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https://www.readbyqxmd.com/read/28802837/development-of-simulation-optimization-methods-for-solving-patient-referral-problems-in-the-hospital-collaboration-environment
#1
Ping-Shun Chen, Ming-Han Lin
This research studied a patient referral problem among multiple cooperative hospitals for sharing imaging services' referrals. The proposed problem consisted of many types of patients and the uncertainty associated with the number of patients of each type, patients' arrival time, and patients' medical operation time, leading to a difficulty in finding solutions due to the uncertain environment. This research used system simulation to construct a model and develop a simulation optimization method, combining the heuristic algorithm (patient referral mechanism) with the particle swarm optimization (PSO) method, to determine a better way to refer patients from one hospital (referring hospital) to another (recipient hospital) to receive certain imaging services...
August 9, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28792986/-implementation-of-the-mobile-emergency-medical-service-in-brazil-action-strategies-and-structural-dimension
#2
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28760696/simulation-training-to-improve-9-1-1-dispatcher-identification-of-cardiac-arrest-a-randomized-controlled-trial
#3
Hendrika Meischke, Ian S Painter, Scott R Stangenes, Marcia R Weaver, Carol E Fahrenbruch, Tom Rea, Anne M Turner
BACKGROUND: The objective of this study was to test the effectiveness of simulation training, using actors to make mock calls, on improving Emergency Medical Dispatchers' (EMDs) ability to recognize the need for, and reduce the time to, telephone-assisted CPR (T-CPR) in simulated and real cardiac arrest 9-1-1 calls. METHODS: We conducted a parallel prospective randomized controlled trial with n=157 EMDs from thirteen 9-1-1 call centers. Study participants were randomized within each center to intervention (i...
July 29, 2017: Resuscitation
https://www.readbyqxmd.com/read/28756826/frequency-of-multi-drug-resistance-and-mutations-in-mycobacterium-tuberculosis-isolates-from-punjab-state-of-india
#4
Ritu Singhal, Jyoti Arora, Grish C Sah, Manpreet Bhalla, Rohit Sarin, Vithal Prasad Myneedu
Data regarding prevalence of multi-drug resistant tuberculosis (MDR-TB) and associated common mutations is scarce from Punjab region. The study was designed to determine rate of MDR-TB among presumptive MDR-TB from Punjab and mutation patterns using GenoType MTBDRplus assay. Total of 812 consecutive sputum samples were received from January 2012 to July 2013, from 14 districts of Punjab at the National Reference Laboratory at New Delhi for diagnosis of MDR-TB as hand holding activity. Presumptive MDR-TB patients were identified on basis of criterion B defined by the programme...
September 2017: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/28756074/-european-guidelines-on-cardiac-arrest-what-s-new
#5
Pascal Cassan
The European recommendations on cardiac arrest are based on the evidence gathered and reviewed by the International Resuscitation Liaison Committee (ILCOR) and were published in October 2015. These recommendations without representing a revolution, constitute an evolution centered on a primary goal to increase survival following cardiac arrest. This improvement in survival depends on four main factors: early identification of cardiac arrest, early access to rescue, early and quality CPR, and access to early defibrillation...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28754526/telephone-cardiopulmonary-resuscitation-is-independently-associated-with-improved-survival-and-improved-functional-outcome-after-out-of-hospital-cardiac-arrest
#6
Zhixin Wu, Micah Panczyk, Daniel W Spaite, Chengcheng Hu, Hidetada Fukushima, Blake Langlais, John Sutter, Bentley J Bobrow
AIM OF STUDY: This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. METHODS: We conducted a prospective, observational study of EMS-treated adult (≥18 years) patients with OHCA of presumed cardiac origin in Arizona, between January 1, 2011, and December 31, 2014...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28741009/the-role-of-dispatch-in-resuscitation
#7
Yih Yng Ng, Siew Hon Benjamin Leong, Marcus Eng Hock Ong
The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation. The dispatch centre is part of the first link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The influence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defibrillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European Resuscitation Council 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740995/basic-cardiac-life-support-2016-singapore-guidelines
#8
Swee Han Lim, Fong Chi Wee, Tek Siong Chee
Basic Cardiac Life Support (BCLS) or cardiopulmonary resuscitation (CPR) refers to the skills required (without use of equipment) in the resuscitation of cardiac arrest individuals. On recognising cardiac arrest, chest compressions should be initiated. Good quality compressions are with arms extended, elbows locked, shoulders directly over the casualty's chest and heel of the palm on the lower half of the sternum. The rescuer pushes hard and fast, compressing 4-6 cm deep for adults at 100-120 compressions per minute with complete chest recoil...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28727555/tid-introducing-and-benchmarking-an-event-delivery-system-for-brain-computer-interfaces
#9
Christian Breitwieser, Michele Tavella, Martijn Schreuder, Febo Cincotti, Robert Leeb, Gernot R Muller-Putz
In this paper, we present and analyze an event distribution system for brain-computer interfaces (BCIs). Events are commonly used to mark and describe incidents during an experiment and are therefore critical for later data analysis or immediate real-time processing. The presented approach, called TiD (Tools for brain-computer interaction - interface D), delivers messages in XML format via a bus-like system using TCP (transmission control protocol) connections or shared memory. A dedicated server dispatches TiD messages to distributed or local clients...
July 18, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#10
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28721549/an-expected-coverage-model-with-a-cutoff-priority-queue
#11
Soovin Yoon, Laura A Albert
Emergency medical services provide immediate care to patients with various types of needs. When the system is congested, the response to urgent emergency calls can be delayed. To address this issue, we propose a spatial Hypercube approximation model with a cutoff priority queue that estimates performance measures for a system where some servers are reserved exclusively for high priority calls when the system is congested. In the cutoff priority queue, low priority calls are not immediately served-they are either lost or entered into a queue-whenever the number of busy ambulances is equal to or greater than the cutoff...
July 19, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28714836/the-importance-of-the-evaluation-of-expectations-and-perceptions-to-improve-the-dental-service-quality
#12
Juliana Rocha, Andres Pinto, Marilia Batista, Janice Simpson de Paula, Glaucia Ambrosano
Purpose The purpose of this paper is to evaluate the use of SERVQUAL to assess service quality in Dentistry, by evaluating patients' expectations and perceptions of dental care and their association to patients' sociodemographic data. Design/methodology/approach The sample constituted of 379 subjects in the first assessment and 155 in the second phase. All employees of the companies that were clients of the dental insurance participated, a total of four companies in two states (São Paulo and Minas Gerais) of Brazil...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28713330/access-to-thrombolysis-for-non-resident-and-resident-stroke-patients-a-registry-based-comparative-study-from-berlin
#13
Ludwig Schlemm, Guillaume Turc, Heinrich J Audebert, Martin Ebinger
OBJECTIVES: Stroke can happen to people away from home. It is unknown whether non-resident and resident stroke patients have equal access to thrombolysis. MATERIALS AND METHODS: Consecutive patients cared for by the Stroke Emergency Mobile between 2011 and 2016 after prompting suspicion of acute stroke during the emergency call were included in our registry. Patients were categorized as residents or non-residents based on their main address. Clinical characteristics, thrombolysis rates, and time intervals from symptom onset/last seen well to alarm and to thrombolysis were compared between groups adjusting for age, pre-stroke modified Rankin Scale (mRS) score, and National Institutes of Health Stroke Scale (NIHSS) score...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28697471/the-relationship-between-airborne-fine-particle-matter-and-emergency-ambulance-dispatches-in-a-southwestern-city-in-chengdu-china
#14
Ruicong Liu, Jie Zeng, Xianyan Jiang, Jianyu Chen, Xufang Gao, Li Zhang, Tiantian Li
High levels of fine particulate matter (PM2.5) are known to cause adverse effects to human health. The goal of this study was to estimate the acute health effects of short-term exposure to ambient PM2.5 by analyzing cause-specific emergency ambulance dispatches as the endpoint in Chengdu, a city in Sichuan Province in southwest China. The ambient PM2.5 concentration of Chengdu reached 63 μg/m(3) in 2015. Data related to the causes of specific emergency ambulance dispatches, air pollution, and meteorological conditions were collected from 2013 to 2015 (1095 days)...
July 8, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28694349/the-linguistic-and-interactional-factors-impacting-recognition-and-dispatch-in-emergency-calls-for-out-of-hospital-cardiac-arrest-a-mixed-method-linguistic-analysis-study-protocol
#15
Marine Riou, Stephen Ball, Teresa A Williams, Austin Whiteside, Kay L O'Halloran, Janet Bray, Gavin D Perkins, Peter Cameron, Daniel M Fatovich, Madoka Inoue, Paul Bailey, Deon Brink, Karen Smith, Phillip Della, Judith Finn
INTRODUCTION: Emergency telephone calls placed by bystanders are crucial to the recognition of out-of-hospital cardiac arrest (OHCA), fast ambulance dispatch and initiation of early basic life support. Clear and efficient communication between caller and call-taker is essential to this time-critical emergency, yet few studies have investigated the impact that linguistic factors may have on the nature of the interaction and the resulting trajectory of the call. This research aims to provide a better understanding of communication factors impacting on the accuracy and timeliness of ambulance dispatch...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28693524/national-consensus-on-communication-in-prehospital-trauma-care-the-denim-study
#16
Annelieke Maria Karien Harmsen, Leo Maria George Geeraedts, Georgios Fredericus Giannakopoulos, Maartje Terra, Herman M T Christiaans, Lidwine Brigitta Mokkink, Frank Willem Bloemers
BACKGROUND: In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#17
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28687709/the-effects-of-public-access-defibrillation-on-survival-after-out-of-hospital-cardiac-arrest-a-systematic-review-of-observational-studies
#18
Josefine Bækgaard, Søren Viereck, Thea Møller, Annette Ersbøll, Freddy Lippert, Fredrik Folke
Background -Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains below 10%. Early defibrillation by an automated external defibrillator (AED) is the most important intervention for OHCA patients, showing survival proportions above 50%. Accordingly, placement of AEDs in the community as part of a public access defibrillation program (PAD) is recommended by international guidelines. However, different strategies have been proposed on how exactly to increase and make use of public available AEDs...
July 7, 2017: Circulation
https://www.readbyqxmd.com/read/28684011/-when-the-patient-calls-the-samu-because-his-pacemaker-is-making-beep-beep-study-on-physicians-knowledge-on-pacemaker-sound-alarm
#19
F Lapostolle, N Laghmari, P-G Reuter, H Akodad, F Adnet
INTRODUCTION: More than 60,000 pacemakers are inserted every year in France. This number has been steadily increasing for a decade. Miscellaneous incidents can lead patients with pacemakers or their relatives to contact emergency services. Following the call to the SAMU-Center 15 of a asymptomatic 90-year-old woman reported that her pacemaker was making "beep-beep", we assessed the knowledge of physicians of the SAMU-Center 15 (call center) dispatching center on the existence of pacemaker sound alarms...
July 3, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28666130/tracking-of-listeria-monocytogenes-in-meat-establishment-using-whole-genome-sequencing-as-a-food-safety-management-tool-a-proof-of-concept
#20
Ivan Nastasijevic, Dubravka Milanov, Branko Velebit, Vesna Djordjevic, Craig Swift, Anais Painset, Brankica Lakicevic
Repeated Listeria outbreaks particularly associated with Ready-To-Eat (RTE) delicatessen meat products have been reported annually at global level. The most frequent scenario that led to foodborne outbreaks was the post-thermal treatment cross-contamination of deli meat products during slicing and modified atmosphere packaging (MAP). The precondition for such cross contamination is the previous introduction of Listeria into meat processing facilities and subsequent colonization of the production environment, associated with formation of biofilms resilient to common sanitation procedures regularly applied in meat establishments...
June 20, 2017: International Journal of Food Microbiology
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