| 1. |
- Ahlman, Håkan, 1947, et al.
(författare)
-
Cytotoxic treatment of adrenocortical carcinoma.
- 2001
-
Ingår i: World journal of surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 25:7, s. 927-33
-
Tidskriftsartikel (refereegranskat)abstract
- Adrenocortical carcinoma (ACC) is a rare, aggressive tumor that is often detected in an advanced stage. Medical treatment with the adrenotoxic drug mitotane has been used for decades, but critical prospective trials on its role in residual disease or as an adjuvant agent after surgical resection are still lacking. The concept of a critical threshold plasma level of the drug must be confirmed in controlled studies. Because individual responsiveness cannot be predicted, the use mitotane is still advised for nonresectable disease. In case of cortisol or other steroid overproduction, several drugs (e.g., ketoconazole or aminoglutethimide) may be used. Chemotherapy with single agents (e.g., doxorubicin or cisplatin) have been disappointing, with low response rates (< 30%) and a short response duration. Part of this refractoriness may be explained by the fact that ACC tumors express the multidrug-resistance gene MDR-1. Chemotherapy with multiple agents has been tested in smaller series and has resulted in significant side effects. The best results were achieved by the combination of etoposide, doxorubicin, and cisplatin associated with mitotane, achieving a response rate of 54%, including individual complete responses. To be able to make progress in treating advanced ACC disease, adjuvant multicenter trials must be encouraged. When mitotane-based therapies are used, monitored drug levels are mandatory.
|
|
| 2. |
- Al-Wathinani, Ahmed M, et al.
(författare)
-
A Cross-Sectional Study on the Flood Emergency Preparedness among Healthcare Providers in Saudi Arabia.
- 2021
-
Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:3
-
Tidskriftsartikel (refereegranskat)abstract
- This study used a descriptive cross-sectional methodology to measure healthcare workers' knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals' ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is through competency-based training, including both table-top and full-scale live exercises. Although the willingness to respond to such a flooding emergency was high among staff, the development of guidelines and educational programs is needed in order to develop the competencies and skills sets to improve disaster preparedness response and preparedness efforts.
|
|
| 3. |
- Al-Wathinani, A. M., et al.
(författare)
-
Raising Awareness of Hearing and Communication Disorders Among Emergency Medical Services Students: Are Knowledge Translation Workshops Useful?
- 2022
-
Ingår i: Disaster Medicine and Public Health Preparedness. - : Cambridge University Press (CUP). - 1935-7893 .- 1938-744X. ; 17
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient-provider communication, but most of this training assumes patients have intact communication capabilities, leading to a lack of preparedness to interact with patients, who have communication disorders. In such cases, first responders could end up delivering suboptimal care or possibly wrong procedures that could harm the disabled person. Method: A quasi-experimental design (pretest-posttest) was used to assess the knowledge of EMS students both before and after a translation workshop on how to deal with patients who have hearing and communication disorders during emergencies. Comparisons between pretest and posttest scores were examined using the Wilcoxon signed rank test. The level of knowledge scores was compared before and after the workshop. Results: The results indicated that EMS students' scores improved after the workshop. There was a 0.763 increase in the average score of knowledge level. The results of this study show that knowledge translation workshops are a useful intervention to enhance the level of knowledge among EMS students when interacting with hearing and communication patients. Conclusions: Our results show that such training workshops lead to better performance. Communication is a vital element in a medical encounter between health care providers and patients at all levels of health care but specifically in the prehospital arena. Insufficient or lack of communication with a vulnerable population, who may suffer from various disabilities, has a significant impact on the outcome of treatment or emergency management.
|
|
| 4. |
- Allwood, Jens, 1947, et al.
(författare)
-
"Vänta och se versus låtsas inte förstå om du inte gör det!" Om svensk sjukvårdspersonals erfarenheter av kommunikation med utländska läkare.
- 2005
-
Ingår i: Aktuellt om Migration. - 1652-7119. ; 2:(finns på internet)
-
Tidskriftsartikel (refereegranskat)abstract
- Det är knappt att de hörs, steg av fötter i vita fotriktiga inomhussandaler, mjuka och tassande. Ljusa korridorer, väggar med scheman, plastblommor vid fönster och fina neutrala ”institutionsgardiner.” Dämpade röster, deltagande leenden, automatiska dörrar, breda nog för en sjukhussäng. På akuten – en samling människor med väntande och uppgivna ansiktsuttryck. Nuläget: Långa väntetider, tajta och utmattande scheman för personalen med ett ökat antal sjukskrivningar som följd. Ständiga påminnelser om anstående neddragningar och sjukvårdens brister som förstasidesnyheter. Önskas: Tid och pengar, arbetskraft som orkar, kan och vill, som ser möjligheterna och inte problemen. Något som ökar vår återspegling av det nya mångkulturella samhället i vården och som även passar in i våra personalvisioner och måldokument.
|
|
| 5. |
- Alruwaili, Abdullah, et al.
(författare)
-
Supporting the Frontlines: A Scoping Review Addressing the Health Challenges of Military Personnel and Veterans
- 2023
-
Ingår i: Healthcare (Switzerland). - 2227-9032. ; 11:12
-
Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Military personnel and veterans meet unique health challenges that stem from the complex interplay of their service experiences, the nature of warfare, and their interactions with both military and civilian healthcare systems. This study aims to examine the myriad of injuries and medical conditions specific to this population, encompassing physical and psychological traumas. (2) Methods: A scoping review (systematic search and non-systematic review) was performed to evaluate the current landscape of military healthcare. (3) Results: A significant change in the injury profile over time is identified, linked to shifts in combat strategies and the integration of advanced technologies in warfare. Environmental exposures to diverse chemical or natural agents further complicate the health of service members. Additionally, the stressors they face, ranging from routine stress to traumatic experiences, lead to various mental health challenges. A major concern is the gap in healthcare accessibility and quality, worsened by challenges in the civilian healthcare system’s capacity to address these unique needs and the military healthcare system’s limitations. (4) Conclusions: This review underscores the need for holistic, integrated approaches to care, rigorous research, and targeted interventions to better serve the health needs of military personnel and veterans.
|
|
| 6. |
- Alruwaili, Abdullah, et al.
(författare)
-
The Use of Prehospital Intensive Care Units in Emergencies—A Scoping Review
- 2023
-
Ingår i: Healthcare (Switzerland). - 2227-9032. ; 11:21
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Amidst a rising tide of trauma-related emergencies, emergency departments worldwide grapple with the challenges of overcrowding and prolonged patient wait times. Addressing these challenges, the integration of prehospital intensive care units has appeared as a promising solution, streamlining trauma care and enhancing patient safety. Nevertheless, the feasibility of such an initiative becomes murky when considered globally. This review delves into the intricacies of prehospital intensive care units’ deployment for trauma care, scrutinizing their configurations, operational practices, and the inherent challenges and research priorities. Methods: A scoping review was performed for eligible studies. The result was uploaded to the RAYYAN research platform, facilitating simultaneous evaluation of the studies by all researchers. Results: A total of 42 studies were initially selected. Four studies were duplicates, and 25 studies were unanimously removed as irrelevant. The remaining studies (n = 13) were included in the review, and the outcomes were categorized into diverse subgroups. Conclusions: A country’s emergency medical services must achieve specific milestones in education, competency, resource availability, and performance to effectively harness the potential of a prehospital intensive care unit. While certain nations are equipped, others lag, highlighting a global disparity in readiness for such advanced care modalities.
|
|
| 7. |
- Berbyuk, Nataliya, 1978, et al.
(författare)
-
How do Non-Swedish Physicians Communicate with their Swedish Patients and Colleagues?
- 2006
-
Ingår i: Dahl, Ø., Jensen, I., Nynäs, P. (ed.). Bridges of Understanding.. - Oslo : Unipub, Oslo Academic Press. - 8274772695 ; , s. 155-170
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 8. |
- Berner, Andreas, et al.
(författare)
-
STREET: Swedish Tool for Risk/Resource Estimation at EvenTs. Part one, risk assessment – face validity and inter–rater reliability
- 2015
-
Ingår i: Journal of Acute Disease. - 2221-6189. ; 4:1, s. 37-43
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To develop a validated and generalized high reliability organizations collaborative tool in order to conduct common assessments and information sharing of potential risks during mass-gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.37 and a mean accuracy of 62% of the tool. Conclusions The collaboration tool, “STREET”, showed acceptable reliability and validity to be used as a foundation for high reliability organization collaboration in a simulated environment. However, the lack of reliability in one of the cases highlights the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but need, on the other hand, an already developed tool.
|
|
| 9. |
- Berner, A, et al.
(författare)
-
STREET: Swedish tool for risk /resource estimation at events. Part two, resource assessment -face validity and inter-rater reliability.
- 2015
-
Ingår i: Journal of acute disease. - 2221-6189. ; 4:2, s. 112-116
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To develop a validated and generalized collaborative tool to be utilized by high reliability organizations in order to conduct common resource assessment before major events and mass gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.44 and a mean accuracy of 61% of the tool. Conclusions A better collaboration ability and more accurate resource assessment with acceptable reliability and validity were shown in this study to be used as a foundation for resource assessment before major events/mass-gathering in a simulated environment. However, the result also indicates the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but needs, on the other hand, an already developed tool.
|
|
| 10. |
- Borowska-Stefanska, M., et al.
(författare)
-
Emergency management of self-evacuation from flood hazard areas in Poland
- 2022
-
Ingår i: Transportation Research Part D-Transport and Environment. - : Elsevier BV. - 1361-9209. ; 107
-
Tidskriftsartikel (refereegranskat)abstract
- This paper analyses the effectiveness of self-evacuation activities of population by private vehicle transport from flood hazard areas, aimed at minimising the negative effects of flooding.. The paper relies on a four-step traffic model which is based, inter alia, on the results of questionnaire studies. Moreover, the model takes into account the entirety of national traffic, which allows the methodological problems related to the border effect to be overcome. As shown in the study, the shortest or the fastest routes achievable in the pre-flood period are not always most optimal when the flood has already occurred. In such a case, evacuation planning will increase the efficiency of the process. Thus, inadequate designation of evacuation routes may adversely affect the process of relocating people to places of safety. Therefore, it is important to create plans that provide information on evacuation zones, routes and destinations.
|
|
| 11. |
- Burkle, Frederick M., et al.
(författare)
-
Bastardizing Peacekeeping and the Birth of Hybrid Warfare
- 2022
-
Ingår i: Prehospital and disaster medicine. - 1945-1938. ; 37:2, s. 147-149
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- United Nations (UN) Peacekeeping is the largest and most visible representation of the UN. It represents a collective investment in global peace, security, and stability. Peacekeepers protect civilians, actively prevent conflict, reduce violence, strengthen security, and empower national authorities to assume these responsibilities. Peacekeepers are not an enforcement tool but are highly regarded as an effective instrument for preventing resumption of civil war.
|
|
| 12. |
- Burkle, Frederick M, et al.
(författare)
-
COVID-19 and Beyond: The Pivotal Role of Health Literacy in Pandemic Preparedness.
- 2023
-
Ingår i: Prehospital and disaster medicine. - 1945-1938. ; 38:3, s. 285-6
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The coronavirus disease 2019 (COVID-19) pandemic has served as a reminder of the critical importance of health literacy in managing global public health (PH) crises. Health literacy, defined as the capacity of health professionals and the public to access, understand, evaluate, and apply health information, plays a crucial role in making informed decisions, adhering to PH measures, and promoting overall well-being
|
|
| 13. |
- Carlström, Eric, 1957, et al.
(författare)
-
Medical Emergencies During a Half Marathon Race - The Influence of Weather
- 2019
-
Ingår i: International Journal of Sports Medicine. - Stuttgart : Georg Thieme Verlag KG. - 0172-4622 .- 1439-3964. ; 40:5, s. 312-316
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to analyze the influence of weather conditions on medical emergencies in a half-marathon, specifically by evaluating its relation to the number of non-finishers, ambulance-required assistances, and collapses in need of ambulance as well as looking at the location of such emergencies on the race course. Seven years of data from the world's largest half marathon were used. Meteorological data were obtained from a nearby weather station, and the Physiological Equivalent Temperature (PET) index was used as a measure of general weather conditions. Of the 315,919 race starters, 104 runners out of the 140 ambulance-required assistances needed ambulance services due to collapses. Maximum air temperature and PET significantly co-variated with ambulance-required assistances, collapses, and non-finishers (R (2) =0.65-0.92; p=0.001-0.03). When air temperatures vary between 15-29 degrees C, an increase of 1 degrees C results in an increase of 2.5 (0.008/1000) ambulance-required assistances, 2.5 (0.008/1000) collapses (needing ambulance services), and 107 (0.34/1000) non-finishers. The results also indicate that when the daily maximum PET varies between 18-35 degrees C, an increase of 1 degrees C PET results in an increase of 1.8 collapses (0.006/1000) needing ambulance services and 66 non-finishers (0.21/1000).
|
|
| 14. |
- Carlström, Eric, et al.
(författare)
-
The Second Opinion Dispatch- Evaluating Decisions Made by an Ambulance Dispatch Center
- 2017
-
Ingår i: Global Journal of Health Science. - : Canadian Center of Science and Education. - 1916-9736 .- 1916-9744. ; 9:12, s. 107-113
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The efficacy and precision of dispatching right ambulance to right patient demands a proper decision-making. Wrong decisions may lead to overloading of emergency departments and shortage of ambulances. The aim of this study was to evaluate and improve the process of prehospital resource allocation conducted by a Swedish ambulance dispatch center. METHODS: A team of three experienced ambulance and dispatch nurses evaluated the decisions made by the dispatch center. The method chosen was “Action Research” divided into five actions during 76 days. In the first action, the team listened passively to the calls. The team gradually increased its involvement in the process of decision-making during the actions. RESULTS: During the actions, specific keywords indicating a need for evaluation were identified. The results showed a need to change the primary decisions in 486 cases out of 24,800 calls (2%). The most common measure after an evaluation was to change an ordinary ambulance transportation to an assessment vehicle staffed by a nurse or a physician who would select an appropriate care level (hospital vs. primary healthcare). CONCLUSION: This model not only optimized the prehospital resources but also changed the process of decision-making at the dispatch center and improved their staffs’ ability to optimize the allocation of emergency resources.
|
|
| 15. |
- chayanin, Angthong, et al.
(författare)
-
Disaster Medicine in Thailand: A Current Update. Are We Prepared?
- 2012
-
Ingår i: Journal of the Medical Association of Thailand. - 0125-2208. ; 95:1, s. 42-49
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To investigate the level of major incident/disasters preparedness in Thailand by evaluating to-date data with main focus on past events and their outcomes to alert national medical societies for their roles in upcoming disasters/major incidents. Material and Method: Besides data from past disasters/major incidents (Jan 2006-Dec 2010), including injury details in each event; all information about current disasters/major incidents preparedness systems, triage and pre hospital management, standard of personnel, co-ordination and command centers, were reviewed by using data from Bangkok Emergency Medical Service, Narenthorn EMS of Rajavithi Hospital, Emergency Medical Institute of Thailand, Royal Thai Police, Department of Disaster prevention and mitigation (Ministry of Interior). Results: There was neither a national registry, nor an authentic centralization of the preparedness system. The current organization was found to be functional, but incomplete. The main dispatch center responsible for medical service in Bangkok metropolitan during the present study period was Bangkok EMS (“Erawan center”). In provincial areas, emergency medical services (Ministry of Public Health) in each province act as dispatcher in their corresponding regions in cooperation with the emergency operation divisions in their related area. Several private organizations also volunteered to assist. There was an increase in the number of disasters/major incidents in Thailand between 2006 and 2010; with a total number of 60,999 deaths, 346,763 wounded patients and 73 missing and total costs of 47,453.69 million Baht (1,581.79 million US Dollar). Discussion and Conclusion: There is an established and functional disaster management organization in Thailand with some overlapping difficulties and a need for improvement. Understanding the national need for registry, public information, preparedness, cooperation and coordination inside and outside hospitals, will not only save lives, but also would be beneficial for the country in terms of major economical measures. Keywords: Disaster Medicine, Thailand, Major incident, Mortality, Injury, Update
|
|
| 16. |
- Czekirda, M., et al.
(författare)
-
Objective and Subjective Stress Parameters in Response to High and Low-Fidelity Simulation Activities
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 19:5
-
Tidskriftsartikel (refereegranskat)abstract
- Nursing graduates are required to have both excellent theoretical and practical skills that should be used during stressful emergency interventions. Since the received knowledge should be practiced to gain skills and trained to achieve competences, simulation exercises can be beneficial to even reduce the stress that each individual may face during emergency management of patients. A total of 146 first-year nursing students participated in the study, including 124 women and 22 men aged between 19 and 50 years, with a mean age of 32 years. The objective method estimated psychophysiological parameters (serum cortisol). Objective and subjective methods were used. The subjective method assessed stress experienced by students based on the standardized Stress Appraisal Questionnaire Version B for dispositional assessment. The study was conducted in the Monoprofile Medical Simulation Centre at the University of Economics and Innovation in Lublin, Poland and was approved by the University Research Ethics Committee. Both participants under and over 25 years of age showed increased levels of stress after low and high-fidelity simulations, with statistically significantly higher stress levels found for the low fidelity method. Low-fidelity simulation methods generated a greater increase in cortisol levels, indicating a higher stress level than the high-fidelity methods. The analysis of the scores obtained in the Stress Appraisal Questionnaire (KOS-B) showed that higher cortisol levels after the low-fidelity simulation reduced the subjective perception of a threat, while higher cortisol levels before the high-fidelity simulation promoted higher intellectual activity among the students. Levels of stress in the education of nursing students using low and high-fidelity methods can limit the sense of threat and activate professional task performance. The use of low and high-fidelity simulation does not generate destructive stress levels.
|
|
| 17. |
- De Cauwer, Harald, et al.
(författare)
-
An Epidemiological Analysis of Terrorist Attacks in the Nordic and Baltic Countries from 1970 through 2020.
- 2023
-
Ingår i: Prehospital and disaster medicine. - 1945-1938. ; 38:3, s. 401-408
-
Tidskriftsartikel (refereegranskat)abstract
- Russia's annexation of Crimea in 2014, and the recent Russo-Ukrainian war that started in 2022, were triggers that radically changed the perception of security in the Nordic and Baltic countries. The on-going Russian hybrid war has resulted in a renewed global interest in the safety and security of many countries (eg, the Nordic-Baltic Eight). The prospective North Atlantic Treaty Organization (NATO) membership of Finland and Sweden may drastically change the regional military and political landscape.The objective of this study was to identify and characterize all documented terrorist attacks in this region as reported to the Global Terrorism Database (GTD) from 1970 through 2020.The GTD was searched using the internal database functions for all terrorism incidents in the Nordic-Baltic states: Denmark, Estonia, Finland, Iceland, Latvia, Lithuania, Norway, and Sweden.Temporal factors, location, target type, attack and weapon type, perpetrator type, number of casualties, and property value loss were collated. Results were exported into an Excel spreadsheet for analysis.There were 298 terrorism-related incidents from 1970 through 2020. Most attacks occurred in Sweden, followed by Norway and Finland. No entries were recorded for the Baltic states prior to their independency in 1991. The 298 incidents resulted in a total of 113 fatalities and 277 injuries.Facility/infrastructure attacks were the most frequently identified attack type (35.0%), followed by bombings and explosions (30.9%). Armed assaults were responsible for 80 fatalities and 105 injuries, followed by bombings/explosions with 15 fatalities and 72 injuries. The predominant target types were immigrants and refugee shelters (64/298 incidents). In only 33.6% of the incidents, perpetrators were known. Right-wing assailants represented the largest group, accounting for 27 incidents.From 1970 through 2020, there were 298 terrorist attacks in the Nordic-Baltic Eight. Sweden accounted for 50% of incidents.The profile of terrorist attacks was very diverse, as were the perpetrators and targets. Every country had its own incident characteristics. The surge of right-wing extremism must be closely monitored.
|
|
| 18. |
- Delbro, Dick, et al.
(författare)
-
Nuclear expression of mu-opioid receptors in a human mesothelial cell line
- 2009
-
Ingår i: Autonomic & Autacoid Pharmacology. - : Wiley. - 1474-8665 .- 1474-8673. ; 29:4, s. 165-170
-
Tidskriftsartikel (refereegranskat)abstract
- 1 Possibly acting via mu-opioid receptors (MORs), morphine inhibits the formation ofexperimentally induced postoperative abdominal adhesions in rats. Mesothelial cells mayparticipate in adhesion formation by secreting mediators that interfere negatively withfibrinolysis. Morphine may prevent adhesions by inhibiting the release of pro-adhesionmediators from mesothelial cells. This study aimed to investigate whether human mesothelialcells express MOR-1; if so, such could constitute a site of action for morphine in adhesionprevention.2 Cells from Met-5A, a human mesothelial cell line were seeded and prepared forimmunocytochemistry and Western blotting.3 Immunocytochemistry showed MOR-1 expression in mesothelial cells, predominantly in thenuclei. Western blotting showed two bands (c. 35 and 50 kDa) which correspond to thoseobtained with a control lysate from cells known to express MORs. In addition, we foundMOR-1 expression with nuclear and cytoplasmatic localization in biopsies from humanabdominal adhesions.4 The current findings may suggest that morphine could interact directly with mesothelial cellsvia MOR-1 receptors, and thereby modulate adhesion formation, possibly by interfering withthe release of pro-adhesion factors from these cells
|
|
| 19. |
- Djalali, A, et al.
(författare)
-
Art of Disaster Preparedness in European Union:a Survey on the Health Systems. PLOS Currents Disasters. Dec 17 ed 1
- 2014
-
Ingår i: PLOS Currents. - : Public Library of Science (PLoS). - 2157-3999.
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Naturally occurring and man-made disasters have been increasing in the world, including Europe, over the past several decades. Health systems are a key part of any community disaster management system. The success of preparedness and prevention depends on the success of activities such as disaster planning, organization and training. The aim of this study is to evaluate health system preparedness for disasters in the 27 European Union member countries. Method: A cross-sectional analysis study was completed between June-September 2012. The checklist used for this survey was a modified from the World Health Organization toolkit for assessing health-system capacity for crisis management. Three specialists from each of the 27 European Union countries were included in the survey. Responses to each survey question were scored and the range of preparedness level was defined as 0-100%, categorized in three levels as follows: Acceptable; Transitional; or Insufficient. Results: Response rate was 79.1%. The average level of disaster management preparedness in the health systems of 27 European Union member states was 68% (Acceptable). The highest level of preparedness was seen in the United Kingdom, Luxemburg, and Lithuania. Considering the elements of disaster management system, the highest level of preparedness score was at health information elements (86%), and the lowest level was for hospitals, and educational elements (54%). Conclusion: This survey study suggests that preparedness level of European Union countries in 2012 is at an acceptable level but could be improved. Elements such as hospitals and education and training suffer from insufficient levels of preparedness. The European Union health systems need a collective strategic plan, as well as enough resources, to establish a comprehensive and standardized disaster management strategy plan. A competency based training curriculum for managers and first responders is basic to accomplishing this goal.
|
|
| 20. |
- Djalali, Ahmadreza, et al.
(författare)
-
Identifying deficiencies in national and foreign medical team responses through expert opinion surveys: implications for education and training.
- 2014
-
Ingår i: Prehospital and disaster medicine. - 1049-023X. ; 29:4, s. 364-8
-
Tidskriftsartikel (refereegranskat)abstract
- Unacceptable practices in the delivery of international medical assistance are reported after every major international disaster; this raises concerns about the clinical competence and practice of some foreign medical teams (FMTs). The aim of this study is to explore and analyze the opinions of disaster management experts about potential deficiencies in the art and science of national and FMTs during disasters and the impact these opinions might have on competency-based education and training.
|
|
| 21. |
|
|
| 22. |
-
Emergencies and Public Health Crisis Management-Current Perspectives on Risks and Multiagency Collaboration
- 2020
-
Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Disasters and public health emergencies are inevitable and can happen anywhere and anytime. However, they can be mitigated and their impacts can be minimized by utilizing appropriate measures in all four different phases of disaster management, i.e., mitigation and prevention, preparedness, response, and recovery. Several factors are crucial for achieving successful disaster management. Altogether, this Issue offers new insights into emergency and public health crisis management from a multiagency perspective and allows discussion about new potential risks; lessons learned; and the introduction of new concepts such as flexible surge capacity, and shows some new aspects of practicing multiagency collaboration before, during, and after disasters and public health emergencies.
|
|
| 23. |
- Glantz, Viktor, et al.
(författare)
-
Regional Flexible Surge Capacity—A Flexible Response System
- 2020
-
Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:15
-
Tidskriftsartikel (refereegranskat)abstract
- Surge capacity is the ability to manage the increased influx of critically ill or injured patients during a sudden onset crisis. During such an event, all ordinary resources are activated and used in a systematic, structured, and planned way to cope with the situation. There are, however, occasions where conventional healthcare means are insufficient, and additional resources must be summoned. In such an event, the activation of existing capabilities within community resources can increase regional surge capacity in a flexible manner. These additional resources together represent the concept of Flexible Surge Capacity. This study aims to investigate the possibility of establishing a Flexible Surge Capacity response system to emergencies by examining the main components of surge capacity (Staff, Stuff, Structure, System) within facilities of interest present in the Western Region of Sweden. Through a mixed-method and use of (A) questionnaires and (B) semi-structured key-informant interviews, data was collected from potential alternative care facilities to determine capacities and capabilities and barriers and limitations as well as interest to be included in a flexible surge capacity response system. Both interest and ability were found in the investigated primary healthcare centers, veterinary and dental clinics, schools, and sports and hotel facilities to participate in such a system, either by receiving resources and/or drills and exercises. Barriers limiting the potential participation in this response system consisted of a varying lack of space, beds, healthcare materials, and competencies along with a need for clear organizational structure and medical responsibility. These results indicate that the concept of flexible surge capacity is a feasible approach to emergency management. Educational initiatives, drills and exercises, layperson empowerment, organizational and legal changes and sufficient funding are needed to realize the concept.
|
|
| 24. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Beyond Boundaries: Addressing Climate Change, Violence, and Public Health.
- 2023
-
Ingår i: Prehospital and disaster medicine. - 1945-1938. ; 38:5, s. 551-4
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The accelerating pace of climate change has far-reaching implications for the sustainability of our planet and the stability of human societies. As global temperatures rise, we are witnessing an unsettling trend: a surge in conflict and violence that correlates directly with these climatic shifts. This observation is not merely anecdotal; there is robust scientific evidence supporting this trend.
|
|
| 25. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Cohort research analysis of disaster experience, preparedness, and competency-based training among nurses.
- 2021
-
Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- It is expected that in unforeseen situations, nurses will provide appropriate medical interventions, using their expertise and skills to reduce the risks associated with the consequences of disasters. Consequently, it is crucial that they are properly prepared to respond to such difficult circumstances. This study aimed to identify the factors influencing the basic competences of nurses in disasters.The survey was directed to 468 nurses from all medical centres in Lublin. IBM SPSS Statistics version 23 was used for statistical analyses, frequency analysis, basic descriptive statistics and logistic regression analysis. The classical statistical significance level was adopted as α = 0.05.Based on the logistic regression analysis, it was found that work experience, workplace preparedness, as well as training and experience in disaster response are important predictors of preparedness.These findings indicate that the nurses' core competencies for these incidents can be improved through education and training programmes which increase their preparedness for disasters. Nurses are among the most important groups of healthcare professionals facing a disaster and should be involved in all phases of disaster management, such as risk assessment and pre-disaster planning, response during crisis situations and risks' mitigation throughout the reconstruction period.
|
|
| 26. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Current Response and Management Decisions of the European Union to the COVID-19 Outbreak: A Review
- 2020
-
Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:9
-
Tidskriftsartikel (refereegranskat)abstract
- COVID-19 has proven to be a formidable challenge for many countries in the European Union to manage effectively. The European Union has implemented numerous strategies to face emerging issues. Member States have adopted measures such as the closure of borders and significant limitations on the mobility of people to mitigate the spread of the virus. An unprecedented crisis coordination effort between Member States has facilitated the ability to purchase equipment, personal protective equipment, and other medical supplies. Attention has also been focused on providing substantive money for research to find a vaccine and promote effective treatment therapies. Financial support has been made available to protect worker salaries and businesses to help facilitate a return to a functional economy. Lessons learned to date from COVID-19 in the European Union are many; the current crisis highlights the need to think about future pandemics from a population-based management approach and apply outside the box critical thinking. Due to the complexity, intensity, and frequency of complex disasters, global leaders in healthcare, government, and business will need to pivot from siloed approaches to decision-making to embrace multidisciplinary and transdisciplinary levels of cooperation. This cooperation requires courage and leadership to recognize that changes are necessary to avoid making the same mistakes we have planned countless times on avoiding. This study focuses on the European Union’s initial response to the COVID-19 pandemic, starting with how the European Union first learned and processed the global information arising out of China, followed by the incremental population-based medicine/management decisions made that currently are defining the European Union’s capacity and capability. The capacity to organize, deliver, and monitor care to a specific clinical population under a population-based management target includes strict social distancing strategies, contact testing and tracing, testing for the virus antigen and its antibodies, isolation, and treatment modalities such as new mitigating medications, and finally, a vaccine.
|
|
| 27. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Empowering Communities in Geopolitical Crises: A Role for Disaster Medicine and Public Health Preparedness
- 2024
-
Ingår i: Disaster Medicine and Public Health Preparedness. - 1935-7893 .- 1938-744X.
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The intersection of public health and geopolitics is abundantly clear, with national leaders' decisions often having profound consequences on population health and disaster response. Delving deeper into this complex interplay, we narrow our focus on the ongoing crisis in Ukraine, a stark illustration of the health implications that arise from the actions of authoritarian leaders.
|
|
| 28. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Global public health leadership: The vital element in managing global health crises
- 2022
-
Ingår i: Journal of global health. - : International Global Health Society. - 2047-2986 .- 2047-2978. ; 12
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The World Health Organization (WHO) and the International Health Regulations Treaty (IHRT) are re- sponsible for modelling global public health crises, and management and mitigation of their consequences. However, both duties are delivered in all nations by their national public health systems. Therefore, the implementation of public health policies at the national level depends on the public trust of the national authorities. A trustful relationship is necessary for developing and maintaining the well-being of a community through various public health programs. The principle aim of public health programs is to assess all risks, to identify underserved populations, and to initiate preventive measures, such as vaccines, non-pharmaceutical interventions (eg, social distancing, isolation) and vector control, through collaboration and coordination with other agencies and organizations, such as hospitals, and schools. These efforts require management authority, resources and financial support for public health and community research and sustainability of the changes they demand.
|
|
| 29. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Implications and limitations of Social Distancing Strategies (SDS) to mitigate the impact of COVID-19 pandemic.
- 2022
-
Ingår i: Disaster Medicine and Public Health Preparedness. - 1935-7893 .- 1938-744X. ; 16:4, s. 1294-1295
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The World Health Organization defines disease outbreak as “the occurrence of diseases in excess of normal expectancy. The number of cases varies according to the size, type, and previous exposure to disease-causing agent.¹” Several viral infections have evolved as epidemic/pandemic, transmitted through person-to-person contact, animal-to-person contact, or from the environment or other media. The vulnerable populations are more likely to develop severe illness, and since initially there are no specific treatments or vaccine, the best way to prevent and slow down transmission is information and prevention.
|
|
| 30. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Integrated Healthcare and the Dilemma of Public Health Emergencies
- 2021
-
Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 13:8
-
Forskningsöversikt (refereegranskat)abstract
- Traditional healthcare services have demonstrated structural shortcomings in the delivery of patient care and enforced numerous elements of integration in the delivery of healthcare services. Integrated healthcare aims at providing all healthcare that makes humans healthy. However, with mainly chronically ill people and seniors, typically suffering from numerous comorbidities and diseases, being recruited for care, there is a need for a change in the healthcare service structure beyond direct-patient care to be compatible in peacetime and during public health emergencies. This article’s objective is to discuss the opportunities and obstacles for increasing the effectiveness of healthcare through improved integration. A rapid evidence review approach was used by performing a systematic followed by a non-systematic literature review and content analysis. The results confirmed that integrated healthcare systems play an increasingly important role in healthcare system reforms undertaken in European Union countries. The essence of these changes is the transition from the episodic treatment of acute diseases to the provision of coordinated medical services, focused on chronic cases, prevention, and ensuring patient continuity. However, integrated healthcare, at a level not yet fully defined, will be necessary if we are to both define and attain the integrated practice of both global health and global public health emergencies. This paper attains the necessary global challenges to integrate healthcare effectively at every level of society. There is a need for more knowledge to effectively develop, support, and disseminate initiatives related to coordinated healthcare in the individual healthcare systems.
|
|
| 31. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Maintaining Social Distancing during the COVID-19 Outbreak
- 2021
-
Ingår i: Social Sciences. - : MDPI AG. - 2076-0760. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- The analyses of the European Centre for Disease Prevention and Control and an increasing amount of scientific research show that the spread of SARS-CoV-2 may be limited by maintaining social distancing, appropriate hand hygiene, and following the basic principles of prophylaxis. While simulating models applied to social distancing have all been tested and evaluated, the implementation of its guidelines in different traditions and cultures has not been discussed sufficiently. Consequently, applying social distancing guidelines alone may not be enough to contain the spread of the coronavirus. This brief report aims to clarify the role of cultural and behavioral differences in the diverse outcomes of COVID-19 management.
|
|
| 32. |
- Goniewicz, Krzysztof, et al.
(författare)
-
The European Union's post-pandemic strategies for public health, economic recovery, and social resilience
- 2023
-
Ingår i: Global Transitions. - 2589-7918. ; 5, s. 201-209
-
Tidskriftsartikel (refereegranskat)abstract
- The European Union has implemented various strategies and policies to mitigate the effects of the coronavirus-19 pandemic and promote recovery. This article reviews the European Union's response and management decisions, examines the public health measures implemented to contain the virus, and explores the Union's economic recovery and support initiatives. These include the “NextGenerationEU” recovery fund, the “European Support” instrument to mitigate “Unemployment Risks in an Emergency” (SURE) program, and the Multiannual Financial Framework recognizing the EU's efforts to promote social welfare and inclusion during the pandemic. The challenges and lessons learned from the EU's experience are analyzed, highlighting the importance of solidarity, cooperation, and resilience in crisis management. Drawing from the pandemic, this study explores the prospects and conclusions drawn from the pandemic, the need for building more resilient healthcare systems, fostering environmentally sustainable initiatives, strengthening social protection and inclusion, enhancing crisis preparedness and response, and promoting global health and equity.
|
|
| 33. |
- Goniewicz, Krzysztof, et al.
(författare)
-
The gap of knowledge and skill – One reason for unsuccessful management of mass casualty incidents and disasters
- 2020
-
Ingår i: American Journal of Emergency Medicine. - : Elsevier BV. - 0735-6757 .- 1532-8171. ; 46, s. 744-5
-
Tidskriftsartikel (refereegranskat)abstract
- Despite several reports confirming the requirements for a successful management of disasters and major incidents (MIDs), the available literature indicates vulnerabilities in both structural and non-structural parts of healthcare systems [[1],[2]]. The former includes the need for alternative medical facilities, and related critical infrastructure and the latter presence of qualified staff [[3],[4]]. Effective preparedness to respond to any emergency requires a well-planned and integrated effort by all personnel, who, equipped with the needed expertise and skills, can deal with the crisis. However, not all specialists are trained for this, and some do not have the necessary knowledge and experience.
|
|
| 34. |
- Goniewicz, Krzysztof, et al.
(författare)
-
The Impact of Experience, Length of Service, and Workplace Preparedness in Physicians' Readiness in the Response to Disasters.
- 2020
-
Ingår i: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 9:10
-
Tidskriftsartikel (refereegranskat)abstract
- With an increasing number of natural and man-made disasters, the need for preparedness in all levels of management is obvious. Among healthcare professionals responding to these emergencies, physicians are of particular importance due to their significant roles as leaders and frontline workers in minimizing morbidity and mortality of the affected population. This study analyses the preparedness of 549 physicians from all medical centers in Lublin, Poland to formulate their observations, suggestions, and recommendations concerning the improvement of the chain of response in disaster management. The results of this study show that the perceived preparedness of physicians for disaster management and response is not as high as it should be, and the majority of the respondents perceived their disaster preparedness insufficient. Training of physicians in disaster management and principles of disaster medicine is needed, by focusing on the specificity of rescue response to emergencies following disasters, and medical and non-medical aspects of the response with particular emphasis on a management approach covering all hazards.
|
|
| 35. |
- Goniewicz, Krzysztof, et al.
(författare)
-
The importance of pre-training gap analyses and the identification of competencies and skill requirements of medical personnel for mass casualty incidents and disaster training
- 2021
-
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21
-
Tidskriftsartikel (refereegranskat)abstract
- Background Effective preparedness to respond to mass casualty incidents and disasters requires a well-planned and integrated effort by all involved professionals, particularly those who are working in healthcare, who are equipped with unique knowledge and skills for emergencies. This study aims to investigate and evaluate the level of knowledge and skills related to mass casualty and disaster management in a cohort of healthcare professionals. Methods A cross-sectional brief study was conducted using a validated and anonymous questionnaire, with a sample of 134 employees at a clinical hospital in Lublin, Poland. Results The findings of this study may indicate a need for standardization of training for hospitals employees. It also suggests a knowledge gap between different professional groups, which calls for adjusting such general training, to at least, the weakest group, while special tasks and mission can be given to other groups within the training occasion. Conclusion Pre-Training gap analyses and identification of participants’ competencies and skills should be conducted prior to training in mass casualty incidents and disasters. Such analyses provide an opportunity to develop a training curriculum at various skill and knowledge levels from basic to advance. All training in mass casualty incidents and disasters should be subject to ongoing, not just periodic, evaluation, in order to assess continued competency.
|
|
| 36. |
- Goniewicz, Krzysztof, et al.
(författare)
-
The Influence of War and Conflict on Infectious Disease: A Rapid Review of Historical Lessons We Have Yet to Learn
- 2021
-
Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 13:19
-
Tidskriftsartikel (refereegranskat)abstract
- Armed conflicts degrade established healthcare systems, which typically manifests as a resurgence of preventable infectious diseases. While 70% of deaths globally are now from non-communicable disease; in low-income countries, respiratory infections, diarrheal illness, malaria, tuberculosis, and HIV/AIDs are all in the top 10 causes of death. The burden of these infectious diseases is exacerbated by armed conflict, translating into even more dramatic long-term consequences. This rapid evidence review searched electronic databases in PubMed, Scopus, and Web of Science. Of 381 identified publications, 73 were included in this review. Several authors indicate that the impact of infectious diseases increases in wars and armed conflicts due to disruption to surveillance and response systems that were often poorly developed to begin with. Although the true impact of conflict on infectious disease spread is not known and requires further research, the link between them is indisputable. Current decision-making management systems are insufficient and only pass the baton to the next unwary generation.
|
|
| 37. |
- Goniewicz, K., et al.
(författare)
-
The Moral, Ethical, Personal, and Professional Challenges Faced by Physicians during the COVID-19 Pandemic
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 19:9
-
Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic, apart from the main problems concerning the health and life of patients, sparked a discussion about physicians' moral and social professional attitudes. During a pandemic, physicians have the same ethical, moral, and medical responsibilities, however, the situation is different since they are self-exposed to a danger, which may influence their willingness to work. The problem of the professional moral attitudes of health care workers, recurring in ethical discussions, prompts us to define the limits of the duties of physicians in the event of a pandemic, hence this research aimed to assess these duties from an ethical perspective and to define their boundaries and scope. The study was conducted in May and June 2020 in the city of Lublin, covering all medical centers, and the questionnaire was completed by 549 physicians. The research was conducted in four areas: emergency standby in the event of a disaster, even if it is not requested; willingness to work overtime in the event of a disaster, even without payment; willingness to take health risks by caring for people who are infectious or exposed to hazardous substances; readiness to be transferred to other departments in the event of a disaster. Although most of the respondents declared to be agreed on personal sacrifices in the performance of professional duties, they were not prepared for a high level of personal risk when working in a pandemic. Excessive workload, its overwhelming nature, and personal risk are not conducive to readiness to work overtime, especially without pay. Research shows how important it is to respect the rights and interests of all parties involved in a pandemic. Physicians' duty to care for a patient is also conditioned by the duty to protect themselves and should not be a tool for intimidating and depersonalizing their social and professional lives.
|
|
| 38. |
- Goniewicz, Krzysztof, et al.
(författare)
-
Ukraine’s Healthcare Crisis: Sustainable Strategies for Navigating Conflict and Rebuilding for a Resilient Future
- 2023
-
Ingår i: Sustainability. - 2071-1050. ; 15:15
-
Tidskriftsartikel (refereegranskat)abstract
- The protracted war in Ukraine, sparked in 2014 and persistently escalating, has significantly impacted the country’s healthcare system. It has amplified existing challenges, such as shortages of medical supplies and personnel, outdated infrastructure, and restricted access to healthcare services. Destruction of medical facilities, non-adherence to prevention and treatment standards, lack of medical personnel and supplies, and logistical disruptions are hampering the provision of timely healthcare to the Ukrainian population. This study employed a rapid review methodology to synthesize available research concerning the healthcare crisis in Ukraine, with an explicit focus on the war’s sustained impact on the healthcare system. Through this review, a series of critical challenges facing Ukraine’s healthcare system were identified. These included the shortage of medical supplies and personnel, insufficient infrastructure, and funding deficits. Additionally, the review brought to light various interventions and strategies aimed at counteracting these challenges. These comprised international aid and support, initiatives enhancing the resilience of the Ukrainian health system, and others. Given the ongoing war, this review highlighted the pressing need for continuous support and investment in the Ukrainian healthcare system. This commitment is essential to guarantee access to quality healthcare for the Ukrainian population during the war and in its aftermath. The findings presented here can serve as a guide for policymakers and healthcare professionals working not only in Ukraine but also in other regions impacted by war. These insights can inform the development and implementation of effective strategies and interventions tailored to such challenging contexts.
|
|
| 39. |
- Goniewicz, Mariusz, et al.
(författare)
-
Hospital Disaster Preparedness: A Comprehensive Evaluation Using the Hospital Safety Index
- 2023
-
Ingår i: Sustainability (Switzerland). - 2071-1050. ; 15:17
-
Tidskriftsartikel (refereegranskat)abstract
- Mass-casualty incidents and disaster scenarios pose significant challenges for medical facilities, necessitating robust preparedness measures. This study aimed to evaluate the preparedness of a specific medical facility in Poland, using the hospital safety index (HSI). A comprehensive analysis of structural, functional, and organizational factors was conducted, assessing facility infrastructure, technical facilities, safety standards, work organization, cooperation with external facilities, human resource management, crisis planning, and communication strategies. The facility exhibited strengths in infrastructural requirements and inter-facility cooperation. Areas of improvement included adherence to safety procedures, crisis communication, and the frequency of evacuation drills. Furthermore, recommendations were provided for enhancing nurse reserves, adopting lean management, promoting a safety culture, and refining business continuity plans. The findings should be interpreted with caution, due to the single-facility focus, potential HSI protocol subjectivity, and the possible Hawthorne effect. This study underscores the importance of continuous research and improvement in crisis management strategies and disaster-victim care, emphasizing the pivotal role of the HSI as an evaluative tool.
|
|
| 40. |
- Goniewicz, Mariusz, et al.
(författare)
-
Influence of experience, tenure, and organisational preparedness on nurses' readiness in responding to disasters: An exploration during the COVID-19 pandemic.
- 2023
-
Ingår i: Journal of global health. - 2047-2986. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- The coronavirus 2019 (COVID-19) pandemic has placed unprecedented challenges on the nursing practice, particularly in Poland. Nurses, as crucial healthcare service providers, have faced organisational disruptions, altered working conditions, and heightened professional anxieties.We undertook a comprehensive survey across all medical centres in Lublin, Poland in 2020 to understand nurses' attitudes towards their roles and working conditions during the pandemic. This involved 470 nurses completing a questionnaire which focused on four pivotal areas: readiness to be on call in a disaster situation (even when not formally asked); willingness to work overtime in a disaster without additional compensation, preparedness to undertake health risks by caring for individuals with infectious diseases or exposure to hazardous substances, and willingness to be transferred to other departments during a disaster.We found that excessive workload, fear of infection, and feelings of helplessness significantly influenced nurses' readiness to work overtime, particularly when unpaid. We also presented the ethical dilemmas that nurses encountered during the pandemic and how these dilemmas affected their decision-making processes. We further explored the impact of variables such as nurses' professional experience, tenure, and level of organisational preparedness on their readiness to respond to crisis situations.Gaining an understanding of nurses' perspectives is key for formulating strategies to bolster their professional engagements and resilience during crises. Addressing these issues can help build a more robust and well-prepared healthcare system that can effectively navigate future crises.
|
|
| 41. |
|
|
| 42. |
- Haner, A, et al.
(författare)
-
The role of physician-staffed ambulances; the outcome of a pilot study.
- 2015
-
Ingår i: Journal of Acute Disease. - 2221-6189. ; 4:1, s. 63-67
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the outcome of physician-staffed ambulances in a pilot study. Methods All physician-staffed ambulance missions conducted in Gothenburg, Sweden, in 2013 were retrospectively reviewed and evaluated for the type of missions and the need of a physician. Results Out of 1 381 physician-staffed missions, 511 were cancelled or managed by telephone. Around 239 (17%) missions required active intervention, of which only one was considered directly life-saving. Conclusions Most of the missions neither required the interventional skills of a physician, nor could they be performed at distance. However, the added medical value of physicians was found to be in other prehospital situations, such as critical decision-making, staff education and research.
|
|
| 43. |
- Hansson, Jeanette, 1972, et al.
(författare)
-
A Model to Select Patients Who May Benefit from Antibiotic Therapy as the First Line Treatment of Acute Appendicitis at High Probability.
- 2014
-
Ingår i: Journal of Gastrointestinal Surgery. - : Springer Science and Business Media LLC. - 1091-255X .- 1873-4626. ; 18:5, s. 961-967
-
Tidskriftsartikel (refereegranskat)abstract
- Randomized studies indicated that 88-95% of patients with acute appendicitis recover on antibiotics without surgery, although it is unclear which patient would benefit with high probability on antibiotics. We hypothesized that patients with phlegmonous appendicitis should be a group where antibiotics may be a sufficient treatment. Accordingly, our aim was to propose a model to support treatment application for unselected patients with acute appendicitis.
|
|
| 44. |
- Hansson, Jeanette, 1972, et al.
(författare)
-
Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients.
- 2009
-
Ingår i: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 96:5, s. 473-81
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A trial in selected men suggested that antibiotic therapy could be an alternative to appendicectomy in appendicitis. This study aimed to evaluate antibiotic therapy in unselected men and women with acute appendicitis. METHODS: Consecutive patients were allocated to study (antibiotics) or control (surgery) groups according to date of birth. Study patients received intravenous antibiotics for 24 h and continued at home with oral antibiotics for 10 days. Control patients had a standard appendicectomy. Follow-up at 1 and 12 months was carried out according to intention and per protocol. RESULTS: Study and control patients were comparable at inclusion; 106 (52.5 per cent) of 202 patients allocated to antibiotics completed the treatment and 154 (92.2 per cent) of 167 patients allocated to appendicectomy had surgery. Treatment efficacy was 90.8 per cent for antibiotic therapy and 89.2 per cent for surgery. Recurrent appendicitis occurred in 15 patients (13.9 per cent) after a median of 1 year. A third of recurrences appeared within 10 days and two-thirds between 3 and 16 months after hospital discharge. Minor complications were similar between the groups. Major complications were threefold higher in patients who had an appendicectomy (P < 0.050). CONCLUSION: Antibiotic treatment appears to be a safe first-line therapy in unselected patients with acute appendicitis. Registration number: NCT00469430 (http://www.clinicaltrials.gov).
|
|
| 45. |
- Hertelendy, Attila J, et al.
(författare)
-
Preparing emergency and disaster medicine physicians to lead future responses: Crisis leadership a core competency.
- 2021
-
Ingår i: The American journal of emergency medicine. - : Elsevier BV. - 1532-8171 .- 0735-6757. ; 47, s. 309-310
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Effective responses to the pandemic have required emergency physicians to transcend clinical patient care responsibilities and provide leadership within their own departments, often stepping into much larger roles such as leading the COVID-19 response for an entire hospital or health system, developing and implementing policy and interfacing with the public at large.
|
|
| 46. |
- Hertelendy, Attila, et al.
(författare)
-
The applications of geographic information systems in disaster and emergency management in Europe
- 2020
-
Ingår i: Disaster and Emergency Medicine Journal. - 2451-4691 .- 2543-5957. ; 5:4
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Today, the effectiveness of public administration depends on the speed of collecting, processing, and providing information. This effectiveness translates into public satisfaction, which is important for maintaining power in democratic countries. What is more, European society, following the example of developed societies from Asia and USA, demands a constant increase in the level of security in practically every area of life [1]. This task, under the will of the majority of voters, is shifted to the governmental and local governmental authorities, which in Europe results from two factors. First, the public sector can accumulate human, financial, logistic, etc. resources on a scale inaccessible to residents, communities, or private sector entities. Secondly, public institutions have the right to apply coercion in specific situations.
|
|
| 47. |
|
|
| 48. |
- Jansson, Svante, 1948, et al.
(författare)
-
Treatment of bilateral pheochromocytoma and adrenal medullary hyperplasia.
- 2006
-
Ingår i: Annals of the New York Academy of Sciences. - : Wiley. - 0077-8923. ; 1073, s. 429-35
-
Tidskriftsartikel (refereegranskat)abstract
- The risk for bilateral tumors and long-term outcome after conservative cortical-sparing adrenal surgery was studied in a consecutive single-center series. One hundred fifty-four patients were operated on (1950-2004) for pheochromocytoma (PC=137), or abdominal paraganglioma (PG=17). Twenty had MEN 2 (16 MEN 2A; 4 MEN 2B), 15 von Recklinghausen's disease (VRD), and 1 von Hippel-Lindau (VHL) disease. Twelve patients had, or developed, bilateral adrenal medullary tumors; four with MEN 2A, four with MEN 2B, three with VRD, and one with probably hereditary PC associated with brain tumors/meningioma. Two patients with MEN 2B and one with MEN 2A with had bilateral adrenalectomy (adx). Three VRD patients, two MEN 2B and one MEN 2A patients had cortical-sparing surgery. Two patients were operated on unilaterally, but developed small contralateral tumors; one of these (MEN 2A) had a second asymptomatic PC diagnosed at an older age, so surgery was withheld; the other patient (hereditary PC syndrome) had a small contralateral PC diagnosed at autopsy 9 years later. Only three of nine patients with bilateral operations needed corticosteroid replacement after surgery. Four of six patients died of associated tumors (MTC and meningioma). The mean follow-up was 13 (1-25) years. Twelve MEN 2A patients with unilateral adx have been followed up for 20 (4-36) years without developing a second PC. Cortical-sparing adrenal surgery can safely be performed in the majority of patients with bilateral PC. On the basis of our long-term experience of MEN 2A we perform contralateral adrenal resection only if a second PC is confirmed. Five patients underwent adrenal exploration because of clinical and biochemical findings compatible with PC. Four had asymmetrical positive MIBG scans. They all underwent unilateral adx and diffuse medullary hyperplasia was confirmed (medullary weight estimated morphometrically to 1.0-3.4 g vs. normal weight 0.3-0.5 g in matched controls). These patients have been followed for 19 (5-27) years with normal clinical and biochemical findings. In this rare condition removal of the largest adrenal seems adequate.
|
|
| 49. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
-
A need for prehospital triage standardizing tool in mass casualty incidents
- 2021
-
Ingår i: Health Problems of Civilization. - : Termedia Sp. z.o.o.. - 2353-6942 .- 2354-0265.
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- There is no global consensus on the use of prehospital triage systems in mass casualty incidents. This heterogeneity constitutes a particular threat in the event of a Mass Casualty Incident (MCI), which often involves rescue personnel from different organizations or nationalities.
|
|
| 50. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
-
A translational triage research development tool: standardizing prehospital triage decision-making systems in mass casualty incidents.
- 2021
-
Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 29:1
-
Tidskriftsartikel (refereegranskat)abstract
- There is no global consensus on the use of prehospital triage system in mass casualty incidents. The purpose of this study was to evaluate the most commonly used pre-existing prehospital triage systems for the possibility of creating one universal translational triage tool.The Rapid Evidence Review consisted of (1) a systematic literature review (2) merging and content analysis of the studies focusing on similarities and differences between systems and (3) development of a universal system.There were 17 triage systems described in 31 eligible articles out of 797 identified initially. Seven of the systems met the predesignated criteria and were selected for further analysis. The criteria from the final seven systems were compiled, translated and counted for in means of 1/7's. As a product, a universal system was created of the majority criteria.This study does not create a new triage system itself but rather identifies the possibility to convert various prehospital triage systems into one by using a triage translational tool. Future research should examine the tool and its different decision-making steps either by using simulations or by experts' evaluation to ensure its feasibility in terms of speed, continuity, simplicity, sensitivity and specificity, before final evaluation at prehospital level.
|
|
