bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint developmental trajectories of internalizing and externalizing disorders between childhood and adolescence
Authors: Nivard Michel G. , Lubke Gitta H. , Dolan Conor V. , Evans David M. , St. Pourcain Beate , Munafò Marcus R. , Middeldorp Christel M. 
Published: July 2016

AbstractThis study sought to identify trajectories of DSM-IV based internalizing (INT) and externalizing (EXT) problem scores across childhood and adolescence and to provide insight into the comorbidity by modeling the co-occurrence of INT and EXT trajectories. INT and EXT were measured repeatedly between age 7 and age 15 years in over 7,000 children and analyzed using growth mixture models. Five trajectories were identified for both INT and EXT, including very low, low, decreasing, and increasing trajectories. In addition, an adolescent onset trajectory was identified for INT and a stable high trajectory was identified for EXT. Multinomial regression showed that similar EXT and INT trajectories were associated. However, the adolescent onset INT trajectory was independent of high EXT trajectories, and persisting EXT was mainly associated with decreasing INT. Sex and early life environmental risk factors predicted EXT and, to a lesser extent, INT trajectories. The association between trajectories indicates the need to consider comorbidity when a child presents with INT or EXT disorders, particularly when symptoms start early. This is less necessary when INT symptoms start at adolescence. Future studies should investigate the etiology of co-occurring INT and EXT and the specific treatment needs of these severely affected children.
Prior Planning to Avoid Responders Becoming “Victims” During Disasters
Authors: Nocera Antony 
Published: July 2016

AbstractPrior planning to meet the physical and mental needs of medical and emergency services responder, is a practical measure to reduce staff stress. This has the potential to improve both the operational efficiency of a disaster response and reduce the incidence of post-traumatic stress disorders in responders. Research is needed to define which interventions provide the greatest benefits to local responders.
Pneumothorax During CPR Training: Case Report and Review of the CPR Literature
Authors: Sullivan Francis , Avstreih Daniel 
Published: July 2016

AbstractCardiopulmonary resuscitation is taught widely to both lay persons and health care oworkers. It is a challenging psychomotor skill. Concerns about its safety to the rescuer have centered around the risk of infectious disease exposure. A young nursing assistant developed a minimally symptomatic pneumothorax during CPR training. This case is the first reported example of this complication for a CPR trainee or provider. The literature is reviewed for complications for CPR provider and recipient and the relevant issues regarding the current status and future direction of this intervention.
Controversy and Consensus in Disaster Mental Health Research
Authors: Tierney Kathleen J. 
Published: July 2016

AbstractControversies regarding the mental health consequences of disasters are rooted both in disciplinary orientations and in the widely varied research strategies that have been employed in disaster mental health studies. However, despite a history of dissensus, there are also key issues on which researchers agree. Disasters constitute stressful and traumatic experiences. However, vulnerability to such experiences, as well as to more chronic Stressors, is socially structured, reflecting the influence of socio-economic status and other axes of stratification, including gender, race, and ethnicity. Disaster events differ in the extent to which they generate stress for victims. A holistic perspective on disaster mental health would take into account not only disaster event characteristics, but also social-systemic sources of both acute and chronic stress, secondary and cumulative Stressors, and victims internal and external coping capacities.
How to Talk To the Media: Televised Coverage of Public Health Issues in a Disaster
Authors: Anzur Terry 
Published: July 2016

AbstractPublic health officials often are critical of the way television news covers disasters, while broadcast journalists complain of a lack of cooperation from the public health sector during disaster coverage. This article summarizes the issues discussed in a session on Televised Coverage of Disasters, presented in April 1999 at the UCLA Conference on Public Health and Disasters in Los Angeles. Public health officials were asked to “talk back to their television sets” in a dialog with television journalists. Concerns included: 1) the lack of balance in television coverage that is dominated by sensational images that may frighten rather than inform the public; 2) the potential for psychological damage to viewers when frightening images are shown repeatedly in the days and weeks of the disaster; and 3) the perception that TV reporters place too much emphasis on crime, property damage, and loss of life, giving relatively low priority to disaster preparedness and to public health issues in the aftermath of a disaster. Options for improving communication between television journalists and public health professionals also are discussed.
Effects Of The Video Case Study in Preparing Paramedic Preceptors For The Role Of Evaluator
Authors: Janing Judy , Sime Wesley 
Published: July 2016

AbstractIntroduction:Accurate field evaluations are critical in determining paramedic students' competency to provide patient care. The [U.S.] National Paramedic Curriculum does not address the skills needed by evaluators, and requirements to be a preceptor/evaluator vary from state to state. Therefore, it is imperative that educational programs develop an evaluation process that reflects valid performance criteria and assure a high degree of rating consistency among the evaluators. This study sought to determine the effects of using a video case based teaching approach in preparing paramedic preceptors for the role of evaluator.Hypothesis:Paramedic preceptors receiving the case-based teaching approach to prepare them for the role of evaluator would demonstrate significantly higher scores on a video posttest than paramedic preceptors who were not prepared for the role of evaluator using the case-based approach.Methods:Thirty-four paramedic preceptors from a Midwestern fire-based Emergency Medical Services system were enrolled in this study. Two scripted video student/patient encounters were used to measure evaluation scores in a pretest-posttest comparison of control versus experimental group. The experimental group was given structured rating guidelines and practice applying those guidelines to a case study. Pretest and posttest scores were weighted and analyzed using Analysis of Variance.Results:Analysis of the pretest–posttest differences revealed significantly higher scores for the experimental group in the categories containing complex behaviors: communication F(1,16) = 13.21,p<.01, assessment F (1,16) = 8.81,p<.01, and knowledge F (1,16) = 29.64,p<.001. There was no significant difference between groups in the categories containing simple, easily observed behaviors: reliability F (1,16) = .55,p>.05 and cooperativeness F (1,16) = 3.02,p>.05.Conclusions:Using the case study method and written guidelines that provide concrete examples of complex behaviors appears to increase reliability of evaluations among preceptors.
Emergency Health Surveillance After Severe Flooding in Louisiana, 1995
Authors: Ogden Cynthia L. , Gibbs-Scharf Lynn I. , Kohn Melvin A. , Malilay Josephine 
Published: July 2016

AbstractIntroduction:In disaster situations, timely surveillance systems that provide illness, injury, and mortality information to public health officials and hospitals are essential for planning and evaluating interventions.Objectives:To describe flood surveillance methodology, the impact of the event on hospitals, and the number of daily patient visits due to selected illnesses and injuries before, during, and after severe flooding in southeastern Louisiana in May 1995.Methods:Survey of disaster-area hospitals regarding flood impact. Emergency department surveillance of injuries and illnesses for the week before, the two days during, and the week after the flood.Results:There occurred an increase in the number of persons who drowned or were injured that presented to the moderately affected hospitals during the storm, but there was no increase in visits for gastroenteritis to any group of hospitals. Services were disrupted in more than half of hospitals. The severely affected hospitals had the least variation in the average number of daily visits. None of the drownings were reported by those hospitals that reported severe service disruption.Conclusions:Data should be collected from all hospitals in or near disaster areas, even if they were not directly affected by the disaster. Public education about the danger of drowning during flash flooding must be improved. The Louisiana experience emphasizes the need for a disaster-preparedness plan for rapid surveillance of illnesses and injuries.
The Effects of Hurricane Mitch on a Community in Northern Honduras
Authors: Guill C.K. , Shandera W.X. 
Published: July 2016

AbstractIntroduction:Hurricane Mitch was an event described as one of the most damaging recent natural disasters in our hemisphere. This study examined its effects on a community of 5,000 residents in northern Honduras.Methods:Survey responses of 110 attendants at an ambulatory clinic 4 months after the event were analyzed. Correlates were established between demographic and housing characteristics and morbidity and mortality.Results:The availability of food, water, and medical care decreased significantly immediately after the hurricane, but by four months afterward returned to baseline values. Residents reported emotional distress correlated with the loss of a house or intrafamilial illness or mortality. Diarrheal illnesses more commonly were found in households with poor, chronic access to medical care. The use of cement block housing correlated with availability of food or running water, with access to medical care and vaccinations, and with a reduced frequency of diarrhea or headaches in the immediate post-hurricane phase.Conclusions:Improvements in housing construction appear to be the most effective preventive measure for withstanding the effects of future hurricanes in tropical regions similar to northern Honduras.
Topical Mafenide Hydrochloride Aqueous Spray in Initial Management of Massive Contaminated Wounds with Devitalized Tissue
Authors: Mendelson Janice A. 
Published: July 2016

AbstractSince at least WWII, some open, contaminated wounds involving massive soft tissue injury and vascular damage have resulted in “irreversible shock,” despite prompt rescue, hemorrhage control, and blood and fluid replacement, without signs of clinical infection.In animal studies, survival time was related statistically to the dosage of Clostridium perfringens in multicontaminated explosive wounds. Survival time was lengthened by the application of some topical antibacterial agents, but actual recovery was achieved only with topical mafenide hydrochloride solution aqueous spray, which resulted in negative clostridium. perfringens cultures. Although not related statistically to survival time, the mafenide hydrochloride spray also controlled the Pseudomonas aeruginosa in these wounds.Mafenide hydrochloride had the American trade name of Sulfamylon from about 1942 until 1998, when another pharmaceutical company patented Sulfamylon as the trade name for mafenide acetate, a weaker antibacterial agent. However, mafenide hydrochloride still is available from chemical companies.Mafenide hydrochloride solution spray has been used successfully in treatment of patients with severe by contaminated wounds and deep burns, and its use in initial care should be revisited.
Retention of Basic Trauma Life Support Skills
Authors: Werman Howard A. , Keseg David R. , Glimcher Mayer , Schumacher Carol , Shaner Steven , Brown Charles G. 
Published: July 2016

AbstractThe Basic Trauma Life Support (BTLS) course was developed to teach prehospital providers a rapid, prioritized approach to assess and manage the trauma victim. Little data currently are available relative to the retention of the cognitive and psychomotor skilk taught in the course. To examine this question, thirteen paramedics were retested on identically moulaged trauma scenarios and written examinations 14–16 months after initial training in BTLS. No advanced notification of the re-test was given. Written test scores decreased from an initial mean of 93.0±6.6 to a mean of 64.9±11.8 (p<0.001) 14–16 months later. Similarly, the trauma scenario test scores declined from 71.6±10.4 to 61.3±16.2 (p<0.05). The results suggest that there is significant loss of both didactic information and practical skills from the BTLS course 14–16 months after training. Frequent BTLS refresher training in the form of supplemental readings, lectures, and repeated exposures to trauma simulations is needed.
The Physician's Role In Canada's Disaster Response System
Authors: Sookram Sunil , Cummings Garnet 
Published: July 2016

AbstractThe most recent tragedy in Manitoba illustrates that disasters can strike any community. Within Canada, a tiered disaster response system exists. Even though physicians often play an integral role in the disaster plan, few participate in the planning process or even appreciate their potential role in the event a disaster should occur. Physician involvement would guarantee health matters be appropriately addressed resulting in reduced mortality and decreased morbidity. There are ample opportunities to become involved in disaster planning and response at all levels government. The objective of this paper to inform physicians about the disaste planning infrastructure that exists in Canada, show them where they may get involved, and urge them to do so.
Care Provided by VA Mobile Clinic Staff During Northridge Earthquake Relief
Authors: Weiss Thomas , Weiss Linda , Teeter David , Geraci Jane 
Published: July 2016

AbstractIntroduction:From 25 January 1994 to 02 February 1994, staff aboard four Veterans Affairs Mobile Clinics treated Northridge Earthquake victims. This study examined the types of conditions treated by Clinic staff during the disaster.Methods:A descriptive case series using 1,123 ambulatory encounter forms was undertaken. Case-mix was assessed by classifying diagnoses into 120 possible diagnostic clusters.Results:Forty-five percent of patients were infants or children and 60% were female. The primary diagnoses were characterize by acute conditions: 1) upper respiratory infection (34.6%); 2) stress reactions (11.9%); 3) otitis media (10.1%); and injuries (8%). Two-thirds of the infants and children either had an upper respiratory infection (46.4%) or otitis media (20.1%). Increasing age indicated an increased likelihood of stress and anxiety reactions.Conclusion:The results provide additional information for agencies involved in planning for and responding to disasters. Based on the types of conditions diagnosed at the United States Veterans' Administration mobile clinics (i.e., a high prevalence of acute conditions, including stress and anxiety reactions, and the large numbers of children), staff trained in primary care, mental health, and pediatrics should be considered for relief missions that begin several days after an event resulting in a disaster.
Disaster-Site Medical Support Organization in a Small Country
Authors: Anantharaman V. 
Published: July 2016

AbstractOptimal, initial medical care given at the disaster site to victims of civil disasters requires an organized, pre-planned, disaster-site medical support system. Such a system has been developed in Singapore.On notification of a serious civil disaster, the Coordinating Health Agency (CHA) initially dispatches up to three medical teams. Each team consists of two doctors, four nurses, and an allotment of pre-packaged medical supplies. A Disaster-site Medical Command (DSMC) head-quarters (HQ) is established, consisting of a Medical Commander (MC), a Deputy Medical Commander (Dy MC), three hospital staff, and a clerk. The MC conducts an initial assessment of the disaster site and then deploys medical teams and establishes the headquarters. The MC also informs the CHA (via cellular telephone) of the situation at the disaster site and when deemed necessary requests further medical assistance.The MC has two-way radio contact with all medical teams. The medical teams relay information regarding the casualty situation, requirements for ambulances, stretchers, and medical supplies. Direct channel communication with the CHA enables the MC to direct ambulance transport of patients from the disaster site. The MC also has operational control over other paramedical teams from the Fire Service, the Singapore Red Cross, and the Singapore Armed Forces. Prior to transportation to the hospital, the medical teams only carry out trauma resuscitative procedures such as maintenance of airway, ventilation, and circulation.This system is expected to provide a coordinated and rapid medical response to a civil disaster situation.
KAMEDO — A Swedish Disaster Medicine Study Organization
Authors: Kulling Per E. J. , Lorin Henry 
Published: July 2016

AbstractKamedo is a Swedish Disaster Medicine study organization that sends observers to disaster areas anywhere in the world to study recent events, collect useful information, and identify problems relative to the practice of Disaster Medicine. The results of these investigations are published in the KAMEDO Reports, and the English versions will be published in Prehospital and Disaster Medicine.Three of the recent reports follow: 1) KAMEDO Report 69: Ebolus Virus Epidemic in Zaire, 1995; 2) KAMEDO Report 70: The German Rescue and Emergency Organizations: a) Industrial Chemical Fire, Memmingen, Germany 23 January 1997; b) Fire at the Düsseldorf Airport, 01 April 1996; and c) Bus Accident on the Autobahn in Rosenheim, Germany; and 3) Terrorist Attack with Sarin, 20 March 1995. In addition, a catalog listing all of the KAMEDO Reports available in English is provided.
A Model for a Statewide Critical Incident Stress (CIS) Debriefing Program for Emergency Services Personnel
Authors: Neely Keith W. , Spitzer William J. 
Published: July 2016

AbstractPurpose:Emergency services personnel are highly vulnerable to acute and cumulative critical incident stress (CIS) that can manifest as anger, guilt, depression, and impaired decision-making, and, in certain instances, job loss. Interventions designed to identify such distress and restore psychological functioning becomes imperative.Methods:A statewide debriefing team was formed in 1988 through a collaborative effort between an academic department of emergency medicine and a social work department of a teaching hospital, and a metropolitan area fire department and ambulance service. Using an existing CIS debriefing model, 84 pre-screened, mental health professionals and emergency services personnel were provided with 16 hours of training and were grouped into regional teams.Debriefing requests are received through a central number answered by a communicator in a 24-hour communications center located within the emergency department. Debriefings are conducted 48–72 hours after the event for specific types of incidents. Follow-up telephone calls are made by the debriefing team leader two to three weeks following a debriefing. The teams rely on donations to pay for travel and meals.Results:One hundred sixty-eight debriefings were conducted during the first four years. Rural agencies accounted for 116 (69%) requests. During this period, 1,514 individuals were debriefed: 744 (49%) firefighters, 460 (30%) EMTs, and 310 (21%) police officers, dispatchers, and other responders. Deaths of children, extraordinary events, and incidents involving victims known to the responders (35%, 14%, and 14% respectively) were the most common reasons for requesting debriefings. Feedback was received from 48 (28%) of the agencies that requested the debriefing. All of those who responded felt that the debriefing had a beneficial effect on its personnel. Specific individuals identified by agency representatives as having the greatest difficulty were observed to be returned to their pre-incident state.Conclusion:CIS debriefings are judged as beneficial. A statewide response team is an effective way to provide these services at no cost to agencies.
Interactive Computer-Aided Training of Emergency Care Tactics: An Experimental Study with Medical Students
Authors: Mattila Matti A. K. , Jama Timo 
Published: July 2016

AbstractIntroduction:It is important to know which level of tactical preparedness is reached after completing lectures and training included in a medical curriculum. A computer-based interactive programme aimed for tactical training of emergency care tactics at the scene (Matimed,™ Matimed Ltd, Kuopio, Finland) was used in testing the skills of 20 medical students.Methods:In this standardised test, every student first received guided introduction on the technical use of the programme. The test included four severely injured victims. The traumas used were hepatic rupture, flail chest, haemothorax, and femoral fracture. The students were tested in making decisions on the priority of care and transportation and in keeping the patients alive with appropriate emergency care until they were transported to a trauma centre.Results:Only five of20 (25%) succeeded in this task, 50% lost one victim and 25% lost two. The results show that the tactical preparedness of medical students is far from what is presumed. A more detailed analysis shows serious deficiencies in decision-making, priority order of actions, and in the use of available resources.Conclusion:This type of interactive computer-aided training of tactics appropriately supplements theoretical lectures, and partially fills the need for practical training.
A Comparative Study of Five Transcutaneous Pacing Devices in Unanesthetized Human Volunteers
Authors: Heller Michael B. , Peterson Joseph , Ilkahpamipour Keveh , Kaplan Richard , Paris Paul M. 
Published: July 2016

Transcutaneous Pacing (TCP) is a rapidly applied “non-invasive” technique that can be used successfully in the hospital, emergency department or field setting (1–9). Although the technique has been studied for three decades (7), it is only in the last few years that commercial units have been widely available. Improvements in pad design (particularly the development of non-metallic electrodes) and pulse characteristics (a pulse width of greater than 20 msec.) have allowed the development of units which may provide high capture rates with a level of discomfort which is tolerable in the conscious patient. Transcutaneous pacing may obviate the need for emergency transvenous pacing; further, it is easily adaptable to the field setting although early application appears to be needed for success (1,2).No study has compared the relative effectiveness of different TCP units, and there are no published data on some of the devices. The purpose of this investigation was to compare the functions of five different external pacemaker units on ten volunteers, in order to determine: 1) what percent of subjects could be captured within the limits of tolerability (the capture rate); 2) how much current was required by each unit to capture (the capture threshold); and 3) the degree of discomfort produced by each pacemaker at the capture threshold.