Measuring the Masses: A Proposed Template for Post-Event Medical Reporting (Paper 4)

Author(s):  
Sheila Turris ◽  
Haddon Rabb ◽  
Elizabeth Chasmar ◽  
Matthew Brendan Munn ◽  
Christopher W. Callaghan ◽  
...  

Abstract Background: Standardizing and systematizing the reporting of health outcomes from mass gatherings (MGs) will improve the quality of data being reported. Setting minimum standards for case reporting is an important strategy for improving data quality. This paper is one of a series of papers focused on understanding the current state, and shaping the future state, of post-event case reporting. Methods: Multiple data sources were used in creating a lean, yet comprehensive list of essential reporting fields, including a: (1) literature synthesis drawn from analysis of 54 post-event case reports; (2) comparison of existing data models for MGs; (3) qualitative analysis of gaps in current case reports; and (4) set of data domains developed based on the preceding sources. Findings: Existing literature fails to consistently report variables that may be essential for not only describing the health outcomes of a given event, but also for explaining those outcomes. In the context of current and future state reporting, 25 essential variables were identified. The essential variables were organized according to four domains, including: (i) Event Domain; (ii) Hazard and Risk Domain; (iii) Capacity Domain; and (iv) Clinical Domain. Discussion: The authors propose a first-generation template for post-event medical reporting. This template standardizes the reporting of 25 essential variables. An accompanying data dictionary provides background and standardization for each of the essential variables. Of note, this template is lean and will develop over time, with input from the international MG community. In the future, additional groups of variables may be helpful as “overlays,” depending on the event category and type. Conclusions: This paper presents a template for post-event medical reporting. It is hoped that consistent reporting of essential variables will improve both data collection and the ability to make comparisons between events so that the science underpinning MG health can continue to advance.

2021 ◽  
Vol 36 (2) ◽  
pp. 202-210 ◽  
Author(s):  
Sheila Turris ◽  
Haddon Rabb ◽  
Matthew Brendan Munn ◽  
Elizabeth Chasmar ◽  
Christopher W. Callaghan ◽  
...  

AbstractIntroduction:Case reports are commonly used to report the health outcomes of mass gatherings (MGs), and many published reports of MGs demonstrate substantial heterogeneity of included descriptors. As such, it is challenging to perform rigorous comparisons of health services and outcomes between similar and dissimilar events. The degree of variation in published reports has not yet been investigated.Objective:Examine patterns of post-event medical reporting in the existing literature and identify inconsistencies in reporting.Methods:A systematic review of case reports was conducted. Included were English studies, published between January 2009 and December 2018, in Prehospital and Disaster Medicine (PDM) or Current Sports Medicine Reports (CSMR). Analysis of each paper was used to develop a list of 27 categories of data.Results:Seventy-five studies were initially reviewed with 54 publications meeting the inclusion criteria. Forty-two were full case reports (78%) and 12 were conference proceedings (22%). Of the 27 categories of data studied, only 13 were consistently reported in more than 50% of publications. Reporting patterns included inconsistent use of terminology/language and variable retrievability of reports. Reporting on event descriptors, hazard and risk analysis, and clinical outcomes were also inconsistent.Discussion:Case reports are essential tools for researchers and event team members such as medical directors and event producers. The authors found that current case reports, in addition to being inconsistent in content, were generally descriptive rather than explanatory; that is, focused on describing the outcomes as opposed to exploring possible connections between context and health outcomes.Conclusion:This paper quantifies and demonstrates the current state of heterogeneity in MG event reporting. This heterogeneity is a significant impediment to the functional use of published reports to further the science of MG planning and to improve health outcomes. Future work based on the insights gained from this analysis will aim to align and standardize reporting to improve the quality and value of event reporting.


Author(s):  
Sheila Turris ◽  
Haddon Rabb ◽  
Matthew Brendan Munn ◽  
Elizabeth Chasmar ◽  
Christopher W. Callaghan ◽  
...  

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199687
Author(s):  
Peng Zhu ◽  
Xiao-Yan Li

Pharyngeal teratomas are very rare congenital tumours derived from pluripotent stem cells. Surgical resection is the main treatment to avoid breathing and feeding difficulties. This current case report describes two newborn infants with congenital oropharyngeal teratomas. In one of the infants, the tumour presented along with a cleft tongue and cleft palate. Prenatal diagnosis by ultrasonography did not identify the tumours because the masses were small and there was no polyhydramnios. Both cases were treated surgically and histological examination of the masses in both cases confirmed the diagnosis of a congenital epignathus. There were no complications such as infection, bleeding or residual recurrence following surgery. After 1-year follow-up, there was no recurrence of the epignathus in either case. Oropharyngeal teratoma is a very rare congenital tumour that may cause upper airway obstruction and feeding difficulties in the newborn, so it should be treated surgically in a timely manner.


2021 ◽  
Vol 36 (2) ◽  
pp. 211-217 ◽  
Author(s):  
Sheila Turris ◽  
Adam Lund ◽  
Matthew Brendan Munn ◽  
Elizabeth Chasmar ◽  
Haddon Rabb ◽  
...  

AbstractIntroduction:Without a robust evidence base to support recommendations for medical services at mass gatherings (MGs), levels of care will continue to vary and preventable morbidity and mortality will exist. Accordingly, researchers and clinicians publish case reports and case series to capture and explain some of the health interventions, health outcomes, and host community impacts of MGs. Streamlining and standardizing post-event reporting for MG medical services and associated health outcomes could improve inter-event comparability, thereby supporting and promoting growth of the evidence base for this discipline. The present paper is focused on theory building, proposing a set of domains for data that may support increasingly comprehensive, yet lean, reporting on the health outcomes of MGs. This paper is paired with another presenting a proposal for a post-event reporting template.Methods:The conceptual categories of data presented are based on a textual analysis of 54 published post-event medical case reports and a comparison of the features of published data models for MG health outcomes.Findings:A comparison of existing data models illustrates that none of the models are explicitly informed by a conceptual lens. Based on an analysis of the literature reviewed, four data domains emerged. These included: (i) the Event Domain, (ii) the Hazard and Risk Domain, (iii) the Capacity Domain, and (iv) the Clinical Domain. These domains mapped to 16 sub-domains.Discussion:Data modelling for the health outcomes related to MGs is currently in its infancy. The proposed illustration is a set of operationally relevant data domains that apply equally to small, medium, and large-sized events. Further development of these domains could move the MG community forward and shift post-event health outcomes reporting in the direction of increasing consistency and comprehensiveness.Conclusion:Currently, data collection and analysis related to understanding health outcomes arising from MGs is not informed by robust conceptual models. This paper is part of a series of nested papers focused on the future state of post-event medical reporting.


2019 ◽  
Vol 34 (s1) ◽  
pp. s148-s149
Author(s):  
Sheila Turris ◽  
Haddon Rabb ◽  
Christopher Callaghan ◽  
Matthew Brendan Munn ◽  
Jamie Ranse ◽  
...  

Introduction:The science supporting event medicine is growing rapidly. In order to improve the ability of researchers to access event data and improve the quality of publishing mass gathering cases, it would be of benefit to standardize event reports to permit the comparison of similar events across local and national boundaries. These data would support the development of practice standards across settings.Aim:The authors propose the creation of a publication guideline to support authors seeking to publish in this field.Method: Derivation study via analysis of published case reports using the Delphi process.Results:Data elements were inconsistently reported within published case reports. Categories of variables included: event demographics (descriptors of date, time, genre, activity, risks), attendance and population demographics, data related to climate and weather conditions, composition and deployment of an onsite medical team, highest level of care available onsite, patient demographics, patient presentations and measures of impact on the local health care system such as transfer to hospital rates. Of note, there was a high incidence of “missing” variables that would be of central interest to researchers.Discussion:Approaches to standardizing the collection and reporting of data are often discussed in the health care literature. The benefits of consistent, structured data collection are well understood. In the context of mass gathering event case reporting, the time is ripe for the introduction of a guideline (with accompanying guidance notes and dictionary). The proposed guideline requires the input of subject matter experts (in progress) to enhances its relevance and uptake. This work is timely as there is ongoing work on improving an international event medicine registry. If the evolution of both proceeds in lockstep, there is a good chance that access to a rigorous data set will become a reality.


CFA Magazine ◽  
2018 ◽  
Vol 29 (1) ◽  
pp. 6-7
Author(s):  
Ed McCarthy
Keyword(s):  

Author(s):  
Sandra L. Neate ◽  
Keryn L. Taylor ◽  
Nupur Nag ◽  
George A. Jelinek ◽  
Steve Simpson-Yap ◽  
...  

People with multiple sclerosis (PwMS) often experience uncertainty and fear about their futures. Partners of PwMS may share their concerns and experience fears about their own futures, limitations on their lives, ability to work, and becoming a carer. For PwMS, modification of lifestyle-related risk factors has been associated with improved health outcomes. For PwMS who attended residential lifestyle modification workshops (RLMW), sustained improved health outcomes have been demonstrated. Whether improved outcomes for PwMS who engage with lifestyle modification translate to improved partner perceptions of the future, is yet to be explored. We explored the perspectives of partners of PwMS who had attended a RLMW and the impact that the person with MS’s illness and their engagement with lifestyle modification had on their partners’ views of the future. Analysis of 21 semi-structured interviews used a methodology informed by Heidegger’s Interpretive Phenomenology. Three themes emerged: ‘uncertainty’, ‘planning for the future’ and ‘control, empowerment and confidence’. Subthemes included MS and lifestyle modification being a catalyst for positive change; developing a sense of control and empowerment; and hope, optimism and positivity. Lifestyle modification may provide benefits, not only to PwMS, but also to their partners, and should be considered part of mainstream management of MS.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mawuli F. Attipoe ◽  
Charles D. Sturgis

Definitive cytomorphologic diagnosis of small cell carcinoma of the uterine cervix is possible but can be challenging in routine cervicovaginal cancer screening specimens. Several small series of reported cases of cervical small cell carcinoma have shown this uncommon malignancy to represent fewer than 2% of all invasive cervical cancers. This tumor type is associated with poor prognosis and rapid disease progression and can develop to an advanced stage in the interval between screening visits. Only rare case reports of small cell carcinoma arising in gravid cervices are known. In the current case a 29-year-old, gravida 6, para 2, pregnant (10-week gestation) female presented with postcoital bleeding. A definitive diagnosis of small cell carcinoma of the cervix was made possible by liquid based Pap testing with ancillary cell block preparation allowing for immunocytochemical characterization of the lesional cell population.


2021 ◽  
pp. 568-577
Author(s):  
Ryo Katsumata ◽  
Noriaki Manabe ◽  
Masaki Matsubara ◽  
Jun Nakamura ◽  
Kazuma Kawahito ◽  
...  

Ischemic enteritis (IE) is a rare disorder which is caused by inadequate blood flow to small intestine. The diagnostic procedure of this disease has not sufficiently established because of its rarity. Here, we report a case of IE in a hemodialysis-dependent 70-year-old man and summarize the diagnostic options for IE. The patient was admitted to our hospital because of acute abdominal distention and vomiting. He presented with mild tenderness in the lower abdomen and slightly elevated C-reactive protein level as revealed by blood tests. Radiographic imaging showed small bowel obstruction due to a stricture in the distal ileum. Contrast-enhanced abdominal ultrasonography revealed a 7-cm stenotic site with increased intestinal wall thickening, which preserved mucosal blood perfusion. Elastography revealed a highly elastic alteration of the stenotic lesion, indicating benign fibrotic changes resulting from chronic insufficient blood flow. Based on a clinical diagnosis of IE with fibrous stenosis, a partial ileostomy was performed. After surgical treatment, oral intake was initiated without recurrence of intestinal obstruction. Pathological findings revealed deep ulceration with inflammatory cell infiltration at the stenotic site. Occlusion and hyalinization of the venules in the submucosal layer indicated IE. In addition to current case, we reviewed past case reports of IE. Through this case presentation and literature review, we summarize the usefulness and safety of transabdominal ultrasonography for diagnosing IE.


2021 ◽  
Vol 37 (1) ◽  
pp. 37-45
Author(s):  
Kalinda Griffiths ◽  
Ian Ring ◽  
Richard Madden ◽  
Lisa Jackson Pulver

Since March 2020 in Australia, there has been decisive national, and state and territory policy as well as community led action involving Aboriginal and Torres Strait Islander people as information about COVID-19 arose. This has resulted in, what could only be framed as a success story in self-determination. However, there continues to be issues with the quality of data used for the surveillance and reporting of Aboriginal and Torres Strait Islander people during the pandemic. This article discusses some of the important events in pandemic planning regarding Aboriginal and Torres Strait Islander people and how this relates to surveillance and monitoring in the emerging and ongoing threat of COVID-19 within Aboriginal and Torres Strait Islander communities. The authors also identify some of the data considerations required in the future to monitor and address public health.


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