Practicing Pediatrics in a Rather Special Underdeveloped Country

PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 925-926
Author(s):  
WESLEY BOODISH

As I near the end of a 12-month tour spent in a 400 bed civilian hospital in South Vietnam as a "pediatrician," I am of course quite interested in Dr. Eskes' letter on pediatrics in underdeveloped countries (Pediatrics, 37:851, 1966). I head a 16 man Navy medical team situated in Quang Tri, working under a program called MILHAP (Military Provincial Hospital Assistance Program). There are now 21 of these military medical teams in South Vietnam—Army, Navy and Air Force—each consisting of three doctors, an administrative officer, and twelve corpsmen.

2021 ◽  
Vol 36 (3) ◽  
pp. 313-320
Author(s):  
Phillip A. Jacobson ◽  
Paul N. Severin ◽  
Dino P. Rumoro ◽  
Shital Shah

AbstractPurpose:Training emergency department (ED) personnel in the care of victims of mass-casualty incidents (MCIs) is a highly challenging task requiring unique and innovative approaches. The purpose of this study was to retrospectively explore the value of high-fidelity simulators in an exercise that incorporates time and resource limitation as an optimal method of training health care personnel in mass-casualty care.Methods:Mass-casualty injury patterns from an explosive blast event were simulated for 12 victims using high-fidelity computerized simulators (HFCS). Programmed outcomes, based on the nature of injuries and conduct of participants, ranged from successful resuscitation and survival to death. The training exercise was conducted five times with different teams of health care personnel (n = 42). The exercise involved limited time and resources such as blood, ventilators, and imaging capability. Medical team performance was observed and recorded. Following the exercise, participants completed a survey regarding their training satisfaction, quality of the exercise, and their prior experiences with MCI simulations. The Likert scale responses from the survey were evaluated using mean with 95% confidence interval, as well as median and inter-quartile range. For the categorical responses, the frequency, proportions, and associated 95% confidence interval were calculated.Results:The mean rating on the quality of experiences related trainee survey questions (n = 42) was between 4.1 and 4.6 on a scale of 5.0. The mean ratings on a scale of 10.0 for quality, usefulness, and pertinence of the program were 9.2, 9.5, and 9.5, respectfully. One hundred percent of respondents believed that this type of exercise should be required for MCI training and would recommend this exercise to colleagues. The five medical team (n = 5) performances resulted in the number of deaths ranging from two (including the expectant victims) to six. Eighty percent of medical teams attempted to resuscitate the “expectant” infant and exhausted the O- blood supply. Sixty percent of medical teams depleted the supply of ventilators. Forty percent of medical teams treated “delayed” victims too early.Conclusion:A training exercise using HFCS for mass casualties and employing limited time and resources is described. This exercise is a preferred method of training among participating health care personnel.


2011 ◽  
Vol 26 (S1) ◽  
pp. s84-s84
Author(s):  
G.V. Kipor ◽  
N.K. Pichugina ◽  
B.V. Bobi

Training special medical teams to be prepared for delivering emergency relief to the injured requires a special psychological conformity of individuals and mutual inter-understanding based on professional qualifications. The psycho-physiological approach comprises a set of methods of computerized tools for medical staff education, training, and preparedness, keeping in mind the aim of the necessity of mutual activities in triage process, medical care, and decision-making for evacuating injured victims from the emergency site. The goal of this presentation is to expose the battery of new original methods and technologies of staff preparedness in order to realize the maximum conformity of personal composed together in one unique mobile team sent into the situations of emergency accompanied by psychological tension, insufficient volume of info sharing, field conditions, etc. Methods are based on the measurements of the functional asymmetry of brain hemispheres tested by computer-loaded, original software. Several levels of evaluation of functional asymmetry status have been proposed for discussion and for choosing of criteria for the conformity matrix study. These include: (1) a primary table of digital variables characterizing the first level of comparison of psycho-physiological individual regulation obtained for everyone of the emergency medical team permitting to propose the primary team composition; (2) co-efficients of psycho-physiological regulation for the determination of conformity between the individualities of medical staff team and the dynamics of psychological resistance in emergency environment; and (3) integrative profiles of functional asymmetry, giving the objective fundamentals for team composition and its training, to the ideal sophisticated model of psycho-physiological conformity. Quantitative, objective data give the arguments to prepare the criteria for the composition of field medical team. The individual programs issued from examination are proposed for the improvement of permanent psycho physiological staff conformity.


2018 ◽  
Vol 11 (2) ◽  
pp. 121
Author(s):  
Valentin Uwizeyimana

Various studies have elaborated on the concept of ‘digital native(ness)’, i.e. (an identity of) the generation of students who were born during the digital technology era, i.e. from the 1980s onwards (Prensky 2001). Those studies claim that digital natives have been exposed to modern technologies, and thus are familiar with using them in their everyday activities (Dang 2013; Jacobson & Turner 2010). Those studies do not go beyond the access to and the general use of technologies. They ignore the fact that the ability to use technologies for personal purposes does not represent the ability to use them for educational and other specialized purposes (Stockwell & Hubbard 2013:4). Furthermore, there is a gap in terms of technological devices and geographical locations which were considered by those studies (Burston 2014; Thinyane 2010; Brown & Czerniewicz 2010). In these regards, by using a proficiency test and a survey with 60 digital natives from an underdeveloped country, this study investigated the effect of mobile technologies in language learning (MTLL) on English proficiency. In terms of English proficiency, this study found no significant difference among the participants, although some of them were making use of MTLL whereas others were not. With the fact that MTLL have the potential to improve the language proficiency (Park & Slater 2014; Alotaibi, Alamer & Al-Khalifa 2015; Stockwell & Liu 2015), this article recommends how teachers should provide guidance and assistance to the learners in order to benefit from modern technologies.


2019 ◽  
Vol 32 (2) ◽  
pp. 255-259
Author(s):  
Ivanka Stambolova ◽  
Stefan Stambolov

Introduction: Immunizations represent the most effective and most useful prophylactic activity to achieve individual and collective immunity against a particular infectious disease. Over the last decade the number of non-immunized children has increased in the country. This problem should become a priority for solving for every country according to the WHO. The implementation of obligatory planned immunizations and reimmunizations as well as targeted immunizations and recommended immunizations include the nurse as an active participant in the medical team that carries out them. The operation of the physician and the nurse are leading and very responsible. Objective: To outline the problems and priorities in the nursing activity related to immunoprevention in the conditions of primary care. Material and Methods: Study was conducted in the 2019. on the territory in Sofia, in, with 560 children up to 18 years subject to immunization. Documentary methods, lectures and statistical methods were used. Results and discussion: Immunization prophylaxis is precisely regulated and performed by medical teams in outpatient care. It has a number of specifics and requires knowledge, communication and technical skills from the nurse. Conclusions: The control of the implementation of the preventive measures is carried out correctly by the structures of the RHI and the doctor in the ambulatory. Nursing care related to immune prophylaxis requires the nurse to know and accurately complete and complete the documentation, plan, transport and store the vaccinations that are administered properly. To be able to motivate and explain to the parents the necessity of the immunizations and the reimmunizations as well as their behaviour in case of post-vaccination reactions. Increasing the health culture of parents regarding immune prophylaxis will lead to a decrease in non-immunized children due to refusal and will also improve and broaden the immune prophylaxis in the country.


2013 ◽  
Vol 18 (5) ◽  
pp. 595-614 ◽  
Author(s):  
Hide-Fumi Yokoo ◽  
Thomas C. Kinnaman

AbstractElectronic waste generated from the consumption of durable goods in developed countries is often exported to underdeveloped countries for reuse, recycling and disposal with unfortunate environmental consequences. The lack of efficient disposal policies within developing nations coupled with global free trade agreements make it difficult for consumers to internalize these costs. This paper develops a two-country model, one economically developed and the other underdeveloped, to solve for optimal tax policies necessary to achieve the efficient allocation of economic resources in an economy with a durable good available for global reuse without policy measures in the underdeveloped country. A tax in the developed country on purchases of the new durable good combined with a waste tax set below the domestic external cost of disposal is sufficient for global efficiency. The implication of allowing free global trade in electronic waste is also examined, where optimal policy resembles a global deposit-refund system.


1966 ◽  
Vol 6 (63) ◽  
pp. 304-306

Medical teams at work.—Welcomed by the delegation of the International Committee of the Red Cross, the medical team of the Swiss Red Cross arrived in Saigon then flew to Kontum on the high central plateau. It consisted of nine persons to whom one more was added a few days later. These ten doctors, male nurses and nursing sisters immediately set to work at the Kontum hospital.


2011 ◽  
Vol 26 (S1) ◽  
pp. s101-s101
Author(s):  
T. Norii ◽  
Y. Terasaka ◽  
M. Miura ◽  
T. Nishinaka ◽  
R. Lueken ◽  
...  

IntroductionInternational collaboration for disaster response is an increasing phenomenon. Japan-United States joint field exercises have been conducted annually since 2004, triggered by an incident in which a US helicopter crashed into a university campus in Okinawa, Japan. The fifth Japan-US disaster field exercise was conducted testing the disaster response of the Okinawa government and US military.MethodsThe simulated exercise involved a US Navy aircraft that crashed into a city center in Okinawa, Japan. There were 16 simulated casualties that included US military members and Japanese citizens. The participants in this exercise were US military members, including the Disaster Assistance Response Team (DART) and local rescue and medical teams including the Okinawa Disaster Medical Assistance Team (DMAT). Data were gathered from the joint debriefing session held by both medical teams. Furthermore, interviews with team leaders from both nations were conducted and feedback obtained.ResultsLack of communication and inaccurate communication remained the root of most problems encountered. There were several miscommunications at the scene due to the language barrier and ignorance of different medical teams' capability and method of practice. Due to the unclear signage of the initial triage zone, another triage zone was developed later by a second medical team. Confusion regarding gathering information and order of transport also was witnessed. The capabilities of team members were not well known between teams, resulting in inappropriate expectations and difficulty in effective cooperation.ConclusionsUnderstanding the systems and backgrounds of each medical team is essential. Signs or symbols of key elements including triage areas should be clear, universal, and multilingual. Communication remains the Achilles' heel of multi-national disaster response activities.


2019 ◽  
Vol 86 (2-3) ◽  
pp. 198-206 ◽  
Author(s):  
Michal Pruski ◽  
Nathan K. Gamble

The English cases of Charlie Gard and Alfie Evans involved a conflict between the desires of their parents to preserve their children’s lives and judgments of their medical teams in pursuit of clinically appropriate therapy. The treatment the children required was clearly extraordinary, including a wide array of advanced life-sustaining technological support. The cases exemplify a clash of worldviews rooted in different philosophies of life and medical care. The article highlights the differing perspectives on parental authority in medical care in England, Canada, and the United States. Furthermore, it proposes a solution that accommodates for both reasonable parental desires and professional medical opinion. This is achieved by looking at concepts of extraordinary therapy, best interest, reasonable parenthood and medical objections. Summary: In cases where a child’s treatment involves extraordinary therapy, there is often a conflict of opinion between the medical team and the parents with regard to the best course of action. The assumption should be that responsible, caring parents make reasonable and acceptable decisions for the good of their children. Rather than focusing on making a hypothetical best interest judgment, courts should in the first instance side with the parents. Only when parents act unreasonably or malevolently should their wishes be overridden. This should not affect the medics' right to conscientiously object towards carrying out procedures that they deem to be medically unnecessary or harmful.


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