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With increasing numbers of international flights and air travelers arriving in the US annually, the rapid spread of communicable diseases has grown. Epidemics of novel infectious diseases have emerged and rapidly spread globally in association with air travel, including the severe acute respiratory syndrome (SARS) outbreak in 2003 and H1N1 in 2009. In order to anticipate and mitigate the consequences of future rapid disease spread, the MITRE Corporation, in collaboration with the (US) Centers for Disease Control and Prevention, developed a risk assessment tool using a Susceptible-Exposed-Infectious-Recovered model and detailed flight and population data. The emergence and spread of prototypic pandemic influenza was simulated based on a theoretical geographical point of origin and its communicability. More than 50 international metropolitan areas were analyzed as potential points of origin to simulate the rapidity of spread to the US. The basic reproduction number (Ro), defined as the average number of persons to whom one infected individual transmits disease in an immune naive population, was varied from 1.4 to 1.9. The starting numbers of infectious persons at each origin also were varied (100 or 500 persons, 5% infectious may travel). Waves were computed as aggregate across metropolitan areas modeled in the US. The visualization of the first pandemic wave was most apparent in simulations of Ro = 1.9, resulting from 500 infectious persons at each origin. More than 50% of origins indicated that aggregate waves peaked around Day 125, while 30% of origins peaked around Day 90. Additionally, the time, in days, from its origin in six continents into the US was compared, and a two-week delay was found from South America compared with other continents. This simulation tool better equips policy makers and public health officials to quickly assess risk and leverage resources efficiently via targeted and scalable border mitigation measures during a rapid global outbreak.
Disaster preparedness and response requires an integrated response by all aspects of the health professions. The most successful outcome can occur when interprofessional cooperation exists between community, first responders, and the many facets of health professions. At Western University Health Sciences we have replaced our interprofessional disaster club with a disaster focused element in several other health professional interest clubs. The primary coordination is centered in the Public Health Club which is composed of students from many of our medical colleges. The public health club mirrors our community disaster response in that preventive medicine and preparedness lies in our public health program. Public health interest such as rabies prevention and education on world rabies they are centered in our public health club with support from our faculty expertise in public health. Educational components such as wilderness medicine fit well into the human emergency and critical care student group. Both human and veterinary emergency and critical care student group's natural interest lies in triage and first response. Student interest groups or clubs that focus on community outreach in medicine, nursing, dentistry and veterinary shelter medicine have a take the lead in emergency sheltering for vulnerable populations. Using the model presented here, disaster preparedness is promoted as routine extensions of daily professional endeavors. By building upon student interest groups we can build a culture of connectivity across the professions. Extending student club supported training endeavors to the community surrounding can allow the disaster responder community to meet on neutral ground. Western University Health Sciences is uniquely situated in Los Angeles County and our faculty and students reside in neighboring Orange Riverside and San Bernardino counties. At a private health professions university, our focus is to provide educational opportunities in a real-world setting which is integrated with community.
Animal production is an important component to economic stability and food security in developing country. Economic development programs have targeted agriculture in developing country as a means of decreasing poverty and empowering vulnerable populations throughout much of the developing world. Disasters due to natural and man-made hazards that impact animal agriculture have a disproportionate impact on the rural poor and vulnerable populations affecting the economic well being and health of the greater population. Protection of livelihoods dependent on animal agriculture is important to consider in community resilience and humanitarian assistance activities that range from capacity building through response and recovery. In order to meet the challenges of the next generation of global health threats, policy, research, and practice must adopt a new cross-cutting approach that targets the human-animal-ecologic interface taking into account political, socioeconomic, and cultural factors.
The number of victims in various refugee camps who experience anxiety after the Mount Merapi eruption. Various factors that cause this condition include a lack of concern for the early treatment of psychological casualties. Support from health professionals, particularly nurses, is needed to prevent the onset of mild anxiety.
Objectives
The study was carried out in order to help understand the meaning of nurses' experiences of trauma healing to prevent anxiety among the victims of the Mount Merapi eruption.
Method
This was a qualitative research study with a phenomenological approach. In-depth interviews were used to explore participants' experiences conducting trauma healing therapy to the Mount Merapi eruption victims.
Result
The result showed the implementation of trauma healing therapy includes: (1) assessment of emotional responses; (2) physical examination; and (3) psychological assistance. The therapy being implemented includes: (1) five-finger hypnosis therapy; (2) stopped thinking therapy; and (3) progressive relaxation. The impacts of trauma healing included: (1) spirit returning; (2) increased of relaxation; (3) calmness; (4) normal vital signs; and (5) the ability to interact with other refugees. Problems experienced included the large number of refugees, the noisy environment, and a lack of concentration from the nurse when providing therapy.
Conclusion
To solve the problem, nurses are expected to recognize the response required for the victim and apply interventions based on the assessment, data analysis, planning, implementation, and evaluation. Victims of the Mount Merapi eruption are expected to attempt to apply the self-trauma healing.
L'exercice medical ou soignant en conditions de medecine de catastrophe se detache de l'exercice classique du fait du nombre important de victimes a traiter en un laps de temps reduit. S'y surajoute, en contexte chimique, le port d'une tenue de protection reduisant de maniere significative les performances du soignant qui la porte. Il est donc necessaire de proposer aux equipes amenees a exercer dans ces conditions des seances d'entrainement visant a acquerir la competence requise en pareilles circonstances. Une premiere etape a ete franchie avec la validation de realisation en tenue de protection des gestes (perfusion intraveineuse ou intraosseuse, controle des voies aeriennes superieures, ventilation assistee) utiles dans ce contexte. L'etape suivante qui vient de s'ouvrir vise a “immerger” le soignant dans une ambiance quasi-reelle (port de la tenue de protection, victime realiste et surtout dynamique, reagissant aux diverses actions entreprises). Il lui sera ainsi possible d'acquerir non seulement la gestuelle mais egalement la mise en pratique des notions enseignees lors des formations theoriques, avec un resultat beaucoup plus parlant et plus rapidement evaluable. Le cout eleve, au moins pour l'instant, des mannequins constitue un ultime obstacle pour la realisation d'exercices veritablement realistes associant de nombreuses victims
According to the Belgian Hospital Disaster Planning Act, all hospitals are required to have written disaster plans and to routinely conduct annual disaster drills. In 2010, the management of the Military Hospital decided to organize an evacuation exercise of the newly built 24-bed BU.
Aim
To evaluate this new BU's evacuation plan and drills and the overall hospital emergency incident response and command system.
Methods and Results
It was decided to conduct a simulated evacuation exercise following an internal fire, before the BU effectively was put into use, thereby deploying fashioned simulated patients and visitors but bringing into action the regular attending medical, nursing and logistic staff. A multidisciplinary design and organizing team was launched, consisting of the hospitals disaster preparedness coordinator, the EMS-staff, external burn care, emergency incident management and operational engineering experts. The appointed objectives for evaluation were the knowledge of the regular evacuation drills, especially the clearance of an intensive care room; access to evacuation routes; visibility of safety guidelines; mission and tasks of the hospital's first response team and the medical incident manager; communication and information flow and the establishment of the hospital's coordination committee. In the mean time and following lessons learned, a number of mitigation measures have been instituted: adequate identification of evacuated rooms, new configuration of the fire detection alarm, optimized access to stairwells and elevators, adjustment of action cards and specific fire fighting training for hospital staff. Finally the decision was made not to purchase specific evacuation equipment for the movement of patients.
Conclusion
Taking advantage of the BU's provisional vacancy, a simulated hospital evacuation exercise increased the hospital emergency preparedness, awareness and response to disasters within the hospital, in particular in a critical care department, otherwise difficult to assess.
The first decade of the 2000s has advanced the field of mental health and psychosocial support (MHPSS) in disasters by providing expert consensus guidance. Nevertheless, MHPSS response to major disasters is frequently uncoordinated and rarely based on scientific evidence. Moreover, MHPSS response is not customized to the unique constellation of stressors and psychological risk factors that distinguish each disaster event. To address this lack of science and specificity, we have developed trauma signature (TSIG) analysis.
Methods
TSIG analysis consists of the following steps. Risk factors for disaster-related psychological distress and psychopathology (e.g., PTSD, depression) are continuously documented, updated, and refined. When disaster strikes, situation reports (sitreps) are issued in the early aftermath. We examine initial sitreps to determine the presence and intensity of evidence-based risk factors, subsumed under the headings of exposure to hazards, loss, and change. We estimate the size of the affected population. We rapidly create an initial TSIG and translate findings into actionable guidance regarding probable MHPSS needs for services and personnel.
Results
We have constructed TSIGs for prominent 2010 disasters: Haiti earthquake, Deepwater Horizon oil spill, and Pakistan monsoonal flooding. Psychological risk factor profiles contrast sharply across these three salient events. Regarding exposure to hazards, numbers of persons experiencing physical injury and perceiving threat to life are highly divergent. Losses differ dramatically when quantified in terms of deaths, numbers bereaved, homes and livelihoods lost, and economic toll. The degree of lifestyle and societal change, including displacement, lack of survival needs, lack of security, and interpersonal violence, also differentiates the psychological impact of these disparate events.
Conclusion
TSIG analysis can be used to provide rapid post-impact/pre-deployment MHPSS response guidance based on risk factor assessment. Using TSIG analysis, MHPSS response can be tailored and timed to the defining features of the disaster event.
El desastre deja de ser un momento de disrupció n en la cotidianeidad y quienes está n ante la coordinació n de gestió n de estrategias de respuesta son responsables de generar efectos no iatrogé nicos en la salud pú blica. La mayorí a de las catá strofes no son sorpresivas ni inmanejables. Observamos que la discontinuidad en las acciones genera desorden y mayor sufrimiento humano. Los costos de estas situaciones no son solamente econó mico- financieros, sino que generan pé rdida de vidas, bienes, desequilibrios psico-sociales, deterioro del medio ambiente y profundas crisis polí ticas y econó micas-financieras.
Metodologí a
Mejoramos en cada evento en el que se trabajo, la eficiencia y la capacidad de planificació n operativa con base en datos “ cientí ficos en el manejo de instrumentos especí ficos y evaluaciones rá pidas de dañ os.
Evaluamos
seis eventos trá gicos en el paí s, incendio, atentado, inundació n, guerra, en 10 añ os y el efecto de la evolució n de las acciones normatizadas y no interrumpidas para evaluar la eficiencia y la eficacia de las acciones no interrumpidas en estrategias de respuesta logí stica.
Conclusió
La contenció n psicosocial y evaluació n de los Recursos Humanos se impone como una tarea ineludible en la logí El rol del á mbito de la Salud y de la comunicació n es de fundamental importancia ante los impactos psicosociales previstos tragedia. Amenazas, riesgos y vulnerabilidades, recursos de acrecentamiento de la resiliencia deben estar contemplados en todo trabajo que busque disminuir el sufrimiento humano Gestionar la crisis era resolver lo caó tico, gestionar los riesgos es evitar lo caó tico. Programas “ help to help” la, consideració n de la Resiliencia, burn-out y stress se incluye en situaciones de emergencia y desastres. La discontinuidad del aprendizaje de estrategias de respuesta es iatrogé nica.
Chemical warfare agents (CWAs) are a growing concern for many countries. The uses of CWAs as they can be synthesized by simple chemical reactions, and often have an extremely high toxicity. Conventional, analytical techniques for the detection of nerve agents from environmental and biological samples include gas chromatography, liquid chromatography, gas chromatography– mass spectrometry, ion chromatography, atomic emission detection, capillary electrophoresis, etc. These methods have very high sensitivity, reliability, and precision. However, in spite of these advantages, these techniques require expensive instrumentation and highly trained personnel. They also are time-consuming and unsuitable for field analysis. To meet these prerequisites of rapid warning and field deployment, more compact, low-cost instruments are highly desirable for facilitating the task of on-site monitoring of nerve agents. a quartz crystal microbalance (QCM) sensors could be a reliable and promising alternative to routine methods because of their simplicity, ease of use and high sensitivity and selectivity.1,2 In this study, we prepared QCM sensors functionalized with –NH2 and –COOH groups for differentiate diethyl ester phosphonic acid (DEHP) from diethyl phthalate (DEP), which are known as G and VX agent stimulants respectively. Infrared spectroscopy (FT-IR) was performed in order to characterize the surface of the sensor after modification and the detection. Furthermore, impact of hydrogen bonds on detection will be discussed.
During the planning phase of a mass gathering, it is important to organize the most suitable healthcare responses to assure primary, emergency, and major accident care, with the best balance between available resources and costs.
Objectives
This study tries to develop a Mass-Gathering Event Risk Scoring Model (MGE-RS) to predict Medical Usage Rate (MUR) that can assist emergency medical services providers in planning for mass gatherings across a variety of events and venue types in a metropolitan area.
Methods and Results
This study includes 48 mass gatherings in Rome (35 mass gatherings; 2005–2006) and Milan (13 mass gatherings; 2009–2010). All 35 mass gatherings in Rome had > 100,000 attendees (100,000 to 5,000,000), while the 13 mass gatherings in Milan had a median of 100,000 attendees (50,000–200,000). The median patient presentation rate (PPR) was 0.5 patients/1,000 persons: this rate is close to PPRs for mass gatherings reported in the literature (0.5–2.0 patients/1,000 attendees). For each event, the predicted MURs, calculated using the Arbon Model and the MGE-RS Model, were compared with the actual MUR. The MGE-RS scoring model uses a formula that assigns points based on known information (type of event, place, duration, crowd, health system facilities) to predict the risk. The MGE-RS score ranged from 16 to 77. There are five risk levels, each one corresponds to an expected MUR from 1.5 to 45. In the events studied, the predicted MUR calculated with the Arbon model corresponded in 60% of cases (20% under/overestimation); the MGE-RS was in range in 88% of cases (0% underestimated; 12% overestimation).
Conclusions
The MGE-RS seems to be a provider-friendly tool to be used in planning phase, and is able to give an acceptable estimation of the risk level and expected MUR for a mass gathering, without underestimating the estimated MUR during the planning phase.
There are six children's hospitals in Chicago, Illinois and the surrounding region. These hospitals often have bed limitations due to high censuses in daily operations. The Pediatric Committee of the Chicago Healthcare System Coalition for Preparedness and Response had provided two conferences in pediatric emergency preparedness in Spring 2010 that identified a need to examine scarce critical care resources in the region. A “Pediatric Critical Care and Transport Stakeholder's Summit” was convened in April 2010. This meeting brought together the Pediatric Critical Care Medical and Nursing Directors along with Transport Team representatives from major hospitals to identify the key issues related to pediatric emergency preparedness and scarce resources. The four-hour Summit, was held in a Conference Center, away from any hospital or clinical setting, was organized into seven sections: (1) Welcome & Introductions; (2) Issues Identification; (3) Scenario Introduction; (4) Specific Issues Indentification; (5) Prioritization of Specific Issues; (6) Development of Action Steps; and (7) Moving Forward. A Facilitator with specific knowledge of hospital-based preparedness led the Summit process. He utilized a pediatric scenario to engage the participants in discussion, interaction, and planning. Action steps, with statements of need and specific action items were developed, based on the following prioritized issues: (1) lack of pediatric training and experience for front line personnel; (2) alternate care sites/bed capacity/surge planning; (3) ethical issues; (4) transport; (5) credentialing/pediatric specialist availability; (6) incident command/community integration; (7) pediatric supplies and equipment; (8) patient indentification; (9) financial tracking/reimbursement; and (10) Crisis Standards of Care/Crisis Operation Standards Moving forward, the participants of the Summit will reconvene into small workgroups to develop plans and training for the areas specified above. In May, 2011 a statewide exercise utilizing the special population of children will occur to test these plans.
Flood Disaster Averted: Red River Resilience It is estimated that floods make up 40% of all natural disasters and that the majority of natural disaster deaths are attributable to these events. The vast majority of literature on mental health and disaster revolves around response and recovery after the event. Mitigation of flooding can have a tremendous impact on health, including the prevention of common physical ailments including diarrhea, hepatitis, typhoid, tetanus, malnutrition, dermatologic conditions, orthopedic injuries, etc… It can also reduce mental health difficulties including stress, anxiety, depression, PTSD and other disorders. Psychosocial reactions to trauma are recognized to be among the most long-term and debilitating outcomes of disasters. This presentation describes a community's successful efforts to prevent a major flood disaster in the midst of a changing risk landscape. The authors focus on factors contributing to the resilience of a community in the upper Midwest of the United States in responding to the threat of a catastrophic natural disaster. In addition, the presentation includes the building blocks for successful integration of mental health presence through all phases of disaster: mitigation, preparedness, response and recovery. Andrew J. McLean, MD Medical Director, Department of Human Services, State of North Dakota. 2624 9th Ave. SW, Fargo, ND 58103 ajmclean@nd.gov, amclean@medicine.nodak.edu James M. Shultz, MS PhD. Director, Center for Disaster & Extreme Event Preparedness (DEEP Center) University of Miami Miller School of Medicine, Clinical Research Building 1120 NW 14 St., Miami, FL 33160, USA and Partner, High-Alert International, Orlando, FL, USA 305-219-9011 jamesmichaelshultz@gmail.com. jshultz1@med.miami.edu. jshultz@high-alert.com.
To reduce nationwide door-to-balloon times (DTB) in patients presenting with acute ST-elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI), by adoption of pre-hospital wireless 12-lead electrocardiogram (ECG) transmission by Singapore's national ambulance service.
Methods
A phased, prospective, before-after, interventional study of all patients who presented to the national ambulance service with the diagnosis of STEMI. In the ‘Before’ phase, chest pain patients only received 12-lead ECGs on arrival at the Emergency Departments (ED), where diagnosis of STEMI could be made. In the ‘After’ phase, 12-lead ECGs were performed in the field by ambulance crews and transmitted while en-route to the hospitals. Diagnoses of STEMI was made by on-duty emergency physicians (EP) prior to patients' arrival and PCI activated. Data was collected from ambulance run sheets, ECG transmission logs, EDs and cardiology units.
Results
451 eligible patients from “Before” and 214 patients from “After” phase were included in the analysis. Median DTB time was 88 minutes in the “Before” and 52 minutes in the “After” phase (p = 0.0001). During office hours, median DTB times for ‘Before’ and ‘After’ phases were 84 minutes and 47 minutes, respectively (p = 0.0001). After office hours, median DTB times for ‘Before’ and ‘After’ phases were 95 minutes and 54 minutes, respectively (p = 0.0001). There were 11 false positive activations in “Before” phase and one in the “After” phase.
Conclusion
Pre-hospital ECG transmission resulted in significant reduction of DTB time; this effect occurred regardless of whether patients presented to the ED before or after office hours. No increase in false activations was found in the “After” phase. Pre-hospital ECG transmission should be adopted as “standard of care” for all STEMI cases meeting the criteria for PCI.
China has one of the countries with highest occurrence of disasters and disasters are disproportionately affecting rural area of China where ethnic minorities are inhibiting. Limited studies have been conducted to examine how mental health of ethnic minorities in China might be affected by disasters. Through qualitative focus group study methods, this multi-site project examines the mental health impact of disasters in ethnic minority groups in rural China.
Methods
20 focus groups were conducted in rural Sichuan, Yunnan, Gansu and Hainan province of China to understand the mental health impact and coping of disasters during 2008–2010. Ethnic minority groups including Tai, Naxi, Li, Jiang and Hui affected by earthquake, flooding, mudslide, storm and snow storm were included for the focus group interviews. Guided questions were used and male and female participants participated separately in different groups. Focus groups were held at common area within the village and were all type recorded and transcribed for analyses. Saturation of data was reached and thematic analyses were conducted.
Results
Whilst distress, including mood disturbance, sleep problems and heightened arousal after disaster occurrences, were reported among respondents, when compared with Han Chinese affected in disasters, ethnic minority respondents reported more resilience and coping capacity post disaster. Gender impact and gaps in mental health service were identified.
Conclusion
Study results disparities in resilience and coping behavior among different ethnic groups in China. More in-depth studies should be conducted to understand post disaster mental health needs and service utilization of ethnic minorities in China.
There is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide.
Method
A retrospective study of patients with maxillofacial fractures seen and treated at the Jai Parkash Narayan Apex Trauma Center, AIIMS, New Delhi, India between January 2007 to June 2010. Data extracted from the patients' records include aetiology, age, sex, types and sites of fractures, treatment modality and concomitant injuries.
Results
There were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (56.8%) was the most common aetiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 years to 75 years (mean = 34.7) with a peak incidence in the 3rd decade with a male–female sex ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615(77%) and middle third 205(23%). With regards to mandibular fractures, the body (29.6%) was the commonest sites, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%) and Lefort III (3.3%). Majority of the patients were treated by Open reduction and internal fixation (70.6). Concomitant injuries were 10.8% with orthopaedic injuries accounting for the majority (63.9%). Head injury was associated with 16.3 % of cases.
Conclusion
Maxillofacial fractures are on the increase. We advocate the establishment of regionalized trauma centers with basic training available to all surgical residents for initial emergency room management.
A crisis has been evolving in the region of Darfur following an armed conflict between rebel groups and the assumingly government-supported militia in 2003. It has attracted international attention and intervention where 13 UN agencies and around 100 national and international non-governmental organizations have been serving the affected populations. Research as methodological means of data collection is crucial to timely assessment of the affected populations' needs before humanitarian interventions, raising fund to fulfil these needs, and to assess the effects of the humanitarian aids that have been delivered. However, the factors of (1) insecurity; (2) limited resources; (3) vulnerability of the population; and (4) the potential cultural and moral differences among researchers and the surveyed populations make the research process methodologically and ethically challenging. The aim of this paper is to present the effects of these factors on the ethical review and implementation of research, with emphasis on the issues of benefit-risk analysis, conflict of interests, and informed consent. A practical framework for the ethical review that responds to the need of timely provision of information as well as promoting the adherence to the international ethical principles also will be provided.
Social media (SM) are forms of information and communication technology disseminated through social interaction. SM rely upon peer-to-peer (P2P) networks that are collaborative, decentralized, and community-driven transforming people from content consumers into content producers. The role of SM in disaster management galvanized during the world response to the 2010 Haiti earthquake. (Pew 2010) During the immediate aftermath, much of what people around the world were learning about the earthquake originated from SM sources. (Nielsenwire 2010) During the first 2 weeks following the earthquake, “texting” mobile phone users donated over $25 million to the American Red Cross. (Sysomos 2010) Both public and private response agencies used Google Maps™. Millions joined MySpace™ and Facebook ™discussion groups to share information, donate money, and offer support. SM has also been described as “remarkably well organized, self correcting, accurate and concentrated”, calling into question the ingrained view of unidirectional, official-to-public information broadcasts. (Sutton, et al 2008) SM may also offer potential psychological benefit for vulnerable populations gained through participation as stakeholders in the response. (Sutton, et al 2008) (Laor 2003)
Discussion
However, widespread use of SM also involves several important challenges for disaster management. Although SM is growing rapidly, it remains less widespread and accessible than traditional media. Also, public officials often view person to person communications as “backchannels” with potential to spread misinformation and rumor. (Akre 2010) In addition, in absence of the normal checks and balances that regulate traditional media, privacy rights violations can occur as people use SM to describe personal events and circumstances. (Palen 2007)
To receive trauma victims from site of incidence to the emergency department without mauling with adjuvant by first aid managers.
Material
Poor dressing techniques practiced for first aid in industrial, domestic, traffic, calamity, etc. inflicted wounds. Dressing with copious amounts of cotton on traumatized parts that are open or exposed. Wrong wrapping, storage, transport of amputated parts for attempt of salvage / reimplantation.
Methods
Assessment of increased rate in sepsis and rise in rate of risk of complications or loss of traumatized body part or even life in cases of trauma in which primary / incident manager with poor awareness / skills, shortage of first aid material.
Discussion
Need of training of general public on skills of first aid. Maintaining First Aid Kits for Emergencies as per stipulation and need based.
Observation
Improved results in management of trauma that were properly attended to from time of incidence to casualty.
Results
Improved ratio of post traumatic sequel like sepsis, delayed amputations, revisions, graft rejections, co morbidities, expenditure, etc.
The addition of Tent-pegging to the 2nd Asian Beach games as one of its 14 Competition events was a welcomed step, especially to the equestrian community of the games' host country, Oman. An equestrian sport of ancient military origin with a long history in Asia, Tent-pegging It a fast-paced sport in which a lance or sword is used to pick pegs off the ground while riding a horse at full gallop. The sport is gaining popularity especially in a number of countries around the world, including Oman.
Discussion and Observations
The hazards inherent in equestrian sports and specifically in Tent –pegging, furthermore, the mass gathering created by the equine presence, the participants, as well as the spectators, required a well planned medical coverage to safely conduct the games. Taking into account that Tent-pegging events normally receive limited medical support, the presentation will discuss the concepts and methods that are commonly followed by the host country on planning and implementing the medical care to sport events of Olympic standards, along with an illustration on how exclusively these concepts were applied to the Tent -pegging events during the 2nd Asian Beach Games. In addition, the presentation will elaborate on the challenges that were dealt with by the medical care providers, and the outcome following a 1st major sporting event of such a scale to be conducted by the host country, Oman. As more countries bid to host major sport events for their first time, suggestion for improving the methodology of providing medical coverage to a sport event will be discussed in the presentation.
Community Health Centers (CHCs) constitute the secondary level of health in India. However, these centers are fulfilling the tasks entrusted to them only to a limited extent. In order to provide quality care in these CHCs, Indian Public Health Standards (IPHS) are being prescribed to provide optimal expert care to the community and to maintain an acceptable standard of quality of care. These standards would help to monitor and improve the functioning of the CHCs.
Objectives
The aim of this study is to apply the IPHS for evaluation of the CHCs of Rajasthan.
Methods
A cross-sectional observational study was conducted during August to October 2010. Four CHCs of Rajasthan were visited and data were collected in a pre-designed Performa. The quality of services provided in the selected CHCs as per the IPHS norms was assessed.
Result
All the four CHCs were rendering the assured services of the outpatient department, 24-hour general emergency services, new born care, normal delivery, and referral (transport). All CHCs had full-time physicians, but only three (75%) had surgeons and obstetricians, two (50%) CHCs had pediatricians. One (25%) had anesthetists and one (25%) had a program manager. There was a blood storage facility at one (25%) CHC. Nursing staff were adequate. Basic laboratory facilities were available in all CHCs.
Conclusions
The present study revealed important deficiencies as per IPHS norms in the studied CHCs so that adequate measures can be taken to improve the healthcare facility.