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Global Emergency Care

Michelle A Wood-Trageser, Andrew J Lesniak, Anthony J Demetris
INTRODUCTION: Traditional histopathological allograft biopsy evaluation provides, within hours, diagnoses, prognostic information, and mechanistic insights into disease processes. However, proponents of an array of alternative monitoring platforms, broadly classified as "invasive" or "noninvasive" depending on whether allograft tissue is needed, question the value proposition of tissue histopathology. The authors explore the pros and cons of current analytical methods relative to the value of traditional and next generation histopathological evaluation of tissue biopsies...
February 6, 2019: Transplantation
Jonathan Braun Bsc, S David Gertz, Ariel Furer, Tarif Bader, Hagay Frenkel, Jacob Chen, Elon Glassberg, Dean Nachman
Unmanned aerial vehicles (UAV), commonly referred to as drones, have been made widely available in recent years leading to an exponential growth in their roles and applications. The rapidly developing field of medical drones is on the verge of revolutionizing pre-hospital medicine enabling advanced healthcare delivery to once-inaccessible patients. The aim of this review is to clarify the basic technical properties of currently available medical drones and review recent advances and their usefulness in military and civilian healthcare missions...
February 13, 2019: Journal of Trauma and Acute Care Surgery
Ruth Feldman, Katharina Braun, Frances A Champagne
In recent decades, human sociocultural changes have increased the numbers of fathers that are involved in direct caregiving in Western societies. This trend has led to a resurgence of interest in understanding the mechanisms and effects of paternal care. Across the animal kingdom, paternal caregiving has been found to be a highly malleable phenomenon, presenting with great variability among and within species. The emergence of paternal behaviour in a male animal has been shown to be accompanied by substantial neural plasticity and to be shaped by previous and current caregiving experiences, maternal and infant stimuli and ecological conditions...
February 13, 2019: Nature Reviews. Neuroscience
Emma Radbron, Valerie Wilson, Tanya McCance, Rebekkah Middleton
BACKGROUND: The global acceptance and use of technology in health care has resulted in an abundance of mobile health (mHealth) applications (apps) available for use in the delivery and improvement of care. With so many apps available to patients and clinicians, it is important to understand how data from apps are being used to inform quality improvement in practice. AIM: The aim of this integrative review is to establish current knowledge of how mHealth apps are used to produce data to inform quality improvement in health care...
February 2019: Worldviews on Evidence-based Nursing
Kelly Thompson, Balasubramanian Venkatesh, Simon Finfer
Sepsis, defined as life-threatening organ dysfunction due to a dysregulated host response to infection, is recognised by the World Health Organization as a global health priority. Each year, 5000 of the 18 000 adults with sepsis treated in Australian intensive care units die, with survivors suffering long-term physical, cognitive and psychological dysfunction, which is poorly recognised and frequently untreated. There are currently no effective pharmacological treatments for sepsis, making early recognition, resuscitation and immediate treatment with appropriate antibiotics the key to reducing the burden of resulting disease...
February 2019: Internal Medicine Journal
Rachel Jeitziner, Mathieu Carrière, Jacques Rougemont, Steve Oudot, Kathryn Hess, Cathrin Brisken
Motivation: Unbiased clustering methods are needed to analyze growing numbers of complex data sets. Currently available clustering methods often depend on parameters that are set by the user, they lack stability, and are not applicable to small data sets. To overcome these shortcomings we used topological data analysis, an emerging field of mathematics that can discerns additional feature and discover hidden insights on data sets and has a wide application range. Results: We have developed a topology-based clustering method called Two-Tier Mapper (TTMap) for enhanced analysis of global gene expression datasets...
February 7, 2019: Bioinformatics
Theun de Groot, Anuradha Chowdhary, Jacques F Meis, Andreas Voss
BACKGROUND: Candida auris is a globally emerging yeast, causing severe infections in patients with underlying diseases. This yeast is responsible for several outbreaks within healthcare facilities, where it can be found on hospital surfaces and patient care devices. Spread from these fomites may be prevented by improving the decontamination of hospital surfaces. UV-C decontamination may constitute an effective adjunct to routine room cleaning. OBJECTIVES: Our aim was to investigate the effect of different UV-C exposure times and distance in killing C...
February 12, 2019: Mycoses
Harel Gilutz, Sevatlana Shindel, Ilana Shoham-Vardi
BACKGROUND: Adherence to guidelines for the initial treatment of ST-Segment Elevation Myocardial Infarction has been thoroughly studied, whereas the study of emergency department (ED) adherence to guidelines for Non-ST-Segment Elevation Myocardial Infarction-Acute Coronary Syndrome (NSTEMI-ACS) has been much scarcer. The recommended guidelines for the initial prompt workup and treatment of NSTEMI-ACS remains a challenge. AIM: We studied adherence to guidelines for NSTEMI in the ED...
March 2019: Critical Pathways in Cardiology
Ahmed Ben Abdelaziz, Asma Ben Abdelaziz, Chokri Zoghlami, Mohamed Khelil, Tarek Barhoumi, Sami Ben Abdelfattah, Kamel Ben Salem
CONTEXT: Following the Tunisian revolution of 2010/2011, a new Public Health literature emerged, by the ministerial departments as well as the civil society, which was marked by the transparency and the comprehensiveness of the approach. OBJECTIVE: To identify the key ideas of the new Tunisian Public Health discourse, reconciling the principles of a globalizing paradigm with the health problems of a country in transition. METHODS: During this qualitative research, a selected series of three Tunisian reports of Public Health, published in the first quinquennium of the revolution, was read by an independent team of experts in Public Health, not having contributed to their elaboration, to identify the consensual foundations of the new Public Health discourse...
October 2018: La Tunisie Médicale
Brittany M Stopa, Stefano Amoroso, Luca Ronfani, Elena Neri, Egidio Barbi, Lois K Lee
BACKGROUND: Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital. METHODS: We conducted a retrospective chart review of children 0-18 years old presenting after minor head trauma (Glasgow Coma Scale 14-15) from two emergency departments, in Boston, Massachusetts, United States and Trieste, Italy, between January and December 2013. Frequencies of demographic, clinical, and management characteristic were calculated...
February 11, 2019: Italian Journal of Pediatrics
Janet V Diaz, Elisabeth D Riviello, Alfred Papali, Neill K J Adhikari, Juliana C Ferreira
Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions...
January 22, 2019: Annals of Global Health
Shumneva Shrestha, Randhir Sagar Yadav, Satish Kumar Deo
Rational use of drugs has immense impact on quality health care. Developing nations have 80% essential drug list prescription. Even though WHO estimates 15-25% antibiotics prescription in these regions, majority of Nepalese patients are prescribed more than one antibiotic in addition to inappropriate prescription in 10%-42% patients.Moreover, Nepal stands as a leading antibiotics prescribing Asian nation. Escalating irrational prescription and excessive over the counter use of antibiotics at peripheral regions of Nepal is possibly leading the emergence of multidrug resistant bacteria...
January 28, 2019: Journal of Nepal Health Research Council
Francisco Rogerlândio Martins-Melo, Mariângela Carneiro, Antonio Luiz Pinho Ribeiro, Juliana Maria Trindade Bezerra, Guilherme Loureiro Werneck
Chagas disease continues to be an important cause of morbidity, mortality and disability in several Latin American countries including Brazil. Using findings from the Global Burden of Disease Study 2016 (GBD 2016), we present years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) due to Chagas disease in Brazil, by sex, age group, and Brazilian states, from 1990 to 2016. Results are reported in absolute numbers and age-standardized rates (per 100,000 population) with 95% uncertainty intervals (UIs)...
February 7, 2019: International Journal for Parasitology
Charles Mock
There is a large and unacceptable burden of death and disability from conditions that are treatable by surgery. Several global efforts to address this burden have included the World Health Assembly resolution (WHA68.15) on emergency and essential surgical care, the Lancet Commission on Global Surgery, and the Disease Control Priorities project. On a country level, progress can be made in almost any location by taking a logical approach that includes defining the most costeffective surgical interventions that can and should be made available to anyone in a given country, identifying and addressing the barriers to such care that often include finding ways to address financial barriers, and developing monitoring mechanisms to ensure that access to quality care is indeed being achieved...
February 2019: JPMA. the Journal of the Pakistan Medical Association
Nahid Bhadelia, Lauren Sauer, Theodore J Cieslak, Richard T Davey, Susan McLellan, Timothy M Uyeki, Mark G Kortepeter
Emerging and re-emerging infectious diseases pose growing global public health threats. However, research on and development of medical countermeasures (MCMs) for such pathogens is limited by the sporadic and unpredictable nature of outbreaks, lack of financial incentive for pharmaceutical companies to develop interventions for many of the diseases, lack of clinical research capacity in areas where these diseases are endemic, and the ethical dilemmas related to conducting scientific research in humanitarian emergencies...
February 6, 2019: Health Security
Mohit Butaney, Nannan Thirumavalavan, Dayron Rodriguez, Martin S Gross, Ricardo Munarriz
Penile shunting is the standard of care in management of ischemic priapism refractory (IPR) to non-surgical interventions. Due to high rates of impotence, corporal fibrosis, and loss of penile length, recent literature suggests these patients benefit from immediate penile prosthesis (PP) placement. An IRB-exempt anonymous electronic survey of the 2168 members of the International Society for Sexual Medicine (ISSM) was conducted. The survey included demographic information, confidence, and experience-related management of IPR...
February 4, 2019: International Journal of Impotence Research
Eleanor R Bull, Joanne K Hart, Juliette Swift, Kirstie Baxter, Neil McLauchlan, Sophia Joseph, Lucie M T Byrne-Davis
BACKGROUND: Health and social care organisations globally are moving towards prevention-focussed community-based, integrated care. The success of this depends on professionals changing practice behaviours. This study explored the feasibility of applying a behavioural science approach to help staff teams from health organisations overcome psychological barriers to change and implement new models of care. METHODS: An Organisational Participatory Research study was conducted with health organisations from North West England, health psychologists and health workforce education commissioners...
February 4, 2019: BMC Health Services Research
A O Mocumbi, D C Langa, S Chicumbe, A E Schumacher, W K Al-Delaimy
BACKGROUND: As Mozambique faces a double burden of diseases, with a rise of Non Communicable Diseases (NCD) superimposed to uncontrolled communicable diseases (CD), routine disease surveillance system does not include NCD. The objectives of our study were to i) upgrade of the current surveillance system by adapting the data collection tools to NCD; ii) describe the occurrence and profile of selected NCD using these data collection tools. METHODS: Workshops were implemented in a first referral urban hospital of Mozambique to train clinical staff, administrative workers and nurses on NCD surveillance, as well as select conditions to be prioritized...
February 4, 2019: BMC Public Health
Olufemi O Desalu, Adeniyi O Aladesanmi, Olutobi B Ojuawo, Christopher M Opeyemi, Rasheedah M Ibraheem, Zakari A Suleiman, Olanrewaju O Oyedepo, Kikelomo T Adesina, Taofeek Oloyede, Emmanuel O Sanya
BACKGROUND: Prescription and administration of oxygen in emergencies by healthcare providers are reported to be inappropriate in most settings. There is a huge gap in the knowledge of health care providers on various aspects of oxygen therapy, and this may be a barrier to optimal oxygen administration. Hence, it is essential to ascertain providers' knowledge of acute oxygen therapy so that appropriate educational interventions are instituted for better delivery. There is no available validated instrument to assess knowledge of acute oxygen therapy...
2019: PloS One
John P Hays, Konstantinos Mitsakakis, Saturnino Luz, Alex van Belkum, Karsten Becker, Ann van den Bruel, Stephan Harbarth, John H Rex, Gunnar Skov Simonsen, Guido Werner, Valentina Di Gregori, Gerd Lüdke, Tjeerd van Staa, Jacob Moran-Gilad, Till T Bachmann
The emergence and spread of antimicrobial resistance is one of the major global issues currently threatening the health and wealth of nations, with effective guidelines and intervention strategies urgently required. Such guidelines and interventions should ideally be targeted at individuals, communities, and nations, requiring international coordination for maximum effect. In this respect, the European Joint Programming Initiative on Antimicrobial Resistance Transnational Working Group 'Antimicrobial Resistance - Rapid Diagnostic Tests' (JPIAMR AMR-RDT) is proposing to consider a 'mix-and-match' package for the implementation of point-of-care testing (PoCT), which is described in this publication...
February 2, 2019: European Journal of Clinical Microbiology & Infectious Diseases
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