Correlation Study of Neurotransmitter and Immune Levels in Pre-Hospital Emergency Nurses with Post-Traumatic Stress Disorder

Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.

Systemic analysis of pre-hospital trauma emergency treatment in Zhengzhou

Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis for effective use of first aid resources and enhance success rate of trauma emergency treatment. Methods: Retrospective analysis was conducted based on pre-hospital emergency resources of Zhengzhou Emergency Medical Rescue Center from 2007 to 2016. Results: The total number of pre-hospital emergency treatment cases was 9305687 from 2007 to 2016 in Zhengzhou, of which 418882 were trauma cases. The top five causes of injury were traffic accident injury, cutting injury, beating injury, crushing injury and falling injury. The top five emergency treatments used were oxygen, hemostasis, dressing and fixation, fluid supplementation, analgesics and sputum aspiration. According to different directions of diagnosis, the pre-hospital emergency patients were divided into four groups:emergency treatment group, emergency observation group, admission to general ward group and admission to ICU group. There was no statistical difference in the ages among the four groups (P>0.05). There were significantly statistical differences in gender composition among the four groups, with more males than females (P<0.01). Significant statistical differences also showed in CRAMS scores among the four groups (P<0.01). Before and after the training of primary trauma care, there was no significant difference in the constituent ratio of the trauma (P>0.05), but the mortality of the trauma, the average arrival time, and the mean treatment time were significantly different (P<0.01). Conclusions: The number of pre-hospital emergency trauma patients increased year by year, but the constituent ratio changed little. CRAMS score is important for the patients triage. Through the training of primary trauma care, the constituent ratio of death was reduced, and the average treatment time was shortened.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Clinical Research of Pre-Hospital Emergency Care, Nursing, Infection Prevention and Control for Senile Osteoporotic Vertebral Compression Fracture during Epidemic Period

Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.

Assessment of HIV/AIDS Stigma in a Rural Namibian Community

Namibia has been affected by the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) pandemic with infected and affected persons experiencing stigma at different levels. Despite the high level of knowledge?on HIV/AIDS, stigma remains a challenge. It was for this reason that this paper describes and measures the level of HIV/AIDS stigma in a rural community in Namibia. Mixed methods were used to collect data from 224 participants consisting of 93 people living with HIV/AIDS (PLWHA) who were recruited voluntarily from their support groups, 77 family members nominated by PLWHA participants, 31 community members who were recruited through simple random sampling and 19 opinion leaders who were purposefully selected and four health care workers from an Antiretroviral clinic who were available at the time of this study. Three measurement instruments namely HIV/AIDS Stigma Instrument-PLWHA (HASI-P), Family & Community Stigma Instrument (F&C-SI) and HIV/AIDS Stigma Instrument-Nurse (HASI- N) were used. In-depth interviews were conducted to complement the quantitative results. The study found that stigma manifests in different ways and results revealed that verbal abuse (55%, n = 50, PLWHA), social isolation (73%, n = 67), negative self-perception (33%, n = 30), and household stigma (26% n = 19, family members) were the most common form of stigma experienced by PLWHA. Furthermore health care workers reported stigma of association (50%, n = 2) as care providers for people living with HIV/AIDS. The study concluded that stigma exists although some scores such as fear of contagion and workplace stigma were low. Therefore, interventions in knowledge on basic facts of HIV transmission need to be strengthened. Nonetheless the majority of participants confirmed their willingness to care for sick relatives with HIV and AIDS. This study did not explore stigma of association against caregivers with other participants other than the four health care workers from the antiretroviral clinic. Future researchers can take this further.

Guidelines for Community-Based HIV/AIDS Stigma Reduction Intervention in a Rural Community

Research encourages evidence-based guidelines for practice. This paper describes the guidelines for HIV/AIDS stigma reduction in the community. These guidelines were developed by the authors based on findings of the study which was conducted to develop and evaluate HIV/AIDS stigma reduction intervention in a rural Namibian community. The developed intervention consisted of three strategies which are recommended as baseline for these guidelines. The three strategies were: education, community involvement and contacts with infected and affected groups that were implemented in this study. These strategies were implemented among the people living with HIV/AIDS (PLWHA), their families and community members from the intervention group. The post-intervention results showed significant differences on stigma reduction between the intervention and control groups, therefore these strategies were recommended for future use. Furthermore, the study found that a combination of strategies was more effective than using a single approach. Another strategy that was absent in this study but was recommended in these guidelines for future stigma reduction was: counselling approach, which could be used to address internal stigma. This paper therefore recommends that these combined strategies: education, community involvement, contacts with affected and infected groups and continuous counselling, which will be named ECCC approach might be useful to reduce HIV/AIDS stigma in the community.

Stigma and Discrimination against People Living with HIV and AIDS in Malawi

A study was conducted to explore stigma and discrimination among people living with HIV and AIDS who were on home based care in the Lilongwe district of Malawi. The study design was descriptive through sectional and utilized qualitative data collection and analysis method. Fifteen people living with HIV and AIDS, aged between 15 and 60 years were purposively sampled from three organizations, which were: Light House, National Association for people living with HIV and AIDS in Malawi and Lilongwe Diocese. Qualitative data were collected using an open ended interview guide during in-depth face to face interviews with the participants. The data were analysed using ATLAS. ti 5.0. Results show that all the participants were facing stigma and discrimination because they were living with HIV and AIDS. Distant relatives were the main source of stigma and discrimination followed by friends and church members. Most participants indicated that they felt they were discriminated because HIV infection is associated with bad behaviours such as prostitution or promiscuity. However some of them complained that they contracted the virus from their married partners and hence they did not deserve to be stigmatized or discriminated against. Results show that there is a need for creation of awareness among community members on the transmission of HIV and the need for home based care for the chronically ill people living with HIV and AIDS.

Comprehensive Analysis,Discussion and Suggestion on the Current Situation of Cardiopulmonary Resuscitation and Automatic External Defibrillator in General Public in China

The number of sudden cardiac death(SCD)has increased year by year,which has become one of the main causes of death in China.Timely cardiopulmonary resuscitation(CPR)and timely and accurate use of automatic external defibrillator(AED)can greatly improve the survival rate of patients with sudden cardiac death.Because the large probability of sudden cardiac death occurs outside the hospital,it is very important for the general public to master first aid skills.This paper will mine all kinds of data from multi-dimensional and multi-angle,analyze the mastery of public first aid skills in China,and provide practical suggestions and ideas for popularizing first aid skills in the future.

Sustaining the community dispensation strategy of HIV antiretroviral through community participation

Background:The advent and widespread use of antiretroviral therapy(ART)has remarkably changed the paradigm of HIV infection,increasing substantially the lifespan and quality of life of people affected.Accordingly and responding to policy makers and international directives,many strategies were put in place in Cameroon to accelerate ART uptake,including the community dispensation of ART through community-based organizations(CBOs).Main body:In its strategic plan to curb the burden of HIV/AIDS and as part of accelerating and reinforcing the provision of ART to all people living with HIV(PLWH),Cameroon opted for different strategies including the dispensation of ART in the community through well identified and tutored CBOs.Actually,financing of ART in Cameroon is mainly the conjugation of resources from the Government and its technical and financial partners,basically the Global Funds supplemented by supports from the Unitaid initiative which allows PLWH residing in Cameroon to benefit from continuous ART without spending a dime.However,this external funding will end-up by 2020.Therefore,there is urgent need to think of alternative and efficient strategies to sustain the fight against HIV/AIDS in Cameroon,especially the provision of ART to patients through community dispensation.Some studies carried out in sub-Saharan African countries have shown that mutual health insurance seems to be a solution with great potential to improve access to quality care,mobilize the necessary funds,improve efficiency of the health sector,and promote dialogue and democratic governance in the health sector along with social and institutional development of the society.Conclusions:The pooling of associations of PLWH in Cameroon and other countries of sub-Saharan Africa in line with the Bamako Initiative constitutes a promising strategy that would undoubtedly help to offset the withdrawal of funding from external sources,and allow an appropriation of the fight against HIV/AIDS by those concerned at the first place.Nevertheless,other lines of research of financing could be explored in the economic sector.

Global burden, distribution, and interventions for infectious diseases of poverty

Infectious diseases of poverty(IDoP)disproportionately affect the poorest population in the world and contribute to a cycle of poverty as a result of decreased productivity ensuing from long-term illness,disability,and social stigma.In 2010,the global deaths from HIV/AIDS have increased to 1.5 million and malaria mortality rose to 1.17 million.Mortality from neglected tropical diseases rose to 152,000,while tuberculosis killed 1.2 million people that same year.Substantial regional variations exist in the distribution of these diseases as they are primarily concentrated in rural areas of Sub-Saharan Africa,Asia,and Latin America,with geographic overlap and high levels of co-infection.Evidence-based interventions exist to prevent and control these diseases,however,the coverage still remains low with an emerging challenge of antimicrobial resistance.Therefore,community-based delivery platforms are increasingly being advocated to ensure sustainability and combat co-infections.Because of the high morbidity and mortality burden of these diseases,especially in resource-poor settings,it is imperative to conduct a systematic review to identify strategies to prevent and control these diseases.Therefore,we attempted to evaluate the effectiveness of one of these strategies,that is community-based delivery for the prevention and treatment of IDoP.In this paper,we describe the burden,epidemiology,and potential interventions for IDoP.In subsequent papers of this series,we describe the analytical framework and the methodology used to guide the systematic reviews,and report the findings and interpretations of our analyses of the impact of community-based strategies on individual IDoPs.

Pre hospital medical services and paramedic engagement in Australian health care - Improving the pathways of care through collaborative action

Paramedics Australasia(PA)is the national body representing paramedics engaged in delivery of pre hospital emergency health care.PA is thus uniquely positioned to provide insights into the role of pre hospital medicine in the continuum of care.Every day in Australia,patients are placed at risk of harm within the health-care system.These risks are particularly notable in pre hospital care where paramedics must often tend for patients under adverse operating conditions and per-form interventions that carry significant risks.Paramedics must make clinical judgements that may profoundly affect patient outcomes-often with no access to patient history.Pre hospital medicine has changed dramatically in recent years.Paramedic practice has evolved as a unique discipline combining medicine,public health and public safety.Contemporary pre hospital medical care is now provided by professionally qualified practitioners.These developments have been built on a strong evidence base demonstrating the capacity to enhance patient outcomes through appropriate clinical interventions.Paramedics and pre hospital service providers alike have had to overcome many challenges in this journey,not the least being the education,recruitment and retention of a professional workforce and the difficulties in funding the infrastructure upon which to build a comprehensive emergency response capability.The PA vision for pre hospital medicine is based on the premise that it is an essential part of primary health care and that its seamless integration into health care will better meet patient needs that might otherwise remain unfulfilled.Paramedics can provide a variety of community health services that are crucial in the provision of more comprehensive care,especially in rural and remote communities.PA has endorsed the philosophical approach to health care outlined in the 15 National Health and Hospitals Reform Commission Health Care Principles,and recommends the translation of those principles into the pre hospital medicine environment.Given those principles it is inexplicable how paramedics have remained unrecognised as health professionals and pre hospital medicine has been ignored as part of the health care reform process.Embracing the National Health and Hospitals Reform Commission principles should see pre hospital medicine forming not only part of the local health care system but also meshed into the fabric of the community.There should be community engagement in the assessment and evaluation of pre hospital medicine care and the regulation of practitioners under a national system of professional registration.These processes will better enable the benefits of holistic care to be realised.Despite the excellence and dedication of the paramedic workforce,PA recognises that formidable challenges remain in health care delivery.These include issues of equality and access,demographic coverage,safety and quality,as well as other workforce and resource issues that affect patient outcomes.Paramedics can assist in identifying and resolving many of these issues.Australia’s health system should provide suitably rapid pre hospital medical responses with levels of care appropriate to the circumstances of each patient.Paramedics moreover hold competencies that can provide prevention,evaluation,care,triage,referral and health advisory services that can be mobilised to enhance community healthcare resources.Access to professional paramedic services should thus form an integral part of the care regime available to the community.This should be an inter-professional model of healthcare practice founded on contributions from a dynamic mixture of professional expertise at all stages of the patient journey.In PA’s view,the virtual absence of references to the role and funding of paramedic services as a key component of the health care system at a national level is a grave oversight.A nationally driven policy perspective is needed that integrates pre hospital medicine into the health system.Fulfilling the PA vision of health care requires significant change in the way paramedic services are funded and administered.It will need advice from the best available minds and committed leadership within government and the health professions to bring the already demonstrated benefits of paramedic practice to the community.Many issues need to be addressed including:(a)Sustainable funding models under national access and equity principles;(b)Education,clinical training,staff recruitment and retention;(c)Safety and quality standards and the minimisation of patient risk;(d)Extended community care models in remote and low-volume settings;(e)Clinical governance,service accreditation and practitioner registration;(f)Adequacy of evidentiary data collection to assess patient outcomes,support service evaluation and underpin research;and(g)Infrastructure integration including communication networks and dynamic referral to manage external events and cope with capacity constraints.PA strongly believes that these issues cannot be considered in isolation.Pre hospital medicine practitioners must be involved in contributing their expertise in conjunction with other health professionals so as to create a seamless system of best practice care beginning at the point of need-the patient.To fulfil that promise PA has outlined a vision for the delivery of pre hospital medicine as part of an integrated health care system.Only by incorporating the input of paramedic clinicians into that national policy and operational arena can the best patient outcomes be achieved.

Tackling the existing burden of infectious diseases in the developing world: existing gaps and the way forward

This series evaluates the effectiveness of community-based interventions(CBIs)to prevent and control infectious diseases of poverty(IDoP).Evidence from our reviews suggests that CBIs and school-based delivery platforms are effective in averting risk behaviors and reducing the disease burden.Co-implementation of interventions through existing community-based programs including immunization campaigns,antenatal care and maternal and child health programs have the potential to scale-up interventions for IDoP.Future research should focus on the process of developing and implementing efficient community-based programs through a comprehensive approach,and to gauge the effectiveness of various existing delivery models in order to improve morbidity and mortality outcomes.

Disaster response approach in Hong Kong-Assistance from volunteer agencies

Following the previous article published in the last issue on the Disaster Response Approach in Hong Kong,this paper will go through the assistance from volunteer agencies during e mergency.The advantages and problems of running of a medical defence volunteer agency will be dis-cussed in details.In order to overcome those structural problems,a new model to operate a volunteer agency will be proposed.Furthermore,tactics of promoting community preparedness for disaster will also be looked into.