiles and pre-participation medical examination health-checks should be considered as critical informational sources for fully resolving physiological defects prior to return-to competitive contexts. Formulation of guideline-inclined preventive injury risk management protocols entrenching player-centered medicine practices could effectively trim down epidemiologic opportunity injury risks and costs and improve the critical base for players’ odds of participation. Regularized in-service professional development trainings for sports medicine professionals through symposiums should inexorably be an esteemed epitomic pedestal delved towards improving their expert base levels in view of contemporary preventive and injury risk management dynamics in sports.
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Кунцевич, Евгения, Evgeniya Kuntsevich, Валентин Морозов, and Valentin Morozov. "On the formation of caravan tours within the framework of adaptive tourism." Services in Russia and abroad 10, no. 1 (May 16, 2016): 137–45. http://dx.doi.org/10.12737/19176.
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The article discusses the relevance of the development of tourism for people with
disabilities and highlights the issue of potential and relevance of the organization of the caravan
tours as part of adaptive tourism in Russia. The authors point out the positive results of the
development of the tourist destination, and also list the main shortcomings and constraining
factors of realization caravanning in the country. The authors have conducted "pilot" survey
among tourists with special needs and summed it up. The research results demonstrate
perceptivity of development of caravan tours for people with disabilities. But it is a great work
must be done to this kind of trailering became popular. First of all it is necessary to adapt the infrastructure of tourist sites for specific requirements of customer with disabilities (lifts,
handrails, ramps, wide doorways, special sanitary zones for wheelchair users, adapted furniture,
etc.), special attention should be paid to camp organization parking (specialized sanitary
facilities, recreational facilities, catering places, etc.). Development of a socially oriented tourist
destination, where the client could be provided with the convenience and security, as well as the
considerate treatment of staff (hospitality workers, medical and social services and transport
services) during the entire trip, is very important for the organization of tours for people with
special needs.
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Blutt, Sarah Elizabeth, Shizuo Akira, Lynn Dustin, and Margaret E. Conner. "MyD88 is required for viral-induced B cell activation and intestinal IgA production (44.20)." Journal of Immunology 182, no. 1_Supplement (April 1, 2009): 44.20. http://dx.doi.org/10.4049/jimmunol.182.supp.44.20.
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Abstract The role of TLR signaling in the induction of specific antibody responses is controversial and defined primarily using model antigens. Our study objective was to determine whether TLR signaling is required to generate pathogen-specific antibody responses. To assess whether TLR signaling is required for a viral-specific intestinal B cell responses, we examined whether B cell responses were aberrant after rotavirus infection of mice lacking expression of specific adapter proteins used in TLR signaling (MyD88, TIRAP, TRIF). Rotavirus infection of MyD88-/- mice did not result in a significant induction of either B cell activation or intestinal rotavirus-specific IgA. In contrast, mice lacking TIRAP and TRIF expression had wild type levels of both B cell activation and intestinal IgA production. B cell activation was normal in mice with a defect in BCR signaling (xid) or mice expressing an OVA-specific BCR, indicating that rotavirus-induced B cell activation does not require a rotavirus-specific BCR. These findings indicate that BCR-independent signaling through MyD88 plays a critical role in pathogen induced B cell activation and the generation of pathogen-specific intestinal IgA. This work was supported by NIH AI10604, AI24998, and by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs.