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An editorial emphasizes the urgent need to treat the climate crisis and biodiversity loss as a single, intertwined global health emergency. It argues that addressing climate change and nature loss separately is a critical error, given their profound and interconnected impacts on health and ecosystems. It call for a unified approach in global policies and health strategies to tackle both crises simultaneously.

BACKGROUND: In-flight medical emergency (IFE) impose considerable challenges on healthcare workers (HCWs) because of limited resources, constrained environment, and medico-legal issues. This study assessed HCWs knowledge, willingness, and confidence in addressing in-flight medical emergencies. MATERIALS AND METHODS: A cross-sectional study was conducted between June and August 2023 among nurses and physicians working in primary healthcare centers and governmental hospitals in Bahrain. Subjects were selected using stratified random sampling; a self-administered online questionnaire of high reliability (Cronbach alpha = 0.914) was used to collect the data. Logistic regression analysis were performed to determine association of knowledge, willingness, and confidence in dealing with in-flight emergencies with various characteristics of HCWs. RESULTS: The study included 805 HCWs with mean age of 35.5 years (SD=9.2). The findings indicated deficiency in training, with <10% of participants trained on IFE. A considerable proportion of participants exhibited low levels of knowledge (88.3%) and confidence (75.9%) with IFE. Nonetheless, more than half of the participants expressed the willingness to assist in IFE (59.1%). Non-Bahraini healthcare professionals (odds ratio [OR] = 2.901, P < 0.001) had higher knowledge of IFE. Nurses (OR = 1.642, P = 0.047) and participants with longer work experience had higher willingness to assist in IFE. In addition, professionals who were non-Bahraini (OR = 3.249, P < 0.001), working in secondary care (OR = 1.619, 95% confidence interval P = 0.021), had had training on IFE (OR = 2.247, P = 0.004), and had encountered IFE before (OR = 1.974, P = 0.006) had greater self-confidence levels. CONCLUSION: Considering the low levels of knowledge and confidence healthcare professionals in Bahrain had with regard to IFE, targeted training initiatives and educational programs are necessary to improve HCW's confidence and preparedness to deal with such emergencies. [ABSTRACT FROM AUTHOR]

Purpose: Three deaths at Cawston Park Hospital shed a bright light on Norfolk's services for people with learning disabilities and autism, including those operated by the company that ran the hospital. The purpose of this paper is to review Norfolk County Council's current position from the unique aspect of a senior manager wihtin the system. Design/methodology/approach: This paper reviews the unique perspective of a social worker from within the system. Findings: The process of making change included engagement and action concerning such thorny challenges as the pressures on community services; the undervaluing of care-giving as a career; and the continuing admissions to specialist mental health services at a time when hospital discharges are being expedited. Originality/value: Norfolk's investment in improving its services involves the adoption of a human rights approach; a capital programme to facilitate new developments; nurturing care-giving as a career; and bringing a clearer evidence base to this work programme. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is a global issue, and implementation of antimicrobial stewardship programs in outpatient settings is crucial. Japan has also focused on outpatient oral antimicrobial stewardship programs and difficulties in standardizing prescriptions have led to overprescription in primary emergency medical centers. There is a lack of research investigating the antibiotic prescription status of pediatric primary emergency medical centers and the benchmark prescription rates in pediatric outpatient settings. We conducted a multi-center, cross-sectional study of seven pediatric primary emergency medical centers located in five prefectures of Japan. We retrospectively extracted data from health claims or directly obtained them from charts at each institution and evaluated trends in the antibiotic prescription rate based on the AWaRe classification between April 2016 and December 2019. Our study included 383,525 encounters, with the most common infectious disease diagnosis being acute upper respiratory tract infection in 93,449 cases (24.4 %). The antibiotic prescription rate during the study period was 7.4 %, representing a decrease of 46 %, from 10.2 % in 2016 to 5.5 % in 2019. The percentage of prescriptions in the Access group increased at all institutions; however, it exceeded 60 % in only three facilities in 2019. The percentage of third-generation cephalosporins varied among facilities, ranging from 1.7 % to 59.4 %, as of 2019. For pediatric primary emergency medical centers where antimicrobial stewardship programs are implemented, we suggest 5 % as a reasonable benchmark level for the antibiotic prescription rate. Prescribing the antibiotics in the Access groups less frequently remains a domestic challenge in Japan. [ABSTRACT FROM AUTHOR]

Blood gas analysis, including parameters like lactate and base excess (BE), is crucial in emergency medicine but less commonly utilized prehospital. This study aims to elucidate the relationship between lactate and BE in various emergencies in a prehospital setting and their prognostic implications. We conducted a retrospective analysis of prehospital emergency patients in Graz, Austria, from October 2015 to November 2020. Our primary aim was to assess the association between BE and lactate. This was assessed using Spearman's rank correlation and fitting a multiple linear regression model with lactate as the outcome, BE as the primary covariate of interest and age, sex, and medical emergency type as confounders. In our analysis population (n=312), lactate and BE levels were inversely correlated (Spearman's ρ, −0.75; p<0.001). From the adjusted multiple linear regression model (n=302), we estimated that a 1 mEq/L increase in BE levels was associated with an average change of −0.35 (95 % CI: −0.39, −0.30; p<0.001) mmol/L in lactate levels. Lactate levels were moderately useful for predicting mortality with notable variations across different emergency types. Our study highlights a significant inverse association between lactate levels and BE in the prehospital setting, underscoring their importance in early assessment and prognosis in emergency care. Additionally, the findings from our secondary aims emphasize the value of lactate in diagnosing acid–base disorders and predicting patient outcomes. Recognizing the nuances in lactate physiology is essential for effective prehospital care in various emergency scenarios. [ABSTRACT FROM AUTHOR]

Purpose The benefits of pharmacists' involvement in medical emergencies are well established, but optimal methods of training pharmacists for emergency response are unknown. The primary objective of this report is to describe the design and evaluation of a pharmacy resident medical emergency response training (PR-MERT) program for preparing trainees to respond to hospital medical emergencies, including cardiac arrest and rapid sequence intubation (RSI). Summary The PR-MERT program was a year-long longitudinal experience designed to prepare postgraduate year 1 pharmacy residents for medical emergency response. During the first month, the residents completed an orientation session that encompassed several lectures, certification by the American Heart Association in basic life support and advanced cardiovascular life support, standardized simulation scenarios, and mock medical emergencies. The trainees continued to utilize these skills and clinical knowledge through a longitudinal didactic lecture series, resident case conferences, and practice-based application by responding to real-life medical emergencies. Residents were assessed and coached throughout the program by clinical pharmacy preceptors and a "code coach" with extensive medical emergency response experience. After the year-long training, residents completed an anonymous survey assessing self-confidence and the structure of the program. The results showed improved confidence in medication selection and dosing, as well as anticipating the needs of the team and speaking up in cardiac arrest and RSI situations. Residents were satisfied with the training offered and structure of the program. Conclusion The development of a PR-MERT program at an academic medical center was successful in achieving longitudinal learning objectives and improving residents' confidence in responding to medical emergencies. The implementation of a similar medical emergency training curriculum in inpatient pharmacy residency programs may be beneficial. [ABSTRACT FROM AUTHOR]

Testicular torsion, as one of the medical emergencies, needs prompt diagnostic and treatment measures. This cross-sectional study aimed to assess the clinical and paraclinical findings and the treatment measures performed in the community of hospitalized patients who underwent surgery in Shahid Beheshti Hospital of Babol from 2012 to 2021 with the initial diagnosis of testicular torsion. The research sample was selected via the convenience sampling method. The necessary information was collected from patients' medical records in the form of a checklist. Thereafter, the data were analyzed in SPSS software (version 22) using descriptive and graphical indicators, as well as Chi-square and Fisher's exact tests at a significance level of 0.05. The findings demonstrated that 197 patients with a mean age of 18.91 years were included in the study. The majority of them (n=121; 61.42%) had torsion on the right side. More than 98% of patients experienced pain, while most of them did not have fever (n=160; 81.22%) and vomiting (n=153; 77.66%). In 148 (75.13%) patients, the final diagnosis was testicular torsion, and in 101 (68.24%) patients, the testicle was preserved. Moreover, the result of the surgery had a significant relationship with the degree of rotation and the duration of the onset of symptoms until hospitalization and from hospitalization to surgery (P>0.001, 0.001 and 0.026, respectively). It can be concluded that an understanding of clinical characteristics of testicular torsion cases and as a result, informing the treatment staff involved in the treatment process, reduce the duration of delay in surgery and leads to more appropriate clinical treatment and improved results in testicular torsion patients. [ABSTRACT FROM AUTHOR]

The article focuses on the Patient Preference Predictor (PPP) and its role in advancing personalized medicine through innovations in genomics and biotechnology. Topics include the development of predictive models using machine learning (ML) and AI to extract patient values, the integration of population-based statistics with individual preferences to enhance healthcare decision-making, and the ethical and technical challenges associated with deploying such systems in clinical settings.

Background: There are limited practical advanced life support algorithms to aid teams in the management of cardiac arrest in patients on extracorporeal membrane oxygenation (ECMO). Methods: In our specialist tertiary referral centre we developed, by iteration, a novel resuscitation algorithm for ECMO emergencies which we validated through simulation and assessment of our multi-disciplinary team. A Mechanical Life Support course was established to provide theoretical and practical education combined with simulation to consolidate knowledge and confidence in algorithm use. We assessed these measures using confidence scoring, a key performance indicator (the time taken to resolve gas line disconnection) and a multiple choice question (MCQ) examination. Results: Following this intervention the median confidence scores increased from 2 (Interquartile range IQR 2, 3) to 4 (IQR 4, 4) out of maximum 5 (n = 53, p < 0.0001). Theoretical knowledge assessed by median MCQ score increased from 8 (6, 9) to 9 (7, 10) out of maximum 11 (n = 53, p0.0001). The use of the ECMO algorithm reduced the time taken by teams in a simulated emergency to identify a gas line disconnection and resolve the problem from median 128 s (65, 180) to 44 s (31, 59) (n = 36, p 0.001) and by a mean of 81.5 s (CI 34, 116, p = 0.001). Conclusions: We present an evidence based practical ECMO resuscitation algorithm that provides guidance to clinical teams responding to cardiac arrest in ECMO patients covering both patient and ECMO troubleshooting. [ABSTRACT FROM AUTHOR]

To mitigate losses from public health emergencies, promptly choosing an emergency medical supply distribution center is essential. The success of rescues hinges on the center's location. Location decision for such centers is fraught with uncertainty and risk, complicating the task for decision makers (DMs). Often, DMs operate under bounded rationality in urgent situations. In response, this paper introduces a novel fuzzy multicriteria decision-making approach, integrating interval-valued intuitionistic fuzzy numbers, interval intuitionistic trapezoidal fuzzy numbers, not-in-my-backyard (NIMBY) effect, and cumulative prospect theory, to address the uncertainty and risk in decision-making. The method begins by introducing the NIMBY effect to construct the evaluation criteria system of emergency medical supply distribution centers. Next, the alternative under the evaluation criteria is evaluated by fuzzy linguistic terms and interval intuitionistic trapezoidal fuzzy numbers. The interval-valued intuitionistic fuzzy numbers are used to determine the weight of each DM by calculating the relative scores of advantage and disadvantage. The criteria weight is determined via a combination of fuzzy network analysis and the entropy weight method. Cumulative prospect theory is then employed to rank site selections, factoring in DM risk preferences. The approach is tested on an emergency medical supply distribution center location for sensitivity and comparative analysis, proving its efficacy and stability. This research presents an innovative fuzzy model for evaluating emergency medical supply distribution center site selection in uncertain conditions, suggesting the need to incorporate multiple dimensions such as realistic criteria systems, uncertain decision information, and variable environments in such decision-making processes. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed unprecedented demands on hospitals around the globe, making timely crisis response critical for organizational success. One mechanism that has played an effective role in health care service management during large-scale crises is the Hospital Incident Command System. Purpose: The aim of this article was to understand the role of HICS in the management of a large academic medical center and its impact on relationships and communication among providers in the delivery of services during a crisis. Methodology: This mixed methods study was based on meeting observations, document reviews, semistructured interviews, and two measures of team performance within an academic medical center in the Northeast during the COVID-19 pandemic. Descriptive and bivariate analyses were applied, and qualitative data were coded and analyzed for themes. Results: HICS provided a systematic information-sharing and decision-making process that increased communication and coordination among team members. Analyses indicate a correlation between dimensions of relational coordination and organizational mindfulness. Qualitative data revealed the importance of shared meetings and huddles and the evolution of HICS across multiple waves of the crisis. Conclusion: HICS facilitated organizational improvements during the crisis response and generated opportunities to maintain specific coordination practices beyond the crisis. The prolonged implementation of HICS during the COVID-19 pandemic created challenges, including the disruption of the routine leadership structure. Practical Implications: Applying relational coordination and organizational mindfulness frameworks may allow hospitals to leverage communications and relationships within a high-stakes environment to improve service delivery. [ABSTRACT FROM AUTHOR]

Introduction. In Poland, interventions of emergency medical teams in patients with malignant tumors represent a small percentage of all interventions. Patients with malignant tumors constitute a diverse group in which the patient may manifest a wide spectrum of symptoms and complaints affecting different systems and organs. The aim of this study was to retrospectively analyze emergency medical team interventions in patients with malignant tumors. Material and methods. 1174 emergency medical services forms from emergency medical team interventions in patients with malignant tumors from April 2019 to December 2022 in the Kujawsko-Pomorskie voivodship in Poland were analyzed. Results. In the study group 52% were male. The mean age of the subjects was 66 years (SD = 12.31). The most common symptoms in patients were pathological respiratory murmurs (11.7%), psychomotor disorders (11.3%), hypoxemia (10.3%), dyspnea (9.5%) and pain (5.8%). 40.5% of patients were transported to hospital. A total of 7496 emergency medical procedures were performed, most of them involving physical examination and assessment of the patient's condition. The pharmacotherapy administered most commonly involved analgesics (30.9%), electrolytes (24%) and glucocorticosteroids (20.1%). Seventy-four patients (6.3%) died during EMT intervention. Conclusions. Emergency medical teams most often provide assistance to patients with malignant tumors of the respiratory and thoracic organs and organs of the digestive system. The majority of oncology patients do not require hospital treatment, but only outpatient care. Therefore, there is a need to regulate and optimize the actions taken by emergency medical teams when intervening in patients with malignant tumors. [ABSTRACT FROM AUTHOR]

Purpose: Several countries, such as South Africa and India, believe that intellectual property rights (IPRs), including patents, impede the efficient increase in vaccine production to inoculate the global population as they scramble to recover from the COVID-19 pandemic. Their proposal at the World Trade Organization (WTO) to waive these pharmaceutical patents has been met with resistance from a few developed countries, who believe that the abrogation of IPRs is unnecessary, even during a pandemic. The purpose of this paper is to discuss the impact of a potential waiver of medical patents at the WTO versus the status quo of IPR laws in the global economy. Design/methodology/approach: This study examines key arguments from economic and moral standpoints regarding the provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement and other related international agreements and their validity based on the premise of the internalisation of positive externalities posed by vaccines. Findings: The effectiveness of the TRIPS agreement in securing medical access is weak on account of the ability of profit-making multinationals to secure IP rights and on account of the Trans-Pacific Partnership, a multilateral agreement that supports patent evergreening and a period of protection on test data which challenges the access to medicines and the fundamental human right to health. Originality/value: This study examines international IPRs through the lens of human rights and proposes a new system that balances the two. [ABSTRACT FROM AUTHOR]

Copyright of Acta Neurológica Colombiana is the property of Colombian Association of Neurology / Asociacion Colombiana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Safety & Fire Technology (2657-8808) is the property of Centrum Naukowo-Badawcze Ochrony Przeciwpozarowej and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Simulation education for anaesthesia trainees is essential to build clinical skills and virtual reality can provide a reproducible, high‐fidelity intra‐operative training environment. Compared to in‐situ manikin‐based simulation, this modality has yet to be thoroughly evaluated. Twenty‐six second post‐graduate year anaesthesiology residents were randomly divided into two groups and participated in both virtual reality and manikin crisis scenarios at sessions six months apart. The exposure order was group A virtual reality followed by manikin and group B manikin followed by virtual reality. Clinical assessments were performed using a standardised checklist. Knowledge assessments were conducted. National Aeronautics and Space Administration Task Load Index and System Usability Scale scores were collected immediately after participation. Clinical scores between groups A and B were not significantly different. Group A had improved post‐simulation knowledge scores after both sessions. Task load index scores were lower in mental demand for virtual reality. System usability scores showed less ease of use and more need for support in virtual reality. [ABSTRACT FROM AUTHOR]

Audience: This small-group workshop is designed for pre-clinical medical students. The workshop can also be offered to other medical students looking to review first aid in the community setting. Introduction: First aid training in medical students varies based on each student's previous experience. Because of this, medical students in their pre-clinical years have expressed a desire for further training in first aid.1 While most bystanders in an emergency situation do not have a medical background, medical students have received additional training that can provide the skillset to process and respond to emergency situations in a different capacity. Most medical schools have not adopted a universal curriculum in teaching medical students first aid.2 Incorporating first aid into a medical school curriculum can enhance medical students' confidence in emergent situations and lead to better outcomes for patients requiring immediate on-site care. Educational Objectives: The goal of this workshop was to improve the confidence of medical students in handling emergencies in the community with the use of first aid while also giving them a standard approach to emergencies using an airway, breathing, and circulation approach. The curriculum was evaluated through student-perceived self-efficacy and confidence in handling the provided scenarios, performance on relevant multiple choice questions, and general appeal of the first aid sessions. By the end of this workshop, students will be able to define the goals of "first aid" and first responder actions, describe clinical signs and symptoms suggestive of an airway, breathing, or circulation emergency in the setting of selected medical emergencies, and demonstrate immediate care steps in the setting of selected medical emergencies, specifically the Heimlich maneuver on adults and infants, direct pressure, wound packing, tourniquet application for external bleeding, epinephrine auto-injector administration, and the recovery position for obtunded or unconscious patients. Educational Methods: Small group activities were performed with a focus on case-based scenarios combined with hands-on instruction. The four scenarios were choking, seizure, anaphylaxis, and bleeding which were taught by an educator who was either faculty, an emergency medicine resident, or an upper-level medical student. Facilitators were provided an educational handout specific to their station to guide them through the teaching session. A PowerPoint presentation was also provided complete with supporting images and videos to share with the students each session. Research Methods: Students were asked to complete a pre-test and post-test survey to assess knowledge outcome, self-efficacy in first aid, and overall appeal of the workshop. The multiple-choice knowledge outcome data was scored for percent correct on each question as well as overall performance on questions grouped by content. Students were also asked to provide feedback and comments on their overall experience in the workshop. Results: Overall, medical students reported increased knowledge and confidence in responding to various first-aid situations. There was overall improvement in pre-test and post-test evaluations. The appeal of the event as a whole and its usefulness was overwhelmingly viewed as positive. Some participants noted they wanted similar workshops with more first-aid topics. Participants also noted they felt better prepared to respond to the various emergencies included in the workshop. Discussion: A workshop directed at teaching first aid to medical students increased their confidence and knowledge in responding to various emergencies and can successfully be accomplished through a focused large group didactic session and multiple clinically relevant small group teaching sessions. [ABSTRACT FROM AUTHOR]

Background: Debate surrounding the organisation and sustainability of primary care in England highlights the desirability of a more integrated approach to patient care across all settings. One such approach is ‘vertical integration’, where a provider of specialist care, such as a hospital, also runs general practices. Aim: To quantify the impact of vertical integration on hospital use in England. Design & setting: Analysis of activity data for NHS hospitals in England between April 2013 and February 2020. Method: Analysis of NHS England data on hospital activity, which looked at the following seven outcome measures: accident and emergency (A&E) department attendances; outpatient attendances; total inpatient admissions; inpatient admissions for ambulatory care sensitive conditions; emergency admissions; emergency readmissions; and length of stay. Rates of hospital use by patients of vertically integrated practices and controls were compared, before and after the former were vertically integrated. Results: In the 2 years after a GP practice changes, for the population registered at that practice, compared with controls, vertical integration is associated with modest reductions in rates of A&E attendances (2% reduction [incidence rate ratio {IRR} 0.98, 95% confidence interval {CI} = 0.96 to 0.99, P<0.0001]), outpatient attendances (1% reduction [IRR 0.99, 95% CI = 0.99 to 1.00, P = 0.0061]), emergency inpatient admissions (3% reduction [IRR 0.97, 95% CI = 0.95 to 0.99, P = 0.0062]), and emergency readmissions within 30 days (5% reduction [IRR 0.95, 95% CI = 0.91 to 1.00, P = 0.039]), with no impact on length of stay, overall inpatient admissions, or inpatient admissions for ambulatory care sensitive conditions. Conclusion: Vertical integration is associated with modest reductions in use of some hospital services and no change in others. [ABSTRACT FROM AUTHOR]

Copyright of Current Research in Dental Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There is a growing body of literature that suggests increased rates of morbidity and mortality for pediatric conditions admitted on a weekend compared with weekdays. Whether this association is seen in Nigerian children presenting with neurologic emergencies is not certain. Understanding the effect of weekend admission on the outcome of pediatric neurologic emergencies is important to allocate personnel and resources more efficiently. This study was conducted to determine whether weekend and out-of-hour duty affect the outcome of neurological emergencies in children. Subjects and Methods: This study used a cross-sectional analytic design over an 18-month period. Children aged 1 month–18 years presenting with neurologic emergencies were prospectively recruited over an 18-month period. The association between the dependent variable and independent variables was tested using the Chi-squared test and odds ratio. The level of statistical significance was accepted as P < 0.05. Results: A total of 146 children with neurologic emergencies were seen during the study period with 33.6% occurring on weekends. The average duration of stay (DOS) was 7.6 (±5.7) days. There was no difference in DOS between children based on the day of admission (P = 0.241) or the hour of admission (P = 0.155). Eleven (7.5%) of study subjects died during the study period. There was no difference in outcome based on day ([weekends – 6.1% vs. weekday – 8.2%] [ P = 0.896]) or hour of admission ([out-of-hour – 7.3% vs. working hours – 7.7%] [ P = 0.958]). Conclusions: Weekend and out-of-hour duty does not affect the outcome of neurological emergencies in children. [ABSTRACT FROM AUTHOR]

Introduction One of the most important aspects of happiness is one's health. Increased industrialization in developing nations has contributed to a change in disease patterns away from infectious illness as the major cause of morbidity and mortality toward chronic diseases such as heart disease and trauma. Most emergency circumstances need immediate medical attention before a person is taken to the hospital; therefore, public awareness and training programs can aid in providing efficient basic life support care and services. Only a few works of literature on basic life support and prehospital emergency care in an Indian context are available and are usually studied among school teachers. However, no comparable research including allied health experts such as speech and hearing professionals has yet been published in the literature. Aim The present study aimed at exploring the awareness of speech and hearing professionals regarding basic life support in an Indian context. Methods The questionnaire consisted of two sections where section A comprised 6 questions related to demographic details and participant's experience, and section B composed of 17 questions related to knowledge of normal bodily physiology, medical emergencies, and first aid and related aspects. A cross-sectional exploratory study design was conducted on 250 participants. Out of 250 responses, 42 of them were incomplete and so were removed from the study. Therefore, a total of 208 complete responses received from the participants in the age range of 22 to 60 years from across 23 states and 1 union territory of India were included in the study. Results The result revealed a low percentage of speech and hearing professionals with an adequate understanding of basic life support. The majority of them were found to have insufficient knowledge of normal bodily physiology, medical emergencies, and first aid and related aspects. Discussion Being the first of its kind, the present study revealed limited awareness about basic life support among professionals, and therefore, the need to improvise the knowledge of basic life support and prehospital emergency care. This may be achieved by introducing training programs of various natures and dimensions to speech and hearing professionals. [ABSTRACT FROM AUTHOR]

(1) Background: To improve the quality of emergency care for children, the Hessian Ministry for Social Affairs and Integration offered paediatric simulation-based training (SBT) for all children's hospitals in Hesse. We investigated the quality of paediatric life support (PLS) in simulated paediatric resuscitations before and after SBT. (2) Methods: In 2017, a standardised, high-fidelity, two-day in-house SBT was conducted in 11 children's hospitals. Before and after SBT, interprofessional teams participated in two study scenarios (PRE and POST) that followed the same clinical course of apnoea and cardiac arrest with a shockable rhythm. The quality of PLS was assessed using a performance evaluation checklist. (3) Results: 179 nurses and physicians participated, forming 47 PRE and 46 POST interprofessional teams. Ventilation was always initiated. Before SBT, chest compressions (CC) were initiated by 87%, and defibrillation by 60% of teams. After SBT, all teams initiated CC (p = 0.012), and 80% defibrillated the patient (p = 0.028). The time to initiate CC decreased significantly (PRE 123 ± 11 s, POST 76 ± 85 s, p = 0.030). (4) Conclusions: The quality of PLS in simulated paediatric cardiac arrests with shockable rhythm was poor in Hessian children's hospitals and improved significantly after SBT. To improve children's outcomes, SBT should be mandatory for paediatric staff and concentrate on the management of shockable rhythms. [ABSTRACT FROM AUTHOR]

Large-scale wireless sensor networks (WSNs) play a critical role in monitoring dangerous scenarios and responding to medical emergencies. However, the inherent instability and error-prone nature of wireless links present significant challenges, necessitating efficient data collection and reliable transmission services. This paper addresses the limitations of existing data transmission and recovery protocols by proposing a systematic end-to-end design tailored for medical event-driven cluster-based large-scale WSNs. The primary goal is to enhance the reliability of data collection and transmission services, ensuring a comprehensive and practical approach. Our approach focuses on refining the hop-count-based routing scheme to achieve fairness in forwarding reliability. Additionally, it emphasizes reliable data collection within clusters and establishes robust data transmission over multiple hops. These systematic improvements are designed to optimize the overall performance of the WSN in real-world scenarios. Simulation results of the proposed protocol validate its exceptional performance compared to other prominent data transmission schemes. The evaluation spans varying sensor densities, wireless channel conditions, and packet transmission rates, showcasing the protocol's superiority in ensuring reliable and efficient data transfer. Our systematic end-to-end design successfully addresses the challenges posed by the instability of wireless links in large-scaleWSNs. By prioritizing fairness, reliability, and efficiency, the proposed protocol demonstrates its efficacy in enhancing data collection and transmission services, thereby offering a valuable contribution to the field of medical event-drivenWSNs. [ABSTRACT FROM AUTHOR]

Abstract Background It is a requirement that medical students are educated in emergencies and feel well prepared for practice as a doctor, yet national surveys show that many students feel underprepared. Virtual reality (VR), combined with 360-degree filming, provides an immersive, realistic, and interactive simulation experience. Unlike conventional in-person simulation, it is scalable with reduced workforce demands. We sought to compare students’ engagement and enjoyment of VR simulation to desktop computer-based simulation. Methods We conducted a prospective, interventional, evaluation study. The study was carried out on final year medical students undertaking their Pre-Foundation Assistantship (n = 116) at Imperial College School of Medicine (ICSM) in London. We compared objective engagement, subjective engagement, and subjective enjoyment of VR simulation to desktop computer-based simulation using cardiac arrest and life-threatening asthma scenarios. Engagement was measured objectively using students’ physiological parameters, including heart rate and eye tracking, and facilitator observations using the validated ‘Behavioural Engagement Related to Instruction’ (BERI) protocol. Students’ subjective engagement and enjoyment levels were measured using a post-session survey. Results Students’ maximum heart rates were significantly higher during VR simulation with a mean difference of 4.2 beats per minute (3.2 to 5.2, p

Objectives Methods Results Conclusions The present study aimed to assess self‐reported experience, knowledge, practices and attitudes of ED medical staff regarding teledermatology.Online questionnaire of ED medical staff at Prince of Wales Hospital (Sydney, Australia).Seventy‐nine staff completed the questionnaire. Photographic technique and compliance with medicolegal policies were variable: 1% obtained written consent and 45.6% documented verbal consent for photography. 54.4% of respondents had concerns about the quality of their photographs.Skin photography image quality, knowledge and adherence to medicolegal policy were poor among ED medical staff. Education could reduce risk and improve outcomes. [ABSTRACT FROM AUTHOR]

The article stresses the need for comprehensive changes and strategic investments to enhance health emergency preparedness. Topics discussed include the tough lessons taught by the COVID-19 pandemic, the need for more bold and more rapid health systems reform, and the virtuous cycle of targeted investments.

The article "Emergency medicine: navigating the challenges of complex patients" discusses the evolving nature of emergency medicine, which now involves treating patients with a wide range of symptoms and concerns beyond life-threatening conditions. The term "hallway medicine" is introduced to describe the practice of treating patients in inappropriate conditions due to increasing pressure on emergency services. The article emphasizes the need for a proactive and preventive approach to address the growing complexity of cases and relieve the strain on resources and staff in emergency medical services. [Extracted from the article]

Fanar Swaida emphasises vital dental emergencies knowledge for dental nurses. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors. Materials and methods: An online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023. Results: In this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work–family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout. Conclusions: Fatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China. [ABSTRACT FROM AUTHOR]

Background: While the number of emergency patients worldwide continues to increase, emergency doctors often face moral distress. It hampers the overall efficiency of the emergency department, even leading to a reduction in human resources. Aim: This study explored the experience of moral distress among emergency department doctors and analyzed the causes of its occurrence and the strategies for addressing it. Method: Purposive and snowball sampling strategies were used in this study. Data were collected through in-depth, semi-structured interviews with 10 doctors working in the emergency department of a tertiary general hospital in southwest China. The interview data underwent processing using the Nvivo 14 software. The data analysis was guided by Colaizzi's phenomenological analysis method. Study findings: This study yielded five themes: (1) imbalance between Limited Medical Resources and High-Quality Treatment Needs; (2) Ineffective Communication with Patients; (3) Rescuing Patients With no prospect of treatment; (4) Challenges in Sustaining Optimal Treatment Measures; and (5) Strategies for Addressing Moral Distress. Conclusion: The moral distress faced by emergency doctors stems from various aspects. Clinical management and policymakers can alleviate this distress by enhancing the dissemination of emergency medical knowledge to the general public, improving the social and economic support systems, and strengthening multidisciplinary collaboration and doctors' communication skills. [ABSTRACT FROM AUTHOR]

Frailty, a condition that was first defined 20 years ago, is now assessed via multiple different tools. The Frailty Phenotype was initially used to identify a population of "pre-frail" and "frail" older adults, so as to prevent falls, loss of mobility, and hospitalizations. A different definition of frailty, via the Clinical Frailty Scale, is now actively used in critical care situations to evaluate over 65 year-old patients, whether it be for Intensive Care Unit (ICU) admissions, limitation of life-sustaining treatments or prognostication. Confusion remains when mentioning "frailty" in older adults, as to which tools are used, and what the impact or the bias of using these tools might be. In addition, it is essential to clarify which tools are appropriate in medical emergencies. In this review, we clarify various concepts and differences between frailty, functional autonomy and comorbidities; then focus on the current use of frailty scales in critically ill older adults. Finally, we discuss the benefits and risks of using standardized scales to describe patients, and suggest ways to maintain a complex, three-dimensional, patient evaluation, despite time constraints. Frailty in the ICU is common, involving around 40% of patients over 75. The most commonly used scale is the Clinical Frailty Scale (CFS), a rapid substitute for Comprehensive Geriatric Assessment (CGA). Significant associations exist between the CFS-scale and both short and long-term mortality, as well as long-term outcomes, such as loss of functional ability and being discharged home. The CFS became a mainstream tool newly used for triage during the Covid-19 pandemic, in response to the pressure on healthcare systems. It was found to be significantly associated with in-hospital mortality. The improper use of scales may lead to hastened decision-making, especially when there are strains on healthcare resources or time-constraints. Being aware of theses biases is essential to facilitate older adults' access to equitable decision-making regarding critical care. The aim is to help counteract assessments which may be abridged by time and organisational constraints. [ABSTRACT FROM AUTHOR]

Background: Timely dispatch of appropriate emergency medical services (EMS) resources to the scene of medical incidents, and/or provision of treatment at the scene by bystanders and medical emergency lay callers (referred to as 'callers' in this review) can improve patient outcomes. Currently, in dispatch systems worldwide, prioritisation of dispatch relies mostly on verbal telephone information from callers, but advances in mobile phone technology provide means for sharing video footage. This scoping review aimed to map and identify current uses, opportunities, and challenges for using video livestreaming from callers' smartphones to emergency medical dispatch centres. Methods: A scoping review of relevant published literature between 2007 and 2023 in the English language, searched within MEDLINE; CINAHL and PsycINFO, was descriptively synthesised, adhering to the PRISMA extension for scoping reviews. Results: Twenty-four articles remained from the initial search of 1,565 articles. Most studies were simulation-based and focused on emergency medical dispatchers' (referred to as 'dispatcher/s' in this review) assisted video cardiopulmonary resuscitation (CPR), predominantly concerned with measuring how video impacts CPR performance. Nine studies were based on real-life practice. Few studies specifically explored experiences of dispatchers or callers. Only three articles explored the impact that using video had on the dispatch of resources. Opportunities offered by video livestreaming included it being: perceived to be useful; easy to use; reassuring for both dispatchers and callers; and informing dispatcher decision-making. Challenges included the potential emotional impact for dispatchers and callers. There were also concerns about potential misuse of video, although there was no evidence that this was occurring. Evidence suggests a need for appropriate training of dispatchers and video-specific dispatch protocols. Conclusion: Research is sparse in the context of video livestreaming. Few studies have focussed on the use of video livestreaming outside CPR provision, such as for trauma incidents, which are by their nature time-critical where visual information may offer significant benefit. Further investigation into acceptability and experience of the use of video livestreaming is warranted, to understand the potential psychological impact on dispatchers and callers. [ABSTRACT FROM AUTHOR]

Intra-abdominal infections (IAIs) are an important cause of morbidity and mortality in hospital settings worldwide. The cornerstones of IAI management include rapid, accurate diagnostics; timely, adequate source control; appropriate, short-duration antimicrobial therapy administered according to the principles of pharmacokinetics/pharmacodynamics and antimicrobial stewardship; and hemodynamic and organ functional support with intravenous fluid and adjunctive vasopressor agents for critical illness (sepsis/organ dysfunction or septic shock after correction of hypovolemia). In patients with IAIs, a personalized approach is crucial to optimize outcomes and should be based on multiple aspects that require careful clinical assessment. The anatomic extent of infection, the presumed pathogens involved and risk factors for antimicrobial resistance, the origin and extent of the infection, the patient's clinical condition, and the host's immune status should be assessed continuously to optimize the management of patients with complicated IAIs. [ABSTRACT FROM AUTHOR]

Introduction: : This study aimed to investigate the work problems and challenges of male prehospital emergency technicians when faced with female medical emergencies. Given that qualitative research has not been done in this field, planning to find the weak points and improve the quality of prehospital emergency as the first line of treatment for female emergency patients, which is considered an important part of the health care system, is considered important and valuable. Therefore, this phenomenological study was conducted in 2023. Methods: This study was conducted using a qualitative method of phenomenology in 2023. The environment of the research was urban and road prehospital emergency centers in Iran and the data were collected through interviews with EMS technicians. The collected data were analyzed using Smith's approach to explain the lived experiences of EMS technicians facing female emergencies or women's emergencies in Iran. Results: All the 15 participants were men. Their mean age was 35 years, with a range of 25 to 45 years, and with a mean work experience of 10.54 years with a range of 4 to 20 years. The lived experiences of 115 emergency technicians in facing women's emergencies in Iran were placed in four main themes cultural-social factors, organizational factors, human resources-related factors, and administrative-legal factors. Conclusion: EMS personnel face various obstacles in carrying out missions related to women's emergencies, Considering the critical nature of women's emergencies, it is recommended that policymakers and clinical educators improve the level of community culture, communication skills, theoretical and practical training, respecting privacy, hiring female personnel, adding specialized equipment, amending and changing laws, removing road-traffic obstacles and to support personnel, patients and their families psychologically to optimize performance in women's emergencies. [ABSTRACT FROM AUTHOR]

Background: It is a requirement that medical students are educated in emergencies and feel well prepared for practice as a doctor, yet national surveys show that many students feel underprepared. Virtual reality (VR), combined with 360-degree filming, provides an immersive, realistic, and interactive simulation experience. Unlike conventional in-person simulation, it is scalable with reduced workforce demands. We sought to compare students’ engagement and enjoyment of VR simulation to desktop computer-based simulation. Methods: We conducted a prospective, interventional, evaluation study. The study was carried out on final year medical students undertaking their Pre-Foundation Assistantship (n = 116) at Imperial College School of Medicine (ICSM) in London. We compared objective engagement, subjective engagement, and subjective enjoyment of VR simulation to desktop computer-based simulation using cardiac arrest and life-threatening asthma scenarios. Engagement was measured objectively using students’ physiological parameters, including heart rate and eye tracking, and facilitator observations using the validated ‘Behavioural Engagement Related to Instruction’ (BERI) protocol. Students’ subjective engagement and enjoyment levels were measured using a post-session survey. Results: Students’ maximum heart rates were significantly higher during VR simulation with a mean difference of 4.2 beats per minute (3.2 to 5.2, p < 0.001), and eye tracking showed they spent a significantly greater mean percentage of time of 6.4% (5.1 to 7.7, p < 0.001) focusing on the scenarios in VR compared to standard desktop. Qualitative data showed students enjoyed and felt engaged with the sessions, which provided a safe space for learning. Conclusions: Our study shows that students found VR simulations enjoyable and were more engaged compared to standard desktop simulation. This suggests that 360-degree VR simulation experiences provide students with immersive, realistic training, which is scalable, giving them the unique opportunity to manage emergencies and work within emergency teams, which would not typically occur during traditional training. [ABSTRACT FROM AUTHOR]

Clinical trials are very important for determining the safety and efficacy of medical trials, which is further critical to the progress of the various healthcare businesses. Conducting such studies requires substantial preparation and adherence to the various ethical norms; such norms which are especially crucial when dealing with medical emergencies like the COVID-19 outbreak. This paper discusses the Site Initiation Visit (SIV) and the development of Essential Document Files (EDF) for clinical research. Site initiation visit specifies fundamental tasks to ensure team preparedness, logistical planning, and regulatory compliance. Team training, investigational product (IP) storage, and post-SIV follow-up procedures are all valuable considerations. On the other hand, throughout the trial's lifecycle, the document files play a very vital role in ensuring a complete documentation process thereby promoting transparency and adherence to Good Clinical Practice (GCP) guidelines. The paper highlights the importance of established protocols and regulatory compliance, in safeguarding safety by outlining these procedures. [ABSTRACT FROM AUTHOR]