Search results for: healthcare regulations

Authors: Jonah Kenei, Elisha Opiyo

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Electronic health records, as a repository of patient information, is nowadays the most commonly used technology to record, store and review patient clinical records and perform other clinical tasks. However, the accurate identification and retrieval of relevant information from clinical records is a difficult task due to the unstructured nature of clinical documents, characterized in particular by a lack of clear structure. Therefore, medical practice is facing a challenge thanks to the rapid growth of health information in electronic health records (EHRs), mostly in narrative text form. As a result, it's becoming important to effectively manage the growing amount of data for a single patient. As a result, there is currently a requirement to visualize electronic health records (EHRs) in a way that aids physicians in clinical tasks and medical decision-making. Leveraging text visualization techniques to unstructured clinical narrative texts is a new area of research that aims to provide better information extraction and retrieval to support clinical decision support in scenarios where data generated continues to grow. Clinical datasets in electronic health records (EHR) offer a lot of potential for training accurate statistical models to classify facets of information which can then be used to improve patient care and outcomes. However, in many clinical note datasets, the unstructured nature of clinical texts is a common problem. This paper examines the very issue of getting raw clinical texts and mapping them into meaningful structures that can support healthcare professionals utilizing narrative texts. Our work is the result of a collaborative design process that was aided by empirical data collected through formal usability testing.

Keywords: classification, electronic health records, narrative texts, visualization

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Mahadehe Hassan

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Transport system and industries which are the main basis of industrial and socio-economic development of any country. It is mainly dependent on fossil fuels. Bangladesh has fossil fuel reserves of 9.51 TCF as of July 2023, and if no new gas fields are discovered in the next 7-9 years and if the existing gas consumption rate continues, the fossil fuel reserves will be exhausted. The demand for petroleum products in Bangladesh is increasing steadily, with 63% imported by BPC and 37% imported by private companies. 61.61% of BPC imported products are used in the transport sector and 5.49% in the industrial sector, which is expensive and harmful to the environment. Liquefied Petroleum Gas (LPG) should be considered as an alternative energy for Bangladesh based on Sustainable Development Goals (SDGs) criteria for sustainable, clean and affordable energy. This will not only lead to the much desired mitigation of energy famine in the country but also contribute favorably to the macroeconomic indicators. Considering the environmental and economic issues, the government has referred to CNG (compressed natural gas) as the fuel carrier since 2000, but currently due to the decline mode of gas reserves, the government of Bangladesh is thinking of new energy sources for transport and industrial sectors which will be sustainable, environmentally friendly and economically viable. Liquefied Petroleum Gas (LPG) is the best choice for fueling transport and industrial sectors in Bangladesh. At present, a total of 1.54 million metric tons of liquefied petroleum gas (LPG) is marketed in Bangladesh by the public and private sectors. 83% of it is used by households, 12% by industry and commerce and 5% by transportation. Industrial and transport sector consumption is negligible compared to household consumption. So the purpose of the research is to find out the challenges of LPG market development in transport and industrial sectors in Bangladesh and make recommendations to reduce the challenges. Secure supply chain, inadequate infrastructure, insufficient investment, lack of government monitoring and consumer awareness in the transport sector and industrial sector are major challenges for LPG market development in Bangladesh. Bangladesh government as well as private owners should come forward in the development of liquefied petroleum gas (LPG) industry to reduce the challenges of secure energy sector for sustainable development. Furthermore, ensuring adequate Liquefied Petroleum Gas (LPG) supply in Bangladesh requires government regulations, infrastructure improvements in port areas, awareness raising and most importantly proper pricing of Liquefied Petroleum Gas (LPG) to address the energy crisis in Bangladesh.

Keywords: transportand industries fuel, LPG consumption, challenges, economical sustainability

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Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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Authors: Mohammed Flaih Alotaibi, Rasheed Ahemad Shaik, Mohammed Z. Nasrullah

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Diabetic foot ulcers are the foremost global healthcare burden. Hyperglycemia in diabetics is incriminating in impeding wound healing and it can allow for more severe medical issues. The study was intended to establish a nanoconjugate of cordycepin-melittin (COR-MEL) and evaluate its healing effects in wounded diabetic rats. Diabetes induced by injecting streptozotocin intraperitoneally (50 mg/kg, body weight). Therefore, animals were classified into various groups; diabetic untreated, vehicle-treated, COR alone, MEL alone, and COR-MEL nanoconjugate treated, respectively. Animals with diabetes were exposed to excision and treated with Vehicle, COR, MEL, or COR-MEL nanoconjugate topically. After 14 days, the wounded skin was sliced and subjected to histological and biochemical assessments. The formulated nanoconjugate has a particle size of 253.5± 17.4 nm by a polydispersity index of 0.36 ± 0.05, and a zeta potential of 1.72 ± 0.3 mV. The study demonstrated an accelerated wound contraction in COR-MEL-treated diabetic rats, which was further validated by histological analysis. The nanoconjugate further exhibited antioxidant activities by inhibiting the accumulation of malondialdehyde and exhaustion of superoxide dismutase and glutathione peroxidase enzymatic activities. The nanoconjugate further demonstrated an enhanced anti-inflammatory activity by retarding the expression of proinflammatory cytokines (IL-6 and TNF-α). Additionally, the nanoconjugate exhibits a strong expression of growth factors (TGF-β1, VEGF-A, and PDGFR-β), indicating enrichment of proliferation. Likewise, nanoconjugate increased the concentration of hydroxyproline as well as the mRNA expression of collagen, type I, alpha 1. Thus, it is concluded that the nanoconjugate possesses a potent wound-healing activity in diabetic rats via antioxidant, anti-inflammatory, and pro-angiogenetic mechanisms.

Keywords: diabetic wounds, cordycepin, melittin, nanoconjugate, wound healing

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Authors: Florian Lienert, Peter Costa, Caroline Aurensan, Elaine Melander

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Introduction: Rabies pre-exposure prophylaxis (PrEP) can be given before travel and simplifies post-exposure prophylaxis (PEP). We studied the knowledge about rabies, the uptake of PrEP, and reasons for deciding for or against PrEP in at-risk travelers. We also examined how healthcare professionals (HCPs) counsel on rabies prevention. Methods: On behalf of Bavarian Nordic, Ipsos MORI conducted two online surveys in the USA. Fieldwork from February 24th to April 23rd, 2021, 689 participants aged 18-85 years, visited one of 91 endemic rabies countries in the past 3 years for at least one week, involved in at least 1 of 7 at-risk activities, heard of rabies, positive towards vaccination and chose to take part (surveyed travelers). Secondly, 76 HCPs, with responsibility for advising/ making decisions about vaccination requirements for their patients, personally recommend or prescribe vaccines for rabies, positive towards vaccination and chose to take part (surveyed HCPs). Results: A minority (36%) of surveyed travelers classified rabies as a life-threatening disease. A third of surveyed HCPs (37%) did not discuss rabies vaccination with at-risk travelers, 18% discussed only PEP, 23% only PrEP and 22% both. A minority (21%) of surveyed travelers reported having received rabies vaccination since they were 18. Among those participants (n=145), the most common reasons for deciding to get PrEP were for their own peace of mind (35%) and following an HCP recommendation (32%). Of those who decided not to receive the rabies vaccine (n=319), the most common reasons were that they did not think their risk of rabies was sufficient (23%) and that the HCP did not suggest it (23%). Conclusions: The survey demonstrated knowledge gaps around rabies and low PrEP coverage among surveyed travelers. It also highlighted the role of HCP recommendations and showed that most HCPs did not discuss PrEP with at-risk travelers.

Keywords: rabies, pre-exposure prophylaxis, travel, travel health, post-travel care, rabies treatment, vaccine, post-exposure, prophylaxis, at-risk, education, PrEP, PEP

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Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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Authors: Giulia I. Pintea

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The Roma people are a nomadic ethnic group native to India, and they are one of the most prevalent minorities in Europe. In the past, Roma were enslaved and they were imprisoned in concentration camps during the Holocaust; today, Roma are subject to hate crimes and are denied access to healthcare, education, and proper housing. The aim of this project is to analyze how the public perception of the Roma people may be influenced by antiziganist and pro-Roma institutions in Europe. In order to carry out this project, we used social network analysis to build two large social networks: The antiziganist network, which is composed of institutions that oppress and racialize Roma, and the pro-Roma network, which is composed of institutions that advocate for and protect Roma rights. Measures of centrality, density, and modularity were obtained to determine which of the two social networks is exerting the greatest influence on the public’s perception of Roma in European societies. Furthermore, data on hate crimes on Roma were gathered from the Organization for Security and Cooperation in Europe (OSCE). We analyzed the trends in hate crimes on Roma for several European countries for 2009-2015 in order to see whether or not there have been changes in the public’s perception of Roma, thus helping us evaluate which of the two social networks has been more influential. Overall, the results suggest that there is a greater and faster exchange of information in the pro-Roma network. However, when taking the hate crimes into account, the impact of the pro-Roma institutions is ambiguous, due to differing patterns among European countries, suggesting that the impact of the pro-Roma network is inconsistent. Despite antiziganist institutions having a slower flow of information, the hate crime patterns also suggest that the antiziganist network has a higher impact on certain countries, which may be due to institutions outside the political sphere boosting the spread of antiziganist ideas and information to the European public.

Keywords: applied mathematics, oppression, Roma people, social network analysis

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Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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Authors: Zerubabel Mihret

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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.

Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

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Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

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Authors: Yarra Sulina, Nunna Tagore Sai Priya, Ankhi Banerjee

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With the rapid growth in tourist arrivals, there has been a huge demand for the growth of infrastructure in the destinations. With the increasing preference of tourists to stay near attractions, there has been a considerable change in the land use around tourist sites. However, with the inclusion of certain regulations and guidelines provided by the authorities based on the nature of tourism activity and geographical constraints, the pattern of growth of built form is different for various tourist sites. Therefore, this study explores the patterns of growth of built-up for a decade from 2009 to 2019 through two-dimensional and three-dimensional analysis. Land use maps are created through supervised classification of satellite images obtained from LANDSAT 4-5 and LANDSAT 8 for 2009 and 2019, respectively. The overall expansion of the built-up area in the region is analyzed in relation to the distance from the city's geographical center and the tourism-related growth regions are identified which are influenced by the proximity of tourist attractions. The primary tourist sites of various destinations with different geographical characteristics and tourism activities, that have undergone a significant increase in built-up area and are occupied with tourism-related infrastructure are selected for further study. Proximity analysis of the tourism-related growth sites is carried out to delineate the influence zone of the tourist site in a destination. Further, a temporal analysis of volumetric growth of built form is carried out to understand the morphology of the tourist precincts over time. The Digital Surface Model (DSM) and Digital Terrain Model (DTM) are used to extract the building footprints along with building height. Factors such as building height, and building density are evaluated to understand the patterns of three-dimensional growth of the built area in the region. The study also explores the underlying reasons for such changes in built form around various tourist sites and predicts the impact of such growth patterns in the region. The building height and building density around tourist site creates a huge impact on the appeal of the destination. The surroundings that are incompatible with the theme of the tourist site have a negative impact on the attractiveness of the destination that leads to negative feedback by the tourists, which is not a sustainable form of development. Therefore, proper spatial measures are necessary in terms of area and volume of the built environment for a healthy and sustainable environment around the tourist sites in the destination.

Keywords: sustainable tourism, growth patterns, land-use changes, 3-dimensional analysis of built-up area

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Authors: Krishna Gopal Lageju

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On 25th April 2015, a 7.6 magnitude earthquake struck Gorkha district of Nepal, which resulted over 8,790 deaths and 22,300 injuries. In addition, almost one-third of the country’s healthcare service has been disrupted. A total of 1,211 health facilities became non-operational, due to 446 completely and other 765 partially damaged. Nearly 84 percent (375 out of 446) of the completely damaged health facilities are in the 14 most affected districts. As a result, the ability of health facilities to respond to health care needs has been harshly affected. In addition, 18 health workers lost their lives and 75 are injured, which added further challenges in the delivery of health services. Thus, to address the immediate health needs in the most devastated areas, Nepal Red Cross Society (NRCS) in coordination with IFRC and Nepal Government, 8 Field hospitals established with surgical capacities, where around 492 international Emergency Response Units (ERUs) Members are mobilized for 3 months period. More than 54,000 patients have been treated in the Red Cross operated field hospitals. Trauma cases accounted 9,180 (17%) of the total patients off which 1,285 (14%) are major surgical cases. Most of the case loads 44,830 (83%) are outpatients and 9,180 patients got inpatients service. Similarly, 112 births have been performed in the field hospitals. Inpatient mortality rate remained 1.5% (21 deaths), many of them are presented with critical injuries or illnesses. No outbreak has been seen during the ERU operation. Deployment of ERUs together with national health workers are very important to address the immediate health needs of the affected communities. This will ease for transition and handover of emergency service and equipments to local provider. Likewise, capacity building of local staff as on the job training on various clinical teachings would be another important issue to look at before phasing out such services.

Keywords: trauma management, critical injuries, earthquake, health

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Authors: Sahar Heidary, Ramin Ghasemi Shayan

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The recent coronavirus disease 2019 (COVID-19) occurrence has carried considerabletrials to the world health system, comprising the training of dental and maxillofacial radiology (DMFR). DMFR will keep avital role in healthcare throughout this disaster. Severe acute breathing disease coronavirus 2 (SARS-CoV-2), the virus producing the current coronavirus disease 2019 (COVID-19) pandemic, is not only extremely contagious but can make solemn consequences in susceptible persons comprising dental patients and dental health care personnel (DHCPs). Reactions to COVID-19 have been available by the Cores for Infection Switch and Inhibition and the American Dental Association, but a more detailed answer is necessary for the harmless preparation of oral and maxillofacial radiology. Our goal is to evaluation the existing information just how the illness threatens patients and DHCPs and how to define which patients are possible to be SARS-CoV-2 infected; study how the usage of private shielding utensils and contamination control measures based on recent top observes, and knowledge can decrease the danger of virus spread in radiologic trials; and scrutinize how intraoral radiography, with its actually superior danger of scattering the infection, might be changed by extraoralradiographic methods for definite diagnostic jobs. In the pandemic, teleradiology has been extensively recycled for diagnostic determinations of COVID-19 patients, for discussions with radiologists in crisis cases, or managing of distance among radiology clinics. Dentists can have the digital radiographic images of their emergency patients through online service area also by electronic message or messaging applications to view in their smart phones, laptops, or other electronic devices.

Keywords: radiology, dental, oral, COVID-19, infection

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Authors: Maimona A. E. Elimam, Suhair Rehan, Miskelyemen A. Elmekki, Mogahid M. Elhassan

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Staphylococcus aureus (Staph. aureus), a major cause of potentially life-threatening infections acquired in healthcare and community settings, has developed resistance to most classes of antimicrobial agents as determined by the dramatic increase. The present study aimed to determine the prevalence of MRSA, and VRSA in patients with different clinical manifestations in Khartoum state. The study population (n, 426) were males and females with different age categories, suffering either from wound infections (105), ear infections (121), or UTI (101), in addition to nasal carriers of medical staff (100). Cultures, Gram staining, and other biochemical tests were performed for conventional identification. Modified Kirby-Bauer disk diffusion method was applied and DNA was extracted from MRSA and VRSA isolates and PCR was then performed for amplification of arc, mecA, VanA, and VanB genes. The results confirmed the existence of Staph. aureus in 49/426 (11.5%) cases among which MRSA were isolated from 34/49 (69.4%) when modified Kirby-Bauer disk diffusion method was applied. Ten out of these 34 MRSA were confirmed as VRSA by cultures on BHI agar containing 6μg/ml vancomycin according to NCCLS criteria. PCR revealed that out of the 34 MRSA isolates, 26 were mecA positive (76.5%) while 8 (23.5%) were arcC positive. No vanA or VanB genes were detected. Molecular method confirmed the results for MRSA through the presence of either arcC or mecA genes while it failed to approve the occurrence of VRSA since neither VanA or VanB genes were detected. Thus, VRSA may be attributed to other factors.

Keywords: antibiotic resistance, Staphylococcus aureus, VRSA, MRSA, Khartoum, Sudan

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Authors: Jui-Chen Huang

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The purpose of this study is to explore the effects of telecare on preventing and delaying the quality of disability care in elderly people with portable comfort Bluetooth brainwave devices with remote healthcare functions. Through the teaching videos and remotely teaching the elderly, which had ever learned the care courses of the prevent and delay disability, these elderly did muscle strength training. Then this paper explores the effect of training with the data by SPSS 18.0 statistical software. The data is collected with pre-test, post-test and analyze data from the measure of the Bluetooth brain wave equipment including the pressure index, relaxation index, attention and fatigue index of the elderly. In this study, 30 elderly people who had taken preventive and delayed disability care courses were studied to explore the effect of their care quality improvement. The results showed that the pressure index, relaxation index, attention, and fatigue index of the elderly had statistically significant differences in two months. It can be seen that elderly people who have been treated to prevent and delay disability care courses can significantly improve their care quality if they continue to receive intensive training to prevent and delay disability through remote mode. This telecare is applied to the elderly program that has been used to prevent and delay disability care courses. It is worth continuing to promote, and it is recommended that follow-up studies be conducted in a longer-term manner to explore long-term benefits. It can solve the current insufficiency of long-term care resources, but the demand is urgent.

Keywords: telecare, bluetooth brainwave equipment, prevention and delay of disability, the elderly, care quality

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Authors: Sunday Moses Ojelabi

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Safety is the protection of the crew, passenger and equipment itself, as well as those living and working near bodies of water, from hazardous situations. To assure safety, watch keeping is paramount because neglecting your watchkeeping can lead to hazardous situations. Navigation is the assignment of a sailor to a specific route on a vessel to operate. Navigation is the process of planning, managing, and directing a vessel safely to the desired destination with the aid of intense and efficient watch keeping. Safety, i,e, all measures done to preserve the welfare of marine life, maritime infrastructure, facilities, ships, offshore installations, crew, and passengers, as well as the preservation of navigation and the ease of maritime trade, are referred to as safety measures;. When it comes to health, the absence of a proper first aid kit will affect injured sailors and passengers. Not using goggles while shipping, ear muffs, etc., in the course of maintenance can be hazardous. Watchkeeping: i.e the specific dutiies assigned to a personnel in a vessel to see to its continous smooth functionality. Your lookout or watch officer [officer on navigational duty] must be active at all times in the course of duty. Navigation refers to the technique of precisely determining a craft or vehicle's position and directing its motion along a particular course. The seafarers are not being put through regular seminars, training, and orientations. In parts of West Africa, sailors go to school without being able to secure jobs until their papers expire. For that, they won’t go for another Standard Trainning Certification and Watch keeping for Seafarers to upgrade their certificate. In light of this, they are not familiar with the new vessels in the country, and for this, they can`t meet the safety, watch keeping, and navigation standards. Also, shipping companies and ship owners are being selfish by not putting the proper things needed onboard regarding safety, watchkeeping, and navigational equipment. The questions raised in these presentations are the breakdown of the safety activities, watch keeping effectiveness, and navigational accuracy. All safety and watch keeping regulations should be applied efficiently. The problem identified includes a lack of safety instruments onboard vessels in African waters. Also, inadequate proper watchkeeping due to the excess workload on the seafarers can lead to an improper lookout, which gives room to collision, hijacking, and piracy. The impact of this research is to inform African seafarers, shipping companies, and ship owners of the necessary information concerning the safety of their lives and that of their passengers, cargo, and equipment.

Keywords: standard of training, certification, watch keeping for seafarers, navigation, safety, watchkeeping

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Authors: Raghavi C. Janaswamy

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In the healthcare sector, heterogenous data elements such as patients, diagnosis, symptoms, conditions, observation text from physician notes, and prescriptions form the essentials of the Electronic Health Record (EHR). The data in the form of clear text and images are stored or processed in a relational format in most systems. However, the intrinsic structure restrictions and complex joins of relational databases limit the widespread utility. In this regard, the design and development of realistic mapping and deep connections as real-time objects offer unparallel advantages. Herein, a graph neural network-based classification of EHR data has been developed. The patient conditions have been predicted as a node classification task using a graph-based open source EHR data, Synthea Database, stored in Tigergraph. The Synthea DB dataset is leveraged due to its closer representation of the real-time data and being voluminous. The graph model is built from the EHR heterogeneous data using python modules, namely, pyTigerGraph to get nodes and edges from the Tigergraph database, PyTorch to tensorize the nodes and edges, PyTorch-Geometric (PyG) to train the Graph Neural Network (GNN) and adopt the self-supervised learning techniques with the AutoEncoders to generate the node embeddings and eventually perform the node classifications using the node embeddings. The model predicts patient conditions ranging from common to rare situations. The outcome is deemed to open up opportunities for data querying toward better predictions and accuracy.

Keywords: electronic health record, graph neural network, heterogeneous data, prediction

Procedia PDF Downloads 86

Authors: Babatope David Omoniyi, Fiona Lalor, Sinead Furey

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This ongoing project investigates the impact of Brexit on consumer perceptions of trust in the food industry. Brexit has significantly impacted the food industry, triggering a paradigm shift in the movement of food/agricultural produce, regulations, and cross-border collaborations between Great Britain, Northern Ireland, and the Republic of Ireland. In a world where the dynamics have shifted because of regulatory changes that impact trade and the free movement of foods and agricultural produce between these three countries, monitoring and controlling every stage of the food supply chain have become challenging, increasing the potential for food fraud and food safety incidents. As consumers play a pivotal role in shaping the market, understanding any shifts in trust post-Brexit enables them to navigate the market with confidence and awareness. This study aims to explore the complexities of consumer perceptions, focusing on trust as a cornerstone of consumer confidence in the post-Brexit food landscape. The objectives include comparing trust in official controls pre- and post-Brexit, determining consumer awareness of food fraud, and devising recommendations that reflect the evidence from this primary research regarding consumer trust in food authenticity post-Brexit. The research design follows an exploratory sequential mixed methods approach, incorporating qualitative methods such as focus groups and structured interviews, along with quantitative research through a large-scale survey. Participants from UCD and Ulster University campuses, comprising academic and non-academic staff, students, and researchers, will provide insights into the impact of Brexit on consumer trust. Preliminary findings from focus groups and interviews highlight changes in labelling, reduced quantity and quality of foods in both Northern Ireland and the Republic of Ireland, fewer food choices, and increased food prices since Brexit. The study aims to further investigate and quantify these impacts through a comprehensive large-scale survey involving participants from Northern Ireland and the Republic of Ireland. The results will inform official controls and consumer-facing messaging contributing valuable insights to navigate the evolving post-Brexit food landscape.

Keywords: Brexit, consumer trust, food fraud, food authenticity, food safety, food industry

Procedia PDF Downloads 47

Authors: Man Wai Leung, Margaret O’Donoghue, Lorna K. P. Suen

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Personal and household hygiene measures are important to prevent upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAP) in the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of parents always perform hand hygiene before touching their mouth, nose, or eyes. For environmental hygiene, only some household items were disinfected with disinfectants (69.8%: door handles, 60.4%: toilet seats, 42.8%: floor, 24.2%: dining chairs, 20.5%: dining tables). Higher knowledge score was associated with parents having a tertiary educational level or above, working as healthcare professionals, living at private residential flat or staff quarter, and having a household income of $70,000 or above. Hand hygiene practices varied significantly with parents’ age and income. During the 5th wave of the COVID-19 epidemic, misconceptions about hygiene knowledge were found among parents. Health promotion programs should target parents, especially those who are in old age, obtain lower educational levels, live in public housing, or have a lower income. Hand hygiene moments and proper use of disinfectants could be one of the targeted educational topics.

Keywords: hygiene, upper respiratory tract infection, parents, children, COVID-19

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

Procedia PDF Downloads 163

Authors: Ephrem Mebratu Dagnew, Mohammed Biset Ayalew, Gizework Alemnew Mekonnen, Alehegn Bishaw Geremew, Ousman Abubeker Abdela

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Objective: To assess the prevalence of drug-related problems and associated factors among adult psychiatric inpatients. Method: Hospital-based multicenter cross-sectional observational study was conducted from April to July 2021 at five randomly selected hospitals in North-west Ethiopia. A total of 325 consecutively sampled patients participated in the study. Clinical pharmacists assessed the DRPs based on clinical judgment supported by updated evidence-based diseases guidelines. A Medscape drug-interactions checker was used to check drug-drug interactions. The results were summarized using descriptive statistics, including frequency, mean, and standard deviation. Odds ratio (OR) with 95% confidence interval were also computed for each variable for the corresponding P-value. The value of P ≤ 0.05 was considered statistically significant. Result : From the total of 325 study participants, more than half of them (52.9%) were females and the mean age ± (standard deviation) was 30.8±11.3 years. At least one drug-related problem was recorded from 60.9%, 95% CI (55.7-65.8) of study participants with a mean of 0.6±0.49 per patient. Need additional drug therapy was the most common DRP (22.8%), followed by non-adherence to medicine (20.6%) and adverse drug reactions (11%), respectively. Factors independently associated with drug-related problems were rural residence [AOR=1.96,95%CI:1.01-2.84, P-value=0.046], self-employed [AOR=6.0 ,95% CI: 1.0-36.9, P-value=0.035] and alcohol drinkers [AOR=6.40,95%CI:1.12-37.5, p-value=0.034]. Conclusion: The prevalence of drug-related problems among adult psychiatric patients admitted to psychiatric wards was high. Healthcare providers give more attention to tackling these problems. Being a rural residence, self-employed, and Alcohol drinkers were associated with drug-related problems.

Keywords: psychiatric patients, drug-relatedproblems, multicenter, Ethiopia

Procedia PDF Downloads 162

Authors: Afshin Azari, Farzad Peiravian, Nazila Yousefi

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Introduction: Community pharmacies have been always played an important role in public health. Therefore, having a decent service provided by these pharmacies is of paramount importance for the healthcare system. The issue of pharmacy ownership and its possible impact on the quality of services and amount of violations has been argued for many years, and there are different opinions around this debate. Since, so far, no scientific research has been performed to investigate this issue in Iran, this study aimed to examine the differences between these two types of pharmacies ownership in terms of violations and service quality. Method: This study investigates the impact of two different kinds of pharmacy ownership (pharmacists and non-pharmacist’s ownership) on the pharmacies’ amount of violations and services quality. Pharmacies’ amount of violations was examined using “pharmacy inspection reports” between September 2018 and September 2019, in their distinguishable categories: minor, major and critical violations. Then, service quality was examined using a questionnaire from the perspective of pharmacy customers. Results: Considering violations, there was no evidence to prove a significant relationship between critical violations and major violations with the type of pharmacy ownership. However, in minor violations, the average of violations was higher in pharmacies owned by pharmacists in comparison to their non-pharmacist owned counterparts. Regarding service quality, the results showed that there is no significant relationship between the quality of service and the type of pharmacy ownership. Discussion and Conclusion: In this study, no significant relationship was found between the amount of violations and the type of pharmacy ownership. This could indicate that the pharmacy ownership would not influence the rate of violations. Considering that more inspections have been carried out in non-pharmacist owned pharmacies, it can be concluded that these pharmacies are more under control, and in fact, this monitoring has reduced violations in these pharmacies. The quality of services in the two types of pharmacies were not significantly different from each other, and this shows that non-pharmacist-owned pharmacies also try to maintain the desired level of service in competition with their competitors.

Keywords: pharmacy ownership, quality of service, violation, community pharmacy

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Authors: Kebret Kebede, Anthony Scinta

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Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

Procedia PDF Downloads 449

Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva Vanlangenhove

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Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto a cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurred. At the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5°C is regulated and maintained continuously by a heating device. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time for the developed heating element was about 6 minutes to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

Procedia PDF Downloads 77

Authors: Magdalena Kowalska, Weronika Rupik

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The pancreas is an important organ present in all vertebrate species. It contains two different tissues, exocrine and endocrine, that act as two glands in one. The development and differentiation of the pancreas in reptiles is poorly known in comparison to other vertebrates. Therefore, the aim of this study was to investigate the particular steps concerning the differentiation of the pancreas in the grass snake (Natrix natrix) embryos. For this, histological methods (including hematoxylin and eosin, and Heidenhain's AZAN staining), transmission electron microscopy and three-dimensional (3D) reconstructions from serial paraffin sections were used. The results of this study indicated that the first step of pancreas development in Natrix was the connection of the two pancreatic buds: dorsal and ventral one. Then, duct walls in both buds started to be remodeled from the multilayered to single-layered epithelium. This remodeling started in the dorsal bud and was simultaneously with the differentiation of the duct lumens which occurred by the cavition. During this process, the cells that had no contact with the mesenchyme underwent cell death named anoikis. These findings indicated that the walls of ducts in the embryonic pancreas of the grass snake were initially formed by the abundant principal and single endocrine cells. Later the basal and goblet cells differentiated. Among the endocrine cells, as the first the B and A cells differentiated, then the D and PP cells. The next step of the pancreatic development was the withdrawing of the endocrine cells from the duct walls to form the pancreatic islets. The endocrine cells and islets were found only in the dorsal part of the pancreas in Natrix embryos what is different than in other vertebrate species. The islets were formed mainly by the A cells. Simultaneously, with the differentiation of the endocrine pancreas, the acinar tissue started to differentiate. The source of the acinar cells were pancreatic ducts similar as in other vertebrates. The acini formation began at the proximal part of the pancreas and went towards the caudal direction. Differentiating pancreatic ducts developed into the branched system that can be divided into extralobular, intralobular, and intercalated ducts, similarly as in other vertebrate species. However, the pattern of branching was different. In conclusions, particular steps of the pancreas differentiation in the grass snake were different than in other vertebrates. It can be supposed that these differences are related to the specific topography of the snake’s internal organs and their taxonomy position. All specimens used in the study were captured according to the Polish regulations concerning the protection of wild species. Permission was granted by the Local Ethics Commission in Katowice (41/2010; 87/2015) and the Regional Directorate for Environmental Protection in Katowice (WPN.6401.257.2015.DC).

Keywords: embryogenesis, organogenesis, pancreas, Squamata

Procedia PDF Downloads 170

Authors: Amy Guidera, Steven Busby, Christian Williams, David Phillippi

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College students are a priority preventative healthcare population that can engage in high-risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the course of an academic semester while evaluating our ability to achieve an improved quality of care at a reduced cost, along with improved STI reporting and documentation. This study was conducted through retrospective chart reviews of STI-related visits and utilized the RADAR matrix to provide a guiding, iterative mechanism to continuously reassess goals and outcomes defined in a memorandum of agreement (MOA) between a university health center and the state department of health (DOH) laboratory. The project failed to increase the amount of STI screenings, most likely due to the emergence of COVID-19, but resulted in improved quality of care for students, improved STI-related visit documentation and reporting, and significantly reduced costs for STI screening for collegiate students at a southeastern private university campus.

Keywords: college health, college students, preventive health, reproductive health, sexually transmitted infections, young adults

Procedia PDF Downloads 135

Authors: Ross J. Maestas

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Biofuels are derived from multiple renewable bioenergy feedstocks including animal fats, wood, starchy grains, and oil seeds. Transportation agencies have considered growing the latter two on underutilized and nontraditional lands that they manage, such as in the Right of Way (ROW), abandoned weigh stations, and at maintenance yards. These crops provide the opportunity to generate revenue or supplement fuel once converted and offer a solution to increasing fuel costs and instability by creating a ‘home-grown’ alternative. Biofuels are non-toxic, biodegradable, and emit less Green House Gasses (GHG) than fossil fuels, therefore allowing agencies to meet sustainability goals and regulations. Furthermore, they enable land managers to achieve soil erosion and roadside aesthetic strategies. The research sought to understand if the cultivation of a biofuel feedstock within the Arkansas State Highway Transportation Department’s (AHTD) managed and marginalized lands is feasible by identifying potential land areas and crops. To determine potential plots the parcel data was downloaded from Arkansas’s GIS office. ArcGIS was used to query the data for all variations of the names of property owned by AHTD and a KML file was created that identifies the queried parcel data in Google Earth. Furthermore, biofuel refineries in the state were identified to optimize the harvest to transesterification process. Agricultural data was collected from federal and state agencies and universities to assess various oil seed crops suitable for conversion and suited to grow in Arkansas’s climate and ROW conditions. Research data determined that soybean is the best adapted biofuel feedstock for Arkansas with camelina and canola showing possibilities as well. Agriculture is Arkansas’s largest industry and soybean is grown in over half of the state’s counties. Successful cultivation of a feedstock in the aforementioned areas could potentially offer significant employment opportunity for which the skilled farmers already exist. Based on compiled data, AHTD manages 21,489 acres of marginalized land. The result of the feasibility assessment offer suggestions and guidance should AHTD decide to further investigate this type of initiative.

Keywords: Arkansas highways, biofuels, renewable energy initiative, marginalized lands

Procedia PDF Downloads 329

Authors: Ryan Houser

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Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy

Procedia PDF Downloads 156