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Weinstein ES, Cuthbertson JL, Herbert TL, Voicescu GT, Bortolin M, Magalini S, Gui D, Helou M, Lennquist Montan K, Montan C, Rafalowsky C, Ratto G, Damele S, Bazurro S, Laist I, Marzi F, Borrello A, Fransvea P, Fidanzio A, Benitez CY, Faccincani R, Ragazzoni L, Caviglia M. Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage. Eur J Trauma Emerg Surg 2023; 49:1647-1660. [PMID: 37060443 PMCID: PMC10449715 DOI: 10.1007/s00068-023-02266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/26/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements. METHODS The authors were divided into three work groups (WGs) MCI Triage, PH Life Support and Damage Control (PHLSDC), and PH Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping reviews. Relevant data were extracted from the included articles and indexed using pre-identified PH MCI response themes and subthemes. RESULTS The initial search yielded 925 total references to be considered for title and abstract review (MCI Triage 311, PHLSDC 329, PHP 285), then 483 articles for full reference review (MCI Triage 111, PHLSDC 216, PHP 156), and finally 152 articles for the database extraction process (MCI Triage 27, PHLSDC 37, PHP 88). Most frequent subthemes and novel concepts have been identified as a basis for the elaboration of draft statements for the T2 modified Delphi study. CONCLUSION The three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study.
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Affiliation(s)
- Eric S Weinstein
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy.
| | - Joseph L Cuthbertson
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Teri Lynn Herbert
- Research and Education Services, Medical University of South Carolina Library, Charleston, SC, USA
| | - George T Voicescu
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Michelangelo Bortolin
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Sabina Magalini
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniele Gui
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Mariana Helou
- School of Medicine, Department of Emergency Medicine, Lebanese American University, Beirut, Lebanon
| | - Kristina Lennquist Montan
- MRMID-International Association for Medical Response to Major Incidents and Disasters, and Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Carl Montan
- MRMID-International Association for Medical Response to Major Incidents and Disasters, and Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Chaim Rafalowsky
- Magen David Adom, National Emergency Medical, Disaster, Ambulance and Blood Bank Service, Ashkelon, Israel
| | - Giuseppe Ratto
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Stefano Damele
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Simone Bazurro
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Itamar Laist
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Federica Marzi
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Borrello
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Pietro Fransvea
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Andrea Fidanzio
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlos Yanez Benitez
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Roberto Faccincani
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Luca Ragazzoni
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Marta Caviglia
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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Everyday life information seeking in South Korea during the COVID-19 pandemic: daily topics of information needs in social Q&A. ONLINE INFORMATION REVIEW 2022. [DOI: 10.1108/oir-10-2021-0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study investigated information needs on COVID-19 by identifying topics discussed on social questions and answers (Q&A) about daily routines, problems, and health issues for survival. A layered model of contexts for everyday life information seeking (ELIS) was adapted for interpreting topics to better understand the contexts in which users could relate information needs.Design/methodology/approachQuestions and answers posted on Naver Knowledge-iN were collected and analyzed during the first nine months following the outbreak. Time distribution, topic modeling, and association rule mining were applied to examine the topics on COVID-19 and their temporal variation.FindingsNumerous topics related to the cognitive context (symptoms and masks) and situational contexts (international affairs, financial support, study, and work) were discovered. Topics related to social context were discussed moderately, but the number of questions on this topic increased with time. Strong associations were observed between terms related to symptoms, indicating their importance as a COVID-19 topic in health.Originality/valueThis study investigated topics of information needs using social Q&A data in which not only information inquiry but also information sharing coexist. The findings can help bridge the theory of ELIS to topic modeling in practice. The insights gained from this study can be used by information service providers for developing guidance and programs about how to survive during a pandemic.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-10-2021-0547.
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Henning E, Bakir MS, Haralambiev L, Kim S, Schulz-Drost S, Hinz P, Kohlmann T, Ekkernkamp A, Gümbel D. Digital versus analogue record systems for mass casualty incidents at sea-Results from an exploratory study. PLoS One 2020; 15:e0234156. [PMID: 32502206 PMCID: PMC7274416 DOI: 10.1371/journal.pone.0234156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/19/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Mis-triage may have serious consequences for patients in mass casualty incidents (MCI) at sea. The purpose of this study was to assess outcome, reliability and validity of an analogue and a digital recording system for triage of a MCI at sea. Methods The study based on a triage exercise conducted with a cross-over-design. Forty-eight volunteers were presented a fictional MCI with 50 cases. The volunteers were randomly assigned to start with the analogue (Group A, starting with the analogue followed by the digital system) or digital system (Group B, starting with the digital followed by the analogue system). Triage score distribution and agreement between the triage methods and a predefined standard were reported. Reliability was analysed using Cronbach’s Alpha and Cohen’s Kappa. Validity was measured through sensitivity, specificity and predictive value. Treatment, period and carry-over-effects were analysed using a linear mixed-effects model. Results The number of patients triaged (total: n = 3545) with the analogue system (n = 1914; 79.75%) was significantly higher (p = 0.001) than with the digital system (n = 1631; 67.96%). A trend towards a higher percentage of correct triages with the digital system was observed (p = 0.282). Ratio of under-triage was significantly smaller with the digital system (p = 0.001). Validity measured with Cronbach’s Alpha and Cohen’s Kappa was higher with the digital system. So was sensitivity (category; green: 80.67%, yellow: 73.24%, red: 83.54%; analogue: green: 93.28%, yellow: 82.36%, red: 94.04%) and specificity of the digital system (green: 78.07%, yellow: 63.75%, red: 66.25%; analogue: green: 85.50%, yellow: 79.88%, red: 91.50%). Comparing the predictive values and accuracy, the digital system showed higher scores than the analogue system. No significant patterns of carry-over-effects were observed. Conclusions Significant differences were found for the number of triages comparing the analogue and digital recording system. The digital system has a slightly higher reliability and validity than the analogue triage system.
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Affiliation(s)
- Esther Henning
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- * E-mail:
| | - Mustafa Sinan Bakir
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Lyubomir Haralambiev
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Simon Kim
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Peter Hinz
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kohlmann
- Institute for Community Medicine, Section Methods in Community Medicine, University Medicine Greifswald, Germany
| | - Axel Ekkernkamp
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Denis Gümbel
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
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Tasnim S, Hossain MM, Mazumder H. Impact of Rumors and Misinformation on COVID-19 in Social Media. J Prev Med Public Health 2020; 53:171-174. [PMID: 32498140 PMCID: PMC7280809 DOI: 10.3961/jpmph.20.094] [Citation(s) in RCA: 282] [Impact Index Per Article: 70.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 04/02/2020] [Indexed: 11/09/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has not only caused significant challenges for health systems all over the globe but also fueled the surge of numerous rumors, hoaxes, and misinformation, regarding the etiology, outcomes, prevention, and cure of the disease. Such spread of misinformation is masking healthy behaviors and promoting erroneous practices that increase the spread of the virus and ultimately result in poor physical and mental health outcomes among individuals. Myriad incidents of mishaps caused by these rumors have been reported globally. To address this issue, the frontline healthcare providers should be equipped with the most recent research findings and accurate information. The mass media, healthcare organization, community-based organizations, and other important stakeholders should build strategic partnerships and launch common platforms for disseminating authentic public health messages. Also, advanced technologies like natural language processing or data mining approaches should be applied in the detection and removal of online content with no scientific basis from all social media platforms. Furthermore, these practices should be controlled with regulatory and law enforcement measures alongside ensuring telemedicine-based services providing accurate information on COVID-19.
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Affiliation(s)
- Samia Tasnim
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
| | - Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
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Allergy Symptom Response Following Conversation from Injection Immunotherapy to Sublingual Immunotherapy. Prehosp Disaster Med 2017. [DOI: 10.1017/s1049023x00024304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tavakoli N, Yarmohammadian MH, Safdari R, Keyvanara M. Patient tracking in earthquake emergency response in Iran: A qualitative study. World J Emerg Med 2017; 8:91-98. [PMID: 28458751 DOI: 10.5847/wjem.j.1920-8642.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran. METHODS A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers. Participants were identified using a snow ball sampling method. Interviews were audiotaped, transcribed, coded, and entered into MAXQDA (version 10) for coding and content analysis. RESULTS Three main themes and seven categories including content (recoding data), function (identification of victims, identification of the deceased, informing the patients' relatives, patients' evacuation and transfer, and statistical reporting), technology (the state of using technology) were identified that showed the patient tracking status in past earthquakes in Iran. CONCLUSION Participants believed that to identify and register the data related to patients or the dead, no consistent action plan was available. So developing a consistent patient tracking system could overcome this issue and improve patient safety.
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Affiliation(s)
- Nahid Tavakoli
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad H Yarmohammadian
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Safdari
- Health Information Management, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Keyvanara
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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ROSS COLLEEN, BAŞDERE MEHMET, CHAN JENNIFERL, MEHROTRA SANJAY, SMILOWITZ K, CHIAMPAS GEORGE. Data Value in Patient Tracking Systems at Racing Events. Med Sci Sports Exerc 2015; 47:2014-23. [DOI: 10.1249/mss.0000000000000637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Claudio D, Velázquez MA, Bravo-Llerena W, Okudan GE, Freivalds A. Perceived Usefulness and Ease of Use of Wearable Sensor-Based Systems in Emergency Departments. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/21577323.2015.1040559] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Culley JM, Svendsen E. A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures. Am J Disaster Med 2014; 9:137-50. [PMID: 25068943 PMCID: PMC4187211 DOI: 10.5055/ajdm.2014.0150] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Mass casualty incidents (MCIs) include natural (eg, earthquake) or human (eg, terrorism or technical) events. They produce an imbalance between medical needs and resources necessitating the use of triage strategies. Triage of casualties must be performed accurately and efficiently if providers are to do the greatest good for the greatest number. There is limited research on the validation of triage system efficacy in determining the priority of care for victims of MCI, particularly those involving chemicals. OBJECTIVE To review the literature on the validation of current triage systems to assign on-site treatment status codes to victims of mass casualties, particularly those involving chemicals, using actual patient outcomes. METHODS The focus of this article is a systematic review of the literature to describe the influences of MCIs, particularly those involving chemicals, on current triage systems related to the on-site assignment of treatment status codes to a victim and the validation of the assigned code using actual patient outcomes. RESULTS There is extensive literature published on triage systems used for MCI but only four articles used actual outcome data to validate mass casualty triage outcomes including three for chemical events. Currently, the amount and type of data collected are not consistent or standardized and definitions are not universal. CONCLUSIONS Current literature does not provide needed evidence on the validity of triage systems for MCI in particular those involving chemicals. Well designed studies are needed to validate the reliability, sensitivity, and specificity of triage systems used for MCI including those involving chemicals.
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Affiliation(s)
- Joan M Culley
- Assistant Professor, College of Nursing, University of South Carolina Columbia, Columbia, South Carolina
| | - Erik Svendsen
- Associate Professor, Department of Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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Abstract
Mobile health care technology (mHealth) has the potential to improve communication and clinical information management in disasters. This study reviews the literature on health care and computing published in the past five years to determine the types and efficacy of mobile applications available to disaster medicine, along with lessons learned. Five types of applications are identified: (1) disaster scene management; (2) remote monitoring of casualties; (3) medical image transmission (teleradiology); (4) decision support applications; and (5) field hospital information technology (IT) systems. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Deployments of teleradiology and field hospital IT systems to disaster zones suggest that mHealth can improve resource allocation and patient care. The key problems include suitability of equipment for use in disaster zones and providing sufficient training to ensure staff familiarity with complex equipment. Future research should focus on providing unbiased observations of the use of mHealth in disaster medicine.
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Lenert LA, Kirsh D, Griswold WG, Buono C, Lyon J, Rao R, Chan TC. Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J Am Med Inform Assoc 2011; 18:842-52. [PMID: 21709162 DOI: 10.1136/amiajnl-2011-000229] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD). MATERIALS AND METHODS WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds. RESULTS WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53-1:05:32 vs 18:55-57:22). CONCLUSION Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.
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Affiliation(s)
- L A Lenert
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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Zhao J, Zheng B, Zhang X, Wang J, Zhou Y, Chen S, Zhang M, Zhou L, Chen X, Liu T. The design and implementation of a rescue terminal with vital signs telemonitoring based on Beidou 1 navigation satellite system. Telemed J E Health 2011; 17:76-9. [PMID: 21250829 DOI: 10.1089/tmj.2010.0107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article presents the design and applications of a rescue terminal with positioning, vital signs sensing, and communicating function for special environment. The terminal provides three-dimensional positioning functionality via China's Beidou 1 Navigation Satellite (BD1) System and can collect users' vital signs with a set of wireless sensors. A controller of the terminal is in charge of processing data collected from the wireless sensors and communicating with the monitoring platform. With features such as small sizing, low power consumption, and accurate positioning, this terminal is very helpful in special circumstances such as disaster relief, dangerous outdoor sports and adventure monitoring, and antiterrorism activities.
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Affiliation(s)
- Junping Zhao
- The Institute of Medical Informatics (Key Laboratory of Digital Medicine), Chinese PLA General Hospital , Beijing, China.
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Abstract
OBJECTIVE: The goal of this paper is to identify strategies for connectivity that will optimize point-of-care testing (POCT) organized as small-world networks in disaster settings. METHODS: We evaluated connectivity failures during the 2010 Haiti Earthquake, applied small-world network concepts, and reviewed literature for point-of-care (POC) connectivity systems. RESULTS: Medical teams responding to the Haiti Earthquake faced connectivity failures that affected patient outcomes. Deploying robust wireless connectivity systems can enhance the efficiency of the disaster response by improving health care delivery, medical documentation, logistics, response coordination, communication, and telemedicine. Virtual POC connectivity education and training programs can enhance readiness of disaster responders. CONCLUSIONS: The admirable humanitarian efforts of more than 4000 organizations substantially impacted the lives of earthquake victims in Haiti. However, the lack of connectivity and small-world network strategies, combined with communication failures, during early stages of the relief effort must be addressed for future disaster preparedness.
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Recurrent medical response problems during five recent disasters in the Netherlands. Prehosp Disaster Med 2010; 25:127-36. [PMID: 20467991 DOI: 10.1017/s1049023x00007858] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this qualitative, retrospective review is to identify and analyze the occurrence of recurrent problems in 20 processes that cover all relevant aspects of disaster health during the response phase. Consequently, an attempt is made to determine if there are generic themes of coherences in these problems. METHODS Eight after-action reports of five consecutive disasters in the Netherlands, between 1996 and 2005, were integrally analyzed in a structured manner. The analysis was confined to processes from the start of the event up to and including the initial stages of hospital admission. RESULTS Problems during all five disasters arose with eight processes: (1) submission of information to the ambulance dispatch center (ADC); (2) provision of information by the ADC to disaster response personnel; (3) scaling-up of prehospital response; (4) communication; (5) logistics; (6) registration; (7) multidisciplinary cooperation; and (8) preparation. Three generic themes of coherence were identified: (1) processes in which exchange of information among medical personal plays a major role are more likely to be affected by problems than processes in which this is less relevant; (2) processes in which disaster circumstances differ from day-to-day health care, or do not figure in day-to-day health care, are more likely to give rise to problems than processes that remain essentially similar; and (3) the existence of a protocol or disaster plan governing a process does not prevent problems. CONCLUSIONS The method used enables a systematic analysis of the problems in health-related processes following five consecutive disasters. The analysis confirms that the majority of problems are repeated. The identified themes of coherences are in agreement with case reports and expert opinions. They are now supported with a higher level of evidence.
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Bethesda hospitals' emergency preparedness partnership: a model for transinstitutional collaboration of emergency responses. Disaster Med Public Health Prep 2010; 3:168-73. [PMID: 19834325 DOI: 10.1097/dmp.0b013e3181aa2719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The events of September 11, 2001 identified a need for health care institutions to develop flexible, creative, and adaptive response mechanisms in the event of a local, regional, or national disaster. The 3 major health care institutions in Bethesda, MD-the National Naval Medical Center (NNMC), the Suburban Hospital Healthcare System (SHHS), and the National Institutes of Health Clinical Center (NIHCC)-have created a preparedness partnership that outstrips what any of the institutions could provide independently by pooling complementary resources. The creation of the partnership initially was driven by geographic proximity and by remarkably complementary resources. This article describes the creation of the partnership, the drivers and obstacles to creation, and the functioning and initial accomplishments of the partnership. The article argues that similar proximity and resource relationships exist among institutions at academic centers throughout the United States and suggests that this partnership may serve as a template for other similarly situated institutions.
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Burke RV, Ryutov T, Neches R, Upperman JS. Health informatics for pediatric disaster preparedness planning. Appl Clin Inform 2010; 1:256-64. [PMID: 23616840 DOI: 10.4338/aci-2009-12-r-0019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 07/06/2010] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE 1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. METHODS A literature search was conducted using MEDLINE, CINHL and the Cochrane Library using the key words "children" AND "disaster preparedness and disaster" AND "informatics". RESULTS A total of 314 papers were initially produced by the search and eight that met the selection criteria were included in the review. Four themes emerged: tools for disaster preparedness, education, reunification and planning and response. CONCLUSION The literature pertaining to informatics and pediatric disaster preparedness is sparse and many gaps still persist. Current disaster preparedness tools focus on the general population and do not specifically address children. The most progress has been achieved in family reunification; however, the recommendations delineated are yet to be completed.
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Affiliation(s)
- R V Burke
- Department of Pediatric Surgery , Childrens Hospital Los Angeles, Los Angeles, CA 90027
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Koop C, Mosher R, Kun L, Geiling J, Grigg E, Long S, Macedonia C, Merrell R, Satava R, Rosen J. Future delivery of health care: Cybercare. ACTA ACUST UNITED AC 2008; 27:29-38. [DOI: 10.1109/memb.2008.929888] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Orwat C, Graefe A, Faulwasser T. Towards pervasive computing in health care - a literature review. BMC Med Inform Decis Mak 2008; 8:26. [PMID: 18565221 PMCID: PMC2467411 DOI: 10.1186/1472-6947-8-26] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 06/19/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The evolving concepts of pervasive computing, ubiquitous computing and ambient intelligence are increasingly influencing health care and medicine. Summarizing published research, this literature review provides an overview of recent developments and implementations of pervasive computing systems in health care. It also highlights some of the experiences reported in deployment processes. METHODS There is no clear definition of pervasive computing in the current literature. Thus specific inclusion criteria for selecting articles about relevant systems were developed. Searches were conducted in four scientific databases alongside manual journal searches for the period of 2002 to 2006. Articles included present prototypes, case studies and pilot studies, clinical trials and systems that are already in routine use. RESULTS The searches identified 69 articles describing 67 different systems. In a quantitative analysis, these systems were categorized into project status, health care settings, user groups, improvement aims, and systems features (i.e., component types, data gathering, data transmission, systems functions). The focus is on the types of systems implemented, their frequency of occurrence and their characteristics. Qualitative analyses were performed of deployment issues, such as organizational and personnel issues, privacy and security issues, and financial issues. This paper provides a comprehensive access to the literature of the emerging field by addressing specific topics of application settings, systems features, and deployment experiences. CONCLUSION Both an overview and an analysis of the literature on a broad and heterogeneous range of systems are provided. Most systems are described in their prototype stages. Deployment issues, such as implications on organization or personnel, privacy concerns, or financial issues are mentioned rarely, though their solution is regarded as decisive in transferring promising systems to a stage of regular operation. There is a need for further research on the deployment of pervasive computing systems, including clinical studies, economic and social analyses, user studies, etc.
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Affiliation(s)
- Carsten Orwat
- Institut für Technikfolgenabschätzung und Systemanalyse (Institute for Technology Assessment and Systems Analysis), Forschungszentrum Karlsruhe in der Helmholtz-Gemeinschaft (Karlsruhe Research Centre, Member of the Helmholtz Association); Address: P.O. Box 3640, D-76021 Karlsruhe, Germany
| | - Andreas Graefe
- Institut für Technikfolgenabschätzung und Systemanalyse (Institute for Technology Assessment and Systems Analysis), Forschungszentrum Karlsruhe in der Helmholtz-Gemeinschaft (Karlsruhe Research Centre, Member of the Helmholtz Association); Address: P.O. Box 3640, D-76021 Karlsruhe, Germany
| | - Timm Faulwasser
- Institut für Automatisierungstechnik (Institute for Automatic Control), Otto-von-Guericke Universität Magdeburg (Otto-von-Guericke University Magdeburg); Address: P.O. Box 4120, D-39016 Magdeburg, Germany
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