scholarly journals (A78) EMS System Assessment & Gap Analysis

2011 ◽  
Vol 26 (S1) ◽  
pp. s21-s22
Author(s):  
T. Skeen

PurposeThe World Health Organization Model Trauma System Policy suggests that Governments should undertake systematic reviews of the de facto prehospital transport systems for severely ill and injured persons. These systems, be they formal or informal, should be designed to optimize local resources with emphasis on standards of training, equipment, infrastructure and communications so as to assure delivery of prompt, quality, and equitable prehospital care. Scope of Review and Assessment a System Assessment and Gap Analysis (SAGA) tool has been developed to measure 127 key components of a high performance emergency transport system within the realms of Clinical, Organizational and Logistical functionality. The evaluation compares the current status of the specific components with those commonly expected to be seen in a formal international accredited EMS organization.MethodologyThe tool utilizes a thorough investigative process sufficient to produce credible and practical data which can be used to form a “System Improvement Plan.” While the scope of the project can be seen as relatively broad, the assessment process allows for adaptation to a wide variety of EMS system models which bring specific focus to the greatest areas of improvement opportunity with practical applications and alignment with those resources which are available to a given governmental entity.PresentationThis abstract, (in both oral and poster presentation format), demonstrates a portional mock evaluation with focus on those components often overlooked by both evolving and mature formal system designs by the international EMS community. The SAGA approach is an invaluable tool for those responsible for integrating the functionality and needs of a broad range of stake holders into the overarching prehospital delivery system in building support for qualitative improvements.

Author(s):  
M. Teresa Sena-Esteves ◽  
Cristina Morais ◽  
Anabela Guedes ◽  
Isabel Brás Pereira ◽  
Margarida Ribeiro ◽  
...  

Fluid Transport Systems topic is of fundamental importance in most Engineering areas. In this topic basic knowledge must be taught yet students normally resist and do not perform well in theoretical syllabus. In order to reinforce the importance of these issues, and based on teachers’ perceptions and experience, a change was made in the assessment process: a Practical Work and different moments and types of assessment were introduced. The objective is to evaluate the influence of these changes in the students’ final grades and to obtain students’ perceptions regarding these changes, and to know which teaching/learning methodologies are most effective. The students’ perceptions were analyzed through a questionnaire developed and validated for that purpose. Fifty students (88% of the enrolled students) carried out this new course format and answered the questionnaire. It is interesting to observe that most students (55.1%) do not perceive this course as essentially theoretical and 37% view it as balanced between theory and practice. One of the main reasons could be the fact that students realize that practical applications proposed during classes are enough to understand the theoretical concepts (75.5%). Globally students preferred several assessment moments (mini tests) to just one. Regarding the Practical Work, it was well accepted by students. The technical and soft skills promoted by the Practical Work as well as students’ learning styles were also analyzed through the questionnaires. The majority of students (71.4%) learn through the creation of concepts (abstract conceptualization) and perform things by an active experimentation. The grades obtained in the different moments of assessments were crossed with the final and Practical Work grades. It is worth pointing out that students increased their grades with the Practical Work.


2020 ◽  
Vol 27 ◽  
Author(s):  
Kush K. Maheshwari ◽  
Debasish Bandyopadhyay

Background: Neglected tropical diseases (NTDs) affect a huge population of the world and majority of the victims belong to the poor community of the developing countries. Until now, the World Health Organization (WHO) has identified 20 tropical diseases as NTDs that must be addressed with high priority. However, many heterocyclic scaffolds have demonstrated potent therapeutic activity against several NTDs. Objective: There are three major objectives: (1) To discuss the causes, symptoms, and current status of all the 20 NTDs; (2) To explore the available heterocyclic drugs, and their mechanism of actions (if known) that are being used to treat NTDs; (3) To develop general awareness on NTDs among the medicinal/health research community and beyond. Methods: The 20 NTDs have been discussed according to their alphabetic orders along with the possible heterocyclic remedies. Current status of treatment with an emphasis on the heterocyclic drugs (commercially available and investigational) has been outlined. In addition, brief discussion of the impacts of NTDs on socio-economic condition is included. Results: NTDs are often difficult to diagnose and the problem is worsened by the unhealthy hygiene, improper awareness, and inadequate healthcare in the developing countries where these diseases primarily affect poor people. The statistics include duration of suffering, numbers affected, and access to healthcare and medication. The mechanism of actions of various heterocyclic drugs, if reported, have been briefly summarized. Conclusion: Scientists and pharmaceutical corporations should allocate more resources to reveal the in-depth mechanism of actions of many heterocyclic drugs that are currently being used for the treatment of NTDs. Analysis of current heterocyclic compounds and development of new medications can help in the fight to reduce/remove the devastating effects of NTDs. An opinion-based concise review has been presented. Based on available literature, this is the first effect to present all the 20 NTDs and related heterocyclic compounds under the same umbrella.


2020 ◽  
Vol 18 ◽  
Author(s):  
Rina Das ◽  
Dinesh Kumar Mehta ◽  
Meenakshi Dhanawat

Abstract:: A novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appeared and expanded globally by the end of year in 2019 from Wuhan, China, causing severe acute respiratory syndrome. During its initial stage, the disease was called the novel coronavirus (2019-nCoV). It was named COVID-19 by the World Health Organization (WHO) on 11 February 2020. The WHO declared worldwide the SARS-CoV-2 virus a pandemic on March 2020. On 30 January 2020 the first case of Corona Virus Disease 2019 (COVID-19) was reported in India. Now in current situation the virus is floating in almost every part of the province and rest of the globe. -: On the basis of novel published evidences, we efficiently summarized the reported work with reference to COVID-19 epidemiology, pathogen, clinical symptoms, treatment and prevention. Using several worldwide electronic scientific databases such as Pubmed, Medline, Embase, Science direct, Scopus, etc were utilized for extensive investigation of relevant literature. -: This review is written in the hope of encouraging the people successfully with the key learning points from the underway efforts to perceive and manage SARS-CoV-2, suggesting sailent points for expanding future research.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Katana ◽  
Bob Omoda Amodan ◽  
Lilian Bulage ◽  
Alex R. Ario ◽  
Joseph Nelson Siewe Fodjo ◽  
...  

Abstract Background In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Many countries in Sub-Saharan Africa, Uganda inclusive, implemented lockdowns, curfew, banning of both private and public transport systems, and mass gatherings to minimize spread. Social control measures for COVID-19 are reported to increase violence and discrimination globally, including in Uganda as some may be difficult to implement resulting in the heavy deployment of law enforcement. Media reports indicated that cases of violence and discrimination had increased in Uganda’s communities following the lockdown. We estimated the incidence and factors associated with experiencing violence and discrimination among Ugandans during the COVID-19 lockdown to inform control and prevention measures. Methods In April 2020, we conducted a secondary analysis of cross-sectional data under the International Citizen Project (ICP) to assess adherence to public health measures and their impact on the COVID-19 outbreak in Uganda. We analyzed data on violence and discrimination from the ICP study. We performed descriptive statistics for all the participants’ characteristics and created a binary outcome variable called experiencing violence and/or discrimination. We performed logistic regression analysis to identify the factors associated with experiencing violence and discrimination. Results Of the 1726 ICP study participants, 1051 (58.8%) were males, 841 (48.7%) were currently living with a spouse or partner, and 376 (21.8%) had physically attended work for more than 3 days in the past week. Overall, 145 (8.4%) experienced any form of violence and/or discrimination by any perpetrator, and 46 (31.7%) of the 145 reported that it was perpetrated by a law enforcement officer. Factors associated with experiencing violence or discrimination were: being male (AOR = 1.60 CI:1.10–2.33), having attended work physically for more than 3 days in the past week (AOR = 1.52 CI:1.03–2.23), and inability to access social or essential health services since the epidemic started (AOR = 3.10 CI:2.14–4.50). Conclusion A substantial proportion of Ugandan residents experienced violence and/or discrimination during the COVID-19 lockdown, mostly perpetrated by law enforcement officers. We recommend mitigation of the collateral impact of lockdowns with interventions that focus on improving policing quality, ensuring continuity of essential services, and strengthening support systems for vulnerable groups including males.


2021 ◽  
Vol 11 (8) ◽  
pp. 3654
Author(s):  
Brigitte Sipos ◽  
Peter Jirak ◽  
Vera Paar ◽  
Richard Rezar ◽  
Moritz Mirna ◽  
...  

Cardiovascular diseases remain the most common causes of death globally, according to the World Health Organization. In recent years, a great number of biomarkers have been investigated, whereas only some have gained value in the diagnosis, prognosis, and risk stratification of different cardiovascular illnesses. As numerous studies have investigated the diagnostic yield of novel biomarkers in various disease entities every year, this review aims to provide an overview of the current status of four promising representatives. In particular, this manuscript refers to soluble suppression of tumorigenicity 2 (sST2), heart-type fatty acid binding protein (H-FABP), growth differentiation factor (GDF-15) and soluble urokinase-type plasminogen activator receptor (suPAR). These markers are of special interest as they are thought to provide an accurate estimate of cardiovascular risk in certain patient populations, especially those with pre-existing diseases, such as obesity or diabetes mellitus. We sought to give an overview of their function, individual diagnostic and predictive value and determination in the laboratory. A review of the literature regarding the aforementioned cardiovascular biomarkers yielded manifold results with respect to their individual diagnostic and prognostic value. Yet, the clinical relevance of these findings remains unclear, warranting further studies to identify their optimal use in clinical routine.


Author(s):  
Vivekanandan Kalaiselvan ◽  
Aishwarya G. ◽  
Ashish Sharma

As Medical device application in disease prevention, diagnosis or treatment is evolving to a greater extent; there is a need for regulation to monitor its quality, safety and efficacy. The present article attempts to study the medical device regulation available in eleven South-East Asian World Health Organization (WHO) member countries. The information searched from the available sources reveals that medical device regulation exists in seven countries. Most of the countries follow the International Organization for Standardization (ISO) 13485 for their quality standards in medical devices. Most countries also specified the time frame and authority to which adverse event is to be reported. Countries like India and Thailand have separate Adverse Event reporting forms for the medical device. The present study reveals that there is no separate web-based database for adverse event reporting of medical devices. Therefore, WHO South-East Asian Regulators Network (SEARN) under South East Regulatory Office (SERO) office may provide handholding support to these regions in developing a common software or tool for the management and analysis of signals arising from the adverse events.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Paul Vulliamy ◽  
Max Marsden ◽  
Richard Carden ◽  
Karim Brohi ◽  
Ross Davenport ◽  
...  

Abstract Aims Trauma patients requiring abdominal surgery have significant morbidity and mortality, but are not included in existing national audits of emergency laparotomy. The aim of this study was to examine processes of care and outcomes among trauma patients undergoing emergency abdominal surgery in the UK and Ireland. Methods A prospective trainee-led multicentre audit was conducted over six months from January 2019 across the national trauma system. Patients undergoing laparotomy or laparoscopy within 24 hours of injury were included. Subgroup analysis was conducted in those requiring major haemorrhage protocol (MHP) activation. Results The study included 363 patients from 34 hospitals (22 major trauma centres). The majority were young males with no co-morbidities who required surgery for control of bleeding (51%) or exploration of penetrating injuries (46%). Over 85% received consultant-led care in the emergency department (318/363) and operating theatre (321/363). The MHP subgroup made up 45% of the cohort but accounted for 97% of deaths and 79% of ICU days, with a mortality rate of 19% and a massive transfusion rate of 32%. Compared to non-MHP patients they had shorter times to theatre (122 vs 218 minutes, p < 0.001), higher rates of advanced prehospital care (60% vs 33%, p < 0.001) and higher rates of consultant-led care (95% vs 85%, p < 0.001). Conclusion The majority of trauma patients requiring emergency abdominal surgery receive consultant-delivered perioperative care which is appropriately tailored to patient risk profile. Despite this, mortality and resource utilization among high-risk patients remains substantial, justifying ongoing performance improvement initiatives and research into novel therapeutics.


2021 ◽  
Vol 12 ◽  
Author(s):  
Safaet Alam ◽  
Taslima Binte Kamal ◽  
Md. Moklesur Rahman Sarker ◽  
Jin-Rong Zhou ◽  
S. M. Abdur Rahman ◽  
...  

COVID-19, transmitted by SARS-CoV-2, is one of the most serious pandemic situations in the history of mankind, and has already infected a huge population across the globe. This horrendously contagious viral outbreak was first identified in China and within a very short time it affected the world's health, transport, economic, and academic sectors. Despite the recent approval of a few anti-COVID-19 vaccines, their unavailability and insufficiency along with the lack of other potential therapeutic options are continuing to worsen the situation, with valuable lives continuing to be lost. In this situation, researchers across the globe are focusing on repurposing prospective drugs and prophylaxis such as favipiravir, remdesivir, chloroquine, hydroxychloroquine, ivermectin, lopinavir-ritonavir, azithromycin, doxycycline, ACEIs/ARBs, rivaroxaban, and protease inhibitors, which were preliminarily based on in vitro and in vivo pharmacological and toxicological study reports followed by clinical applications. Based on available preliminary data derived from limited clinical trials, the US National Institute of Health (NIH) and USFDA also recommended a few drugs to be repurposed i.e., hydroxychloroquine, remdesivir, and favipiravir. However, World Health Organization later recommended against the use of chloroquine, hydroxychloroquine, remdesivir, and lopinavir/ritonavir in the treatment of COVID-19 infections. Combining basic knowledge of viral pathogenesis and pharmacodynamics of drug molecules as well as in silico approaches, many drug candidates have been investigated in clinical trials, some of which have been proven to be partially effective against COVID-19, and many of the other drugs are currently under extensive screening. The repurposing of prospective drug candidates from different stages of evaluation can be a handy wellspring in COVID-19 management and treatment along with approved anti-COVID-19 vaccines. This review article combined the information from completed clinical trials, case series, cohort studies, meta-analyses, and retrospective studies to focus on the current status of repurposing drugs in 2021.


2013 ◽  
Vol 10 (7) ◽  
pp. 8747-8780 ◽  
Author(s):  
T. P. Karjalainen ◽  
P. M. Rossi ◽  
P. Ala-aho ◽  
R. Eskelinen ◽  
K. Reinikainen ◽  
...  

Abstract. Multi-criteria decision analysis (MCDA) methods are increasingly used to facilitate both rigorous analysis and stakeholder involvement in natural and water resource planning. Decision making in that context is often complex and multi-faceted with numerous trade-offs between social, environmental and economic impacts. However, practical applications of decision-support methods are often too technically oriented and hard to use, understand or interpret for all participants. The learning of participants in these processes is seldom examined, even though successful deliberation depends on learning. This paper analyzes the potential of an interactive MCDA framework, the decision analysis interview (DAI) approach, for facilitating stakeholder involvement and learning in groundwater management. It evaluates the results of an MCDA process in assessing land-use management alternatives in a Finnish esker aquifer area where conflicting land uses affect the groundwater body and dependent ecosystems. In the assessment process, emphasis was placed on the interactive role of the MCDA tool in facilitating stakeholder participation and learning. The results confirmed that the structured decision analysis framework can foster learning and collaboration in a process where disputes and diverse interests are represented. Computer-aided interviews helped the participants to see how their preferences affected the desirability and ranking of alternatives. During the process, the participants' knowledge and preferences evolved as they assess their initial knowledge with the help of fresh scientific information. The decision analysis process led to the opening of a dialogue, showing the overall picture of the problem context, and the critical issues for the further process.


2021 ◽  
Vol 15 (5) ◽  
pp. e0009444
Author(s):  
Ryan E. Wiegand ◽  
W. Evan Secor ◽  
Fiona M. Fleming ◽  
Michael D. French ◽  
Charles H. King ◽  
...  

Background World Health Organization (WHO) guidelines for measuring global progress in schistosomiasis control classify individuals with Schistosoma spp. infections based on the concentration of excreted eggs. We assessed the associations between WHO infection intensity categories and morbidity prevalence for selected S. haematobium and S. mansoni morbidities in school-age children. Methodology A total of 22,488 children aged 6–15 years from monitoring and evaluation cohorts in Burkina Faso, Mali, Niger, Uganda, Tanzania, and Zambia from 2003–2008 were analyzed using Bayesian logistic regression. Models were utilized to evaluate associations between intensity categories and the prevalence of any urinary bladder lesion, any upper urinary tract lesion, microhematuria, and pain while urinating (for S. haematobium) and irregular hepatic ultrasound image pattern (C-F), enlarged portal vein, laboratory-confirmed diarrhea, and self-reported diarrhea (for S. mansoni) across participants with infection and morbidity data. Principal findings S. haematobium infection intensity categories possessed consistent morbidity prevalence across surveys for multiple morbidities and participants with light infections had elevated morbidity levels, compared to negative participants. Conversely, S. mansoni infection intensity categories lacked association with prevalence of the morbidity measures assessed. Conclusions/significance Current status infection intensity categories for S. haematobium were associated with morbidity levels in school-age children, suggesting urogenital schistosomiasis morbidity can be predicted by an individual’s intensity category. Conversely, S. mansoni infection intensity categories were not consistently indicative of childhood morbidity at baseline or during the first two years of a preventive chemotherapy control program.


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