BACKGROUND CONTEXT: Sacroiliac (SI) joint dysfunction is a common cause of chronic, unremitting lower back or buttocks pain.
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Δευτέρα 9 Μαΐου 2016
Sacroiliac minimal invasive fusion compared to physical therapy: six-month outcome from a multicentre randomised controlled trial
EMS agencies turn to cloud-based, integrated software packages to improve efficiency
Welcome to the new world of EMS Management Software. What's different from previous versions" Forget spreadsheets, flat-file databases, disconnected data sets and lack of employee or member involvement when it comes to information management in your EMS agency.
In today's world, it's all about breaking down information silos, eliminating redundancy and giving everyone in the organization the appropriate access to information.
Everybody gets to play
Today's EMS management software is web- or cloud-based so that any member of the organization with an Internet connection can interact with your agency's system 24/7/365 from their desktop computer, tablet or smartphone. You can conduct your banking affairs from your smartphone phone at 11:00 p.m., right" So why shouldn't your employees be able to request time off, pick up an overtime shift, or change their home address in your system when it's convenient to them"
Integrated software systems are fast becoming the norm
The most popular EMS software vendors have seemed to come to the same conclusion regarding EMS management software: scheduling, personnel management, and records management should be part of the same package. The leading software programs on the market today have many features in common, including:
- A customizable member database that enables the employer to keep all employment-related information for every employee safe and secure in one place. Just as importantly, that data is available as necessary for use by other modules in the package.
- A form system that enables the agency to convert legacy forms to electronic format as well as creating new forms from within the system to meet new needs.
- Document storage that enables the agency to have all of its governing documents, such as policies, procedures and processes online and accessible from any device with Internet access.
- Time-saving communication tools, like personal mailboxes, forced acknowledgement of messages, email and text messaging, calendar synch to mobile devices and new message alerts for timely notifications to field employees regarding a variety of operational updates from schedule changes, to certification notices, new policies, shift change approvals and more.
Online scheduling features
Managing today's dynamic workforce can be a challenge for even the most seasoned paramedic chief. The current generation of EMS crew scheduling technology provides those managers with an immense variety of tools to get every employee involved in the scheduling process with features such as:
- Availability submission that enables employees to submit their availability for upcoming schedules. An employee can designate their availability as preferred, available or unavailable.
- Manual scheduling allows managers to create and fill schedules based on employee availability, seniority, or hours worked. Multiple schedule views are available such as daily, weekly, monthly pay period views. Additional capabilities include manual entry of special events and extra duty schedules to the base schedule and tracking training classes, meetings, court appearances and more.
- Automatic or template scheduling that provides a vast array of pre-configured rotations including: 24 hours on/48 hours off; 48 on/96 off; the Chicago Rotation; the California Rotation; and many more.
- Shift sign-up features enable employees to view and sign-up for open shifts with those sign-ups being manually or automatically approved depending upon the agency's protocols. Manual approvals are made more simple by auto-sorting based on order of submission, hours worked, seniority and other employer assigned attributes.
- Overtime scheduling and tracking capabilities that enable a manager to easily see which employees can be scheduled without going into overtime. This feature can also alert the manager when they're about to schedule somebody into overtime. A rotating overtime callback list feature ensures that any manager filling an open spot knows who is next in line for overtime.
- Shift trades can be automated enabling employees to giveaway shifts to other qualified employees, swap shifts with other qualified employees and allow automatic approval of trades based on compliance rules or required administrator approval.
- Customizable compliance features enable paramedic chiefs and their managers to: establish maximum continuous work hour limits; establish maximum work hour limits per day, week or month; ensure compliance with union contract provisions and Fair Labor Standards Act requirements; ensure compliance with an agency's internal audit requirements; ensure compliance with minimum training levels for scheduling, trades, and sign-ups; and increase fairness and transparency, reduce employee grievances and turnover, and eliminate accusations of favoritism.
Records management for your employees and assets
It is equally important for EMS managers to document that personnel are compliant with regulatory requirements, such as completion of required OSHA training, as well as EMS certification and recertification requirements. Add in the need for keeping accurate records for vehicle and equipment checks and you've got the need for an automated records management system.
With available software employers can build your member database using standard information fields or customized fields. With that database you and your employees can: maintain their contact information; track and manage their completed training, licenses and certifications. Members can receive alerts when a certification is soon to expire.
Managers can also create online forms for vehicle maintenance, equipment checks, incident reports, inventory and more. Employees can fill out forms electronically from their computer or mobile device and supervisors and managers can have access to those completed forms in real time.
The library or document storage function for several of the software packages available enables you and your staff to store documents, videos, pictures and practically any other type of computer file for online access. Management controls for this function enable paramedic chiefs and their staff to set appropriate access parameters for different employee groups.
Before you get started answer these questions
Paramedic chiefs should carefully consider the following questions when trying to pinpoint key problems that could be causing inefficient scheduling operations and increased costs. The answers to these questions will go a long way toward getting the right resource management system software for the EMS agency.
- How do you currently schedule your employees"
- How many EMTs and paramedics do you have"
- What is your biggest challenge with scheduling"
- Do you have trouble controlling overtime"
- How do employees submit a request for a particular shift"
- How do you ensure your vehicles are staffed with members that have the appropriate qualifications"
- How do you find replacements for last-minute open personnel slots"
- How do you track resources such as vehicles or aircraft"
- How many physical locations do you have"
- Who will be accessing the system"
- What kind of infrastructure and support do you have for informational technology, internet connectivity, pages, email, tablets and smartphones"
- What kind of shifts and rotations do you use"
- Do you use a planning tool to create your staffing plans"
- How do you currently distribute schedules" What are the caveats"
- What are your critical factors for this system"
Share your tips, experiences and resources for implementing new software applications into an EMS agency.
Resources reviewed
1. Aladtec. On-line Employee Scheduling. http://ift.tt/1rN073X
2. eCore Software. ePro Scheduler for EMS. http://ift.tt/1XhU7fY
3. EMS eSchedule. Scheduling & Time Clock Software for Ambulance & EMS Agencies. http://ift.tt/1rN0742
4. Zoll Data. A Scheduling Solution Should Be About Saving Both Time and Money. White Paper. [Available online] http://ift.tt/1XhUabF
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Simulated patient monitor video
Simulated patient monitor video shows the deterioration of a patient from stable to unstable and the accompanying auditory overload. (Video courtesy of iSimulate)
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Cranial nerve song
The lyrics give the functions of each cranial nerve, and also the foramen of exit and pathological conditions of some of them!
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Cranial nerve song
The lyrics give the functions of each cranial nerve, and also the foramen of exit and pathological conditions of some of them!
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Cranial nerve song
The lyrics give the functions of each cranial nerve, and also the foramen of exit and pathological conditions of some of them!
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10 helpful stethoscope tips for EMTs, paramedics and students
Use these tips to pick the stethoscope best for you and to use it correctly on every patient
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Effects of interstimulus intervals on behavioral, heart rate, and event-related potential indices of infant engagement and sustained attention
Abstract
Maximizing infant attention to stimulus presentation during an EEG or ERP experiment is important for making valid inferences about the neural correlates of infant cognition. The present study examined the effects of stimulus presentation interstimulus interval (ISI) on behavioral and physiological indices of infant attention including infants' fixation to visual presentation, the amount of heart rate (HR) change during sustained attention, and ERP components. This study compared an ISI that is typically used in infant EEG/ERP studies (e.g., 1,500–2,000 ms) with two shorter durations (400–600 ms and 600–1,000 ms). Thirty-six infants were tested cross-sectionally at 3, 4.5, and 6 months. It was found that using the short (400–600 ms) and medium (600–1,000 ms) ISIs resulted in more visually fixated trials and reduced frequency of fixation disengagement per experimental block. We also found larger HR changes during sustained attention to both of the shorter ISIs compared with the long ISI, and larger ERP responses when using the medium ISI compared to using the short and long ISIs. These data suggest that utilizing an optimal ISI (e.g., 600–1,000 ms), which increases the presentation complexity and provides sufficient time for information processing, can promote infant engagement and sustained attention during stimulus presentation.
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The interplay of subjective social status and essentialist beliefs about cognitive aging on cortisol reactivity to challenge in older adults
Abstract
Older adults are more likely than younger adults to experience stress when confronted with cognitive challenges. However, little is known about individual differences that might explain why some older adults exhibit stronger stress responses than others. We examined the interplay of two social-cognitive factors to explain older adults' cortisol reactivity: (1) subjective social status, and (2) essentialist beliefs about cognitive aging. We hypothesized that, depending on whether older adults believe that aging-related cognitive decline is inevitable versus modifiable, low subjective social status should lead to stronger or weaker cortisol reactivity. Using longitudinal data, we assessed the impact of cognitive challenges on stress reactivity in a sample of older adults (N = 389; 61–86 years). As predicted, regression analyses confirmed that 44 min after cognitively challenging tasks, older adults exhibited a significantly different cortisol reactivity depending on their subjective social status and their essentialist beliefs about cognitive aging. Specifically, older adults with low subjective social status and high essentialist beliefs showed a significantly elevated cortisol reactivity. We discuss the role of essentialist beliefs about cognitive aging to predict when and why high versus low subjective social status leads to stress responses in older adults.
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National EMS Weekend of Honor to pay tribute to fallen EMS heroes
WASHINGTON — The National EMS Memorial Service, the National EMS Memorial Foundation and the National EMS Memorial Bike Ride will pay tribute to 32 fallen EMS and air medical providers from 15 states during the 2016 National EMS Weekend of Honor, scheduled May 20-22 at the Hyatt Regency Crystal City at Reagan National Airport, 2799 Jefferson Davis Highway in Arlington, Va.
There are many activities and events during the three-day 2016 National EMS Weekend of Honor, including two events that the public and media are invited and encouraged to attend as a show of support for the selfless service and sacrifice of the 2016 honorees:
Friday, May 20: Arrival and tribute of the National EMS Memorial Bike Ride (NEMSMBR)
- The NEMSMBR celebrates the lives of those who have made the ultimate sacrifice as well as those EMS legacy personnel who have died of natural or non-employment-related causes.
- About 100 EMS Memorial Bike Riders, led by a procession of EMS vehicles, will arrive at the Hyatt Regency Crystal City, concluding a trip that began on May 14 in Boston and kicking off the 2016 Weekend of Honor.
- Riders are predominantly EMS professionals from across the U.S., and each rider wears dog tags bearing an honoree's name, agency and date of their loss.
- Upon arrival at the Hyatt Regency Crystal City, the Presentation of Dog Tags to the families will occur. The rider will meet the family in front of the honoree's biography to present one of their two dog tags worn during the ride — an emotionally powerful part of the Honor Weekend. The rider will keep the other dog tag as a lifetime reminder of the honoree's sacrifice.
- The Presentation of the Dog Tags is immediately followed by a short ceremony.
Saturday, May 21: National EMS Memorial Service (NEMSMS)
- The National EMS Memorial Service, a formal ceremony to honor fallen EMS professionals, will be held at the Hyatt Regency Crystal City.
- The entire memorial service can be viewed via live-streaming.
- Hundreds of EMS personnel from across the country will travel to Washington, D.C. to participate in the NEMSMS, along with friends, co-workers of current and past honorees, dignitaries, EMS and business leaders, and government officials.
- All participants in the NEMSMS will be in dress uniform, flight suits, or similar appropriate attire.
- Honor Guards, along with bagpipe and drum corps will volunteer their time and services throughout the weekend.
- An American flag, sent by President Barack Obama on behalf of a grateful nation, is presented to each honoree's family along with the NEMSMS medallion.
- During the service, a National Moment of Silence will be called at 6:00 PM (Eastern), so that EMS agencies across the U.S. can pause simultaneously in 30 seconds of radio silence to pay respect and remember the fallen—together.
- The year's honorees are highlighted in a special Tribute Video, followed by an uplifting Candlelight Ceremony that concludes the service.
- The National EMS Memorial "Tree of Life" will be on display. Bronze oak leaves are engraved with the names of fallen honorees for each year since 1993.
In August 2015, the three EMS organizations named above agreed to collaborate on a shared vision and strategic plan to honor EMS heroes who have died in the line of duty. They are continuing to move forward with efforts to establish a permanent National EMS Memorial in the greater Washington, D.C. area, an effort being led by the National EMS Memorial Foundation. More updates on these efforts will be forthcoming.
"This year, the National EMS Weekend of Honor coincides with the conclusion of National EMS Week, which is May 15-21," said Jana Williams, president of the National EMS Memorial Service. "Our nation's capital area in Northern Virginia is a fitting location for these annual memorial events that commemorate our country's brave men and women in the field of emergency medical services."
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Characteristics of recurrent emergency department visits within 72 hours of visits for the same or related complaints
2016-05-09T02-22-42Z
Source: Medicine Science | International Medical Journal
Sercan Bicakci, Nurcan Bicakci, Ali Duman, Ridvan Atilla.
We aimed to investigate the characteristics of recurrent emergency department visits within 72 hours for the same or related complaints. Recurrent visits were defined as any repeated visits to the emergency department within the first 72 hours of discharge after the first admission with the same or similar complaints. The study population included patients revisiting the emergency department within 72 hours after the first visit. Recurrent visit files were screened from the Hospital Information Management System, and data were compared between the first and second visits. Of the 83,578 patients included, 1,952 (2.3%) fulfilled the inclusion criteria. Thus, the revisit rate was 2.3%. Emergency Department triage scores showed no significant differences between the visits, but 2 patients with triage scores of 4 in the first visit subsequently had triage score of 1 in the recurrent visits. In addition, the presence of comorbidities was found to be significantly associated with revisit and hospitalization. Measuring and evaluating the causes of revisits to the emergency department allow assessment of hospital quality. We believe that to reduce the revisit rate, prolonged emergency room observation is necessary, particularly for patients with comorbidities and those presenting complaints related to the cardiovascular system, oncology, and respiratory system. Further, morbidity and mortality rates will consequently decrease.
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A fatal dermatosis in the emergency department: toxic epidermal necrolysis
2016-05-09T02-22-42Z
Source: Medicine Science | International Medical Journal
Ayhan Akoz, Serhat Orun, Mucahit Avcil, Ali Duman, Kenan Ahmet Turkdogan.
Toxic Epidermal Necrolysis (TEN) is acute life-threatening mucocutaneous reactions, which are mainly induced by drugs. The annual incidence is 0.51.2 cases per million population and the mortality rate is 2030%. The genetic background associated with drug hypersensitivity is very important in the development of TEN. Antimicrobials and anticonvulsants are most commonly associated with the development of TEN. TEN is a disease which acutely starts and has prodromes such as cough lasting 1-3 days, throat ache, burning eyes, arthralgia before the disease. Intraoral erosion is a constant result. Sepsis and respiratory insufficiency were the most important complications in TEN. The main therapy are drugs used by the patient were stopped, systemic corticosteroid and supportive treatment. The aim of our study is recognized of TEN by emergency physicians.
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The role of chemerin and ChemR23 in stimulating the invasion of squamous oesophageal cancer cells
British Journal of Cancer
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Serum interleukin (IL)-9 and IL-10, but not T-helper 9 (Th9) cells, are associated with survival of patients with acute-on-chronic hepatitis B liver failure
Medicine
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Severe acute hepatocellular injury attributed to OxyELITE Pro: A case series
Digestive Diseases and Sciences
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The risk of community-acquired pneumonia among 9803 patients with coeliac disease compared to the general population: a cohort study
Alimentary Pharmacology and Therapeutics
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Effect of a Financial Incentive for Colorectal Cancer Screening Adherence on the Appropriateness of Colonoscopy Orders
American Journal of Medical Quality
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Impact of hypocaloric hyperproteic diet on gut microbiota in overweight or obese patients with nonalcoholic fatty liver disease: A pilot study
Digestive Diseases and Sciences
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French national consensus clinical guidelines for the management of ulcerative colitis
Digestive and Liver Diseases
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The role of combined 24-h multichannel intraluminal impedance-pH monitoring in the evaluation of children with gastrointestinal symptoms suggesting gastro-esophageal reflux disease
Neurogastroenterology & Motility
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Insufficient evidence of benefit regarding mortality due to albumin substitution in HCC-free cirrhotic patients undergoing large volume paracentesis.
Journal of Gastroenterology and Hepatology
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Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer
Journal of Clinical Oncology
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Most premature surveillance colonoscopy is not attributable to bowel preparation or new clinical indications
Digestive Diseases and Sciences
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Treatment allocation in patients with early-stage esophageal adenocarcinoma: Prevalence and predictors of lymph node involvement
Cancer
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Magnetic resonance enterography changes after antibody to tumor necrosis factor (anti-TNF) alpha therapy in Crohn’s disease: correlation with SES-CD and clinical-biological markers
BMC Medical Imaging
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Patient-Reported Outcomes Measurement Information System in children with Crohn's disease
The Journal of Pediatrics
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Clinical activity and quality of life indices are valid across ulcerative colitis but not Crohn’s disease phenotypes
Digestive Diseases and Sciences
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Brain responses to uncertainty about upcoming rectal discomfort in quiescent Crohn's disease – a fMRI study
Neurogastroenterology & Motility
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Correlation of CTNNB1 mutation status with progression arrest rate in RECIST progressive desmoid-type fibromatosis treated with imatinib: translational research results from a phase 2 study of the german interdisciplinary sarcoma group (GISG-01)
Annals of Surgical Oncology
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MBL2 genetic variants in HCV infection susceptibility, spontaneous viral clearance and peghylated-interferon plus ribavirin treatment response
Scandinavian Journal of Immunology
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Profiling Patients Healthcare Needs to Support Integrated, Person-Centered Models for Long-Term Disease Management (PROFILe): Research design
Hepatobiliary Surgery and Nutrition
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The role of the gastrointestinal microbiome in infectious complications during induction chemotherapy for acute myeloid leukemia
Cancer
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Bioinformatics: Benchmarking transcript expression quantification
Nature Reviews Genetics. doi:10.1038/nrg.2016.62
Author: Linda Koch
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Genetic Engineering: A CORRECT step forward in disease modelling
Nature Reviews Genetics. doi:10.1038/nrg.2016.60
Author: Linda Koch
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Genetic variation: Genomic monomorphism off the scale
Nature Reviews Genetics. doi:10.1038/nrg.2016.61
Author: Linda Koch
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Cancer genomics: A catalogue of somatic mutations
Nature Reviews Genetics. doi:10.1038/nrg.2016.65
Author: Linda Koch
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Human genetics: Splicing: linking genetic variation and disease
Nature Reviews Genetics. doi:10.1038/nrg.2016.64
Author: Denise Waldron
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Genetic sources of population epigenomic variation
Nature Reviews Genetics. doi:10.1038/nrg.2016.45
Authors: Aaron Taudt, Maria Colomé-Tatché & Frank Johannes
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Population genetics: Bursts of male-lineage expansions
Nature Reviews Genetics. doi:10.1038/nrg.2016.63
Author: Bryony Jones
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