The Applicability of eVTOLs in Emergency Medical Care in Japan

Background: The present study aims to elucidate the applicability of electric vertical takeoff and landing (eVTOL) aircraft that dispatch only a doctor to provide a solution to the operational challenges of utilizing a helicopter to transport a doctor to the patient/s, with such physician-staffed emergency medical helicopters being known as doctor heli (DH), in Japan.Methods: This study conducted interviews with 17 parties related to DHs in five prefectures in Japan to depict challenges of DHs and eVTOL requirements. Subsequently, this study analyzed the Hokusoh DH flight data, as an example, in terms of cases for which flight doctors consider condition assessment and initial treatment provision by a doctor would be particularly effective, to assess the hypothesis that a two-seater is applicable for emergency medical care (EMS) and that eVTOLs help reduce duplicate dispatch requests for DHs as well as the percentage and delayed dispatch time of duplicate requests.Results: Challenges of DHs and eVTOL requirements were identified and classified into six major categories. Data analysis results indicated that two-seater eVTOLs would be particularly effective for trauma, cardiac disease, brain disease cases, and pediatric patient cases and help solve duplicate requests.Conclusions: Two-seater eVTOLs are likely applicable in EMS in Japan.

Danger signs and management of suspected severe malaria cases at community level and in referral health facilities: an operational study in the Democratic Republic of the Congo

BackgroundEvidence from one trial in Africa suggests that pre-referral Rectal Artesunate (RAS) can be a life-saving intervention for severe malaria in remote settings, where parenteral treatment is not available. Recognition of danger signs indicative of severe malaria is critical for prompt and appropriate case management.MethodsAn observational study was conducted in the Democratic Republic of the Congo (DRC) in the frame of the multi-country CARAMAL project, to assess the effectiveness of RAS under real-world conditions. Severely ill feverish children <5 years seeking care from a community-based healthcare provider were recruited in three rural health zones into a patient surveillance system. They were subsequently followed within the healthcare system and at home after 28 days to determine care seeking, antimalarial treatment provision and health outcomes.ResultsOverall, 66.4% of patients had iCCM general danger signs, as well as more specific danger signs. Children aged 2-5 years (aOR=1.58, 95% CI 1.20–2.08) and those presenting iCCM general danger signs were more likely to receive RAS (aOR = 2.77, 95% CI 2.04–3.77). Injectable treatment was less likely with RAS pre-referral treatment (aOR=0.21, 95% 0.13– 0.33). In the post-RAS phase, the case fatality ratio was 7.1%. Children not receiving RAS had a higher risk of dying, but this was not statistically significant (aOR = 1.50, 95% CI 0.86– 2.60). The odds of dying were reduced in patients without iCCM general danger signs, but just not statistically so (aOR = 0.64, 95% CI 0.38–1.06). Full oral therapy at a RHF was highly protective (aOR = 0.13, 95% CI 0.07-0.26), while a full treatment of severe malaria (injectable + oral) was shown to also decrease massively the odds of dying (aOR = 0.26, 95% CI 0.09– 0.79) compared to injectable treatment alone.ConclusionsBetter understanding the determinants of successful case management, and targeted improvements of the health system (especially the provision of a full course of an oral antimalarial) are crucial for improving health oucomes of children with suspected severe malaria.

PENGARUH FOTOTERAPI TERHADAP PENURUNAN TANDA IKTERUS NEONATORUM PATOLOGIS DI RUMAH SAKIT GRANDMED LUBUK PAKAM

Pathological neonatal jaundice is a liver or liver disease which causes yellowing of the baby’s skin and newborn’s eyes. The yellow color that occurs is caused by hight bilirubin in the blood because that baby’s liver is not yet mature enough. Objective : this study generally aims to determine whether there is an effect of phototerapy on the reduction in pathological neonatal care unit (NICU) room at the Grandmed Lubuk Pakam Hospital in 2020. Method : The type of ths research is expermental quantitative with One Group pre Test and post-test,namely research using comparison ( control ) groups, measurements are carried out before and after treatment. Provision of phototerapy is beneficial iin reducing the pathological neonatal jaundice sign. The number of samples with male sex is 31 people ( 57.4%) and the sample of female gender is 23 people (42.6%). Results : The administration of phototeray for the reducton in pathological neonatal jaundice signs using statistical analysis paired t- test obtained a value of p 0,000 <c 0.05. Conclusion : There s significant effect on the administration of phototherapy on the decrease in pathological neonatal jaundice signs. Suggeston : The researcher recommends that the researcher recommends that the researcher recommends that the researcher recommends that the researcher further adds the number of samples and a longer time so that the results obtained are more optimal.

Identifying opportunities to engage communities with social mobilisation activities to tackle NCDs in El Salvador in the context of the global COVID-19 pandemic

Background Social mobilisation is potentially a key tool in the prevention of non-communicable diseases (NCDs) in fragile settings. This formative study addressed existing and potential social mobilisation mechanisms seeking behaviour to tackle NCDs in El Salvador, with an emphasis on the implications in the context of the current COVID-19 pandemic. Methods We conducted 19 semi-structured interviews with health workers, government officials, NGO leaders, and community members. Interviews addressed mechanisms for social mobilisation which existed prior to COVID-19, the ways in which these mechanisms tackled NCDs, the impact of COVID-19 on social mobilisation activities and new, emerging mechanisms for social mobilisation in the wake of the COVID-19 pandemic. Results Findings indicate a growing awareness of NCDs within communities, with social mobilisation activities seen as valuable in tackling NCDs. However, major barriers to NCD prevention and treatment provision remain, with COVID-19 constraining many possible social mobilisation activities, leaving NCD patients with less support. Factors linked with effective social mobilisation of communities for NCD prevention included strong engagement of community health teams within community structures and the delivery of NCD prevention and management messages through community meetings with trusted health professionals or community members. There are gender differences in the experience of NCDs and women were generally more engaged with social mobilisation activities than men. In the context of COVID-19, traditional forms of social mobilisation were challenged, and new, virtual forms emerged. However, these new forms of engagement did not benefit all, especially those in hard-to-reach rural areas. In these contexts, specific traditional forms of mobilisation such as through radio (where possible) and trusted community leaders - became increasingly important. Conclusions New mechanisms of fostering social mobilisation include virtual connectors such as mobile phones, which enable mobilisation through platforms such as WhatsApp, Facebook and Twitter. However, traditional forms of social mobilisation hold value for those without access to such technology. Therefore, a combination of new and traditional mechanisms for social mobilisation hold potential for the future development of social mobilisation strategies in El Salvador and, as appropriate, in other fragile health contexts.

Perspectives of prisoners on alcohol and other drug group treatment approaches

Purpose The purpose of this study is to describe what a sample of men in prison believe works well for the delivery of prison-based group alcohol and other drug (AoD) treatment programs. The authors hope the findings will help inform future practise in AoD program delivery in prison. Design/methodology/approach A qualitative research paper reporting on a thematic analysis of in-depth interviews with 30 male prisoners on their perspectives on AoD group treatment approaches. Findings Results indicate that matching readiness and motivation to start treatment is important for group success. Program content must be relevant and delivered by empathic facilitators who maintain confidentiality. It would be advantageous if one of the program facilitators was a peer with personal experience of overcoming an AoD use disorder. Originality/value According to the authors’ knowledge, this is one of few qualitative studies into the delivery of AoD treatment for men in prison and the only study of its kind in Australia. The consumer perspective is an important element in improving quality of treatment provision.

Demographic Equality of Access to Cognitive Behavioural Treatment for Early Psychosis in Community Mental Healthcare in Greater London

Individuals experiencing psychosis have been described as one of the most stigmatised, disadvantaged and socially excluded groups in modern societies. Despite the development of evidence-based psychological treatments for psychosis, the access to such intervention remains debateable. In metropolitan areas, where clinical caseloads of mental health services should reflect the ethnic diversity of local populations, equal provision of recommended therapies might be further confounded, while empirical literature investigating this appears limited. The present study inspects equality of access to cognitive behavioural therapy for psychosis across four specialist healthcare teams located in Greater London. Subsequent acceptance and participation in treatment are also examined. A retrospective analysis of electronic medical records of 244 patients was conducted using binary logistic regression and multiple linear regression. Participants were shown to have received treatment offers equally across demographic variables. Likewise, once the treatment commenced, engagement was equally distributed. However, despite having equal access to the offered treatment, patients of Black ethnic group seemed less likely to accept such offer, hence appeared disadvantaged in terms of treatment provision. This study demonstrates that, in multicultural communities, equal access to core interventions for psychosis is achievable, however does not on its own merits ensure equitable treatment provision. Thus mental health services need to proactively focus on specific ethnic groups requiring further efforts to increase treatment uptake. Keywords: mental health, psychosis, cognitive behavioural treatment, diversity, equal access to healthcare

Is it better to be good or to do good?

People have contemplated what it entails to be good and to do good. Philosophers propose that being good is an idea about yourself or others, while doing good is an action, towards yourself or others. Other theorists feel that those who want to ‘be good’ actually want to ‘be seen as good’, while those who strive to ‘do good’ are more concerned with following some calling or moral character. If we consider the dental situation, it raises the question of whether the motivation to do good should reign over the practical delivery of good dental treatment. This brings up many new considerations related to being good and doing good, and whether we are looking at good in terms of the practical performance of the clinical work or in terms of addressing the patient’s best interests and welfare. This paper will explore some of the interesting dilemmas that clinicians may face in their daily practices. It aims to raise their awareness of the differences between patients’ demands, actual needs, as well as their own philosophy towards treatment provision.

Firesetting Reoffending: A Meta-Analysis

Despite the significant adverse consequences of deliberate firesetting, it has been unclear what proportion of individuals repeat this problematic behavior, owing to methodological differences and large variability in reported reoffending rates. A meta-analysis of 25 samples of untreated adults and children with a history of firesetting, examining reoffending over a follow-up period, was conducted. The base rates of reoffending from this meta-analysis indicated that between 57% and 66% of untreated firesetters engage in general reoffending, between 8% and 10% engage in criminal arson, and around 20% engage in deliberate firesetting behavior. The odds of firesetting during the follow-up period were 5 times greater for known firesetters in comparison with other offenders. Clinical and criminological correlates of reoffending, including age, are examined. Implications for enabling evidence-based practice with this population, including defensible risk assessments and treatment provision, are discussed.

Mental Ills for All

MGMH was created by reassembling psychiatric epidemiology, health economics, health systems research, evidence-based therapeutics, lay awareness, human rights, and sustainable development into an set of policy instruments. I retrace the emergence and crisis of three “pillars” of MGMH: epidemiology, economics of minds and moods, and the gap in treatment provision. I argue that MGMH remains limited by its strategic ignorance of flaws in the data, of paradoxical relations between economic development and health improvement, and of how people actually seek help in low income countries. I conclude by arguing that MGMH policies are bound to fail if they fail to reckon with the contradictions in its approach.