scholarly journals Helicopter emergency medical services in sudden-onset major incidents ; Patterns of use

2021 ◽  
Author(s):  
Anne Siri Johnsen
Keyword(s):  
Delphi Study ◽  
Case Reports ◽  
Cross Sectional Study ◽  
Sudden Onset ◽  
Major Incident ◽  
Future Research ◽  
Sectional Study ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Major Incidents

Major incidents happen infrequently and challenge the health care system by demanding more resources than are readily available. Critically injured patients need rapid treatment and swift transport to the right hospital to prevent unnecessary death and disability. Helicopter emergency medical services (HEMS) are incorporated into emergency medical systems in Norway and other countries around the world. Anecdotally, HEMS have become integrated in the immediate management of sudden-onset major incidents and case reports depict that helicopters may play a key operational role. Although the amount of research on benefits and challenges of HEMS is rapidly growing, the optimal use in major incidents remains unanswered. The main aim of this thesis is to explore the use of HEMS in sudden- onset major incidents in a systematic way from different angles. The thesis focus on optimizing HEMS role in sudden-onset major incident management by sharing experiences for policy makers to improve major incident preparedness. This is done through four studies, a systematic review, a cross-sectional study, a Delphi study and a retrospective observational study. With these studies, we found that previous research published on HEMS role in sudden-onset major incident management are mainly case reports and that little systematic research has been done. In the cross-sectional study and the retrospective observational studies, we found that HEMS participation in sudden-onset major incidents are rare in Norway. The cross-sectional study showed that HEMS personnel were experienced but only a little more than half of the crew members had attended a major incident within the previous five years. Further, the retrospective observational study showed that in a major incident, HEMS treat more patients on-scene than they transport to definite care. In this complex environment, the participation of multiple emergency services that not necessarily cooperate on a daily basis makes communication and coordination (including with HEMS) challenging. These challenges deserve focus in major incident training and planning. To provide a better knowledge base for future research, data collection from major incidents and major incident exercises should be done systematically. The template developed in the Delphi study would enable other clinicians and researchers to submit structured open access reports, to share lessons learnt, collate data and compare major incident responses. The lack of a universally accepted definition of major incidents and removal of barriers in recruiting reports to the template remain important areas for future research. To enhance the knowledge on HEMS in major incidents, it remains pivotal that the pre-hospital environment acknowledges and address these challenges.

scholarly journals Overestimated, still less than competent: A cross-sectional study concerning emergency department registered nurses’ disaster preparedness

2020 ◽  
Author(s):  
Jason Patrick Murphy ◽  
Lisa Kurland ◽  
Monica Rådestad ◽  
Sofia Magnusson ◽  
Tove Ringqvist ◽  
...  
Keyword(s):  
Emergency Department ◽  
Registered Nurses ◽  
Disaster Preparedness ◽  
Cross Sectional Study ◽  
Major Incident ◽  
Self Awareness ◽  
Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
Major Incidents

Abstract BackgroundMajor incidents continue to pose a threat to health care systems by overwhelming them with a sudden surge of patients. A major factor impacting a hospital's surge capacity is the skills, abilities, and knowledge of emergency department registered nurses. The level of disaster nursing competency they possess affects patient safety and outcome. ED RNs' ability to accurately assess their competency and knowledge is imperative for mitigating the effect of major incidents. ED RN’s perception of overall disaster preparedness has not been thoroughly addressed. The aim of this study was to assess emergency department registered nurses' self-perceived disaster preparedness.MethodThe study was a cross-sectional study. A self-assessment questionnaire based on the results of a study identifying specific disaster nursing competencies for emergency department registered nurses was distributed to all emergency department registered nurses at six participating hospitals between January 10th to February 19th of 2019. A five-point Likert-type scale was used to assess competency.ResultsEmergency department registered nurses’ disaster preparedness according to the Total Disaster Competency mean, was low. Furthermore, the results indicate that ED RNs’ overestimate their disaster nursing competency when compared to the Total Disaster Competency score. When asked to estimate their overall the mean was ”less than competent” yet higher than the Total Disaster Competency score. Knowledge gaps concerning disaster preparedness plans were also identified. Additionally, this study identified factors associated with disaster preparedness and self-assessment ability.Conclusion ED RNs’ overestimate their disaster preparedness and may lack self-awareness concerning their disaster competencies. However, ED RNs with formal disaster education appeared to have better insight concerning their preparedness. Clinical experiences, higher levels of education, and training were positively associated with preparedness. A lack of self-awareness may negatively impact patient outcomes during a major incident.

scholarly journals Media consumption and mental health during COVID-19 lockdown: a UK cross-sectional study across England, Wales, Scotland and Northern Ireland

2021 ◽  
Author(s):  
Ruth D Neill ◽  
Carolyn Blair ◽  
Paul Best ◽  
Emily McGlinchey ◽  
Cherie Armour
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Media Exposure ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Future Research ◽  
Media Consumption ◽  
Sectional Study ◽  
Cross Sectional ◽  
Longitudinal Data Collection

Abstract Aim As individuals adjust to new ‘norms’ and ways of living during the COVID-19 lockdown, there is a continuing need for up-to-date information and guidance. Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression. The aim of this study was to determine whether COVID-19 related media consumption is associated with changes in mental health outcomes. Methods This paper presents baseline data from the COVID-19 Psychological Wellbeing Study. The cross-sectional study data was collected using an online survey following the Generalised Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), with some other basic information collected. Logistic regression analysis was used to examine the influence of socio-demographic and media specific factors on anxiety and depression. Results The study suggested that media usage is statistically significantly associated with anxiety and depression on the GAD-7 and PHQ-9 scales with excessive media exposure related to higher anxiety and depression scores. Conclusion This study indicated that higher media consumption was associated with higher levels of anxiety and depression. Worldwide it should be acknowledged that excessive media consumption, particularly social media relating to COVID-19, can have an effect on mental health. However, as this was a cross-sectional study we cannot infer any directionality as we cannot infer cause and effect; therefore, future research involving longitudinal data collection and analyses of variables over time is warranted.

scholarly journals SAT0078 SAFETY OF LOW DOSE METHOTREXATE (MTX) IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 974.2-974
Author(s):  
A. Gunay ◽  
A. Davidson ◽  
I. Colmegna ◽  
D. Lacaille ◽  
H. Loewen ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Adverse Events ◽  
Low Dose ◽  
Opportunistic Infections ◽  
Case Reports ◽  
Cross Sectional Study ◽  
Study Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus

Background:Increased awareness of the efficacy of MTX in rheumatic disease is leading to more MTX use in patients from HIV endemic areas. While HIV related immunosuppression may contribute to improvement of some rheumatic diseases, immune reconstitution from highly active antiretroviral therapy (HAART) may lead to exacerbation or presentation of autoimmune disorders for which MTX therapy may be warranted. Most management guidelines for rheumatic disease do not address MTX use in the context of HIV.Objectives:To systematically review the published literature on the safety of using MTX ≤30 mg per week in HIV.Methods:We searched CINAHL, Embase, Global, MEDLINE and World of Science databases (Jan 1990 to May 2018) for terms including ‘methotrexate’ and ‘human immunodeficiency virus’. We also searched citations from review articles. Titles, abstracts or full manuscripts were screened independently by 2 reviewers to identify studies reporting HIV in patients taking MTX. Study quality was assessed using the McGill Mixed Methods Appraisal Tool (MMAT). Data was extracted on MTX and HIV adverse events (MTX toxicity, HIV viral load, CD4 count). Descriptive summaries are presented for studies providing outcomes in patients taking MTX ≤30 mg per week.Results:After removing duplicates and studies not meeting criteria or not providing sufficient information, 42 of the 2714 identified reports were included (1 clinical trial, 2 cohort, 1 cross-sectional study, 38 case reports/case series). Most reports (81%) originated from USA or Europe. Study quality was generally good with most studies fulfilling 50-100% of MMAT criteria. The randomized controlled trial (USA) assessing MTX on atherosclerotic disease in HIV showed that adverse events were more common in MTX versus placebo (12.8% vs 5.6%, p non-inferiority <0.05) and included infection, transient CD4 and CD8 drop, pulmonary toxicity, and death (1 attributed to MTX/HIV, 1 unrelated). One cohort study (South Africa) reported 43 RA patients on MTX who acquired HIV. In this cohort, RA generally improved despite only 5 individuals continuing MTX. No data on MTX adverse event rates was reported. One cohort study (USA) reported 13 HIV patients with myositis. One received MTX (with other immunosuppression) without MTX adverse effects but died due to AIDS. A cross-sectional study (France) of 43 HIV pts with autoimmune disease reported one patient on MTX (and other immunosuppression) developed an adverse event (cytopenia) compared to 5/33 patients not on MTX (cytopenia). The 38 case reports/series described 54 individuals with HIV receiving MTX. Of these studies, 27 (describing 42 subjects) reported on MTX adverse events and 35 (describing 46 subjects) reported on HIV adverse events. MTX adverse events developed in 29 subjects (hematologic 13, renal/hepatic 1, opportunistic infections 10, other events 2). HIV adverse events were noted in 23 subjects (Kaposi’s sarcoma 4, CD4 decrease 16, HIV viral titer increase 4). Five deaths were reported (2 infection, 1 infection and wasting, 2 HIV related deaths). Most subjects also received corticosteroids or other immunosuppressants including biologics.Conclusion:There remains limited data on the safety of low dose MTX in HIV. Surveillance for HIV is warranted for individuals on MTX who are at risk for acquiring HIV. Caution and careful monitoring for MTX toxicity, opportunistic infections and HIV state is suggested if MTX is used in the setting of HIV particularly if combined with other immunosuppression.References:[1] Clin Infectious Disease 2019:68[2] J Rheumatology 2014:41[3] Arthritis and Rheumatism 2003:49[4] Medicine 2017:96Acknowledgments :Funding from International League Against RheumatismMcGill University Global Health Scholar AwardsDisclosure of Interests:Alize Gunay: None declared, Anna Davidson: None declared, Ines Colmegna: None declared, Diane Lacaille: None declared, Hal Loewen: None declared, Michele Meltzer: None declared, Yewondwossen Mengistu: None declared, Rosie Scuccimarri: None declared, Zenebe Yirsaw: None declared, Sasha Bernatsky: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

scholarly journals Patients’ Perspectives about Lifestyle Behaviors and Health in the Context of Family Medicine: A Cross-Sectional Study in Portugal

2021 ◽  
Vol 18 (6) ◽  
pp. 2981
Author(s):  
Rosália Páscoa ◽  
Andreia Teixeira ◽  
Micaela Gregório ◽  
Rosa Carvalho ◽  
Carlos Martins
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Future Research ◽  
Lifestyle Behaviors ◽  
Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
The Family

Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.

scholarly journals Prehospital Stressors: A Cross-sectional Study of Norwegian Helicopter Emergency Medical Physicians

2020 ◽  
Vol 39 (5) ◽  
pp. 383-388
Author(s):  
Bjørn Ole Reid ◽  
Helge Haugland ◽  
Håkon Bjorheim Abrahamsen ◽  
Lars Petter Bjørnsen ◽  
Oddvar Uleberg ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Emergency Medical

scholarly journals A cross-sectional study of physical activity participation among adults with chronic conditions participating in a digital health program

2019 ◽  
Vol 5 ◽  
pp. 205520761988098
Author(s):  
Renae L Smith-Ray ◽  
Nima Nikzad ◽  
Tanya Singh ◽  
Jenny Z Jiang ◽  
Michael S Taitel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Epidemiological Study ◽  
Health Program ◽  
Digital Health ◽  
Cross Sectional Study ◽  
Wearable Devices ◽  
Future Research ◽  
Sectional Study ◽  
Activity Data ◽  
Cross Sectional

Objective Many American adults are insufficiently active. Digital health programs are designed to motivate this population to engage in regular physical activity and often rely on wearable devices and apps to objectively measure physical activity for a large number of participants. The purpose of this epidemiological study was to analyze the rates of physical activity among participants in a digital health program. Method We conducted a cross-sectional study of participants enrolled in a digital health program between January 2014 and December 2016. All activity data were objectively collected through wearable devices. Results Participants ( n =  241,013) were on average 39.7 years old and 65.7% were female. Participants walked on average 3.72 miles per day. Overall, 5.3% and 21.8% of participants were being treated with diabetes and cardiovascular medications respectively, but these rates varied across young, middle and older adults. Participants of all ages being treated with cardiovascular and/or diabetes medications walked significantly less than those not being treated for these conditions. Conclusion The feasibility of using a large database containing data from consumer-grade activity trackers was demonstrated through this epidemiological study of physical activity rates across age and condition status of participants. The approach and findings described may inform future research as the information age brings about new opportunities to manage and study massive amounts of data generated by connected devices.

scholarly journals Prevalence ofStaphylococcus aureuscarriage among dogs and their owners

2007 ◽  
Vol 136 (7) ◽  
pp. 953-964 ◽  
Author(s):  
M. V. BOOST ◽  
M. M. O'DONOGHUE ◽  
A. JAMES
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Case Reports ◽  
Nasal Carriage ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Human Contact ◽  
Care Workers

SUMMARYCase reports have indicated transmission ofStaphylococcus aureusbetween humans and pets. We investigated associations between level of contact between dog and owner, andS. aureuscolonization. In a cross-sectional study, nasal carriage and antibiotic susceptibility ofS. aureuswas determined for 830 dogs and 736 owners. Relatedness of isolates was investigated using antibiograms and pulsed-field gel electrophoresis (PFGE). Associations between carriage and demographics or amount of contact between owners and dogs were documented.S. aureuswas isolated in 24% of humans and 8·8% of dogs. Antibiotic resistance was significantly more common in canine isolates. Of 17 owner/dog colonized pairs, six were indistinguishable by PFGE. Colonization of dogs was not associated with close human contact, but was strongly associated with health-care occupations (OR 3·29, 95% CI 1·49–7·26,P=0·002). In outbreak situations health-care workers' pets should be considered as a source ofS. aureus. High rates of resistance indicate increased monitoring of antibiotic use in veterinary practice is needed.

scholarly journals Factors Associated with Migration in Individuals Affected by Leprosy, Maranhão, Brazil: An Exploratory Cross-Sectional Study

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
C. Murto ◽  
C. Kaplan ◽  
L. Ariza ◽  
K. Schwarz ◽  
C. H. Alencar ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Health Sector ◽  
Healthcare Facility ◽  
Cross Sectional Study ◽  
Future Research ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Factors Associated

In Brazil, leprosy is endemic and concentrated in high-risk clusters. Internal migration is common in the country and may influence leprosy transmission and hamper control efforts. We performed a cross-sectional study with two separate analyses evaluating factors associated with migration in Brazil’s Northeast: one among individuals newly diagnosed with leprosy and the other among a clinically unapparent population with no symptoms of leprosy for comparison. We included 394 individuals newly diagnosed with leprosy and 391 from the clinically unapparent population. Of those with leprosy, 258 (65.5%) were birth migrants, 105 (26.6%) were past five-year migrants, and 43 (10.9%) were circular migrants. In multivariate logistic regression, three independent factors were found to be significantly associated with migration among those with leprosy: (1) alcohol consumption, (2) separation from family/friends, and (3) difficulty reaching the healthcare facility. Separation from family/friends was also associated with migration in the clinically unapparent population. The health sector may consider adapting services to meet the needs of migrating populations. Future research is needed to explore risks associated with leprosy susceptibility from life stressors, such as separation from family and friends, access to healthcare facilities, and alcohol consumption to establish causal relationships.

“Staffing to the Test”

2011 ◽  
Vol 33 (4) ◽  
pp. 483-505 ◽  
Author(s):  
Lora Cohen-Vogel
Keyword(s):  
School Districts ◽  
School Leaders ◽  
Cross Sectional Study ◽  
Future Research ◽  
Sectional Study ◽  
Cross Sectional ◽  
Policy Practice ◽  
Teacher Resources ◽  
State Accountability ◽  
Overall Performance

Faced with mounting policy pressures from federal and state accountability programs, school leaders are reallocating curricula, time, even diet in an attempt to boost student achievement. To explore whether they are using test score data to reallocate their teacher resources as well, I designed a cross-case, cross-sectional study and explored principals’ reported staffing practices in one higher performing and one lower performing elementary school in each of five Florida school districts. Findings show that school leaders are “staffing to the test” by hiring, moving, and developing teachers in an effort to increase their schools’ overall performance. The paper discusses the implications of evidence-based staffing for policy, practice and future research.

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