576 Firefighter Post-injury Return to Work: A Balance of Dedication and Obligation

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S130-S130
Author(s):  
Lauren B Nosanov ◽  
Kathleen S Romanowski
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Organizational Level ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Post Injury ◽  
Cross Sectional ◽  
Burn Center ◽  
Medical Evaluation ◽  
The Individual

Abstract Introduction Over the duration of firefighters’ careers there exists a high probability of sustaining burn injuries necessitating medical evaluation and treatment. While many are minor and do not significantly affect the ability to work in full capacity, there exists risk for both short and long-term incapacitation. It is not uncommon for firefighters to push for earlier return to work than is medically advisable. However, there are additional external factors which drive premature return to duty. Methods An online cross-sectional survey was sent to firefighters who were members of a statewide Professional Firefighters’ Union. A multiple-choice format was used to assess demographics, injury details, medical care received and return to work. Free text format allowed for elaboration regarding factors influencing decisions to return to work. Results The survey was sent to 30,000 firefighters, with 413 (1.4%) responses received. Excluding those with incomplete data, 354 remained for analysis. Of these, 132 (37.3%) reported a burn injury which required medical evaluation. The majority were sustained during active duty, with 90.7% using protective gear at the time. Most burns were small and affected the head (50.8%) and upper extremities (48.3%). The majority were not treated at a Burn Center. While 12 (16.2%) reported returning to work prematurely themselves, nearly half indicated that they knew a colleague whom they felt had returned to work too soon. Factors cited include firefighter culture, finances, limitations of workman’s compensation, pressure from peers and employers, dislike of light duty and a driving desire to get back to work. Conclusions While many cite love of the job and a culture of pride and camaraderie that is “in our DNA”, firefighters’ decisions to return to work after burn injury are equally driven external pressures and obligations. Additional education is needed at both the individual and organizational level, which may best be facilitated by evaluation and treatment at a Burn Center. Applicability of Research to Practice Improved understanding of factors driving firefighters’ views on returning to duty after injury may help establish support systems and improve education regarding risks of premature return to work, particularly with regard to reinjury.

Firefighter Postinjury Return to Work: A Balance of Dedication and Obligation

2020 ◽  
Vol 41 (5) ◽  
pp. 935-944
Author(s):  
Lauren B Nosanov ◽  
Kathleen S Romanowski
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Significant Risk ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Burn Center ◽  
External Pressures ◽  
Full Capacity ◽  
Additional Education

Abstract Firefighters are at significant risk for burn injuries. Most are minor and do not significantly affect ability to work in full capacity, but there exists risk for both short- and long-term incapacitation. Many push for earlier return to work than is medically advisable. An online cross-sectional survey was sent to a statewide Professional Firefighters’ Union. Multiple-choice format was used to assess demographics, injury details, medical care received, and return to work, with free-text format for elaboration. The survey was sent to 30,000 firefighters, with 413 (1.4%) responses. After exclusions, 354 remained for analysis with 132 burn-injured. Burns were small and affected the head (45.5%) and upper extremities (43.2%). Reported gear use was 90.7%, and the majority were not treated at a Burn Center. While 12 (12.1%) returned prematurely, nearly half knew a colleague who they felt had returned too soon. Factors cited include firefighter culture, finances, pressure from peers and employers, dislike of light duty, and a driving desire to get back to work. While many cite love of the job and a culture of pride and camaraderie that is “in our DNA,” firefighters’ decisions to return to work after burn injury are equally driven external pressures and obligations. Additional education is needed, which may best be facilitated by treatment at a Burn Center. Improved understanding of factors driving firefighters’ views on returning to duty after injury may help establish support systems and improve education regarding risks of premature return to work, particularly with regard to reinjury.

scholarly journals The Psychological Impact of COVID-19 on Healthcare Providers in Obstetrics: A Cross-Sectional Survey Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Lidia Del Piccolo ◽  
Valeria Donisi ◽  
Ricciarda Raffaelli ◽  
Simone Garzon ◽  
Cinzia Perlini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
General Health Questionnaire ◽  
Healthcare Providers ◽  
Organizational Level ◽  
Survey Study ◽  
University Hospitals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Gynecology And Obstetrics ◽  
The Individual

Objective: To assess the psychological distress of healthcare providers (HCPs) working in the field of obstetrics during the coronavirus disease 2019 (COVID-19) pandemic and to identify factors associated with psychological distress at the individual, interpersonal, and organizational level.Design: Cross-sectional survey study.Setting: Four University hospitals in Italy.Participants: HCPs working in obstetrics, including gynecologists, residents in gynecology and obstetrics, and midwives.Methods: The 104-item survey Impatto PSIcologico COVID-19 in Ostetricia (IPSICO) was created by a multidisciplinary expert panel and administered to HCPs in obstetrics in May 2020 via a web-based platform.Main Outcome Measures: Psychological distress assessed by the General Health Questionnaire-12 (GHQ-12) included in the IPSICO survey.Results: The response rate to the IPSICO survey was 88.2% (503/570), and that for GHQ-12 was 84.4% (481/570). Just over half (51.1%; 246/481) of the GHQ-12 respondents reported a clinically significant level of psychological distress (GHQ-12 ≥3). Psychological distress was associated with either individual (i.e., female gender, stressful experience related to COVID-19, exhaustion, and the use of dysfunctional coping strategies), interpersonal (i.e., lower family support, limitations in interactions with colleagues), and organizational (i.e., reduced perception of protection by personal protective equipment, perceived delays on updates and gaps in information on the pandemic) factors in dealing with the pandemic.Conclusions: Results confirm the need for monitoring and assessing the psychological distress for HCPs in obstetrics. Interventions at the individual, interpersonal, and organizational level may relieve the psychological distress during the COVID-19 pandemic and foster resilience skills in facing emotional distress.

A cross-sectional survey among physicians on Internet use for epilepsy-related information (Preprint)

2019 ◽  
Author(s):  
Francesco Brigo ◽  
Simona Lattanzi ◽  
Giorgia Giussani ◽  
Laura Tassi ◽  
Nicola Pietrafusa ◽  
...  
Keyword(s):  
Internet Use ◽  
The Internet ◽  
Online Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Information ◽  
Internet Users ◽  
Therapeutic Decisions ◽  
The Individual ◽  
The Web

BACKGROUND The Internet has become one of the most important sources of health information, accessed daily by an ever-growing number of both patients and physicians, seeking medical advice and clinical guidance. A deeper insight into the current use of the Web as source of information on epilepsy would help in clarifying the individual attitude towards this medium by Internet users. OBJECTIVE We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to explore factors which explained the influence of information found on the internet. METHODS This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018. RESULTS 184 questionnaires were analyzed. 97.8% of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9%) or to confirm a diagnostic or therapeutic decision (37.3%). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95%CI: 1.28-6.76; p=0.011), higher frequency of Internet use (OR: 3.66; 95%CI: 1.56-9.21; p=0.006) and higher confidence in reliability of online information (OR: 2.61; 95%CI: 1.09-6.26; p=0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information. CONCLUSIONS Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.

Redeveloping Secure Psychiatric Services for Women

2005 ◽  
Vol 45 (4) ◽  
pp. 331-339 ◽  
Author(s):  
Stuart D M Thomas ◽  
Mairead Dolan ◽  
Jenny Shaw ◽  
Samantha Thomas ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Psychiatric Hospitals ◽  
Antisocial Behaviour ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Suitable Alternative ◽  
High Security ◽  
Risk Treatment ◽  
The Individual

Historically, a substantial proportion of women have been unduly detained in conditions of high security in England due to the lack of suitable alternative facilities. There have been no studies that have comprehensively examined the individual needs of these women in relation to their placement needs. A cross sectional survey was undertaken of the individual and placement needs of all females detained in the three high security psychiatric hospitals (HSPHs) in England on 18th October 1999. Whilst there are clearly differences in accommodation needs among the women, those requiring lower secure services are significantly less likely to have needs in relation to violence (OR 0.29, 95% CI 0.14-0.62) and drugs (OR 0.29, 95% CI 0.12-0.67) when length of stay is taken into account. They also have lower security, treatment and dependency needs than women still requiring HSPH treatment. A significant reorganisation of services is required. There is a need to gain further understanding of the relationships between traumatic histories, clinical presentation and antisocial behaviour and how these impact on assessed risk, treatment and care needs and outcome. The special needs of these women should be considered a priority when developing treatment and care packages.

scholarly journals Cross-sectional survey of the undergraduate rheumatology curriculum in European medical schools: a EULAR School of Rheumatology initiative

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000743 ◽  
Author(s):  
Abhishek Abhishek ◽  
Annamaria Iagnocco ◽  
J W J Bijlsma ◽  
Michael Doherty ◽  
Frédéric Lioté
Keyword(s):  
Musculoskeletal Diseases ◽  
Site Response ◽  
Joint Infection ◽  
Medical Schools ◽  
Calcium Pyrophosphate ◽  
Free Text ◽  
Curriculum Content ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Additional Information

ObjectivesTo survey the undergraduate rheumatic and musculoskeletal diseases (RMDs) curriculum content in a sample of medical schools across Europe.MethodsThe undergraduate musculoskeletal diseases and disability curriculum of University of Nottingham, UK, was used as a template to develop a questionnaire on curriculum content. The questionnaire elicited binary (yes/no) responses and included the option to provide additional information as free text. The survey was mailed to members of the European League Against Rheumatism (EULAR) School of Rheumatology (Undergraduate Classroom) and to EULAR Standing Committee on Education and Training members in January 2017, with a reminder in February 2017.ResultsResponses were received from 21 schools belonging to 11 countries. Assessment of gait, hyperalgesic tender site response and hypermobility were not included in many curricula. Similarly, interpretation of investigations undertaken on synovial fluid was taught in only 16 schools. While disease-modifying anti-rheumatic drugs and biological agents, and urate-lowering treatment were included in the curricula of 20 and 21 institutions, respectively, only curricula from 18 schools included core non-pharmacological interventions. Osteoarthritis, gout, rheumatoid arthritis, spondyloarthropathy, polymyalgia rheumatica and lupus were included in the curriculum of all institutions. However, common RMDs such as calcium pyrophosphate deposition, fibromyalgia, giant cell arteritis and bone and joint infection were included in 19 curricula.ConclusionThis survey highlights areas of similarities and differences in undergraduate curricula across Europe. It is hoped that the results of this survey will catalyse the development and agreement of a minimum core European Curriculum for undergraduate education in RMDs.

Public service motivation and willingness to collaborate

2014 ◽  
Vol 2 (1) ◽  
pp. 80-95 ◽  
Author(s):  
Heather Getha-Taylor ◽  
Alexa Haddock-Bigwarfe
Keyword(s):  
Homeland Security ◽  
Public Service ◽  
Public Service Motivation ◽  
The Body ◽  
Organizational Level ◽  
Cross Sectional ◽  
Content Type ◽  
Individual Level ◽  
Original Survey ◽  
The Individual

Purpose – The purpose of this paper is to examine public service motivation (PSM) and the connection with collaborative attitudes among a sample of homeland security actors representing the public, private, and nonprofit sectors. Design/methodology/approach – This study examines relationships between measures of PSM and collaboration using original survey data and hierarchical multiple regression. Findings – Findings reveal strong positive relationships between PSM measures and attitudes toward collaboration at the individual and organizational level. Research limitations/implications – Survey results are cross-sectional and are from respondents participating in a single state's homeland security summit. Practical implications – It is expected that results can be used to enhance collaboration at the individual and organizational levels. At the organizational level, results can be used for matching individuals with collaborative opportunities. At the individual level, results can be used for enhanced self-reflection and effectiveness purposes. Originality/value – This study provides insights on the relationship between PSM measures and collaborative attitudes. The research contributes to the body of scholarly work connecting PSM and correlates of interest.

scholarly journals The Veterinary Treatment Facility as a Readiness Platform for Veterinary Corps Officers

2021 ◽  
Author(s):  
Sara B Mullaney ◽  
Heather Bayko ◽  
Gerald D Moore ◽  
Hannah E Funke ◽  
Matthew J Enroth ◽  
...  
Keyword(s):  
Public Health ◽  
Animal Health ◽  
Published Data ◽  
Veterinary Services ◽  
Multiple Sources ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Online Readiness ◽  
Representative Random Sample ◽  
The Individual

ABSTRACT Introduction U.S. Army Veterinary Corps provides highly skilled and adaptive veterinary professionals to protect and improve the health of people and animals while enhancing readiness throughout the DOD. Army veterinarians must be trained and credentialed for critical tasks within the animal health and food protection missions across all components. The Veterinary Metrics Division in the U.S. Army Public Health Center’s Veterinary Services and Public Health Sanitation Directorate is responsible for tracking readiness metrics of Army veterinarians and maintains a robust online Readiness Metrics Platform. Readiness targets were developed based on trends in readiness platform data, input of senior veterinary subject matter experts, and feedback from the field. To date, no data have been published describing the cases presented to DOD-owned Veterinary Treatment Facilities (VTFs). Without capturing and codifying the types of cases that present to the VTF and comparing to cases typically encountered during deployments, it is difficult to determine whether the VTF serves as an adequate readiness platform. In this study, we compare a representative random sample of non-wellness VTF patient encounters in garrison to cases reported from two different combat zones to determine if the VTF is a suitable clinical readiness platform. Materials and Methods Multiple data sources, including pre-existing published data and new data extracted from multiple sources, were used. The Iraq 2009-2010 dataset includes data collected from a Medical Detachment, Veterinary Service Support (MDVSS) deployed to Iraq from January 5, 2009 through August 23, 2010. The Iraq 2003-2007 dataset originated from a retrospective cross-sectional survey that included database and medical record abstraction. The Afghanistan 2014-2015 dataset includes data collected from the MDVSS deployed to Afghanistan from June 2014 to March 2015. Working dog veterinary encounter data were manually extracted from monthly and daily clinical reports. Data for the Garrison 2016-2018 dataset were extracted from the Remote Online Veterinary Record. A random representative sample of government-owned animal (GOA) and privately owned animal (POA) encounters seen across all DOD-owned VTFs from June 2016 to May 2018 were selected. Results We found that animals present to the VTF for a wide variety of illnesses. Overall, the top 10 encounter categories (90.3%) align with 84.2%, 92.4%, and 85.9% of all the encounter types seen in the three combat zone datasets. Comparing these datasets identifies potential gaps in readiness training relying solely on the VTF, especially in the areas of traumatic and combat-related injuries. Conclusions Ultimately, the success of the DOD Veterinary Services Animal Health mission depends on both the competence and confidence of the individual Army veterinarian. As the MHS transitions and DOD Veterinary Services continues to transform emphasizing readiness through a public health and prevention-based Army medicine approach, Army veterinarians must strike a delicate balance to continue to provide comprehensive health care to GOAs and POAs in the VTFs. Leaders at all levels must recognize the roles VTFs play in overall public health readiness and disease prevention through the proper appropriation and allocation of resources while fostering the development, confidence, and competence of Army veterinarians training within these readiness platforms.

Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: An International Cross-sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Edmond Li ◽  
Rosy Tsopra ◽  
Geronimo Jimenez ◽  
Alice Serafini ◽  
Gustavo Gusso ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Lessons Learned ◽  
Survey Study ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Face To Face ◽  
Remote Care

BACKGROUND With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. OBJECTIVE We explored GPs’ perspectives on the main benefits and challenges of using digital remote care. METHODS GPs across 20 countries completed an online questionnaire between June – September 2020. GPs’ perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. RESULTS A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patient’s preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. CONCLUSIONS At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions, and support the long-term development of platforms that are more technologically robust, secure. INTERNATIONAL REGISTERED REPORT RR2-10.2196/30099

scholarly journals Splenomegaly in relation to Schistosoma mansoni egg counts: a population based study

1986 ◽  
Vol 28 (6) ◽  
pp. 389-394 ◽  
Author(s):  
Maria Fernanda Furtado de Lima e Costa ◽  
R. S. Bocha ◽  
Naftale Katz
Keyword(s):  
Geometric Mean ◽  
Age Groups ◽  
Individual Case ◽  
Population Based ◽  
Control Analysis ◽  
Ecological Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Individual Analysis ◽  
The Individual

A cross: sectional survey on schistosomiasis was done in Comercinho (Minas Gerais State, Brazil), a town with 1474 inhabitants. Stool (Kato-Katz method) and physical examinations were done on 90% of the population and on 84% of the individuals over 2 years of age, respectively. The ecological and individual (case-control) analysis were used to investigate the relation between splenomegaly and S. mansoni egg counts in different age groups. In the ecological analysis there was a clearly correspondence between higher geometric mean of eggs and higher percentage of splenomegaly in the age groups 5-9 and 10-12 years. In the individual analysis it was found that only in the youngest individuals (5-8 or 5-9 years old) the splenomegaly was related with higher mean egg counts in the feces, having been a tendency to the decrease of excretion of eggs in patients with splenomegaly as the age increased. These results strongly suggest that the ecological data are' better indicator of the severity of schistosomiasis in endemic areas, as the decrease of the egg excretion in patients with splenomegaly may be a confounding variable for the individual analysis.

scholarly journals Patient-Reported Use of the After Visit Summary in a Primary Care Internal Medicine Practice

2019 ◽  
Vol 7 (5) ◽  
pp. 703-707
Author(s):  
Sarita Pathak ◽  
Gregory Summerville ◽  
Celia P Kaplan ◽  
Sarah S Nouri ◽  
Leah S Karliner
Keyword(s):  
Primary Care ◽  
Multivariable Analysis ◽  
Free Text ◽  
Primary Care Visit ◽  
Communication Tool ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Visit ◽  
Patient Reported ◽  
Communication Errors

Participants completed a cross-sectional survey about their use of the after visit summary (AVS) at a previous primary care visit. Of 355 participants, 294 (82.8%) recalled receiving it, 67.4% consulted it, 45.9% consulted it more than once, and 31.6% shared the AVS. In multivariable analysis, higher education and older age were associated with AVS consultation. Among the subset of 133 patients recalling personalized free-text instructions, 96% found them easy to understand and 94.4% found them useful. Our findings suggest that the AVS is a useful communication tool and improvement efforts should emphasize clarity for those most vulnerable to communication errors.

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