bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acquiring and Maintaining Competence in the Application of Extrication Cervical Collars by a Group of First Responders
Authors: Ireland Colin J. , Zeitz Kathryn M. , Bridgewater Franklin H.G. 
Published: August 2016

AbstractIntroduction:Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization.Objective:This study was conducted to confirm that a group of first responders could acquire and maintain competency in the application of an extrication cervical collar over a 12-month period.Methods:Participants attended a standardized training session that addressed the theory of application of an extrication cervical collar followed by hands-on practice. The training was presented by the same instructor and covered the nine key elements necessary in order to be deemed competent in extraction cervical collar application. Following the practical session, the competency of the participants was assessed. Participants were requested not to practice the skill during the 12-month period. Following the 12-month period, their skills were re-assessed by the same assessor.Results:Of the 64 subjects who participated in the study, 100% were competent after the initial first assessment. Forty-one participants (64%) were available for the second assessment (12 months later); of these, 25 (61%) maintained competence.Conclusions:Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.
Out-of-Hospital Cardiac Arrest: First Documented Experience in a Mexican Urban Setting
Authors: Fraga-Sastrías Juan Manuel , Asensio-Lafuente Enrique , Martínez Ricardo , Bárcenas Iris A. , Prieto-Sagredo Julio , Castillo Lilia , Pinet-Peralta Luis Mauricio 
Published: August 2016

AbstractObjective:Out-of-hospital cardiac arrest is one of the leading causes of death in Mexico, but many survival and prognostic factors are unknown. The aim of this study was to assess out-of-hospital cardiac arrest in a Mexican city.Methods:This was a prospective, cohort study that evaluated the records of the major ambulance services in the city of Queretaro, Mexico. Means, standard deviation, and percentages for the categorical variables were obtained. Logistic regression was performed to determine the effects between interventions, times, and return of spontaneous circulation (ROSC).Results:For an 11-month period, 148 out-of-hospital cardiac arrest cases were recorded. The mean age of the victims was 54 ±22.6 years and 90 (65.3%) were males. Forty-nine cases were related to cardiac disease, 46 to other disease, 27 to trauma, 18 to terminal illnesses, and three to drowning. Twelve (8.6%) patients had a pulse upon hospital arrival, but none survived to discharge. No victims were defibrillated prior to ambulance arrival. The collapse-assessment interval was 22.5 ±19:1 minutes, the mean value for the ambulance response times was 13:6 ±10:4 minutes. Basic emergency medical technicians applied chest compressions to 40 victims (27.2%), controlled the airway in 32 (21.8%), and defibrillated seven (4.8%). Chest compressions and airway control showed an OR of 8 and 12 respectively for ROSC.Conclusions:The poor survival rate in this study emphasizes the need to improve efforts in provider training and public education. Authorities must promote actions to enhance prehospital emergency services capabilities, shorten response times, and provide community education to increase the chances of survival for out-of-hospital cardiac arrest victims in Mexico.
Interruption of Medication among Outpatients with Chronic Conditions after a Flood
Authors: Tomio Jun , Sato Hajime , Mizumura Hairoko 
Published: August 2016

AbstractIntroduction:The disruption of routine treatment, including the interruption of medication, exacerbates chronic conditions during disasters. However, the health consequences of the interruption of medication have not been fully examined. On 22 July 2006, a flash flood affected more than 3,000 households in five cities and four towns in the northern part of Kagoshima Prefecture in southwest Japan. The aims of this study are to describe the prevalence of the interruption of medication among the outpatients in the flood-affected area and to determine the risk and preventive factors for the interruption of medication.Methods:This was a cross-sectional study using a self-administered questionnaire. The study subjects were the outpatients who visited nine of 15 medical facilities in the flood-affected area from 23 January and 31 January 2007. Of 810 valid respondents, 309 who received medication treatment before the event were eligible for the study. Information on socio-demographic factors, chronic health conditions, preparedness-related factors before the event and damage-related factors were collected. Overall and evacuation status-specific prevalence of interruption of medication were presented. For those evacuated, the associations between interruption of medication and relevant patient characteristics, as well as deterioration of health status after the event, were examined.Results:The prevalence of interruption of medication was 9% in total, but it increased up to 23% among the evacuated subjects. Interruption of medication was more likely among those aged ≥75 years (odds ratio [OR] = 3.6; 95% confidence interval [CI] = 1.0−12.6) and those receiving long-term care services (OR = 4.6; 95% CI = 1.1−19.1), while it was less likely among those with hypertension (OR = 0.2; 95% CI = 0.1−0.8) and those prepared to go out with medication (OR = 0.2; 95% CI = 0.03−0.8). Those who experienced interruption of medication were more likely to have deteriorated health status one month after the event (OR = 4.5; 95% CI = 1.2−17.6).Conclusions:Interruption of medication occurred more commonly among the evacuated subjects. Among the evacuated, the elderly and those receiving longterm care services were at high risk for interruption of medication, while the preparedness behavior of “preparing to go out with medication” had preventive effect. Special attention must be paid to the high-risk subgroups, and some preventive behaviors should be recommended.
A Graduate Curriculum in Emergency Public Health
Authors: Rottman Steven J. , Shoaf Kimberley I. , Stratton Samuel J. 
Published: August 2016

AbstractThe increase in adverse health impacts of disasters has raised awareness of the need for education in the field of emergency public health. In the past, most traditional models of graduate education in schools of public health have not incorporated the theory and practice of disaster public health into their curricula. This paper describes the development of a curriculum in emergency public health within a US masters program in public health, and provides a description of the courses that comprise an area of specialization in the field. The interdisciplinary nature of the faculty, close ties with public health practitioners, and practical applications of the nine courses in this program are highlighted. The curriculum is presented as one model that can be used to meet the educational needs of professionals who will assume the responsibility for planning for and responding to the public health impacts of mass-populations disasters.
Comparison of Two Protocols for Pulseless Cardiopulmonary Arrest: Vasopressin Combined with Epinephrine Versus Epinephrine Alone
Authors: Cody Patrick , Lauderdale Sean , Hogan David E. , Frantz Robert R. 
Published: August 2016

AbstractIntroduction:Survival from pulseless cardiac arrest typically is dismal. Some suggest that adding vasopressin to epinephrine as a cardiovascular stimulant can improve outcomes.Problem:This study compares survival outcomes using epinephrine verses vasopressin and epinephrine in persons with pulseless cardiac arrest.Methods:This is a retrospective, cohort evaluation of two resuscitative protocols (P1-epinephrine or P2-vasopressin with epinephrine) in a tiered response, community emergency medical service (EMS) with an approximately 100,000 catchment area. Cases are defined as 18 years or older determined to be in pulseless cardiac arrest. Outcomes were survival to emergency department arrival, to 24 hours, and to hospital discharge. Data were entered into Microsoft Office Excel® and processed using Analyze-it® for continuous and categorical data and Epi-Info® for odds ratios with confidence intervals.Results:There were 204 cases (60.3% males and 39.7% females) who met the inclusion criteria. Thirteen cases received electrical therapy only, and were dropped from analysis, leaving 191 (93.6%) who were included in the study; P1 to 85 (44.5%) and P2 to 106 (55.5%). Younger age was associated with improved survival to discharge home in both protocols, p = 0.003 (95% CI = 0.004–0.010). No difference in survival was noted at the levels of emergency department arrival OR 1.42 (95% CI = 0.73, 2.76) p = 0.26; 24 hour survival OR 0.54 (95% CI = 0.22–1.30) p = 0.133, or discharge home OR = 1.81 (95% CI = 0.49–6.88) p = 0.319.Conclusions:This study in a community EMS did not demonstrate improved survival with the addition of vasopressin to epinephrine for pulseless cardiac arrest.
Surgery under Extreme Conditions in the Aftermath of the 2010 Haiti Earthquake: The Importance of Regional Anesthesia
Authors: Missair Andres , Gebhard Ralf , Pierre Edgar , Cooper Lebron , Lubarsky David , Frohock Jeffery , Pretto Ernesto A. 
Published: August 2016

AbstractThe 12 January 2010 earthquake that struck Port-au-Prince, Haiti caused >200,000 deaths, thousands of injuries requiring immediate surgical interventions, and 1.5 million internally displaced survivors. The earthquake destroyed or disabled most medical facilities in the city, seriously hampering the ability to deliver immediate life- and limb-saving surgical care. A Project Medishare/University of Miami Miller School of Medicine trauma team deployed to Haiti from Miami within 24 hours of the earthquake. The team began work at a pre-existing tent facility in the United Nations (UN) compound based at the airport, where they encountered 225 critically injured patients. However, non-sterile conditions, no means to administer oxygen, the lack of surgical equipment and supplies, and no anesthetics precluded the immediate delivery of general anesthesia. Despite these limitations, resuscitative care was administered, and during the first 72 hours following the event, some amputations were performed with local anesthesia. Because of these austere conditions, an anesthesiologist, experienced and equipped to administer regional block anesthesia, was dispatched three days later to perform anesthesia for limb amputations, debridements, and wound care using single shot block anesthesia until a better equipped tent facility was established. After four weeks, the relief effort evolved into a 250-bed, multi-specialty trauma/intensive care center staffed with >200 medical, nursing, and administrative staff. Within that timeframe, the facility and its staff completed 1,000 surgeries, including spine and pediatric neurological procedures, without major complications. This experience suggests that when local emergency medical resources are completely destroyed or seriously disabled, a surgical team staffed and equipped to provide regional nerve block anesthesia and acute pain management can be dispatched rapidly to serve as a bridge to more advanced field surgical and intensive care, which takes longer to deploy and set up.
Development of a Mass-Gathering Medical Resource Matrix for a Developing World Scenario
Authors: Smith Wayne P. , Wessels Vernon , Naicker Diane , Leuenberger Elizabeth , Fuhri Peter , Wallis Lee A. 
Published: August 2016

AbstractMass gatherings have a higher patient presentation rate than is found within the general population. Despite this fact, many mass gatherings are occurring without suitable medical coverage. South Africa has had no standard approach or model to determine the number of medical personnel needed to deploy to an event. The awarding of the FIFA (Federation International de Football Association) 2010 World Cup to South Africa has provided the impetus for the development of such a model. The model presented in this paper is based on existing recommendations that originate from the United Kingdom.This paper outlines the modifications that have been made to this model to ensure that adequate medical resources still are provided, albeit in a developing country where medical resources may not be as plentiful.
Comparison of Techniques for Securing the Endotracheal Tube while Wearing Chemical, Biological, Radiological, or Nuclear Protection: A Manikin Study
Authors: Castle Nick , Owen Robert , Clark Simon , Hann Mark , Reeces David , Gurney Ian 
Published: August 2016

AbstractObjective:The objective of this study was to assess the impact of chemical, biological, radiological, nuclear personal protective equipment (CBRN-PPE) on the ability to secure an endotracheal tube (ETT) with either the Thomas Tube Holder™ or cotton tape tied in a knot.Methods:Seventy-five clinicians secured an ETT in a previously intubated manikin with the Thomas Tube Holder™ and cotton tape. A mixed quantitative and qualitative research design was used to gauge actual performance times and perceptions of difficulties. Following completion of the study, 25 clinicians were interviewed to gauge their experiences of securing the ETT with both devices while wearing CBRN-PPE.Results:The mean time to apply the Thomas Tube Holder was 29.02 seconds, compared with tape which took a mean of 58 seconds (p= 0.001). Clinicians rated the Thomas Tube Holder as easier to use than tape (Mann-Whitneyz= 9.934;p<0.001), which was confirmed during interviews. Of the clinicians interviewed, 92% perceived that the Thomas Tube Holder provided the better method for securing an ETT, none of the clinicians identified the tape as the best method for securing the endotracheal tube while wearing CBRN-PPE. Clinicians identified that the design of the Thomas Tube Holder facilitated the gross motor movement required for application.Conclusions:The Thomas Tube Holder is easier and faster to apply when wearing CBRN-PPE when compared with cotton, and the Thomas Tube Holder is perceived by the participants as being more effective at preventing accidential extubation
Central System of Psychosocial Support to the Czech Victims Affected by the Tsunami in Southeast Asia
Authors: Vymetal Stepan 
Published: August 2016

AbstractThe Tsunami disaster affected several countries in Southeast Asia in December 2004 and killed or affected many tourists, most of them from Europe. Eight Czech citizens died, and about 500 Czechs were seriously mentally traumatized. The psychosocial needs of tourists included: (1) protection; (2) treatment; (3) safety; (4) relief; (5) psychological first aid; (6) connecting with family members; (7) transportation home; (8) information about possible mental reactions to trauma; (9) information about the normality of their reaction; (10) procedural and environmental orientation; (11) reinforcement of personal competencies; and (12) psycho-trauma therapy.The Ministry of Foreign Affairs of the Czech Republic was in charge of general emergency management. General coordination of psychosocial support was coordinated under the Ministry of Interior of the Czech Republic, which is connected to the Central Crisis Staff of the Czech Government. The major cooperative partners were: the Ministry of Foreign Affairs, the Ministry of Defence, the Ministry of Health, Czech Airlines, psychosocial intervention teams of the Czech Republic, and the Czech Association of Clinical Psychologists.The main goals of relief workers were: (1) to bring back home the maximum number of Czech citizens; (2) to provide relevant information to the maximum number of affected Czech citizens; (3) to provide relevant information to rescue workers and professionals; and (4) to prepare working psychosocial support regional network.Major activities of the Ministry of Interior (psychology section) included: (1) establishing a psychological helpline; (2) running a team of psychological assistance (assistance in the Czech airports, psychological monitoring of tourists, crisis intervention, psychological first aid, assistance in the collection of DNA material from relatives); (3) drafting and distributing specific information materials (brochures, leaflets, address lists, printed and electronic instructions); (4) communicating via the media and advertising; and (5) providing analysis and research studies.Central coordination of psychosocial support has been found as successful in the first phase after the disaster. The plans must be built for preferable cooperation in the psychosocial field in the Czech Republic. Better collaborates with journalists must exist in order to reduce secondary psycho-trauma.There is a need for intensive international cooperation in the psychosocial field and to build the network at the global level.
Health Aspects of Disaster Preparedness and Response Panel Session 2: Seismic Risks including Tsunamis
Authors:   Southeast Asia Regional Office/World Health Organization
Published: August 2016

AbstractThis Panel Session consisted of five country reports (India, Indonesia, Maldives, Thailand, andNepal) and the common issues identified during the Panel discussions relative to seismic events in the Southeast Asia Region. Important issues identified included the needs for: (1) a legal framework upon which to base preparedness and response; (2) coordination between the many organizations involved; (3) early warning systems within and between countries; (4) command and control; (5) access to resources including logistics; (6) strengthening the health infrastructure; (7) professionalizing the field of disaster medicine and management; (8) management of communications and information; (9) management of dead bodies; and (10) mental health of the survivors and health workers.
TAP CBRN Preparedness: Knowledge, Training and Networks
Authors: van der Woude Irene , de Cock Johan S. , Bierens Joost J.L.M. , Christiaanse Jan C. 
Published: August 2016

AbstractThe main goal of this targeted agenda program (TAP) was the establishment of an international network that would be able to advise on how to improve education and training for chemical, biological, radiological, or nuclear (CBRN)) responders. By combining the members of the TAP group, the CBRN Task Force of the World Association for Disaster and Emergency Medicine (WADEM) and the European network of the Hesculaep Group, an enthusiastic and determined group has been established to achieve the defined goal. It was acknowledged that the bottlenecks for education and training for CBRN responders are mainly awareness and preparedness. For this reason, even basic education and training on CBRN is lacking. It was advised that the focus for the future should be on the development of internationally standardized protocols and standards. The face-to-face discussions of the TAP will be continued at future Hesculaep expert meetings. The intention is that during the 16WCDEM, the achievements of the established network will be presented.
The Professionalization of Humanitarian Health Assistance: Report of a Survey on What Humanitarian Health Workers Tell Us
Authors: Kene Mamata , Pack Mary E. , Greenough P. Gregg , Burkle Frederick M. 
Published: August 2016

AbstractIntroduction:While the number of humanitarian health workers has grown considerably along with the emphasis on evidence-based humanitarian practice over the last 15 years, no organization exists to ensure ongoing professionalization of this area of expertise.Hypothesis/Problem:To determine whether and to what degree the community of humanitarian health workers self-identify as a professional group; whether a need for a professional society exists to support such a group; and if so, what fundamental elements and activities should it encompass and provide.Methods:A humanitarian, listserv-based survey was undertaken to evaluate humanitarian professional self-identification, needs for and interest in professional support functions, and priorities toward developing a professional organization to provide needed services.Results:The resulting respondent population represented a broad distribution of age and experience with education and experience being equally important factors in defining humanitarian health professionals. Respondents viewed themselves as humanitarian professionals nearly to the extent they viewed themselves as health-specific technical experts who happen to work in humanitarian assistance; they expressed a strong desire to establish a professional society reflecting that self-identification; and that body should focus on activities of education and training, networking and dialogue, and developing and refining core competencies to support best practices.Conclusions:Humanitarian health workers self-identify as professionals in humanitarian assistance and as technical experts. A professional organization with specific support functions would be of interest to many humanitarian health professionals.
Burden of Surgical Disease: Strategies to Manage an Existing Public Health Emergency
Authors: McQueen K.A. Kelly , Parmar Parveen , Kene Mamata , Broaddus Sam , Casey Kathleen , Chu Kathryn , Hyder Joseph A. , Mihailovic Alexandra , Semer Nadine , Sullivan Stephen , Weiser Thomas , Burkle Frederick M. 
Published: August 2016

AbstractThe World Health Organization estimates that the burden of surgical disease due to war, self-inflicted injuries, and road traffic incidents will rise dramatically by 2020. During the 2009 Harvard Humanitarian Initiative's Humanitarian Action Summit (HHI/HAS), members of the Burden of Surgical Disease Working Group met to review the state of surgical epidemiology, the unmet global surgical need, and the role international organizations play in filling the surgical gap during humanitarian crises, conflict, and war. An outline of the group's findings and recommendations is provided.
miR-23a/b regulates the balance between osteoblast and adipocyte differentiation in bone marrow mesenchymal stem cells
Authors: Guo Qi , Chen Yusi , Guo Lijuan , Jiang Tiejian , Lin Zhangyuan 
Published: August 2016

AbstractAge-related osteoporosis is associated with the reduced capacity of bone marrow mesenchymal stem cells (BMSCs) to differentiate into osteoblasts instead of adipocytes. However, the molecular mechanisms that decide the fate of BMSCs remain unclear. In our study, microRNA-23a, and microRNA-23b (miR-23a/b) were found to be markedly downregulated in BMSCs of aged mice and humans. The overexpression of miR-23a/b in BMSCs promoted osteogenic differentiation, whereas the inhibition of miR-23a/b increased adipogenic differentiation. Transmembrane protein 64 (Tmem64), which has expression levels inversely related to those of miR-23a/b in aged and young mice, was identified as a major target of miR-23a/b during BMSC differentiation. In conclusion, our study suggests that miR-23a/b has a critical role in the regulation of mesenchymal lineage differentiation through the suppression of Tmem64.