scholarly journals (A29) Effect of Institutional Education and Exercise Programs on Knowledge, Views, and Compliance during Unusual Biological Events

2011 ◽  
Vol 26 (S1) ◽  
pp. s8-s9
Author(s):  
O. Benin-goren ◽  
E. Miller ◽  
I. Dallal ◽  
J. Abu Hanna
Keyword(s):  
Health System ◽  
Emergency Preparedness ◽  
Large Scale ◽  
Medical Center ◽  
Medical Knowledge ◽  
Medical Personnel ◽  
Family Status ◽  
Educational Tools ◽  
National Response ◽  
Self Learning

BackgroundUnusual biological events (UBEs) pose a distinct challenge for emergency preparedness. Not only are these events rare and difficult to detect, but they also pose clear hazards for both medical personnel and their families. Distinct skills include identifying UBEs and activating institutional and national response. Staff attendance and confidence in the health system play a vital role in effective management of UBEs. The Israeli Ministry of health conducts yearly drills on the personal, institutional, and national response to UBEs.AimThe aim of this study was to evaluate the effect of various educational tools and personnel characteristics on personnel skills, views, and compliance to participate in the management of UBEs.MethodsAs part of the preparations for an institutional drill in the Tel Aviv Medical Center, several educational methods were employed. These included e-mail notifications, computer-based self learning, publication of an institutional protocol, tabletop drills, personal briefings, and finally, a large scale exercise. Questionnaires regarding personnel characteristics, participation in pre-drill education, personal views, compliance, and familiarity of institutional protocols and selected diseases were distributed.ResultsAge, family status, and years of experience had no significant influence on personal views. Confidence in the health system increased with experience. Intensity of training had significant positive effect on personal confidence and compliance to attend work during a UBE, however it did not appear to significantly influence personal views or medical knowledge.ConclusionsComprehensive education and exercise of personnel is beneficial effect in terms of personal confidence and work attendance during UBEs. Specific educational tools, such as self-learning software, increase proficiency.

Disaster Management following the Chi-Chi Earthquake in Taiwan

2006 ◽  
Vol 21 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Yu-Feng Chan ◽  
Kumar Alagappan ◽  
Arpita Gandhi ◽  
Colleen Donovan ◽  
Malti Tewari ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Disaster Response ◽  
Large Scale ◽  
Prehospital Care ◽  
Medical Personnel ◽  
Response System ◽  
Health Measures ◽  
Earthquake Resistant ◽  
The Military ◽  
Command Center

AbstractThe earthquake that occurred in Taiwan on 21 September 1999 killed >2,000 people and severely injured many survivors. Despite the large scale and sizeable impact of the event, a complete overview of its consequences and the causes of the inadequate rescue and treatment efforts is limited in the literature. This review examines the way different groups coped with the tragedy and points out the major mistakes made during the process. The effectiveness of Taiwan's emergency preparedness and disaster response system after the earthquake was analyzed.Problems encountered included: (1) an ineffective command center; (2) poor communication; (3) lack of cooperation between the civil government and the military; (4) delayed prehospital care; (5) overloading of hospitals beyond capacity; (6) inadequate staffing; and (7) mismanaged public health measures.The Taiwan Chi-Chi Earthquake experience demonstrates that precise disaster planning, the establishment of one designated central command, improved cooperation between central and local authorities, modern rescue equipment used by trained disaster specialists, rapid prehospital care, and medical personnel availability, as well earthquake-resistant buildings and infrastructure, are all necessary in order to improve disaster responses.

Hospital solution for COVID-19 isolation facility

2021 ◽  
Vol 16 (1) ◽  
pp. 35-41
Author(s):  
Gidon Berger, MD ◽  
Netanel A. Horowitz, MD ◽  
Yael Shachor-Meyouhas, MD ◽  
Vardit Gepstein, MD ◽  
Khetam Hussein, MD ◽  
...  
Keyword(s):  
Large Scale ◽  
Medical Center ◽  
Medical Personnel ◽  
Lessons Learned ◽  
Medical Standards ◽  
Israeli Government ◽  
Clinical Scenarios ◽  
Maximum Protection ◽  
Set Up ◽  
Isolation Facility

Objective: In response to the coronavirus disease 2019 (COVID-19) pandemic, the Israeli government strategy initially focused on containment. The Ministry of Health mandated isolation of COVID-19 patients in hospitals and instructed healthcare institutions to make necessary arrangements. As the second Israeli hospital to establish a COVID-19 department, this article describes our experience in its rapid establishment, while maintaining normal medical center activities.Setting: Establishing the COVID-19 department involved planning, set-up, and implementations phases, each one based on knowledge available regarding the pandemic and established medical standards for isolation and protection of patients and staff. Wherever possible, new innovative technologies were utilized to provide maximum protection for both patients and staff, together with special online training that was developed for medical teams.Results: A COVID-19 department was successfully established on the hospital campus, remote from other ongoing patient activities. A novel methodology of disease-adapted medicine was implemented successfully among the department's medical staff, who underwent training tailored to expected clinical scenarios. The COVID-19 department is receiving patients, with no contamination of medical personnel to date. A recent survey of COVID-19 patients revealed a very high patient satisfaction rate.Conclusion: Based on the experience described herein and lessons learned, the hospital is preparing for a potential large-scale COVID-19 wave, aimed at full readiness through utilization of a fortified underground emergency hospital to treat up to 900 COVID-19 patients, and establishment of versatile in-hospital infrastructure for quick conversion from standard conditions to COVID-19 appropriate conditions.

scholarly journals Amalgamation of cloud-based colonoscopy videos with patient-level metadata to facilitate large-scale machine learning

2021 ◽  
Vol 09 (02) ◽  
pp. E233-E238
Author(s):  
Rajesh N. Keswani ◽  
Daniel Byrd ◽  
Florencia Garcia Vicente ◽  
J. Alex Heller ◽  
Matthew Klug ◽  
...  
Keyword(s):  
Machine Learning ◽  
Large Scale ◽  
Medical Center ◽  
Academic Medical Center ◽  
Procedure Time ◽  
Image Capture ◽  
Common Procedure ◽  
Patient Level Data ◽  
Patient Level ◽  
Level Data

Abstract Background and study aims Storage of full-length endoscopic procedures is becoming increasingly popular. To facilitate large-scale machine learning (ML) focused on clinical outcomes, these videos must be merged with the patient-level data in the electronic health record (EHR). Our aim was to present a method of accurately linking patient-level EHR data with cloud stored colonoscopy videos. Methods This study was conducted at a single academic medical center. Most procedure videos are automatically uploaded to the cloud server but are identified only by procedure time and procedure room. We developed and then tested an algorithm to match recorded videos with corresponding exams in the EHR based upon procedure time and room and subsequently extract frames of interest. Results Among 28,611 total colonoscopies performed over the study period, 21,170 colonoscopy videos in 20,420 unique patients (54.2 % male, median age 58) were matched to EHR data. Of 100 randomly sampled videos, appropriate matching was manually confirmed in all. In total, these videos represented 489,721 minutes of colonoscopy performed by 50 endoscopists (median 214 colonoscopies per endoscopist). The most common procedure indications were polyp screening (47.3 %), surveillance (28.9 %) and inflammatory bowel disease (9.4 %). From these videos, we extracted procedure highlights (identified by image capture; mean 8.5 per colonoscopy) and surrounding frames. Conclusions We report the successful merging of a large database of endoscopy videos stored with limited identifiers to rich patient-level data in a highly accurate manner. This technique facilitates the development of ML algorithms based upon relevant patient outcomes.

scholarly journals COVID-19 and doctor emigration: the case of Ireland

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Niamh Humphries ◽  
Jennifer Creese ◽  
John-Paul Byrne ◽  
John Connell
Keyword(s):  
Health System ◽  
Large Scale ◽  
Qualitative Interviews ◽  
Snowball Sampling ◽  
Contact Potential ◽  
Work From Home ◽  
Travel Restrictions ◽  
Hospital Doctors ◽  
June July ◽  
Global Travel

Abstract Background Since the 2008 recession, Ireland has experienced large-scale doctor emigration. This paper seeks to ascertain whether (and how) the COVID-19 pandemic might disrupt or reinforce existing patterns of doctor emigration. Method This paper draws on qualitative interviews with 31 hospital doctors in Ireland, undertaken in June–July 2020. As the researchers were subject to a government mandated work-from-home order at that time, they utilised Twitter™ to contact potential respondents (snowball sampling); and conducted interviews via Zoom™ or telephone. Findings Two cohorts of doctors were identified; COVID Returners (N = 12) and COVID Would-be Emigrants (N = 19). COVID Returners are Irish-trained emigrant doctors who returned to Ireland in March 2020, just as global travel ground to a halt. They returned to be closer to home and in response to a pandemic-related recruitment call issued by the Irish government. COVID Would-be Emigrants are hospital doctors considering emigration. Some had experienced pandemic-related disruptions to their emigration plans as a result of travel restrictions and border closures. However, most of the drivers of emigration mentioned by respondents related to underlying problems in the Irish health system rather than to the pandemic, i.e. a culture of medical emigration, poor working conditions and the limited availability of posts in the Irish health system. Discussion/conclusion This paper illustrates how the pandemic intensified and reinforced, rather than radically altered, the dynamics of doctor emigration from Ireland. Ireland must begin to prioritise doctor retention and return by developing a coherent policy response to the underlying drivers of doctor emigration.

scholarly journals Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 686-686
Author(s):  
Erin Emery-Tiburcio ◽  
Rani Snyder
Keyword(s):  
Older Adults ◽  
New York ◽  
Health System ◽  
Medical Center ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
New York University ◽  
The Us ◽  
Treatment Plans

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.

Hair Follicle Melanogenesis Reflected in Hair Pigmentation as a Developmental Factor in Alopecia Areata

2021 ◽  
pp. 1-3
Author(s):  
Margit Juhasz ◽  
Rosalynn R.Z. Conic ◽  
Natasha Atanaskova Mesinkovska
Keyword(s):  
Hair Follicle ◽  
Alopecia Areata ◽  
Large Scale ◽  
Medical Center ◽  
Control Group ◽  
Hair Color ◽  
Natural Hair ◽  
Hair Pigmentation ◽  
Developmental Factor ◽  
Record Review

The mechanism of alopecia areata (AA) is not well-elucidated, and hair follicle melanogenesis pathways are implicated as possible sources for autoantigens. After a retrospective medical record review at a single tertiary medical center, the hair color of 112 AA patients were identified and compared to a control group of 104 androgenetic alopecia patients. There were no statistically significant differences in the natural hair color prevalence between the 2 groups (<i>p</i> = 0.164), and hair color was not a predictor of the alopecia type. Our results suggest hair pigmentation, determined by the eumelanin-to-pheomelanin ratio, is not a positive risk factor for AA development. We hope that our study will encourage multiple large-scale, collaborative, retrospective medical reviews to determine if our results are reproducible in diverse patient populations.

scholarly journals Cloud-based intelligent self-diagnosis and department recommendation service using Chinese medical BERT

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Junshu Wang ◽  
Guoming Zhang ◽  
Wei Wang ◽  
Ka Zhang ◽  
Yehua Sheng
Keyword(s):  
Cloud Computing ◽  
Large Scale ◽  
Medical Service ◽  
Rapid Development ◽  
Medical Knowledge ◽  
Language Models ◽  
Computing Environment ◽  
Computing Power ◽  
Cloud Computing Environment ◽  
Proposed Model

AbstractWith the rapid development of hospital informatization and Internet medical service in recent years, most hospitals have launched online hospital appointment registration systems to remove patient queues and improve the efficiency of medical services. However, most of the patients lack professional medical knowledge and have no idea of how to choose department when registering. To instruct the patients to seek medical care and register effectively, we proposed CIDRS, an intelligent self-diagnosis and department recommendation framework based on Chinese medical Bidirectional Encoder Representations from Transformers (BERT) in the cloud computing environment. We also established a Chinese BERT model (CHMBERT) trained on a large-scale Chinese medical text corpus. This model was used to optimize self-diagnosis and department recommendation tasks. To solve the limited computing power of terminals, we deployed the proposed framework in a cloud computing environment based on container and micro-service technologies. Real-world medical datasets from hospitals were used in the experiments, and results showed that the proposed model was superior to the traditional deep learning models and other pre-trained language models in terms of performance.

Comparison of rates of adherence to oral chemotherapy medications filled through an internal health-system specialty pharmacy vs external specialty pharmacies

2020 ◽  
Vol 77 (14) ◽  
pp. 1118-1127
Author(s):  
Colleen C McCabe ◽  
Meagan S Barbee ◽  
Marley L Watson ◽  
Alyssa Billmeyer ◽  
Collin E Lee ◽  
...  
Keyword(s):  
Health System ◽  
Multiple Regression ◽  
Patient Adherence ◽  
Medical Center ◽  
Academic Medical Center ◽  
Medication Possession Ratio ◽  
Primary Objective ◽  
Wilcoxon Test ◽  
Tumor Type ◽  
Specialty Pharmacy

Abstract Purpose The primary objective of the study described here was to compare rates of patient adherence to anticancer medications filled at an internal health system specialty pharmacy (HSSP) vs external specialty pharmacies. The primary outcome was the medication possession ratio (MPR), and the secondary outcomes included proportion of days covered (PDC), and time to treatment (TTT). Methods A retrospective chart review was conducted to compare the MPR, PDC, and TTT for patients who received oral anticancer therapy using prescriptions claim data. A t test or Wilcoxon test was used to explore the effect of demographic and other factors on adherence and TTT. A multiple regression model with backward elimination was used to analyze significant factors to identify covariates significantly associated with the outcomes. Results Of the 300 patients screened for study inclusion, 204 patients whose records had complete MPR and PDC data and 164 whose records had TTT data were included in the analysis. There were significant between-group differences in mean MPR and mean PDC with patient use of the HSSP vs external pharmacies (1.00 vs 0.75 [P &lt; 0.001] and 0.95 vs 0.7 [P &lt; 0.001], respectively). Pharmacy type (P = 0.024) and tumor type (P = 0.048) were significantly associated with TTT. Conclusion The multiple regression analysis indicated that oncology patients who filled their anticancer medication precriptions at an internal HSSP at an academic medical center had significantly higher adherence, as measured by MPR and PDC, and quicker TTT than those who filled their prescriptions at an external specialty pharmacy.

PRACTICAL EPIGRAM OF APGAR SCORE

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 778-778
Author(s):  
Joseph Butterfield
Keyword(s):  
Apgar Score ◽  
Scoring System ◽  
Medical Center ◽  
Medical Personnel ◽  
Effective Adjunct

Despite the value of the [Apgar] scoring system, experience has shown that it may be difficult to memorize the categories that make up the score and that [some] medical personnel are not familiar with it. The purpose of this communication is to describe an epigram (Figure) which embodies the basic components of the scoring system and implements its application. [SEE TABLE 1 IN SOURCE PDF.] The epigram has not altered the essence of the Apgar scoring system. . . . It does afford a means of remembering it easily. This has been an effective adjunct in expanding the use of the Apgar Score in this medical center, and it may be of value to those physicians who are interested in furthering the employment of this scoring system in their hospitals.

scholarly journals (P2-1) Large Civilian Jets Configured for Aeromedical Use: Implications for Disaster Health

2011 ◽  
Vol 26 (S1) ◽  
pp. s135-s135
Author(s):  
S. Curnin
Keyword(s):  
Emergency Preparedness ◽  
Large Scale ◽  
International Study ◽  
Extensive Literature ◽  
Aeromedical Evacuation ◽  
Study Tour ◽  
Health Agencies ◽  
Effective Option ◽  
The Military

BackgroundAustralia is a vast and isolated country and often the only viable option of transporting multiple casualties is using fixed wing aircraft. A number of civilian aeromedical services and the military are responsible for the evacuation of casualties, both nationally and internationally. Due to Australia's increased operational commitments, the military can no longer be expected to provide a rapid aeromedical deployment. This situation, coupled with the limited surge capacity of Australia's civilian fixed wing aeromedical services, highlights the need for Australia to improve preparation and readiness for a large scale civilian aeromedical response.Discussion and ObservationsHistorically, the use of large jets configured for aeromedical use has been exclusively the domain of the military. Yet in recent years the use of large civilian jets configured for aeromedical capability has been suggested as a solution. The purpose of this paper is to explore the role of large civilian jets configured for aeromedical use in the event of a disaster with multiple casualties. This study involved an extensive literature review and an international study tour of aeromedical services that are at the forefront of using large jets in aeromedical evacuation. The findings identified that standard civilian jets can easily be reconfigured for transporting multiple casualties. It is argued that this strategy can be an inexpensive and effective option and should be included in emergency preparedness arrangements. The aim of this paper is to prompt disaster health agencies in Australia to consider the use of a civilian jet system that can be used for a disaster requiring a large scale aeromedical response.

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