Preparing Emergency Personnel in Dialysis: A Just-in-Time Training Program for Additional Staffing During Disasters

2013 ◽  
Vol 7 (3) ◽  
pp. 272-277 ◽  
Author(s):  
Genevieve B. Stoler ◽  
James R. Johnston ◽  
Judy A. Stevenson ◽  
Joe Suyama
Keyword(s):  
Medical Students ◽  
Training Program ◽  
Continuity Of Care ◽  
Disaster Preparedness ◽  
Large Scale ◽  
The United States ◽  
Just In Time ◽  
Entire Study ◽  
Emergency Personnel ◽  
Dialysis Facility

AbstractBackgroundThere are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster.MethodsA 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects.ResultsWhen comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P < .05 for all comparisons).ConclusionsPREP-D participants were able to demonstrate improved tests scores when taught in a just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster. (Disaster Med Public Health Preparedness. 2013;7:272-277).

Disaster Preparedness

1985 ◽  
Vol 1 (S1) ◽  
pp. 118-121 ◽  
Author(s):  
E. L. Quarantelli
Keyword(s):  
United States ◽  
Natural Disasters ◽  
Emergency Medical Service ◽  
Disaster Preparedness ◽  
Large Scale ◽  
Medical Service ◽  
The United States ◽  
Mass Casualties ◽  
Disaster Plan ◽  
Emergency Medical

The 1973 Emergency Medical Services System Act in the United States mandates that one of the 15 functions to be performed by every EMS system is coordinated disaster planning. Implicit in the legislation is the assumption that everyday emergency medical service (EMS) systems will be the basis for the provisions of EMS in extraordinary mass emergencies, or in the language of the act, during “mass casualties, natural disasters or national emergencies.” Policy interpretations of the Act specified that the EMS system must have links to local, regional and state disaster plans and must participate in biannual disaster plan exercises. Thus, the newly established EMS systems have been faced with both planning for, as well as providing services in large-scale disasters.

Experimental Evidence on the Long-Term Effects of a Youth Training Program

ILR Review ◽  
2018 ◽  
Vol 72 (1) ◽  
pp. 185-222 ◽  
Author(s):  
Pablo Ibarrarán ◽  
Jochen Kluve ◽  
Laura Ripani ◽  
David Rosas Shady
Keyword(s):  
Training Program ◽  
Large Scale ◽  
Controlled Trial ◽  
The United States ◽  
Capital Investments ◽  
Long Term Effects ◽  
Long Run ◽  
The One ◽  
The Right ◽  
Youth Training

Identifying the right human capital investments for disadvantaged youths is a key policy concern worldwide, yet almost no rigorous evidence on the long-run effects of these investments exists outside the United States. The authors present a large-scale randomized controlled trial of a youth training program, estimating effects six years after random assignment from a representative sample of more than 3,200 youths. The intervention is prototypical of training programs worldwide and is implemented at scale in the Dominican Republic. Empirical findings indicate, on the one hand, significant effects on formal employment, particularly for men, and on earnings for both men and women in Santo Domingo. On the other hand, no significant effects on overall average employment are evident.

scholarly journals UME-to-GME PandEMonium in COVID-19: Large-Scale Implementation of a Virtual ACGME Milestone-Based Curriculum for Senior Medical Students Matched Into Emergency Medicine

2021 ◽  
Vol 13 (6) ◽  
pp. 848-857
Author(s):  
Mary E. McLean ◽  
Adrian A. Cotarelo ◽  
Thomas A. Huls ◽  
Abbas Husain ◽  
Emily A. Hillman ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Medical Students ◽  
Large Scale ◽  
The United States ◽  
Negative Effects ◽  
Residency Programs ◽  
Perceived Preparedness ◽  
Competency Based ◽  
June July

ABSTRACT Background The COVID-19 pandemic displaced newly matched emergency medicine “pre-interns” from in-person educational experiences at the end of medical school. This called for novel remote teaching modalities. Objective This study assesses effectiveness of a multisite Accreditation Council for Graduate Medical Education (ACGME) sub-competency-based curricular implementation on Slack during the first wave of the COVID-19 pandemic in the United States. Methods Emergency medicine residency programs were recruited via national organization listservs. Programs designated instructors to manage communications and teaching for the senior medical students who had matched to their programs (pre-interns) in spring/summer 2020. Pre- and post-surveys of trainees and instructors assessed perceived preparedness for residency, perceived effectiveness of common virtual educational modalities, and concern for the pandemic's effects on medical education utilizing a Likert scale of 1 (very unconcerned) to 5 (very concerned). Data were analyzed using descriptive statistics and the t test. Results Of 276 possible residency programs, 28 enrolled. Of 324 possible pre-interns, 297 (91.7%) completed pre-surveys in April/May and 249 (76.9%) completed post-surveys in June/July. The median weeks since performing a physical examination was 8 (IQR 7–12), since attending in-person didactics was 10 (IQR 8–15) and of rotation displacement was 4 (IQR 2–6). Perceived preparedness increased both overall and for 14 of 21 ACGME Milestone topics taught. Instructors reported higher mean concern (4.32, 95% CI 4.23–4.41) than pre-interns (2.88, 95% CI 2.74–3.02) regarding the pandemic's negative effects on medical education. Conclusions Pre-interns reported improvements in residency preparedness after participating in this ACGME sub-competency-based curriculum on Slack.

Practice on an Education and Training Program to Development of Response Literacy to Earthquake Disaster in a Central Business District in Japan

2014 ◽  
Vol 9 (2) ◽  
pp. 216-236 ◽  
Author(s):  
Yoe Masuzawa ◽  
◽  
Yoshiaki Hisada ◽  
Masahiro Murakami ◽  
Jun Shindo ◽  
...  
Keyword(s):  
Training Program ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Large Scale ◽  
Central Business District ◽  
Education And Training ◽  
Training And Education ◽  
Experiential Training ◽  
Business District ◽  
And Training

This paper discusses an experiential training and education program designed to improve the response literacy in the event of a large-scale earthquake in the Shinjuku station area in Tokyo, which is a central business district representative of Japan. The features of the Shinjuku station area are described, and the activities of the Shinjuku Station Area Disaster Response Measure Committee, made up of businesses and other concerns located in the vicinity of Shinjuku station, as well as the education and training program implemented by the committee to train personnel are introduced. An overview is given of the seminars and workshops given as part of the education and training program in fiscal 2013, targeted at employees of businesses in charge of disaster response. The report then describes the Comprehensive Disaster Preparedness Drill, which was conducted for the purpose of enabling the participants of the seminars and workshops to practice the skills and techniques for disaster response they had acquired, and conducting a comprehensive exercise on disaster response activities within businesses or the area. Finally, the results of a questionnaire survey conducted on the drill participants are discussed.

scholarly journals Overcoming the language barrier: a novel curriculum for training medical students as volunteer medical interpreters

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Erik S Carlson ◽  
Tatiana M Barriga ◽  
Dale Lobo ◽  
Guadalupe Garcia ◽  
Dayana Sanchez ◽  
...  
Keyword(s):  
Medical Students ◽  
Training Program ◽  
Limited English Proficiency ◽  
Code Of Ethics ◽  
The United States ◽  
Language Barrier ◽  
University Hospital ◽  
Spanish Speaking ◽  
Medical Interpreters ◽  
Interpreter Training

Abstract Background Over 41 million people in the United States speak Spanish as their primary language, of which 16 million have limited English proficiency (LEP). It is well-established that language barriers contribute to health disparities and that the use of ad-hoc interpretation by untrained family members results in substandard care. We developed a novel interpreter training program for medical students to serve as in-person interpreters at a charitable, resident continuity clinic so as to overcome the language barrier in the delivery of healthcare to LEP patients. Methods The Medical Student Interpreter Training Program (MSITP) consists of three steps. First, fluent Spanish-speaking students shadowed a licensed interpreter. Second, students took a standardized phone exam to demonstrate language proficiency. Finally, students completed a three-hour training on the methodology and ethics of interpreting conducted by the Department of Interpreter Services. Results Pre- and post-tests were administered to assess students’ familiarity with the Interpreter Code of Ethics and interpreter skills. Familiarity with the Interpreter Code of Ethics increased significantly with all students reporting feeling comfortable (47%) or very comfortable (53%) after training. The pre- and post-tests included free response questions, which were administered to assess competence in the methodology and ethics of interpreting. The cohort’s aggregate score increased by 35% after the training (Wilcoxon signed rank z-score = 2.53; p = .01). Conclusions Implementing the MSITP resulted in an increased number of trained, Spanish-speaking interpreters available to provide their services to LEP patients at an affiliated charitable clinic and throughout the university hospital. Unlike other program models which are time and resource-intensive, this program is replicable and easily managed by volunteers. The MSITP is an effective model for training students as medical interpreters to ensure the delivery of quality healthcare for LEP patients.

Quality Control of Data in a Large-Scale Cancer Register Program

1966 ◽  
Vol 05 (02) ◽  
pp. 67-74 ◽  
Author(s):  
W. I. Lourie ◽  
W. Haenszeland
Keyword(s):  
United States ◽  
Quality Control ◽  
Cancer Patients ◽  
Large Scale ◽  
The United States ◽  
Newly Diagnosed ◽  
Related Data ◽  
Cancer Register ◽  
Independent Review ◽  
End Results

Quality control of data collected in the United States by the Cancer End Results Program utilizing punchcards prepared by participating registries in accordance with a Uniform Punchcard Code is discussed. Existing arrangements decentralize responsibility for editing and related data processing to the local registries with centralization of tabulating and statistical services in the End Results Section, National Cancer Institute. The most recent deck of punchcards represented over 600,000 cancer patients; approximately 50,000 newly diagnosed cases are added annually.Mechanical editing and inspection of punchcards and field audits are the principal tools for quality control. Mechanical editing of the punchcards includes testing for blank entries and detection of in-admissable or inconsistent codes. Highly improbable codes are subjected to special scrutiny. Field audits include the drawing of a 1-10 percent random sample of punchcards submitted by a registry; the charts are .then reabstracted and recoded by a NCI staff member and differences between the punchcard and the results of independent review are noted.

Utopias of One

2019 ◽  
Author(s):  
Joshua Kotin
Keyword(s):  
United States ◽  
Soviet Union ◽  
World War I ◽  
Large Scale ◽  
Jim Crow ◽  
Personal Autonomy ◽  
The United States ◽  
Soviet Period ◽  
Original Research ◽  
The Soviet Union

This book is a new account of utopian writing. It examines how eight writers—Henry David Thoreau, W. E. B. Du Bois, Osip and Nadezhda Mandel'shtam, Anna Akhmatova, Wallace Stevens, Ezra Pound, and J. H. Prynne—construct utopias of one within and against modernity's two large-scale attempts to harmonize individual and collective interests: liberalism and communism. The book begins in the United States between the buildup to the Civil War and the end of Jim Crow; continues in the Soviet Union between Stalinism and the late Soviet period; and concludes in England and the United States between World War I and the end of the Cold War. In this way it captures how writers from disparate geopolitical contexts resist state and normative power to construct perfect worlds—for themselves alone. The book contributes to debates about literature and politics, presenting innovative arguments about aesthetic difficulty, personal autonomy, and complicity and dissent. It models a new approach to transnational and comparative scholarship, combining original research in English and Russian to illuminate more than a century and a half of literary and political history.

The Obesity Epidemic in Chinese American Youth?: A Literature Review and Pilot Study

2008 ◽  
Vol 6 (1) ◽  
pp. 31-42 ◽  
Author(s):  
Robyn Matloff ◽  
Angela Lee ◽  
Roland Tang ◽  
Doug Brugge
Keyword(s):  
Asian Americans ◽  
Ethnic Diversity ◽  
Large Scale ◽  
Community Health Center ◽  
Chinese American ◽  
The United States ◽  
Overweight And Obesity ◽  
Waiting Room ◽  
Obesity Epidemic ◽  
American Children

Despite nearly 12 million Asian Americans living in the United States and continued immigration, this increasingly substantial subpopulation has consistently been left out of national obesity studies. When included in national studies, Chinese-American children have been grouped together with other Asian Americans, Pacific Islanders or simply as “other,” yielding significantly lower rates of overweight and obesity compared to non-Asians. There is a failure to recognize the ethnic diversity of Asian Americans as well as the effect of acculturation. Results from smaller studies of Chinese American youth suggest that they are adopting lifestyles less Chinese and more Americans and that their share of disease burden is growing. We screened 142 children from the waiting room of a community health center that serves primarily recent Chinese immigrants for height, weight and demographic profile. Body Mass Index was calculated and evaluated using CDC growth charts. Overall, 30.1 percent of children were above the 85th we found being male and being born in the U .S. to be statistically significant for BMI > 85th percentile (p=0.039, p=0.001, respectively). Our results suggest that being overweight in this Chinese American immigrant population is associated with being born in the U.S. A change in public policy and framework for research are required to accurately assess the extent of overweight and obesity in Chinese American children. In particular, large scale data should be stratified by age, sex, birthplace and measure of acculturation to identify those at risk and construct tailored interventions.

Situational Breakdowns

2019 ◽  
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
Large Scale ◽  
Contextual Factors ◽  
The United States ◽  
Social Outcomes ◽  
Dynamic Processes ◽  
Collective Decisions ◽  
Different Types ◽  
The Impact

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.

Accidental Sustainability

2017 ◽  
Author(s):  
Geoffrey Jones
Keyword(s):  
Large Scale ◽  
Negative Impact ◽  
Positive Impact ◽  
Organic Food ◽  
The United States ◽  
Air Travel ◽  
Business Leaders ◽  
Natural Beauty ◽  
And Diffusion ◽  
Whole Foods

This chapter examines the scaling and diffusion of green entrepreneurship between 1980 and the present. It explores how entrepreneurs and business leaders promoted the idea that business and sustainability were compatible. It then examines the rapid growth of organic foods, natural beauty, ecological architecture, and eco-tourism. Green firms sometimes grew to a large scale, such as the retailer Whole Foods Market in the United States. The chapter explores how greater mainstreaming of these businesses resulted in a new set of challenges arising from scaling. Organic food was now transported across large distances causing a negative impact on carbon emissions. More eco-tourism resulted in more air travel and bigger airports. In other industries scaling had a more positive impact. Towns were major polluters, so more ecological buildings had a positive impact.

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