Sample records for web-based emergency medical

  1. Nip, tuck and click: medical tourism and the emergence of web-based health information. (United States)

    Lunt, Neil; Hardey, Mariann; Mannion, Russell


    An emerging trend is what has become commonly known as 'Medical Tourism' where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions.This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making.This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework.

  2. Nip, Tuck and Click: Medical Tourism and the Emergence of Web-Based Health Information (United States)

    Lunt, Neil; Hardey, Mariann; Mannion, Russell


    An emerging trend is what has become commonly known as ‘Medical Tourism’ where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions. This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making. This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework. PMID:20517465

  3. Web-based training on weapons of mass destruction response for emergency medical services personnel. (United States)

    Gershon, Robyn R M; Canton, Allison N; Magda, Lori A; DiMaggio, Charles; Gonzalez, Dario; Dul, Mitchell W


    To develop, implement, and assess a web-based simulation training program for emergency medical services (EMS) personnel on recognition and treatment of ocular injuries resulting from weapons of mass destruction (WMD) attacks. The training program consisted of six modules: WMD knowledge and event detection, ocular anatomy, ocular first aid (ie, flushing, cupping, and patching), and three WMD simulations (ie, sarin gas release, anthrax release, and radioactive dispersal device). Pretest, post-test, and 1-month follow-up test and a program evaluation were used to measure knowledge gain and retention and to assess the effectiveness of the program. New York State EMS. Four hundred and sixty-four individuals participated in the training program and all waves of the testing (86 percent retention rate). The effectiveness of the training intervention was measured using pretest and post-test questionnaires and analyzed using dependent t-tests. Assessment scores for overall knowledge increased from the pretest (mean = 15.7, standard deviation [SD] = 2.1) to the post-test (mean = 17.8, SD = 1.3), p < 0.001, and from pretest (mean = 15.7, SD = 2.1) to 1-month follow-up test (mean = 16.6, SD = 2.0), p < 0.001. Ninety-two percent of respondents indicated that the program reinforced understanding of WMDs. This training method provides an effective and low-cost approach to educate and evaluate EMS personnel on emergency treatment of eye trauma associated with the use of WMD. Online training should also be supplemented with hands-on practice and refresher trainings.

  4. Comparison of emergency medical services systems across Pan-Asian countries: a Web-based survey. (United States)

    Shin, Sang Do; Ong, Marcus Eng Hock; Tanaka, Hideharu; Ma, Matthew Huei-Ming; Nishiuchi, Tatsuya; Alsakaf, Omer; Karim, Sarah Abdul; Khunkhlai, Nalinas; Lin, Chih-Hao; Song, Kyoung Jun; Ryoo, Hyun Wook; Ryu, Hyun Ho; Tham, Lai Peng; Cone, David C


    There are great variations in out-of-hospital cardiac arrest (OHCA) survival outcomes among different countries and different emergency medical services (EMS) systems. The impact of different systems and their contribution to enhanced survival are poorly understood. This paper compares the EMS systems of several Asian sites making up the Pan-Asian Resuscitation Outcomes Study (PAROS) network. Some preliminary cardiac arrest outcomes are also reported. This is a cross-sectional descriptive survey study addressing population demographics, service levels, provider characteristics, system operations, budget and finance, medical direction (leadership), and oversight. Most of the systems are single-tiered. Fire-based EMS systems are predominant. Bangkok and Kuala Lumpur have hospital-based systems. Service level is relatively low, from basic to intermediate in most of the communities. Korea, Japan, Singapore, and Bangkok have intermediate emergency medical technician (EMT) service levels, while Taiwan and Dubai have paramedic service levels. Medical direction and oversight have not been systemically established, except in some communities. Systems are mostly dependent on public funding. We found variations in available resources in terms of ambulances and providers. The number of ambulances is 0.3 to 3.2 per 100,000 population, and most ambulances are basic life support (BLS) vehicles. The number of human resources ranges from 4.0 per 100,000 population in Singapore to 55.7 per 100,000 population in Taipei. Average response times vary between 5.1 minutes (Tainan) and 22.5 minutes (Kuala Lumpur). We found substantial variation in 11 communities across the PAROS EMS systems. This study will provide the foundation for understanding subsequent studies arising from the PAROS effort.

  5. Web-Based Medical Appointment Systems: A Systematic Review. (United States)

    Zhao, Peng; Yoo, Illhoi; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo


    Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients' reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies.

  6. Text mining of web-based medical content

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    Neustein, Amy


    Text Mining of Web-Based Medical Content examines web mining for extracting useful information that can be used for treating and monitoring the healthcare of patients. This work provides methodological approaches to designing mapping tools that exploit data found in social media postings. Specific linguistic features of medical postings are analyzed vis-a-vis available data extraction tools for culling useful information.

  7. Emergency department orientation utilizing web-based streaming video. (United States)

    Mahadevan, Swaminatha V; Gisondi, Michael A; Sovndal, Shannon S; Gilbert, Gregory H


    To assure a smooth transition to their new work environment, rotating students and housestaff require detailed orientations to the physical layout and operations of the emergency department. Although such orientations are useful for new staff members, they represent a significant time commitment for the faculty members charged with this task. To address this issue, the authors developed a series of short instructional videos that provide a comprehensive and consistent method of emergency department orientation. The videos are viewed through Web-based streaming technology that allows learners to complete the orientation process from any computer with Internet access before their first shift. This report describes the stepwise process used to produce these videos and discusses the potential benefits of converting to an Internet-based orientation system.

  8. [Web-based support system for medical device maintenance]. (United States)

    Zhao, Jinhai; Hou, Wensheng; Chen, Haiyan; Tang, Wei; Wang, Yihui


    A Web-based technology system was put forward aiming at the actual problems of the long maintenance cycle and the difficulties of the maintenance and repairing of medical equipments. Based on analysis of platform system structure and function, using the key technologies such as search engine, BBS, knowledge base and etc, a platform for medical equipment service technician to use by online or offline was designed. The platform provides users with knowledge services and interactive services, enabling users to get a more ideal solution.

  9. Web-based medical facilitators in medical tourism: the third party in decision-making. (United States)

    Wagle, Suchitra


    The emergence of web-based medical tourism facilitators (MTFs) has added a new dimension to the phenomenon of cross-border travel. These facilitators are crucial connectors between foreign patients and host countries. They help patients navigate countries, doctors and specialties. However, little attention has been paid to the authenticity of information displayed on the facilitators' web portals, and whether they follow ethical guidelines and standards. This paper analyses the available information on MTF portals from an ethics perspective. It compares 208 facilitators across 47 countries for the services offered. Data were collected from the databases of the Medical Tourism Association and World Medical Resources. India was the most common destination country linked to 81 facilitators. The five countries with the maximum number of facilitators were the USA, the UK, India, Canada and Poland. This paper identifies concerns regarding the information displayed about patients' safety, and the maintenance of confidentiality. There is a need to develop ethical standards for this field.

  10. Web-based learning for continuing nursing education of emergency unit staff. (United States)

    Paavilainen, Eija; Salminen-Tuomaala, Mari


    The authors describe a Web-based continuing education course focusing on patient counseling in an emergency department. Course materials were developed based on data collected from the department's patients and their family members and on earlier findings on counseling. Web-based education is an appropriate method for continuing education in a specific hospital department. This puts special demands for nurse managers in arranging, designing, and implementing the education together with educators.



    Alexander Nikov; Tramaine Alaina Gumaia


    Emotional User Experience Design (eUXD) has become increasingly important for web-based services. The primary objective of this study is to enable users to use websites that are easy to understand and operate and pleasing to use. A checklist tool for an emotional user experience (eUX) assessment that supports web-based medical services is proposed. This tool measures user moods while using medical services’ websites. The tool allocates emotive design-oriented problems and thus defines relevan...

  12. Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention. (United States)

    Wang, Shan Huei


    Web-based medical service (WBMS), a cooperative relationship between medical service and Internet technology, has been called one of the most innovative services of the 21st century. However, its business promotion and implementation in the medical industry have neither been expected nor executed. Few studies have explored this phenomenon from the viewpoint of inexperienced patients. The primary goal of this study was to explore whether technology attractiveness, medical creditability, and diversified medical information sources could increase users' behavior intention. This study explored the effectiveness of web-based medical service by using three situations to manipulate sources of medical information. A total of 150 questionnaires were collected from people who had never used WBMS before. Hierarchical regression was used to examine the mediation and moderated-mediation effects. Perceived ease of use (P=.002) and perceived usefulness (P=.001) significantly enhance behavior intentions. Medical credibility is a mediator (P=.03), but the relationship does not significantly differ under diverse manipulative information channels (P=.39). Medical credibility could explain the extra variation between technology attractiveness and behavior intention, but not significant under different moderating effect of medical information sources.

  13. Web-Based Versus Conventional Training for Medical Students on Infant Gross Motor Screening. (United States)

    Pusponegoro, Hardiono D; Soebadi, Amanda; Surya, Raymond


    Early detection of developmental abnormalities is important for early intervention. A simple screening method is needed for use by general practitioners, as is an effective and efficient training method. This study aims to evaluate the effectiveness, acceptability, and usability of Web-based training for medical students on a simple gross motor screening method in infants. Fifth-year medical students at University of Indonesia in Jakarta were randomized into two groups. A Web-based training group received online video modules, discussions, and assessments (at ). A conventional training group received a 1-day live training using the same module. Both groups completed identical pre- and posttests and the User Satisfaction Questionnaire (USQ). The Web-based group also completed the System Usability Scale (SUS). The module was based on a gross motor screening method used in the World Health Organization Multicentre Growth Reference Study. There were 39 and 32 subjects in the Web-based and conventional groups, respectively. Mean pretest versus posttest scores (correct answers out of 20) were 9.05 versus 16.95 (p=0.0001) in the Web-based group and 9.31 versus 16.88 (p=0.0001) in the conventional group. Mean difference between pre- and posttest scores did not differ significantly between the Web-based and conventional groups (mean [standard deviation], 7.56 [3.252] versus 7.90 [5.170]; p=0.741]. Both training methods were acceptable based on USQ scores. Based on SUS scores, the Web-based training had good usability. Web-based training is an effective, efficient, and acceptable training method for medical students on simple infant gross motor screening and is as effective as conventional training.

  14. A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk. (United States)

    Franchi, Daniele; Cini, Davide; Iervasi, Giorgio


    Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient's data collection represents a critical issue. A new multipurpose computer-based program has been developed in order to:1) easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2) to design a web-based computerized tool for prospective collection of structured data; 3) to support the doctor in the decision-making process for patients at risk according to recent international guidelines. During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient's data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient's goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report. In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [±SD]) the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values. The web-based system proposed here may represent a feasible and flexible tool for clinical management of patients at risk of cardiovascular disease and for epidemiological research.

  15. The use of sleep aids among Emergency Medicine residents: a web based survey

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    Raja Ali


    Full Text Available Abstract Background Sleepiness is a significant problem among residents due to chronic sleep deprivation. Recent studies have highlighted medical errors due to resident sleep deprivation. We hypothesized residents routinely use pharmacologic sleep aids to manage their sleep deprivation and reduce sleepiness. Methods A web-based survey of US allopathic Emergency Medicine (EM residents was conducted during September 2004. All EM residency program directors were asked to invite their residents to participate. E-mail with reminders was used to solicit participation. Direct questions about use of alcohol and medications to facilitate sleep, and questions requesting details of sleep aids were included. Results Of 3,971 EM residents, 602 (16% replied to the survey. Respondents were 71% male, 78% white, and mean (SD age was 30 (4 years, which is similar to the entire EM resident population reported by the ACGME. There were 32% 1st year, 32% 2nd year, 28% 3rd year, and 8% 4th year residents. The Epworth Sleepiness Scale (ESS showed 38% of residents were excessively sleepy (ESS 11–16 and 7% were severely sleepy (ESS>16. 46% (95 CI 42%–50% regularly used alcohol, antihistamines, sleep adjuncts, benzodiazepines, or muscle relaxants to help them fall or stay asleep. Study limitations include low response and self-report. Conclusion Even with a low response rate, sleep aid use among EM residents may be common. How this affects performance, well-being, and health remains unknown.

  16. Association Between Acute Medical Exacerbations and Consuming or Producing Web-Based Health Information: Analysis From Pew Survey Data. (United States)

    Gidwani, Risha; Zulman, Donna


    The Internet is an increasingly important resource for individuals who seek information from both health professionals and peers. While the demographic and health characteristics of persons who use health information technology has been well described, less is known about the relationship between these health characteristics and level of engagement with health information technology. Even less is known about whether persons who produce Web-based health information differ in health status from persons who consume such content. We explored the health characteristics of persons who engage with the Internet for the purposes of consuming or producing Web-based health information, and specifically, whether healthier versus sicker persons engage with health information technology in different ways. We analyzed data from the 2012 Pew Health survey, a landline and cell phone survey of 3104 adults in the United States. Using multiple logistic regression with sampling weights, we examined the association between sociodemographic and health characteristics and the consumption or production of Web-based health information. Sociodemographic variables included age, sex, race, and education. Health characteristics included self-reported health status, presence of chronic condition(s), and having an acute medical exacerbation. Acute medical exacerbations were defined as an emergency department visit, hospitalization, or other serious medical emergency in the last 12 months. The majority of the sample reported good or excellent health (79.7%), although 50.3% reported having at least one chronic condition. About a fifth (20.2%) of the sample experienced an acute medical exacerbation in the past year. Education was the sociodemographic characteristic most strongly associated with consuming Web-based health information. The strongest health-related predictors of consuming Web-based health information were an acute medical exacerbation (OR 2.39, Pcontent of peer-generated Web-based

  17. Utilization of Web-Based Resources for Medical Research and ...

    African Journals Online (AJOL)

    Questionnaires were administered to the health professionals in various departments in the Hospital. The results showed a low level of use in spite of high awareness level. This was due inter-alia, to lack of information technology skills, fluctuation of electricity, non-access to useful medical information internet addresses.

  18. A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk

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    Daniele Franchi


    Full Text Available Daniele Franchi1,2, Davide Cini1, Giorgio Iervasi11Istituto di Fisiologia Clinica, CNR, Pisa, Italy; 2Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, ItalyBackground: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient's data collection represents a critical issue.Design: A new multipurpose computer-based program has been developed in order to:1 easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2 to design a web-based computerized tool for prospective collection of structured data; 3 to support the doctor in the decision-making process for patients at risk according to recent international guidelines.Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient's data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient's goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report.Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [± SD] the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values.Conclusion: The web-based system proposed here may represent a feasible and

  19. Development and implementation of a web-based continuing professional development (CPD) programme on medical genetics. (United States)

    Kulatunga, Gumindu G A K; Marasinghe, Rohana B; Karunathilake, Indika M; Dissanayake, Vajira H W


    We developed, implemented and evaluated a web-based continuing professional development (CPD) programme on medical genetics. Development of the CPD programme followed the ADDIE model, i.e. Analysis, Design, Develop, Implement and Evaluation. An invitation to participate in a needs analysis survey was sent to all doctors on the email list of the Sri Lanka Medical Association. A total of 129 completed surveys was received (57% of the 228 who accessed the online survey). The average age of respondents was 42 years (range 27-81). The male: female ratio was approximately 2 : 1. Almost all respondents (96%) selected web-based CPD programmes, or web-based and conventional lectures, as their preferred method of learning. The programme was piloted on a group of 10 doctors. The average pre-knowledge score was 40.3 and the post-knowledge score was 62.1 marks out of 100 (P = 0.002). We conclude that a web-based CPD programme on medical genetics is feasible in Sri Lanka.

  20. Informing web-based communication curricula in veterinary education: a systematic review of web-based methods used for teaching and assessing clinical communication in medical education. (United States)

    Artemiou, Elpida; Adams, Cindy L; Toews, Lorraine; Violato, Claudio; Coe, Jason B


    We determined the Web-based configurations that are applied to teach medical and veterinary communication skills, evaluated their effectiveness, and suggested future educational directions for Web-based communication teaching in veterinary education. We performed a systematic search of CAB Abstracts, MEDLINE, Scopus, and ERIC limited to articles published in English between 2000 and 2012. The review focused on medical or veterinary undergraduate to clinical- or residency-level students. We selected studies for which the study population was randomized to the Web-based learning (WBL) intervention with a post-test comparison with another WBL or non-WBL method and that reported at least one empirical outcome. Two independent reviewers completed relevancy screening, data extraction, and synthesis of results using Kirkpatrick and Kirkpatrick's framework. The search retrieved 1,583 articles, and 10 met the final inclusion criteria. We identified no published articles on Web based communication platforms in veterinary medicine; however, publications summarized from human medicine demonstrated that WBL provides a potentially reliable and valid approach for teaching and assessing communication skills. Student feedback on the use of virtual patients for teaching clinical communication skills has been positive,though evidence has suggested that practice with virtual patients prompted lower relation-building responses.Empirical outcomes indicate that WBL is a viable method for expanding the approach to teaching history taking and possibly to additional tasks of the veterinary medical interview.

  1. A web-based solution for 3D medical image visualization (United States)

    Hou, Xiaoshuai; Sun, Jianyong; Zhang, Jianguo


    In this presentation, we present a web-based 3D medical image visualization solution which enables interactive large medical image data processing and visualization over the web platform. To improve the efficiency of our solution, we adopt GPU accelerated techniques to process images on the server side while rapidly transferring images to the HTML5 supported web browser on the client side. Compared to traditional local visualization solution, our solution doesn't require the users to install extra software or download the whole volume dataset from PACS server. By designing this web-based solution, it is feasible for users to access the 3D medical image visualization service wherever the internet is available.

  2. Can medical students from two cultures learn effectively from a shared web-based learning environment? (United States)

    Evans, Phillip; Suzuki, Yasuyuki; Begg, Michael; Lam, Wayne


    This study aimed to establish whether medical students from 2 different cultures can learn effectively from a shared web-based learning environment. Students from the College of Medicine, Edinburgh, UK and the Medical School, Gifu, Japan shared 2 weeks of teaching and learning in clinical genetics, using problem-based learning in a web-based application (WBA). Questions about language, time zone, agreement about the curriculum (learning outcomes, tutor activity and assessment) and specific pedagogical issues about the educational effectiveness of students' learning were considered. The evidence indicates that a shared WBA is practical where the learning outcomes and problem scenarios are common and students are fluent in the same language. Problem-based learning transfers itself best to online discussion boards when the numbers in the group are 16 or more. Students do not use the WBA as a primary source of resource material, and they augment the discussion boards with face-to-face meetings with peers and tutors.

  3. Face and content validity of a novel, web-based otoscopy simulator for medical education


    Wickens, Brandon; Lewis, Jordan; Morris, David P; Husein, Murad; Ladak, Hanif M; Agrawal, Sumit K


    Background Despite the fact that otoscopy is a widely used and taught diagnostic tool during medical training, errors in diagnosis are common. Physical otoscopy simulators have high fidelity, but they can be expensive and only a limited number of students can use them at a given time. Objectives 1) To develop a purely web-based otoscopy simulator that can easily be distributed to students over the internet. 2) To assess face and content validity of the simulator by surveying experts in otosco...

  4. A Framework for Web-Based Interprofessional Education for Midwifery and Medical Students. (United States)

    Reis, Pamela J; Faser, Karl; Davis, Marquietta


    Scheduling interprofessional team-based activities for health sciences students who are geographically dispersed, with divergent and often competing schedules, can be challenging. The use of Web-based technologies such as 3-dimensional (3D) virtual learning environments in interprofessional education is a relatively new phenomenon, which offers promise in helping students come together in online teams when face-to-face encounters are not possible. The purpose of this article is to present the experience of a nurse-midwifery education program in a Southeastern US university in delivering Web-based interprofessional education for nurse-midwifery and third-year medical students utilizing the Virtual Community Clinic Learning Environment (VCCLE). The VCCLE is a 3D, Web-based, asynchronous, immersive clinic environment into which students enter to meet and interact with instructor-controlled virtual patient and virtual preceptor avatars and then move through a classic diagnostic sequence in arriving at a plan of care for women throughout the lifespan. By participating in the problem-based management of virtual patients within the VCCLE, students learn both clinical competencies and competencies for interprofessional collaborative practice, as described by the Interprofessional Education Collaborative Core Competencies for Interprofessional Collaborative Practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

  5. RayPlus: a Web-Based Platform for Medical Image Processing. (United States)

    Yuan, Rong; Luo, Ming; Sun, Zhi; Shi, Shuyue; Xiao, Peng; Xie, Qingguo


    Medical image can provide valuable information for preclinical research, clinical diagnosis, and treatment. As the widespread use of digital medical imaging, many researchers are currently developing medical image processing algorithms and systems in order to accommodate a better result to clinical community, including accurate clinical parameters or processed images from the original images. In this paper, we propose a web-based platform to present and process medical images. By using Internet and novel database technologies, authorized users can easily access to medical images and facilitate their workflows of processing with server-side powerful computing performance without any installation. We implement a series of algorithms of image processing and visualization in the initial version of Rayplus. Integration of our system allows much flexibility and convenience for both research and clinical communities.

  6. Prototype Web-based continuing medical education using FlashPix images. (United States)

    Landman, A; Yagi, Y; Gilbertson, J; Dawson, R; Marchevsky, A; Becich, M J


    Continuing Medical Education (CME) is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Previous research has harnessed the Web to disseminate complete pathology CME case studies including history, images, diagnoses, and discussions to the medical community. Users submit real-time diagnoses and receive instantaneous feedback, eliminating the need for hard copies of case material and case evaluation forms. This project extends the Web-based CME paradigm with the incorporation of multi-resolution FlashPix images and an intuitive, interactive user interface. The FlashPix file format combines a high-resolution version of an image with a hierarchy of several lower resolution copies, providing real-time magnification via a single image file. The Web interface was designed specifically to simulate microscopic analysis, using the latest Javascript, Java and Common Gateway Interface tools. As the project progresses to the evaluation stage, it is hoped that this active learning format will provide a practical and efficacious environment for continuing medical education with additional application potential in classroom demonstrations, proficiency testing, and telepathology. Using Microsoft Internet Explorer 4.0 and above, the working prototype Web-based CME environment is accessible at

  7. Face and content validity of a novel, web-based otoscopy simulator for medical education. (United States)

    Wickens, Brandon; Lewis, Jordan; Morris, David P; Husein, Murad; Ladak, Hanif M; Agrawal, Sumit K


    Despite the fact that otoscopy is a widely used and taught diagnostic tool during medical training, errors in diagnosis are common. Physical otoscopy simulators have high fidelity, but they can be expensive and only a limited number of students can use them at a given time. 1) To develop a purely web-based otoscopy simulator that can easily be distributed to students over the internet. 2) To assess face and content validity of the simulator by surveying experts in otoscopy. An otoscopy simulator, OtoTrain™, was developed at Western University using web-based programming and Unity 3D. Eleven experts from academic institutions in North America were recruited to test the simulator and respond to an online questionnaire. A 7-point Likert scale was used to answer questions related to face validity (realism of the simulator), content validity (expert evaluation of subject matter and test items), and applicability to medical training. The mean responses for the face validity, content validity, and applicability to medical training portions of the questionnaire were all ≤3, falling between the "Agree", "Mostly Agree", and "Strongly Agree" categories. The responses suggest good face and content validity of the simulator. Open-ended questions revealed that the primary drawbacks of the simulator were the lack of a haptic arm for force feedback, a need for increased focus on pneumatic otoscopy, and few rare disorders shown on otoscopy. OtoTrain™ is a novel, web-based otoscopy simulator that can be easily distributed and used by students on a variety of platforms. Initial face and content validity was encouraging, and a skills transference study is planned following further modifications and improvements to the simulator.

  8. 3D web based learning of medical equipment employed in intensive care units. (United States)

    Cetin, Aydın


    In this paper, both synchronous and asynchronous web based learning of 3D medical equipment models used in hospital intensive care unit have been described over the moodle course management system. 3D medical equipment models were designed with 3ds Max 2008, then converted to ASE format and added interactivity displayed with Viewpoint-Enliven. 3D models embedded in a web page in html format with dynamic interactivity-rotating, panning and zooming by dragging a mouse over images-and descriptive information is embedded to 3D model by using xml format. A pilot test course having 15 h was applied to technicians who is responsible for intensive care unit at Medical Devices Repairing and Maintenance Center (TABOM) of Turkish High Specialized Hospital.

  9. Happiness Among College Students: A Cross-Sectional Web-Based Study Among Iranian Medical Students

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    Full Text Available Background During the recent decades, happiness and psychological wellbeing have been among the most attractive issues for researchers in the fields of social sciences and health. Medical and paramedical students in comparison with other college students are less happy due to work circumstance in hospital and special education. Objectives The aim of the present study was to evaluate happiness among college students of Qazvin University of Medical Sciences in terms of socio-demographic variables. Materials and Methods In this cross-sectional web-based study, all the students of Qazvin University of Medical Sciences in Iran who had course classes were invited to participate in the study and 541 students filled out the web-based questionnaire including questions for measuring happiness oxford happiness questionnaire (OHQ, health status, stress experience in the past six months, cigarette and hookah smoking, physical activity rapid assessment of physical activity (RAPA, as well as socio-economic and demographic information. Results The mean happiness score was 114.59 ± 18.31. Socio-economic status, physical activity, and experience of stress in the last 6 months were related to the happiness score (P = 0.009, P < 0.001, P < 0.001, respectively. However, gender, cigarette smoking, hookah smoking and body mass index were not significantly correlated with happiness. Conclusions The findings of the present study show that a happiness score among our sample study was slightly low and people with high happiness scores had a healthier lifestyle, i.e. more physical activity and less tobacco smoking. College students should be encouraged to do regular exercise as a way to increase the happiness level.

  10. Monitoring medication adherence in multiple sclerosis using a novel web-based tool: A pilot study. (United States)

    Settle, Jill R; Maloni, Heidi W; Bedra, McKenzie; Finkelstein, Joseph; Zhan, Min; Wallin, Mitchell T


    Monitoring medication adherence in multiple sclerosis (MS) can be time consuming and expensive; however, non-adherence is common and is very costly in terms of lost therapeutic benefit and unused medications. To address this problem, we employed a web-based system to monitor and potentially modify medication adherence. Participants (n = 30) were randomized either to routine care or to the MS Home Automated Telehealth (MS HAT) system. Weekly interferon beta-1a intramuscular (INFbeta-1a IM) injections and daily vitamin D adherence were tracked over a six-month period using multiple modalities: self-reported adherence, calendar diaries, pharmacy refill rates, blood serum levels, and MS HAT alerts. Weekly INFbeta-1a IM adherence was highly correlated across measures; however, vitamin D adherence was not as consistent. Healthcare providers were able to efficiently monitor adherence in a patient-centered way by using the MS HAT system to monitor adherence rather than employing chart reviews and phone calls. In addition, patients with more preserved cognitive function appeared to benefit more from use of the MS HAT system than those with cognitive impairment. While further research is needed to understand the differential effects of MS HAT on specific medications and for different individuals, it is a promising tool for monitoring medication adherence in patients with MS. © The Author(s) 2015.

  11. Information-Seeking Behaviors of Medical Students: A Cross-Sectional Web-Based Survey. (United States)

    O'Carroll, Aoife Marie; Westby, Erin Patricia; Dooley, Joseph; Gordon, Kevin E


    Medical students face an information-rich environment in which retrieval and appraisal strategies are increasingly important. To describe medical students' current pattern of health information resource use and characterize their experience of instruction on information search and appraisal. We conducted a cross-sectional web-based survey of students registered in the four-year MD Program at Dalhousie University (Halifax, Nova Scotia, and Saint John, New Brunswick, sites), Canada. We collected self-reported data on information-seeking behavior, instruction, and evaluation of resources in the context of their medical education. Data were analyzed using descriptive statistics. Surveys were returned by 213 of 462 eligible students (46.1%). Most respondents (165/204, 80.9%) recalled receiving formal instruction regarding information searches, but this seldom included nontraditional tools such as Google (23/107, 11.1%), Wikipedia, or social media. In their daily practice, however, they reported heavy use of these tools, as well as EBM summaries. Accessibility, understandability, and overall usefulness were common features of highly used resources. Students identified challenges managing information and/or resource overload and source accessibility. Medical students receive instruction primarily on searching and assessing primary medical literature. In their daily practice, however, they rely heavily on nontraditional tools as well as EBM summaries. Attention to appropriate use and appraisal of nontraditional sources might enhance the current EBM curriculum.

  12. Analysis of Documentation Speed Using Web-Based Medical Speech Recognition Technology: Randomized Controlled Trial. (United States)

    Vogel, Markus; Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan


    Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted

  13. Medication use in pregnancy: a cross-sectional, multinational web-based study (United States)

    Lupattelli, A; Spigset, O; Twigg, M J; Zagorodnikova, K; Mårdby, A C; Moretti, M E; Drozd, M; Panchaud, A; Hämeen-Anttila, K; Rieutord, A; Gjergja Juraski, R; Odalovic, M; Kennedy, D; Rudolf, G; Juch, H; Passier, A; Björnsdóttir, I; Nordeng, H


    Objectives Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants Pregnant women and new mothers with children less than 1 year of age. Primary and secondary outcome measures Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. Conclusions In this study, the majority of women in

  14. Content of web-based continuing medical education about HPV vaccination. (United States)

    Kornides, Melanie L; Garrell, Jacob M; Gilkey, Melissa B


    Addressing low HPV vaccination coverage will require U.S. health care providers to improve their recommendation practices and vaccine delivery systems. Because readily available continuing medical education (CME) could be an important tool for supporting providers in this process, we sought to assess the content of web-based CME activities related to HPV vaccination. We conducted a content analysis of web-based CME activities about HPV vaccination available to U.S. primary care providers in May-September 2016. Using search engines, educational clearinghouses, and our professional networks, we identified 15 activities eligible for study inclusion. Through a process of open coding, we identified 45 commonly occurring messages in the CME activities, which we organized into five topic areas: delivering recommendations for HPV vaccination, addressing common parent concerns, implementing office-based strategies to increase HPV vaccination coverage, HPV epidemiology, and guidelines for HPV vaccine administration and safety. Using a standardized abstraction form, two coders then independently assessed which of the 45 messages each CME activity included. CME activities varied in the amount of content they delivered, with inclusion of the 45 messages ranging from 17% to 86%. Across activities, the most commonly included messages were related to guidelines for HPV vaccine administration and safety. For example, all activities (100%) specified that routine administration is recommended for ages 11 and 12. Most activities (73%) also noted that provider recommendations are highly influential. Fewer activities modeled examples of effective recommendations (47%), gave specific approaches to addressing common parent concerns (47%), or included guidance on office-based strategies to increase coverage (40%). Given that many existing CME activities lack substantive content on how to change provider practice, future activities should focus on the practical application of interpersonal

  15. Development and implementation of an asynchronous emergency medicine residency curriculum using a web-based platform. (United States)

    Kornegay, Joshua G; Leone, Katrina A; Wallner, Clare; Hansen, Matthew; Yarris, Lalena M


    The Residency Review Committee in Emergency Medicine requires residency programs to deliver at least 5 hours of weekly didactics. Achieving at least a 70 % average attendance rate per resident is required for residency program accreditation, and is used as a benchmark for residency graduation in our program. We developed a web-based, asynchronous curriculum to replace 1 hour of synchronous didactics, and hypothesized that the curriculum would be feasible to implement, well received by learners, and improve conference participation. This paper describes the feasibility and learner acceptability of a longitudinal asynchronous curriculum, and describes its impact on postgraduate year-1(PGY-1) resident conference participation and annual in-training examination scores. Using formal curriculum design methods, we developed modules and paired assessment exercises to replace 1 hour of weekly didactics. We measured feasibility (development and implementation time and costs) and learner acceptability (measured on an anonymous survey). We compared pre- and post-intervention conference participation and in-service training examination scores using a two sample t test. The asynchronous curriculum proved feasible to develop and implement. PGY-1 resident conference participation improved compared to the pre-intervention year (85.6 vs. 62 %; 95 % CI 0.295-0.177; p curriculum changes. Strengths of the curriculum included clarity and timeliness of assignments. Weaknesses included technical difficulties with the online platform. Our curriculum is feasible to develop and implement. Despite technical difficulties, residents report high satisfaction with this new curriculum. Among PGY-1 residents there is improved conference participation compared to the prior year.

  16. Blinded randomized controlled study of a web-based otoscopy simulator in undergraduate medical education. (United States)

    Stepniak, Camilla; Wickens, Brandon; Husein, Murad; Paradis, Josee; Ladak, Hanif M; Fung, Kevin; Agrawal, Sumit K


    OtoTrain is a Web-based otoscopy simulator that has previously been shown to have face and content validity. The objective of this study was to evaluate the effectiveness of this Web-based otoscopy simulator in teaching diagnostic otoscopy to novice learners STUDY DESIGN: Prospective, blinded randomized control trial. Second-year medical students were invited to participate in the study. A pretest consisted of a series of otoscopy videos followed by an open-answer format assessment pertaining to the characteristics and diagnosis of each video. Participants were then randomly divided into a control group and a simulator group. Following the pretest, both groups attended standard otology lectures, but the simulator group was additionally given unlimited access to OtoTrain for 1 week. A post-test was completed using a separate set of otoscopy videos. Tests were graded based on a comprehensive marking scheme. The pretest and post-test were anonymized, and the three evaluators were blinded to student allotment. A total of 41 medical students were enrolled in the study and randomized to the control group (n = 20) and the simulator group (n = 21). There was no significant difference between the two groups on their pretest scores. With the standard otology lectures, the control group had a 31% improvement in their post-test score (mean ± standard error of the mean, 30.4 ± 1.5) compared with their pretest score (23.3 ± 1.8) (P simulator group had the addition of OtoTrain to the otology lectures, and their score improved by 71% on their post-test (37.8 ± 1.6) compared to their pretest (22.1 ± 1.9) (P simulator group had a 24% higher score than the control group (P < .002). Inter-rater reliability between the blinded evaluators was excellent (r = 0.953, P < .001). The use of OtoTrain increased the diagnostic otoscopic performance in novice learners. OtoTrain may be an effective teaching adjunct for undergraduate medical students. 1b. Laryngoscope, 127:1306-1311, 2017.

  17. Development and evaluation of an interactive Web-based breast imaging game for medical students. (United States)

    Roubidoux, Marilyn A; Chapman, Chris M; Piontek, Mary E


    The purpose of this study was to develop and evaluate by student survey an interactive computer tool for teaching breast imaging to 4th-year medical students. An interactive computer game was designed for competitive play between two students or between one student and one of two cyber players. Content was determined from a survey of faculty members in breast imaging, and the survey results were grouped into 10 learning objectives. Pre-existing knowledge of these objectives in 16 4th-year medical students was tested by a quiz. On the basis of the learning objectives, case scenarios and questions were incorporated into the game, which was programmed in JavaScript and available on a Web site. Preliminary and final versions of the game were used for teaching 55 4th-year medical students. A subgroup of 42 students received an informational handout. Student surveys were performed. Mean quiz score for pre-existing knowledge of the learning objectives was 45% (range, 13%-67%). Survey results showed that images contributed to educational value (92%), the Web site was more interesting to students than the handout (93.6%), and the Web site provided additional reinforcement of learning beyond that of the handout or lecture (88.8%). Students liked the Web site accessibility (96%), and more than 70% agreed the Web site was also appropriate for other medical specialties. An Internet search identified no other Web-based computer games for medical students. Students surveyed found the Web site to be worthwhile, convenient, and applicable to other specialties.

  18. A software framework for the development of Web-based medical education using learning object classes. (United States)

    Wu, Ting; Zimolong, Andreas; Schiffers, Norbert; Radermacher, Klaus


    A software framework for the development of Web-based medical education is proposed. The objective is to optimize the development process by introducing Learning Objects (LO) and Learning Object Classes (LO Classes) so that the content preparation can be separated from the educational issues, ergonomic design, and technical realization. Based on the concept of case-based, problem-oriented education, different learning scenarios were analysed and then modelled as different LOs. These LOs can be further abstracted in several reusable LO Classes that represent certain patterns of content structure, pedagogical concept, and user interface. With the help of LO input templates, the educational material can be prepared by the authors in the authoring process easily and appropriately. An LO content management system was developed to store and maintain different LOs and to generate the Web-presentation of LOs adaptively and dynamically in the tutoring process. This software framework has been applied to the exemplary development of an interactive course in orthopaedics. The LOs and LO Classes also help to maintain consistency of the course representation to users. As a result, more efficiency in the development phase and good usability and quality of the end products can be achieved.

  19. Evaluation of an interactive web-based nursing course with streaming videos for medication administration skills. (United States)

    Sowan, Azizeh K; Idhail, Jamila Abu


    Nursing students should exhibit competence in nursing skills in order to provide safe and quality patient care. This study describes the design and students' response to an interactive web-based course using streaming video technology tailored to students' needs and the course objectives of the fundamentals of nursing skills clinical course. A mixed-methodology design was used to describe the experience of 102 first-year undergraduate nursing students at a school of nursing in Jordan who were enrolled in the course. A virtual course with streaming videos was designed to demonstrate medication administration fundamental skills. The videos recorded the ideal lab demonstration of the skills, and real-world practice performed by registered nurses for patients in a hospital setting. After course completion, students completed a 30-item satisfaction questionnaire, 8 self-efficacy scales, and a 4-item scale solicited their preferences of using the virtual course as a substitute or a replacement of the lab demonstration. Students' grades in the skill examination of the procedures were measured. Relationships between the main variables and predictors of satisfaction and self-efficacy were examined. Students were satisfied with the virtual course (3.9 ± 0.56, out of a 5-point scale) with a high-perceived overall self-efficacy (4.38 ± 0.42, out of a 5-point scale). Data showed a significant correlation between student satisfaction, self-efficacy and achievement in the virtual course (r = 0.45-0.49, p streaming videos for clinical courses is a complex process that should be carefully designed to positively influence the learning experience. However, the learning benefits gained from such pedagogical approach are worth faculty, institution and students' efforts. Published by Elsevier Ireland Ltd.

  20. Medical student web-based formative assessment tool for renal pathology

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    Vanesa Bijol


    Full Text Available Background: Web-based formative assessment tools have become widely recognized in medical education as valuable resources for self-directed learning. Objectives: To explore the educational value of formative assessment using online quizzes for kidney pathology learning in our renal pathophysiology course. Methods: Students were given unrestricted and optional access to quizzes. Performance on quizzed and non-quizzed materials of those who used (‘quizzers’ and did not use the tool (‘non-quizzers’ was compared. Frequency of tool usage was analyzed and satisfaction surveys were utilized at the end of the course. Results: In total, 82.6% of the students used quizzes. The greatest usage was observed on the day before the final exam. Students repeated interactive and more challenging quizzes more often. Average means between final exam scores for quizzed and unrelated materials were almost equal for ‘quizzers’ and ‘non-quizzers’, but ‘quizzers’ performed statistically better than ‘non-quizzers’ on both, quizzed (p=0.001 and non-quizzed (p=0.024 topics. In total, 89% of surveyed students thought quizzes improved their learning experience in this course. Conclusions: Our new computer-assisted learning tool is popular, and although its use can predict the final exam outcome, it does not provide strong evidence for direct improvement in academic performance. Students who chose to use quizzes did well on all aspects of the final exam and most commonly used quizzes to practice for final exam. Our efforts to revitalize the course material and promote learning by adding interactive online formative assessments improved students’ learning experience overall.

  1. Real-Time Web-Based Assessment of Total Population Risk of Future Emergency Department Utilization: Statewide Prospective Active Case Finding Study (United States)

    Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric


    Background An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Objective Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Methods Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine’s Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. Results The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple “anchoring” demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. Conclusions The active case finding model and associated real-time Web-based app were designed to

  2. Emergency Medical Services (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people ... facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  3. Web based parallel/distributed medical data mining using software agents

    Energy Technology Data Exchange (ETDEWEB)

    Kargupta, H.; Stafford, B.; Hamzaoglu, I.


    This paper describes an experimental parallel/distributed data mining system PADMA (PArallel Data Mining Agents) that uses software agents for local data accessing and analysis and a web based interface for interactive data visualization. It also presents the results of applying PADMA for detecting patterns in unstructured texts of postmortem reports and laboratory test data for Hepatitis C patients.

  4. Effects of a web-based educational module on pediatric emergency medicine physicians' knowledge, attitudes, and behaviors regarding youth violence. (United States)

    Madsen, Tracy E; Riese, Alison; Choo, Ester K; Ranney, Megan L


    Youth seen in the emergency department (ED) with injuries from youth violence (YV) have increased risk for future violent injury and death. Pediatric emergency medicine (PEM) physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians' knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED. We invited all PEM fellows and attendings at an urban Level I pediatric trauma center to complete an interactive web-based education module (and 1-month booster) with information on YV's public health impact and how to screen, counsel and refer YV-involved patients. Consenting subjects completed electronic assessments of YV prevention knowledge and attitudes (using validated measures when possible) before and after the initial module and after the booster. To measure behavior change, chart review identified use of YV-specific discharge instructions in visits by YV-injured PEM patients (age 12-17; identified by E codes) 6 months before and after the intervention. We analyzed survey data were analyzed with Fisher's exact for binary outcomes and Kruskal-Wallis for Likert responses. Proportion of patients given YV discharge instructions before and after the intervention was compared using chi-square. Eighteen (67%) of 27 PEM physicians participated; 1 was lost at post-module assessment and 5 at 1 month. Module completion time ranged from 15-30 minutes. At baseline, 50% of subjects could identify victims' re-injury rate; 28% were aware of ED YV discharge instructions. After the initial module and at 1 month, there were significant increases in knowledge (pattitudes about YV prevention and may have affected behavior changes related to caring for YV victims in the ED. Further research should investigate web-based educational strategies to improve care of YV victims in a larger population of PEM physicians.

  5. Effects of a Web-based Educational Module on Pediatric Emergency Medicine Physicians’ Knowledge, Attitudes, and Behaviors Regarding Youth Violence

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    Tracy E. Madsen


    Full Text Available Introduction: Youth seen in the emergency department (ED with injuries from youth violence (YV have increased risk for future violent injury and death. Pediatric emergency medicine (PEM physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians’ knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED. Methods: We invited all PEM fellows and attendings at an urban Level I pediatric trauma center to complete an interactive web-based education module (and 1-month booster with information on YV’s public health impact and how to screen, counsel and refer YV-involved patients. Consenting subjects completed electronic assessments of YV prevention knowledge and attitudes (using validated measures when possible before and after the initial module and after the booster. To measure behavior change, chart review identified use of YV-specific discharge instructions in visits by YV-injured PEM patients (age 12–17; identified by E codes 6 months before and after the intervention. We analyzed survey data were analyzed with Fisher’s exact for binary outcomes and Kruskal-Wallis for Likert responses. Proportion of patients given YV discharge instructions before and after the intervention was compared using chi-square. Results: Eighteen (67% of 27 PEM physicians participated; 1 was lost at post-module assessment and 5 at 1 month. Module completion time ranged from 15–30 minutes. At baseline, 50% of subjects could identify victims’ re-injury rate; 28% were aware of ED YV discharge instructions. After the initial module and at 1 month, there were significant increases in knowledge (p,0.001 and level of confidence speaking with patients about avoiding YV (p¼0.01, df¼2. Almost all (94% said the module would change future management. In pre-intervention visits, 1.6% of patients with YV injuries were discharged with

  6. Web-based learning in undergraduate medical education: development and assessment of an online course on experimental surgery. (United States)

    Bernardo, Viviane; Ramos, Monica Parente; Plapler, Helio; De Figueiredo, Luiz Francisco Poli; Nader, Helena B; Anção, Meide Silva; Von Dietrich, Carl P; Sigulem, Daniel


    In order to increase the number of practical and discussion classes offered to students in the traditional-curriculum scenario, while decreasing the lecture-based ones and to create an online community to share knowledge on surgery, we developed and assessed the first online course for undergraduate medical students on experimental surgery at the Federal University of Sao Paulo-UNIFESP, Brazil. The purposes of the present study are: describe and discuss the process and the lessons learned involved in developing an undergraduate web-based course and analyze the students' attitude towards this educational environment. A group of medical students was taught online during 5 weeks on the theory of experimental surgery through video quizzes, required readings, collaborative activities using discussion board and asynchronous communication. The students' knowledge gain, their web session variables and the results of the course evaluation were used to support our study. The students have significantly improved their knowledge on experimental surgery after the course. Among factors in the online course that could possibly have contributed to this gain, the interactive activities (video quizzes), key element in our online material, seemed to be promising for candidates. The evaluation results demonstrated high levels of course functionality, effectiveness of its online content and acceptance among medical students. This study indicated that a web-based course for undergraduate students may be successfully developed and implemented in medical settings and the students seem to be quite supportive. We encourage undergraduate medical learning strategies involving the Web.

  7. Emergency radiology fellowship training in the USA: a web-based survey of academic programs. (United States)

    Cox, Mougnyan; Hansberry, David; Balasubramanya, Rashmi; Li, Zhengteng; Gandhe, Ashish; Selvarajan, Santosh; Sharma, Pranshu


    Interest in emergency radiology as a distinct subspecialty within radiology continues to rise in the USA and globally. While acute care imaging has been performed since the earliest days of the specialty, fellowship training in emergency radiology is a relatively new phenomenon. The purpose of this study was to examine the current status of emergency radiology training in the USA, using data derived from the official websites of US residency training programs. The most current list of radiology residency programs participating in the 2017 match was obtained from the official Electronic Residency Application Service (ERAS) website. The total number of emergency radiology fellowships was recorded after visiting available websites of each academic radiology program. The total number of subspecialty fellowships offered by each academic radiology program was also recorded. There were 12 confirmed emergency radiology fellowships offered in the USA for a combined total of 22 fellowship positions. Eleven programs were 1 year in duration, with one program offering a one- or two-year option. One hundred eight of the 174 (approximately 62 %) surveyed academic radiology programs offered at least one subspecialty fellowship. Emergency radiology fellowships are on the rise, paralleling the growth of emergency radiology as a distinct subspecialty within radiology.

  8. Effectiveness of web based educational on improving knowledge of acne vulgaris self medication among senior high school students

    Directory of Open Access Journals (Sweden)



    Full Text Available The presence of technology can provide real alternatives to build knowledge in delivering health education materials. The aim of this study was to investigate if web-based education methods may rising a student’s knowledge about self medication of acne. This research using an experimental pretest-posttest control group design while the sampling technique using convenience nonprobability sampling. Inclusion criteria for participants were senior high school students aged 13-19 years, active social media users, and willing to fill out the research questionnaire. Participants were allocated to the exclusion criteria as students who perform routine skin care in the acne treatment. Control group consisted of 62 respondents who were given face to face education and treatment group consisted of 62 respondents who were given website-based education. Data analysis were performed with a student t-test to assess the effect of educational intervention on student’s knowledge. The independent t-test showed there was a significant increase of knowledge between the control and the treatment groups (p = 0,000 with 95% confidence level. This study demonstrate that web-based educational intervention had a significant increase on the student’s knowledge about acne vulgaris self medication.

  9. Web-based social media for professional medical education: Perspectives of senior stakeholders in the nursing home sector. (United States)

    Kitching, Fiona; Winbolt, Margaret; MacPhail, Aleece; Ibrahim, Joseph E


    Participatory web-based platforms, including social media, have been recognised as valuable learning tools in healthcare education for over a decade. Use of these platforms is now widespread in tertiary education. It is less widely accepted as a tool for continuing professional education and development at the industry level. This study explores perspectives of senior stakeholders in the nursing home sector to explore perceived benefits, barriers and risks for use in professional education. Qualitative data were collected through semi-structured interviews of 'high level' clinical and executive staff from a cross section of nursing home stakeholder organisations. Established printed educational material (PEM) was used as a case study for adaptation to web-based social applications. Questions were designed to gather information about the interviewee's views on the potential to apply PEM to programs such as blogs, Twitter and YouTube to deliver education and aid communication in the sector. Twelve participants from eleven stakeholder organisations took part in the study. Most participants were cautious about the use of social media programs in continuing professional education. Participants described the benefits (contemporary information, delivered rapidly, varying formats) and barriers (credibility of information, potential misinterpretation, sector demographics, time constraints) to uptake of these programs. The majority of participants preferred formal e-learning programs to web-based social media applications. Reservations expressed about the use of social media, such as accuracy, legal and privacy risks to the organisation reflected those previously expressed by the broader medical community. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Web-based, virtual course units as a didactic concept for medical teaching. (United States)

    Schultze-Mosgau, Stefan; Zielinski, Thomas; Lochner, Jürgen


    The objective was to develop a web-based, virtual series of lectures for evidence-based, standardized knowledge transfer independent of location and time with possibilities for interactive participation and a concluding web-based online examination. Within the framework of a research project, specific Intranet and Internet capable course modules were developed together with a concluding examination. The concept of integrating digital and analogue course units supported by sound was based on FlashCam (Nexus Concepts), Flash MX (Macromedia), HTML and JavaScript. A Web server/SGI Indigo Unix server was used as a platform by the course provider. A variety of independent formats (swf, avi, mpeg, DivX, etc.) were integrated in the individual swf modules. An online examination was developed to monitor the learning effect. The examination papers are automatically forwarded by email after completion. The results are also returned to the user automatically after they have been processed by a key program and an evaluation program. The system requirements for the user PC have deliberately been kept low (Internet Explorer 5.0, Flash-Player 6, 56 kbit/s modem, 200 MHz PC). Navigation is intuitive. Users were provided with a technical online introduction and a FAQ list. Eighty-two students of dentistry in their 3rd to 5th years of study completed a questionnaire to assess the course content and the user friendliness (SPSS V11) with grades 1 to 6 (1 = 'excellent' and 6 = 'unsatisfactory'). The course units can be viewed under the URL: and URL: Some 89% of the students gave grades 1 (excellent) and 2 (good) for accessibility independent of time and 83% for access independent of location. Grades 1 and 2 were allocated for an objectivization of the knowledge transfer by 67% of the students and for the use of video sequences for demonstrating surgical techniques by 91% of the

  11. Development and alignment of undergraduate medical curricula in a web-based, dynamic Learning Opportunities, Objectives and Outcome Platform (LOOOP). (United States)

    Balzer, Felix; Hautz, Wolf E; Spies, Claudia; Bietenbeck, Andreas; Dittmar, Martin; Sugiharto, Firman; Lehmann, Lars; Eisenmann, Dorothea; Bubser, Florian; Stieg, Markus; Hanfler, Sven; Georg, Waltraud; Tekian, Ara; Ahlers, Olaf


    This study presents a web-based method and its interface ensuring alignment of all parts of a curriculum map including competencies, objectives, teaching and assessment methods, workload and patient availability. Needs, acceptance and effectiveness are shown through a nine-year study. After a comprehensive needs assessment, the curriculum map and a web-based interface "Learning Opportunities, Objectives and Outcome Platform" (LOOOP) were developed according to Harden's conceptual framework of 10-steps for curriculum mapping. The outcome was measured by surveys and results of interdisciplinary MCQ-assessments. The usage rates and functionalities were analysed. The implementation of LOOOP was significantly associated with improved perception of the curriculum structure by teachers and students, quality of defined objectives and their alignment with teaching and assessment, usage by students to prepare examinations and their scores in interdisciplinary MCQ-assessment. Additionally, LOOOP improved the curriculum coordination by faculty, and assisted departments for identifying patient availability for clinical training. LOOOP is well accepted among students and teachers, has positive effect on curriculum development, facilitates effective utilisation of educational resources and improves student's outcomes. Currently, LOOOP is used in five undergraduate medical curricula including 85,000 mapped learning opportunities (lectures, seminars), 5000 registered users (students, teachers) and 380,000 yearly page-visits.

  12. A Web-Based Platform for Designing Vaccines against Existing and Emerging Strains of Mycobacterium tuberculosis. (United States)

    Dhanda, Sandeep Kumar; Vir, Pooja; Singla, Deepak; Gupta, Sudheer; Kumar, Shailesh; Raghava, Gajendra P S


    Development of an effective vaccine against drug-resistant Mycobacterium tuberculosis (Mtb) is crucial for saving millions of premature deaths every year due to tuberculosis. This paper describes a web portal developed for assisting researchers in designing vaccines against emerging Mtb strains using traditional and modern approaches. Firstly, we annotated 59 genomes of Mycobacterium species to understand similarity/dissimilarity between tuberculoid, non-tuberculoid and vaccine strains at genome level. Secondly, antigen-based vaccine candidates have been predicted in each Mtb strain. Thirdly, epitopes-based vaccine candidates were predicted/discovered in above antigen-based vaccine candidates that can stimulate all arms of immune system. Finally, a database of predicted vaccine candidates at epitopes as well at antigen level has been developed for above strains. In order to design vaccine against a newly sequenced genome of Mtb strain, server integrates three modules for identification of strain-, antigen-, epitope-specific vaccine candidates. We observed that 103,522 unique peptides (9mers) had the potential to induce an antibody response and/or promiscuous binder to MHC alleles and/or have the capability to stimulate T lymphocytes. In summary, this web-portal will be useful for researchers working on designing vaccines against Mtb including drug-resistant strains. The database is available freely at

  13. Feasibility of a web-based continuing medical education program in dermatology: the DermoFAD experience in Italy. (United States)

    Naldi, Luigi; Manfrini, Roberto; Martin, Leigh; Deligant, Christian; Dri, Pietro


    Web-based systems are increasingly being considered for medical education. A draft legislation on distance-learning programs was licensed in Italy by the National Commission for Continuous Education in November 2003. A series of pilot studies were developed, among these the DermoFAD project, based on five simulated clinical cases of acne and a systematic appraisal of the evidence for their clinical management. From July 1 to August 27, 2004, a total of 500 medical doctors participated in a free of charge evaluation program of the project. Users were distributed all over Italy. Two hundred and eighty-one (56.2%) were primary care physicians, 83 (16.6%) dermatologists, and 136 (27.2%) other medical specialists. A wide range of connecting times was observed. The pass rate of each individual case, at first attempt, ranged from 44 to 77%. When asked to assess the overall distance-learning experience, 98% of the doctors considered it to be enjoyable. A total of 2,152 continuing medical education (CME) credits were awarded. Over 50% of the users stated they would still use the system if they had to pay for it. Our experience shows that distance learning is feasible and is well accepted by physicians. The DermoFAD program was an efficient means of delivering CME to the Italian medical community at large.

  14. Intranet health clinic: Web-based medical support services employing XML. (United States)

    Stalidis, G; Prentza, A; Vlachos, I N; Anogianakis, G; Maglavera, S; Koutsouris, D


    In this paper, the implementation of an Internet-based telematic service for medical support is presented, which operates in pilot form within the INTRANET HEALTH CLINIC project--a two-year project supported by the European Commission under the Health Telematics Programme. The aim of the application is to offer high quality care to users of health services over inexpensive communication pathways, using Internet-based, interactive communication tools, like remote access to medical records and transmission of multimedia information. The XML technology was employed to achieve customised views on patient data, according to the access rights of different users. Strict security and access control policy were implemented to ensure secure transmission of medical data through the Internet. The system is designed to collaborate with existing clinical patient record systems and to be adjustable to different medical applications. Current pilot implementations are under clinical evaluation and include oncological patients (Greece), Lupus Erythrematosis (Canada), Obstetrics (Belgium) and Chronic Obstructive Pulmonary disease (Spain).

  15. eMedOffice: A web-based collaborative serious game for teaching optimal design of a medical practice

    Directory of Open Access Journals (Sweden)

    Hannig Andreas


    Full Text Available Abstract Background Preparing medical students for the takeover or the start-up of a medical practice is an important challenge in Germany today. Therefore, this paper presents a computer-aided serious game (eMedOffice developed and currently in use at the RWTH Aachen University Medical School. The game is part of the attempt to teach medical students the organizational and conceptual basics of the medical practice of a general practitioner in a problem-based learning environment. This paper introduces methods and concepts used to develop the serious game and describes the results of an evaluation of the game's application in curricular courses at the Medical School. Results Results of the conducted evaluation gave evidence of a positive learning effect of the serious game. Educational supervisors observed strong collaboration among the players inspired by the competitive gaming aspects. In addition, an increase in willingness to learn and the exploration of new self-invented ideas were observed and valuable proposals for further prospective enhancements were elicited. A statistical analysis of the results of an evaluation provided a clear indication of the positive learning effect of the game. A usability questionnaire survey revealed a very good overall score of 4.07 (5=best, 1=worst. Conclusions We consider web-based, collaborative serious games to be a promising means of improving medical education. The insights gained by the implementation of eMedOffice will promote the future development of more effective serious games for integration into curricular courses of the RWTH Aachen University Medical School.

  16. MIIP: a web-based platform for medical image interpretation training and evaluation focusing on ultrasound (United States)

    Lindseth, Frank; Nordrik Hallan, Marte; Schiller Tønnessen, Martin; Smistad, Erik; Vâpenstad, Cecilie


    Introduction: Medical imaging technology has revolutionized health care over the past 30 years. This is especially true for ultrasound, a modality that an increasing amount of medical personal is starting to use. Purpose: The purpose of this study was to develop and evaluate a platform for improving medical image interpretation skills regardless of time and space and without the need for expensive imaging equipment or a patient to scan. Methods, results and conclusions: A stable web application with the needed functionality for image interpretation training and evaluation has been implemented. The system has been extensively tested internally and used during an international course in ultrasound-guided neurosurgery. The web application was well received and got very good System Usability Scale (SUS) scores.

  17. Developing a Web-Based Hiring Resource at a State Medical College (United States)

    Drane, Daniel, III


    This study uses a sequential, mixed method, action research, quantitative to qualitative research design. The purpose of this study was to develop a useful standardized hiring process at a state medical college that brings clarity to the hiring process and policies. Two conceptual frameworks guided the innovations in this study--communities of…

  18. Marketing to Increase Participation in a Web-Based Continuing Medical Education Cultural Competence Curriculum (United States)

    Estrada, Carlos A.; Krishnamoorthy, Periyakaruppan; Smith, Ann; Staton, Lisa; Korf, Michele J.; Allison, Jeroan J.; Houston, Thomas K.


    Introduction: CME providers may be interested in identifying effective marketing strategies to direct users to specific content. Online advertisements for recruiting participants into activities such as clinical trials, public health programs, and continuing medical education (CME) have been effective in some but not all studies. The purpose of…

  19. A web-based team-oriented medical error communication assessment tool: development, preliminary reliability, validity, and user ratings. (United States)

    Kim, Sara; Brock, Doug; Prouty, Carolyn D; Odegard, Peggy Soule; Shannon, Sarah E; Robins, Lynne; Boggs, Jim G; Clark, Fiona J; Gallagher, Thomas


    Multiple-choice exams are not well suited for assessing communication skills. Standardized patient assessments are costly and patient and peer assessments are often biased. Web-based assessment using video content offers the possibility of reliable, valid, and cost-efficient means for measuring complex communication skills, including interprofessional communication. We report development of the Web-based Team-Oriented Medical Error Communication Assessment Tool, which uses videotaped cases for assessing skills in error disclosure and team communication. Steps in development included (a) defining communication behaviors, (b) creating scenarios, (c) developing scripts, (d) filming video with professional actors, and (e) writing assessment questions targeting team communication during planning and error disclosure. Using valid data from 78 participants in the intervention group, coefficient alpha estimates of internal consistency were calculated based on the Likert-scale questions and ranged from α=.79 to α=.89 for each set of 7 Likert-type discussion/planning items and from α=.70 to α=.86 for each set of 8 Likert-type disclosure items. The preliminary test-retest Pearson correlation based on the scores of the intervention group was r=.59 for discussion/planning and r=.25 for error disclosure sections, respectively. Content validity was established through reliance on empirically driven published principles of effective disclosure as well as integration of expert views across all aspects of the development process. In addition, data from 122 medicine and surgical physicians and nurses showed high ratings for video quality (4.3 of 5.0), acting (4.3), and case content (4.5). Web assessment of communication skills appears promising. Physicians and nurses across specialties respond favorably to the tool.

  20. [Team dynamics and clinical performance of medical students in web-based and high-fidelity simulations]. (United States)

    Bang, Jae Beum; Yoon, Yoo Sang; Lee, Young Hwan; Lee, Sam Beom


    The importance of team dynamics with regard to clinical performance is being emphasized to improve patient safety and the quality of health care. The aim of this study was to examine the correlation and differences in team dynamics and team clinical performance in a web-based simulation (WS) and high-fidelity simulation (HS) in the medical students. The simulations were held for 15 teams of fourth year medical students (n=52). They were given two clinical cases, dyspnea (case 1) and chest pain (case 2) by WS and then HS. The scores on the team dynamics and the team's clinical performance were analyzed by paired t-test and multiple regression using SPSS version 21.0 (IBM Corp.). The teamwork scores on case 2 (22.67 ± 6.58) were higher than for case 1 in the HS (20.47 ± 7.22). Team clinical performance scores were the same the WS and HS. Team clinical performances were significantly associated with team dynamics in both cases by HS. Teamwork scores of team dynamics were each explanation on case 1 (74.9%), case 2 (63.4%) in the HS. The team dynamics and clinical performance can improve if undergraduate medical students have more opportunities. They should be trained in these endeavors to become future doctors for which scenario-based simulations could be valuable.

  1. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger


    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  2. Medical students' experiences of moral distress: development of a web-based survey. (United States)

    Wiggleton, Catherine; Petrusa, Emil; Loomis, Kim; Tarpley, John; Tarpley, Margaret; O'Gorman, Mary Lou; Miller, Bonnie


    To develop an instrument for measuring moral distress in medical students, measuring the prevalence of moral distress in a cohort of students, and identifying the situations most likely to cause it. Moral distress, defined as the negative feelings that arise when one knows the morally correct thing to do but cannot act because of constraints or hierarchies, has been documented in nurses but has not been measured in medical students. The authors constructed a survey consisting of 55 items describing potentially distressing situations. Responders rated the frequency of these situations and the intensity of distress that they caused. The survey was administered to 106 fourth-year medical students during a three-week period in 2007; the response rate was 60%. Each of the situations was experienced by at least some of the 64 respondents, and each created some degree of moral distress. On average, students witnessed almost one-half of the situations at least once, and more than one-third of the situations caused mild-to-moderate distress. The survey measured individual distress (Cronbach alpha = 0.95), which varied among the students. Whereas women witnessed potentially distressing situations significantly more frequently than did men (P = .04), men tended to become more distressed by each event witnessed (P = .057). Medical students frequently experience moral distress. Our survey can be used to measure aspects of the learning environment as well as individual responses to the environment. The variation found among student responses warrants further investigation to determine whether students at either extreme of moral distress are at risk of burnout or erosion of professionalism.

  3. Web-Based Immersive Virtual Patient Simulators: Positive Effect on Clinical Reasoning in Medical Education. (United States)

    Kleinert, Robert; Heiermann, Nadine; Plum, Patrick Sven; Wahba, Roger; Chang, De-Hua; Maus, Martin; Chon, Seung-Hun; Hoelscher, Arnulf H; Stippel, Dirk Ludger


    Clinical reasoning is based on the declarative and procedural knowledge of workflows in clinical medicine. Educational approaches such as problem-based learning or mannequin simulators support learning of procedural knowledge. Immersive patient simulators (IPSs) go one step further as they allow an illusionary immersion into a synthetic world. Students can freely navigate an avatar through a three-dimensional environment, interact with the virtual surroundings, and treat virtual patients. By playful learning with IPS, medical workflows can be repetitively trained and internalized. As there are only a few university-driven IPS with a profound amount of medical knowledge available, we developed a university-based IPS framework. Our simulator is free to use and combines a high degree of immersion with in-depth medical content. By adding disease-specific content modules, the simulator framework can be expanded depending on the curricular demands. However, these new educational tools compete with the traditional teaching It was our aim to develop an educational content module that teaches clinical and therapeutic workflows in surgical oncology. Furthermore, we wanted to examine how the use of this module affects student performance. The new module was based on the declarative and procedural learning targets of the official German medical examination regulations. The module was added to our custom-made IPS named ALICE (Artificial Learning Interface for Clinical Education). ALICE was evaluated on 62 third-year students. Students showed a high degree of motivation when using the simulator as most of them had fun using it. ALICE showed positive impact on clinical reasoning as there was a significant improvement in determining the correct therapy after using the simulator. ALICE positively impacted the rise in declarative knowledge as there was improvement in answering multiple-choice questions before and after simulator use. ALICE has a positive effect on knowledge gain and

  4. Efficient 3D rendering for web-based medical imaging software: a proof of concept (United States)

    Cantor-Rivera, Diego; Bartha, Robert; Peters, Terry


    Medical Imaging Software (MIS) found in research and in clinical practice, such as in Picture and Archiving Communication Systems (PACS) and Radiology Information Systems (RIS), has not been able to take full advantage of the Internet as a deployment platform. MIS is usually tightly coupled to algorithms that have substantial hardware and software requirements. Consequently, MIS is deployed on thick clients which usually leads project managers to allocate more resources during the deployment phase of the application than the resources that would be allocated if the application were deployed through a web interface.To minimize the costs associated with this scenario, many software providers use or develop plug-ins to provide the delivery platform (internet browser) with the features to load, interact and analyze medical images. Nevertheless there has not been a successful standard means to achieve this goal so far. This paper presents a study of WebGL as an alternative to plug-in development for efficient rendering of 3D medical models and DICOM images. WebGL is a technology that enables the internet browser to have access to the local graphics hardware in a native fashion. Because it is based in OpenGL, a widely accepted graphic industry standard, WebGL is being implemented in most of the major commercial browsers. After a discussion on the details of the technology, a series of experiments are presented to determine the operational boundaries in which WebGL is adequate for MIS. A comparison with current alternatives is also addressed. Finally conclusions and future work are discussed.

  5. Pharmacist Web-Based Training Program on Medication Use in Chronic Kidney Disease Patients: Impact on Knowledge, Skills, and Satisfaction (United States)

    Legris, Marie-eve; Seguin, Noemie Charbonneau; Desforges, Katherine; Sauve, Patricia; Lord, Anne; Bell, Robert; Berbiche, Djamal; Desrochers, Jean-Francois; Lemieux, Jean-Philippe; Morin-Belanger, Claudia; Paradis, Francois Ste-Marie; Lalonde, Lyne


    Introduction: Chronic kidney disease (CKD) patients are multimorbid elderly at high risk of drug-related problems. A Web-based training program was developed based on a list of significant drug-related problems in CKD patients requiring a pharmaceutical intervention. The objectives were to evaluate the impact of the program on community…

  6. Pretests or advance organizers for Web-based allergy-immunology medical education? A randomized controlled trial. (United States)

    Rank, Matthew A; Volcheck, Gerald W; Swagger, Timothy; Cook, David A


    Web-based modules may facilitate instruction on core topics in allergy and immunology (AI). Pretests (PTs) have been shown to improve learning in Web-based courses, but their effectiveness in comparison with advance organizers (AOs) is unknown. We performed a randomized controlled trial of a Web-based educational intervention for teaching the practical aspects of allergen immunotherapy (AIT). AI Fellows-in-Training were randomly assigned to receive the introduction to the modules in an AO outline (AO group) or as PT questions (PT group). The primary outcome was the difference in posttest scores between groups. The secondary outcome was the difference in PT and posttest scores in the PT group. Thirty participants in the AO group and 35 in the PT group completed the modules and the posttest. The mean (SD) posttest score for the AO group was 74% (14%) compared with 73% (9%) for the PT group, a mean difference of -1% (95% CI, -7%, 5%; p = 0.67). A multivariate analysis controlling for year-in-training and total time spent on the modules revealed virtually identical results. The mean (SD) PT score for the PT group increased from 49 (10%) to 73% (9%), a mean difference of 24% (95% CI, 19%, 28%; p < 0.0001). Introducing Web-based allergy education with PT questions or an AO resulted in similar posttest scores. Posttest scores in the PT group improved significantly compared with PT scores.

  7. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey.

    Directory of Open Access Journals (Sweden)

    Erica Rose Denhoff

    Full Text Available One of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment.We conducted a web-based survey from September 2011 to December 2011 of all principal investigators with an Institutional Review Board approved human subjects protocol at Boston Children's Hospital, a pediatric Academic Medical Center. The survey captured various characteristics of the protocols including study design, staffing, resources, and investigator experience and training as well as respondents' perceived barriers and facilitators to recruitment. We used chi square tests and Mantel-Haenszel test for linear trend to examine the relationship between selected predictor variables and the binary outcome of successful vs. unsuccessful recruitment and multivariable logistic regression analyses to examine the simultaneous influence of potential predictors on each outcome.Among the 349 eligible investigators, 52% responded to the survey, and 181 with valid data were included in the analyses. Two-thirds of the 87 protocols closed to enrollment reached 80% or more of their target enrollment, whereas, only one-third of the 94 protocols actively recruiting were meeting 80% of their target. Recruitment method appeared to be the only significant and independent factor associated with achieving 80% or more of target enrollment in closed to enrollment protocols. Closed to enrollment protocols that used recruitment in person were 4.55 times (95% CI 1.30 to 15.93; p = 0.02 more likely to achieve 80% or more of their target enrollment when

  8. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center—A Web-Based Survey (United States)

    Denhoff, Erica Rose; Milliren, Carly E.; de Ferranti, Sarah D.; Steltz, Sarah K.; Osganian, Stavroula K.


    Background One of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment. Methods We conducted a web-based survey from September 2011 to December 2011 of all principal investigators with an Institutional Review Board approved human subjects protocol at Boston Children’s Hospital, a pediatric Academic Medical Center. The survey captured various characteristics of the protocols including study design, staffing, resources, and investigator experience and training as well as respondents’ perceived barriers and facilitators to recruitment. We used chi square tests and Mantel-Haenszel test for linear trend to examine the relationship between selected predictor variables and the binary outcome of successful vs. unsuccessful recruitment and multivariable logistic regression analyses to examine the simultaneous influence of potential predictors on each outcome. Results Among the 349 eligible investigators, 52% responded to the survey, and 181 with valid data were included in the analyses. Two-thirds of the 87 protocols closed to enrollment reached 80% or more of their target enrollment, whereas, only one-third of the 94 protocols actively recruiting were meeting 80% of their target. Recruitment method appeared to be the only significant and independent factor associated with achieving 80% or more of target enrollment in closed to enrollment protocols. Closed to enrollment protocols that used recruitment in person were 4.55 times (95% CI 1.30 to 15.93; p = 0.02) more likely to achieve 80% or more of their target

  9. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey. (United States)

    Denhoff, Erica Rose; Milliren, Carly E; de Ferranti, Sarah D; Steltz, Sarah K; Osganian, Stavroula K


    One of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment. We conducted a web-based survey from September 2011 to December 2011 of all principal investigators with an Institutional Review Board approved human subjects protocol at Boston Children's Hospital, a pediatric Academic Medical Center. The survey captured various characteristics of the protocols including study design, staffing, resources, and investigator experience and training as well as respondents' perceived barriers and facilitators to recruitment. We used chi square tests and Mantel-Haenszel test for linear trend to examine the relationship between selected predictor variables and the binary outcome of successful vs. unsuccessful recruitment and multivariable logistic regression analyses to examine the simultaneous influence of potential predictors on each outcome. Among the 349 eligible investigators, 52% responded to the survey, and 181 with valid data were included in the analyses. Two-thirds of the 87 protocols closed to enrollment reached 80% or more of their target enrollment, whereas, only one-third of the 94 protocols actively recruiting were meeting 80% of their target. Recruitment method appeared to be the only significant and independent factor associated with achieving 80% or more of target enrollment in closed to enrollment protocols. Closed to enrollment protocols that used recruitment in person were 4.55 times (95% CI 1.30 to 15.93; p = 0.02) more likely to achieve 80% or more of their target enrollment when compared to those

  10. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren


    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ...

  11. Medical emergencies in dental practice.

    LENUS (Irish Health Repository)

    Wilson, M H


    Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

  12. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren


    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

  13. Implementation of a web-based tool for patient medication self-management: the Medication Self-titration Evaluation Programme (Med-STEP for blood pressure control

    Directory of Open Access Journals (Sweden)

    Richard W Grant


    Full Text Available Background Informatics tools may help support hypertension management.Objective To design, implement and evaluate a web-based system for patient anti-hypertensive medication self-titration.Methods Study stages included: six focus groups (50 patients to identify barriers/facilitators to patient medication self-titration, software design informed by qualitative analysis of focus group responses and a six-month single-arm pilot study (20 patients to assess implementation feasibility.Results Focus groups emphasised patient need to feel confident that their own primary care providers were directly involved and approved of the titration protocol. Physicians required 3.3 ± 2.8 minutes/patient to create individualised six-step medication pathways for once-monthly blood pressure evaluations. Pilot participants (mean age of 51.5 ± 11 years, 45% women, mean baseline blood pressure 139/84 ± 12.2/7.5 mmHg had five medication increases, two non-adherence self-reports, 52months not requiring medication changes, 24 skipped months and 17 months with no evaluations due to technical issues. Four pilot patients dropped out before study completion. From baseline to study completion, blood pressure decreased among the 16 patients remaining in the study (8.0/4.7 mmHg, p = 0.03 for both systolic and diastolic pressures.Conclusions Lessons learned included the benefit of qualitative patient analysis prior to system development and the feasibility of physicians designing individual treatment pathways. Any potential clinical benefits were offset by technical problems, the tendency for patients to skip their monthly self-evaluations and drop outs. To be more widely adopted such systems must effectively generalise to a wider range of patients and be integrated into clinical workflow.

  14. A comparison of live counseling with a web-based lifestyle and medication intervention to reduce coronary heart disease risk: a randomized clinical trial. (United States)

    Keyserling, Thomas C; Sheridan, Stacey L; Draeger, Lindy B; Finkelstein, Eric A; Gizlice, Ziya; Kruger, Eliza; Johnston, Larry F; Sloane, Philip D; Samuel-Hodge, Carmen; Evenson, Kelly R; Gross, Myron D; Donahue, Katrina E; Pignone, Michael P; Vu, Maihan B; Steinbacher, Erika A; Weiner, Bryan J; Bangdiwala, Shrikant I; Ammerman, Alice S


    Most primary care clinicians lack the skills and resources to offer effective lifestyle and medication (L&M) counseling to reduce coronary heart disease (CHD) risk. Thus, effective and feasible CHD prevention programs are needed for typical practice settings. To assess the effectiveness, acceptability, and cost-effectiveness of a combined L&M intervention to reduce CHD risk offered in counselor-delivered and web-based formats. A comparative effectiveness trial in 5 diverse family medicine practices in North Carolina. Participants were established patients, aged 35 to 79 years, with no known cardiovascular disease, and at moderate to high risk for CHD (10-year Framingham Risk Score [FRS], ≥10%). Participants were randomized to counselor-delivered or web-based format, each including 4 intensive and 3 maintenance sessions. After randomization, both formats used a web-based decision aid showing potential CHD risk reduction associated with L&M risk-reducing strategies. Participants chose the risk-reducing strategies they wished to follow. The primary outcome was within-group change in FRS at 4-month follow-up. Other measures included standardized assessments of blood pressure, blood lipid levels, lifestyle behaviors, and medication adherence. Acceptability and cost-effectiveness were also assessed. Outcomes were assessed at 4 and 12 months. Of 2274 screened patients, 385 were randomized (192 counselor; 193 web): mean age, 62 years; 24% African American; and mean FRS, 16.9%. Follow-up at 4 and 12 months included 91% and 87% of the randomized participants, respectively. There was a sustained reduction in FRS at both 4 months (primary outcome) and 12 months for both counselor-based (-2.3% [95% CI, -3.0% to -1.6%] and -1.9% [95% CI, -2.8% to -1.1%], respectively) and web-based groups (-1.5% [95% CI, -2.2% to -0.9%] and -1.7% [95% CI, -2.6% to -0.8%] respectively). At 4 months, the adjusted difference in FRS between groups was -1.0% (95% CI, -1.8% to -0.1%) (P = .03

  15. Automated generation of a World Wide Web-based data entry and check program for medical applications. (United States)

    Kiuchi, T; Kaihara, S


    The World Wide Web-based form is a promising method for the construction of an on-line data collection system for clinical and epidemiological research. It is, however, laborious to prepare a common gateway interface (CGI) program for each project, which the World Wide Web server needs to handle the submitted data. In medicine, it is even more laborious because the CGI program must check deficits, type, ranges, and logical errors (bad combination of data) of entered data for quality assurance as well as data length and meta-characters of the entered data to enhance the security of the server. We have extended the specification of the hypertext markup language (HTML) form to accommodate information necessary for such data checking and we have developed software named AUTOFORM for this purpose. The software automatically analyzes the extended HTML form and generates the corresponding ordinary HTML form, 'Makefile', and C source of CGI programs. The resultant CGI program checks the entered data through the HTML form, records them in a computer, and returns them to the end-user. AUTOFORM drastically reduces the burden of development of the World Wide Web-based data entry system and allows the CGI programs to be more securely and reliably prepared than had they been written from scratch.

  16. Emergency Medical Service (EMS) Stations (United States)

    Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

  17. In-flight Medical Emergencies


    Amit Chandra; Shauna Conry


    Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions. This paper reviews the literature quantifying and categorizing in-flight medical incidents, discusses the unique challenges posed by the in-flight environment, evaluates the legal aspects of volunteering to provide care, and suggests an approa...

  18. Using a web-based game to prevent posttraumatic stress in children following medical events: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Nancy Kassam-Adams


    Full Text Available Background: Medical events including acute illness and injury are among the most common potentially traumatic experiences for children. Despite the scope of the problem, only limited resources are available for prevention of posttraumatic stress symptoms (PTSS after pediatric medical events. Web-based programs provide a low-cost, accessible means to reach a wide range of families and show promise in related areas of child mental health. Objectives: To describe the design of a randomized controlled trial that will evaluate feasibility and estimate preliminary efficacy of Coping Coach, a web-based preventive intervention to prevent or reduce PTSS after acute pediatric medical events. Method: Seventy children and their parents will be randomly assigned to either an intervention or a waitlist control condition. Inclusion criteria require that children are aged 8–12 years, have experienced a medical event, have access to Internet and telephone, and have sufficient competency in the English language to complete measures and understand the intervention. Participants will complete baseline measures and will then be randomized to the intervention or waitlist control condition. Children in the intervention condition will complete module 1 (Feelings Identification in the hospital and will be instructed on how to complete modules 2 (Appraisals and 3 (Avoidance online. Follow-up assessments will be conducted via telephone at 6, 12, and 18 weeks after the baseline assessment. Following the 12-week assessment, children in the waitlist control condition will receive instructions for completing the intervention. Results: Primary study outcomes include data on intervention feasibility and outcomes (child appraisals, coping, PTSS and health-related quality of life. Discussion: Results will provide data on the feasibility of the implementation of the Coping Coach intervention and study procedures as well as estimations of efficacy to determine sample size for a

  19. Usability Evaluation of Ulite Web-Based Picture Archiving and communication Systems Software in Shiraz University of Medical Science Hospitals

    Directory of Open Access Journals (Sweden)

    Somayyeh Zakerabasali


    Full Text Available Introduction: Health information systems have the potential of improving the quality of healthcare and treatment procedures and supporting the physicians in their clinical diagnoses. Nowadays, evaluating the usability is widely accepted as a crucial factor in the acceptance and success of the interactive healthcare systems. The present study aimed to evaluate the usability of Ulite Software based on the ISO 9241 model. Method: This analytical-empirical study was performed in 2014. The target population consisted of 50 Utile Software users. The data were collected througha valid and reliable questionnaire containing questions from 10 valid and reliable questionnaires on the related field. The content validity of the questionnaire was evaluated and confirmed by the scholars and experts in Picture Archiving and Communication Systems (PACS and the reliability was estimated through statistical procedures using Chronbach’s alpha Test (α=0.958 . Data were analyzed in SPSS 20 using descriptive statistics and Smart-PLS version 3, using Structural Equation Method and Partial Least Square Approach. Results:The obtained results of the simultaneous analysis of all constructs regarding ISO 9241 model indicated a positive effect of “effectiveness” (P-value= 0.05 and “satisfaction” (P-value= 0.00 on the usability of web-based PACS, while the effect of “efficiency” (P-value= 0.68 was not confirmed. Conclusion: Usability evaluation of Ulite software in the demo version was performed based on the ISO 9241 model. Based on the results, it seems that this software has the necessary effectiveness and user satisfaction has been somewhat successful, but since the evaluation in the demo version aimed to purchasethe system and eliminate initial problems,we should focus on the deficiencies that decrease the efficiency of the system

  20. Wilderness Emergency Medical Services Systems. (United States)

    Millin, Michael G; Hawkins, Seth C


    Wilderness emergency medical services (WEMS) are designed to provide high quality health care in wilderness environments. A WEMS program should have oversight by a qualified physician responsible for protocol development, education, and quality improvement. The director is also ideally fully trained as a member of that wilderness rescue program, supporting the team with real-time patient care. WEMS providers function with scopes of practice approved by the local medical director and regulatory authority. With a focus on providing quality patient care, it is time for the evolution of WEMS as an integrated element of a local emergency response system. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. A case study of successful e-learning: a web-based distance course in medical physics held for school teachers of the upper secondary level. (United States)

    Jönsson, Bo-Anders


    Learning activities and course design in the new context of e-learning, such as in web-based courses involves a change both for teachers and students. The paper discusses factors important for e-learning to be successful. The development of an online course in medical physics and technology for high school teachers of physics, details of the course, and experience gained in connection with it are described. The course syllabus includes basics of radiation physics, imaging techniques using ionizing or non-ionizing radiation, and external and internal radiation therapy. The course has a highly didactic approach. The final task is for participants to design a course of their own centered on some topic of medical physics on the basis of the knowledge they have acquired. The aim of the course is to help the teachers integrate medical physics into their own teaching. This is seen as enhancing the interest of high school students in later studying physics, medical physics or some other branch of science at the university level, and as increasing the knowledge that they and people generally have of science. It is suggested that the basic approach taken can also have applicability to the training of medical, nursing or engineering students, and be used for continuing professional development in various areas.

  2. The Picmonic® Learning System: enhancing memory retention of medical sciences, using an audiovisual mnemonic Web-based learning platform

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    Yang A


    Full Text Available Adeel Yang,1,* Hersh Goel,1,* Matthew Bryan,2 Ron Robertson,1 Jane Lim,1 Shehran Islam,1 Mark R Speicher2 1College of Medicine, The University of Arizona, Tucson, AZ, USA; 2Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA *These authors contributed equally to this work Background: Medical students are required to retain vast amounts of medical knowledge on the path to becoming physicians. To address this challenge, multimedia Web-based learning resources have been developed to supplement traditional text-based materials. The Picmonic® Learning System (PLS; Picmonic, Phoenix, AZ, USA is a novel multimedia Web-based learning platform that delivers audiovisual mnemonics designed to improve memory retention of medical sciences. Methods: A single-center, randomized, subject-blinded, controlled study was conducted to compare the PLS with traditional text-based material for retention of medical science topics. Subjects were randomly assigned to use two different types of study materials covering several diseases. Subjects randomly assigned to the PLS group were given audiovisual mnemonics along with text-based materials, whereas subjects in the control group were given the same text-based materials with key terms highlighted. The primary endpoints were the differences in performance on immediate, 1 week, and 1 month delayed free-recall and paired-matching tests. The secondary endpoints were the difference in performance on a 1 week delayed multiple-choice test and self-reported satisfaction with the study materials. Differences were calculated using unpaired two-tailed t-tests. Results: PLS group subjects demonstrated improvements of 65%, 161%, and 208% compared with control group subjects on free-recall tests conducted immediately, 1 week, and 1 month after study of materials, respectively. The results of performance on paired-matching tests showed an improvement of up to 331% for PLS group subjects. PLS group

  3. Simulation in Medical Student Education: Survey of the Clerkship Directors in Emergency Medicine


    Michael Fitch; Michael Smith; Raymond Ten Eyck; Corey Heitz


    Introduction: The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulationbased programs; and (3) educational advances to meet these challenges. Methods: We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey ...

  4. Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine


    Heitz, Corey; Eyck, Raymond Ten; Smith, Michael; Fitch, Michael


    Introduction The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulation-based programs; and (3) educational advances to meet these challenges. Methods We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey el...

  5. Rural Emergency Medical Services (EMS) and Trauma (United States)

    ... Rural Health Topics & States Topics View more Rural Emergency Medical Services (EMS) and Trauma Emergency medical services ( ... related deaths and nonfatal injuries treated in rural emergency departments? According to a Centers for Disease Control ...

  6. Patterns and factors associated with low adherence to psychotropic medications during pregnancy--a cross-sectional, multinational web-based study. (United States)

    Lupattelli, Angela; Spigset, Olav; Björnsdóttir, Ingunn; Hämeen-Anttila, Katri; Mårdby, Ann-Charlotte; Panchaud, Alice; Juraski, Romana Gjergja; Rudolf, Gorazd; Odalovic, Marina; Drozd, Mariola; Twigg, Michael J; Juch, Herbert; Moretti, Myla E; Kennedy, Debra; Rieutord, Andre; Zagorodnikova, Ksenia; Passier, Anneke; Nordeng, Hedvig


    No previous studies have explored how closely women follow their psychotropic drug regimens during pregnancy. This study aimed to explore patterns of and factors associated with low adherence to psychotropic medication during pregnancy. Multinational web-based study was performed in 18 countries in Europe, North America, and Australia. Uniform data collection was ensured via an electronic questionnaire. Pregnant women were eligible to participate. Adherence was measured via the 8-item Morisky Medication Adherence Scale (MMAS-8). The Beliefs about Prescribed Medicines Questionnaire (BMQ-specific), the Edinburgh Postnatal Depression Scale (EPDS), and a numeric rating scale were utilized to measure women's beliefs, depressive symptoms, and antidepressant risk perception, respectively. Participants reporting use of psychotropic medication during pregnancy (n = 160) were included in the analysis. On the basis of the MMAS-8, 78 of 160 women (48.8%, 95% CI: 41.1-56.4%) demonstrated low adherence during pregnancy. The rates of low adherence were 51.3% for medication for anxiety, 47.2% for depression, and 42.9% for other psychiatric disorders. Smoking during pregnancy, elevated antidepressant risk perception (risk≥6), and depressive symptoms were associated with a significant 3.9-, 2.3-, and 2.5-fold increased likelihood of low medication adherence, respectively. Women on psychotropic polytherapy were less likely to demonstrate low adherence. The belief that the benefit of pharmacotherapy outweighed the risks positively correlated (r = .282) with higher medication adherence. Approximately one of two pregnant women using psychotropic medication demonstrated low adherence in pregnancy. Life-style factors, risk perception, depressive symptoms, and individual beliefs are important factors related to adherence to psychotropic medication in pregnancy. © 2015 Wiley Periodicals, Inc.

  7. Structured global health programs in U.S. medical schools: a web-based review of certificates, tracks, and concentrations. (United States)

    Peluso, Michael J; Forrestel, Amy K; Hafler, Janet P; Rohrbaugh, Robert M


    To determine the prevalence and requirements of structured, longitudinal, nondegree global health (GH) programs (e.g., certificates, tracks, concentrations) in U.S. MD-granting medical schools. In March 2011, two reviewers independently searched the Web sites of all 133 U.S. MD-granting medical schools and reviewed Google search results seeking evidence of, information about, and the requirements of structured GH programs. The authors excluded programs that were not open to medical students, granted a degree, and/or required medical students to extend training time. Of 133 institutions analyzed, 32 (24%) had evidence of a structured GH program. Of the 30 (94%) programs for which the authors could find further information online, 16/30 (53%) were administered by the medical school, whereas 13/30 (43%) were administered by a different entity within the university; 1/30 (3%) was jointly administered. All 30 of the programs required additional didactic course work. The median number of courses was 4 (range: 1-12). Of the 30 schools with GH programs, 22 (73%) required an international experiential component, but only 12/30 (40%) specifically required an international clinical experience. Only 1 school (3%) directly addressed language or cultural proficiency. Although structured GH programs were offered at one-quarter of U.S. medical schools, little standardization across programs existed in terms of requirements for didactic, clinical, scholarly, and cultural components. Online GH program information is not easily accessible, but it may be valuable in the development of new structured programs, the refinement of programs that already exist, and students' selection of medical schools.

  8. Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity. (United States)

    Hulsman, Robert L; van der Vloodt, Jane


    Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed. Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events. Peers reviewed the video and self-evaluations and provided feedback. Analyzed were the number of marked positive and negative annotations and the amount of text entered. Topics and specificity of the annotations were coded and analyzed qualitatively. Students annotated on average more negative than positive events. Additional peer-feedback was more often positive. Topics most often related to structuring the consultation. Students were most critical about their biomedical topics. Negative annotations were more specific than positive annotations. Self-evaluations were more specific than peer-feedback and both show a significant correlation. Four response patterns were detected that negatively bias specificity assessment ratings. Teaching students to be more specific in their self-evaluations may be effective for receiving more specific peer-feedback. Videofragmentrating is a convenient tool to implement reflective practice activities like self-evaluation and peer-feedback to the classroom in the teaching of clinical skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Mirjana Bakic


    Full Text Available Medical students, non-native English speakers, who have not been well-served by foreign language education, cannot take advantage of the educational benefits of web- based learning and benefits of scientific work. Foreign language education affects not only the language and culture of students, but also their socio-economic status and interpersonal relationship.The aim of this study was to determine the cohesive role of foreign language in students’ adoption of medical knowledge and its influence on the conjunction of classical learning and web- based learning.The investigation was carried out among students of Faculty of Medicine in Nis during June, 2006. The investigation included 312 students of all study years and departments and was conducted by means of a questionnaire. Students’ performance in scientific work was evaluated according to the achievements at faculty. Language literacy was evaluated according to students’ ability to use and understand scientific web contents in English.Generally, the average grade of the mother tongue knowledge (including writing, and speaking skills was higher at high educational departments compared to the College of Nursing. Writing skill was differently evaluated among departments. The highest average grade was obtained at the Departments of Medicine and Pharmacy; it was significantly lower at the Department of Dentistry and the lowest at the Department of Nursing, which was confirmed by T test. Speaking skill was the highest among medical students, significantly lower among students of dentistry and pharmacy, whereas it was the lowest among students of the College of Nursing, which represents a statistically significant finding. A very high average grade for reading skill was obtained at the Departments of Medicine and Pharmacy; it was significantly lower at the Department of Dentistry and the lowest at the College of Nursing. Listening skill was the best among medical students; it was

  10. Medical Journalism and Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Saeed Safari


    Full Text Available Nowadays, many researches in the field of medicine are conducting all around the world and medical journalism is a way to share the results. In fact, dissemination of the related manuscripts can prevent the repetitive research or may even lead to conducting a better survey. Therefore high quality medical journals are considered as up-to-date resources for further investigations. Medical journals are propagating their papers in various media including television programs, newspapers, internet websites and different social media. So they can influence the government policy makers, health-care professionals and even public. Moreover, most researchers hear about medical discoveries for the first time through medical journals and their related social media. So as well a high quality journal can help to improve medical science, a journal of poor quality can be damaging and distorting. Indeed, popular journals have the power of inventing a “communication storm” to draw attention to a certain topic. Thus they have to respect the accepted international principles to prevent spreading inaccurate and misleading data. This paper aims to review the previous and current situation of medical journalism by focus on field of emergency medicine.

  11. A Web-Based and Mobile Health Social Support Intervention to Promote Adherence to Inhaled Asthma Medications: Randomized Controlled Trial (United States)

    Koufopoulos, Justin T; Conner, Mark T; Gardner, Peter H


    Background Online communities hold great potential as interventions for health, particularly for the management of chronic illness. The social support that online communities can provide has been associated with positive treatment outcomes, including medication adherence. There are few studies that have attempted to assess whether membership of an online community improves health outcomes using rigorous designs. Objective Our objective was to conduct a rigorous proof-of-concept randomized controlled trial of an online community intervention for improving adherence to asthma medicine. Methods This 9-week intervention included a sample of asthmatic adults from the United Kingdom who were prescribed an inhaled corticosteroid preventer. Participants were recruited via email and randomized to either an “online community” or “no online community” (diary) condition. After each instance of preventer use, participants (N=216) were required to report the number of doses of medication taken in a short post. Those randomized to the online community condition (n=99) could read the posts of other community members, reply, and create their own posts. Participants randomized to the no online community condition (n=117) also posted their medication use, but could not read others’ posts. The main outcome measures were self-reported medication adherence at baseline and follow-up (9 weeks postbaseline) and an objective measure of adherence to the intervention (visits to site). Results In all, 103 participants completed the study (intervention: 37.8%, 39/99; control: 62.2%, 64/117). MANCOVA of self-reported adherence to asthma preventer medicine at follow-up was not significantly different between conditions in either intention-to-treat (P=.92) or per-protocol (P=.68) analysis. Site use was generally higher in the control compared to intervention conditions. Conclusions Joining an online community did not improve adherence to preventer medication for asthma patients. Without

  12. Implementation of a web-based interactive virtual patient case simulation as a training and assessment tool for medical students. (United States)

    Oliven, A; Nave, R; Gilad, D; Barch, A


    Structured Clinical Examinations (OSCE) are resource intensive, not practical as teaching tools, and their reliability depends on evaluators. Computer-based case simulations ("virtual patients", VP) have been advocated as useful and reliable tools for teaching clinical skills and evaluating competence. We have developed an internet-based VP system designed both for practice and assessment of medical students. The system uses interactive dialogue with natural language processing, and is designed for history taking, evaluation of physical examination, including recognition of visual findings and heart and lung sounds, and ordering lab-and imaging tests. The system includes a practice modality that provides feedback, and a computerized OSCE. The reliability of our system was assessed over the last three years by comparing the clinical competence of medical students in similar VP and human OSCE. A total of 262 students were evaluated with both exam modalities. The correlation between the two exams scores was highly significant (p<0.001). Alpha Cronbach for the computerized exam was 0.82-0.89 in the 3 years, and was substantially higher than that of the conventional OSCE each year. We conclude that a computerized VP OSCE is a reliable examination tool, with the advantage of providing also a training modality.

  13. Medical Emergencies in Pediatric Dentistry. (United States)

    Vranić, Dubravka Negovetić; Jurković, Josipa; Jeličić, Jesenka; Balenović, Antonija; Stipančić, Gordana; Čuković-Bagić, Ivana


    Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system). For all the above conditions, guidelines have been established that need to be known. If complications occur or necessary measures are not taken, it can lead to cardiac and respiratory arrest. Therefore, cardiopulmonary resuscitation is needed. All procedures and dosages should be adapted to the age of the child.

  14. Improvement of medical education using web-based lecture repetition and extension: e-learning experiences of the Department of Obstetrics and Gynecology, University of Tuebingen

    Directory of Open Access Journals (Sweden)

    Wallwiener, Markus


    Full Text Available In order to improve the education of its medical students, the Department of Obstetrics and Gynecology of the University of Tuebingen established e-learning in terms of web-based lecture repetition and extension. Subsequent to lectures, questions are provided online. The participation is voluntary, but requires registration. The results of the analysed period (winter term 2004/2005, summer term 2005 and winter term 2005/2006 including more than 380 e-learning users are encouraging. An average of 45% of the target group used the offered online questions. The students who completed at least 75% of all prepared question units achieved significantly better results than their traditional learning fellow students (p=0.002. Users got more frequent the marks "good" and "very good". Twice as much conventional learning students as e-learning users failed the examination. E-Learning and the technical implementation are repeatedly appreciated by the students. In the future, more medical courses will be supplemented with e-learning, according to the students request.

  15. Evaluating the value of a web-based natural medicine clinical decision tool at an academic medical center

    Directory of Open Access Journals (Sweden)

    Karpa Kelly


    Full Text Available Abstract Background Consumer use of herbal and natural products (H/NP is increasing, yet physicians are often unprepared to provide guidance due to lack of educational training. This knowledge deficit may place consumers at risk of clinical complications. We wished to evaluate the impact that a natural medicine clinical decision tool has on faculty attitudes, practice experiences, and needs with respect to H/NP. Methods All physicians and clinical staff (nurse practitioners, physicians assistants (n = 532 in departments of Pediatrics, Family and Community Medicine, and Internal Medicine at our medical center were invited to complete 2 electronic surveys. The first survey was completed immediately before access to a H/NP clinical-decision tool was obtained; the second survey was completed the following year. Results Responses were obtained from 89 of 532 practitioners (16.7% on the first survey and 87 of 535 (16.3% clinicians on the second survey. Attitudes towards H/NP varied with gender, age, time in practice, and training. At baseline, before having an evidence-based resource available, nearly half the respondents indicated that they rarely or never ask about H/NP when taking a patient medication history. The majority of these respondents (81% indicated that they would like to learn more about H/NP, but 72% admitted difficulty finding evidence-based information. After implementing the H/NP tool, 63% of database-user respondents indicated that they now ask patients about H/NP when taking a drug history. Compared to results from the baseline survey, respondents who used the database indicated that the tool significantly increased their ability to find reliable H/NP information (P Conclusions Our results demonstrate healthcare provider knowledge and confidence with H/NP can be improved without costly and time-consuming formal H/NP curricula. Yet, it will be challenging to make providers aware of such resources.

  16. A time-efficient web-based teaching tool to improve medical knowledge and decrease ABIM failure rate in select residents

    Directory of Open Access Journals (Sweden)

    Sean M. Drake


    Full Text Available Aim: The American Board of Internal Medicine (ABIM exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR program with an aim to increase medical knowledge and reduce ABIM exam failure rate. Methods: Internal medicine residents at our academic medical center with In-Training Examination (ITE scores ≤35th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤35 percentile pre- (2002–2006 and post-intervention (2007–2013. A time commitment survey was also given to physicians and DR residents at the end of the study. Results: Residents who never scored ≤35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p<0.001. This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response. Conclusions: Although residents who ever scored ≤35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty.

  17. Web-based technology: its effects on small group "problem-based learning" interactions in a professional veterinary medical program. (United States)

    Schoenfeld-Tacher, Regina; Bright, Janice M; McConnell, Sherry L; Marley, Wanda S; Kogan, Lori R


    The objective of this investigation was to ascertain whether and how the introduction of a new technology (WebCT) influenced faculty teaching styles while facilitating small group problem-based learning (PBL) sessions in a professional veterinary medical (PVM) program. The following questions guided the study: (1) How does the use of technology affect faculty teaching behaviors? (2) Do the facilitators' interactions with WebCT technology change over the course of one semester? (3) What is the perceived impact of WebCT on facilitators' role in PBL? The study employed a combination of qualitative (case study) and semi-quantitative (survey) methods to explore these issues. Nine clinical sciences faculty members, leading a total of six PBL groups, were observed over the course of an academic semester for a total of 20 instructional sessions. The qualitative data gathered by observing faculty as they facilitated PBL sessions yielded three major themes: (1) How do PBL facilitators adapt to the addition of WebCT technology? (2) Does this technology affect teaching? and (3) How do PBL facilitators interact with their students and each other over the course of a semester? No direct evidence was found to suggest that use of WebCT affected teaching behaviors (e.g., student-centered vs. teacher-centered instruction). However, all facilitators showed a moderate increase in comfort with the technology during the semester, and one participant showed remarkable gains in technology skills. The teaching theme provided insight into how facilitators foster learning in a PBL setting as compared to a traditional lecture. A high degree of variability in teaching styles was observed, but individuals' styles tended to remain stable over the course of the semester. Nevertheless, all facilitators interacted similarly with students, in a more caring and approachable manner, when compared to the classroom or clinic atmospheres.


    Estrada, Carlos A.; Krishnamoorthy, Periyakaruppan; Smith, Ann; Staton, Lisa; Korf, Michele J.; Allison, Jeroan J.; Houston, Thomas K.


    Introduction CME providers may be interested in identifying effective marketing strategies to direct users to specific content. The use of online advertisements to recruit participants for clinical trials, public health programs, and Continuing Medical Education (CME) has been shown to be effective in some but not all studies. The purpose of this study was to compare the impact of two marketing strategies in the context of an online CME cultural competence curriculum ( Methods In an interrupted time-series quasi-experimental design, two marketing strategies were tested: a) wide dissemination to relevant organizations over a period of approximately four months, and b) Internet paid search using Google Ads (five consecutive eight-week periods--control 1, cultural/ CME advertisement, control 2, hypertension/ content advertisement, control 3). Outcome measures were CME credit requests, Web traffic (visits per day, page views, pages viewed per visit), and cost. Results Overall, the site was visited 19,156 times and 78,160 pages were viewed. During the wide dissemination phase, the proportion of visits requesting CME credit decreased between the first (5.3%) and second halves (3.3%) of this phase (p= .04). During the Internet paid search phase, the proportion of visits requesting CME credit was highest during the cultural/ CME advertisement period (control 1, 1.4%; cultural/CME ad, 4.3%; control 2, 1.5%; hypertension/content ad, 0.6%; control 3, 0.8%; pcultural advertisement per CME credit requested was $0.64US. Discussion Internet advertisement focusing on cultural competence and CME was associated with about a three-fold increase in requests for CME credit at an incremental cost of under $1; however, Web traffic changes were independent of the advertisement strategy. PMID:21425356

  19. Designated Medical Directors for Emergency Medical Services: Recruitment and Roles (United States)

    Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel


    Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

  20. Demographics and sexual characteristics of sex-enhancing medication users: Study of a web-based cross-sectional sample of sexually active men

    Directory of Open Access Journals (Sweden)

    Abul-Fotouh Ahmed


    Full Text Available Objectives: To evaluate the frequency of sex-enhancing medications (S-EM use and to investigate the demographics and sexual characteristics of the S-EM users amongst a Saudi Arabian male population. Subjects and methods: A cross-sectional sample of 1176 Saudi Arabian men was recruited using a web-based survey between 1 January and 1 April 2015. The survey included multiple open and closed questions to assess the frequency of S-EM use; and demographics, clinical, and sexual characteristics of S-EM users, as well as their perceptions of S-EM. Results: Amongst the participants, 1008 were sexually active and included in the data analysis. Of the sexually active participants, 402 (39.9% reported S-EM use in the form of herbal or phosphodiesterase type 5 inhibitors at some time in their lives. Comparing S-EM users with S-EM non-users, the S-EM users had a number of demographic and sexual characteristics including: higher education level, higher income, smoking, more than one sexual partner, longer sexual activity duration, higher frequency of sexual intercourse, and lower sexual satisfaction level. Most of the S-EM users (82.1% bought S-EM without a medical prescription and 62.5% had used them recreationally. In all, 52% of respondents used S-EM to treat ED and 69% of those who used it recreationally reported enhancement of erection with S-EM usage. Conclusions: Demographic and sexual characteristics of S-EM users and the attitude of the users towards the S-EM were identified amongst a Saudi Arabian male population. Keywords: Characteristics, Phosphodiesterase type 5 inhibitors, Sex-enhancing medication use

  1. Adaptation of a web-based, open source electronic medical record system platform to support a large study of tuberculosis epidemiology

    Directory of Open Access Journals (Sweden)

    Fraser Hamish SF


    Full Text Available Abstract Background In 2006, we were funded by the US National Institutes of Health to implement a study of tuberculosis epidemiology in Peru. The study required a secure information system to manage data from a target goal of 16,000 subjects who needed to be followed for at least one year. With previous experience in the development and deployment of web-based medical record systems for TB treatment in Peru, we chose to use the OpenMRS open source electronic medical record system platform to develop the study information system. Supported by a core technical and management team and a large and growing worldwide community, OpenMRS is now being used in more than 40 developing countries. We adapted the OpenMRS platform to better support foreign languages. We added a new module to support double data entry, linkage to an existing laboratory information system, automatic upload of GPS data from handheld devices, and better security and auditing of data changes. We added new reports for study managers, and developed data extraction tools for research staff and statisticians. Further adaptation to handle direct entry of laboratory data occurred after the study was launched. Results Data collection in the OpenMRS system began in September 2009. By August 2011 a total of 9,256 participants had been enrolled, 102,274 forms and 13,829 laboratory results had been entered, and there were 208 users. The system is now entirely supported by the Peruvian study staff and programmers. Conclusions The information system served the study objectives well despite requiring some significant adaptations mid-stream. OpenMRS has more tools and capabilities than it did in 2008, and requires less adaptations for future projects. OpenMRS can be an effective research data system in resource poor environments, especially for organizations using or considering it for clinical care as well as research.

  2. Comparison of the Impact of Wikipedia, UpToDate, and a Digital Textbook on Short-Term Knowledge Acquisition Among Medical Students: Randomized Controlled Trial of Three Web-Based Resources


    Scaffidi, Michael A.; Khan, Rishad; Wang, Christopher; Keren, Daniela; Tsui, Cindy; Garg, Ankit; Brar, Simarjeet; Valoo, Kamesha; Bonert, Michael; de Wolff, Jacob F; Heilman, James M.; Samir C Grover


    Background Web-based resources are commonly used by medical students to supplement curricular material. Three commonly used resources are UpToDate (Wolters Kluwer Inc), digital textbooks, and Wikipedia; there are concerns, however, regarding Wikipedia’s reliability and accuracy. Objective The aim of this study was to evaluate the impact of Wikipedia use on medical students’ short-term knowledge acquisition compared with UpToDate and a digital textbook. Methods This was a prospective, nonblind...

  3. Organizational Semantic Web based Portals


    Necula, Sabina-Cristiana


    This paper tries to treat organizational semantic web based portals. The first part of the paper focuses on concepts regarding semantic web based portals. After discussing some concepts we treat the basic functionalities that a semantic web based portal must have and we finish by presenting these functionalities by actual examples. We present semantic web based portals after studying the necessary implementations from literature and practice. We develop some examples that use semantic web ...

  4. Web-based collaboration tools. (United States)

    Wink, Diane M


    In this bimonthly series, the author examines how nurse educators can use Internet and Web-based computer technologies such as search, communication, and collaborative writing tools; social networking and social bookmarking sites; virtual worlds; and Web-based teaching and learning programs. This article describes Web-based collaboration tools and techniques to increase their effectiveness.

  5. eGender-from e-Learning to e-Research: a web-based interactive knowledge-sharing platform for sex- and gender-specific medical education. (United States)

    Seeland, Ute; Nauman, Ahmad T; Cornelis, Alissa; Ludwig, Sabine; Dunkel, Mathias; Kararigas, Georgios; Regitz-Zagrosek, Vera


    Sex and Gender Medicine is a novel discipline that provides equitable medical care for society and improves outcomes for both male and female patients. The integration of sex- and gender-specific knowledge into medical curricula is limited due to adequate learning material, systematic teacher training and an innovative communication strategy. We aimed at initiating an e-learning and knowledge-sharing platform for Sex and Gender Medicine, the eGender platform (, to ensure that future doctors and health professionals will have adequate knowledge and communication skills on sex and gender differences in order to make informed decisions for their patients. The web-based eGender knowledge-sharing platform was designed to support the blended learning pedagogical teaching concept and follows the didactic concept of constructivism. Learning materials developed by Sex and Gender Medicine experts of seven universities have been used as the basis for the new learning tools . The content of these tools is patient-centered and provides add-on information on gender-sensitive aspects of diseases. The structural part of eGender was designed and developed using the open source e-learning platform Moodle. The eGender platform comprises an English and a German version of e-learning modules: one focusing on basic knowledge and seven on specific medical disciplines. Each module consists of several courses corresponding to a disease or symptom complex. Self-organized learning has to be managed by using different learning tools, e.g., texts and audiovisual material, tools for online communication and collaborative work. More than 90 users from Europe registered for the eGender Medicine learning modules. The most frequently accessed module was "Gender Medicine-Basics" and the users favored discussion forums. These e-learning modules fulfill the quality criteria for higher education and are used within the elective Master Module "Gender Medicine

  6. 38 CFR 1.485 - Medical emergencies. (United States)


    ... disclosure; (4) The nature of the emergency (or error, if the report was to FDA); (5) The information... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medical emergencies. 1... PROVISIONS Disclosures Without Patient Consent § 1.485 Medical emergencies. (a) General rule. Under the...

  7. Enhanced Web-Based Otitis Study Case vs. Simple Paper-Case: Impact on Medical Student Objective Structured Clinical Exam Performance

    Directory of Open Access Journals (Sweden)

    Michael H. Malloy, M.D., M.S.


    Full Text Available Background: Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. Objective: To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Design/Methods: Students were randomized by community site to receive either the enhanced (E or simple otitis study case (S. Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: (American Academy of Pediatrics Otitis Web Site. They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR. Scores on the two stations were compared by group. Results: There were 198 students who took the OSCE. 178 (90% responded to a survey that indicated they had opened and read the e-mailed case. There

  8. Alcohol as a trigger for medical emergencies. (United States)

    Borges, Guilherme; Cherpitel, Cheryl; Orozco, Ricardo; MacDonald, Scott; Giesbrecht, Norman; Moskalewicz, Jacek; Swiatkiewicz, Grazyna; Cremonte, Mariana


    In this paper, our goal is to report relative risks of the impact of alcohol consumption 6 hours prior to medical emergencies presenting in the emergency department for 8,346 patients in seven countries using data from the Emergency Room Collaborative Alcohol Analysis Project. We found that alcohol increased the risk of a medical emergency by 2.17 times (confidence interval: 1.78-2.65), and those without a regular pattern of heavy drinking and those younger showed a greater risk. Acute alcohol is associated not only with injury but also with medical emergencies. More studies are needed on the acute role of alcohol in medical emergencies, preferably with data on the type of medical emergencies.

  9. A web-based audiometry database system. (United States)

    Yeh, Chung-Hui; Wei, Sung-Tai; Chen, Tsung-Wen; Wang, Ching-Yuang; Tsai, Ming-Hsui; Lin, Chia-Der


    To establish a real-time, web-based, customized audiometry database system, we worked in cooperation with the departments of medical records, information technology, and otorhinolaryngology at our hospital. This system includes an audiometry data entry system, retrieval and display system, patient information incorporation system, audiometry data transmission program, and audiometry data integration. Compared with commercial audiometry systems and traditional hand-drawn audiometry data, this web-based system saves time and money and is convenient for statistics research. Copyright © 2013. Published by Elsevier B.V.

  10. Design and implementation of a web-based patient portal linked to an electronic health record designed to improve medication safety: the Patient Gateway medications module

    Directory of Open Access Journals (Sweden)

    Jeffrey Schnipper


    Full Text Available In this article we describe the background, design, and preliminary results of a medications module within Patient Gateway (PG, a patient portal linked to an electronic health record (EHR. The medications module is designed to improve the accuracy of medication lists within the EHR, reduce adverse drug events and improve patient_provider communication regarding medications and allergies in several primary care practices within a large integrated healthcare delivery network. This module allows patients to view and modify the list of medications and allergies from the EHR, report nonadherence, side effects and other medication-related problems and easily communicate this information to providers, who can verify the information and update the EHR as needed. Usage and satisfaction data indicate that patients found the module easy to use, felt that it led to their providers having more accurate information about them and enabled them to feel more prepared for their forthcoming visits. Further analyses will determine the effects of this module on important medication-related outcomes and identify further enhancements needed to improve on this approach.

  11. A Web-Based Learning System for Software Test Professionals (United States)

    Wang, Minhong; Jia, Haiyang; Sugumaran, V.; Ran, Weijia; Liao, Jian


    Fierce competition, globalization, and technology innovation have forced software companies to search for new ways to improve competitive advantage. Web-based learning is increasingly being used by software companies as an emergent approach for enhancing the skills of knowledge workers. However, the current practice of Web-based learning is…

  12. 42 CFR 2.51 - Medical emergencies. (United States)


    ... and time of the disclosure; and (4) The nature of the emergency (or error, if the report was to FDA... 42 Public Health 1 2010-10-01 2010-10-01 false Medical emergencies. 2.51 Section 2.51 Public... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical...

  13. Identification and prediction of the fertile window with a new web-based medical device using a vaginal biosensor for measuring the circadian and circamensual core body temperature. (United States)

    Regidor, Pedro-Antonio; Kaczmarczyk, Marta; Schiweck, Esther; Goeckenjan-Festag, Maren; Alexander, Henry


    the ovulation was 99.11%. Accuracy of 88.8% for a window of 3 days before ovulation, the day of ovulation and the 3 days after ovulation was achieved for the prospective analysis. In the subgroup of woman with recorded pregnancies, it could be shown that after 3.79 months of use (median) pregnancies were observed. In 67.72% in up to 3 months, in 16.36% between 3 and 6 months of use, in 7.27% between 7 and 9 months, in 5.45% between 10 and 12 months and in 1.82% between 13 and 15 months of use of the system. With this new web-based system, a precise determination of the fertile window even in women with ultralong cycles (>35 days) could be detected independently of their personal live circumstances. Exact determination of the fertile window is herewith possible so that OvulaRing represents an evolution in the FAB method for the cycle diagnosis of women with regular, irregular or anovulatory menstrual cycles.

  14. Emergency Medical Rescue in a Radiation Environment

    Energy Technology Data Exchange (ETDEWEB)

    Briesmeister, L.; Ellington, Y.; Hollis, R.; Kunzman, J.; McNaughton, M.; Ramsey, G.; Somers, B.; Turner, A.; Finn, J.


    Previous experience with emergency medical rescues in the presence of radiation or contamination indicates that the training provided to emergency responders is not always appropriate. A new course developed at Los Alamos includes specific procedures for emergency response in a variety of radiological conditions.

  15. Emergency medical epidemiology in Assam, India

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo


    Full Text Available Background: Assam, with its capital in Dispur has one of the highest rates of infant and maternal mortality in India. Being under both tribal and hilly regions, it has lacked adequate healthcare and emergency services. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments, prior to launching emergency services across the state. Materials and Methods: On a prospective basis and using a stratified random sampling design, all emergencies presenting to the three government hospitals in Guwahati, Assam, which handle 90% of all emergencies currently, were studied on specially designed datasheets in order to collect data. Emergency medical technicians (EMTs were placed in the Casualty of the medical colleges and recorded all emergencies on the datasheet. The collected data was then analysed for stratification and mapping of emergencies. In addition, retrospective data for a period of 15 days was collected from the emergency case registers of all three hospitals and the adjoining district civil hospitals, in order to give a wider perspective of the nature of emergencies. Results: A total of 2169 emergencies were recorded over a seven-day prospective and fifteen-day retrospective period. Guwahati Medical College Hospital attended to majority of emergencies (42%, which were mainly of the nature of pregnancies (22.7%, accidents (12.2% or assaults (15.4% and fever related. Maximum emergencies also presented from the border districts, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents and assaults, while females presented with pregnancies as emergencies. Conclusion: Potential emergency services need to target young pregnant females. Law and order needs to be also tightened in order to curb accidents and assaults among young males.

  16. Securing web-based exams

    NARCIS (Netherlands)

    Sessink, O.D.T.; Beeftink, H.H.; Tramper, J.; Hartog, R.J.M.


    Learning management systems may offer web-based exam facilities. Such facilities entail a higher risk to exams fraud than traditional paper-based exams. The article discusses security issues with web-based exams, and proposes precautionary measures to reduce the risks. A security model is presented

  17. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte


    with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. DISCUSSION: We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered......BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We...... performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch...

  18. Asthma Medication Ratio Predicts Emergency Depart... (United States)

    U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

  19. Emergency Medicine for medical students world wide!

    DEFF Research Database (Denmark)

    Perinpam, Larshan; Thi Huynh, Anh-Nhi


    A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) -

  20. Intranasal medications in pediatric emergency medicine. (United States)

    Del Pizzo, Jeannine; Callahan, James M


    Intranasal medication administration in the emergency care of children has been reported for at least 20 years and is gaining popularity because of ease of administration, rapid onset of action, and relatively little pain to the patient. The ability to avoid a needle stick is often attractive to practitioners, in addition to children and their parents. In time-critical situations for which emergent administration of medication is needed, the intranasal route may be associated with more rapid medication administration. This article reviews the use of intranasal medications in the emergency care of children. Particular attention will be paid to anatomy and its impact on drug delivery, pharmacodynamics, medications currently administered by this route, delivery devices available, tips for use, and future directions.

  1. Medical and Surgical Emergencies in Ferrets. (United States)

    Di Girolamo, Nicola; Selleri, Paolo


    In the last few years, significant improvement in diagnosis and treatment of ferret emergencies has occurred. Scientific advances demonstrated the need of specific practices when dealing with emergencies in ferrets. The risk of overdiagnosis of hypoglycemia with human portable blood glucose meters is a clear example. The purpose of this article is to describe the current approach to common medical and surgical emergencies in ferrets. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. A web-based audiometry database system


    Yeh, Chung-Hui; Wei, Sung-Tai; Chen, Tsung-Wen; Wang, Ching-Yuang; Tsai, Ming-Hsui; Lin, Chia-Der


    To establish a real-time, web-based, customized audiometry database system, we worked in cooperation with the departments of medical records, information technology, and otorhinolaryngology at our hospital. This system includes an audiometry data entry system, retrieval and display system, patient information incorporation system, audiometry data transmission program, and audiometry data integration. Compared with commercial audiometry systems and traditional hand-drawn audiometry data, this ...

  3. Integrating Medical Emergencies into Dental Curricula

    African Journals Online (AJOL)

    Medicine and medical education are constantly changing and improving. This is one of the attractions to working in healthcare and long may it continue. However, when a new medical treatment emerges, then this must be covered in curricula - possibly for both under- and post-graduates. Similarly, when an innovation in ...

  4. [Asthma bronchiale - Emergency medical treatment]. (United States)

    Hansen, Michael; Hachenberg, Thomas


    Treatment of patients with acute severe or life-threatening asthma in the emergency department or in rescue services is a challenge for the physician. The decision on which therapy is needed depends on the clinical assessment of severity. Early administration of bronchodilators, ipratropium bromide and oral or intravenous corticosteroids is the cornerstone of treatment. If these treatments fail, systemic administration of bronchodilators, MgSO4 and theophylline should be carried in order to avoid intubation. Patients with incomplete or poor response should stay in hospital. © Georg Thieme Verlag Stuttgart · New York.

  5. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte


    BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We...... performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch...... records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15...

  6. [Nontraumatic medical emergencies in mountain rescues]. (United States)

    Sierra Quintana, Eva; Martínez Caballero, Carmen María; Batista Pardo, Sara Abigail; Abella Barraca, Salas; de la Vieja Soriano, María


    To describe the clinical and epidemiologic characteristics of patients with nontraumatic medical problems rescued by a Spanish mountain emergency response service (061 Aragon). Retrospective observational analysis of records of mountain rescues completed between July 2010 and December 2016. A total of 164 patients with nontraumatic medical emergencies were rescued; 82.3% were males. Most patients were between the ages of 50 and 59 years. Environmentally related problems, most often hypothermia, accounted for 36.6% of the emergencies. Cardiac problems led to 20.7% and digestive problems to 12.8%. Eighty-two percent of the patients were hiking or engaged in general mountain activities (other than rock climbing, canyoning, hunting, or skiing). Recent years have seen a rise in the number of patients requiring rescue from mountains for nontraumatic medical emergencies, particularly heart problems. The typical patient to expect would be a man between the ages of 50 and 59 years who is hiking in the summer.

  7. Design Patterns in Adaptive Web-Based Educational Systems : An Overview

    NARCIS (Netherlands)

    Avgeriou, Paris; Vogiatzis, Dimitrios; Tzanavari, Aimilia; Retalis, Symeon


    Adaptive Web-based Educational Systems represent an emerging technology that provides a unique advantage over traditional Web-based Educational Systems; that is the ability to adapt to the user's needs, goals, preferences etc. Adaptive Web-based Educational Systems are increasingly becoming part of

  8. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study. (United States)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge


    Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

  9. Information Infrastructure for Emergency Medical Services


    Orthner, Helmuth; Mishra, Ninad; Terndrup, Thomas; Acker, Joseph; Grimes, Gary; Gemmill, Jill; Battles, Marcie


    The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We hav...

  10. Medical emergency management among Iranian dentists. (United States)

    Khami, Mohammad Reza; Yazdani, Reza; Afzalimoghaddam, Mohammad; Razeghi, Samaneh; Moscowchi, Anahita


    More than 18,000 patients need medical emergencies management in dental offices in Iran annually. The present study investigates medical emergencies management among Iranian dentists. From the list of the cell phone numbers of the dentists practicing in the city of Tehran, 210 dentists were selected randomly. A self-administered questionnaire was used as the data collection instrument. The questionnaire requested information on personal and professional characteristics of the dentists, as well as their knowledge and self-reported practice in the field of medical emergency management, and availability of required drugs and equipments to manage medical emergencies in their offices. Totally, 177 dentists (84%) completed the questionnaire. Less than 60% of the participants were knowledgeable about characteristics of hypoglycemic patient, chest pain with cardiac origin, and true cardiopulmonary resuscitation (CPR) practice. Regarding practice, less than one quarter of the respondents acquired acceptable scores. In regression models, higher practice scores were significantly associated with higher knowledge scores (p emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.

  11. Medical Students' Perceptions of Emergency Medicine Careers. (United States)

    Pianosi, Kiersten; Stewart, Samuel A; Hurley, Katrina


    Introduction Previous studies on specialty choice have investigated specialty characteristics that are appealing to undergraduate students. Little is known about how students' attitudes towards Emergency Medicine (EM) careers evolve over their schooling. Methods An open-ended survey of medical students' career interests was distributed five times over the four-year undergraduate curriculum from 1999 to 2008 at Memorial University. We tested specialty choices across genders, and looked at how likely a student's choice in their first year influenced their final year choice, a metric we termed "endurance". The qualitative data was coded to identify key themes and sentinel quotes. Lastly, we conducted semi-structured interviews with academic emergency physicians at Dalhousie University to assess the relevance of these findings to postgraduate training. Results Males expressed more interest in EM than females. EM had more endurance than internal medicine, but less than family medicine, over the four-year curriculum. The biggest drawbacks for EM included lack of patient follow-up and lack of EM experience; positive perspectives focused on clinical variety and elective experiences. Lifestyle was prominent, seen as both positive and negative. Emergency physicians considered EM lifestyle attractive, and characterized medical students' perceptions as "skewed," highlighting lack of insight into system flaws. Conclusions Medical students' opinions towards EM tended to shift over time, particularly the perception of the work. Medical students' perceptions differ from that of experienced emergency physicians. Medical schools may be able to improve clinical exposure and provide more informed counselling or mentoring with respect to EM.

  12. Physician medical oversight in emergency medical services: where are we? (United States)

    Studnek, Jonathan R; Fernandez, Antonio R; Margolis, Gregg S; O'Connor, Robert E


    The objective of this study was to quantify the amount of direct contact with medical direction that nationally registered emergency medical services (EMS) professionals receive. The secondary objective was to determine whether differences in medical director contact were associated with work-related characteristics. As part of biennial reregistration paperwork, nationally registered EMS professionals reregistering in 2004 were asked to complete a survey regarding medical direction. There were three survey questions asking participants to indicate, on a five-point scale, how often they interacted with their medical director in specific situations (whether the medical director participated in continuing education, met personally to discuss an EMS issue, and was seen at the scene of an EMS call). Individuals were categorized as having limited contact if they had not observed their medical director in any of the above situations for more than six months. All others where categorized as having recent contact. Demographic characteristics were collected and statistical analysis was performed using chi-square. In 2004, 45,173 individuals reregistered, with 28,647 (63%) returning surveys. A complete case analysis was performed, leaving 22,026 (49%) individuals. There were 13,756 (62.5%) individuals who reported having recent medical director contact. A stepwise increase in the percentage of those reporting recent contact was present when comparing the providers' certification levels (emergency medical technician EMT-Basic 47.6%, EMT-Intermediate 62.3%, and EMT-Paramedic 78.5%, p medical director. Nearly one-third of participants in this study reported having limited medical director contact. Certification level, service type, and community size were significantly associated with the amount of contact with medical direction.

  13. Parent and emergency physician comfort with a system of on-line emergency-focused medical summaries for infants with significant cardiac disease. (United States)

    Pyles, Lee A; Scheid, Margaret; McBrady, Michael P; Hoyman, Kathryn H; Hanse, Molly; Jamrozek, Kathy; Hannan, Jessica C; Baker, Charles M; Duval, Susan J; Moller, James H; Hines, Claudia I


    Surveys were developed and administered to assess parental comfort with emergency care for children with special health care needs (CSHCN) with cardiac disease and the impact of a web-based database of emergency-focused clinical summaries (emergency information forms-EIF) called Midwest Emergency Medical Services for Children Information System (MEMSCIS) on parental attitudes regarding emergency care of their CSHCN. We hypothesized that MEMSCIS would improve the parent and provider outlook regarding emergencies of young children with heart disease in a randomized controlled trial. Children under age 2 were enrolled in MEMSCIS by study nurses associated with pediatric cardiac centers in a metropolitan area. Parents were surveyed at enrollment and 1 year on a 5-Point Likert Scale. Validity and reliability of the survey were evaluated. Study nurses formulated the emergency-focused summaries with cardiologists. One-hundred-seventy parent subjects, 94 study and 76 control, were surveyed at baseline and 1 year. Parents felt that hospital personnel were well-prepared for emergencies of their children and this improved from baseline 4.07 ± 1.03 to 1 year 4.24 ± 1.04 in study parents who had an EIF for their child and participated in the program (p = 0.0114) but not control parents. Parents perceived an improved comfort level by pre-hospital (p = 0.0256) and hospital (p = 0.0031) emergency personnel related to the MEMSCIS program. The MEMSCIS Program with its emergency-focused web-based clinical summary improved comfort levels for study parents. We speculate that the program facilitated normalization for parents even if the EIF was not used in an emergency during the study. The MEMSCIS program helps to prepare the family and the emergency system for care of CSHCN outside of the medical home.

  14. 75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations (United States)


    ... SECURITY Federal Emergency Management Agency Recovery Policy, RP9525.4, Emergency Medical Care and Medical..., Emergency Medical Care and Medical Evacuations. This is an existing policy that is scheduled for review to... policy identifies the extraordinary emergency medical care and medical evacuation expenses that are...

  15. "MedTRIS" (Medical Triage and Registration Informatics System): A Web-based Client Server System for the Registration of Patients Being Treated in First Aid Posts at Public Events and Mass Gatherings. (United States)

    Gogaert, Stefan; Vande Veegaete, Axel; Scholliers, Annelies; Vandekerckhove, Philippe


    First aid (FA) services are provisioned on-site as a preventive measure at most public events. In Flanders, Belgium, the Belgian Red Cross-Flanders (BRCF) is the major provider of these FA services with volunteers being deployed at approximately 10,000 public events annually. The BRCF has systematically registered information on the patients being treated in FA posts at major events and mass gatherings during the last 10 years. This information has been collected in a web-based client server system called "MedTRIS" (Medical Triage and Registration Informatics System). MedTRIS contains data on more than 200,000 patients at 335 mass events. This report describes the MedTRIS architecture, the data collected, and how the system operates in the field. This database consolidates different types of information with regards to FA interventions in a standardized way for a variety of public events. MedTRIS allows close monitoring in "real time" of the situation at mass gatherings and immediate intervention, when necessary; allows more accurate prediction of resources needed; allows to validate conceptual and predictive models for medical resources at (mass) public events; and can contribute to the definition of a standardized minimum data set (MDS) for mass-gathering health research and evaluation. Gogaert S , Vande veegaete A , Scholliers A , Vandekerckhove P . "MedTRIS" (Medical Triage and Registration Informatics System): a web-based client server system for the registration of patients being treated in first aid posts at public events and mass gatherings. Prehosp Disaster Med. 2016;31(5):557-562.

  16. A Web-based Architecture Enabling Multichannel Telemedicine Applications

    Directory of Open Access Journals (Sweden)

    Fabrizio Lamberti


    Full Text Available Telemedicine scenarios include today in-hospital care management, remote teleconsulting, collaborative diagnosis and emergency situations handling. Different types of information need to be accessed by means of etherogeneous client devices in different communication environments in order to enable high quality continuous sanitary assistance delivery wherever and whenever needed. In this paper, a Web-based telemedicine architecture based on Java, XML and XSL technologies is presented. By providing dynamic content delivery services and Java based client applications for medical data consultation and modification, the system enables effective access to an Electronic Patient Record based standard database by means of any device equipped with a Web browser, such as traditional Personal Computers and workstation as well as modern Personal Digital Assistants. The effectiveness of the proposed architecture has been evaluated in different scenarios, experiencing fixed and mobile clinical data transmissions over Local Area Networks, wireless LANs and wide coverage telecommunication network including GSM and GPRS.

  17. Web Based ATM PVC Management

    NARCIS (Netherlands)

    van der Waaij, B.D.; Sprenkels, Ron; van Beijnum, Bernhard J.F.; Pras, Aiko


    This paper discusses the design of a public domain web based ATM PVC Management tool for the Dutch SURFnet research ATM network. The aim of this tool is to assists in the creation and deletion of PVCs through local and remote ATM network domains. The tool includes security mechanisms to restrict the

  18. Comparison of the Impact of Wikipedia, UpToDate, and a Digital Textbook on Short-Term Knowledge Acquisition Among Medical Students: Randomized Controlled Trial of Three Web-Based Resources. (United States)

    Scaffidi, Michael A; Khan, Rishad; Wang, Christopher; Keren, Daniela; Tsui, Cindy; Garg, Ankit; Brar, Simarjeet; Valoo, Kamesha; Bonert, Michael; de Wolff, Jacob F; Heilman, James; Grover, Samir C


    Web-based resources are commonly used by medical students to supplement curricular material. Three commonly used resources are UpToDate (Wolters Kluwer Inc), digital textbooks, and Wikipedia; there are concerns, however, regarding Wikipedia's reliability and accuracy. The aim of this study was to evaluate the impact of Wikipedia use on medical students' short-term knowledge acquisition compared with UpToDate and a digital textbook. This was a prospective, nonblinded, three-arm randomized trial. The study was conducted from April 2014 to December 2016. Preclerkship medical students were recruited from four Canadian medical schools. Convenience sampling was used to recruit participants through word of mouth, social media, and email. Participants must have been enrolled in their first or second year of medical school at a Canadian medical school. After recruitment, participants were randomized to one of the three Web-based resources: Wikipedia, UpToDate, or a digital textbook. During testing, participants first completed a multiple-choice questionnaire (MCQ) of 25 questions emulating a Canadian medical licensing examination. During the MCQ, participants took notes on topics to research. Then, participants researched topics and took written notes using their assigned resource. They completed the same MCQ again while referencing their notes. Participants also rated the importance and availability of five factors pertinent to Web-based resources. The primary outcome measure was knowledge acquisition as measured by posttest scores. The secondary outcome measures were participants' perceptions of importance and availability of each resource factor. A total of 116 medical students were recruited. Analysis of variance of the MCQ scores demonstrated a significant interaction between time and group effects (P<.001, ηg2=0.03), with the Wikipedia group scoring higher on the MCQ posttest compared with the textbook group (P<.001, d=0.86). Access to hyperlinks, search functions

  19. [Emergency medical actions in firefighting operations]. (United States)

    Drinhaus, H; Nüsgen, S; Hinkelbein, J


    Being called to a firefighting operation is a rare albeit typical scenario for emergency physicians, which apart from medical expertise requires efficient collaboration with the firefighting team. This article outlines the characteristics of collaboration with the team and incident commanders of the fire service and of the medical aspects in firefighting operations, whereby treating the victims of fire as well as hazards to the firefighters are considered. This overview is based on a selective search of the literature and own experiences in emergency medicine and firefighting. Collaboration with the fire service needs to respect the organizational and leadership structures at the scene. Firefighting staff are mainly endangered by the enormous cardiopulmonary strain of the mission, by the rapid development of fire phenomena as well as diverse kinds of accidents. The main features of fire victims are smoke intoxication, burns as well as other injuries. Choosing the right hospital for optimal treatment is crucial. Medical expertise and basic knowledge of methods and tactics employed by the fire service are prerequisites for successful participation as an emergency physician in a firefighting operation. An integrative view of all aspects of injuries of the fire victims and the subsequent therapeutic decisions represent special challenges, which have not yet received much attention in the medical literature.

  20. Pediatric emergency medical services and their drawbacks

    Directory of Open Access Journals (Sweden)

    Abdullah Foraih Al-Anazi


    Full Text Available Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.

  1. Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity

    NARCIS (Netherlands)

    Hulsman, Robert L.; van der Vloodt, Jane


    Objective: Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video

  2. Information infrastructure for emergency medical services. (United States)

    Orthner, Helmuth; Mishra, Ninad; Terndrup, Thomas; Acker, Joseph; Grimes, Gary; Gemmill, Jill; Battles, Marcie


    The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We propose a conceptual model to enable improved clinical decision making in the pre-hospital environment using these change agents.

  3. Chemical Hazards Emergency Medical Management (CHEMM). (United States)

    Vardell, Emily


    The Chemical Hazards Emergency Medical Management (CHEMM) website from the National Library of Medicine is designed for first responders and medical providers who are planning for and responding to chemical hazards events. It includes pages tailored to the individual interests of specific groups, including first responders, health care providers, mental health professionals, toxicologists, and more. The featured decision support system CHEMM Intelligent Syndromes Tool allows users to identify the chemical a patient was exposed to in a mass casualty event. Copyright © Taylor & Francis Group, LLC

  4. HealthFace: A web-based remote monitoring interface for medical healthcare systems based on a wireless body area sensor network


    KIRBAŞ, İsmail; BAYILMIŞ, Cüneyt


    The wireless body area sensor network (WBASN) is a type of wireless sensor network. The wireless sensor nodes in a WBASN are placed on, near, or within a human body. In a medical healthcare system, WBASNs continuously provide healthcare monitoring, especially of elderly or ill people, wherever the patient goes. Wireless nodes sense and process human vital signs such as heart rate, blood pressure, body temperature, and respiration. They then send collected data to a medical center v...

  5. Medication adherence among pregnant women with hypothyroidism-missed opportunities to improve reproductive health? A cross-sectional, web-based study. (United States)

    Juch, Herbert; Lupattelli, Angela; Ystrom, Eivind; Verheyen, Sarah; Nordeng, Hedvig


    To evaluate patterns of and factors associated with a lack of pharmacotherapy as well as low adherence to treatment of hypothyroidism in pregnancy. This multinational, cross-sectional, internet-based study recruited pregnant woman in 18 countries. Data about women's socio-demographic and medical characteristics, medication adherence (8-item Morisky Medication Adherence Scale), beliefs about medication (Beliefs about Medicine Questionnaire), and personality traits (Big Five Personality Trait questionnaire) were collected via an online questionnaire. 229 of 5095 women had hypothyroidism during pregnancy; of these, 93% reported hypothyroidism pharmacotherapy. Adherence was low among 17% (95% CI: 12.5-22.5%) of medicated women, whilst it was moderate and high among 44% and 39%, respectively. Not using folic acid and not living in a stable relationship were associated with an increased likelihood for untreated hypothyroidism. Younger maternal age and not using folic acid in pregnancy were factors significantly associated with low adherence. Conscientiousness and the perception that the benefit of pharmacotherapy outweighed the risks were associated with higher levels of adherence. There is room for improvement of adherence to hypothyroidism treatment in pregnancy. Counselling of women with hypothyroidism in pregnancy should include a proper risk communication and information framing, to ameliorate maternal and foetal health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Medical student milestones in emergency medicine. (United States)

    Santen, Sally A; Peterson, William J; Khandelwal, Sorabh; House, Joseph B; Manthey, David E; Sozener, Cemal B


    Medical education is a continuum from medical school through residency to unsupervised clinical practice. There has been a movement toward competency-based medical education prompted by the Accreditation Council for Graduate Medical Education (ACGME) using milestones to assess competence. While implementation of milestones for residents sets specific standards for transition to internship, there exists a need for the development of competency-based instruments to assess medical students as they progress toward internship. The objective of this study was to develop competency-based milestones for fourth-year medical students completing their emergency medicine (EM) clerkships (regardless of whether the students were planning on entering EM) using a rigorous method to attain validity evidence. A literature review was performed to develop a list of potential milestones. An expert panel, which included a medical student and 23 faculty members (four program directors, 16 clerkship directors, and five assistant deans) from 19 different institutions, came to consensus on these milestones through two rounds of a modified Delphi protocol. The Delphi technique builds content validity and is an accepted method to develop consensus by eliciting expert opinions through multiple rounds of questionnaires. Of the initial 39 milestones, 12 were removed at the end of round 1 due to low agreement on importance of the milestone or because of redundancy with other milestones. An additional 12 milestones were revised to improve clarity or eliminate redundancy, and one was added based on expert panelists' suggestions. Of the 28 milestones moving to round 2, consensus with a high level of agreement was achieved for 24. These were mapped to the ACGME EM residency milestone competency domains, as well as the Association of American Medical Colleges (AAMC) core entrustable professional activities for entering residency to improve content validity. This study found consensus support by

  7. Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: A randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Brandyn D Lau

    Full Text Available Venous thromboembolism (VTE is a common cause of preventable harm in hospitalized patients. While numerous successful interventions have been implemented to improve prescription of VTE prophylaxis, a substantial proportion of doses of prescribed preventive medications are not administered to hospitalized patients. The purpose of this trial was to evaluate the effectiveness of nurse education on medication administration practice.This was a double-blinded, cluster randomized trial in 21 medical or surgical floors of 933 nurses at The Johns Hopkins Hospital, an academic medical center, from April 1, 2014 -March 31, 2015. Nurses were cluster-randomized by hospital floor to receive either a linear static education (Static module with voiceover or an interactive learner-centric dynamic scenario-based education (Dynamic module. The primary and secondary outcomes were non-administration of prescribed VTE prophylaxis medication and nurse-reported satisfaction with education modules, respectively.Overall, non-administration improved significantly following education (12.4% vs. 11.1%, conditional OR: 0.87, 95% CI: 0.80-0.95, p = 0.002 achieving our primary objective. The reduction in non-administration was greater for those randomized to the Dynamic arm (10.8% vs. 9.2%, conditional OR: 0.83, 95% CI: 0.72-0.95 versus the Static arm (14.5% vs. 13.5%, conditional OR: 0.92, 95% CI: 0.81-1.03, although the difference between arms was not statistically significant (p = 0.26. Satisfaction scores were significantly higher (p<0.05 for all survey items for nurses in the Dynamic arm.Education for nurses significantly improves medication administration practice. Dynamic learner-centered education is more effective at engaging nurses. These findings suggest that education should be tailored to the NCT02301793.

  8. Intelligent Medical Systems for Aerospace Emergency Medical Services (United States)

    Epler, John; Zimmer, Gary


    The purpose of this project is to develop a portable, hands free device for emergency medical decision support to be used in remote or confined settings by non-physician providers. Phase I of the project will entail the development of a voice-activated device that will utilize an intelligent algorithm to provide guidance in establishing an airway in an emergency situation. The interactive, hands free software will process requests for assistance based on verbal prompts and algorithmic decision-making. The device will allow the CMO to attend to the patient while receiving verbal instruction. The software will also feature graphic representations where it is felt helpful in aiding in procedures. We will also develop a training program to orient users to the algorithmic approach, the use of the hardware and specific procedural considerations. We will validate the efficacy of this mode of technology application by testing in the Johns Hopkins Department of Emergency Medicine. Phase I of the project will focus on the validation of the proposed algorithm, testing and validation of the decision making tool and modifications of medical equipment. In Phase 11, we will produce the first generation software for hands-free, interactive medical decision making for use in acute care environments.

  9. A Web-Based Telehealth Training Platform Incorporating Automated Nonverbal Behavior Feedback for Teaching Communication Skills to Medical Students: A Randomized Crossover Study. (United States)

    Liu, Chunfeng; Lim, Renee L; McCabe, Kathryn L; Taylor, Silas; Calvo, Rafael A


    In the interests of patient health outcomes, it is important for medical students to develop clinical communication skills. We previously proposed a telehealth communication skills training platform (EQClinic) with automated nonverbal behavior feedback for medical students, and it was able to improve medical students' awareness of their nonverbal communication. This study aimed to evaluate the effectiveness of EQClinic to improve clinical communication skills of medical students. We conducted a 2-group randomized crossover trial between February and June 2016. Participants were second-year medical students enrolled in a clinical communication skills course at an Australian university. Students were randomly allocated to complete online EQClinic training during weeks 1-5 (group A) or to complete EQClinic training during weeks 8-11 (group B). EQClinic delivered an automated visual presentation of students' nonverbal behavior coupled with human feedback from a standardized patient (SP). All students were offered two opportunities to complete face-to-face consultations with SPs. The two face-to-face consultations were conducted in weeks 6-7 and 12-13 for both groups, and were rated by tutors who were blinded to group allocation. Student-Patient Observed Communication Assessment (SOCA) was collected by blinded assessors (n=28) at 2 time points and also by an SP (n=83). Tutor-rated clinical communications skill in face-to-face consultations was the primary outcome and was assessed with the SOCA. We used t tests to examine the students' performance during face-to-face consultations pre- and postexposure to EQClinic. We randomly allocated 268 medical students to the 2 groups (group A: n=133; group B: n=135). SOCA communication skills measures (score range 4-16) from the first face-to-face consultation were significantly higher for students in group A who had completed EQClinic training and reviewed the nonverbal behavior feedback, compared with group B, who had completed

  10. Emergency medical dispatch codes association with emergency department outcomes. (United States)

    Hettinger, A Zachary; Cushman, Jeremy T; Shah, Manish N; Noyes, Katia


    Emergency medical dispatch systems are used to help categorize and prioritize emergency medical services (EMS) resources for requests for assistance. We examined whether a subset of Medical Priority Dispatch System (MPDS) codes could predict patient outcomes (emergency department [ED] discharge versus hospital admission/ED death). This retrospective observational cohort study analyzed requests for EMS through a single public safety answering point (PSAP) serving a mixed urban, suburban, and rural community over one year. Probabilistic matching was used to link subjects. Descriptive statistics, 95% confidence intervals (CIs), and logistic regression were calculated for the 107 codes and code groupings (9E vs. 9E1, 9E2, etc.) that were used 50 or more times during the study period. Ninety percent of PSAP records were matched to EMS records and 84% of EMS records were matched to ED data, resulting in 26,846 subjects with complete records. The average age of the cohort was 46.2 years (standard deviation [SD] 24.8); 54% were female. Of the transported patients, 70% were discharged from the ED, with nine dispatch codes demonstrating a 90% or greater predictive power. Three code groupings had more than 60% predictive power for admission/death. Subjects aged 65 years and older were found to be at increased risk for admission/death in 33 dispatch codes (odds ratio [OR] 2.0 [95% confidence interval 1.3-3.0] to 19.6 [5.3-72.6]). A small subset (8% of codes; 7% by call volume) of MPDS codes were associated with greater than 90% predictive ability for ED discharge. Older adults are at increased risk for admission/death in a separate subset of MPDS codes, suggesting that age criteria may be useful to identify higher-acuity patients within the MPDS code. These findings could assist in prehospital/hospital resource management; however, future studies are needed to validate these findings for other EMS systems and to investigate possible strategies for improvements of emergency

  11. Teaching Emergency Care to First-Year Medical Students (United States)

    McCally, Michael; And Others


    At the George Washington University School of Medicine a 52-hour course in emergency care was adapted for first-year medical students from an 81-hour program for training emergency medical technicians. (Author/LBH)

  12. Emergency medical care in The Netherlands. (United States)

    Boom, P S


    In The Netherlands a serious effort is underway to improving the performance of the emergency medical care system by functionally integrating ambulance services and hospitals into a comprehensive care network. Ambulance services are actively stimulated to join regional bodies offering adequate resources to deal with a whole range of incidents from day-to-day accidents to large-scale disasters. At the same time the development of a network of 'Accident and Emergency' hospitals is being promoted. Such networks will be centred around government-appointed traumacentres. Regional ambulance bodies and 'A&E-network' will be geographically attuned into an integral EMC-system, supervised by an EMC-officer assigned by the local authorities that constitute the regional authority. The Dutch government has initiated a project to streamline and monitor the developments. The project has proved to be a stimulating example of effective collaboration between the government and various involved professional disciplines.

  13. Web Based Video Educational Resources for Surgeons

    Directory of Open Access Journals (Sweden)

    Petre Vlah-Horea BOŢIANU


    Full Text Available During the last years, video files showing different surgical procedures have become extremely available and popular on the internet. They are available on both free and unrestricted sites, as well as on dedicated sites which control the medical quality of the information. Honest presentation and a minimal video-editing to include information about the procedure are mandatory to achieve a product with a true educational value. The integration of the web-based video educational resources in the continuing medical information system seems to be limited and the true educational impact very difficult to assess. A review of the available literature dedicated on this subject shows that the main challenge is related to the human factor and not to the available technology.

  14. Medical image of the week: hypertensive emergencies


    Raschke RA


    No abstract available. Article truncated at 150 words. A 39-year-old man had sudden onset of left sided hemiparesis, headache and nausea. He had a history of untreated hypertension and diabetes mellitus. On initial evaluation by emergency medical services, his blood pressure was 270/170 mm Hg. Shortly after admission, he suffered a generalized seizure treated with levetiracetam. His labs were remarkable for a creatinine of 4.4 mg/dL and microscopic hematuria. His head CT findings are consiste...

  15. Medical Geology: a globally emerging discipline

    Energy Technology Data Exchange (ETDEWEB)

    Bunnell, J.E.; Finkelman, R.B.; Centeno, J.A.; Selinus, O. [Armed Forces Institute of Pathology, Washington, DC (United States)


    Medical Geology, the study of the impacts of geologic materials and processes on animal and human health, is a dynamic emerging discipline bringing together the geoscience, biomedical, and public health communities to solve a wide range of environmental health problems. Among the Medical Geology described in this review are examples of both deficiency and toxicity of trace element exposure. Goiter is a widespread and potentially serious health problem caused by deficiency of iodine. In many locations the deficiency is attributable to low concentrations of iodine in the bedrock. Similarly, deficiency of selenium in the soil has been cited as the principal cause of juvenile cardiomyopathy and muscular abnormalities. Overexposure to arsenic is one of the most widespread Medical Geology problems affecting more than one hundred million people in Bangladesh, India, China, Europe, Africa and North and South America. The arsenic exposure is primarily due to naturally high levels in groundwater but combustion of mineralized coal has also caused arsenic poisoning. Dental and skeletal fluorosis also impacts the health of millions of people around the world and, like arsenic, is due to naturally high concentrations in drinking water and, to a lesser extent, coal combustion. Other Medical Geology issues described include geophagia, the deliberate ingestion of soil, exposure to radon, and ingestion of high concentrations of organic compounds in drinking water. Geoscience and biomedical/public health researchers are teaming to help mitigate these health problems as well as various non-traditional issues for geoscientists such as vector-borne diseases.

  16. Emerging medical technologies and emerging conceptions of health. (United States)

    Stempsey, William E


    Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect more and more that our bodies should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation.

  17. 32 CFR 1656.20 - Expenses for emergency medical care. (United States)


    ... 32 National Defense 6 2010-07-01 2010-07-01 false Expenses for emergency medical care. 1656.20... ALTERNATIVE SERVICE § 1656.20 Expenses for emergency medical care. (a) Claims for payment of actual and reasonable expenses for emergency medical care, including hospitalization, of ASWs who suffer illness or...

  18. Medical image of the week: hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Raschke RA


    Full Text Available No abstract available. Article truncated at 150 words. A 39-year-old man had sudden onset of left sided hemiparesis, headache and nausea. He had a history of untreated hypertension and diabetes mellitus. On initial evaluation by emergency medical services, his blood pressure was 270/170 mm Hg. Shortly after admission, he suffered a generalized seizure treated with levetiracetam. His labs were remarkable for a creatinine of 4.4 mg/dL and microscopic hematuria. His head CT findings are consistent with two simultaneous neurological hypertensive emergencies – intracranial hemorrhage of the basal ganglia and posterior reversible encephalopathy syndrome (PRES (Figure 1 (1. PRES is areas of edema seen as multiple cortico-subcortical areas of hyperintense (white signal involving the occipital and parietal lobes bilaterally and pons. His renal failure likely represents a third hypertensive emergency. His blood pressure was lowered into the 140/90 range within 2 hours by nicardipine infusion and intravenous labetalol boluses. He subsequently suffered worsening mental status and unilateral pupillary dilation and …

  19. CMS Web-Based Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Badgett, William [Fermilab; Lopez-Perez, Juan Antonio [Fermilab; Maeshima, Kaori [Fermilab; Soha, Aron [Fermilab; Sulmanas, Balys [Fermilab; Wan, Zongru [Kansas State U.


    With the growth in size and complexity of High Energy Physics experiments, and the accompanying increase in the number of collaborators spread across the globe, the importance of widely relaying timely monitoring and status information has grown. To this end, we present online Web Based Monitoring solutions from the CMS experiment at CERN. The web tools developed present data to the user from many underlying heterogeneous sources, from real time messaging system to relational databases. We provide the power to combine and correlate data in both graphical and tabular formats of interest to the experimentalist, with data such as beam conditions, luminosity, trigger rates, detector conditions and many others, allowing for flexibility on the user side. We also present some examples of how this system has been used during CMS commissioning and early beam collision running at the Large Hadron Collider.

  20. Web based foundry knowledge base

    Directory of Open Access Journals (Sweden)

    A. Stawowy


    Full Text Available The main assumptions and functions of proposed Foundry Knowledge Base (FKB are presented in this paper. FKB is a framework forinformation exchange of casting products and manufacturing methods. We use CMS (Content Management System to develope andmaintain our web-based system. The CastML – XML dialect developed by authors for description of casting products and processes – isused as a tool for information interchange between ours and outside systems, while SQL is used to store and edit knowledge rules and alsoto solve the basic selection problems in the rule-based module. Besides the standard functions (companies data, news, events, forums and media kit, our website contains a number of nonstandard functions; the intelligent search module based on expert system is the main advantage of our solution. FKB is to be a social portal which content will be developed by foundry community.

  1. Feasibility of web-based decision aids in neurological patients

    NARCIS (Netherlands)

    van Til, Janine Astrid; Drossaert, Constance H.C.; Renzenbrink, Gerbert J.; Snoek, Govert J.; Dijkstra, Evelien; Stiggelbout, Anne M.; IJzerman, Maarten Joost


    Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of

  2. Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

    Directory of Open Access Journals (Sweden)

    Timmermann Arnd


    Full Text Available Abstract Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21; problem-based learning at 29% (n = 10, e-learning at 3% (n = 1, and internship in ambulance service is mandatory at 11% (n = 4. In terms of assessment methods, multiple-choice exams (15 to 70 questions are favoured (89%, n = 31, partially supplemented by open questions (31%, n = 11. Some faculties also perform single practical tests (43%, n = 15, objective structured clinical examination (OSCE; 29%, n = 10 or oral examinations (17%, n = 6. Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard

  3. Undergraduate medical education in emergency medical care: a nationwide survey at German medical schools. (United States)

    Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix


    Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.

  4. Hand hygiene in emergency medical services. (United States)

    Teter, Jonathan; Millin, Michael G; Bissell, Rick


    Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of

  5. Can public health registry data improve Emergency Medical Dispatch?

    DEFF Research Database (Denmark)

    Andersen, M S; Christensen, E F; Jepsen, S B


    BACKGROUND: Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. METHODS: This 30-day follow-up study evaluated time-critical emergencies...... callers. Additional efforts are warranted to clarify the role for risk prediction tools in emergency medical dispatch....

  6. Development of a large urban longitudinal HIV clinical cohort using a web-based platform to merge electronically and manually abstracted data from disparate medical record systems: technical challenges and innovative solutions. (United States)

    Greenberg, Alan E; Hays, Harlen; Castel, Amanda D; Subramanian, Thilakavathy; Happ, Lindsey Powers; Jaurretche, Maria; Binkley, Jeff; Kalmin, Mariah M; Wood, Kathy; Hart, Rachel


    Electronic medical records (EMRs) are being increasingly utilized to conduct clinical and epidemiologic research in numerous fields. To monitor and improve care of HIV-infected patients in Washington, DC, one of the most severely affected urban areas in the United States, we developed a city-wide database across 13 clinical sites using electronic data abstraction and manual data entry from EMRs. To develop this unique longitudinal cohort, a web-based electronic data capture system (Discovere®) was used. An Agile software development methodology was implemented across multiple EMR platforms. Clinical informatics staff worked with information technology specialists from each site to abstract data electronically from each respective site's EMR through an extract, transform, and load process. Since enrollment began in 2011, more than 7000 patients have been enrolled, with longitudinal clinical data available on all patients. Data sets are produced for scientific analyses on a quarterly basis, and benchmarking reports are generated semi-annually enabling each site to compare their participants' clinical status, treatments, and outcomes to the aggregated summaries from all other sites. Numerous technical challenges were identified and innovative solutions developed to ensure the successful implementation of the DC Cohort. Central to the success of this project was the broad collaboration established between government, academia, clinics, community, information technology staff, and the patients themselves. Our experiences may have practical implications for researchers who seek to merge data from diverse clinical databases, and are applicable to the study of health-related issues beyond HIV. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email:

  7. Emergency medical treatment and 'do not resuscitate' orders: When ...

    African Journals Online (AJOL)

    Whether there is a conflict between these two requirements is answered by considering: (i) the meaning of emergency medical treatment; (ii) the relationship between emergency medical treatment and DNR orders; (iii) the meaning of futile medical treatment; (iv) the relationship between DNR orders and euthanasia; and (v) ...

  8. Emergency medical kits on board commercial aircraft: a comparative study. (United States)

    Sand, Michael; Gambichler, Thilo; Sand, Daniel; Thrandorf, Christina; Altmeyer, Peter; Bechara, Falk G


    In cases of critical medical situations on board commercial aircraft, access to emergency medical kits can be lifesaving. Thus, this comparative study investigated acute care medication and equipment supplied in emergency medical kits on board both low-cost carriers and full-service carriers. Thirty-two European airlines (sixteen low-cost carriers and sixteen full-service-carriers) were asked to provide anonymous data on the contents of their emergency medical kits. All emergency medical equipment and medication carried on board were subject to a descriptive analysis with regards to International Civil Aviation Organization (ICAO) standards for emergency medical kits, as well as variation and differences between low-cost carriers and full-service carriers. A total of twelve airlines (seven full-service carriers and five low-cost carriers) participated in this study. None complied with ICAO standards. Emergency medical kits from both full-service carriers and low-cost carriers exhibited a high degree of variability. Two European low-cost carriers were assessed as being insufficiently equipped for a medical emergency requiring acute care. This study demonstrates the high degree of variability in the contents of emergency medical kits. Additionally, some airlines were equipped insufficiently for a critical medical situation on board their aircraft. Frequent checks of national authorities and further evaluation of acute care equipment are required to prepare for potentially life-threatening critical conditions occurring in special environments, such as in airplane during flight. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Web Based Seismological Monitoring (wbsm) (United States)

    Giudicepietro, F.; Meglio, V.; Romano, S. P.; de Cesare, W.; Ventre, G.; Martini, M.

    Over the last few decades the seismological monitoring systems have dramatically improved tanks to the technological advancements and to the scientific progresses of the seismological studies. The most modern processing systems use the network tech- nologies to realize high quality performances in data transmission and remote controls. Their architecture is designed to favor the real-time signals analysis. This is, usually, realized by adopting a modular structure that allow to easy integrate any new cal- culation algorithm, without affecting the other system functionalities. A further step in the seismic processing systems evolution is the large use of the web based appli- cations. The web technologies can be an useful support for the monitoring activities allowing to automatically publishing the results of signals processing and favoring the remote access to data, software systems and instrumentation. An application of the web technologies to the seismological monitoring has been developed at the "Os- servatorio Vesuviano" monitoring center (INGV) in collaboration with the "Diparti- mento di Informatica e Sistemistica" of the Naples University. A system named Web Based Seismological Monitoring (WBSM) has been developed. Its main objective is to automatically publish the seismic events processing results and to allow displaying, analyzing and downloading seismic data via Internet. WBSM uses the XML tech- nology for hypocentral and picking parameters representation and creates a seismic events data base containing parametric data and wave-forms. In order to give tools for the evaluation of the quality and reliability of the published locations, WBSM also supplies all the quality parameters calculated by the locating program and allow to interactively display the wave-forms and the related parameters. WBSM is a modular system in which the interface function to the data sources is performed by two spe- cific modules so that to make it working in conjunction with a

  10. Emergency Medicine Resident Perceptions of Medical Professionalism. (United States)

    Jauregui, Joshua; Gatewood, Medley O; Ilgen, Jonathan S; Schaninger, Caitlin; Strote, Jared


    Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (pprofessional attributes and this may be useful to educators. Explanations for these differences are hypothesized, as are the potential implications for professionalism education. Because teaching professional behavior is taught most effectively via behavior modeling, faculty awareness of resident values and faculty development to address potential gaps may improve professionalism education.

  11. A web-based information system for a regional public mental healthcare service network in Brazil. (United States)

    Yoshiura, Vinicius Tohoru; de Azevedo-Marques, João Mazzoncini; Rzewuska, Magdalena; Vinci, André Luiz Teixeira; Sasso, Ariane Morassi; Miyoshi, Newton Shydeo Brandão; Furegato, Antonia Regina Ferreira; Rijo, Rui Pedro Charters Lopes; Del-Ben, Cristina Marta; Alves, Domingos


    Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized

  12. Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations. (United States)

    Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R


    Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  13. Web-Based Distributed XML Query Processing

    NARCIS (Netherlands)

    Smiljanic, M.; Feng, L.; Jonker, Willem; Blanken, Henk; Grabs, T.; Schek, H-J.; Schenkel, R.; Weikum, G.


    Web-based distributed XML query processing has gained in importance in recent years due to the widespread popularity of XML on the Web. Unlike centralized and tightly coupled distributed systems, Web-based distributed database systems are highly unpredictable and uncontrollable, with a rather

  14. Emergency Medicine Resident Perceptions of Medical Professionalism

    Directory of Open Access Journals (Sweden)

    Joshua Jauregui


    Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in

  15. EMcounter-charting the epidemiology of medical emergencies in India: a status report. (United States)

    Balsari, Satchit


    In the last decade, the specialty of Emergency Medicine has gained tremendous interest in low and middle income countries, with a demand for new training programs, pre-hospital systems, emergency department expansions and policy change. Yet, little is known about the actual distribution of medical emergencies in these settings. Project EMcounter proposes the implementation of this much needed, uniform, multi-center epidemiologic survey of emergencies in India to provide sound scientific data upon which new training programs, infrastructural expansions, and legislative change can be built. A standardized, web-based, user-friendly data entry tool, EMcounter, forms the backbone of this project. The tool is currently piloted at a tertiary center in Chennai, India. The project is aimed at capturing the geographic and temporal variations in over 20 participating centers across the private and public sector in rural and urban India. The uniform use of the web-based tool ensures standardization in data collection across the centers. Our pilot project logs patient demographics, pre-hospital transportation, chief complaints, vitals, interventions, disposition and diagnoses. The volume of data thus collected is large and is currently saved in a spread sheet format. The first quarter has already begun to highlight the epidemiologic differences between a local hospital in Chennai and national averages in the US. The pilot phase has been critical in gauging the robustness of the tool before its expansion to multiple centers and has proved to be invaluable in identifying potential flaws. The early pilot phase has demonstrated that combining the multiple parameters available through the EMcounter database will allow the study of demographics and existing practice algorithms. Expansion of the project to multiple centers will shed objective light on the gaps in health-care provision at various levels and help design triage and transfer guidelines based on these data. This

  16. Customer satisfaction measurement in emergency medical services. (United States)

    Kuisma, Markku; Määttä, Teuvo; Hakala, Taisto; Sivula, Tommi; Nousila-Wiik, Maria


    The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured. Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction. This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.

  17. Self-reported preparedness for medical emergencies among ...

    African Journals Online (AJOL)

    Context: Medical emergencies have been known to occur in dental offices and can lead to loss of life if not well managed. Objective: The objective of this study was to assess self-reported preparedness by practicing dentists for management of medical emergencies in Benin City, Nigeria. Methods: A self-administered ...

  18. Emerging research trends in medical textiles

    CERN Document Server

    Gokarneshan, N; Rajendran, V; Lavanya, B; Ghoshal, Arundhathi


    This book provides a comprehensive review of the significant researches reported during the recent years in the field of medical textiles. It also highlights the use of new types of fibres in developing medical textile products and their promising role in the respective areas of application. Considerable developments have taken place in the development of medical textiles for varied applications.

  19. 76 FR 29131 - Emergency Medical Services Week, 2011 (United States)


    ... the EMS system function, including emergency dispatchers, physicians, nurses, and researchers, as well... May 19, 2011 Part V The President Proclamation 8674--Emergency Medical Services Week, 2011... May 17, 2011--Continuation of the National Emergency With Respect to the Stabilization of Iraq #0; #0...

  20. Curriculum design of emergency medical services program at the College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences

    Directory of Open Access Journals (Sweden)

    Alanazi AF


    Full Text Available Abdullah Foraih AlanaziCollege of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaBackground: The emergency medical services program at the College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia, was adapted from the integrated problem-based learning curriculum of Flinders University, Adelaide, South Australia.Purpose: The purpose of this article is to discuss the major adaptations required for adoption of the full-fledged PBL curriculum, use of sequential blocks, and multilayer alignment of the curriculum.Methods: A logical model and step-by-step approach were used to design the curriculum. Several studies using Delphi methods, focus group interviews, and expert opinions were performed to identify the priority health problems; related competencies, learning objectives, and learning strategies; the web-based curriculum for delivery; student assessment; and program evaluation.Results: Sixty priority health problems were identified for inclusion in different blocks of the curriculum. Identified competencies matched the satisfaction of different stakeholders, and ascertained learning objectives and strategies were aligned with the competencies. A full-fledged web-based curriculum was designed and an assessment was created that aligned with a blueprint of the objectives and the mode of delivery.Conclusion: Step-by-step design ensures the multilayer alignment of the curriculum, including priority health problems, competencies, objectives, student assessment, and program evaluation.Keywords: emergency medical services, problem-based learning, logical model, step-by-step approach, multilayer alignment

  1. CoP Sensing Framework on Web-Based Environment (United States)

    Mustapha, S. M. F. D. Syed

    The Web technologies and Web applications have shown similar high growth rate in terms of daily usages and user acceptance. The Web applications have not only penetrated in the traditional domains such as education and business but have also encroached into areas such as politics, social, lifestyle, and culture. The emergence of Web technologies has enabled Web access even to the person on the move through PDAs or mobile phones that are connected using Wi-Fi, HSDPA, or other communication protocols. These two phenomena are the inducement factors toward the need of building Web-based systems as the supporting tools in fulfilling many mundane activities. In doing this, one of the many focuses in research has been to look at the implementation challenges in building Web-based support systems in different types of environment. This chapter describes the implementation issues in building the community learning framework that can be supported on the Web-based platform. The Community of Practice (CoP) has been chosen as the community learning theory to be the case study and analysis as it challenges the creativity of the architectural design of the Web system in order to capture the presence of learning activities. The details of this chapter describe the characteristics of the CoP to understand the inherent intricacies in modeling in the Web-based environment, the evidences of CoP that need to be traced automatically in a slick manner such that the evidence-capturing process is unobtrusive, and the technologies needed to embrace a full adoption of Web-based support system for the community learning framework.

  2. Improvement of knowledge and practical skills in venipuncture through web-based training. (United States)

    Bodelle, Boris; Sziegoleit, Andreas


    This paper reports on the implementation of web-based training in venipuncture as standardizable knowledge transfer. For this purpose, we performed an experimental study with nursing students and medical students.

  3. Web-based Project Reporting System (United States)

    US Agency for International Development — Web-PRS is a web-based system that captures financial information and project status information that is sortable by geographical location, pillar, project type and...

  4. Web-based Digital Lexicographic Bilingual Resources

    Directory of Open Access Journals (Sweden)

    Ralitsa Dutsova


    Full Text Available Web-based Digital Lexicographic Bilingual Resources The paper presents briefly a web-based system for creation and management of bilingual resources with Bulgarian as one of the paired language. This is useful and easy to use tool for collection and management of a large amount of different linguistic knowledge. The system uses two sets of natural language data: bilingual dictionary and aligned text corpora

  5. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study

    NARCIS (Netherlands)

    Gelder, M.M.H.J. van; Schouten, N.P.; Merkus, P.J.F.M.; Verhaak, C.M.; Roeleveld, N.; Roukema, J.


    BACKGROUND: Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this

  6. Towards Web-based representation and processing of health information

    DEFF Research Database (Denmark)

    Gao, S.; Mioc, Darka; Yi, X.L.


    at their fingertips. Increasingly complex problems in the health field require increasingly sophisticated computer software, distributed computing power, and standardized data sharing. To address this need, Web-based mapping is now emerging as an important tool to enable health practitioners, policy makers......, and the public to understand spatial health risks, population health trends and vulnerabilities. Today several web-based health applications generate dynamic maps; however, for people to fully interpret the maps they need data source description and the method used in the data analysis or statistical modeling....... For the representation of health information through Web-mapping applications, there still lacks a standard format to accommodate all fixed (such as location) and variable (such as age, gender, health outcome, etc) indicators in the representation of health information. Furthermore, net-centric computing has not been...

  7. REMINDER: In a medical emergency call 74444

    CERN Multimedia


    What happened? A CERN colleague, complaining of pains that might indicate serious heart problem, went to the ?infirmary' on the Prévessin site for medical aid. He was unaware that the ?infirmary' was in fact no such thing, but the office of the French contractors' medical practitioner, and, on top of that, it was closed. He therefore took his own car and went to the CERN Fire Station on the Meyrin Site (Building 65). The firemen and the CERN medical team took care of him and requested helicopter transport to the Geneva cantonal hospital, where he responded well to medical treatment. What do we learn from this event? You must call the CERN internal number 74444 in the event of serious and acute illness, and do not have to present yourself in person or get somebody to go with you. This number is not reserved exclusively for accident, pollution, fire etc. The Firemen can prodice professional assistance at all times as required: first aid on the spot, amulance transport and medical assistance as necessary. ...

  8. The association between birthdays and medical emergencies

    Directory of Open Access Journals (Sweden)

    Harish Kurup


    Conclusions: People are more likely to present to emergency departments in the week starting from their birthday than any other week of the year. There is scope for public health initiatives such as sending health education information in the form of a birthday card to raise awareness of this risk.

  9. Perceived barriers and facilitators of using a Web-based interactive decision aid for colorectal cancer screening in community practice settings: findings from focus groups with primary care clinicians and medical office staff. (United States)

    Jimbo, Masahito; Shultz, Cameron Garth; Nease, Donald Eugene; Fetters, Michael Derwin; Power, Debra; Ruffin, Mack Thomas


    Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients' lack of Internet access or low computer literacy, and potential impediments to the clinics' daily workflow. Expanding patients' use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients' screening preferences. Participants described that a system to link the online decision aid to a computerized reminder

  10. NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory (United States)

    Federal Laboratory Consortium — The NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory is a 2005 Wheeled Coach Type III ambulance mounted on a Ford E-450 cut-away van chassis....

  11. Hand Washing Practices Among Emergency Medical Services Providers

    National Research Council Canada - National Science Library

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan


    Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS...

  12. Reporting Helicopter Emergency Medical Services in Major Incidents

    DEFF Research Database (Denmark)

    Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M


    OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...

  13. Web-based learning: pros, cons and controversies. (United States)

    Cook, David A


    Advantages of web-based learning (WBL) in medical education include overcoming barriers of distance and time, economies of scale, and novel instructional methods, while disadvantages include social isolation, up-front costs, and technical problems. Web-based learning is purported to facilitate individualised instruction, but this is currently more vision than reality. More importantly, many WBL instructional designs fail to incorporate principles of effective learning, and WBL is often used for the wrong reasons (e.g., for the sake of technology). Rather than trying to decide whether WBL is superior to or equivalent to other instructional media (research addressing this question will always be confounded), we should accept it as a potentially powerful instructional tool, and focus on learning when and how to use it. Educators should recognise that high fidelity, multimedia, simulations, and even WBL itself will not always be necessary to effectively facilitate learning.

  14. Simulation in Medical Student Education: Survey of the Clerkship Directors in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Michael Fitch


    Full Text Available Introduction: The objective of this study is to identify (1 the current role of simulation in medical student emergency medicine (EM education; (2 the challenges to initiating and sustaining simulationbased programs; and (3 educational advances to meet these challenges. Methods: We solicited members of the Clerkship Directors in Emergency Medicine (CDEM e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey elements addressed the nature of the undergraduate EM clerkship and utilization of simulation, types of technology, and barriers to increased use in each setting. Results: CDEM members representing 60 EM programs on the list (80% responded. Sixty-seven percent of EM clerkships are in the fourth year of medical school only and 45% are required. Fewer than 25% of clerkship core curriculum hours incorporate simulation. The simulation modalities used most frequently were high-fidelity models (79%, task trainers (55%, and low-fidelity models (30%. Respondents identified limited faculty time (88.7% and clerkship hours (47.2% as the main barriers to implementing simulation training in EM clerkships. Financial resources, faculty time, and the volume of students were the main barriers to additional simulation in preclinical years. Conclusion: A focused, stepwise application of simulation to medical student EM curricula can help optimize the ratio of student benefit to faculty time. Limited time in the curriculum can be addressed by replacing existing material with simulation-based modules for those subjects better suited to simulation. Faculty can use hybrid approaches in the preclinical years to combine simulation with classroom settings for either small or large groups to more actively engage learners while minimizing identified barriers.

  15. Assessment of emergency medical services in the Ashanti region of ...

    African Journals Online (AJOL)

    Background: We aimed to assess the structure, function and performance of Ashanti Region's emergency medical services system in the context of the regional need for prehospital emergency care. Design: A mixed-methods approach was employed, using retrospective collection of quantitative data and prospectively ...

  16. Profile and Outcome of Medical Emergencies in a Tertiary Health ...

    African Journals Online (AJOL)


    cardiovascular and cerebrovascular diseases and HIV/AIDS related infectious as the most significant contributors. There is need for action to improve on the responsiveness of our healthcare systems to cope with this trend of disease pattern in our emergency rooms and reduce mortality from medical emergencies.

  17. Acute Dystonic Reaction as Medical Emergency: A Report of Two ...

    African Journals Online (AJOL)

    Drug‑induced dystonic reactions are common presentations to the emergency department. Two cases of acute dystonic reactions presenting as acute medical emergency illustrate the associated fatality and possibility of misdiagnosis. This case series reports two cases of medication‑induced (haloperidol and ...

  18. Effective medical leadership in times of emergency: a perspective. (United States)

    Hershkovich, Oded; Gilad, David; Zimlichman, Eyal; Kreiss, Yitshak


    Leadership, and more specifically medical leadership, is an unmeasured potential that has the power to influence every aspect of a person's professional life and its challenges and is more evident in times of emergency. Medical leadership is receiving increasing recognition especially in discussing actions to be taken in times of stress and emergency. We propose a comprehensive conceptual model that examines the elements that build successful medical leadership, especially during emergency scenarios. The model is based on two sets of medical leadership capabilities and skills, while the first set is more relevant to everyday challenges, the second set represents abilities and characteristics that arise mostly during emergencies. The model gathers together the characteristics and abilities of the medical leader based on our unique personal experiences during conflicts, terror, civilian challenges and numerous humanitarian missions. This article suggests a framework for the foundations on which the medical leader's education should be built and describes our perception of how to establish medical leadership, its unique elements and the processes leading to outstanding performance in times of emergency.

  19. A Review of Medical Emergencies in Dental Practice | Uyamadu ...

    African Journals Online (AJOL)

    Background: Medical emergencies in dental practice are those adverse medical events that may present in the course of dental treatment. Each of those events requires a correct diagnosis for effective and safe management. The contemporary dentist must be prepared to manage expeditiously and effectively those few ...

  20. 22 CFR 71.10 - Emergency medical assistance. (United States)


    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Emergency medical assistance. 71.10 Section 71... government; (2) All reasonable attempts to obtain private resources (prisoner's family, friends, etc.) have... family or friends who might serve as a source of private funds for medical services, and attempt to...

  1. Going online: The role of web-based initiatives in health information technology. (United States)

    Clingan, Scott A


    As Internet usage grows, so does the desire for online accessibility to healthcare services. In addition to patient convenience, Web-based services improve efficiency, further patient-provider communication, increase patient participation in healthcare decision-making, and enhance patient safety, all while containing healthcare costs. More than just an electronic medical record, examples of Web-based initiatives range from e-prescriptions, e-scheduling, and an e-mail-type Web-based messaging system to an online healthcare portal. Medicare and private insurers have offered incentives to promote adoption of health information technology, although they have yet to establish a universally accepted reimbursement model and outcome measures.


    Directory of Open Access Journals (Sweden)

    Hakan KAPTAN


    Full Text Available As a result of developing on Internet and computer fields, web based education becomes one of the area that many improving and research studies are done. In this study, web based education materials have been explained for multimedia animation and simulation aided Computer Networks course in Technical Education Faculties. Course content is formed by use of university course books, web based education materials and technology web pages of companies. Course content is formed by texts, pictures and figures to increase motivation of students and facilities of learning some topics are supported by animations. Furthermore to help working principles of routing algorithms and congestion control algorithms simulators are constructed in order to interactive learning

  3. 3D medical collaboration technology to enhance emergency healthcare

    DEFF Research Database (Denmark)

    Welch, Gregory F; Sonnenwald, Diane H.; Fuchs, Henry


    of the dynamic reconstructions. We call this idea remote 3D medical collaboration. In this article we motivate and explain the vision for 3D medical collaboration technology; we describe the relevant computer vision, computer graphics, display, and networking research; we present a proof-of-concept prototype...... system; and we present evaluation results supporting the general hypothesis that 3D remote medical collaboration technology could offer benefits over conventional 2D videoconferencing in emergency healthcare....

  4. 77 FR 12908 - Appointment/Reappointment to the National Emergency Medical Services Advisory Council (NEMSAC) (United States)


    ... Emergency Nurses Hospital Administration Public Health Emergency Management State Homeland Security Director... National Highway Traffic Safety Administration Appointment/Reappointment to the National Emergency Medical... the National Emergency Medical Services Advisory Council (NEMSAC). SUMMARY: NHTSA is soliciting...

  5. Radiation emergency medical preparedness and assistance network in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, E. S.; Kong, H. J.; Noh, J. H.; Lim, Y. K.; Kim, C. S. [Radiation Health Research Institute, Seoul (Korea, Republic of)


    Nationwide Medical Preparedness for Nuclear Accidents as an integral part of nuclear safety system has been discussed for several years and Radiation Health Research Institute (RHRI) of Korea Hydro and Nuclear Power Co. was established on July, 1999. The National Radiation Emergency Medical Center (NREMC) of Korea Cancer Center Hospital was also founded on September, 2002. Two organizations have established Radiation Emergency Medical Preparedness and Assistance Network in Korea to cope with accidental situations in nuclear power plants and also in handling sites of radionuclides. In order to construct an effective Nationwide Emergency Medical Network System they maintain good cooperation among regional hospitals. RHRI is going to make three types of medical groups, that is to say, the collaboration of the regional (primary appointed) hospital group around the nuclear power plants, the regional core (secondary appointed) hospital group and the central core hospital (RHRI). NREMC is also playing a central role in collaboration with 10 regional hospitals. Two cores are working key role for the maintenance of the network. Firstly, They maintain a radiological emergency response team consisting of physicians, nurses, health physicists, coordinators, and necessary support personnel to provide first-line responders with consultative or direct medical and radiological assistance at their facility or at the accident site. Secondly, they serves educational programs for the emergency personnel of collaborating hospitals not only as a treatment facility but also as a central training and demonstration unit. Regularly scheduled courses for the physician and nurse, and health/medical physicists are conducted. Therefore, to activate Nationwide Emergency Medical Network System and to maintain it for a long time, well-trained specialists and budgetary supports are indispensable.

  6. Web-based treatment for infertility-related psychological distress. (United States)

    Sexton, Minden B; Byrd, Michelle R; O'Donohue, William T; Jacobs, Negar Nicole


    Infertility has been associated with stigma and negative psychosocial functioning. However, only a small proportion of this population actually receives care. Fertility patients predominantly use the Internet for information gathering, social support, and assistance with decision-making; yet, available web resources are unreliable sources of mental health care. Web-based alternatives also have the potential to assist with intervention access difficulties and may be of significant lower cost. This study evaluated the efficacy of a web-based approach to providing a cognitive behavioral intervention with 31 infertile women seeking medical reproductive technologies. Following randomized assignment, participants using the web-based intervention were compared with those in a wait-list control condition on general and infertility-related psychological stress measures. Results were mixed regarding intervention efficacy. Significant declines in general stress were evidenced in the experimental group compared with a wait-list control group. However, website access did not result in statistically significant improvements on a measure of infertility-specific stress. These findings add to the literature on psychological interventions for women experiencing fertility problems. Moreover, despite the widespread use of the Internet by this population, the present study is one of the first to investigate the usefulness of the Internet to attenuate stress in this population. Preliminary results suggest general stress may be significantly reduced in infertile women using an online cognitive behavioral approach.

  7. Emergency medical services and congestion : urban sprawl and pre-hospital emergency care time. (United States)


    This research measured the association between urban sprawl and emergency medical service (EMS) response time. The purpose was to test the hypothesis that features of the built environment increase the probability of delayed ambulance arrival. Using ...

  8. Web-Based Physician Ratings for California Physicians on Probation. (United States)

    Murphy, Gregory P; Awad, Mohannad A; Osterberg, E Charles; Gaither, Thomas W; Chumnarnsongkhroh, Thanabhudee; Washington, Samuel L; Breyer, Benjamin N


     Web-based physician ratings systems are a popular tool to help patients evaluate physicians. Websites help patients find information regarding physician licensure, office hours, and disciplinary records along with ratings and reviews. Whether higher patient ratings are associated with higher quality of care is unclear.  The aim of this study was to characterize the impact of physician probation on consumer ratings by comparing website ratings between doctors on probation against matched controls.  A retrospective review of data from the Medical Board of California for physicians placed on probation from December 1989 to September 2015 was performed. Violations were categorized into nine types. Nonprobation controls were matched by zip code and specialty with probation cases in a 2:1 ratio using the California Department of Consumer Affairs website. Web-based reviews were recorded from,, and (ratings range from 1-5).  A total of 410 physicians were placed on probation for 866 violations. The mean (standard deviation [SD]) number of ratings per doctor was 5.2 (7.8) for cases and 4 (6.3) for controls (P=.003). The mean rating for physicians on probation was 3.7 (1.6) compared with 4.0 (1.0) for controls when all three rating websites were pooled (P1.0-2.2). This association was not significant in a multivariate model when we included age and gender.  Web-based physician ratings were lower for doctors on probation indicating that patients may perceive a difference. Despite these statistical findings, the absolute difference was quite small. Physician rating websites have utility but are imperfect proxies for competence. Further research on physician Web-based ratings is warranted to understand what they measure and how they are associated with quality.

  9. Challenges to web-based learning in pharmacy education in Arabic language speaking countries

    Directory of Open Access Journals (Sweden)

    Ramez M Alkoudmani


    Full Text Available Web-based learning and web 2.0 tools which include new online educational technologies (EdTech and social media websites like Facebook® are playing crucial roles nowadays in pharmacy and medical education among millennial learners. Podcasting, webinars, and online learning management systems like Moodle® and other web 2.0 tools have been used in pharmacy and medical education to interactively share knowledge with peers and students. Learners can use laptops, iPads, iPhones, or tablet devices with a stable and good Internet connection to enroll in many online courses. Implementation of novel online EdTech in pharmacy and medical curricula has been noticed in developed countries such as European countries, the US, Canada, and Australia. However, these trends are scarce in the majority of Arabic language speaking countries (ALSC, where traditional and didactic educational methods are still being used with some exceptions seen in Palestine, Kuwait, Jordan, Saudi Arabia, Egypt, UAE, and Qatar. Although these new trends are promising to push pharmacy and medical education forward, major barriers regarding adaptation of E-learning and new online EdTech in Arab states have been reported such as higher connectivity costs, information communication technology (ICT problems, language barriers, wars and political conflicts, poor education, financial problems, and lack of qualified ICT-savvy educators. More research efforts are encouraged to study the effectiveness and proper use of web-based learning and emerging online EdTech in pharmacy education not only in ALSC but also in developing and developed countries.

  10. [Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units]. (United States)

    Dick, W


    clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.

  11. IMPRESS: medical location-aware decision making during emergencies (United States)

    Gkotsis, I.; Eftychidis, G.; Leventakis, G.; Mountzouris, M.; Diagourtas, D.; Kostaridis, A.; Hedel, R.; Olunczek, A.; Hahmann, S.


    Emergency situations and mass casualties involve several agencies and public authorities, which need to gather data from the incident scene and exchange geo-referenced information to provide fast and accurate first aid to the people in need. Tracking patients on their way to the hospitals can prove critical in taking lifesaving decisions. Increased and continuous flow of information combined by vital signs and geographic location of emergency victims can greatly reduce the response time of the medical emergency chain and improve the efficiency of disaster medicine activity. Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware medical applications. IMPRESS is an advanced ICT platform based on adequate technologies for developing location-aware medical response during emergencies. The system incorporates mobile and fixed components that collect field data from diverse sources, support medical location and situation-based services and share information on the patient's transport from the field to the hospitals. In IMPRESS platform tracking of victims, ambulances and emergency services vehicles is integrated with medical, traffic and crisis management information into a common operational picture. The Incident Management component of the system manages operational resources together with patient tracking data that contain vital sign values and patient's status evolution. Thus, it can prioritize emergency transport decisions, based on medical and location-aware information. The solution combines positioning and information gathered and owned by various public services involved in MCIs or large-scale disasters. IMPRESS solution, were validated in field and table top exercises in cooperation with emergency services and hospitals.

  12. Web-based education in bioprocess engineering

    NARCIS (Netherlands)

    Sessink, O.D.T.; Schaaf, van der H.; Beeftink, H.H.; Hartog, R.; Tramper, J.


    The combination of web technology, knowledge of bioprocess engineering, and theories on learning and instruction might yield innovative learning material for bioprocess engineering. In this article, an overview of the characteristics of web-based learning material is given, as well as guidelines for

  13. Web Based Training for the Hellenic Navy (United States)


    distance, time distance, and possibly even intellectual distance. Second, the term ‘distance education’ has been applied to a tremendous amount of...identification of the student. Plagiarism is a concern for all Web-based tests. As described previously, participant had 33 ID’s as student 1, 2,.. , etc and

  14. Web-Based Learning Design Tool (United States)

    Bruno, F. B.; Silva, T. L. K.; Silva, R. P.; Teixeira, F. G.


    Purpose: The purpose of this paper is to propose a web-based tool that enables the development and provision of learning designs and its reuse and re-contextualization as generative learning objects, aimed at developing educational materials. Design/methodology/approach: The use of learning objects can facilitate the process of production and…

  15. Web-Based CALL to Listening Comprehension (United States)

    Chen, Li-Mei; Zhang, Ruiming


    This study investigated effectiveness of Web-based CALL on listening comprehension. Both students' academic performance and attitudes were examined. T-tests were used to analyze the results of students' academic performance. Descriptive statistics interpreted students' attitudes toward this learning. Students' participation was also recorded.…

  16. Human health hazards of veterinary medications: information for emergency departments. (United States)

    Lust, Elaine Blythe; Barthold, Claudia; Malesker, Mark A; Wichman, Tammy O


    There are over 5000 approved prescription and over-the-counter medications, as well as vaccines, with labeled indications for veterinary patients. Of these, there are several products that have significant human health hazards upon accidental or intentional exposure or ingestion in humans: carfentanil, clenbuterol (Ventipulmin), ketamine, tilmicosin (Micotil), testosterone/estradiol (Component E-H and Synovex H), dinoprost (Lutalyse/Prostamate), and cloprostenol (Estromate/EstroPlan). The hazards range from mild to life-threatening in terms of severity, and include bronchospasm, central nervous system stimulation, induction of miscarriage, and sudden death. To report medication descriptions, human toxicity information, and medical management for the emergent care of patients who may have had exposure to veterinary medications when they present to an emergency department (ED). The intended use of this article is to inform and support ED personnel, drug information centers, and poison control centers on veterinary medication hazards. There is a need for increased awareness of the potential hazards of veterinary medications within human medicine circles. Timely reporting of veterinary medication hazards and their medical management may help to prepare the human medical community to deal with such exposures or abuses when time is of the essence. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Usefulness of emergency medical teams in sport stadiums. (United States)

    Leusveld, E; Kleijn, S; Umans, V A W M


    In August 2006, the new AZ Alkmaar soccer stadium (capacity 17,000) opened. To provide adequate emergency support, medical teams of Red Cross volunteers and coronary care unit and emergency room nurses were formed, and facilities including automated external defibrillators were made available at the stadium. During every match, 3 teams are placed among the spectators. All patients who had cardiac events were stabilized by the teams and transported to the hospital. They formed the study group. From August 2006 to May 2007, >800,000 individuals attended soccer matches at the new stadium. Four cardiac events (3 out-of-hospital-resuscitations for ventricular fibrillation, 1 patient with chest pain) requiring emergency medical support occurred. On-site resuscitations using defibrillators were successful. Two patients with triple-vessel disease subsequently underwent coronary bypass surgery and implantable cardioverter-defibrillator implantation. One patient had single-vessel disease of the circumflex branch, for which he received a coronary stent. All had uneventful recoveries. An acute coronary syndrome was ruled out in the patient presenting with chest pain. In conclusion, the presence of emergency medical teams at a large sport stadium was of vital importance in the immediate care of critically ill patients. On-site resuscitation using automated external defibrillators was lifesaving in all cases. The presence of medical teams equipped with defibrillators and emergency action plans is recommended at large venues that host sports and other activities.

  18. Helicopter Emergency Medical Service in the Republic of Croatia

    Directory of Open Access Journals (Sweden)

    Andrija Vidović


    Full Text Available Current situation of emergency medical assistance indicatesthe need to organize faster and more efficient system oflinking all the parts of the Republic of Croatia. The solutioncan be found in the implementation of aviation as the fastestand therefore the best method of transporting the injured, diseasedand other persons who need urgent transpmt. The use ofmilitary helicopters for the purposes of emergency aviation doesnot satisfy the needs of the Republic of Croatia from the organizationaland legal aspect. There were 597 fatalities on the Croatianroads in 2005 and with the establishment of emergencyhelicopter medical service, the number of fatalities may be reducedby one third.

  19. Medical Identity Theft in the Emergency Department: Awareness is Crucial

    Directory of Open Access Journals (Sweden)

    Michelino Mancini


    Full Text Available Medical Identity theft in the emergency department (ED can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. [West J Emerg Med. 2014;15(7:–0.

  20. Implementing a nationwide criteria-based emergency medical dispatch system

    DEFF Research Database (Denmark)

    Andersen, Mikkel S; Johnsen, Søren Paaske; Sørensen, Jan Nørtved


    A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.......A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks....

  1. Leadership in medical emergencies depends on gender and personality. (United States)

    Streiff, Seraina; Tschan, Franziska; Hunziker, Sabina; Buehlmann, Cyrill; Semmer, Norbert K; Hunziker, Patrick; Marsch, Stephan


    Leadership is an important predictor of team performance in medical emergencies. There are no data on why some healthcare workers take the lead in emergencies while others do not. Accordingly, the aim of the study was to determine predictors of leadership in a medical emergency. Two hundred thirty-seven medical students in fourth year of medical school participated and filled in a questionnaire assessing knowledge, experience, and personality traits. Students were randomly assigned to 79 groups of three. Each group was confronted with a standardized scenario of a simulated witnessed cardiac arrest. The primary outcome was the predictors of the number of leadership statements during the first 3 minutes of the cardiac arrest. In the first 3 minutes of the cardiac arrest, the participants made a median of five leadership statements (range, 0-22; interquartile range, 2). Thirteen participants (5.5%) made no single leadership statement. Multivariate analysis revealed that male gender (unstandardized coefficient, 1.9; P = 0.01), extraversion (unstandardized coefficient, 0.9; P = 0.02), and agreeableness (unstandardized coefficient, -1.1; P = 0.023) predicted leadership statements. Context knowledge, context experience, and other personality traits had no significant effect on leadership. During the initial phase of a medical emergency, there is a substantial interindividual variation in the amount of leadership. Leadership behavior as assessed by the number of leadership statements is determined by gender and personality and not by knowledge or experience.

  2. Medical identity theft in the emergency department: awareness is crucial. (United States)

    Mancini, Michelino


    Medical identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient's identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior.

  3. Blood cultures in emergency medical admissions: a key patient cohort. (United States)

    Chotirmall, Sanjay H; Callaly, Elizabeth; Lyons, Judith; O'Connell, Brian; Kelleher, Mary; Byrne, Declan; O'Riordan, Deirdre; Silke, Bernard


    Blood cultures are performed in the emergency room when sepsis is suspected, and a cohort of patients is thereby identified. The present study investigated the outcomes (mortality and length of hospital stay) in this group following an emergency medical admission. Prospective assessment of all emergency medical admissions presenting to the emergency department at St James's Hospital, Dublin, over an 11-year period (2002-2012) was carried out. Outcomes including 30-day in-hospital mortality and length of stay were explored in the context of an admission blood culture. Generalized estimating equations, logistic or zero-truncated Poisson multivariate models were used, with adjustment for confounding variables including illness severity, comorbidity, and chronic disabling disease, to assess the effect of an urgent blood culture on mortality and length of stay. A total of 60 864 episodes were recorded in 35 168 patients admitted over the time period assessed. Patients more likely to undergo blood cultures in the emergency department were male, younger, and had more comorbidity. Univariate and multivariate analyses showed that those who had a blood culture, irrespective of result, had increased mortality and a longer in-hospital stay. This was highest for those with a positive culture, irrespective of the organism isolated. A clinical decision to request a blood culture identified a subset of emergency admissions with markedly worse outcomes. This patient cohort warrants close monitoring in the emergency setting.

  4. A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department. (United States)

    Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A


    Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department.

  5. Knowledge and use of emergency contraception by medical doctors ...

    African Journals Online (AJOL)


    Dec 9, 2013 ... Conclusion: The correct knowledge and professional disposition toward EC as a form of contraception is low. We recommend that in‑service training should focus more on EC to improve the quality of their knowledge and attitude towards it. Key words: Emergency contraception, knowledge, Medical Doctor, ...

  6. Benchmarking online dispatch algorithms for Emergency Medical Services

    NARCIS (Netherlands)

    C.J. Jagtenberg (Caroline); P. L.-J. van den Berg (Pieter); R.D. van der Mei (Rob)


    textabstractProviders of Emergency Medical Services (EMS) face the online ambulance dispatch problem, in which they decide which ambulance to send to an incoming incident. Their objective is to minimize the fraction of arrivals later than a target time. Today, the gap between existing solutions and

  7. Medical Emergencies in Primary Schools and School Ownership of ...

    African Journals Online (AJOL)

    Introduction: The school system aims at developing pupils academically and socially. In the process of achieving this, pupils are prone to accidents and medical emergencies due to their vulnerabilities. The ability of the school system to respond to these challenges may depend on the availability of well equipped First Aid ...

  8. 'No one may be refused emergency medical treatment' – ethical ...

    African Journals Online (AJOL)

    Enshrined in section 27(3) of the Constitution of South Africa is the right that 'no one may be refused emergency medical treatment'. While this universal human right is altruistic in its simplistic meaning and appears to be in tune with the requirement of freedom, equality and dignity for all in South Africa, in-depth analysis ...

  9. Three Types of Memory in Emergency Medical Services Communication (United States)

    Angeli, Elizabeth L.


    This article examines memory and distributed cognition involved in the writing practices of emergency medical services (EMS) professionals. Results from a 16-month study indicate that EMS professionals rely on distributed cognition and three kinds of memory: individual, collaborative, and professional. Distributed cognition and the three types of…

  10. The effect of emergency medical services response on outcome of ...

    African Journals Online (AJOL)

    Background: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any ...

  11. Acute Dystonic Reaction as Medical Emergency: A Report of Two ...

    African Journals Online (AJOL)

    Drug‑induced acute dystonic reaction is a common presentation to emergency department. They occur in 0.5‑1% of patients given metoclopramide or prochlorperazine as anti‑emetic in the medical ward.[1] Up to 33% of acutely psychotic patients will have some sort of drug‑induced movement disorder within the first few ...

  12. Medical Mortality in the Accident and Emergency Unit of the ...

    African Journals Online (AJOL)

    Ten patients (4.3%) died from diabetic ketoacidosis, and hepatic encephalopathy and tetanus were responsible for 10(4.3%) and 7 (3.0%) deaths respectively. Conclusion: In the period studied, medical mortality was high in the accident and emergency room of UPTH. The major causes of deaths were cerebrovascular ...


    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai); L. Yilmaz; W.K.V. Chan; I. Moon; T.M.K. Roeder; C. Macal; M.D. Rosetti


    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  14. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    van Buuren, M.; Kommer, G.J.; van der Mei, R.D.; Bhulai, S.


    In pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response time to the

  15. Achievements in emergency medical care service, North-West ...

    African Journals Online (AJOL)

    Objective. To analyse the performance of the Emergency Medical Rescue Service (EMRS) in North-West province. Design. A prospective study of the activity of the EMRS. Setting. North-West province, 2002 - 2004. Results. During this period the EMRS response time tended to decrease (reduction of 8 minutes for rural and ...

  16. Knowledge and use of emergency contraception by medical doctors ...

    African Journals Online (AJOL)

    Context: Emergency contraception (EC) is widely used to prevent unwanted pregnancy and it is largely adopted in many countries as over the counter drug to improve access. Aims: To determine and compare the correct knowledge, attitude and current use of EC among newly graduated medical doctors (MDs). Settings and ...

  17. 3. Medical emergencies in primary schools and school ownership of ...

    African Journals Online (AJOL)


    Key words:Schools, First Aid Boxes, Medical Emergencies. ABSTRACT. Introduction: The school system aims at ... the school system, it is not completely devoid of health challenges to the enrolee if adequate measures .... example, the Health and Safety (First-Aid) Regulations for schools since 1981 set out that schools must ...

  18. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai)


    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  19. [The nurse within emergency medical-psychological units]. (United States)

    Darbon, Rémy; Dalphin, Catherine; Prieto, Nathalie; Cheucle, Éric


    The growing recognition of post-traumatic stress disorders and the need to intervene early justifies the creation of emergency medical-psychological units. The nurse has a major role to play within these teams. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Long-Term Mortality of Emergency Medical Services Patients

    DEFF Research Database (Denmark)

    Bøtker, Morten T; Terkelsen, Christian J; Sørensen, Jan Nørtved


    STUDY OBJECTIVE: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark. METHODS: We analyzed linked EMS, hospital...

  1. On the Alert: Preparing for Medical Emergencies in Schools (United States)

    Mahoney, Dan


    Medical emergencies can happen in any school at any time. They can be the result of preexisting health problems, accidents, violence, unintentional actions, natural disasters, and toxins. Premature deaths in schools from sudden cardiac arrest, blunt trauma to the chest, firearm injuries, asthma, head injuries, drug overdose, allergic reactions,…

  2. Some emerging issues in medical admission pattern in the tropics

    African Journals Online (AJOL)


    Apr 4, 2011 ... Some emerging issues in medical admission pattern in the tropics. OO Okunola, AA Akintunde, PO Akinwusi. Department of Medicine, Ladoke Akintola University of Technology, Teaching Hospital, Osogbo, Osun State, Nigeria. Access this article online. Quick Response Code: Website:

  3. Factors influencing nurses' decisions to activate medical emergency teams. (United States)

    Pantazopoulos, Ioannis; Tsoni, Aikaterini; Kouskouni, Evangelia; Papadimitriou, Lila; Johnson, Elizabeth O; Xanthos, Theodoros


    To evaluate the relationship between nurse demographics and correct identification of clinical situations warranting specific nursing actions, including activation of the medical emergency team. If abnormal physiology is left untreated, the patient may develop cardiac arrest. Nurses in general wards are those who perceive any clinical deterioration in patients. A descriptive, quantitative design was selected. An anonymous survey with 13 multiple choice questions was distributed to 150 randomly selected nurses working in general medical and surgical wards of a large tertiary hospital in Athens, Greece. After explanation of the purposes of the study, 94 nurses (response ratio: 62%) agreed to respond to the questionnaire. Categories with the greatest nursing concern were patients with heart ratemedical emergency team activation in a significantly higher rate and also scored significantly higher in questions concerning clinical evaluation than nurses who had graduated from a two-year educational programme. Activation of the medical emergency team is influenced by factors such as level of education and cardiopulmonary resuscitation courses attendance. Graduating from a four-year educational programme helps nurses identify emergencies. However, irrespective of the educational programme they have followed, undertaking a basic life support or advanced life support provider course is critical as it helps them identify cardiac or respiratory emergencies. © 2012 Blackwell Publishing Ltd.

  4. Effect of a Medical Student Emergency Ultrasound Clerkship on Number of Emergency Department Ultrasounds

    Directory of Open Access Journals (Sweden)

    Fox, J Christian


    Full Text Available Objective: To determine whether a medical student emergency ultrasound clerkship has an effect on the number of patients undergoing ultrasonography and the number of total scans in the emergency department.Methods: We conducted a prospective, single-blinded study of scanning by emergency medicine residents and attendings with and without medical students. Rotating ultrasound medical students were assigned to work equally on all days of the week. We collected the number of patients scanned and the number of scans, as well as participation of resident and faculty.Results: In seven months 2,186 scans were done on the 109 days with students and 707 scans on the 72 days without them. Data on 22 days was not recorded. A median of 13 patients per day were scanned with medical students (CI 12-15 versus seven (CI 6-9 when not. In addition, the median number of scans was 18 per day with medical students (CI 16-20 versus eight (CI 6-10 without them.Conclusion: There were significantly more patients scanned and scans done when ultrasound medical students were present. [West J Emerg Med. 2010; 11:31-34].

  5. Web Based Reputation Index of Turkish Universities


    Arslan, Mehmet Lutfi; Seker, Sadi Evren


    This paper attempts to develop an online reputation index of Turkish universities through their online impact and effectiveness. Using 16 different web based parameters and employing normalization process of the results, we have ranked websites of Turkish universities in terms of their web presence. This index is first attempt to determine the tools of reputation of Turkish academic websites and would be a basis for further studies to examine the relation between reputation and the online eff...

  6. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. (United States)

    Heffner, Jaimee L; Wyszynski, Christopher M; Comstock, Bryan; Mercer, Laina D; Bricker, Jonathan


    Web-based behavioral interventions for substance use are being developed at a rapid pace, yet there is a dearth of information regarding the most effective methods for recruiting participants into web-based intervention trials. In this paper, we describe our successful recruitment of participants into a pilot trial of web-based Acceptance and Commitment Therapy (ACT) for smoking cessation and compare traditional and web-based methods of recruitment in terms of their effects on baseline participant characteristics, association with study retention and treatment outcome, yield, and cost-effectiveness. Over a 10-week period starting June 15, 2010, we recruited 222 smokers for a web-based smoking cessation study using a variety of recruitment methods. The largest portion of randomized participants were recruited through Google AdWords (36%), followed by medical Internet media (23%), standard media (14%), word of mouth (12%), broadcast emails (11%), and social media (6%). Recruitment source was not related to baseline participant characteristics, 3-month data retention, or 30-day point prevalence smoking abstinence at the 3-month outcome assessment. Cost per randomized participant ranged from $5.27/participant for word of mouth to $172.76/participant for social media, with a mean cost of $42.48/participant. Our diversified approach to recruitment, including both traditional and web-based methods, enabled timely enrollment of participants into the study. Because there was no evidence of a substantive difference in baseline characteristics, retention, or outcomes based on recruitment channel, the yield and cost-effectiveness of recruitment methods may be the more critical considerations in developing a feasible recruitment plan for a web-based smoking cessation intervention study. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Smartphones and Medical Applications in the Emergency Department Daily Practice. (United States)

    Jahanshir, Amirhosein; Karimialavijeh, Ehsan; Sheikh, Hojjat; Vahedi, Motahar; Momeni, Mehdi


    Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice. In a cross sectional study, a modified standard questionnaire (Payne et al.) consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart), in January 2015. The questionnaire was put online using open access "Web-form Module" and the address of the web page was e-mailed along with a cover letter explaining the survey. Finally, responses were analyzed using descriptive statistics and SPSS 22 software. 65 cases participated (response rate 86%). The mean age of interns and residents were 25.03 ± 1.13 and 30.27 ± 4.68 years, respectively (p UpToDate, respectively. 38 (61.3%) of the respondents were using their apps more than once a day and mostly for drug information. English (83.9%), Persian (12.9%), and other languages (3.2%) were preferred languages for designing a medical software among the participants, respectively. The findings of present study showed that smartphones are very popular among Iranian interns and residents in emergency department and a substantial number of them own a smartphone and are using medical apps regularly in their clinical practice.

  8. Security Assessment of Web Based Distributed Applications

    Directory of Open Access Journals (Sweden)

    Catalin BOJA


    Full Text Available This paper presents an overview about the evaluation of risks and vulnerabilities in a web based distributed application by emphasizing aspects concerning the process of security assessment with regards to the audit field. In the audit process, an important activity is dedicated to the measurement of the characteristics taken into consideration for evaluation. From this point of view, the quality of the audit process depends on the quality of assessment methods and techniques. By doing a review of the fields involved in the research process, the approach wants to reflect the main concerns that address the web based distributed applications using exploratory research techniques. The results show that many are the aspects which must carefully be worked with, across a distributed system and they can be revealed by doing a depth introspective analyze upon the information flow and internal processes that are part of the system. This paper reveals the limitations of a non-existing unified security risk assessment model that could prevent such risks and vulnerabilities debated. Based on such standardize models, secure web based distributed applications can be easily audited and many vulnerabilities which can appear due to the lack of access to information can be avoided.

  9. Regional coordination in medical emergencies and major incidents; plan, execute and teach

    Directory of Open Access Journals (Sweden)

    Hedelin Annika


    Full Text Available Abstract Background Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC with authority to act as "gold control," i.e. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities. Methods All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period. Results There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication. Conclusion The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.

  10. Web-based teaching in point-of-care ultrasound: an alternative to the classroom?

    Directory of Open Access Journals (Sweden)

    Kang TL


    Full Text Available Tarina Lee Kang,1 Kristin Berona,1 Marsha A Elkhunovich,2 Roberto Medero-Colon,1 Dina Seif,1 Mikael L Chilstrom,1 Tom Mailhot1 1Department of Emergency Medicine, Los Angeles County and the University of Southern California (LAC + USC Medical Center, 2Department of Emergency Medicine, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Objectives: To evaluate two educational methods for point-of-care ultrasound (POC US in order to: 1 determine participant test performance and attitudes in using POC US and 2 compare cost and preparation time to run the courses.Methods: This was a pilot study conducted at a county teaching hospital. Subjects were assigned to participate in either a large group course with live classroom lectures (Group A or a group asked to watch 4.5 hours of online prerecorded lectures (Group B. Both groups participated in small-group hands-on training after watching the lectures. Both groups took a pre- and post-course exam, and completed course surveys. Cost and time spent running the courses were also compared.Results: Forty-seven physicians participated in the study. The pre-test and post-test scores between the two groups did not differ significantly. Of those with prior ultrasound experience, the majority of both groups preferred to continue classroom-based teaching for future courses. Interestingly, in the groups who had no ultrasound experience prior to their course participation, there was a higher percentage who preferred web-based teaching. Lastly, Group B was shown to have the potential to take less preparatory time when compared to Group A.Conclusion: A web-based curriculum in POC US appears to be a promising and potentially time saving alternative to live classroom lectures and seems to offer similar educational benefits for the postgraduate learner. Keywords: attending education, classroom-based teaching, hands-on training

  11. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education. (United States)

    Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak


    There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

  12. Telemedicine consultations and medication errors in rural emergency departments. (United States)

    Dharmar, Madan; Kuppermann, Nathan; Romano, Patrick S; Yang, Nikki H; Nesbitt, Thomas S; Phan, Jennifer; Nguyen, Cynthia; Parsapour, Kourosh; Marcin, James P


    To compare the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). We conducted retrospective chart reviews on seriously ill and injured children presenting to 8 rural EDs with access to pediatric critical care physicians from an academic children's hospital. Physician-related ED medication errors were independently identified by 2 pediatric pharmacists by using a previously published instrument. The unit of analysis was medication administered. The association of telemedicine consultations with ED medication errors was modeled by using hierarchical logistic regression adjusting for covariates (age, risk of admission, year of consultation, and hospital) and clustering at the patient level. Among the 234 patients in the study, 73 received telemedicine consultations, 85 received telephone consultations, and 76 received no specialist consultations. Medications for patients who received telemedicine consultations had significantly fewer physician-related errors than medications for patients who received telephone consultations or no consultations (3.4% vs. 10.8% and 12.5%, respectively; P telemedicine consultations had a lower odds of physician-related errors than medications for patients who received telephone consultations (odds ratio: 0.19, P telemedicine consultations were associated with a significantly reduced risk of physician-related ED medication errors among seriously ill and injured children in rural EDs.

  13. Social Media: Portrait of an Emerging Tool in Medical Education. (United States)

    Roy, Durga; Taylor, Jacob; Cheston, Christine C; Flickinger, Tabor E; Chisolm, Margaret S


    The authors compare the prevalence of challenges and opportunities in commentaries and descriptive accounts versus evaluative studies of social media use in medical education. A previously published report of social media use in medical education provided an in-depth discussion of 14 evaluative studies, a small subset of the total number of 99 articles on this topic. This study used the full set of articles identified by that review, including the 58 commentaries and 27 descriptive accounts which had not been previously reported, to provide a glimpse into how emerging tools in medical education are initially perceived. Each commentary, descriptive account, and evaluative study was identified and compared on various characteristics, including discussion themes regarding the challenges and opportunities of social media use in medical education. Themes related to the challenges of social media use in medical education were more prevalent in commentaries and descriptive accounts than in evaluative studies. The potential of social media to affect medical professionalism adversely was the most commonly discussed challenge in the commentaries (53%) and descriptive accounts (63%) in comparison to technical issues related to implementation in the evaluative studies (50%). Results suggest that the early body of literature on social media use in medical education-like that of previous innovative education tools-comprises primarily commentaries and descriptive accounts that focus more on the challenges of social media than on potential opportunities. These results place social media tools in historical context and lay the groundwork for expanding on this novel approach to medical education.

  14. Emergency medical service providers' experiences with traffic congestion. (United States)

    Griffin, Russell; McGwin, Gerald


    The population's migration from urban to suburban areas has resulted in a more dispersed population and has increased traffic flow, possibly resulting in longer emergency response times. Although studies have examined the effect of response times on time to definitive care and survival, no study has addressed the possible causes of slowed response time from the point of view of emergency medical services (EMS) first responders. To assess the variables most commonly associated with increased emergency response time as described by the opinions and views of EMS first responders. A total of 500 surveys were sent to randomly selected individuals registered as first responders with the Alabama Department of Public Health, and 112 surveys were returned completed. The survey included questions regarding roadway design, response to emergency calls, in-vehicle technology aimed at decreasing travel time, and public education regarding emergency response. Respondents reported traveling on city streets most often during emergency calls, and encountering traffic more often on interstates and national highways. Traffic congestion, on average, resulted in nearly 10min extra response time. Most agreed that the most effective in-vehicle technology for reducing response time was a pre-emptive green light device; however, very few reported availability of this device in their emergency vehicles. Public education regarding how to react to approaching emergency vehicles was stated as having the greatest potential impact on reducing emergency response time. The results of the survey suggest that the best methods for reducing emergency response times are those that are easy to implement (e.g., public education). Copyright © 2013 Elsevier Inc. All rights reserved.

  15. [Cirurgia Taurina--emergency medical treatment of bullfighters in Spain]. (United States)

    Lehmann, V; Lehmann, J


    A considerable risk of life-threatening injury is inherent to bullfighting. Thus, a unique form of emergency treatment has evolved over recent decades of organized bull-fighting. Today bullfight arenas in larger cities are equipped with emergency facilities including fully furnished operating rooms. During a fiesta these facilities are run by a medical team consisting of three surgeons, one intensive care specialist, and one anesthesiologist with their supporting medical personnel. In smaller arenas or villages immediate care units consist of emergency vehicles, and a mobile container equipped with a fully functional operating room. Of all toreros the matadores including the novilleros are most often injured in 56 % of cases. This rate decreases for banderillos (30 %), and for picadores (14 %). Parts of the body that are most frequently affected are thighs, and the inguinal region (54 %). Head and neck injuries are seen in 19 %, and 12 % of cases present with open abdominal wounds including liver or gastrointestinal tract traumas. 10 % of injuries affect the thorax, and 4 % the pelvic floor. The particular form of organised medical treatment for bullfighters in Spain has only developed since the nineteen-thirties. In 1972 a scientific society for bullfight surgery was founded in Spain by specialized surgeons, and immediate care specialists holding a first convention that year. The society is continuously striving to improve technical and logistical aspects of immediate medical care for injured bullfighters.

  16. Targeted simulation and education to improve cardiac arrest recognition and telephone assisted CPR in an emergency medical communication centre. (United States)

    Hardeland, Camilla; Skåre, Christiane; Kramer-Johansen, Jo; Birkenes, Tonje S; Myklebust, Helge; Hansen, Andreas E; Sunde, Kjetil; Olasveengen, Theresa M


    Recognition of cardiac arrest and prompt activation time by emergency medical dispatch are key process measures that have been associated with improved survival after out-of-hospital cardiac arrest (OHCA). The aim of this study is to improve recognition of OHCA and time to initiation of telephone assisted chest compressions in an emergency medical communication centre (EMCC). A prospective, interventional study implementing targeted interventions in an EMCC. Interventions included: (1) lectures focusing on agonal breathing and interrogation strategy (2) simulation training (3) structured dispatcher feedback (4) web-based telephone assisted CPR training program. All ambulance-confirmed OHCA calls in the study period were assessed and relevant process and result measures were recorded pre- and post-intervention. Cardiac arrest was reported as (1) recognised, (2) not recognised or (3) delayed recognition. We included 331 and 230 calls pre- and post-intervention, respectively. Recognition of cardiac arrest improved significantly after intervention (89 vs. 95%, p=0.024). Delayed recognition was significantly reduced (21 vs. 6%, p>0.001), as was misinterpretation of agonal breathing (25 vs. 10%, pquality metrics can facilitate development of targeted education and training. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Implementation a Medical Simulation Curriculum in Emergency Medicine Residency Program

    Directory of Open Access Journals (Sweden)

    Amirhossein Jahanshir


    Full Text Available Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks. Our plan was to induct simulation in emergency medicine residency program in order to ameliorate our defects in clinical bedside training. Our residents believed that simulation could be effective in their real medical practice. They mentioned that facilitators’ expertise and good medical knowledge, was the strongest point of the program and lack of proper facilities was the weakest.

  18. Preventable deaths following emergency medical dispatch - an audit study

    DEFF Research Database (Denmark)

    Andersen, Mikkel S; Johnsen, Søren; Hansen, Andreas


    BackgroundCall taker triage of calls to the 112 emergency number, can be error prone because rapid decisions must be made based on limited information. Here we investigated the preventability and common characteristics of same-day deaths among patients who called 112 and were not assigned...... an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC).MethodsAn audit was performed by an external panel of experienced prehospital consultant anaesthesiologists. The panel focused exclusively on the role of the EMCC, assessing whether same-day deaths among 112 callers could...

  19. Effect of barcode-assisted medication administration on emergency department medication errors. (United States)

    Bonkowski, Joseph; Carnes, Cynthia; Melucci, Joseph; Mirtallo, Jay; Prier, Beth; Reichert, Erin; Moffatt-Bruce, Susan; Weber, Robert


    Barcode-assisted medication administration (BCMA) is technology with demonstrated benefit in reducing medication administration errors in hospitalized patients; however, it is not routinely used in emergency departments (EDs). EDs may benefit from BCMA, because ED medication administration is complex and error-prone. A naïve observational study was conducted at an academic medical center implementing BCMA in the ED. The rate of medication administration errors was measured before and after implementing an integrated electronic medical record (EMR) with BCMA capacity. Errors were classified as wrong drug, wrong dose, wrong route of administration, or a medication administration with no physician order. The error type, severity of error, and medications associated with errors were also quantified. A total of 1,978 medication administrations were observed (996 pre-BCMA and 982 post-BCMA). The baseline medication administration error rate was 6.3%, with wrong dose errors representing 66.7% of observed errors. BCMA was associated with a reduction in the medication administration error rate to 1.2%, a relative rate reduction of 80.7% (p < 0.0001). Wrong dose errors decreased by 90.4% (p < 0.0001), and medication administrations with no physician order decreased by 72.4% (p = 0.057). Most errors discovered were of minor severity. Antihistamine medications were associated with the highest error rate. Implementing BCMA in the ED was associated with significant reductions in the medication administration error rate and specifically wrong dose errors. The results of this study suggest a benefit of BCMA on reducing medication administration errors in the ED. © 2013 by the Society for Academic Emergency Medicine.

  20. Readiness for Radiological and Nuclear Events among Emergency Medical Personnel. (United States)

    Dallas, Cham E; Klein, Kelly R; Lehman, Thomas; Kodama, Takamitsu; Harris, Curtis Andrew; Swienton, Raymond E


    Among medical providers, even though radiological and nuclear events are recognized as credible threats, there is a lack of knowledge and fear about the medical consequences among medical personnel which could significantly affect the treatment of patients injured and/or contaminated in such scenarios. This study was conducted to evaluate the relative knowledge, willingness to respond, and familiarity with nuclear/radiological contamination risks among U.S. and Japanese emergency medical personnel. An institutional review board-approved anonymous paper survey was distributed at various medical and disaster conferences and medicine courses in Japan and in the U.S. The surveys were written in Japanese and English and collected information on the following four categories: generalized demographics, willingness to manage, knowledge of disaster systems, and contamination risks. A total of 418 surveys were completed and collected. Demographics showed that physicians and prehospital responders were the prevalent survey responders. The majority of responders, despite self-professed disaster training, were still very uncomfortable with and unaware how to respond to a radiological/nuclear event. Despite some educational coverage in courses and a limited number of disaster events, it is concluded that there is a lack of comfort and knowledge regarding nuclear and radiological events among the medical community. It is recommended that considerable development and subsequent distribution is needed to better educate and prepare the medical community for inevitable upcoming radiological/nuclear events.

  1. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 3--Anatomy and Physiology. Revised. (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This student manual, the third in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains one section covering the following topics: general anatomical terms, the body cavities and contents, the integumentary system, the skeletal system, the muscular system, the nervous system, the respiratory…

  2. Participatory Design in Emergency Medical Service: Designing for Future Practice

    DEFF Research Database (Denmark)

    Kristensen, Margit; Kyng, Morten; Palen, Leysia Ann


    We describe our research—its approach, results and prod-ucts—on Danish emergency medical service (EMS) field or “pre-hospital” work in minor and major incidents. We dis-cuss how commitments to participatory design and attention to the qualitative differences between minor and major incidents...... address challenges identified by disaster sociologists when designing for major incidents. Through qualitative research and participatory design, we have ex-amined the features of EMS work and technology use in different emergency situations from the perspective of mul-tiple actors. We conceptualize...... victims in incidents—and particularly in major incidents, where on-site medical as-sessments is highly incomplete—as boundary objects over which the complex and imperfect work of coordination is done. As an outcome of our participatory design approach, we describe a set of designs in support of future EMS...

  3. A forgotten life-threatening medical emergency: myxedema coma

    Directory of Open Access Journals (Sweden)

    Elisa Pizzolato


    Full Text Available Nowadays myxedema coma is a rare medical emergency but, sometimes, it still remains a fatal condition even if appropriate therapy is soon administered. Although physical presentation is very non-specific and diversified, physicians should pay attention when patients present with low body temperature and alteration of neurological status; the presence of precipitating events in past medical history can help in making a diagnosis. Here we discuss one such case: an 83-year-old female presented with abdominal pain since few days. Laboratory tests and abdomen computed tomography scan demonstrated alithiasic cholecystitis; she was properly treated but, during the Emergency Department stay she experienced a cardiac arrest. Physicians immediately started advance cardiovascular life support algorithm and she survived. Later on, she was admitted to the Intensive Care Unit where doctors discovered she was affected by severe hypothyroidism. Straightway they started the right therapy but, unfortunately, the patient died in a few hours.

  4. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

    Directory of Open Access Journals (Sweden)

    Sricharoen P


    Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma

  5. Communicating climate change adaptation information using web-based platforms (United States)

    Karali, Eleni; Mattern, Kati


    To facilitate progress in climate change adaptation policy and practice, it is important not only to ensure the production of accurate, comprehensive and relevant information, but also the easy, timely and affordable access to it. This can contribute to better-informed decisions and improve the design and implementation of adaptation policies and other relevant initiatives. Web-based platforms can play an important role in communicating and distributing data, information and knowledge that become constantly available, reaching out to a large group of potential users. Indeed in the last decade there has been an extensive increase in the number of platforms developed for this purpose in many fields including climate change adaptation. This short paper concentrates on the web-based adaptation platforms developed in Europe. It provides an overview of the recently emerged landscape, examines the basic characteristics of a set of platforms that operate at national, transnational and European level, and discusses some of the key challenges related to their development, maintenance and overall management. Findings presented in this short paper are discussed in greater detailed in the Technical Report of the European Environment Agency Overview of climate change adaptation platforms in Europe.

  6. Web-based pre-Analysis Tools

    CERN Document Server

    Moskalets, Tetiana


    The project consists in the initial development of a web based and cloud computing services to allow students and researches to perform fast and very useful cut-based pre-analysis on a browser, using real data and official Monte-Carlo simulations (MC). Several tools are considered: ROOT files filter, JavaScript Multivariable Cross-Filter, JavaScript ROOT browser and JavaScript Scatter-Matrix Libraries. Preliminary but satisfactory results have been deployed online for test and future upgrades.

  7. CMS OnlineWeb-Based Monitoring

    CERN Document Server

    Wan, Zongru; Chakaberia, Irakli; Lopez-Perez, Juan Antonio; Maeshima, Kaori; Maruyama, Sho; Soha, Aron; Sulmanas, Balys; Wan, Zongru


    For large international High Energy Physics experiments, modern web technologies make the online monitoring of detector status, data acquisition status, trigger rates, luminosity, etc., accessible for the collaborators anywhere and anytime. This helps the collaborating experts monitor the status of the experiment, identify the problems, and improve data-taking efficiency. We present the Web-Based Monitoring project of the CMS experiment at the LHC of CERN. The data sources are relational databases and various messaging systems. The project provides a vast amount of in-depth information including real time data, historical trend, and correlations, in a user friendly way.

  8. Web-Based Programs Assess Cognitive Fitness (United States)


    The National Space Biomedical Research Institute, based in Houston and funded by NASA, began funding research for Harvard University researchers to design Palm software to help astronauts monitor and assess their cognitive functioning. The MiniCog Rapid Assessment Battery (MRAB) was licensed by the Criteria Corporation in Los Angeles and adapted for Web-based employment testing. The test battery assesses nine different cognitive functions and can gauge the effect of stress-related deficits, such as fatigue, on various tasks. The MRAB can be used not only for pre-employment testing but also for repeat administrations to measure day-to-day job readiness in professions where alertness is critical.

  9. Automated electronic medical record sepsis detection in the Emergency Department


    Nguyen, Su; Mwakalindile, Edwin; Booth, James S.; Hogan, Vicki; Morgan, Jordan; Prickett, Charles T; Donnelly, John P.; Wang, Henry E.


    Background: While often first treated in the Emergency Department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis. The objective of this study was to test the accuracy of an EMR-based, automated sepsis identification system. Methods : We tested an EMR-based sepsis identification tool at a major academic, urban ED with 64,000 annual visits. The EMR system collected vital sign and la...

  10. Automated electronic medical record sepsis detection in the emergency department


    Nguyen, Su Q.; Edwin Mwakalindile; Booth, James S.; Vicki Hogan; Jordan Morgan; Prickett, Charles T; Donnelly, John P.; Wang, Henry E.


    Background. While often first treated in the emergency department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis. The objective of this study was to test the accuracy of an EMR-based, automated sepsis identification system. Methods. We tested an EMR-based sepsis identification tool at a major academic, urban ED with 64,000 annual visits. The EMR system collected vital sign and lab...

  11. Measuring Disaster Preparedness of Local Emergency Medical Services Agencies (United States)


    flight under the provisions of 14 Code of Federal Regulations Part 121 from Lic Gustavo Diaz Ordaz International Airport, Puerto Vallarta, Mexico , to...Chief of Emergency Medical Services for San Diego County The 2007 San Diego County Firestorms started on October 21, 2007, near the U.S./ Mexico ... Agua Tibia Wilderness. The Poomacha Fire burned 49,410 acres and was not fully contained until November 9, 2007. It was the last fire of the 2007

  12. The State of Emergency Medical Services (EMS) Systems in Africa. (United States)

    Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A


    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

  13. Expanding the Role of Emergency Medical Services in Homeland Security (United States)


    iii+52 Pp. (Oct 2011). 40 Robert Berne , Emergency Medical Services: The Forgotten First Responder (New York City, NY: New York University, Center...responders do not have the training or skills to identify chemical, biological, bomb , or other terrorist tools or tactics, we will not know if any...and mortality. An example of this would be where a paramedic would report identifying bomb making materials, since it could be associated with

  14. Emergency Medical Services Capacity for Prehospital Stroke Care

    Centers for Disease Control (CDC) Podcasts


    In this audio podcast, lead author and Preventing Chronic Disease’s 2013 Student Research Contest Winner, Mehul D. Patel, talks about his article on stroke care and emergency medical services.  Created: 9/5/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/5/2013.

  15. Web-based infectious disease surveillance systems and public health perspectives: a systematic review. (United States)

    Choi, Jihye; Cho, Youngtae; Shim, Eunyoung; Woo, Hyekyung


    Emerging and re-emerging infectious diseases are a significant public health concern, and early detection and immediate response is crucial for disease control. These challenges have led to the need for new approaches and technologies to reinforce the capacity of traditional surveillance systems for detecting emerging infectious diseases. In the last few years, the availability of novel web-based data sources has contributed substantially to infectious disease surveillance. This study explores the burgeoning field of web-based infectious disease surveillance systems by examining their current status, importance, and potential challenges. A systematic review framework was applied to the search, screening, and analysis of web-based infectious disease surveillance systems. We searched PubMed, Web of Science, and Embase databases to extensively review the English literature published between 2000 and 2015. Eleven surveillance systems were chosen for evaluation according to their high frequency of application. Relevant terms, including newly coined terms, development and classification of the surveillance systems, and various characteristics associated with the systems were studied. Based on a detailed and informative review of the 11 web-based infectious disease surveillance systems, it was evident that these systems exhibited clear strengths, as compared to traditional surveillance systems, but with some limitations yet to be overcome. The major strengths of the newly emerging surveillance systems are that they are intuitive, adaptable, low-cost, and operated in real-time, all of which are necessary features of an effective public health tool. The most apparent potential challenges of the web-based systems are those of inaccurate interpretation and prediction of health status, and privacy issues, based on an individual's internet activity. Despite being in a nascent stage with further modification needed, web-based surveillance systems have evolved to complement

  16. 20 CFR 10.300 - What are the basic rules for authorizing emergency medical care? (United States)


    ... emergency medical care? 10.300 Section 10.300 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...' COMPENSATION ACT, AS AMENDED Medical and Related Benefits Emergency Medical Care § 10.300 What are the basic rules for authorizing emergency medical care? (a) When an employee sustains a work-related traumatic...

  17. Emergency department discharge prescription errors in an academic medical center. (United States)

    Murray, Kelly A; Belanger, April; Devine, Lauren T; Lane, Aaron; Condren, Michelle E


    This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions was 13.4%, with "incomplete or inadequate prescription" being the most commonly detected error (58.2%). The adult and pediatric error rates were 11.7% and 22.7%, respectively. The antibiotics reviewed had the highest number of errors. The highest within-class error rates were with antianginal medications, antiparasitic medications, antacids, appetite stimulants, and probiotics. Emergency medicine residents wrote the highest percentage of prescriptions (46.7%) and had an error rate of 9.2%. Residents of other specialties wrote 340 prescriptions and had an error rate of 20.9%. Errors occurred most often between 10:00 am and 6:00 pm.

  18. A web-based virtual lighting simulator

    Energy Technology Data Exchange (ETDEWEB)

    Papamichael, Konstantinos; Lai, Judy; Fuller, Daniel; Tariq, Tara


    This paper is about a web-based ''virtual lighting simulator,'' which is intended to allow architects and lighting designers to quickly assess the effect of key parameters on the daylighting and lighting performance in various space types. The virtual lighting simulator consists of a web-based interface that allows navigation through a large database of images and data, which were generated through parametric lighting simulations. At its current form, the virtual lighting simulator has two main modules, one for daylighting and one for electric lighting. The daylighting module includes images and data for a small office space, varying most key daylighting parameters, such as window size and orientation, glazing type, surface reflectance, sky conditions, time of the year, etc. The electric lighting module includes images and data for five space types (classroom, small office, large open office, warehouse and small retail), varying key lighting parameters, such as the electric lighting system, surface reflectance, dimming/switching, etc. The computed images include perspectives and plans and are displayed in various formats to support qualitative as well as quantitative assessment. The quantitative information is in the form of iso-contour lines superimposed on the images, as well as false color images and statistical information on work plane illuminance. The qualitative information includes images that are adjusted to account for the sensitivity and adaptation of the human eye. The paper also includes a section on the major technical issues and their resolution.

  19. A Model Curriculum for an Emergency Medical Services (EMS Rotation for Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Michael Mancera


    Full Text Available Audience: This EMS curriculum is designed for Emergency Medicine residents at all levels of training. Introduction: Emergency Medicine (EM physicians have routine interaction with Emergency Medical Services (EMS in their clinical practice. Additionally, the American College of Graduate Medical Education (ACGME mandates that all Emergency Medicine resident physicians receive specific training in the area of EMS.1 Historically, EMS training for EM residents has been conducted in the absence of a standardized didactic curriculum. Despite advancements in the area of prehospital training, there remains wide inconsistency in EMS training experiences among EM residency training programs.2 To our knowledge a standardized and reproducible EMS curriculum for EM residents does not exist. Objectives: The aim of this curriculum is to provide a robust learning experience for EM residents around prehospital care and EMS that fulfills the ACGME requirements and which can be easily replicated and implemented in a variety of EM residency training programs. Method: The educational strategies used in this curriculum include didactics, asynchronous learning through online modules and a focused reading list, experiential learning through ride-alongs, structured small group discussion, supervised medical command shifts, and mentored practice in organizing and delivering didactics to EMS providers.

  20. Helicopter emergency medical service in Italy: reality and perspectives. (United States)

    Marinangeli, Franco; Tomei, Marco; Ursini, Maria Laura; Ricotti, Valeria; Varrassi, Giustino


    The organization of a homogeneous medical emergency system was developed in Italy in 1999. Currently, 104 stations manage medical emergencies with ambulances and 47 helicopter-capable bases for more difficult missions. The current study describes the organization of the helicopter emergency system in Italy. Data were collected from questionnaires filled in by each base commander. Six hundred twenty-seven physicians are enrolled in helicopter-capable base emergency teams. Of those physicians, 89.5% are specialists in anesthesiology. Professional nurses are enrolled in 46 bases. Twenty-six bases specialize in search-and-rescue (SAR) missions (which take place in geographically unfriendly terrain), where a mountain rescue technician (CNSAS) is part of the team. Twenty-one bases are for missions in geographically friendly terrain (HEMS bases). Eight bases provide 24-hour service. Specialized training is given to physicians and nurses: it is considered of first level (high standard) in 21 bases, of second level (intermediary) in 17 bases, and of third level (low) in nine bases. In the mountain bases (Alps and Apennines), the more widely used helicopters are the AB412 and the BK117C1. During 2004, there were 20,660 primary interventions and 7,790 secondary interventions. From 1999 to 2004 there was a 33% increase of activity for primary and 35% for secondary interventions. The data show the activity of the helicopter-ambulance service, the role of anesthetists within the helicopter-based Advanced Cardiac Life Support (ACLS) team, and the diverse organization of training for medical staff in different regions of Italy.

  1. Assimilation of Web-Based Urgent Stroke Evaluation: A Qualitative Study of Two Networks (United States)

    Mathiassen, Lars; Switzer, Jeffrey A; Adams, Robert J


    Background Stroke is a leading cause of death and serious, long-term disability across the world. Urgent stroke care treatment is time-sensitive and requires a stroke-trained neurologist for clinical diagnosis. Rural areas, where neurologists and stroke specialists are lacking, have a high incidence of stroke-related death and disability. By virtually connecting emergency department physicians in rural hospitals to regional medical centers for consultations, specialized Web-based stroke evaluation systems (telestroke) have helped address the challenge of urgent stroke care in underserved communities. However, many rural hospitals that have deployed telestroke have not fully assimilated this technology. Objective The objective of this study was to explore potential sources of variations in the utilization of a Web-based telestroke system for urgent stroke evaluation and propose a telestroke assimilation model to improve stroke care performance. Methods An exploratory, qualitative case study of two telestroke networks, each comprising an academic stroke center (hub) and connected rural hospitals (spokes), was conducted. Data were collected from 50 semistructured interviews with 40 stakeholders, telestroke usage logs from 32 spokes, site visits, published papers, and reports. Results The two networks used identical technology (called Remote Evaluation of Acute isCHemic stroke, REACH) and were of similar size and complexity, but showed large variations in telestroke assimilation across spokes. Several observed hub- and spoke-related characteristics can explain these variations. The hub-related characteristics included telestroke institutionalization into stroke care, resources for the telestroke program, ongoing support for stroke readiness of spokes, telestroke performance monitoring, and continuous telestroke process improvement. The spoke-related characteristics included managerial telestroke championship, stroke center certification, dedicated telestroke

  2. Emergency motorcycle: has it a place in a medical emergency system? (United States)

    Soares-Oliveira, Miguel; Egipto, Paula; Costa, Isabel; Cunha-Ribeiro, Luis Manuel


    In an emergency medical service system, response time is an important factor in determining the prognosis of a victim. There are well-documented increases in response time in urban areas, mainly during rush hour. Because prehospital emergency care is required to be efficient and swift, alternative measures to achieve this goal should be addressed. We report our experience with a medical emergency motorcycle (MEM) and propose major criteria for dispatching it. This work presents a prospective analysis of the data relating to MEM calls from July 2004 to December 2005. The analyzed parameters were age, sex, reason for call, action, and need for subsequent transport. A comparison was made of the need to activate more means and, if so, whether the MEM was the first to arrive. There were 1972 calls. The average time of arrival at destination was 4.4 +/- 2.5 minutes. The main action consisted of administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport. The MEM can intervene in a wide variety of clinical situations and a quick response is guaranteed. Moreover, in specific situations, MEM safely and efficiently permits better management of emergency vehicles. We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.

  3. Pre-Service Teachers' Views on Web-Based Classroom Management (United States)

    Boyaci, Adnan


    With the invention of World Wide Web in 1992, delivery of distance education via internet and emergency of web-based classrooms have rapidly gained acceptance as an alternative and supplement to traditional face to face classroom instruction (Alavi, Yoo & Vogel, 1997; Rahm & Reed, 1997), which represents a paradigm shift challenging all…

  4. After the Injury: Initial Evaluation of a Web-Based Intervention for Parents of Injured Children (United States)

    Marsac, M. L.; Kassam-Adams, N.; Hildenbrand, A. K.; Kohser, K. L.; Winston, F. K.


    The purpose of this study was to survey parent knowledge of child injury reactions (including post-traumatic stress symptoms) and to evaluate parent satisfaction and learning outcomes following a video- or web-based intervention. Fifty parents of children ages 6-17 years who were injured within the past 2 months were recruited from emergency and…

  5. Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

    LENUS (Irish Health Repository)

    Gorman, J


    Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

  6. Medical emergencies facing general practitioners: Drugs for the doctor's bag

    Directory of Open Access Journals (Sweden)

    Janković Slobodan


    Full Text Available General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever, morphine (for severe pain, naloxone (for heroin poisoning, ceftriaxone (for meningococcal meningitis, albuterol (for bronchial asthma attack, hydrocortisone (for bronchial asthma attack, glucagon (for severe hypoglycemia, dextrose (for mild to moderate hypoglycemia, diazepam (for febrile convulsions or epileptic status, epinephrine (for anaphylaxis and cardiac arrest, atropine (for symptomatic bradicardia, chloropyramine (for acute allergy, aspirin (for acute myocardial infarction, nitroglycerine (for acute coronary syndrome, metoclopramide (for nausea and vomiting, haloperidol (for delirium, methylergometrine (for control of bleeding after delivery or abortion, furosemide (for acute pulmonary edema and flumazenil (for benzodiazepine poisoning. For each of the listed drugs a physician should well know the recommended doses, indications, contraindications and warnings. All of the listed drugs are either registered in Serbia or available through special import, so general practitioners may fill their bags with all necessary drugs and effectively and safely treat medical emergencies.

  7. Emerging Security Mechanisms for Medical Cyber Physical Systems. (United States)

    Kocabas, Ovunc; Soyata, Tolga; Aktas, Mehmet K


    The following decade will witness a surge in remote health-monitoring systems that are based on body-worn monitoring devices. These Medical Cyber Physical Systems (MCPS) will be capable of transmitting the acquired data to a private or public cloud for storage and processing. Machine learning algorithms running in the cloud and processing this data can provide decision support to healthcare professionals. There is no doubt that the security and privacy of the medical data is one of the most important concerns in designing an MCPS. In this paper, we depict the general architecture of an MCPS consisting of four layers: data acquisition, data aggregation, cloud processing, and action. Due to the differences in hardware and communication capabilities of each layer, different encryption schemes must be used to guarantee data privacy within that layer. We survey conventional and emerging encryption schemes based on their ability to provide secure storage, data sharing, and secure computation. Our detailed experimental evaluation of each scheme shows that while the emerging encryption schemes enable exciting new features such as secure sharing and secure computation, they introduce several orders-of-magnitude computational and storage overhead. We conclude our paper by outlining future research directions to improve the usability of the emerging encryption schemes in an MCPS.

  8. Managing and monitoring tuberculosis using web-based tools in combination with traditional approaches. (United States)

    Chapman, Ann Ln; Darton, Thomas C; Foster, Rachel A


    Tuberculosis (TB) remains a global health emergency. Ongoing challenges include the coordination of national and international control programs, high levels of drug resistance in many parts of the world, and availability of accurate and rapid diagnostic tests. The increasing availability and reliability of Internet access throughout both affluent and resource-limited countries brings new opportunities to improve TB management and control through the integration of web-based technologies with traditional approaches. In this review, we explore current and potential future use of web-based tools in the areas of TB diagnosis, treatment, epidemiology, service monitoring, and teaching and training.

  9. Uniformity testing: assessment of a centralized web-based uniformity analysis system. (United States)

    Klempa, Meaghan C


    Uniformity testing is performed daily to ensure adequate camera performance before clinical use. The aim of this study is to assess the reliability of Beth Israel Deaconess Medical Center's locally built, centralized, Web-based uniformity analysis system by examining the differences between manufacturer and Web-based National Electrical Manufacturers Association integral uniformity calculations measured in the useful field of view (FOV) and the central FOV. Manufacturer and Web-based integral uniformity calculations measured in the useful FOV and the central FOV were recorded over a 30-d period for 4 cameras from 3 different manufacturers. These data were then statistically analyzed. The differences between the uniformity calculations were computed, in addition to the means and the SDs of these differences for each head of each camera. There was a correlation between the manufacturer and Web-based integral uniformity calculations in the useful FOV and the central FOV over the 30-d period. The average differences between the manufacturer and Web-based useful FOV calculations ranged from -0.30 to 0.099, with SD ranging from 0.092 to 0.32. For the central FOV calculations, the average differences ranged from -0.163 to 0.055, with SD ranging from 0.074 to 0.24. Most of the uniformity calculations computed by this centralized Web-based uniformity analysis system are comparable to the manufacturers' calculations, suggesting that this system is reasonably reliable and effective. This finding is important because centralized Web-based uniformity analysis systems are advantageous in that they test camera performance in the same manner regardless of the manufacturer.

  10. Health Evaluation and Referral Assistant: A Randomized Controlled Trial of a Web-Based Screening, Brief Intervention, and Referral to Treatment System to Reduce Risky Alcohol Use Among Emergency Department Patients (United States)

    Davis-Martin, Rachel; Abar, Beau; Baumann, Brigitte M; Harralson, Tina; Boudreaux, Edwin D


    Background Computer technologies hold promise for implementing alcohol screening, brief intervention, and referral to treatment (SBIRT). Questions concerning the most effective and appropriate SBIRT model remain. Objective The aim of this study was to evaluate the impact of a computerized SBIRT system called the Health Evaluation and Referral Assistant (HERA) on risky alcohol use treatment initiation. Methods Alcohol users (N=319) presenting to an emergency department (ED) were considered for enrollment. Those enrolled (n=212) were randomly assigned to the HERA, to complete a patient-administered assessment using a tablet computer, or a minimal-treatment control, and were followed for 3 months. Analyses compared alcohol treatment provider contact, treatment initiation, treatment completion, and alcohol use across condition using univariate comparisons, generalized estimating equations (GEEs), and post hoc chi-square analyses. Results HERA participants (n=212; control=115; intervention=97) did not differ between conditions on initial contact with an alcohol treatment provider, treatment initiation, treatment completion, or change in risky alcohol use behavior. Subanalyses indicated that HERA participants, who accepted a faxed referral, were more likely to initiate contact with a treatment provider and initiate treatment for risky alcohol use, but were not more likely to continue engaging in treatment, or to complete treatment and change risky alcohol use behavior over the 3-month period following the ED visit. Conclusions The HERA promoted initial contact with an alcohol treatment provider and initiation of treatment for those who accepted the faxed referral, but it did not lead to reduced risky alcohol use behavior. Factors which may have limited the HERA’s impact include lack of support for the intervention by clinical staff, the low intensity of the brief and stand-alone design of the intervention, and barriers related to patient follow-through, (eg, a lack of

  11. Requirements of a Web-based experiment management system. (United States)

    Jakobovits, R; Soderland, S G; Taira, R K; Brinkley, J F


    Recent advances in tools for scientific data acquisition, visualization, and analysis have lead to growing information management problems for medical research laboratories. An exponential increase in the volume of data, combined with a proliferation of heterogeneous formats and autonomous systems, has driven the need for flexible and powerful Experiment Management Systems (EMS). This paper provides a detailed analysis of the informatics requirements of an EMS, and proposes a new type of middleware called an EMS-Building Environment (EMSBE), which enables the rapid development of web-based systems for managing laboratory data and workflow. We describe the Web-Interfacing Respository Manager (WIRM), an open-source application server for building customizable experiment management systems. WIRM is being used to manage several ongoing experiments, including a natural language processor of radiological findings, and an interdisciplinary project for studying brain function.

  12. Advances in personalized web-based education

    CERN Document Server

    Chrysafiadi, Konstantina


    This book aims to provide important information about adaptivity in computer-based and/or web-based educational systems. In order to make the student modeling process clear, a literature review concerning student modeling techniques and approaches during the past decade is presented in a special chapter. A novel student modeling approach including fuzzy logic techniques is presented. Fuzzy logic is used to automatically model the learning or forgetting process of a student. The presented novel student model is responsible for tracking cognitive state transitions of learners with respect to their progress or non-progress. It maximizes the effectiveness of learning and contributes, significantly, to the adaptation of the learning process to the learning pace of each individual learner. Therefore the book provides important information to researchers, educators and software developers of computer-based educational software ranging from e-learning and mobile learning systems to educational games including stand a...

  13. Implementation of Emergency Medical Text Classifier for syndromic surveillance. (United States)

    Travers, Debbie; Haas, Stephanie W; Waller, Anna E; Schwartz, Todd A; Mostafa, Javed; Best, Nakia C; Crouch, John


    Public health officials use syndromic surveillance systems to facilitate early detection and response to infectious disease outbreaks. Emergency department clinical notes are becoming more available for surveillance but present the challenge of accurately extracting concepts from these text data. The purpose of this study was to implement a new system, Emergency Medical Text Classifier (EMT-C), into daily production for syndromic surveillance and evaluate system performance and user satisfaction. The system was designed to meet user preferences for a syndromic classifier that maximized positive predictive value and minimized false positives in order to provide a manageable workload. EMT-C performed better than the baseline system on all metrics and users were slightly more satisfied with it. It is vital to obtain user input and test new systems in the production environment.

  14. Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

    Directory of Open Access Journals (Sweden)

    Heradstveit Bård E


    Full Text Available Abstract Background Intraosseous access (IO is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. Methods We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed, manual bone marrow aspiration needle (Inter V - Medical Device Technologies and EZ-IO® (Vidacare, used on both adults and paediatric patients. Results During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p Conclusions Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric patients in critical situations. We believe that all emergency services that handle critically ill or injured paediatric and adult patients should be familiar with intraosseous techniques.

  15. The emotional content and cooperation score in emergency medical dispatching. (United States)

    Clawson, J J; Sinclair, R


    A common belief regarding scripted-protocol-driven emergency medical dispatch is that the caller is "too hysterical" or "too uncooperative" to allow a structured interrogation or to receive and act upon dispatch life support instructions. To examine the emotional content and cooperation scores (ECCSs) of callers in more than 6,000 cases from two communication centers and to investigate the relationships between ECCS and caller party, incident nature, time of day, and geographical location. The ECCS has five levels: 5, uncontrollable, hysterical; 4, uncooperative, not listening, yelling; 3, moderately upset but cooperative; 2; anxious but cooperative; and 1, normal conversational speech. The authors tabulated the ECCS as recorded during case review for a random sample of each center's ongoing quality assurance programs. Statistical tests were used to identify the presence of relationships between ECCS and caller party, arrest/nonarrest situations, time of day, and geographical location. Regardless of the caller party, the type of call, the time of day, or the geographical location, the mean ECCS of emergency callers is extremely low, indicating that most emergency callers are, in fact, very calm. The average ECCS computed from more than 3,000 cases from British Columbia was 1.05; the average score from almost 3,500 cases from New York State was 1.21. While relationships between ECCS and the different parameters were noted, the differences were so small as to be of little or no use as additional information to assist with complaint triage. The low overall ECCS shows that the typical caller who requests emergency medical assistance is calm enough to be interrogated in a scripted and structured fashion, and is cooperative enough to be responsive to dispatch life support instructions.

  16. Updated posters to help manage medical emergencies in the dental practice. (United States)

    Jevon, P


    Medical emergencies can occur in the dental practice. Medical Emergencies in the Dental Practice and Emergency Drugs in the Dental Practice posters have been designed to help dental practitioners to respond effectively and safely to a medical emergency. These posters, endorsed by the British Dental Association, are included with this issue of the British Dental Journal. Further copies can be downloaded from:

  17. Sexual rape in children and adolescents: a medical emergency

    Directory of Open Access Journals (Sweden)

    García Piña Corina Araceli


    Full Text Available Sexual rape is defined as vaginal, anal or oral sex with violent and forceful penetration of the penis or of any other object. Patients who have been raped are a medical emergency which requires immediate attention, if possible, within 24 to 72 hours, since there is the risk of sustaining external and internal injuries and of acquiring a sexually transmitted infection (STI. Detection and Centers for Disease Control (CDC have reported that the maximum effective- ness of HIV prophylaxis is obtained when given within the first 24 to 72 hours post exposure.

  18. Previous Emergency Medical Services Use by Victims of Child Homicide. (United States)

    Shenoi, Rohit P; Nassif, Anriada; Camp, Elizabeth A; Pereira, Faria A


    The medical diagnoses and frequency of emergency department visits made by children who are later given a diagnosis of maltreatment do not differ much from those of nonabused children. However, the type of medical complaints and frequency of emergency medical services (EMS) use by child homicide victims before their death are not known. We compared EMS use between child homicide victims and children who died from natural causes before their death. This was a retrospective case-control study of children 0 to 5 years old who died in Houston, Texas, from 2005 to 2010. Cases were child homicide victims. Controls were children who died from natural causes. We reviewed death data and EMS and child protective services (CPS) encounter information before the victim's death. The association between death type (natural vs homicide) and EMS use was assessed using Poisson regression with EMS count adjusted for exposure time. There were 89 child homicides and 183 natural deaths. Age at death was significantly higher for homicides than natural deaths (1.1 vs 0.2 y, P Homicide victims used EMS services (39% vs 14%, P homicide group had more EMS calls than the natural death group (β = 0.55; 95% confidence interval, 0.04-1.07; P = 0.03). However, the EMS use frequency and working assessments were not helpful in identifying maltreatment victims. Child homicide victims use EMS more often and have a higher number of CPS investigations before their death than children who die from natural causes. However, the frequency and nature of EMS medical complaints are not helpful in identifying maltreatment.


    Directory of Open Access Journals (Sweden)

    Adnan BOYACI


    Full Text Available With the invention of World Wide Web in 1992, delivery of distance education via internet and emergency of web-based classrooms have rapidly gained acceptance as an alternative and supplement to traditional face to face classroom instruction (Alavi, Yoo & Vogel, 1997; Rahm & Reed, 1997, which represents a paradigm shift challenging all traditionally accepted assumptions concerning dynamics of classroom management. Classroom is highly complicated environment with its features of multi-dimensionality, simultaneity, immediacy, unpredictability, publicness and history. And web based classroom is more complicated than traditional classroom because the web technology is added. Students’ views are considered by many researchers as one of the critical and valid source data in evaluating the teaching effectiveness and learning settings. The purpose of this study is to find out views of pre-service teachers about web based classroom management. With qualitative research method, particularly descriptive technique 20 pre-service teachers’ views were evaluated. Research findings revealed that students defined web-based classroom management with extra workloads of the students thus effectiveness is associated with students’ roles. Guiding/mentoring on technical issues, on the field knowledge, classroom interaction were defined by the students as the essential leadership roles of teachers. Concerning interaction while student to course content/material interaction was perceived as satisfactory, level of student to student interaction was reported as low. Web-based instruction itself and being free form time and place emerged as motivating factors. Besides, discipline is identified within the responsibility of students and accessing information without time/place limitation was perceived as advantageous side of web based classroom.

  20. Pedagogy for teaching and learning cooperatively on the Web: a Web-based pharmacology course. (United States)

    Tse, Mimi M Y; Pun, Sandra P Y; Chan, Moon Fai


    The Internet is becoming a preferred place to find information. Millions of people go online in the search of health and medical information. Likewise, the demand for Web-based courses grows. This article presents the development, utilization and evaluation of a web-based pharmacology course for nursing students. The course was developed based on 150 commonly used drugs. There were 110 year 1 nursing students took part in the course. After attending six hours face to face lecture of pharmacology over three weeks, students were invited to complete a questionnaire (pre-test) about learning pharmacology. The course materials were then uploaded to a WebCT for student's self-directed learning and attempts to pass two scheduled online quizzes. At the end of the semester, students were given the same questionnaire (post-test). There were a significant increase in the understanding compared with memorizing the subject content, the development of problem solving ability in learning pharmacology and becoming an independent learner (p ,0.05). Online quizzes yielded satisfactory results. In the focused group interview, students appreciated the time flexibility and convenience associated with web-based learning, also, they had made good suggestions in enhancing web-based learning. Web-based approach is promising for teaching and learning pharmacology for nurses and other health-care professionals.

  1. Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

    DEFF Research Database (Denmark)

    Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C


    ). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS...... in proportion to a known tone of 94 dB. Before and after episodes of noise exposure, the physicians underwent a hearing test indicating whether the noise had had any impact on the function of the outer sensory hair cells. This was accomplished by measuring the amplitude level shifts of the Distortion Product...

  2. IMPORTANT REMINDER - In a Medical Emergency Call 74444

    CERN Multimedia


    What happened? A CERN employee, complaining of pains that might indicate a serious heart problem, went to building 57 for medical assistance1). He went to the first floor and found the reception desk temporarily unoccupied. He then went to the CERN Fire Station. The firemen and the CERN medical team took care of him and requested helicopter transport to the Geneva cantonal hospital, where he responded well to medical treatment. What do we learn from this event? Although in this case the patient is doing well, precious time was lost. In the event of serious and acute illness, you must call the CERN internal number 74444 and avoid going in person, even accompanied by someone else. This number is available for all types of emergency. The firemen can provide professional assistance at all times as required: first aid on the spot, ambulance transport and medical assistance as necessary. The CERN Fire Station is located in building 65, on ‘Route Einstein', the first road on your right when you enter CERN Ent...

  3. New and emerging medical therapies in Parkinson's disease. (United States)

    Lotia, Mitesh; Jankovic, Joseph


    Parkinson's disease (PD) is one of the most challenging neurodegenerative disorders to treat as it manifests with a large variety of troublesome, and often disabling, motor and non-motor symptoms. Despite limitations, such as motor and other complications, levodopa remains the most effective drug in the treatment of PD. In this review, we focus on phase 2 and 3 studies describing new and emerging medical therapies in PD. We discuss new formulations of levodopa, medications that prolong levodopa response and ameliorate levodopa-induced dyskinesias, and innovative delivery methods that are currently being evaluated in clinical trials or are in development with the promise of better efficacy and tolerability. We also describe novel non-dopaminergic drugs that have been identified for treatment of motor and non-motor symptoms. A specific section is designated for potential disease modifying therapies. Alternative formulations of levodopa appear to be promising especially to help with the motor fluctuations either by providing sustained benefits with controlled released formulations or ameliorate sudden OFF by formulations such as inhaled levodopa. Several different medications affecting non-dopaminergic pathways are being evaluated which may aide levodopa. As the understanding of the disease grows further, numerous novel neuroprotective or disease modifying therapies have been suggested. This along with development of medications to treat various non-motor symptoms will help improve quality of life of patients with PD.

  4. 3 CFR 8383 - Proclamation 8383 of May 20, 2009. Emergency Medical Services Week, 2009 (United States)


    ... responders, emergency medical technicians, paramedics, nurses, physicians, and many others. These highly... 3 The President 1 2010-01-01 2010-01-01 false Proclamation 8383 of May 20, 2009. Emergency Medical..., 2009 Proc. 8383 Emergency Medical Services Week, 2009By the President of the United States of America A...

  5. 21 CFR 203.11 - Applications for reimportation to provide emergency medical care. (United States)


    ... emergency medical care. 203.11 Section 203.11 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Applications for reimportation to provide emergency medical care. (a) Applications for reimportation for emergency medical care shall be submitted to the director of the FDA District Office in the district where...

  6. Web-Based Alcohol Intervention: Study of Systematic Attrition of Heavy Drinkers. (United States)

    Radtke, Theda; Ostergaard, Mathias; Cooke, Richard; Scholz, Urte


    Web-based alcohol interventions are a promising way to reduce alcohol consumption because of their anonymity and the possibility of reaching a high numbers of individuals including heavy drinkers. However, Web-based interventions are often characterized by high rates of attrition. To date, very few studies have investigated whether individuals with higher alcohol consumption show higher attrition rates in Web-based alcohol interventions as compared with individuals with lower alcohol consumption. The aim of this study was to examine the attrition rate and predictors of attrition in a Web-based intervention study on alcohol consumption. The analysis of the predictors of attrition rate was performed on data collected in a Web-based randomized control trial. Data collection took place at the University of Konstanz, Germany. A total of 898 people, which consisted of 46.8% males (420/898) and 53.2% females (478/898) with a mean age of 23.57 years (SD 5.19), initially volunteered to participate in a Web-based intervention study to reduce alcohol consumption. Out of the sample, 86.9% (781/898) were students. Participants were classified as non-completers (439/898, 48.9%) if they did not complete the Web-based intervention. Potential predictors of attrition were self-reported: alcohol consumption in the last seven days, per week, from Monday to Thursday, on weekends, excessive drinking behavior measured with the Alcohol Use Disorder Identification Test (AUDIT), and drinking motives measured by the Drinking Motive Questionnaire (DMQ-R SF). Significant differences between completers and non-completers emerged regarding alcohol consumption in the last seven days (B=-.02, P=.05, 95% CI [0.97-1.00]), on weekends (B=-.05, P=.003, 95% CI [0.92-0.98]), the AUDIT (B=-.06, P=.007, 95% CI [0.90-0.98], and the status as a student (B=.72, P=.001, 95% CI [1.35-3.11]). Most importantly, non-completers had a significantly higher alcohol consumption compared with completers. Hazardous

  7. Influence of Family on Saudi Arabian Emergency Medical Services Students

    Directory of Open Access Journals (Sweden)

    William Leggio


    Full Text Available Objective: To identify influences on learning for Saudi male students studying Emergency Medical Services at a college in Riyadh, Saudi Arabia. Previous research on influences on student learning in the Kingdom of Saudi Arabia focused on the historical development of education in Saudi Arabia, English language development, and intrinsic motivations of students and excluded a focus on students studying Emergency Medical Services. Methods: Exploratory sequential mixed-methods study was deployed. Results: Family support was an exceptionally strong predictor of student confidence in both skills and post-graduate EMS employment. Concepts involving application, memorization, motivation, and English language did not present as statically significant. The discovery of the strong influences that a family can have on Saudi EMS student’s confidence is noteworthy, as this was not previously discovered in the literature. Conclusion: This discovery holds practical implications for EMS education and training programs as emphasizes the importance of developing practical ways to include a student’s family as a source of support in ensuring student success and confidence.

  8. Usage of emergency contraception between medical related and non-medical related students.

    LENUS (Irish Health Repository)

    Khalid, A K


    Teenagers and young adultshave the most risk of unplanned pregnancy, due to lack of awareness to see a family planning provider after unprotected sexual intercourse. In addition, nearly one in five physicians is reluctant to provide information regarding Emergency Contraception (EC) to women and this may contribute to their lack of awareness. This study was conducted to assess the knowledge, attitudes and practices regarding the use of EC between medical related students compared to non-medical related students. Data collection was done using questionnaires distributed among students in University College Cork (UCC). 93% of medically related students were aware of EC compared to only 73.5% of non-medically related students. Medical related students also were more aware about the mechanism of action and detailed knowledge of EC compared to the non-medical students. This study has proven that medically related students have more detailed knowledge regarding EC compared to non-medical related students. However, there was no significant difference noted regarding the attitude and practice between the two groups.

  9. The impact of web-based and face-to-face simulation on patient deterioration and patient safety: protocol for a multi-site multi-method design. (United States)

    Cooper, Simon J; Kinsman, Leigh; Chung, Catherine; Cant, Robyn; Boyle, Jayne; Bull, Loretta; Cameron, Amanda; Connell, Cliff; Kim, Jeong-Ah; McInnes, Denise; McKay, Angela; Nankervis, Katrina; Penz, Erika; Rotter, Thomas


    There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST(2)ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST(2)ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016).

  10. Working styles of medicine professionals in emergency medical service

    Directory of Open Access Journals (Sweden)

    Lazarević Marija


    Full Text Available Introduction: Transactional analysis is a personality and communication theory established by psychiatrist Eric Berne, at the end of the fifties. Counter script is the way of life in accordance with parental imperative. The person with a counter-script has a compulsion to fulfill the required task in order to avoid the disaster of ban. There are five drivers that are considered essential, and these are: 'Be perfect!', 'Be strong!', 'Hurry up!', 'Please others!' and 'Work hard!' Objective: a Determination of the most dominant driver in this medical service. b Because of the specifics of this job which requires speed and humanity, the emphasis will be on doublet: 'Hurry up!' and 'Please others!' Method: The study was conducted on a group of subjects employed in a general service with medical emergency. The instrument used in the study was Julie Hay's questionnaire for diagnosing the working styles. Results: Statistical research was conducted on a sample of 30 subjects employed in the emergency medical service. Availability of all afore mentioned drivers was tested. The research hypotheses were formulated as follows: H0: The driver is not present among the employees in this service; H1: The driver is present among the employees in this service. Calculated value of the t-statistics for the driver 'Hurry up!' is 1.398; for the driver 'Be perfect!' 3.616; for the driver 'Please others!' 11.693; for the driver 'Work hard!' -0.673; and for the driver 'Be strong!' 3.880. Since the realizable value of the t-statistics for the drivers: 'Be perfect!' and 'Please others!' and 'Be strong!' is bigger than the critical value 1.699, and p<0.05 we reject the null hypothesis and we accept the alternative hypothesis on the significance level of 95%. For the drivers 'Hurry up!' and 'Work hard!' the values of t-statistics are lower than the critical value 1.699 for significance level of 95%, so the alternative hypothesis are not acceptable. Conclusion: The results of

  11. Web Based Distributed Coastal Image Analysis System Project (United States)

    National Aeronautics and Space Administration — This project develops Web based distributed image analysis system processing the Moderate Resolution Imaging Spectroradiometer (MODIS) data to provide decision...

  12. Evaluation of Dutch Helicopter Emergency Medical Services in transporting children. (United States)

    Peters, Joost; Beekers, Christian; Eijk, Ruud; Edwards, Michael; Hoogerwerf, Nico


    In the Netherlands, helicopter emergency medical services (HEMS) function as an adjunct to paramedic ambulance service delivering hospital-level medical care to a prehospital location. The main goal of Dutch HEMS is to provide on-scene medical expertise and not primarily to serve as transport. The transportation of patients to specialized hospitals is sometimes mandatory, especially in cases of critically ill or wounded children. In the literature, no support can be found to support the safety of transportation by helicopter. We retrospectively evaluated the safety of this type of transportation and if any problems were encountered transporting children by helicopter. We reviewed our local HEMS database for all children (, 16 years) transported by helicopter to a level 1 trauma center between January 2007 and December 2012. A total number of 430 patients were transported by helicopter to a hospital (0-87 years, mean 5 31.6 years). Of these patients, 83 (19%) were younger than 16 years (0-15.7 years, mean 5 6.6 years). Causes for HEMS transport in children varied, but the main groups were road traffic accidents (40%), cardiopulmonary arrests (15%), falls from height (12%), and horse riding accidents (7%). In the children group, 1 accidental extubation of the orotracheal tube was noted while lifting the patient (10 years old) into the helicopter. This was immediately noticed, and the patient was reintubated without complications. No further adverse events were encountered during transportation time. The accidental extubation is not a specific complication of helicopter transportation but is inextricably linked with moving severely injured and intubated patients/children. We conclude that transporting children by helicopter is a safe method of transportation for critically ill children to adequately equipped medical centers. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  13. Evaluation of Web-Based Ostomy Patient Support Resources. (United States)

    Pittman, Joyce; Nichols, Thom; Rawl, Susan M

    To evaluate currently available, no-cost, Web-based patient support resources designed for those who have recently undergone ostomy surgery. Descriptive, correlational study using telephone survey. The sample comprised 202 adults who had ostomy surgery within the previous 24 months in 1 of 5 hospitals within a large healthcare organization in the Midwestern United States. Two of the hospitals were academic teaching hospitals, and 3 were community hospitals. The study was divided into 2 phases: (1) gap analysis of 4 Web sites (labeled A-D) based on specific criteria; and (2) telephone survey of individuals with an ostomy. In phase 1, a comprehensive checklist based on best practice standards was developed to conduct the gap analysis. In phase 2, data were collected from 202 participants by trained interviewers via 1-time structured telephone interviews that required approximately 30 minutes to complete. Descriptive analyses were performed, along with correlational analysis of relationships among Web site usage, acceptability and satisfaction, demographic characteristics, and medical history. Gap analysis revealed that Web site D, managed by a patient advocacy group, received the highest total content score of 155/176 (88%) and the highest usability score of 31.7/35 (91%). Two hundred two participants completed the telephone interview, with 96 (48%) reporting that they used the Internet as a source of information. Sixty participants (30%) reported that friends or family member had searched the Internet for ostomy information on their behalf, and 148 (75%) indicated they were confident they could get information about ostomies on the Internet. Of the 90 participants (45%) who reported using the Internet to locate ostomy information, 73 (82%) found the information on the Web easy to understand, 28 (31%) reported being frustrated during their search for information, 24 (27%) indicated it took a lot of effort to get the information they needed, and 39 (43%) were

  14. Management of In-Flight Medical Emergencies: Are Senior Medical Students Prepared to Respond to this Community Need?

    Directory of Open Access Journals (Sweden)

    Robert J. Katzer


    Full Text Available Introduction: In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medical emergencies. Methods: A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions and perceived ability to respond to in-flight medical emergencies. Results: 229 participants completed the survey (75% response rate. The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. Conclusion: This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flight medical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medical education. [West J Emerg Med. 2014;15(7:–0.

  15. Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure

    Directory of Open Access Journals (Sweden)

    Ajdukovic M


    Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED. The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods: The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results: Twenty four participants were classified as ‘language barrier’; 12 participants were from residential aged care facilities, and 64 participants were classified as ‘general’. The number of correctly recorded medications was lowest in the ‘language barrier’ group (13.8% compared with 18% and 19.6% of medications for ‘general’ patients and patients from residential aged care facilities respectively. Seven of the patients (29.2% with ‘language barrier’; 1 from a residential aged care facility (8.3% and 13 of the (20.3% patients from the ‘general’ category were suspected as having a medication related ED presentation. Conclusion: This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.

  16. Syringe Administration of Epinephrine by Emergency Medical Technicians for Anaphylaxis. (United States)

    Latimer, Andrew J; Husain, Sofia; Nolan, Jonathan; Doreswamy, Vinod; Rea, Thomas D; Sayre, Michael R; Eisenberg, Mickey S


    In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction. Treatment was guided by an EMT protocol that required a trigger and symptoms. We sought to determine if the "Check and Inject" program was safely implemented by EMTs treating presumed prehospital anaphylaxis or serious allergic reaction. We conducted a prospective investigation of all cases treated as part of the "Check and Inject" program from July 2014 through December 2016 in suburban King County, Washington, and January 2016 through December 2016 within the city of Seattle. All cases were prospectively collected using a custom quality improvement data form completed by the first responding EMTs. Two physicians completed a structured review of each EMS medical record to determine if the EMTs followed the Check and Inject protocol and determine if epinephrine was clinically-indicated based on physician review. Of the 411 cases eligible for analysis, EMTs followed the protocol appropriately in 367 (89.3%) cases. In the remaining 44 (10.7%) cases, the EMS incident report form failed to document either a clear inciting allergic trigger or an appropriate symptom from the protocol list. Physician review determined that epinephrine was clinically indicated in 36 of the 44 cases. Among the remaining 8 cases (1.9%) that did not meet protocol criteria and were not clinically-indicated based on physician review, none had a documented adverse reaction to the epinephrine. We observed that EMTs successfully implemented the manual "Check and Inject" program for severe

  17. Variation in emergency medical services workplace safety culture. (United States)

    Patterson, P Daniel; Huang, David T; Fairbanks, Rollin J; Simeone, Scott; Weaver, Matthew; Wang, Henry E


    Workplace attitude, beliefs, and culture may impact the safety of patient care. This study characterized perceptions of safety culture in a nationwide sample of emergency medical services (EMS) agencies. We conducted a cross-sectional survey involving 61 advanced life support EMS agencies in North America. We administered a modified version of the Safety Attitudes Questionnaire (SAQ), a survey instrument measuring dimensions of workplace safety culture (Safety Climate, Teamwork Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition). We included full-time and part-time paramedics and emergency medical technicians. We determined the variation in safety culture scores across EMS agencies. Using hierarchical linear models, we determined associations between safety culture scores and individual and EMS agency characteristics. We received 1,715 completed surveys from 61 EMS agencies (mean agency response rate 47%; 95% confidence interval [CI] 10%, 83%). There was wide variation in safety culture scores across EMS agencies [mean (minimum, maximum)]: Safety Climate 74.5 (min 49.9, max 89.7), Teamwork Climate 71.2 (min 45.1, max 90.1), Perceptions of Management 67.2 (min 31.1, max 92.2), Job Satisfaction 75.4 (min 47.5, max 93.8), Working Conditions 66.9 (min 36.6, max 91.4), and Stress Recognition 55.1 (min 31.3, max 70.6). Air medical EMS agencies tended to score higher across all safety culture domains. Lower safety culture scores were associated with increased annual patient contacts. Safety Climate domain scores were not associated with other individual or EMS agency characteristics. In this sample, workplace safety culture varies between EMS agencies.

  18. Emergency medical care for spectators attending National Football League games. (United States)

    Roberts, D M; Blackwell, T H; Marx, J A


    average stadium staffs 8 EMT-Bs, 7 EMT-Ps, 3 registered nurses, and 2 physicians. Nine stadiums pay a predesignated fee per game to an agency to provide emergency care to spectators. Medical personnel are compensated by an hourly rate (n = 15), a fixed rate per event (n = 9), overtime wages (n = 3), or volunteerism (n = 4). Four NFL organizations pay their medical personnel by more than one type of compensation. Courtesy seats are provided to physicians and nurses in 1 stadium and to just physicians in 8 stadiums, with a range of 2 to 6 and a mean of 3.3 +/- 1.3. All stadiums use two-way radios for the communication and coordination of medical care in the stadium. Additionally, 20 use fixed telephones in the first aid rooms, 3 use cellular telephones, and 2 incorporate a pager system to dispatch personnel within the stadium. A wide variety of system designs, facilities, and personnel configurations are used to provide emergency medical care for spectators attending NFL games. This information may be useful for assisting those individuals responsible for organizing stadium medical coverage.

  19. Pharmacotherapeutics knowledge of some nonemergency and emergency conditions among medical undergraduates in an Indian medical college. (United States)

    Khan, Sarfaraz Alam; Siddiqui, Nazeem Ishrat


    To assess pharmacotherapeutics (PT) knowledge of second professional medical undergraduates. It is a questionnaire-based cross-sectional study. The questionnaire was designed to objectively assess the current level of knowledge of PT acquired by the second MBBS students in a medical college in India. Thirty Type-A multiple choice questions (MCQs) related with the PT of common and important medical conditions and some emergency conditions were administered to 125 participants. Grading of knowledge was also done as poor, average, and good both subjectively and objectively. Descriptive statistics were used to analyze responses. Association of PT knowledge with respect to mode of admission in a medical college was analyzed with Chi-square test. MCQs related with PT of nonemergency conditions were responded correctly by 9.8-77.7% of participants. MCQs related with PT of some emergency conditions were responded correctly by 17-66.1% of participants. No statistically significant association was observed in PT knowledge with respect to mode of admission. Gross deficiency in the PT knowledge can potentially and adversely affect future rational prescribing skills. PT knowledge about common medical conditions should be emphasized during undergraduate training program.

  20. Educating for ethical leadership through web-based coaching. (United States)

    Eide, Tom; Dulmen, Sandra van; Eide, Hilde


    Ethical leadership is important for developing ethical healthcare practice. However, there is little research-based knowledge on how to stimulate and educate for ethical leadership. The aim was to develop and investigate the feasibility of a 6-week web-based, ethical leadership educational programme and learn from participants' experience. Training programme and research design: A training programme was developed consisting of (1) a practice part, where the participating middle managers developed and ran an ethics project in their own departments aiming at enhancing the ethical mindfulness of the organizational culture, and (2) a web-based reflection part, including online reflections and coaching while executing the ethics project. Focus group interviews were used to explore the participants' experiences with and the feasibility of the training. Participants and research context: Nine middle managers were recruited from a part-time master's programme in leadership in Oslo, Norway. The research context was the participating leaders' work situation during the 6 weeks of training. Ethical considerations: Participation was voluntary, data anonymized and the confidentiality of the participating leaders/students and their institutions maintained. No patient or medical information was involved. Eight of the nine recruited leaders completed the programme. They evaluated the training programme as efficient and supportive, with the written, situational feedback/coaching as the most important element, enhancing reflection and motivation, counteracting a feeling of loneliness and promoting the execution of change. The findings seem consistent with the basic assumptions behind the educational design, based partly on e-health research, feedback studies and organizational ethics methodology, partly on theories on workplace learning, reflection, recognition and motivation. The training programme seems feasible. It should be adjusted according to participants' proposals and tested

  1. [Elemental status of the medical personnel of the emergency medical services in the city of Khanty-Mansiysk]. (United States)

    Korchina, T Ya; Kuzmenko, A P; Korchina, I V


    Spectrometric analysis of hair from 110 medical workers (54--from the Emergency medical services and 56--from polyclinics) was performed with the use of atomic emission spectrometry and mass spectrometry, inductively coupled argon plasma spectrometry (AES-ISP) methods. There were revealed features of the elemental status of the medical personnel of the Emergency medical services: a deficiency of Mg, K and Li was typical for this group (presented more then in half of cases).

  2. Web-Based Training Applications in Safeguards and Security

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, R.L.


    The U.S. Department of Energy (DOE) requires all employees who hold a security clearance and have access to classified information and/or special nuclear material to be trained in the area of Safeguards and Security. Since the advent of the World Wide Web, personnel who are responsible for training have capitalized on this communication medium to develop and deliver Web-based training. Unlike traditional computer based training where the student was required to find a workstation where the training program resided, one of Web-based training strongest advantage is that the training can be delivered right to the workers desk top computer. This paper will address reasons for the driving forces behind the utilization of Web-based training at the Laboratory with a brief explanation of the different types of training conducted. Also discussed briefly is the different types of distance learning used in conjunction with Web-based training. The implementation strategy will be addressed and how the Laboratory utilized a Web-Based Standards Committee to develop standards for Web-based training applications. Web-based problems resulting from little or no communication between training personnel across the Laboratory will be touched on and how this was solved. Also discussed is the development of a ''Virtual Training Center'' where personnel can shop on-line for their training needs. Web-based training programs within the Safeguards and Security arena will be briefly discussed. Specifically, Web-based training in the area of Materials Control and Accountability will be explored. A Web-based example of what a student would experience during a training session is also discussed. A short closing statement of what the future of Web-based Training holds in the future is offered.

  3. Web-Based Tools in Education

    Directory of Open Access Journals (Sweden)

    Lupasc Adrian


    Full Text Available Technology is advancing at a rapid pace, and what we knew a year ago is likely to no longer apply today. With it, the technology brings new ways of transmitting information, machining and processing, storage and socializing. The continuous development of information technologies contributes more than ever to the increase of access to information for any field of activity, including education. For this reason, education must help young people (pupils and students to collect and select from the sheer volume of information available, to access them and learn how to use them. Therefore, education must constantly adapt to social change; it must pass on the achievements and richness of human experience. At the same time, technology supports didactic activity because it leads learning beyond the classroom, involving all actors in the school community and prepares young people for their profession. Moreover, web tools available for education can yield added benefits, which is why, especially at higher levels of the education system, their integration starts being more obvious and the results are soon to be seen. Moreover, information technologies produce changes in the classic way of learning, thus suffering rapid and profound transformations. In addition, current information technologies offer many types of applications, representing the argument for a new system of providing education and for building knowledge. In this regard, the paper aims to highlight the impact and benefits of current information technologies, particularly web-based, on the educational process.

  4. A Web-Based Geospatial Metadata Browser (United States)

    Arko, R. A.; Chayes, D. N.


    We are developing a simple Web-based browser for the search and display of earth science metadata. Our design goals are: 1. to permit both map-based (geographical) and forms-based (textual) searching; 2. to integrate a wide variety of data types in a hierarchical fashion; 3. to conform to the FGDC metadata standard; 4. to take advantage of existing open source software wherever possible; 5. to be platform-independent, browser-independent, and "robust" (i.e. avoid application layers which are resource-intensive or behave unpredictably, such as Java applets); and 6. to present metadata in a dynamic fashion via live database connections. Our implementation is based on the MapServer GIS platform (developed at the University of Minnesota with NSF and NASA funding), PostgreSQL relational database management system, and PostGIS geographic database extensions (developed by Refractions Research Inc and available under GNU Public License). All of these packages are well-documented open source software and have been proven in commercial-grade applications. We combine geographical searching (click-and-drag on maps, in both global and polar projections) and textual searching (drop-down menus organized by FGDC category) for a range of geophysical, chemical, and biological data types. A corresponding framework for collecting and ingesting earth science metadata is reported elsewhere at this meeting (Chayes & Arko, "Real-time Metadata Capture Implementations").

  5. A web-based peer feedback tool for physical examination. (United States)

    Luther, Ryan; Richardson, Lisa


    Medical students do not have many formal opportunities to practise physical examinations during their pre-clerkship years. Consequently, they often practise their examination skills with peers outside of formal teaching sessions. There are also few opportunities for observation and feedback on their skills in this area. The undergraduate medical programme at the University of Toronto is a 4-year programme where students learn clinical skills in the first 2 years prior to beginning clinical rotations. We describe a web-based, mobile device-friendly tool to facilitate structured peer-peer observation and feedback of physical examination skills. The tool is designed for use by pre-clerkship medical students, and includes assessment criteria for select physical examinations based on expectations for pre-clerkship medical students. In addition, supplemental instructional material was developed to aid the students' learning. The tool was piloted with first-year medical students as they prepared for their autumn objective structured clinical examination (OSCE) at the University of Toronto. Its use was voluntary. The tool has been used enthusiastically by students, and their feedback has been positive. This tool is an innovation that guides students as they practise their physical examination skills, and gives them a framework to provide feedback to one another during this process. It also encourages students to reflect critically on their own skills, as well as those of their peers, through the use of an engaging digital platform. The tool will be expanded to include history-taking vignettes, photos and videos. The tool is sustainable, and could be easily implemented at other institutions without a substantial investment. Students often practise their examination skills with peers outside of formal teaching sessions. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  6. Constructing Common Information Space across Distributed Emergency Medical Teams

    DEFF Research Database (Denmark)

    Zhang, Zhan; Sarcevic, Aleksandra; Bossen, Claus


    This paper examines coordination and real-time information sharing across four emergency medical teams in a high-risk and distributed setting as they provide care to critically injured patients within the first hour after injury. Through multiple field studies we explored how common understanding...... of critical patient data is established across these heterogeneous teams and what coordination mechanisms are being used to support information sharing and interpretation. To analyze the data, we drew on the concept of Common Information Spaces (CIS). Our results showed that teams faced many challenges...... in achieving efficient information sharing and coordination, including difficulties in locating and assembling team members, communicating and interpreting information from the field, and accommodating differences in team goals and information needs, all while having minimal technology support. We reflect...

  7. Customers' satisfaction about prehospital emergency medical services in Lorestan, Iran. (United States)

    Heydari, Heshmatolah; Kamran, Aziz; Zali, Morad Esmaiel; Novinmehr, Nasser; Safari, Mehdi


    Patient's satisfaction with health care in ambulance services is an important quality indicator and a helpful tool for managers of prehospital emergency services. This study aimed to measure patient satisfaction with health provided by prehospital emergency medical services (EMS) in Lorestan, Iran. This cross-sectional study was conducted on patients (n=450) transferred by EMS to hospitals of Lorestan University of Medical Sciences in a two-year period (2013-2014). Data collection was performed by patient questionnaire, which is a standard LKFR tool. Validity and reliability of the instrument was confirmed by scientific method. Collected data were analyzed by SPSS Version 19. Descriptive and inferential statistics such as Chi-square, paired-samples t-test, independent-samples t-test, ANOVA, Pearson's product-moment correlation coefficient, and Fisher's exact test were used. One hundred ninety-two (42.8%) and 257 (57.2%) patients were female and male, respectively (mean: 41 years, r: 37-83). Patient satisfaction of the dispatcher was good, and satisfaction level in regards to the technicians' performance, physical situation, and facilities inside the ambulance was moderate. The Wilcoxon test did not show any significant difference between pain severity before and after arriving EMS in the cardiac and respiratory patients (p=0.691), but severity of pain in orthopedic patients after arriving EMS was decreased (p=0.001). Cardiac and respiratory patients had low satisfaction of EMS, and the Chi-square test was significant (p=0.001). Orthopedic patients had the most satisfaction of EMS. Generally, patients' satisfaction of EMS was low. Satisfaction with pain relief in orthopedic patients was better than pain relief in cardiac and respiratory patients. It is recommended to take necessary actions to improve the level of patient satisfaction of EMS.

  8. Customers’ satisfaction about prehospital emergency medical services in Lorestan, Iran (United States)

    Heydari, Heshmatolah; Kamran, Aziz; Zali, Morad Esmaiel; Novinmehr, Nasser; Safari, Mehdi


    Introduction Patient’s satisfaction with health care in ambulance services is an important quality indicator and a helpful tool for managers of prehospital emergency services. This study aimed to measure patient satisfaction with health provided by prehospital emergency medical services (EMS) in Lorestan, Iran. Methods This cross-sectional study was conducted on patients (n=450) transferred by EMS to hospitals of Lorestan University of Medical Sciences in a two-year period (2013–2014). Data collection was performed by patient questionnaire, which is a standard LKFR tool. Validity and reliability of the instrument was confirmed by scientific method. Collected data were analyzed by SPSS Version 19. Descriptive and inferential statistics such as Chi-square, paired-samples t-test, independent-samples t-test, ANOVA, Pearson’s product-moment correlation coefficient, and Fisher’s exact test were used. Results One hundred ninety-two (42.8%) and 257 (57.2%) patients were female and male, respectively (mean: 41 years, r: 37–83). Patient satisfaction of the dispatcher was good, and satisfaction level in regards to the technicians’ performance, physical situation, and facilities inside the ambulance was moderate. The Wilcoxon test did not show any significant difference between pain severity before and after arriving EMS in the cardiac and respiratory patients (p=0.691), but severity of pain in orthopedic patients after arriving EMS was decreased (p=0.001). Cardiac and respiratory patients had low satisfaction of EMS, and the Chi-square test was significant (p=0.001). Orthopedic patients had the most satisfaction of EMS. Conclusion Generally, patients’ satisfaction of EMS was low. Satisfaction with pain relief in orthopedic patients was better than pain relief in cardiac and respiratory patients. It is recommended to take necessary actions to improve the level of patient satisfaction of EMS. PMID:28461872

  9. Emergency Medical Services Provider Experiences of Hospice Care. (United States)

    Barnette Donnelly, Cassandra; Armstrong, Karen Andrea; Perkins, Molly M; Moulia, Danielle; Quest, Tammie E; Yancey, Arthur H


    Growing numbers of emergency medical services (EMS) providers respond to patients who receive hospice care. The objective of this investigation was to assess the knowledge, attitudes, and experiences of EMS providers in the care of patients enrolled in hospice care. We conducted a survey study of EMS providers regarding hospice care. We collected quantitative and qualitative data on EMS provider's knowledge, attitudes, and experiences in responding to the care needs of patients in hospice care. We used Chi-squared tests to compare EMS provider's responses by credential (Emergency Medical Technician [EMT] vs. Paramedic) and years of experience (0-5 vs. 5+). We conducted a thematic analysis to examine open-ended responses to qualitative questions. Of the 182 EMS providers who completed the survey (100% response rate), 84.1% had cared for a hospice patient one or more times. Respondents included 86 (47.3%) EMTs with Intermediate and Advanced training and 96 (52.7%) Paramedics. Respondent's years of experience ranged from 0-10+ years, with 99 (54.3%) providers having 0-5 years of experience and 83 (45.7%) providers having 5+ years of experience. There were no significant differences between EMTs and Paramedics in their knowledge of the care of these patients, nor were there significant differences (p education on the care of hospice patients. A total of 36% respondents felt that patients in hospice care required a DNR order. In EMS providers' open-ended responses on challenges in responding to the care needs of hospice patients, common themes were family-related challenges, and the need for more education. While the majority of EMS providers have responded to patients enrolled in hospice care, few providers received formal training on how to care for this population. EMS providers have expressed a need for a formal curriculum on the care of the patient receiving hospice.

  10. design and implementation of a web based information system for ...

    African Journals Online (AJOL)


    The design and implementation of a web-based administrative information system for National Health. Insurance Scheme ... NET framework has been explored for use in designing a web-based working prototype for the scheme with cold fusion mark-up .... licensed Government or Private Health Care Practitioner or facility ...

  11. Webdatanet: Innovation and quality in web-based data collection

    NARCIS (Netherlands)

    Steinmetz, S.; Slavec, A.; Tijdens, K.; Reips, U.-D.; de Pedraza, P.; Popescu, A.; Belchior, A.; Birgegard, A.; Bianchi, A.; Ayalon, A.; Selkala, A.; Villacampa, A.; Winer, B.; Mlacic, B.; Vogel, C.; Gravem, D.; Gayo Avello, D.; Constantin, D.; Toninelli, D.; Troitino, D.; Horvath, D.; de Leeuw, E.; Oren, E.; Fernandez-Macias, E.; Thorsdottir, F.; Ortega, F.; Funke, F.; Campagnolo, G.M.; Milas, G.; Grünwald, C.; Jonsdottir, G.; Haraldsen, G.; Doron, G.; Margetts, H.; Miklousic, I.; Andreadis, I.; Berzelak, J.; Angelovska, J.; Schrittwieser, K.; Kissau, K.; Lozar Manfreda, K.; Kolsrud, K.; Kalgraff Skjak, K.; Tsagarakis, K.; Kaczmirek, L.; Lesnard, L.; Moga, L.M.; Lopes Teixeira, L.; Plate, M.; Kozak, M.; Fuchs, M.; Callegaro, M.; Cantijoch, M.; Kahanec, M.; Stopa, M.; Ernst Staehli, M.; Neculita, M.; Ivanovic, M.; Foulonneau, M.; Cheikhrouhou, N.; Fornara, N.; Finnemann, N.O.; Zajc, N.; Nyirå, N.; Louca, P.; Osse, P.; Mavrikiou, P.; Gibson, R.; Vatrapu, R.; Dar, R.; Pinter, R.; Martinez Torres, R.; Douhou, S.; Biffignandi, S.; Grceva, S.; David, S.; Ronkainen, T.; Csordas, T.; Lenzner, T.; Vesteinsdottir, V.; Vehovar, V.; Markov, Y.


    In light of the growing importance of web-based data in the social and behavioral sciences, WEBDATANET was established in 2011 as a COST Action (IS 1004) to create a multidisciplinary network of web-based data collection experts: (web) survey methodologists, psychologists, sociologists, linguists,

  12. Utilization of Web-Based Information Resources for Researchers in ...

    African Journals Online (AJOL)

    The findings revealed that respondents generally showed positive attitude towards use of web-based information resources. The implication of the findings implies that university libraries that provide such resources effectively will help to promote academic scholarship and research. Key Words: Web-Based, Information, ...

  13. The problem of medical dispatchers’ responsibility functioning in the emergency medical services system

    Directory of Open Access Journals (Sweden)

    Czesław Chowaniec


    Full Text Available Aim of the study : Deaths due to inappropriate functioning of the emergency medical services system, as recently described by Polish mass media, has drawn the attention of society to the activities of medical dispatchers. Legal regulations impose obligations on those persons associated with receiving phone calls and dispensing appropriate emergency medical teams. In this paper an analysis of chosen medicolegal opinions from the practice of the Department of Forensic Medicine and Forensic Toxicology, Medical University of Silesia in Katowice, towards malpractices committed by dispatchers of EMS, was performed. Material and methods: The authors analysed 12 of medicolegal opinions, issued from 2007 to 2012 by a team of experts. Results : The errors noted in the work of dispatchers consisted of delays in giving appropriate assistance due to the inability to properly converse, a propensity to downplay patients’ symptoms, and dispatchers crossing their own competences. Conclusions : The problem may be resolved by the subsidy of EMS, fine-tuning the algorithms for conduct, and proper education of both staff and public.

  14. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    Directory of Open Access Journals (Sweden)

    James Robert Langabeer


    Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  15. Emergency Medical Service Information System:the ARES 118 experience. (United States)

    Ientile, D A; Cardinale, M A; Cataldi, S; Parafati, M; Pasquarella, A; Trani, N; Corradi, M P


    In this paper we describe ARES 118, the prehospital Emergency Medical Service of the Region Lazio, Italy, focusing on its data system used to populate a data warehouse and to create ad hoc reports. ARES 118 is a regional public mono-specialized health company, established in 2004, that manages the emergency care throughout the Region Lazio. Being a peculiar company in its kind, and being the first experience of this kind in Italy, ARES 118 has begun to equip itself, in an autonomous way, with a corporate information system, starting from what already existed as data collection from the individual provincial operating Centers and then by activating a unique information system at a regional and company level by deploying a data warehouse. All operations were carried out using open source software. Currently, ARES 118 is equipped with a business information system that enables data collection with its storage, management and processing of the same in fairly and easy way. The system allows the production of specific reports and measures modulated on the user requests in order to highlight the different aspects of the activity. The production of ad hoc reports, with the possibility of developing specific indicators, allows the identification and analysis of critical areas/processes in order to implement any corrective actions and monitor the effectiveness of the sam.

  16. The dangers of detrimental coping in emergency medical services. (United States)

    Holland, Mark


    To manage the untoward effects of exposure to personally disturbing incidents (PDIs), fire/emergency medical services (EMS) professionals use a variety of coping methods. Some detrimental coping patterns have been steeped in the tradition of emergency services. To examine the effectiveness of various coping methods utilized by fire/EMS professionals for mitigating the negative effects of exposure to PDIs. To differentiate a relationship between the demographic data, traumatic stress, exposure to personally disturbing incidents, and coping methods of fire/EMS professionals, three questionnaires were utilized: a background/demographic questionnaire (BDQ), the 28-item General Health Questionnaire (GHQ-28), and the Ways of Coping Questionnaire (WOC). Descriptive and correlational analyses were used to evaluate the level of traumatic stress symptomatology associated with personally disturbing incidents and describe the relationship between the psychological health of fire/EMS professionals and coping methods. One hundred eighty fire/EMS professionals were surveyed. This study identified the subjective stress associated with five PDIs and pinpointed five detrimental coping methods of fire/EMS personnel that were predictors for increasing traumatic stress symptomatology. A significant relationship has been established between the dangers of detrimental coping methods and traumatic stress in fire/EMS professionals. Five detrimental coping methods have been correlated with traumatic stress. Three optimal coping methods offer promise in managing the untoward effects of PDIs.

  17. Hyponatraemia in Emergency Medical Admissions—Outcomes and Costs

    Directory of Open Access Journals (Sweden)

    Richard Conway


    Full Text Available Healthcare systems in the developed world are struggling with the demand of emergency room presentations; the study of the factors driving such demand is of fundamental importance. From a database of all emergency medical admissions (66,933 episodes in 36,271 patients to St James’ Hospital, Dublin, Ireland, over 12 years (2002 to 2013 we have explored the impact of hyponatraemia on outcomes (30 days in-hospital mortality, length of stay (LOS and costs. Identified variables, including Acute Illness Severity, Charlson Co-Morbidity and Chronic Disabling Disease that proved predictive univariately were entered into a multivariable logistic regression model to predict the bivariate of 30 days in-hospital survival. A zero truncated Poisson regression model assessed LOS and episode costs and the incidence rate ratios were calculated. Hyponatraemia was present in 22.7% of episodes and 20.3% of patients. The 30 days in-hospital mortality rate for hyponatraemic patients was higher (15.9% vs. 6.9% p < 0.001 and the LOS longer (6.3 (95% CI 2.9, 12.2 vs. 4.0 (95% CI 1.5, 8.2 p < 0.001. Both parameters worsened with the severity of the initial sodium level. Hospital costs increased non-linearly with the severity of initial hyponatraemia. Hyponatraemia remained an independent predictor of 30 days in-hospital mortality, length of stay and costs in the multi-variable model.

  18. Development of a Web-based concept for patients with ulcerative colitis and 5-aminosalicylic acid treatment

    DEFF Research Database (Denmark)

    Elkjaer, Margarita; Burisch, Johan; Avnstrøm, Søren


    BACKGROUND: Ulcerative colitis (UC) is a lifelong disease with increasing incidence. UC requires frequent outpatient clinic visits and continuous medical treatment. Web-based self-management in other chronic diseases influences disease course, and increases self-adherence, compliance and quality...... of life (QoL). Lack of easy access to inflammatory bowel disease clinics and patient education, their understanding of the importance of early treatment at relapse, poor compliance and self-adherence can be partly solved by a newly developed Web-based concept. AIMS: To describe the development...... and validation of the Web-based 'Constant-Care' concept. METHODS: A Web-based treatment program ( and a Patient Educational Centre for UC patients were developed. The feasibility and acceptance of the concept was validated before (group A) and 6 months after (group B) the start...

  19. Medical sports injuries in the youth athlete: emergency management. (United States)

    Merkel, Donna L; Molony, Joseph T


    As the number of youth sports participants continues to rise over the past decade, so too have sports related injuries and emergency department visits. With low levels of oversight and regulation observed in youth sports, the responsibility for safety education of coaches, parents, law makers, organizations and institutions falls largely on the sports medicine practitioner. The highly publicized catastrophic events of concussion, sudden cardiac death, and heat related illness have moved these topics to the forefront of sports medicine discussions. Updated guidelines for concussion in youth athletes call for a more conservative approach to management in both the acute and return to sport phases. Athletes younger than eighteen suspected of having a concussion are no longer allowed to return to play on the same day. Reducing the risk of sudden cardiac death in the young athlete is a multi-factorial process encompassing pre-participation screenings, proper use of safety equipment, proper rules and regulations, and immediate access to Automated External Defibrillators (AED) as corner stones. Susceptibility to heat related illness for youth athletes is no longer viewed as rooted in physiologic variations from adults, but instead, as the result of various situations and conditions in which participation takes place. Hydration before, during and after strenuous exercise in a high heat stress environment is of significant importance. Knowledge of identification, management and risk reduction in emergency medical conditions of the young athlete positions the sports physical therapist as an effective provider, advocate and resource for safety in youth sports participation. This manuscript provides the basis for management of 3 major youth emergency sports medicine conditions.

  20. Clinical presentation of hypertensive crises in emergency medical services. (United States)

    Salkic, Sabina; Batic-Mujanovic, Olivera; Ljuca, Farid; Brkic, Selmira


    The objective of this study is to evaluate the incidence and clinical presentation of hypertensive crises in the Emergency medical services of the Community Health Centre "Dr. Mustafa Šehović" Tuzla in relation to age, sex, duration and severity of hypertension, as well as the prevalence of accompanying symptoms and clinical manifestations. The study was conducted between November 2009 and April 2010 and included 180 subjects of both sexes, aged 30-80 with a diagnosis of arterial hypertension. All subjects were divided into two groups: a control group, which consisted of subjects without hypertensive crisis (95 subjects) and an experimental group that consisted of subjects with hypertensive crisis (85 subjects). The study results indicate that female subjects were significantly over- represented compared to men (60% vs. 40 %, p=0.007). The average age of the male subjects was 55.83±11.06 years, while the female subjects' average age was 59.41±11.97 years. The incidence of hypertensive crisis was 47.22%, with hypertensive urgency significantly more represented than emergency (16.47% vs. 83.53%, phypertensive subjects were headache (75%), chest pain (48.33%), vertigo (44.44%), shortness of breath (38.88%) and nausea (33.89%). The most common symptoms in subjects with hypertensive crisis were headache (74.11%), chest pain and shortness of breath (62.35%), vertigo (49.41%), and nausea and vomiting (41.17%). Chest pain, shortness of breath, nausea and vomiting were significantly over-represented in subjects with hypertensive crisis (phypertensive emergencies in almost all subjects included acute coronary syndrome, and only one subject had acute pulmonary edema.

  1. Web-based Cooperative Learning in College Chemistry Teaching

    Directory of Open Access Journals (Sweden)

    Bin Jiang


    Full Text Available With the coming of information era, information process depend on internet and multi-media technology in education becomes the new approach of present teaching model reform. Web-based cooperative learning is becoming a popular learning approach with the rapid development of web technology. The paper aims to how to carry out the teaching strategy of web-based cooperative learning and applied in the foundation chemistry teaching.It was shown that with the support of modern web-based teaching environment, students' cooperative learning capacity and overall competence can be better improved and the problems of interaction in large foundation chemistry classes can be solved. Web-based cooperative learning can improve learning performance of students, what's more Web-based cooperative learning provides students with cooperative skills, communication skills, creativity, critical thinking skills and skills in information technology application.

  2. Perception of stroke symptoms and utilization of emergency medical services

    Directory of Open Access Journals (Sweden)

    Maximiliano A. Hawkes

    Full Text Available ABSTRACT Lack of stroke awareness and slow activation of emergency medical services (EMS are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75% arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02. Nineteen patients (20% were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001. Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

  3. Estimated Lifetime Medical and Work-Loss Costs of Emergency Department-Treated Nonfatal Injuries--United States, 2013. (United States)

    Florence, Curtis; Haegerich, Tamara; Simon, Thomas; Zhou, Chao; Luo, Feijun


    A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies.

  4. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM). (United States)

    Cooper, Simon; Cant, Robyn; Porter, Joanne; Sellick, Ken; Somers, George; Kinsman, Leigh; Nestel, Debra


    To develop a valid, reliable and feasible teamwork assessment measure for emergency resuscitation team performance. Generic and profession specific team performance assessment measures are available (e.g. anaesthetics) but there are no specific measures for the assessment of emergency resuscitation team performance. (1) An extensive review of the literature for teamwork instruments, and (2) development of a draft instrument with an expert clinical team. (3) Review by an international team of seven independent experts for face and content validity. (4) Instrument testing on 56 video-recorded hospital and simulated resuscitation events for construct, consistency, concurrent validity and reliability and (5) a final set of ratings for feasibility on fifteen simulated 'real time' events. Following expert review, selected items were found to have a high total content validity index of 0.96. A single 'teamwork' construct was identified with an internal consistency of 0.89. Correlation between the total item score and global rating (rho 0.95; pleadership, teamwork and task management. In this primary study TEAM was found to be a valid and reliable instrument and should be a useful addition to clinicians' tool set for the measurement of teamwork during medical emergencies. Further evaluation of the instrument is warranted to fully determine its psychometric properties. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  5. A Practical Guide To Developing Effective Web-based Learning (United States)

    Cook, David A; Dupras, Denise M


    OBJECTIVE Online learning has changed medical education, but many “educational” websites do not employ principles of effective learning. This article will assist readers in developing effective educational websites by integrating principles of active learning with the unique features of the Web. DESIGN Narrative review. RESULTS The key steps in developing an effective educational website are: Perform a needs analysis and specify goals and objectives; determine technical resources and needs; evaluate preexisting software and use it if it fully meets your needs; secure commitment from all participants and identify and address potential barriers to implementation; develop content in close coordination with website design (appropriately use multimedia, hyperlinks, and online communication) and follow a timeline; encourage active learning (self-assessment, reflection, self-directed learning, problem-based learning, learner interaction, and feedback); facilitate and plan to encourage use by the learner (make website accessible and user-friendly, provide time for learning, and motivate learners); evaluate learners and course; pilot the website before full implementation; and plan to monitor online communication and maintain the site by resolving technical problems, periodically verifying hyperlinks, and regularly updating content. CONCLUSION Teaching on the Web involves more than putting together a colorful webpage. By consistently employing principles of effective learning, educators will unlock the full potential of Web-based medical education. PMID:15209610

  6. Physician medical direction and clinical performance at an established emergency medical services system. (United States)

    Munk, Marc-David; White, Shaun D; Perry, Malcolm L; Platt, Thomas E; Hardan, Mohammed S; Stoy, Walt A


    Few developed emergency medical services (EMS) systems operate without dedicated medical direction. We describe the experience of Hamad Medical Corporation (HMC) EMS, which in 2007 first engaged an EMS medical director to develop and implement medical direction and quality assurance programs. We report subsequent changes to system performance over time. Over one year, changes to the service's clinical infrastructure were made: Policies were revised, paramedic scopes of practice were adjusted, evidence-based clinical protocols were developed, and skills maintenance and education programs were implemented. Credentialing, physician chart auditing, clinical remediation, and online medical command/hospital notification systems were introduced. Following these interventions, we report associated improvements to key indicators: Chart reviews revealed significant improvements in clinical quality. A comparison of pre- and post-intervention audited charts reveals a decrease in cases requiring remediation (11% to 5%, odds ratio [OR] 0.43 [95% confidence interval (CI) 0.20-0.85], p = 0.01). The proportion of charts rated as clinically acceptable rose from 48% to 84% (OR 6 [95% CI 3.9-9.1], p < 0.001). The proportion of misplaced endotracheal tubes fell (3.8% baseline to 0.6%, OR 0.16 [95% CI 0.004-1.06], (exact) p = 0.05), corresponding to improved adherence to an airway placement policy mandating use of airway confirmation devices and securing devices (0.7% compliance to 98%, OR 714 [95% CI 64-29,334], (exact) p < 0.001). Intravenous catheter insertion in unstable cases increased from 67% of cases to 92% (OR 1.31 [95% CI 1.09-1.71], p = 0.004). EMS administration of aspirin to patients with suspected ischemic chest pain improved from 2% to 77% (OR 178 [95% CI 35-1,604], p < 0.001). We suggest that implementation of a physician medical direction is associated with improved clinical indicators and overall quality of care at an established EMS system.

  7. Preparation With Web-Based Observational Practice Improves Efficiency of Simulation-Based Mastery Learning. (United States)

    Cheung, Jeffrey J H; Koh, Jansen; Brett, Clare; Bägli, Darius J; Kapralos, Bill; Dubrowski, Adam


    Our current understanding of what results in effective simulation-based training is restricted to the physical practice and debriefing stages, with little attention paid to the earliest stage: how learners are prepared for these experiences. This study explored the utility of Web-based observational practice (OP) -featuring combinations of reading materials (RMs), OP, and collaboration- to prepare novice medical students for a simulation-based mastery learning (SBML) workshop in central venous catheterization. Thirty medical students were randomized into the following 3 groups differing in their preparatory materials for a SBML workshop in central venous catheterization: a control group with RMs only, a group with Web-based groups including individual OP, and collaborative OP (COP) groups in addition to RM. Preparation occurred 1 week before the SBML workshop, followed by a retention test 1-week afterward. The impact on the learning efficiency was measured by time to completion (TTC) of the SBML workshop. Web site preparation behavior data were also collected. Web-based groups demonstrated significantly lower TTC when compared with the RM group, (P = 0.038, d = 0.74). Although no differences were found between any group performances at retention, the COP group spent significantly more time and produced more elaborate answers, than the OP group on an OP activity during preparation. When preparing for SBML, Web-based OP is superior to reading materials alone; however, COP may be an important motivational factor to increase learner engagement with instructional materials. Taken together, Web-based preparation and, specifically, OP may be an important consideration in optimizing simulation instructional design.

  8. Practical guidelines for development of web-based interventions. (United States)

    Chee, Wonshik; Lee, Yaelim; Chee, Eunice; Im, Eun-Ok


    Despite a recent high funding priority on technological aspects of research and a high potential impact of Web-based interventions on health, few guidelines for the development of Web-based interventions are currently available. In this article, we propose practical guidelines for development of Web-based interventions based on an empirical study and an integrative literature review. The empirical study aimed at development of a Web-based physical activity promotion program that was specifically tailored to Korean American midlife women. The literature review included a total of 202 articles that were retrieved through multiple databases. On the basis of the findings of the study and the literature review, we propose directions for development of Web-based interventions in the following steps: (1) meaningfulness and effectiveness, (2) target population, (3) theoretical basis/program theory, (4) focus and objectives, (5) components, (6) technological aspects, and (7) logistics for users. The guidelines could help promote further development of Web-based interventions at this early stage of Web-based interventions in nursing.

  9. The acquisition and retention of ECG interpretation skills after a standardized web-based ECG tutorial-a randomised study

    DEFF Research Database (Denmark)

    Rolskov Bojsen, Signe; Räder, Sune Bernd Emil Werner; Holst, Anders Gaardsdal


    BACKGROUND: Electrocardiogram (ECG) interpretation is of great importance for patient management. However, medical students frequently lack proficiency in ECG interpretation and rate their ECG training as inadequate. Our aim was to examine the effect of a standalone web-based ECG tutorial...... of teaching ECG interpretation skills to medical students. The newly acquired skills are, however, rapidly lost when the intervention is not repeated....

  10. Opioid pain medication prescriptions obtained through emergency medical visits in the Veterans Health Administration. (United States)

    Grasso, Michael A; Dezman, Zachary D W; Grasso, Clare T; Jerrard, David A

    This study sought to characterize national patterns for opioid pain medication (OPM) prescriptions received during emergency medical encounters in the Veterans Health Administration (VA). The authors conducted a retrospective study of all emergency department (ED) visits by adults in the VA between January 2009 and June 2015. We examined demographics, comorbidities, utilization measures, diagnoses, and prescriptions. The percentage of ED visits that culminated in the receipt of a prescription for an OPM. There were 6,721,134 emergency medical visits by 1,708,545 individuals during the study period. An OPM was prescribed during 913,872 visits (13.6 percent), and 407,408 individuals (27.5 percent) received at least one OPM prescription. Prescriptions for OPMs peaked in 2011 at 14.5 percent, declining to 12.3 percent in 2015. The percentage of prescriptions limited to 12 pills increased from 25.0 to 32.4 percent. The heaviest users (top 1.5 percent, n = 7,247) received an average 602.5 total doses, and had at least 10 ED visits during the study period. The most frequently prescribed OPMs were acetaminophen/hydrocodone, followed by tramadol and acetaminophen/oxycodone. Receiving a prescription was associated with younger patients, musculoskeletal diagnoses, higher pain scores, a history of chronic pain, a history of mental illness, a history of substance abuse, prior heavy prescription OPM use, and lower participation in outpatient services. The writing of OPM prescriptions after an ED visit is on the decline in the VA. Compliance with prescribing guidelines is increasing, but is not yet at goal.

  11. Patients crash more than airlines: a medical emergency at 35,000 ft

    Directory of Open Access Journals (Sweden)

    Talha Bashir


    Full Text Available An estimated 1 in 600 commercial flights will have an onboard medical emergency and approximately half of the time a passenger physician will provide medical assistance. A medical emergency on an aircraft can be a daunting task for even the most seasoned physician. This article is a narrative case report from a physician passenger who found himself in the midst of such an emergency on a 15-hour international flight.

  12. Enhancing Accessibility of Web Based GIS Applications through User Centered Design


    Babar, Shahzad; Mehmood, Aamer


    Web Accessibility emerged as problem when disabled and elder people started interaction with web contents soon after the inception of World Wide Web. When web based GIS applications appeared on the scene of web and users of these kinds of applications increased, these applications faced the similar problem of accessibility. The intensity of web accessibility problems in GIS based applications has increased rapidly during recent years due to extensive interaction of user with maps. Web Accessi...

  13. "When every second counts..." : The emergency runs carried out by the Emergency Medical Service in Oslo September 2002


    Modalsli, Ellen Heilmann; Østebø, Kristin


    The Emergency Medical Service (EMS) in Oslo has insufficient routines for surveillance of the medical activity, beyond the number of ambulance missions and response times. Norwegian authorities lack regular registration of information about important quantitative and qualitative aspects of the EMS. Documentation is necessary to evaluate the EMS, to improve the quality and to calculate the dimension of the service. We therefore analysed the case-records, from the emergency runs, carried o...

  14. The Impact of Web-based Technology on Small Businesses


    Courtney S. Baldwin


    The problem discussed in this paper is the need to understand ways to implement web-based technology to reduce the cost and time in doing business. The specific focus of this paper is to understand what the risks, challenges, and methodology are for implementing web-based technology for reducing the operating costs for the small business and still protect the security of the business. The key research questions included are: (a) What are the challenges of small business implementing web-based...

  15. Development of a Web-based financial application System (United States)

    Hasan, M. R.; Ibrahimy, M. I.; Motakabber, S. M. A.; Ferdaus, M. M.; Khan, M. N. H.; Mostafa, M. G.


    The paper describes a technique to develop a web based financial system, following latest technology and business needs. In the development of web based application, the user friendliness and technology both are very important. It is used ASP .NET MVC 4 platform and SQL 2008 server for development of web based financial system. It shows the technique for the entry system and report monitoring of the application is user friendly. This paper also highlights the critical situations of development, which will help to develop the quality product.

  16. Medical identity theft: an emerging problem for informatics. (United States)

    Gillette, William; Patrick, Timothy B


    This poster reports a preliminary review of medical identity theft. Financial identity theft has received a great deal of media attention. Medical identity theft is a particular kind of identity theft that has received little attention. There are two main subtypes of medical identity theft. In the first type the stolen medical identity is used to receive medical services, and in the second type the stolen medical identity is used to commit healthcare fraud.

  17. Web-based radiology applications for clinicians and radiologists (United States)

    Feingold, Eric R.; Grevera, George J.; Mezrich, Reuben S.; Horii, Steven C.; Khalsa, Satjeet S.; Phan, Le


    The University of Pennsylvania Radiology Department has developed a suite of Web based applications for clinicians and radiologists to provide wide spread, cost-effective and easy access to radiological information. The Image Viewer application provides clinicians and radiologists access to all diagnostic reports and digital images performed in the last week for all Emergency Dept., Intensive Care Unit and Neuro/CT studies. Image control options including zoom/pan, rotate, flip, and window/level are all available. The image mover/viewer application gives radiologists and technologists the ability to both move studies between any DICOM Storage Class Provider (SCP) and DICOM storage class user (SCU) and to view studies from any DICOM displayed. Web server support requires integration using Perl based CGI scripts with our DICOM/PACS and the MIR/CTN for images and our IDXrad/RIS for reports. Targeted images and reports are automatically routed from the PACS and RIS for storage on the web server. All images sent to the web server are modality specific per-processed to reduce size and improve contrast. After processing, all images are stored in DICOM and GIF formats. Client support requires web browsers with JavaScript and frame support.

  18. Effect of Triage Training on Concordance of Triage Level between Triage Nurses and Emergency Medical Technicians. (United States)

    Ghanbarzehi, Nezare; Balouchi, Abbas; Sabzevari, Sakineh; Darban, Fatemeh; Khayat, Nastaran Haydari


    The transfer of care occurs frequently between emergency medical technicians and emergency ward nurses during which emergency medical technicians transfer the patients from the society to the hospital. This transfer of care often occurs under crowded conditions and in high acuity which would pave the way for a disruption of communication. This study aimed to investigate the effect of training Emergency Severity Index (ESI) triage on concordance of triage level between emergency medical technicians and triage nurses. This interventional study was conducted on all triage nurses and emergency medical technicians in Iranshahr City in winter of 2014. Five triage nurses and 30 emergency medical technicians were included into the study using census. To collect data, Personal Information Form (PIF) and ESI Triage Criterion were used. During the project implementation, patients were separately classified before and after triage training by emergency medical technicians and triage nurses. To analyse the data, kappa coefficient under SPSS 16 statistical software was used. According to the study results, Cohen's kappa concordance coefficient showed that triage concordance between emergency medical technicians and triage nurses before training was 0.20 which was at an unfavorable level. After training, Cohen's kappa concordance coefficient reached 0.62, which showed a desirable level of concordance as well as a significant difference after training. It is recommended to train and use common triage system to facilitate transfer or delivery of care between emergency medical technicians and triage nurses.

  19. Viability of a Web-Based Module for Teaching Electrocardiogram Reading Skills to Psychiatry Residents: Learning Outcomes and Trainee Interest. (United States)

    DeBonis, Katrina; Blair, Thomas R; Payne, Samuel T; Wigan, Katherine; Kim, Sara


    Web-based instruction in post-graduate psychiatry training has shown comparable effectiveness to in-person instruction, but few topics have been addressed in this format. This study sought to evaluate the viability of a web-based curriculum in teaching electrocardiogram (EKG) reading skills to psychiatry residents. Interest in receiving educational materials in this format was also assessed. A web-based curriculum of 41 slides, including eight pre-test and eight post-test questions with emphasis on cardiac complications of psychotropic medications, was made available to all psychiatry residents via email. Out of 57 residents, 30 initiated and 22 completed the module. Mean improvement from pre-test to post-test was 25 %, and all 22 completing participants indicated interest in future web-based instruction. This pilot study suggests that web-based instruction is feasible and under-utilized as a means of teaching psychiatry residents. Potential uses of web-based instruction, such as tracking learning outcomes or patient care longitudinally, are also discussed.

  20. [The organizational technologies of quality support of emergency and acute medical care in megalopolis: Moscow case]. (United States)


    The article deals with the issues of emergency medical care in conditions of megalopolis on the example of the Moscow A.S. Putchkov emergency and acute medical care station. The analysis is applied to such new organizational technologies as the automatic navigational dispatcher system of field brigades 'management, the zoning of transport mains according accessibility of emergency medical are stations, the organization of emergency medical posts on the most conducive to accident areas of megalopolis, the integrated municipal inter-warning system in case of road accidents.

  1. The 2012 derecho: emergency medical services and hospital response. (United States)

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B


    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  2. Hand Washing Practices Among Emergency Medical Services Providers. (United States)

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan


    Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

  3. Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

    Directory of Open Access Journals (Sweden)

    Janice Halpern


    Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

  4. Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Andréll, Cecilia; Viereck, Søren


    INTRODUCTION: Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching...... of the emergency medical services. AIM: To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. METHOD: An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed...... in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template...

  5. Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College (United States)

    Rosen, Joshua B.; Olson, Mark H.; Kelly, Marianne


    Objective: The authors examined the impact of a collegiate-based emergency medical service (CBEMS) on the frequency of emergency department (ED) transports. Participants: Students transported to the ED for acute alcohol intoxication during the Fall 2008 and the Fall 2009 semesters (N = 50). Methods: The frequency of students receiving…

  6. 2008 Utilization of Web-Based Resources for Medical Research

    African Journals Online (AJOL)

    Gbaje E.S

    book. Much progress in online ..... references in full text. d). Computer illiteracy. Conclusion. It is obvious that the online information resources and services are becoming prominent in the drive for making information and data available to the.

  7. An intelligent IoT emergency vehicle warning system using RFID and WiFi technologies for emergency medical services. (United States)

    Lai, Yeong-Lin; Chou, Yung-Hua; Chang, Li-Chih


    Collisions between emergency vehicles for emergency medical services (EMS) and public road users have been a serious problem, impacting on the safety of road users, emergency medical technicians (EMTs), and the patients on board. The aim of this study is to develop a novel intelligent emergency vehicle warning system for EMS applications. The intelligent emergency vehicle warning system is developed by Internet of Things (IoT), radio-frequency identification (RFID), and WiFi technologies. The system consists of three major parts: a system trigger tag, an RFID system in an emergency vehicle, and an RFID system at an intersection. The RFID system either in an emergency vehicle or at an intersection contains a controller, an ultrahigh-frequency (UHF) RFID reader module, a WiFi module, and a 2.4-GHz antenna. In addition, a UHF ID antenna is especially designed for the RFID system in an emergency vehicle. The IoT system provides real-time visual warning at an intersection and siren warning from an emergency vehicle in order to effectively inform road users about an emergency vehicle approaching. The developed intelligent IoT emergency vehicle warning system demonstrates the capabilities of real-time visual and siren warnings for EMS safety.

  8. Drug related medical emergencies in the elderly: role of adverse drug reactions and non-compliance


    Malhotra, S; Karan, R; Pandhi, P; Jain, S


    BACKGROUND—Adverse drug reactions and non-compliance are important causes of admissions in the elderly to medical clinics. The contribution of adverse drug reactions and non-compliance to admission by the medical emergency department was analysed.
METHODS—A total of 578 consecutive elderly patients admitted to the medical emergency department were interviewed to determine the percentage of admissions due to adverse drug reactions or non-compliance with medication regimens, their causes, conse...

  9. The Effectiveness of Web-Based Asthma Self-Management System, My Asthma Portal (MAP): A Pilot Randomized Controlled Trial. (United States)

    Ahmed, Sara; Ernst, Pierre; Bartlett, Susan J; Valois, Marie-France; Zaihra, Tasneem; Paré, Guy; Grad, Roland; Eilayyan, Owis; Perreault, Robert; Tamblyn, Robyn


    Whether Web-based technologies can improve disease self-management is uncertain. My Asthma Portal (MAP) is a Web-based self-management support system that couples evidence-based behavioral change components (self-monitoring of symptoms, physical activity, and medication adherence) with real-time monitoring, feedback, and support from a nurse case manager. The aim of this study was to compare the impact of access to a Web-based asthma self-management patient portal linked to a case-management system (MAP) over 6 months compared with usual care on asthma control and quality of life. A multicenter, parallel, 2-arm, pilot, randomized controlled trial was conducted with 100 adults with confirmed diagnosis of asthma from 2 specialty clinics. Asthma control was measured using an algorithm based on overuse of fast-acting bronchodilators and emergency department visits, and asthma-related quality of life was assessed using the Mini-Asthma Quality of Life Questionnaire (MAQLQ). Secondary mediating outcomes included asthma symptoms, depressive symptoms, self-efficacy, and beliefs about medication. Process evaluations were also included. A total of 49 individuals were randomized to MAP and 51 to usual care. Compared with usual care, participants in the intervention group reported significantly higher asthma quality of life (mean change 0.61, 95% CI 0.03 to 1.19), and the change in asthma quality of life for the intervention group between baseline and 3 months (mean change 0.66, 95% CI 0.35 to 0.98) was not seen in the control group. No significant differences in asthma quality of life were found between the intervention and control groups at 6 (mean change 0.46, 95% CI -0.12 to 1.05) and 9 months (mean change 0.39, 95% CI -0.2 to 0.98). For poor control status, there was no significant effect of group, time, or group by time. For all self-reported measures, the intervention group had a significantly higher proportion of individuals, demonstrating a minimal clinically

  10. Person-centred web-based support--development through a Swedish multi-case study. (United States)

    Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela


    Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

  11. Nursing students' perception of a Web-based intervention to support learning. (United States)

    Koch, Jane; Andrew, Sharon; Salamonson, Yenna; Everett, Bronwyn; Davidson, Patricia M


    Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point(R) presentations, animations and digitised video clips were introduced in a first year Bachelor of Nursing biological sciences subject at a university in metropolitan Sydney. All students enrolled in this unit were invited to obtain access to the site and the number of hits to the site was recorded using the student tracking facility available on WebCT, an online course delivery tool adopted widely by many educational institutions and used in this study. Eighty-five percent of students enrolled in the subject accessed the learning support site. Students' perception of the value of a learning support site was assessed using a web-based survey. The survey was completed by 123 participants, representing a response rate of 22%. Three themes emerged from the qualitative data concerning nursing students' perception of the web-based activities: 'enhances my learning', 'study at my own pace', and 'about the activities: what I really liked/disliked'. Web-based interventions, supplementing a traditionally presented nursing science course were perceived by students to be beneficial in both learning and language development. Although students value interactive, multimedia learning they were not ready to completely abandon traditional modes of learning including face-to-face lectures. The findings of this study contribute to an understanding of how web-based resources can be best used to support students' learning in bioscience. Copyright 2009 Elsevier Ltd. All rights reserved.

  12. A Web-Based Airborne Remote Sensing Telemetry Server Project (United States)

    National Aeronautics and Space Administration — A Web-based Airborne Remote Sensing Telemetry Server (WARSTS) is proposed to integrate UAV telemetry and web-technology into an innovative communication, command,...

  13. Web-Based Instruction A Guide for Libraries

    CERN Document Server

    Smith, Susan Sharpless


    Expanding on the popular, practical how-to guide for public, academic, school, and special libraries, technology expert Susan Sharpless Smith offers library instructors the confidence to take Web-based instruction into their own hands.

  14. The Persuasiveness of Web-Based Alcohol Interventions (United States)

    Lehto, Tuomas; Oinas-Kukkonen, Harri

    There are a variety of Web-based alcohol interventions that may reach problem drinkers, who would not otherwise participate in conventional treatment. Web-based alcohol interventions vary greatly in level of finesse: some offer static self-help materials, whereas some sites have highly interactive content and persuasive features embedded. In this study, six Web-based alcohol interventions were evaluated based on a framework for evaluating and designing persuasive systems. This study demonstrates the potential lack of persuasive features on Web-based alcohol interventions sites. Important primary task support elements, such as tailoring and personalization, were used tenuously throughout the sites. The dialogue support demonstrated throughout the sites was average. All evaluated sites successfully demonstrated trustworthiness, expertise, and surface credibility. Many of the evaluated sites were lacking in the social support category. In general, the authors suggest that the persuasive system qualities should be considered concurrently with the feasibility and effectiveness for studying technology-based interventions.

  15. Business intelligence and capacity planning: web-based solutions. (United States)

    James, Roger


    Income (activity) and expenditure (costs) form the basis of a modern hospital's 'business intelligence'. However, clinical engagement in business intelligence is patchy. This article describes the principles of business intelligence and outlines some recent developments using web-based applications.

  16. [Development and application of emergency medical information management system]. (United States)

    Wang, Fang; Zhu, Baofeng; Chen, Jianrong; Wang, Jian; Gu, Chaoli; Liu, Buyun


    To meet the needs of clinical practice of rescuing critical illness and develop the information management system of the emergency medicine. Microsoft Visual FoxPro, which is one of Microsoft's visual programming tool, is used to develop computer-aided system included the information management system of the emergency medicine. The system mainly consists of the module of statistic analysis, the module of quality control of emergency rescue, the module of flow path of emergency rescue, the module of nursing care in emergency rescue, and the module of rescue training. It can realize the system management of emergency medicine and,process and analyze the emergency statistical data. This system is practical. It can optimize emergency clinical pathway, and meet the needs of clinical rescue.

  17. The information-seeking behaviour of paediatricians accessing web-based resources.

    LENUS (Irish Health Repository)

    Prendiville, T W


    OBJECTIVES: To establish the information-seeking behaviours of paediatricians in answering every-day clinical queries. DESIGN: A questionnaire was distributed to every hospital-based paediatrician (paediatric registrar and consultant) working in Ireland. RESULTS: The study received 156 completed questionnaires, a 66.1% response. 67% of paediatricians utilised the internet as their first "port of call" when looking to answer a medical question. 85% believe that web-based resources have improved medical practice, with 88% reporting web-based resources are essential for medical practice today. 93.5% of paediatricians believe attempting to answer clinical questions as they arise is an important component in practising evidence-based medicine. 54% of all paediatricians have recommended websites to parents or patients. 75.5% of paediatricians report finding it difficult to keep up-to-date with new information relevant to their practice. CONCLUSIONS: Web-based paediatric resources are of increasing significance in day-to-day clinical practice. Many paediatricians now believe that the quality of patient care depends on it. Information technology resources play a key role in helping physicians to deliver, in a time-efficient manner, solutions to clinical queries at the point of care.

  18. Demographic-Based Content Analysis of Web-Based Health-Related Social Media. (United States)

    Sadah, Shouq A; Shahbazi, Moloud; Wiley, Matthew T; Hristidis, Vagelis


    An increasing number of patients from diverse demographic groups share and search for health-related information on Web-based social media. However, little is known about the content of the posted information with respect to the users' demographics. The aims of this study were to analyze the content of Web-based health-related social media based on users' demographics to identify which health topics are discussed in which social media by which demographic groups and to help guide educational and research activities. We analyze 3 different types of health-related social media: (1) general Web-based social networks Twitter and Google+; (2) drug review websites; and (3) health Web forums, with a total of about 6 million users and 20 million posts. We analyzed the content of these posts based on the demographic group of their authors, in terms of sentiment and emotion, top distinctive terms, and top medical concepts. The results of this study are: (1) Pregnancy is the dominant topic for female users in drug review websites and health Web forums, whereas for male users, it is cardiac problems, HIV, and back pain, but this is not the case for Twitter; (2) younger users (0-17 years) mainly talk about attention-deficit hyperactivity disorder (ADHD) and depression-related drugs, users aged 35-44 years discuss about multiple sclerosis (MS) drugs, and middle-aged users (45-64 years) talk about alcohol and smoking; (3) users from the Northeast United States talk about physical disorders, whereas users from the West United States talk about mental disorders and addictive behaviors; (4) Users with higher writing level express less anger in their posts. We studied the popular topics and the sentiment based on users' demographics in Web-based health-related social media. Our results provide valuable information, which can help create targeted and effective educational campaigns and guide experts to reach the right users on Web-based social chatter.

  19. Medication Overdoses at a Public Emergency Department in Santiago, Chile

    Directory of Open Access Journals (Sweden)

    Pablo Aguilera, MD


    Full Text Available Introduction: While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients’ self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile. Methods: This study is a retrospective, explicit chart review conducted at Hospital Sótero del Rio from July 2008 until June 2010. We included all cases of identified intentional MO. Alcohol and recreational drugs were included only when they were ingested with other medications. Results: We identified 1,557 cases of intentional MO and analyzed a total of 1,197 cases, corresponding to 0.51% of all emergency department (ED presentations between July 2008 and June 2010. The median patient age was 25 years. The majority was female (67.6%. Two peaks were identified, corresponding to the spring of each year sampled. The rate of hospital admission was 22.2%. Benzodiazepines, selective serotonin reuptake inhibitors, and tricyclic antidepressants (TCA were the causative agents most commonly found, comprising 1,044 (87.2% of all analyzed cases. Acetaminophen was involved in 81 (6.8% cases. More than one active substance was involved in 35% of cases. In 7.3% there was ethanol co-ingestion and in 1.0% co-ingestion of some other recreational drug (primarily cocaine. Of 1,557 cases, six (0.39% patients died. TCA were involved in two of these deaths. Conclusion: Similar to other developed and developing nations, intentional MO accounts for a significant number of ED presentations in Chile. Chile is unique in the region, however, in that its spectrum of intentional overdoses includes an excess burden of tricyclic antidepressant and benzodiazepine overdoses, a

  20. The Effectiveness of Web-Based Instruction: An Initial Inquiry

    Directory of Open Access Journals (Sweden)

    Tatana M. Olson


    Full Text Available As the use of Web-based instruction increases in the educational and training domains, many people have recognized the importance of evaluating its effects on student outcomes such as learning, performance, and satisfaction. Often, these results are compared to those of conventional classroom instruction in order to determine which method is “better.” However, major differences in technology and presentation rather than instructional content can obscure the true relationship between Web-based instruction and these outcomes. Computer-based instruction (CBI, with more features similar to Web-based instruction, may be a more appropriate benchmark than conventional classroom instruction. Furthermore, there is little consensus as to what variables should be examined or what measures of learning are the most appropriate, making comparisons between studies difficult and inconclusive. In this article, we review the historical findings of CBI as an appropriate benchmark to Web-based instruction. In addition, we review 47 reports of evaluations of Web-based courses in higher education published between 1996 and 2002. A tabulation of the documented findings into eight characteristics is offered, along with our assessments of the experimental designs, effect sizes, and the degree to which the evaluations incorporated features unique to Web-based instruction.

  1. Use of medical emergency call data as a marker of quality of emergency department care in the post-National Emergency Access Target era. (United States)

    Westacott, Lorraine; Graves, Judy; Khatun, Mohsina; Burke, John


    Objectives Any new model of care should always be accompanied by rigorous monitoring to ensure that there are no negative consequences, especially any that impact upon patient safety. In 2013, 'THERMoSTAT' (Two- Hour Evaluation and Referral Model for Shorter Turnaround Times), an emergency department model of care developed by Royal Brisbane and Women's Hospital staff was launched to gain efficiencies and improve hospital National Emergency Access Target (NEAT) compliance. The aim of this study was to trial the use of medical emergency call data as a novel marker of the quality of care delivered by our emergency department. Methods Incidence of medical emergency calls for hospital emergency admission patients for the 2 years pre- and 1 year post-THERMoSTAT were compared after standardising for overall hospital activity. Results During the study period, hospital activity increased 10%, and the emergency department experienced a total of 222645 presentations, 68000 (30.5%) of which converted into an admission. THERMoSTAT improved NEAT compliance by 17% (from 57.7% to 74.9%) with no change in any patient-safety indicators. A total of 8432 medical emergency calls were made on 5930 patients, 2831 of whom were emergency admissions. After adjusting for hospital activity, there was no change in the average number of patients per week who triggered a medical emergency call after the introduction of THERMoSTAT. These results were reproduced when data was analysed for: total number of inpatients triggering calls; emergency admission patients; and emergency admission patients within the first 24h or first 4h of admission. Conclusions This is the first report to investigate the correlation between inpatient medical emergency call incidence and emergency department model of care. Medical emergency call data showed significant promise as a measure of morbidity and as a more direct, objective, simple, quantitative and meaningful measure of patient safety. What is known about the

  2. Measuring teamwork and conflict among Emergency Medical Technician personnel (United States)

    Patterson, P. Daniel; Weaver, Matthew D.; Weaver, Sallie J.; Rosen, Michael A.; Todorova, Gergana; Weingart, Laurie R.; Krackhardt, David; Lave, Judith R.; Arnold, Robert M.; Yealy, Donald M.; Salas, Eduardo


    Objective We sought to develop a reliable and valid tool for measuring teamwork among Emergency Medical Technician (EMT) partnerships. Methods We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool. We performed a series of Exploratory Factor Analyses (EFA) and Confirmatory Factor Analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. Results We received 687 completed surveys. The EFA analyses identified a 9-factor solution. We labeled these factors [1] Team Orientation, [2] Team Structure & Leadership, [3] Partner Communication, Team Support, & Monitoring, [4] Partner Trust and Shared Mental Models, [5] Partner Adaptability & Back-Up Behavior, [6] Process Conflict, [7] Strong Task Conflict, [8] Mild Task Conflict, and [9] Interpersonal Conflict. We tested a short form (30-item SF) and long form (45-item LF) version. The CFA analyses determined that both the SF and LF versions possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties with a mean Cronbach’s alpha coefficient ≥0.70 across all 9-factors (mean=0.84; min=0.78, max=0.94). The mean Cronbach’s alpha coefficient for the EMT-TEAMWORK-LF version was 0.87 (min=0.79, max=0.94). There was wide variation in weighted scores across all 9 factors and the global score for the SF and LF versions. Mean scores were lowest for the Team Orientation factor (48.1, SD 21.5 SF; 49.3 SD 19.8 LF) and highest (more positive) for the Interpersonal Conflict factor (87.7 SD 18.1 for both SF and LF). Conclusions We developed a reliable and valid survey to evaluate teamwork between EMT partners. PMID:22128909

  3. Lessons learned from an emergency medical services fire safety intervention. (United States)

    Pirrallo, Ronald G; Cady, Charles E


    The authors conducted a pilot study, finding that many households that experienced fires had received prior emergency medical services (EMS) visits, but few had operational smoke alarms. The study hypothesis is that dwellings that received smoke alarms and/or batteries during an EMS call were more likely to have an operational alarm, less property dollar loss, and decreased morbidity and mortality at the time of a subsequent fire. Smoke detectors and batteries were provided to an urban fire department for placement in unprotected homes at the time of an EMS call from March 1, 1999, through January 31, 2001. After addressing the reason for the 911 EMS call, verification or installation of an operational smoke alarm was performed. The authors examined records for dwellings that had a subsequent fire for outcomes of smoke alarm status, estimated property dollar loss, and number of injuries and fatalities. This program placed 1,335 smoke detectors. Of these, 99 dwellings were found to have a fire or smoke condition with 20 exclusions. Our final number was 79; 28 (35%) still had an operating smoke alarm. In homes with operational alarms, the mean dollar loss was 2,870 dollars (U.S. 2001) (95% confidence interval [CI], 143-5,596). In homes without operational alarms, mean loss was 10,468 dollars (U.S. 2001) (95% CI, 5,875-15,061). No injuries or fatalities occurred in either group. This program was successful in placing 1,335 smoke alarms in at-risk dwellings and reaffirmed that an operational smoke alarm significantly decreases property dollar loss. However, if the goal is to have all homes protected by smoke alarms, this program has long-term effectiveness limitations.

  4. Measuring teamwork and conflict among emergency medical technician personnel. (United States)

    Patterson, P Daniel; Weaver, Matthew D; Weaver, Sallie J; Rosen, Michael A; Todorova, Gergana; Weingart, Laurie R; Krackhardt, David; Lave, Judith R; Arnold, Robert M; Yealy, Donald M; Salas, Eduardo


    We sought to develop a reliable and valid tool for measuring teamwork among emergency medical technician (EMT) partnerships. We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool (EMT-TEAMWORK). We performed a series of exploratory factor analyses (EFAs) and confirmatory factor analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. We received 687 completed surveys. The EFAs identified a nine-factor solution. We labeled these factors 1) Team Orientation, 2) Team Structure & Leadership, 3) Partner Communication, Team Support, & Monitoring, 4) Partner Trust and Shared Mental Models, 5) Partner Adaptability & Back-Up Behavior, 6) Process Conflict, 7) Strong Task Conflict, 8) Mild Task Conflict, and 9) Interpersonal Conflict. We tested a short-form (30-item SF) and long-form (45-item LF) version. The CFAs determined that both the SF and the LF possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties, with a mean Cronbach's alpha coefficient ≥0.70 across all nine factors (mean = 0.84; minimum = 0.78, maximum = 0.94). The mean Cronbach's alpha coefficient for the EMT-TEAMWORK-LF was 0.87 (minimum = 0.79, maximum = 0.94). There was wide variation in weighted scores across all nine factors and the global score for the SF and LF. Mean scores were lowest for the Team Orientation factor (48.1, standard deviation [SD] 21.5, SF; 49.3, SD 19.8, LF) and highest (more positive) for the Interpersonal Conflict factor (87.7, SD 18.1, for both SF and LF). We developed a reliable and valid survey to evaluate teamwork between EMT partners.

  5. Quality of Web-based information on obsessive compulsive disorder

    Directory of Open Access Journals (Sweden)

    Klila H


    Full Text Available Hedi Klila,1 Anne Chatton,2 Ariane Zermatten,2 Riaz Khan,2 Martin Preisig,1,3 Yasser Khazaal2,4 1Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; 2Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland; 3Lausanne University, Lausanne, Switzerland; 4Geneva University, Geneva, Switzerland Background: The Internet is increasingly used as a source of information for mental health issues. The burden of obsessive compulsive disorder (OCD may lead persons with diagnosed or undiagnosed OCD, and their relatives, to search for good quality information on the Web. This study aimed to evaluate the quality of Web-based information on English-language sites dealing with OCD and to compare the quality of websites found through a general and a medically specialized search engine. Methods: Keywords related to OCD were entered into Google and OmniMedicalSearch. Websites were assessed on the basis of accountability, interactivity, readability, and content quality. The "Health on the Net" (HON quality label and the Brief DISCERN scale score were used as possible content quality indicators. Of the 235 links identified, 53 websites were analyzed. Results: The content quality of the OCD websites examined was relatively good. The use of a specialized search engine did not offer an advantage in finding websites with better content quality. A score ≥16 on the Brief DISCERN scale is associated with better content quality. Conclusion: This study shows the acceptability of the content quality of OCD websites. There is no advantage in searching for information with a specialized search engine rather than a general one. Practical implications: The Internet offers a number of high quality OCD websites. It remains critical, however, to have a provider–patient talk about the information found on the Web. Keywords: Internet, quality indicators, anxiety disorders, OCD, search engine

  6. 30 CFR 75.1713 - Emergency medical assistance; first-aid. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in first-aid...

  7. 77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... (United States)


    ... enter the Archives Building at the Research Entrance on Pennsylvania Avenue. Public Comment: Members of... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... (NHTSA), U.S. Department of Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical...

  8. A Two-Year Review of Medical Admissions at the Emergency Unit of ...

    African Journals Online (AJOL)

    The main objective of this study is to describe the spectrum of medical conditions presenting at the emergency department of the Federal Medical Centre, Abeokuta, Nigeria over a two year period. This is a retrospective analysis of a prospectively collected data. Data was collected from the emergency room admission ...

  9. Work-Stress Burnout in Emergency Medical Technicians and the Use of Early Recollections. (United States)

    Vettor, Susan M.; Kosinski, Frederick A., Jr.


    Numerous studies have indicated a high work-stress burnout rate of emergency medical technicians, although none have used techniques predicting work-stress burnout. Discusses early memories that are representative of emergency medical technicians who may be susceptible to burnout, and memories that may indicate an individual's resistance to…

  10. Emergency Medical Technician Training During Medical School: Benefits for the Hidden Curriculum. (United States)

    Russ-Sellers, Rebecca; Blackwell, Thomas H


    Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery. To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared. Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness. The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.

  11. Developing an interactive web-based learning program on skin cancer: the learning experiences of clinical educators. (United States)

    Shaikh, Waqas R; Geller, Alan; Alexander, Gwen; Asgari, Maryam M; Chanange, Gunther J; Dusza, Stephen; Eide, Melody J; Fletcher, Suzanne W; Goulart, Jacqueline M; Halpern, Allan C; Landow, Shoshana; Marghoob, Ashfaq A; Quigley, Elizabeth A; Weinstock, Martin A


    Web-based learning in medical education is rapidly growing. However, there are few firsthand accounts on the rationale for and development of web-based learning programs. We present the experience of clinical educators who developed an interactive online skin cancer detection and management course in a time-efficient and cost-efficient manner without any prior skills in computer programming or technical construction of web-based learning programs. We review the current state of web-based learning including its general advantages and disadvantages as well as its specific utility in dermatology. We then detail our experience in developing an interactive online skin cancer curriculum for primary care clinicians. Finally, we describe the main challenges faced and lessons learned during the process. This report may serve medical educators who possess minimal computer programming and web design skills but want to employ the many strengths of web-based learning without the huge costs associated with hiring a professional development team.

  12. Managing and monitoring tuberculosis using web-based tools in combination with traditional approaches

    Directory of Open Access Journals (Sweden)

    Chapman AL


    Full Text Available Ann LN Chapman,1 Thomas C Darton,2 Rachel A Foster11Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, 2Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UKAbstract: Tuberculosis (TB remains a global health emergency. Ongoing challenges include the coordination of national and international control programs, high levels of drug resistance in many parts of the world, and availability of accurate and rapid diagnostic tests. The increasing availability and reliability of Internet access throughout both affluent and resource-limited countries brings new opportunities to improve TB management and control through the integration of web-based technologies with traditional approaches. In this review, we explore current and potential future use of web-based tools in the areas of TB diagnosis, treatment, epidemiology, service monitoring, and teaching and training.Keywords: tuberculosis, information communication technology, Internet

  13. College prevention: a view of present (and future) web-based approaches. (United States)

    Walters, Scott T; Neighbors, Clayton


    College campuses in the United States may be the most electronically "wired" environments on earth. College students use the Internet not only to write term papers and receive correspondence but also to report (and keep track of) friends' personal status, download music, view classroom lectures, and receive emergency messages. In fact, college students spend considerably more time online than the average person. In a recent survey of U.S. college students (Jones et al. 2009), nearly all respondents (94 percent) stated that they spent at least 1 hour on the Internet each day, with the main tasks including social communication, entertainment, and class work. In keeping with this trend, Web-based programs that address alcohol consumption among college students have become widely available in the United States. This sidebar provides an overview of currently available programs as well as of the advantages and disadvantages of this approach and the future outlook of Web-based programs.

  14. Cultural and Rhetorical Bases for communicating knowledge in web based communities

    DEFF Research Database (Denmark)

    Kampf, Constance; Kommers, Piet


    This call for papers invites papers focused on theoretical frameworks or empirical research which highlights the cultural and/or rhetorical aspects of communicating knowledge in web based communities. We are looking for work that brings together methods and perspectives across disciplines......Cultural and Rhetorical Bases for communicating knowledge in web based communities How can we extend learner-centred theories for educational technology to include, for instance, the cultural and rhetorical backgrounds which influence participants in online communities as they engage in knowledge...... communication processes? To begin to answer this question, we are looking for papers which engage concepts such as: communities of practice (Wenger 1998) the emerging field of knowledge communication the connections between communicating knowledge and discourse structures cultural situatedness of communication...

  15. Theoretical Perspectives of Adherence to Web-Based Interventions: a Scoping Review. (United States)

    Ryan, Cathal; Bergin, Michael; Wells, John Sg


    The purpose of this paper is to review the literature as this relates to theoretical perspectives of adherence to web-based interventions, drawing upon empirical evidence from the fields of psychology, business, information technology and health care. A scoping review of the literature utilising principles outlined by Arksey and O'Malley was undertaken. Several relevant theoretical perspectives have emerged, eight of which are charted and discussed in this review. These are the Internet Intervention Model, Persuasive Systems Design, the 'PERMA' framework, the Support Accountability Model, the Model of User Engagement, the Technology Acceptance Model, the Unified Theory of Acceptance and Use of IT and the Conceptual Model of User Engagement. The findings of the review indicate that an interdisciplinary approach, incorporating a range of technological, environmental and individual factors, may be needed in order to comprehensively explain user adherence to web-based interventions.

  16. Improving the non-technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™). (United States)

    Cant, Robyn P; Porter, Joanne E; Cooper, Simon J; Roberts, Kate; Wilson, Ian; Gartside, Christopher


    This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services. (United States)

    Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C; Johansen, Jakob Kjersgaard; Zwisler, Stine; Mikkelsen, Søren


    Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed in proportion to a known tone of 94 dB. Before and after episodes of noise exposure, the physicians underwent a hearing test indicating whether the noise had had any impact on the function of the outer sensory hair cells. This was accomplished by measuring the amplitude level shifts of the Distortion Product Otoacoustic Emissions. Furthermore, the prehospital personnels' hearing was investigated using pure-tone audiometry to reveal any occupational hearing loss. All prehospital personnel were compared to ten in-hospital controls. Our results indicate high-noise exposure levels of ≥80 dB(A) during use of sirens on the MECU and during HEMS operations compared to in-hospital controls (70 dB(A)). We measured an exposure up to ≥90 dB(A) under the helmet for HEMS crew. No occupational hearing loss was identified with audiometry. A significant level shift of the Distortion Product Otoacoustic Emissions at 4 kHz for HEMS crew compared to MECU physicians was found indicating that noise affected the outer hair cell function of the inner ear, thus potentially reducing the hearing ability of the HEMS crew. Further initiatives to prevent noise exposure should be taken, such as active noise reduction or custom-made in-ear protection with communication system for HEMS personnel. Furthermore, better insulation of MECU and ambulances is warranted. We found that the exposure levels exceeded the

  18. Medical dispatchers recognise substantial amount of acute stroke during emergency calls

    DEFF Research Database (Denmark)

    Viereck, Søren; Møller, Thea Palsgaard; Iversen, Helle Klingenberg


    BACKGROUND: Immediate recognition of stroke symptoms is crucial to ensure timely access to revascularisation therapy. Medical dispatchers ensure fast admission to stroke facilities by prioritising the appropriate medical response. Data on medical dispatchers' ability to recognise symptoms of acute...... stroke are therefore critical in organising emergency stroke care. We aimed to describe the sensitivity and positive predictive value of medical dispatchers' ability to recognise acute stroke during emergency calls, and to identify factors associated with recognition. METHODS: This was an observational...... study of 2653 consecutive unselected patients with a final diagnosis of stroke or transient ischemic attack (TIA). All admitted through the Emergency Medical Services Copenhagen, during a 2-year study period (2012-2014). Final diagnoses were matched with dispatch codes from the Emergency Medical...

  19. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention. (United States)


    ... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

  20. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians. (United States)


    ... technician by a fire department or emergency medical services responder unit of the federal government, a... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Eligible firefighter/emergency... SINGLE FAMILY PROPERTY Good Neighbor Next Door Sales Program § 291.530 Eligible firefighter/emergency...

  1. Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management. (United States)

    Malamed, Stanley F


    Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

  2. Personalized cardiovascular risk management linking SCORE and behaviour change to Web-based education. (United States)

    Davis, Selena; Abidi, Syed Sibte Raza; Cox, Jafna


    The PULSE (Personalization Using Linkages of SCORE and behaviour change readiness to web-based Education) project objectives are to generate and evaluate a web-based personalized educational intervention for the management of cardiovascular risk. The program is based on a patient profile generated by combining: (a) an electronic patient data capture template (DCT); (b) the Systematic COronary Risk Evaluation (SCORE) algorithm; and (c) a Stage of Change determination model. The DCT inherently contains a set of evidence-based parameters for patient description and disease evaluation. The patient's stage of behaviour change determines messages consistent with the individual's change processes, decisional balance, and self-efficacy. The interventions are designed to address both medical and psychosocial aspects of risk management and, as such, we combine staged lifestyle modification materials and non-staged messages based on Canadian clinical guidelines to motivate personal risk management. The personalization decision logic is represented in Medical Logic Modules implemented in Java. An intelligent interactive system generates the personally relevant materials and delivers the education to the patient via the Web. An evaluation study will be conducted to determine whether web-based personalized educational strategies exert favourable influence on patient's interest, knowledge, and perceived compliance to the suggested lifestyle modifications.

  3. Is Web-Based Education Effective in Reducing Belief Toward Drug Abuse Among College Students?

    Directory of Open Access Journals (Sweden)



    Full Text Available Background Addiction is considered a basic structural problem in modern society, and seems to reach an epidemic scale in the last decades. Choosing a method to fulfill the intervention is an important issue to conduct educational interventions to prevent addictive behaviors. In this regard, web-based education has been widely used to introduce preventive programs to risky behaviors during recent years. Objectives The aim of the present study was to investigate the impact of web-based education intervention to decrease positive beliefs encouraging drug abuse among male medical college students. Patients and Methods This was a prospective-retrospective intervention study that was conducted among 75 male students in Kermanshah University of Medical Sciences, Kermanshah, Iran, during 2014. t-test was used for the statistical analysis. Results Our findings indicated that the belief toward drug abuse was significantly reduced after education (P = 0.003. In addition, compared pre and post-intervention scores on survey items showed a significant reduction in enjoyment, improve energy, attraction, higher strength, and higher self-esteem items after education (P 0.05. Conclusions Our findings showed that designing and implementing web-based educational intervention could be effective to reduce the positive beliefs toward drug abuse among college students.

  4. Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial. (United States)

    Lehmann, Ronny; Thiessen, Christiane; Frick, Barbara; Bosse, Hans Martin; Nikendei, Christoph; Hoffmann, Georg Friedrich; Tönshoff, Burkhard; Huwendiek, Sören


    E-learning and blended learning approaches gain more and more popularity in emergency medicine curricula. So far, little data is available on the impact of such approaches on procedural learning and skill acquisition and their comparison with traditional approaches. This study investigated the impact of a blended learning approach, including Web-based virtual patients (VPs) and standard pediatric basic life support (PBLS) training, on procedural knowledge, objective performance, and self-assessment. A total of 57 medical students were randomly assigned to an intervention group (n=30) and a control group (n=27). Both groups received paper handouts in preparation of simulation-based PBLS training. The intervention group additionally completed two Web-based VPs with embedded video clips. Measurements were taken at randomization (t0), after the preparation period (t1), and after hands-on training (t2). Clinical decision-making skills and procedural knowledge were assessed at t0 and t1. PBLS performance was scored regarding adherence to the correct algorithm, conformance to temporal demands, and the quality of procedural steps at t1 and t2. Participants' self-assessments were recorded in all three measurements. Procedural knowledge of the intervention group was significantly superior to that of the control group at t1. At t2, the intervention group showed significantly better adherence to the algorithm and temporal demands, and better procedural quality of PBLS in objective measures than did the control group. These aspects differed between the groups even at t1 (after VPs, prior to practical training). Self-assessments differed significantly only at t1 in favor of the intervention group. Training with VPs combined with hands-on training improves PBLS performance as judged by objective measures.

  5. The Case of the Pilfered Paper: Implications of Online Writing Assistance and Web-Based Plagiarism Detection Services (United States)

    Morgan, Phoebe; Vaughn, Jacqueline


    While there is nothing new about academic dishonesty, how it is committed, prevented, and detected has been dramatically transformed by the advent of online technologies. This article briefly describes the concurrent emergence of online writing assistance services and Web-based plagiarism detection tools and examines the implications of both for…

  6. Web-Based Tools for Text-Based Patient-Provider Communication in Chronic Conditions: Scoping Review (United States)

    Grunfeld, Eva; Makuwaza, Tutsirai; Bender, Jacqueline L


    Background Patients with chronic conditions require ongoing care which not only necessitates support from health care providers outside appointments but also self-management. Web-based tools for text-based patient-provider communication, such as secure messaging, allow for sharing of contextual information and personal narrative in a simple accessible medium, empowering patients and enabling their providers to address emerging care needs. Objective The objectives of this study were to (1) conduct a systematic search of the published literature and the Internet for Web-based tools for text-based communication between patients and providers; (2) map tool characteristics, their intended use, contexts in which they were used, and by whom; (3) describe the nature of their evaluation; and (4) understand the terminology used to describe the tools. Methods We conducted a scoping review using the MEDLINE (Medical Literature Analysis and Retrieval System Online) and EMBASE (Excerpta Medica Database) databases. We summarized information on the characteristics of the tools (structure, functions, and communication paradigm), intended use, context and users, evaluation (study design and outcomes), and terminology. We performed a parallel search of the Internet to compare with tools identified in the published literature. Results We identified 54 papers describing 47 unique tools from 13 countries studied in the context of 68 chronic health conditions. The majority of tools (77%, 36/47) had functions in addition to communication (eg, viewable care plan, symptom diary, or tracker). Eight tools (17%, 8/47) were described as allowing patients to communicate with the team or multiple health care providers. Most of the tools were intended to support communication regarding symptom reporting (49%, 23/47), and lifestyle or behavior modification (36%, 17/47). The type of health care providers who used tools to communicate with patients were predominantly allied health professionals of

  7. Effectiveness of a Web-Based Protocol for the Screening and Phenotyping of Individuals with Tourette Syndrome for Genetic Studies (United States)

    Egan, Crystelle; Marakovitz, Susan; O’Rourke, Julia; Osiecki, Lisa; Illmann, Cornelia; Barton, Lauren; McLaughlin, Elizabeth; Proujansky, Rachel; Royal, Justin; Cowley, Heather; Rangel-Lugo, Martha; Pauls, David; Scharf, Jeremiah M.; Mathews, Carol A.


    Genome-wide association studies (GWAS) and other emerging technologies offer great promise for the identification of genetic risk factors for complex psychiatric disorders, yet such studies are constrained by the need for large sample sizes. Web-based collection offers a relatively untapped resource for increasing participant recruitment. Therefore, we developed and implemented a novel web-based screening and phenotyping protocol for genetic studies of Tourette Syndrome (TS), a childhood-onset neuropsychiatric disorder characterized by motor and vocal tics. Participants were recruited over a 13 month period through the membership of the Tourette Syndrome Association (TSA) (n=28,878). Of the TSA members contacted, 4.3% (1,242) initiated the questionnaire, and 79.5% (987) of these were enrollment eligible. 63.9% (631) of enrolled participants completed the study by submitting phenotypic data and blood specimens. Age was the only variable that predicted study completion; children and young adults were significantly less likely to be study completers than adults 26 and older. Compared to a clinic-based study conducted over the same time period, the web-based method yielded a 60% larger sample. Web-based participants were older and more often female; otherwise, the sample characteristics did not differ significantly. TS diagnoses based on the web-screen demonstrated 100% accuracy compared to those derived from in-depth clinical interviews. Our results suggest that a web-based approach is effective for increasing the sample size for genetic studies of a relatively rare disorder and that our web-based screen is valid for diagnosing TS. Findings from this study should aid in the development of web-based protocols for other disorders. PMID:23090870

  8. [Quality and improvement propositions for the Annecy emergency medical services]. (United States)

    Courtois, X; Baniachemi, J J; Carrier, D; Driencourt, J B; Fabretti, A M; Gaillat, J; Bissuel, J P


    Emergency visits are one of the most common ways patients are admitted to hospitals. This study aims to characterise emergency visits in the Annecy District, in order to identify future actions for better management. Four studies were implemented: telephone surveys among 600 households and 130 physicians; and two observational studies of emergency visits to 80 physicians and to hospital emergency services. We observed that the hospital emergency service offers patients a good service, and therefore attracts many minor pathologies not requiring a hospital visit. Implementation of alternative structures, outside the hospital, to offer similar service must be considered. Co-operation among the different actors must be improved, and can benefit from new communication technology.

  9. Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Aala


    Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error. Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.   Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.   Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.    Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

  10. Analyzing engagement in a web-based intervention platform through visualizing log-data. (United States)

    Morrison, Cecily; Doherty, Gavin


    Engagement has emerged as a significant cross-cutting concern within the development of Web-based interventions. There have been calls to institute a more rigorous approach to the design of Web-based interventions, to increase both the quantity and quality of engagement. One approach would be to use log-data to better understand the process of engagement and patterns of use. However, an important challenge lies in organizing log-data for productive analysis. Our aim was to conduct an initial exploration of the use of visualizations of log-data to enhance understanding of engagement with Web-based interventions. We applied exploratory sequential data analysis to highlight sequential aspects of the log data, such as time or module number, to provide insights into engagement. After applying a number of processing steps, a range of visualizations were generated from the log-data. We then examined the usefulness of these visualizations for understanding the engagement of individual users and the engagement of cohorts of users. The visualizations created are illustrated with two datasets drawn from studies using the SilverCloud Platform: (1) a small, detailed dataset with interviews (n=19) and (2) a large dataset (n=326) with 44,838 logged events. We present four exploratory visualizations of user engagement with a Web-based intervention, including Navigation Graph, Stripe Graph, Start-Finish Graph, and Next Action Heat Map. The first represents individual usage and the last three, specific aspects of cohort usage. We provide examples of each with a discussion of salient features. Log-data analysis through data visualization is an alternative way of exploring user engagement with Web-based interventions, which can yield different insights than more commonly used summative measures. We describe how understanding the process of engagement through visualizations can support the development and evaluation of Web-based interventions. Specifically, we show how visualizations

  11. 77 FR 36039 - Federal Interagency Committee on Emergency Medical Services (United States)


    ... discussion of FICEMS strategic planning process A discussion of recently finalized recommendations from the... Security, to provide administrative support to the Interagency Committee, including scheduling meetings... Response to Recommendations from the National Transportation Safety Board Update on Helicopter Emergency...

  12. 75 FR 27917 - Emergency Medical Services Week, 2010 (United States)


    ... children. It also prohibits insurance companies from imposing prior authorization requirements or increased..., train themselves on the latest life-saving techniques, and maintain vital emergency equipment, often... own safety and preparedness skills. [[Page 27920

  13. Involvement of Pharmacists in Medical Care in Emergency and Critical Care Centers. (United States)

    Imai, Toru; Yoshida, Yoshikazu


    Emergency and critical care centers provide multidisciplinary therapy for critically ill patients by centralizing the expertise and technology of many medical professionals. Because the patients' conditions vary, different drug treatments are administered along with surgery. Therefore, the role of pharmacists is important. Critically ill patients who receive high-level invasive treatment undergo physiological changes differing from their normal condition along with variable therapeutic effects and pharmacokinetics. Pharmacists are responsible for recommending the appropriate drug therapy using their knowledge of pharmacology and pharmacokinetics. Further, pharmacists need to determine the general condition of patients by understanding vital signs, blood gas analysis results, etc. It is therefore necessary to conduct consultations with physicians and nurses. The knowledge required for emergency medical treatment is not provided during systematic training in pharmaceutical education, meaning that pharmacists acquire it in the clinical setting through trial and error. To disseminate the knowledge of emergency medical care to pharmacy students, emergency care training has been started in a few facilities. I believe that medical facilities and universities need to conduct joint educational sessions on emergency medical care. Moreover, compared with other medical fields, there are fewer studies on emergency medical care. Research-oriented pharmacists must resolve this issue. This review introduces the work conducted by pharmacists for clinical student education and clinical research at the Emergency and Critical Care Center of Nihon University Itabashi Hospital and discusses future prospects.

  14. Emergency medical service systems in Sri Lanka: problems of the past, challenges of the future. (United States)

    Wimalaratne, Kelum; Lee, Jeong Il; Lee, Kang Hyun; Lee, Hee Young; Lee, Jung Hun; Kang, In Hye


    The concept of emergency medical services (EMS) is new to Sri Lanka. This article describes the development, delivery, and future ideas for EMS in Sri Lanka. Sri Lanka also faces frequent natural hazards that justify the establishment of an EMS service. Data and information regarding emergency medical care in Sri Lanka were collected and reviewed from resources including websites and research papers. Currently, there are no qualified emergency medical physicians in Sri Lanka. However, a specialist training program for emergency physicians was initiated in 2012. There is no formal system to train emergency medical technicians (EMTs). Sri Lankans usually use taxies or their private vehicles to get to the hospital in the case of an emergency. All of the hospitals have ambulances that they can use to transport patients between hospitals. Most hospitals have emergency treatment units. Those at larger hospitals tend to be better than those at smaller hospitals. Although there is a disaster management system, it is not focused on emergency medical needs. Many aspects of the EMS system in Sri Lanka need improvement. To start, the emergency telephone number should cover the entire country. Training programs for EMTs should be conducted regularly. In addition, ambulances should be allocated for prehospital care. In the process of these developmental changes, public awareness programs are essential to improve the function of the EMS system. Despite many current shortcomings, Sri Lanka is capable of developing a successful EMS system.

  15. Innovation in preregistration midwifery education: Web based interactive storytelling learning. (United States)

    Scamell, Mandie; Hanley, Thomas


    through a critical description of the implementation of a web based interactive storytelling learning activity introduced into an undergraduate, preregistration midwifery education programme, this paper will explore how low-cost, low-fidelity online storytelling, designed using Moodle, can be used to enhance students' understanding of compassion and empathy in practice. cross sectional sample of first year undergraduate Midwifery students (n111) METHOD: drawing from both research and audit data collected in an Higher Education Institution in London England, the paper presents the case for using web based technology to create a sustainable model for midwifery education. initial results indicate that it is both the low cost and positive student evaluations of web based interactive storytelling, which make this approach to preregistration midwifery education which suggests that this approach has significant potential for learning and teaching in midwifery education in diverse settings around the world. Or how about: global relevance? . Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The instructional effectiveness of a web-based audiometry simulator. (United States)

    Lieberth, Ann K; Martin, Douglas R


    With distance learning becoming more of a reality than a novelty in many undergraduate and graduate training programs, web-based clinical simulations can be identified as an instructional option in distance education that has both a sound pedagogical foundation and clinical relevance. The purpose of this article is to report on the instructional effectiveness of a web-based pure-tone audiometry simulator by undergraduate and graduate students in speech-language pathology. Graduate and undergraduate majors in communication sciences and disorders practiced giving basic hearing tests on either a virtual web-based audiometer or a portable audiometer. Competencies in basic testing skills were evaluated for each group. Results of our analyses of the data indicate that both undergraduate and graduate students learned basic audiometric testing skills using the virtual audiometer. These skills were generalized to basic audiometric testing skills required of a speech language pathologist using a portable audiometer.

  17. Influence of awareness and availability of medical alternatives on parents seeking paediatric emergency care. (United States)

    Ellbrant, Julia A; Åkeson, S Jonas; Karlsland Åkeson, Pia M


    Direct seeking of care at paediatric emergency departments may result from an inadequate awareness or a short supply of medical alternatives. We therefore evaluated the care-seeking patterns, availability of medical options and initial medical assessments - with overall reference to socioeconomic status - of parents at an urban paediatric emergency department in a Scandinavian country providing free paediatric healthcare. The parents of children assessed by paediatric emergency department physicians at a Swedish university hospital over a 25-day winter period completed a questionnaire on recent medical contacts and their reasons for attendance. Additional information was obtained from ledgers, patient records and population demographics. In total, 657 of 713 eligible patients (92%) were included. Seventy-nine per cent of their parents either failed to or managed to establish medical contact before the emergency department visit, whereas 21% sought care with no attempt at recent medical contact. Visits with a failed telephone or primary care contact (18%) were more common outside office hours ( p=0.014) and were scored as less urgent ( p=0.014). A perceived emergency was the main reason for no attempt at medical contact before the visit. Direct emergency department care-seeking was more common from the city district with the lowest socioeconomic status ( p=0.027). Although most parents in this Swedish study tried to seek medical advice before attending a paediatric emergency department, perceived emergency, a short supply of telephone health line or primary care facilities and lower socioeconomic status contributed to direct care-seeking by almost 40% of parents. Pre-hospital awareness and the availability of medical alternatives with an emphasis on major differences in socioeconomic status should therefore be considered to further optimize care-seeking in paediatric emergency departments.

  18. The Emerging Therapeutic Role of Medical Foods for Gastrointestinal Disorders (United States)

    Ciampa, Brian P.; Reyes Ramos, Emmanuel; Borum, Marie


    In addition to drugs approved by the US Food and Drug Administration (FDA) that treat, cure, or mitigate disease, medical foods are a tool to help manage chronic conditions and diseases. A medical food, according to the FDA, is a food that is developed to be eaten or administered enterally under the guidance of a physician and that is meant for the specific dietary management of a condition or disease for which distinctive nutritional requirements, based upon known scientific principles, are established by medical evaluation. A variety of medical foods exist to help manage a wide range of medical conditions, from Alzheimer disease to HIV-associated enteropathy. EnteraGam contains serum-derived bovine immunoglobulin/protein isolate, which has been studied extensively in diarrhea-predominant irritable bowel syndrome, inflammatory bowel disease (IBD), and HIV-associated enteropathy. VSL#3 is a probiotic that is used in pouchitis for patients with ulcerative colitis as well as irritable bowel syndrome. Modulen IBD is a whole-protein, sole-nutrition formulation used to manage the active phase of Crohn’s disease. Vivonex is an elemental diet that is used in a variety of diseases associated with severe gastrointestinal dysfunction. Medical foods are safe and must have proven efficacy in helping to manage a variety of gastrointestinal conditions and diseases. These therapies represent tools that can be used prior or in addition to traditional medical therapies. This article discusses the history and development of medical foods under the FDA and concentrates specifically on medical foods used to help manage diseases of the gastrointestinal tract. PMID:28450817

  19. Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

    CERN Document Server


    Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

  20. A web-based decision support tool for prognosis simulation in multiple sclerosis. (United States)

    Veloso, Mário


    A multiplicity of natural history studies of multiple sclerosis provides valuable knowledge of the disease progression but individualized prognosis remains elusive. A few decision support tools that assist the clinician in such task have emerged but have not received proper attention from clinicians and patients. The objective of the current work is to implement a web-based tool, conveying decision relevant prognostic scientific evidence, which will help clinicians discuss prognosis with individual patients. Data were extracted from a set of reference studies, especially those dealing with the natural history of multiple sclerosis. The web-based decision support tool for individualized prognosis simulation was implemented with NetLogo, a program environment suited for the development of complex adaptive systems. Its prototype has been launched online; it enables clinicians to predict both the likelihood of CIS to CDMS conversion, and the long-term prognosis of disability level and SPMS conversion, as well as assess and monitor the effects of treatment. More robust decision support tools, which convey scientific evidence and satisfy the needs of clinical practice by helping clinicians discuss prognosis expectations with individual patients, are required. The web-based simulation model herein introduced proposes to be a step forward toward this purpose. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Development and process evaluation of a Web-based responsible beverage service training program. (United States)

    Danaher, Brian G; Dresser, Jack; Shaw, Tracy; Severson, Herbert H; Tyler, Milagra S; Maxwell, Elisabeth D; Christiansen, Steve M


    Responsible beverage service (RBS) training designed to improve the appropriate service of alcohol in commercial establishments is typically delivered in workshops. Recently, Web-based RBS training programs have emerged. This report describes the formative development and subsequent design of an innovative Web-delivered RBS program, and evaluation of the impact of the program on servers' knowledge, attitudes, and self-efficacy. Formative procedures using focus groups and usability testing were used to develop a Web-based RBS training program. Professional alcohol servers (N = 112) who worked as servers and/or mangers in alcohol service settings were recruited to participate. A pre-post assessment design was used to assess changes associated with using the program. Participants who used the program showed significant improvements in their RBS knowledge, attitudes, and self-efficacy. Although the current study did not directly observe and determine impact of the intervention on server behaviors, it demonstrated that the development process incorporating input from a multidisciplinary team in conjunction with feedback from end-users resulted in creation of a Web-based RBS program that was well-received by servers and that changed relevant knowledge, attitudes, and self-efficacy. The results also help to establish a needed evidence base in support of the use of online RBS training, which has been afforded little research attention.

  2. Creating an Advanced Web Based Environment using Semantic Web


    Panchajanyeswari M Achar


    E-learning systems are of no help to the users if there are no powerful search engines and browsing tools to assist them. Most of the current web-based learning systems are closed systems where the courses and the learning material are fixed. The only thing that is dynamic is that the organization of the learning content is adapted to allow individualized learning environment. The learners of web-based e-learning systems belong to different categories based on their skills, background, prefer...

  3. Computer-based and web-based radiation safety training

    Energy Technology Data Exchange (ETDEWEB)

    Owen, C., LLNL


    The traditional approach to delivering radiation safety training has been to provide a stand-up lecture of the topic, with the possible aid of video, and to repeat the same material periodically. New approaches to meeting training requirements are needed to address the advent of flexible work hours and telecommuting, and to better accommodate individuals learning at their own pace. Computer- based and web-based radiation safety training can provide this alternative. Computer-based and web- based training is an interactive form of learning that the student controls, resulting in enhanced and focused learning at a time most often chosen by the student.

  4. Session management for web-based healthcare applications. (United States)

    Wei, L; Sengupta, S


    In health care systems, users may access multiple applications during one session of interaction with the system. However, users must sign on to each application individually, and it is difficult to maintain a common context among these applications. We are developing a session management system for web-based applications using LDAP directory service, which will allow single sign-on to multiple web-based applications, and maintain a common context among those applications for the user. This paper discusses the motivations for building this system, the system architecture, and the challenges of our approach, such as the session objects management for the user, and session security.

  5. Web-based multimedia information retrieval for clinical application research (United States)

    Cao, Xinhua; Hoo, Kent S., Jr.; Zhang, Hong; Ching, Wan; Zhang, Ming; Wong, Stephen T. C.


    We described a web-based data warehousing method for retrieving and analyzing neurological multimedia information. The web-based method supports convenient access, effective search and retrieval of clinical textual and image data, and on-line analysis. To improve the flexibility and efficiency of multimedia information query and analysis, a three-tier, multimedia data warehouse for epilepsy research has been built. The data warehouse integrates clinical multimedia data related to epilepsy from disparate sources and archives them into a well-defined data model.

  6. Efficient Image Blur in Web-Based Applications

    DEFF Research Database (Denmark)

    Kraus, Martin


    Scripting languages require the use of high-level library functions to implement efficient image processing; thus, real-time image blur in web-based applications is a challenging task unless specific library functions are available for this purpose. We present a pyramid blur algorithm, which can...... be implemented using a subimage copy function, and evaluate its performance with various web browsers in comparison to an infinite impulse response filter. While this pyramid algorithm was first proposed for GPU-based image processing, its applicability to web-based applications indicates that some GPU...

  7. Licensing web-based nursing programs, courses, and course materials. (United States)

    Billings, Diane M; Hoke, Mary M; Waldhuetter, Kurt


    With the advent of the digital information age, schools of nursing are developing and using web-based programs, courses, and course materials to meet students' needs for access and high-quality learning experiences. In an attempt to maximize scant resources, including faculty, many schools are seeking grant funding, joining consortia, or forming partnerships that require sharing of web-based course materials. Entering such collaborative arrangements usually requires licensing agreements to transfer intellectual capital. This article explains licensing and the related concepts of intellectual property, copyright, and technology transfer. It also identifies the advantages and disadvantages of licensing and describes a licensing process.

  8. Caught in the web: a review of web-based suicide prevention. (United States)

    Lai, Mee Huong; Maniam, Thambu; Chan, Lai Fong; Ravindran, Arun V


    Suicide is a serious and increasing problem worldwide. The emergence of the digital world has had a tremendous impact on people's lives, both negative and positive, including an impact on suicidal behaviors. Our aim was to perform a review of the published literature on Web-based suicide prevention strategies, focusing on their efficacy, benefits, and challenges. The EBSCOhost (Medline, PsycINFO, CINAHL), OvidSP, the Cochrane Library, and ScienceDirect databases were searched for literature regarding Web-based suicide prevention strategies from 1997 to 2013 according to the modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The selected articles were subjected to quality rating and data extraction. Good quality literature was surprisingly sparse, with only 15 fulfilling criteria for inclusion in the review, and most were rated as being medium to low quality. Internet-based cognitive behavior therapy (iCBT) reduced suicidal ideation in the general population in two randomized controlled trial (effect sizes, d=0.04-0.45) and in a clinical audit of depressed primary care patients. Descriptive studies reported improved accessibility and reduced barriers to treatment with Internet among students. Besides automated iCBT, preventive strategies were mainly interactive (email communication, online individual or supervised group support) or information-based (website postings). The benefits and potential challenges of accessibility, anonymity, and text-based communication as key components for Web-based suicide prevention strategies were emphasized. There is preliminary evidence that suggests the probable benefit of Web-based strategies in suicide prevention. Future larger systematic research is needed to confirm the effectiveness and risk benefit ratio of such strategies.

  9. Engaging Physician Learners Through a Web-Based Platform: Individualized End-of-Life Education. (United States)

    Bergman, Jonathan; Ballon-Landa, Eric; Lerman, Steven E; Kwan, Lorna; Bennett, Carol J; Litwin, Mark S


    Web-based modules provide a convenient and low-cost education platform, yet should be carefully designed to ensure that learners are actively engaged. In order to improve attitudes and knowledge in end-of-life (EOL) care, we developed a web-based educational module that employed hyperlinks to allow users access to auxiliary resources: clinical guidelines and seminal research papers. Participants took pre-test evaluations of attitudes and knowledge regarding EOL care prior to accessing the educational module, and a post-test evaluation following the module intervention. We recorded the type of hyperlinks (guideline or paper) accessed by learners, and stratified participants into groups based on link type accessed (none, either, or both). We used demographic and educational data to develop a multivariate mixed-effects regression analysis to develop adjusted predictions of attitudes and knowledge. 114 individuals participated. The majority had some professional exposure to EOL care (prior instruction 62%; EOL referral 53%; EOL discussion 56%), though most had no family (68%) or personal experience (51%). On bivariate analysis, non-partnered (p = .04), medical student training level (p = .03), prior palliative care referral (p = .02), having a family member (p = .02) and personal experience of EOL care (p web-based learning in end-of-life care. © The Author(s) 2015.

  10. Web-Based Evaluation System to Measure Learning Effectiveness in Kampo Medicine. (United States)

    Iizuka, Norio; Usuku, Koichiro; Nakae, Hajime; Segawa, Makoto; Wang, Yue; Ogashiwa, Kahori; Fujita, Yusuke; Ogihara, Hiroyuki; Tazuma, Susumu; Hamamoto, Yoshihiko


    Measuring the learning effectiveness of Kampo Medicine (KM) education is challenging. The aim of this study was to develop a web-based test to measure the learning effectiveness of KM education among medical students (MSs). We used an open-source Moodle platform to test 30 multiple-choice questions classified into 8-type fields (eight basic concepts of KM) including "qi-blood-fluid" and "five-element" theories, on 117 fourth-year MSs. The mean (±standard deviation [SD]) score on the web-based test was 30.2 ± 11.9 (/100). The correct answer rate ranged from 17% to 36%. A pattern-based portfolio enabled these rates to be individualized in terms of KM proficiency. MSs with scores higher (n = 19) or lower (n = 14) than mean ± 1SD were defined as high or low achievers, respectively. Cluster analysis using the correct answer rates for the 8-type field questions revealed clear divisions between high and low achievers. Interestingly, each high achiever had a different proficiency pattern. In contrast, three major clusters were evident among low achievers, all of whom responded with a low percentage of or no correct answers. In addition, a combination of three questions accurately classified high and low achievers. These findings suggest that our web-based test allows individual quantitative assessment of the learning effectiveness of KM education among MSs.

  11. Web-Based Surveillance Systems for Human, Animal, and Plant Diseases. (United States)

    Madoff, Lawrence C; Li, Annie


    The emergence of infectious diseases, caused by novel pathogens or the spread of existing ones to new populations and regions, represents a continuous threat to humans and other species. The early detection of emerging human, animal, and plant diseases is critical to preventing the spread of infection and protecting the health of our species and environment. Today, more than 75% of emerging infectious diseases are estimated to be zoonotic and capable of crossing species barriers and diminishing food supplies. Traditionally, surveillance of diseases has relied on a hierarchy of health professionals that can be costly to build and maintain, leading to a delay or interruption in reporting. However, Internet-based surveillance systems bring another dimension to epidemiology by utilizing technology to collect, organize, and disseminate information in a more timely manner. Partially and fully automated systems allow for earlier detection of disease outbreaks by searching for information from both formal sources (e.g., World Health Organization and government ministry reports) and informal sources (e.g., blogs, online media sources, and social networks). Web-based applications display disparate information online or disperse it through e-mail to subscribers or the general public. Web-based early warning systems, such as ProMED-mail, the Global Public Health Intelligence Network (GPHIN), and Health Map, have been able to recognize emerging infectious diseases earlier than traditional surveillance systems. These systems, which are continuing to evolve, are now widely utilized by individuals, humanitarian organizations, and government health ministries.

  12. Log In to Experiential Learning Theory: Supporting Web-Based Faculty Development. (United States)

    Omer, Selma; Choi, Sunhea; Brien, Sarah; Parry, Marcus


    For an increasingly busy and geographically dispersed faculty, the Faculty of Medicine at the University of Southampton, United Kingdom, developed a range of Web-based faculty development modules, based on Kolb's experiential learning cycle, to complement the faculty's face-to-face workshops. The objective of this study was to assess users' views and perceptions of the effectiveness of Web-based faculty development modules based on Kolb's experiential learning cycle. We explored (1) users' satisfaction with the modules, (2) whether Kolb's design framework supported users' learning, and (3) whether the design principle impacts their work as educators. We gathered data from users over a 3-year period using evaluation surveys built into each of the seven modules. Quantitative data were analyzed using descriptive statistics, and responses to open-ended questions were analyzed using content analysis. Out of the 409 module users, 283 completed the survey (69.1% response rate). Over 80% of the users reported being satisfied or very satisfied with seven individual aspects of the modules. The findings suggest a strong synergy between the design features that users rated most highly and the key stages of Kolb's learning cycle. The use of simulations and videos to give the users an initial experience as well as the opportunity to "Have a go" and receive feedback in a safe environment were both considered particularly useful. In addition to providing an opportunity for reflection, many participants considered that the modules would enhance their roles as educators through: increasing their knowledge on various education topics and the required standards for medical training, and improving their skills in teaching and assessing students through practice and feedback and ultimately increasing their confidence. Kolb's theory-based design principle used for Web-based faculty development can support faculty to improve their skills and has impact on their role as educators

  13. Woods and Russell, Hill, and the emergence of medical statistics (United States)

    Farewell, Vern; Johnson, Tony


    In 1937, Austin Bradford Hill wrote Principles of Medical Statistics (Lancet: London, 1937) that became renowned throughout the world and is widely associated with the birth of modern medical statistics. Some 6 years earlier Hilda Mary Woods and William Thomas Russell, colleagues of Hill at the London School of Hygiene and Tropical Medicine, wrote a similar book An Introduction to Medical Statistics (PS King and Son: London, 1931) that is little known today. We trace the origins of these two books from the foundations of early demography and vital statistics, and make a detailed examination of some of their chapters. It is clear that these texts mark a watershed in the history of medical statistics that demarcates the vital statistics of the nineteenth and early twentieth centuries from the modern discipline. Moreover, we consider that the book by Woods and Russell is of some importance in the development of medical statistics and we describe and acknowledge their place in the history of this discipline. Copyright © 2010 John Wiley & Sons, Ltd. PMID:20535761

  14. Woods and Russell, Hill, and the emergence of medical statistics. (United States)

    Farewell, Vern; Johnson, Tony


    In 1937, Austin Bradford Hill wrote Principles of Medical Statistics (Lancet: London, 1937) that became renowned throughout the world and is widely associated with the birth of modern medical statistics. Some 6 years earlier Hilda Mary Woods and William Thomas Russell, colleagues of Hill at the London School of Hygiene and Tropical Medicine, wrote a similar book An Introduction to Medical Statistics (PS King and Son: London, 1931) that is little known today. We trace the origins of these two books from the foundations of early demography and vital statistics, and make a detailed examination of some of their chapters. It is clear that these texts mark a watershed in the history of medical statistics that demarcates the vital statistics of the nineteenth and early twentieth centuries from the modern discipline. Moreover, we consider that the book by Woods and Russell is of some importance in the development of medical statistics and we describe and acknowledge their place in the history of this discipline. (c) 2010 John Wiley & Sons, Ltd.

  15. A Comparison of Medical and Psychobehavioral Emergency Department Visits Made by Adults with Intellectual Disabilities

    Directory of Open Access Journals (Sweden)

    Yona Lunsky


    Full Text Available Study Objective. We describe and contrast medical to psychobehavioral emergency visits made by a cohort of adults with intellectual disabilities. Methods. This was a study of 221 patients with intellectual disabilities who visited the emergency department because of a psychobehavioral or medical emergency. Patient profiles are described and logistic regression was used to assess predictors of psychobehavioral emergencies in this group, including age, residence, psychiatric diagnosis, cognitive level, and life events. Results. Ninety-eight individuals had medical emergencies and 123 individuals presented with psychobehavioral emergencies. The most common medical issue was injury and the most common psychobehavioral issue was aggression. In the multivariate analysis, life events (odds ratio (OR 0.28; 95% confidence interval (CI 0.10 to 0.75, psychiatric diagnosis (OR 2.35; 95% CI 1.12 to 4.95, and age group (OR 4.97; 95% CI 1.28 to 19.38 were associated with psychobehavioral emergencies. Psychobehavioral emergencies were more likely to result in admission and caregivers reported lower rates of satisfaction with these visits. Conclusion. Emergency departments would benefit from greater understanding of the different types of presentations made by adults with intellectual disabilities, given the unique presentations and outcomes associated with them.

  16. Profile and Outcome of Medical Emergencies in a Tertiary Health ...

    African Journals Online (AJOL)

    communicable diseases in the cardiovascular 195 (15.5%), renal 105 (8.4%), neurological 224 (17.8%), endocrine 163(13.0%) and gastrointestinal/ hepatobiliary 163(13.0%) systems were the other prevalent emergencies. The crude mortality rate ...

  17. Pattern of medical emergency utilisation in a Nigeria Tertiary Health ...

    African Journals Online (AJOL)

    Methods: All patients seen in the Accident and Emergency Unit of Aminu Kano Teaching Hospital, Kano in December 2008 were recruited. The demographic data of ... While malaria and acute gastroenteritis had higher overall frequency, stroke and heart failure were more frequent among the older population. Conclusions: ...

  18. The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care. (United States)

    Dvorak, Jiri; Kramer, Efraim B; Schmied, Christian M; Drezner, Jonathan A; Zideman, David; Patricios, Jon; Correia, Luis; Pedrinelli, André; Mandelbaum, Bert


    Life-threatening medical emergencies are an infrequent but regular occurrence on the football field. Proper prevention strategies, emergency medical planning and timely access to emergency equipment are required to prevent catastrophic outcomes. In a continuing commitment to player safety during football, this paper presents the FIFA Medical Emergency Bag and FIFA 11 Steps to prevent sudden cardiac death. These recommendations are intended to create a global standard for emergency preparedness and the medical response to serious or catastrophic on-field injuries in football.

  19. Web-based Discussion Forums on Pregnancy Complaints and Maternal Health Literacy in Norway: A Qualitative Study. (United States)

    Fredriksen, Eva Haukeland; Harris, Janet; Moland, Karen Marie


    The Internet is one of the fastest growing information sources for pregnant women and seems to be used across social and economic strata. However, we still lack knowledge on how interaction in Web-based discussion forums influence maternal health literacy, in terms of how pregnant women access, appraise, and apply information to promote and maintain good health. The aim of this study was to understand how Web-based discussion forums influence maternal health literacy; hence, we explored the role of interactions in Web-based discussion forums among women who experienced health problems during pregnancy. More specifically, we explored why media-literate women experiencing the medically unexplained condition, pelvic girdle pain (PGP), during pregnancy participated in Web-based discussion forums and how they appraised and applied the information and advice that they gained from the Web-based interaction with other women. Women were invited to participate in the study via postings on 3 different open websites for pregnant women and mothers. The sample included 11 Norwegian women who participated in open Web-based discussion forums when experiencing PGP in pregnancy. The data were collected using synchronous qualitative email interviews and were analyzed using thematic analysis. In our study sample, interaction in Web-based discussion forums influenced maternal health literacy in terms of increased health-related knowledge and competencies, increased awareness of health promotion and health protection, and increased system navigation. The women appraised and selectively applied information and advice that resonated with their own experiences. For many, the information provided online by other women in the same situation was valued more highly than advice from health professionals. Women reported that they used their knowledge and competency in encounters with health professionals but hesitated to disclose the origin of their knowledge. Those with a high level of

  20. Biomaterials and medical devices a perspective from an emerging country

    CERN Document Server

    Hermawan, Hendra


    This book presents an introduction to biomaterials with the focus on the current development and future direction of biomaterials and medical devices research and development in Indonesia. It is the first biomaterials book written by selected academic and clinical experts experts on biomaterials and medical devices from various institutions and industries in Indonesia. It serves as a reference source for researchers starting new projects, for companies developing and marketing products and for governments setting new policies. Chapter one covers the fundamentals of biomaterials, types of biomaterials, their structures and properties and the relationship between them. Chapter two discusses unconventional processing of biomaterials including nano-hybrid organic-inorganic biomaterials. Chapter three addresses biocompatibility issues including in vitro cytotoxicity, genotoxicity, in vitro cell models, biocompatibility data and its related failure. Chapter four describes degradable biomaterial for medical implants...

  1. The emerging medical ecology of the human gut microbiome. (United States)

    Pepper, John W; Rosenfeld, Simon


    It is increasingly clear that the human gut microbiome has great medical importance, and researchers are beginning to investigate its basic biology and to appreciate the challenges that it presents to medical science. Several striking new empirical results in this area are perplexing within the standard conceptual framework of biomedicine, and this highlights the need for new perspectives from ecology and from dynamical systems theory. Here, we discuss recent results concerning sources of individual variation, temporal variation within individuals, long-term changes after transient perturbations and individualized responses to perturbation within the human gut microbiome. Published by Elsevier Ltd.

  2. 76 FR 39977 - National Emergency Medical Services Advisory Council Teleconference Meeting (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council...) Progress Reports from Committee Chairs (4) Update on the Culture of Safety Project (5) Public Comment...

  3. 78 FR 36300 - Federal Interagency Committee on Emergency Medical Services; Meeting (United States)


    ...) Headquarters Building at 200 Independence Avenue SW., Washington, DC 20201 in Suite 800 on the penthouse floor... on the White House Forum on Military Credentialing and Licensure for Emergency Medical Services...

  4. Evolution of Web-Based Applications Using Domain-Specific Markup Languages


    Guntram Graef; Martin Gaedke


    The lifecycle of Web-based applications is characterized by frequent changes to content, user interface, and functionality. Updating content, improving the services provided to users, drives further development of a Web-based application. The major goal for the success of a Web-based application becomes therefore its evolution. Though, development and maintenance of Web-based applications suffers from the underlying document-based implementation model. A disciplined evolution of Web based app...

  5. Standardized patient-narrated web-based learning modules improve students' communication skills on a high-stakes clinical skills examination. (United States)

    Lee, Christina A; Chang, Anna; Chou, Calvin L; Boscardin, Christy; Hauer, Karen E


    Use of web-based standardized patient (SP) modules is associated with improved medical student history-taking and physical examination skills on clinical performance examinations (CPX), but a benefit for communication skills has not been shown. We describe an innovative web-based SP module using detailed SP and faculty commentary to teach communication skills. A public medical school in 2008-2009. Fourth-year medical students. A 90-minute web-based module with three simulated clinical encounters was narrated by an expert clinician and SP to explain expected history-taking, physical examination, and communication skills behaviors. All 147 students were encouraged to review the module one month before the CPX. One hundred and six students (72%) viewed the web-based module. Students who watched the module performed significantly higher on the CPX communication score (+2.67%, p Students who watched an optional web-based SP module prior to the CPX performed higher than those who did not on communication skills. The web-based module appears to be an effective CPX preparatory activity to enhance communication performance.

  6. Measuring participant rurality in Web-based interventions

    Directory of Open Access Journals (Sweden)

    McKay H Garth


    Full Text Available Abstract Background Web-based health behavior change programs can reach large groups of disparate participants and thus they provide promise of becoming important public health tools. Data on participant rurality can complement other demographic measures to deepen our understanding of the success of these programs. Specifically, analysis of participant rurality can inform recruitment and social marketing efforts, and facilitate the targeting and tailoring of program content. Rurality analysis can also help evaluate the effectiveness of interventions across population groupings. Methods We describe how the RUCAs (Rural-Urban Commuting Area Codes methodology can be used to examine results from two Randomized Controlled Trials of Web-based tobacco cessation programs: the project for smokeless tobacco cessation and the Smokers' Health Improvement Program (SHIP project for smoking cessation. Results Using RUCAs methodology helped to highlight the extent to which both Web-based interventions reached a substantial percentage of rural participants. The ChewFree program was found to have more rural participation which is consistent with the greater prevalence of smokeless tobacco use in rural settings as well as ChewFree's multifaceted recruitment program that specifically targeted rural settings. Conclusion Researchers of Web-based health behavior change programs targeted to the US should routinely include RUCAs as a part of analyzing participant demographics. Researchers in other countries should examine rurality indices germane to their country.

  7. Web Based Organizing and the Management of Human Resources

    NARCIS (Netherlands)

    J. Paauwe (Jaap); R. Visser (Reina); A.R.T. Williams (Roger)


    textabstractThe paper focuses on the consequences of web-based business-to-business transactions in medium and large old economy companies in particular and discusses the implications for HRM and HR professionals. Medium and large old economy companies can be involved in transactions within the new

  8. Security Vulnerabilities of the Web Based Open Source Information ...

    African Journals Online (AJOL)

    This paper exposes security vulnerabilities of the web based Open Source Information Systems (OSIS) from both system angle and human perspectives.It shows the extent of risk that can likely hinder adopting organization from attaning full intended benefits of using OSIS software. To undertake this study, a case study ...

  9. Web-Based Interactive Writing Environment: Development and Evaluation (United States)

    Yang, Jie Chi; Ko, Hwa Wei; Chung, I. Ling


    This study reports the development and evaluation of a web-based interactive writing environment designed for elementary school students. The environment includes three writing themes, "story pass on", "story chameleon" and "thousand ideas", to encourage reading comprehension, creativity and problem-solving skills of…

  10. Formative Evaluation of a Web-Based Course in Meteorology. (United States)

    Phelps, Julia; Reynolds, Ross


    Describes the formative-evaluation process for the EuroMET (European Meteorological Education and Training) project, Web-Based university courses in meteorology that were created to address the education and training needs of professional meteorologists and students throughout Europe. Usability and interactive and multimedia elements are…

  11. Web-Based Modelling and Collaborative Simulation of Declarative Processes

    DEFF Research Database (Denmark)

    Slaats, Tijs; Marquard, Morten; Shahzad, Muhammad


    two years we have taken this adoption of DCR Graphs to the next level and decided to treat the notation as a product of its own by developing a stand-alone web-based collaborative portal for the modelling and simulation of declarative workflows. The purpose of the portal is to facilitate end...

  12. Student Cheating and Alternative Web-Based Assessment (United States)

    Styron, Jennifer; Styron, Ronald A., Jr.


    As distance education continues to expand within the United States so does the amount of faculty concern in regard to student cheating. The purpose of this paper was to explore the concept of eCheating in web-based course environments and review the need for and the types of alternative assessments found in these environments. This paper will also…

  13. Web-Based Learning: Cognitive Styles and Instructional Strategies (United States)

    Alomyan, Hesham Raji


    This paper reports a study, which investigated whether different instructional strategies might interact with individual's cognitive style in learning. A web-based learning package was designed employing three strategies, Interactive Concept Maps, Illustration with Embedded Text and Text-Only. Group Embedded Figure Test was administered to 178…

  14. Influencing woodland management using web-based technology (United States)

    William R. Thomas; Jeffrey W. Stringer


    The University of Kentucky, Department of Forestry Extension delivered hosted Web-based forestry educational programs ("webinars") in 2009 to promote woodland management in Kentucky and engage county extension agents in forestry programming. These webinars were hosted by county extension agents and attended by woodland owners. This hosted webinar approach was...

  15. An Assessment of Streaming Video In Web-based Instruction. (United States)

    Cofield, Jay L.

    Streaming video used as an augmentation in Web-based instruction was investigated to: (1) determine if demographic characteristics would lead to significantly different beliefs about the use and perceived effectiveness of streaming video, and (2) whether or not there are characteristics of streaming video that would lead to beliefs about the…

  16. Firefighter Math - a web-based learning tool (United States)

    Dan Jimenez


    Firefighter Math is a web based interactive resource that was developed to help prepare wildland fire personnel for math based training courses. The website can also be used as a refresher for fire calculations including slope, flame length, relative humidity, flow rates, unit conversion, etc. The website is designed to start with basic math refresher skills and...

  17. An interactive web-based extranet system model for managing ...

    African Journals Online (AJOL)

    The methodology of the special software to be developed involved the collections of main modern tools and technologies, such as Apache Web Server, PHP and MySQL which can work on any platform, such as windows and Linus. Keywords: Extranet-Model, Interactive, Web-Based, Students, Academic, Records ...


    Directory of Open Access Journals (Sweden)



    Full Text Available The paper describes the development of a prototype web-based expert knowledge system that can be used to maintain flexible pavement within a tropical region. This prototype system provides the advantages of using existing web-based expert system technology. Currently, deterioration of asphalt pavement layers is one of the biggest problems in Malaysia and requires maintenance to ensure that the roads remain open and able to guarantee the regularity, punctuality, and safety of all transport services. According to this process, the knowledge collection that has acquired and the date concerning to domain expert system of the development web-based system was launched with knowledge representation IF and THEN rules and coded by PHP programming. The web pages that support the user interface are created using a framework consisting of HTML, CSS, and J-Query. The prototype web-based expert system uses the knowledge of a pavement maintenance expert, or a specialist in pavement problem remediation, to emulate a portion of their professional reasoning abilities, which it can then use to assist with the maintenance of existing roads and enhance the efficiency and accuracy of the professional engineers tasked with the assessment of all available remedies. Thus, the system increases the performance level of the engineers in analysing, discerning and customising the information that will assist decision makers throughout the project, so the probability that the right decision and treatment are implemented at the right time is increased.

  19. Analogies: Explanatory Tools in Web-Based Science Instruction (United States)

    Glynn, Shawn M.; Taasoobshirazi, Gita; Fowler, Shawn


    This article helps designers of Web-based science instruction construct analogies that are as effective as those used in classrooms by exemplary science teachers. First, the authors explain what analogies are, how analogies foster learning, and what form analogies should take. Second, they discuss science teachers' use of analogies. Third, they…

  20. Science gateways for semantic-web-based life science applications. (United States)

    Ardizzone, Valeria; Bruno, Riccardo; Calanducci, Antonio; Carrubba, Carla; Fargetta, Marco; Ingrà, Elisa; Inserra, Giuseppina; La Rocca, Giuseppe; Monforte, Salvatore; Pistagna, Fabrizio; Ricceri, Rita; Rotondo, Riccardo; Scardaci, Diego; Barbera, Roberto


    In this paper we present the architecture of a framework for building Science Gateways supporting official standards both for user authentication and authorization and for middleware-independent job and data management. Two use cases of the customization of the Science Gateway framework for Semantic-Web-based life science applications are also described.

  1. Usage Patterns of a Web-based Library Catalog. (United States)

    Cooper, Michael D.


    Presents a methodology for analyzing patterns of usage of a Web-based library catalog and evaluates the methodology with data collected from the transaction logs of the Web interface version of the University of California's Melvyl Systemwide Library Catalog. Results revealed major differences in usage (number of searches, search time, number of…

  2. A Network of Automatic Control Web-Based Laboratories (United States)

    Vargas, Hector; Sanchez Moreno, J.; Jara, Carlos A.; Candelas, F. A.; Torres, Fernando; Dormido, Sebastian


    This article presents an innovative project in the context of remote experimentation applied to control engineering education. Specifically, the authors describe their experience regarding the analysis, design, development, and exploitation of web-based technologies within the scope of automatic control. This work is part of an inter-university…

  3. Teaching Students about Plagiarism Using a Web-Based Module (United States)

    Stetter, Maria Earman


    The following research delivered a web-based module about plagiarism and paraphrasing to avoid plagiarism in both a blended method, with live instruction paired with web presentation for 105 students, and a separate web-only method for 22 other students. Participants were graduates and undergraduates preparing to become teachers, the majority of…

  4. Quality of Web-Based Information on Cannabis Addiction (United States)

    Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele


    This study evaluated the quality of Web-based information on cannabis use and addiction and investigated particular content quality indicators. Three keywords ("cannabis addiction," "cannabis dependence," and "cannabis abuse") were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed…

  5. Usability Evaluation of a Web-Based Learning System (United States)

    Nguyen, Thao


    The paper proposes a contingent, learner-centred usability evaluation method and a prototype tool of such systems. This is a new usability evaluation method for web-based learning systems using a set of empirically-supported usability factors and can be done effectively with limited resources. During the evaluation process, the method allows for…

  6. Modelling of web-based virtual university administration for Nigerian ...

    African Journals Online (AJOL)

    This research work focused on development of a model of web based virtual University Administration for Nigerian universities. This is necessary as there is still a noticeable administrative constraint in our Universities, the establishment of many University Web portals notwithstanding. More efforts are therefore needed to ...

  7. Using Web-Based GIS in Introductory Human Geography (United States)

    Songer, Lynn C.


    Advocates for using a geographic information system (GIS) in education assert that GIS improves student learning. However, studies to clarify the relationship between learning and using GIS are still needed. This study examines the effects of using Web-based GIS maps in place of paper maps on students' geography content knowledge and motivation…

  8. A Java-Web-Based-Learning Methodology, Case Study ...

    African Journals Online (AJOL)

    A Java-Web-Based-Learning Methodology, Case Study : Waterborne diseases. The recent advances in web technologies have opened new opportunities for computer-based-education. One can learn independently of time and place constraints, and have instantaneous access to relevant updated material at minimal cost.

  9. A Usability Study of Interactive Web-Based Modules (United States)

    Girard, Tulay; Pinar, Musa


    This research advances the understanding of the usability of marketing case study modules in the area of interactive web-based technologies through the assignment of seven interactive case modules in a Principles of Marketing course. The case modules were provided for marketing students by the publisher, McGraw Hill Irwin, of the…

  10. Early childhood intervention: web-based training for transformation ...

    African Journals Online (AJOL)

    In the last decade the number of distance learning programs locally and internationally has escalated as academics explore the use of the Web and its impact on learning. However, very little has been done in relation to the evaluation of students and trainers' learning on the Web. Literature is available on Web-based ...

  11. Evaluating the Usability of Web-Based Learning Tools. (United States)

    Storey, M. -A.; Phillips, B.; Maczewski, M.; Wang, M.


    Discusses Web-based learning tools and reports results from a study at the University of Victoria that compared and evaluated two commercially available learning tools. Considers usability issues and discusses navigation, customization, student management, content creation, and students' perceptions. (Author/LRW)

  12. School Counseling Site Supervisor Training: A Web-Based Approach (United States)

    Swank, Jacqueline M.; Tyson, Lawrence


    A need exists for training school counseling site supervisors in providing clinical supervision to school counseling practicum and internship students. This article outlines a Web-based training program containing six modules to assist counselor education programs in educating school counseling site supervisors. The authors also address the…

  13. Web-Based Course Management and Web Services (United States)

    Mandal, Chittaranjan; Sinha, Vijay Luxmi; Reade, Christopher M. P.


    The architecture of a web-based course management tool that has been developed at IIT [Indian Institute of Technology], Kharagpur and which manages the submission of assignments is discussed. Both the distributed architecture used for data storage and the client-server architecture supporting the web interface are described. Further developments…

  14. Intelligent Web-Based English Instruction in Middle Schools (United States)

    Jia, Jiyou


    The integration of technology into educational environments has become more prominent over the years. The combination of technology and face-to-face interaction with instructors allows for a thorough, more valuable educational experience. "Intelligent Web-Based English Instruction in Middle Schools" addresses the concerns associated with…

  15. A Web-Based Remote Access Laboratory Using SCADA (United States)

    Aydogmus, Z.; Aydogmus, O.


    The Internet provides an opportunity for students to access laboratories from outside the campus. This paper presents a Web-based remote access real-time laboratory using SCADA (supervisory control and data acquisition) control. The control of an induction motor is used as an example to demonstrate the effectiveness of this remote laboratory,…

  16. Design and implementation of a web based information system for ...

    African Journals Online (AJOL)

    The design and implementation of a web-based administrative information system for National Health Insurance Scheme (NHIS) using its guidelines has been carried out. The system allows any NHIS-Registered patient to visit any registered provider anywhere in the country and be assigned to a doctor. To carry out the ...

  17. A Review of Web Based Interventions Focusing on Alcohol Use ...

    African Journals Online (AJOL)

    Alcohol continues to be a major contributor to morbidity and mortality globally. Despite the scientific advances, alcohol use related problems continue to pose a major challenge to medicine and public health. Internet offers a new mode to provide health care interventions. Web based interventions (WBIs) provide the health ...

  18. Using Web-Based Foreign Advertisements in International Marketing Classes (United States)

    Ryan, Jason


    The author examines the use of the Web-based foreign advertisements for enhancing the international awareness of undergraduate marketing students. An analysis compares the adaptation of advertisements for identical products to the cultural perceptions and values of consumers in different countries. In a sample of 110 international marketing…

  19. Development of Web-Based Learning Application for Generation Z (United States)

    Hariadi, Bambang; Dewiyani Sunarto, M. J.; Sudarmaningtyas, Pantjawati


    This study aimed to develop a web-based learning application as a form of learning revolution. The form of learning revolution includes the provision of unlimited teaching materials, real time class organization, and is not limited by time or place. The implementation of this application is in the form of hybrid learning by using Google Apps for…

  20. Educational Assessment via a Web-Based Intelligent System (United States)

    Huang, Jingshan; He, Lei; Davidson-Shivers, Gayle V.


    Effective assessment is vital in educational activities. We propose IWAS (intelligent Web-based assessment system), an intelligent, generalized and real-time system to assess both learning and teaching. IWAS provides a foundation for more efficiency in instructional activities and, ultimately, students' performances. Our contributions are…

  1. An Interactive Graphing Tool for Web-Based Courses. (United States)

    Kennedy, David M.; Fritze, Paul

    This paper reports on a project involving the development and formative evaluation of an interactive World Wide Web-based learning tool. The interactive graphing tool (IGT) permits students to sketch a graph on screen using a mouse and responds to a wide range of common graph types. The IGT facilitates an iterative approach to understanding…

  2. Creating Web-Based Scientific Applications Using Java Servlets (United States)

    Palmer, Grant; Arnold, James O. (Technical Monitor)


    There are many advantages to developing web-based scientific applications. Any number of people can access the application concurrently. The application can be accessed from a remote location. The application becomes essentially platform-independent because it can be run from any machine that has internet access and can run a web browser. Maintenance and upgrades to the application are simplified since only one copy of the application exists in a centralized location. This paper details the creation of web-based applications using Java servlets. Java is a powerful, versatile programming language that is well suited to developing web-based programs. A Java servlet provides the interface between the central server and the remote client machines. The servlet accepts input data from the client, runs the application on the server, and sends the output back to the client machine. The type of servlet that supports the HTTP protocol will be discussed in depth. Among the topics the paper will discuss are how to write an http servlet, how the servlet can run applications written in Java and other languages, and how to set up a Java web server. The entire process will be demonstrated by building a web-based application to compute stagnation point heat transfer.

  3. Reliability, Compliance, and Security in Web-Based Course Assessments (United States)

    Bonham, Scott


    Pre- and postcourse assessment has become a very important tool for education research in physics and other areas. The web offers an attractive alternative to in-class paper administration, but concerns about web-based administration include reliability due to changes in medium, student compliance rates, and test security, both question leakage…

  4. SMILE Maker : a web-based tool for problem solving

    NARCIS (Netherlands)

    Stoyanov, S.; Aroyo, L.M.; Kommers, Petrus A.M.; Ivanov, Ivan


    This paper focuses on the purposes, theoretical model, and functionality of the SMILE (Solution Mapping Intelligent Learning Environment) Maker--a World Wide Web-based problem-solving tool. From an instructional design point of view, an attempt to establish a balance between

  5. Old age and chronic disease: is the emergency medical system the appropriate provider for the elderly? (United States)

    Mochmann, Hans-Christian; Arntz, Hans-Richard; Dincklage, Falk V; Rauch, Ursula; Schultheiss, Heinz P; Bobbert, Peter


    The use of emergency medical services increases with the age of patients. Some care providers hold on to the prejudice that these alarms are unnecessary or of a lower importance. We assessed the relation of age and age-dependent emergency characteristics, taking into consideration the ratings of emergency physicians on whether or not emergency cases were considered truly in need of emergency physician attendance. Emergency physicians dispatched by the Berlin Fire Department evaluated for each case the necessity of emergency physician attendance. Case characteristics such as the day of the week and location of the emergency as well as patient characteristics such as age, sex, prior status, and care dependency were recorded. In addition, whether or not the physician accompanied the patient to the hospital was recorded as a parameter for emergency severity. Analysis was performed using multiple logistic regression modeling. During the 6-month prospective study period, 2702 cases were evaluated. Emergency medical services are used more frequently by older individuals, especially octogenarians. Emergency cases in older individuals were significantly more often rated as in need of emergency physician attendance; however, the rate of patients accompanied by the emergency physician to the hospital did not differ between the age groups. The age of patients, the primary diagnosis, the day and location of the emergency, and the presence of pre-existing dementia showed a significant impact on the necessity of physician-attended emergency missions. Despite common prejudices, emergency cases in elder patients are rated more often as in need of emergency physician attendance compared with those involving younger patients.

  6. Reminder: call 74444 also in case of a medical emergency

    CERN Multimedia


    What happened? A CERN colleague, suffering from heart trouble, went to the ‘infirmary' on the Prévessin site for medical aid. He was unaware that the ‘infirmary' was in fact no such thing, but the office of the French medical officer, and, on top of that, it was closed. He therefore took his own car and went to the CERN Fire Station on the Meyrin site (building 65). The firemen and the CERN infirmary took care of him and requested a helicopter transport to the Geneva cantonal hospital, where he received medical treatment.   What do we learn from this event?   You can call the CERN internal number 74444 also in case of serious and acute illness, not only in the event of an accident, pollution, fire, etc.   Professional aid (ambulance firemen and medical assistance, if needed) will be provided.   The CERN Fire station is located in building 65, on ‘Route Einstein', the first road on your right when you enter CERN entrance B on the Meyrin site. It is open permanently, 24 hours per day, 7 days per we...

  7. Smartphones in medicine: emerging practices in an academic medical center. (United States)

    Johnson, Angela C; El Hajj, Stephanie C; Perret, J Nelson; Caffery, Terrell S; Jones, Glenn N; Musso, Mandi W


    Advances in mobile phone technology now provide a myriad of resources to physicians' fingertips. However, the medical profession continues to struggle with potential for misuse of these devices. There is a need for better understanding of physicians' uses of smartphones in order to establish guidelines for appropriate and professional behavior. The purpose of the current study was to survey physicians' and medical students' practices concerning smartphone use in the healthcare setting. Physicians and medical students were asked to complete anonymous surveys regarding uses of smartphones within the past month in various healthcare settings. Overall, the participants reported distinctly different patterns in the uses they made of their phones in different settings (P<.001), with most individuals engaging in most behaviors while on break but few using their smartphones while with patients or during procedures. It appears that physicians and medical students make decisions about using their smartphones according to some combination of three considerations: degree of relevance to patient care, the appropriateness of the behavior in front of patients, and the issue of how disruptive that behavior may be.

  8. Knowledge and use of emergency contraception by medical doctors ...

    African Journals Online (AJOL)


    Dec 9, 2013 ... medical doctors on internship in a tertiary healthcare facility in Nigeria. IO Morhason‑Bello1 ... other things mechanisms of action and side effects of ECs. However, lack of .... and the internet (10.6%). Concerning the types of ...

  9. Medical Stability Operations: An Emerging Military Health Skillset (United States)


    Humanitarian Assistance/Disaster Relief is not new to the U.S. Military • The Mexican War (1846-1848) • US Occupation of Veracruz , Mexico under Wilson...with the Navy’s hospital ships to the Southern and Pacific Command regions via the USNS Comfort and Mercy • DoD Provides medical aid following natural

  10. The validation of the Utrecht work engagement scale for emergency medical technicians in Gauteng


    JLP Naudé; S. Rothmann


    The objectives of this study were to validate the Utrecht Work Engagement Scale (UWES) for emergency medical technicians in the Gauteng Province of South Africa and to determine its construct equivalence and bias for different language groups. A cross-sectional survey design was used with a convenient sample (N = 318) of emergency medical technicians in Gauteng. The UWES and a biographical questionnaire were administered. A two-factor model of work engagement, consisting of Vigour/Dedication ...

  11. Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre. (United States)

    Ek, Bosse; Svedlund, Marianne


    To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame

  12. Developing a third-year emergency medicine medical student curriculum: a syllabus of content. (United States)

    Tews, Matthew C; Wyte, Collette Marie Ditz; Coltman, Marion; Grekin, Peter A; Hiller, Kathy; Oyama, Leslie C; Pandit, Kiran; Manthey, David E


    Emergency medicine (EM) educators have published several curricular guides designed for medical student rotations and experiences. These guides primarily provided brief overviews of opportunities to incorporate EM into all 4 years of the medical student curriculum, with one specific to the fourth year. However, there are no published guidelines specific to third-year medical students rotating in EM. Given the differences between third-year and fourth-year students in terms of clinical experience, knowledge, and skills, the Clerkship Directors in Emergency Medicine (CDEM) established the Third-year EM Medical Student Curriculum Work Group to create a third-year curriculum. The work group began this process by developing consensus-based recommendations for the content of a third-year medical student EM rotation, which are presented in this syllabus. © 2011 by the Society for Academic Emergency Medicine.

  13. Working with interpreters: an interactive Web-based learning module. (United States)

    Kalet, Adina; Gany, Francesca; Senter, Lindsay


    Medical students are presented with unique challenges when they care for patients with limited English proficiency. Students must learn a complex set of skills needed to care for patients across cultural and language barriers and to understand the impact of their own attitudes and beliefs about caring for these patients. We developed and piloted a multimedia interactive Web-based module aimed at teaching students effective strategies for working with interpreters and diverse patient populations, and at raising their awareness of important legal, ethical, and cultural issues. First the learner completes a 37-multiple-choice-question (MCQ) pre-test that assesses attitudes, factual knowledge, and ability to analyze written clinical scenarios relevant to the module's content. Learners are then shown a series of professionally produced video vignettes, which reflect diverse patient populations, interpreters, and effectiveness of interpretation strategies (e.g., a Russian-speaking woman with chest pain whose daughter interprets, a medical student interpreting for a Chinese-speaking man using herbal medication, a Haitian woman told of an abnormal mammogram through a trained simultaneous interpreter). In each case, learners submit short answers to on-screen questions analyzing the effectiveness of the interpretation strategies demonstrated. Immediate feedback is given comparing student responses with those of experts. At any time during the module, the learners may view video commentary by legal, ethics, and cultural experts, or access a glossary and Web site links. Students conclude the module by again taking the MCQ test. A final screen compares their pre- and post-MCQ test responses and shows best answers, allowing them to assess their learning. The learners also complete a survey, providing personal cultural information and feedback on the module. All 160 first-year medical students completed the module and evaluated its effectiveness this year. On average, students

  14. Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School

    Directory of Open Access Journals (Sweden)

    Temesgen Beyene


    Conclusion: An Emergency Medicine rotation during the final year of medical school provides opportunities to learn about undifferentiated medical emergencies and it should be included for other medical schools in the country. Participants suggest that leadership aspects of Emergency Medicine need more emphasis as the curriculum is further developed in the future.

  15. Web-based Factors Affecting Online Purchasing Behaviour (United States)

    Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad


    The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.

  16. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole


    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  17. Impact of interactive web-based education with mobile and email-based support of general practitioners on treatment and referral patterns of patients with atopic dermatitis: randomized controlled trial. (United States)

    Schopf, Thomas; Flytkjaer, Vibeke


    The effects of various educational strategies have been examined in continuing medical education. Web-based learning has emerged as an alternative to ordinary classroom lessons. To investigate whether an interactive Web-based course including personal guidance via email or cellular phone texting may be used to improve practice behavior of general practitioners in the management of atopic dermatitis. General practitioners from all over Norway were eligible for this randomized controlled educational trial. During a period of 6 months, doctors in the intervention group were offered the opportunity to participate in a Web-based course on the management of atopic dermatitis. This was combined with guidance via email or multimedia messaging service (MMS) through mobile phones from a dermatologist. In the control group there was no education or guidance. Main outcome measures were the duration of topical steroid treatment prescribed to patients with atopic dermatitis (primary outcome), number of treatment modalities, and number of referred patients. We enrolled 46 physicians: 24 doctors were allocated to the intervention group and 22 doctors to the control group. They reported a total of 190 patient treatments. There were no statistically significant differences in the duration of topical steroid treatment or number of treatment modalities between the groups. The lack of effect on the primary outcome may be due to attrition as 54% (13/24) of the participants did not complete the course. 42% (10/24) of physicians sent at least one educational request via email or MMS. While 11% (8/73) of treatment reports in the intervention group were referred to a health care specialist (eg, dermatologist or pediatrician), 30% (21/71) of treatment reports in the control group did so. This difference in the number of referrals was significant (P = .03). A Web-based educational intervention aimed at general practitioners combined with personal support can reduce the number of atopic

  18. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    Directory of Open Access Journals (Sweden)

    Stoneking LR


    Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

  19. Predatory Publishing: An Emerging Threat to the Medical Literature. (United States)

    Harvey, H Benjamin; Weinstein, Debra F


    The quality of medical literature is increasingly threatened by irresponsible publishing, leading to rising retraction rates, irreproducible results, and a flood of inconsequential publications that distract readers from more meaningful scholarship. "Predatory publishers" offer rapid publication with loose peer review, exploiting a system in which faculty seek longer bibliographies to achieve academic promotion. In this Commentary, the authors highlight some of the evidence that this problem exists and suggest actions to address it. Recommendations for protecting the medical literature include preventing predatory journals from being indexed by the National Library of Medicine; encouraging academic promotions committees to ensure that they prioritize value over volume of publications and that faculty understand that priority; excluding publications from predatory journals on curricula vitae and requiring that retractions are included; developing sanctions for repeated retractions or duplicate publications; and convening an expert panel to better elucidate this problem and determine strategies to combat it.

  20. Debriefing of the medical team after emergencies on cruise ships. (United States)

    Dahl, Eilif


    Done to improve safety and patient outcome but not to lay blame, debriefings on cruise ships should preferably be conducted as standard practice in the medical facility immediately after all critical events aboard. The key questions to be asked are: What went well, what could have gone better and what must participants do to improve care? Post-debriefing the ship's doctor might have to deal with team members' mental stress resulting both from the event and from debriefing it. Required by most cruise companies, standardised advanced life support courses teach effective high-performance team dynamics. They provide the multinational medical staff with a clearer understanding of the rescue sequence, which again will reduce the risk of mistakes and simplify post-event debriefings. Their systematic approach to the chain of survival is also helpful for post-event debriefings if something went wrong.