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Emergency Planning

Rossella Letizia Mancusi, Massimo Andreoni, Daniela d'Angela, Cesare Sarrecchia, Federico Spandonaro
Between western European countries, the hepatitis C virus (HCV) endemic is highest in Italy. The main objective of this paper is to estimate the endemic diffusion of hepatitis C at the national level and by geographical area, with an extrapolation at the regional level and by uniform cohorts of subjects (by sex and year of birth). The secondary objective is a stratification by gravity of the estimated statistical figures to provide an overview of possible targets of the new anti-HCV treatments.PubMed and the Cochrane Library were searched for relevant Italian populations studies regarding HCV prevalence...
October 2016: Medicine (Baltimore)
Michael D Caggiano, Wade T Tinkham, Chad Hoffman, Antony S Cheng, Todd J Hawbaker
The wildland-urban interface (WUI), the area where human development encroaches on undeveloped land, is expanding throughout the western United States resulting in increased wildfire risk to homes and communities. Although census based mapping efforts have provided insights into the pattern of development and expansion of the WUI at regional and national scales, these approaches do not provide sufficient detail for fine-scale fire and emergency management planning, which requires maps of individual building locations...
October 2016: Heliyon
Candace I J Nykiforuk, Jennifer Ann McGetrick, Katelynn Crick, Jeffrey A Johnson
Walk Score® is a proprietary walkability metric that ranks locations by proximity to destinations, with emerging health promotion applications for increasing walking as physical activity. Currently, field validations of Walk Score® have only occurred in metropolitan regions of the United States; moreover, many studies employ an earlier Walk Score® version utilizing straight line distance. To address this gap, we conducted a field validation of the newest, network-based metric for three municipal types along a rural-urban continuum in Alberta, Canada...
December 2016: Preventive Medicine Reports
Lucas Brien Chartier, Licinia Simoes, Meredith Kuipers, Barb McGovern
Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients...
2016: BMJ Quality Improvement Reports
Gennaro D'Amato, Carolina Vitale, Antonio Molino, Anna Stanziola, Alessandro Sanduzzi, Alessandro Vatrella, Mauro Mormile, Maurizia Lanza, Giovanna Calabrese, Leonardo Antonicelli, Maria D'Amato
Despite major advances in the treatment of asthma and the development of several asthma guidelines, people still die of asthma currently. According to WHO estimates, approximately 250,000 people die prematurely each year from asthma. Trends of asthma mortality rates vary very widely across countries, age and ethnic groups. Several risk factors have been associated with asthma mortality, including a history of near-fatal asthma requiring intubation and mechanical ventilation, hospitalization or emergency care visit for asthma in the past year, currently using or having recently stopped using oral corticosteroids (a marker of event severity), not currently using inhaled corticosteroids, a history of psychiatric disease or psychosocial problems, poor adherence with asthma medications and/or poor adherence with (or lack of) a written asthma action plan, food allergy in a patient with asthma...
2016: Multidisciplinary Respiratory Medicine
Massimo Di Grazia, Sandra Pellizzoni, Luca Giacomo Tonegatti, Waifro Rigamonti
INTRODUCTION: The bladder exstrophy-epispadias complex (BEEC) represents a spectrum of malformations that affect the anatomical and functional structure of the urogenital system. The parents of patients affected by this condition are subject to particularly stressful situations, such as worrying about their child's health, long hospital stays, concerns about the health and constant need for personal care for their children, that can profoundly compromise the quality of family life. OBJECTIVE: The objective of this explorative qualitative study is to evaluate the social situation and the psychological strategies implemented by the mothers of children between 6 and 10 years of age who are affected by BEEC...
September 15, 2016: Journal of Pediatric Urology
Boriphat Methachan, Kamolrat Thanapprapasr
The emergence of theranostics with ultrasound technology is a promising development, as it opens pathways to providing more effective treatments for cancer. Advancements in ultrasound imaging would give a more detailed and accurate image for better diagnosis and treatment planning. Polymeric ultrasound contrast agents (UCAs) are appealing because they are stable and easily modified for active targeting. In addition, a better therapy could be achieved in conjunction with advancements in UCAs. The active targeting not only makes the precise imaging possible, but also leads to targeted delivery of active components to specific local treatment sites...
October 14, 2016: Ultrasound in Medicine & Biology
Yun Long, Yinxin Zhang, Yanping Gong, Ruixue Sun, Longxiang Su, Xin Lin, Ao Shen, Jiali Zhou, Zhuoma Caiji, Xinying Wang, Dongfang Li, Honglong Wu, Hongdong Tan
BACKGROUND AND AIMS: Bacteremia is a common serious manifestation of disease in the intensive care unit (ICU), which requires quick and accurate determinations of pathogens to select the appropriate antibiotic treatment. To overcome the shortcomings of traditional bacterial culture (BC), we have adapted next-generation sequencing (NGS) technology to identify pathogens from cell-free plasma DNA. METHODS: In this study, 78 plasma samples from ICU patients were analyzed by both NGS and BC methods and verified by PCR amplification/Sanger sequencing and ten plasma samples from healthy volunteers were analyzed by NGS as negative controls to define or calibrate the threshold of the NGS methodology...
July 2016: Archives of Medical Research
Abhinav Aggarwal, Ian A Harris, Justine M Naylor
BACKGROUND: The ideal timing of surgical management for hip fractures remains controversial. Currently, individual surgeon preference and departmental resources guide decision making regarding the use of emergency or planned operating lists for hip fracture surgery. We evaluated patient preference for emergency or planned surgery. METHODS: 102 patients awaiting surgery for a hip fracture at a tertiary hospital were surveyed in this cross-sectional study. After being informed of the benefits and risks associated with an emergency or planned operation, the patients were asked to indicate a hypothetical preference for surgical operating time...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Kimberly A Randell, Danica Harris, Jennifer Stallbaumer-Rouyer
Childhood exposure to intimate partner violence (IPV) results in numerous, lifelong, negative health outcomes, underscoring the American Academy of Pediatrics' recommendation for IPV screening and intervention in the pediatric health care setting. We report a case in which a mother denied IPV during routine IPV screening in a pediatric emergency department (ED). However, subsequent discussion with health care providers during the ED visit revealed IPV. The mother declined to meet with an IPV advocate because the abuser was texting repeatedly to ask about the duration of the ED visit...
October 4, 2016: Pediatric Emergency Care
Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
Michael T Long, Matthew P Murray
Tongue entrapments within bottles are very rare childhood mishaps. The most immediate hazard in a tongue entrapment is airway obstruction. Tongue entrapment is an airway emergency; contingency planning to maintain airway patency, oxygenation, and ventilation is critical. Here, we report the case of a 5-year-old girl presenting to a pediatric emergency department with an increasingly popular novelty soda bottle, featuring a unique and dangerous design, entrapped on her tongue. Operative removal was anticipated...
September 30, 2016: Pediatric Emergency Care
Zulfi Haneef, Sharon Chiang, Holly Rutherford, Arun Antony
INTRODUCTION: Fellowship training in Clinical Neurophysiology (CNP) is often sought following Neurology residency. However, data documenting the reasons for choosing CNP fellowship, and experiences therein, are sparse. METHODS: Current Neurophysiology fellows across the United States participated in a 17-item, internet-based survey. Data regarding demographics, reasons for choosing fellowship, adequacy of training, and future plans were collected. RESULTS: Among respondents (n=49), 84% graduated from a US medical school...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Philip Dickinson, Philip Rempel
BACKGROUND: In 2013, the Amateur International Boxing Association (AIBA) introduced a rule banning headgear for male-senior open class boxers during competition. The AIBA has defended the rule change as motivated by safety and supported by internal unpublished studies. As a result, in 2018, the AIBA plans to universally prohibit headgear in competition: for all competitors (male and female), all ages and all levels. Within Canada, this ruling has generated controversy in the boxing community, yet there has been no overall measure of opinion...
December 2016: Sports Medicine—Open
Sung-Bou Kim, David S Zingmond, Emmett B Keeler, Lee A Jennings, Neil S Wenger, David B Reuben, David A Ganz
BACKGROUND: Identifying fall-related injuries and costs using healthcare claims data is cost-effective and easier to implement than using medical records or patient self-report to track falls. We developed a comprehensive four-step algorithm for identifying episodes of care for fall-related injuries and associated costs, using fee-for-service Medicare and Medicare Advantage health plan claims data for 2,011 patients from 5 medical groups between 2005 and 2009. METHODS: First, as a preparatory step, we identified care received in acute inpatient and skilled nursing facility settings, in addition to emergency department visits...
December 2016: Injury Epidemiology
Tetsurou Satoh, Osamu Isozaki, Atsushi Suzuki, Shu Wakino, Tadao Iburi, Kumiko Tsuboi, Naotetsu Kanamoto, Hajime Otani, Yasushi Furukawa, Satoshi Teramukai, Takashi Akamizu
Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan...
October 15, 2016: Endocrine Journal
Tyra Dark, Heather A Flynn, George Rust, Heidi Kinsell, Jeffrey S Harman
OBJECTIVE: The purpose of this study was to describe the epidemiology of anxiety-related emergency department (ED) visits in the United States and assess the care provided during those visits. METHODS: Data from the 2009-2011 National Hospital Ambulatory Medical Care Survey were used to identify all ED visits in which the patient received a primary anxiety diagnosis or declared anxiety as the reason for the visit (N=1,029). Patient characteristics, treatment provided, and dispositions of these nationally representative visits were assessed...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Chris Kaposy, Nicole R Greenspan, Zack Marshall, Jill Allison, Shelley Marshall, Cynthia Kitson
Antiretroviral therapy for HIV can be expensive if paid for out of pocket. In Canada, there are a variety of federal, provincial, and private prescription drug plans that lower the cost of these lifesaving medications for people living with HIV, and in some cases, these plans result in cost-free access. However, many people living with HIV must contend with high deductibles for their antiretroviral therapies, and many experience difficulty managing the administrative requirements of their drug plans. This article comments on some of the results of a qualitative study into ethical issues in HIV care...
October 15, 2016: Healthcare Management Forum
Ernesto Zecca, Cinzia Brunelli, Paola Bracchi, Giuseppe Biancofiore, Carlo De Sangro, Roberto Bortolussi, Luigi Montanari, Marco Maltoni, Cecilia Moro, Ugo Colonna, Gabriele Finco, Maria Teresa Roy, Vittorio Ferrari, Oscar Alabiso, Giovanni Rosti, Stein Kaasa, Augusto Caraceni
: Context Oxycodone and morphine are recommended as first-choice opioids for moderate/severe cancer pain but evidence about their relative tolerability has significant methodological limitations. OBJECTIVES: This study is mainly aimed at comparing the risk of developing adverse events (AEs) with controlled release oral morphine versus oxycodone; secondary aims were comparing their analgesic efficacy and testing heterogeneity in tolerability across different age and renal function subgroups...
October 11, 2016: Journal of Pain and Symptom Management
Mireia Jané, Mª José Vidal, Mar Maresma, Ana Martínez, Gloria Carmona, Ana Rodés, Nuria Torner, Josep Álvarez, Maria-Rosa Sala, Irene Barrabeig
The Ebola outbreak in Guinea Conakry was notified to the World Health Organization (WHO) in March 2014. It is the most complex Ebola outbreak to date, affecting Guinea Conakry as well as the surrounding countries and with a risk of the disease spreading outside Africa. For this reason, the World Health Organization declared this Ebola outbreak an international public health emergency in August 2014. The Public Health Agency of Catalonia, through the Spanish Alert and Emergencies Coordination Network, initiated public health actions in March 2014, developing a single protocol of action to be applied by all the health care providers in the whole Catalan territory, advice for travellers and voluntary workers arriving from affected countries and a weekly newsletter addressed to health professionals...
October 11, 2016: Gaceta Sanitaria
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