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  • 1
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    Online Resource
    Abstract 245: Dispatcher Assisted Cardiopulmonary Resuscitation in Patients Not in Cardiac Arrest: A Multi-Center, Observation Study
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_4 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_4 ( 2020-11-17)
    Abstract: Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) can increase bystander CPR rates and improve outcomes in out-of-hospital cardiac arrest (OHCA). Protocols used by dispatchers are designed to provide a quick assessment for prompt initiation of CPR. However, there are instances where non-cardiac arrest cases are falsely recognised by dispatchers to be in cardiac arrest. These patients may go on to receive chest compressions and potentially suffer from complications of unnecessary CPR, though the clinical implications of starting DA-CPR on these non-cardiac arrest cases have not been studied. Hence, the objectives of this study are to find the prevalence and clinical outcomes of DA-CPR in patients not in cardiac arrest in the Singapore population. Methods: This was a multi-center, observational study of all dispatcher-recognized cardiac arrests cases between January to December 2017 involving three tertiary hospitals in Singapore. Data was collected through audio review of dispatch calls from the national emergency ambulance service and information about patients’ clinical outcomes were prospectively collected from health records. Results: During the study period, dispatchers recognised 821 patients as having cardiac arrest. Of these, 40.0% (328/ 821) were not in cardiac arrest. 52.7% (173/ 328) of the non-cardiac arrest patients had chest compressions initiated under dispatcher assistance. No complications from chest compressions were reported. The top diagnoses of non-cardiac arrest patients found were cerebrovascular accidents (CVA), syncope and infection. A multiple logistic regression model with estimates adjusted for the presence or absence of chest compressions revealed that only final diagnoses of CVA (OR 20.68), infection (OR 17.34) and myocardial infarction (OR 32.19) were associated with in-hospital mortality. Conclusion: In this study, chest compressions initiated due to false recognition of cardiac arrest by dispatchers did not result in any reported complications and was not associated with in-hospital mortality. This provides reassurance for the continued implementation of DA-CPR.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_4.245
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 2
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    A systematic review and meta-analysis of individual patient data on the impact of the BIM deletion polymorphism on treatment outcomes in epidermal growth factor receptor mutant lung cancer
    Impact Journals, LLC ; 2017
    In:  Oncotarget Vol. 8, No. 25 ( 2017-06-20), p. 41474-41486
    Details
    In: Oncotarget, Impact Journals, LLC, Vol. 8, No. 25 ( 2017-06-20), p. 41474-41486
    Type of Medium: Online Resource
    ISSN: 1949-2553
    URL: Issue
    URL: Article
    DOI: 10.18632/oncotarget.v8i25
    DOI: 10.18632/oncotarget.17102
    Language: English
    Publisher: Impact Journals, LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2560162-3
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  • 3
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    Effect of known history of heart disease on survival outcomes after out‐of‐hospital cardiac arrests
    Wiley ; 2018
    In:  Emergency Medicine Australasia Vol. 30, No. 1 ( 2018-02), p. 67-76
    Details
    In: Emergency Medicine Australasia, Wiley, Vol. 30, No. 1 ( 2018-02), p. 67-76
    Abstract: We aimed to investigate the effect of known heart disease on post‐out‐of‐hospital cardiac arrest ( OHCA ) survival outcomes, and its association with factors influencing survival. Methods This was an observational, retrospective study involving an OHCA database from seven Asian countries in 2009–2012. Heart disease was defined as a documented diagnosis of coronary artery disease or congenital heart disease. Patients with non‐traumatic arrests for whom resuscitation was attempted and with known medical histories were included. Differences in demographics, arrest characteristics and survival between patients with and without known heart disease were analysed. Multivariate logistic regression was performed to identify factors influencing survival to discharge. Results Of 19 044 eligible patients, 5687 had known heart disease. They were older (77 vs 72 years) and had more comorbidities like diabetes (40.9 vs 21.8%), hypertension (60.6 vs 36.0%) and previous stroke (15.2 vs 10.1%). However, they were not more likely to receive bystander cardiopulmonary resuscitation ( P = 0.205) or automated external defibrillation ( P = 0.980). On univariate analysis, known heart disease was associated with increased survival (unadjusted odds ratio 1.16, 95% confidence interval 1.03–1.30). However, on multivariate analysis, heart disease predicted poorer survival (adjusted odds ratio 0.76, 95% confidence interval 0.58–1.00). Other factors influencing survival corresponded with previous reports. Conclusions Known heart disease independently predicted poorer post‐ OHCA survival. This study may provide information to guide future prospective studies specifically looking at family education for patients with heart disease and the effect on OHCA outcomes.
    Type of Medium: Online Resource
    ISSN: 1742-6731 , 1742-6723
    URL: Issue
    URL: Article
    DOI: 10.1111/emm.2018.30.issue-1
    DOI: 10.1111/1742-6723.12809
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1502447-7
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  • 4
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    Delivering trauma and rehabilitation interventions to women and children in conflict settings: a systematic review
    BMJ ; 2020
    In:  BMJ Global Health Vol. 5, No. Suppl 1 ( 2020-04), p. e001980-
    Details
    In: BMJ Global Health, BMJ, Vol. 5, No. Suppl 1 ( 2020-04), p. e001980-
    Abstract: In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation interventions for conflict-affected populations. Methods A systematic search of literature published from 1 January 1990 to 31 March 2018 was conducted across several databases. Eligible publications reported on women and children in low and middle-income countries. Included publications provided information on the delivery of interventions for trauma, sustained injuries or rehabilitation in conflict-affected populations. Results A total of 81 publications met the inclusion criteria, and were included in our review. Nearly all of the included publications were observational in nature, employing retrospective chart reviews of surgical procedures delivered in a hospital setting to conflict-affected individuals. The majority of publications reported injuries due to explosive devices and remnants of war. Injuries requiring orthopaedic/reconstructive surgeries were the most commonly reported interventions. Barriers to health services centred on the distance and availability from the site of injury to health facilities. Conclusions Traumatic injuries require an array of medical and surgical interventions, and their effective treatment largely depends on prompt and timely management and referral, with appropriate rehabilitation services and post-treatment follow-up. Further work to evaluate intervention delivery in this domain is needed, particularly among children given their specialised needs, and in different population displacement contexts. PROSPERO registration number CRD42019125221.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2019-001980
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2851843-3
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  • 5
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    Delivering infectious disease interventions to women and children in conflict settings: a systematic review
    BMJ ; 2020
    In:  BMJ Global Health Vol. 5, No. Suppl 1 ( 2020-04), p. e001967-
    Details
    In: BMJ Global Health, BMJ, Vol. 5, No. Suppl 1 ( 2020-04), p. e001967-
    Abstract: Conflict has played a role in the large-scale deterioration of health systems in low-income and middle-income countries (LMICs) and increased risk of infections and outbreaks. This systematic review aimed to synthesise the literature on mechanisms of delivery for a range of infectious disease-related interventions provided to conflict-affected women, children and adolescents. Methods We searched Medline, Embase, CINAHL and PsychINFO databases for literature published in English from January 1990 to March 2018. Eligible publications reported on conflict-affected neonates, children, adolescents or women in LMICs who received an infectious disease intervention. We extracted and synthesised information on delivery characteristics, including delivery site and personnel involved, as well as barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data. Results A majority of the 194 eligible publications reported on intervention delivery in sub-Saharan Africa. Vaccines for measles and polio were the most commonly reported interventions, followed by malaria treatment. Over two-thirds of reported interventions were delivered in camp settings for displaced families. The use of clinics as a delivery site was reported across all intervention types, but outreach and community-based delivery were also reported for many interventions. Key barriers to service delivery included restricted access to target populations; conversely, adopting social mobilisation strategies and collaborating with community figures were reported as facilitating intervention delivery. Few publications reported on intervention coverage, mostly reporting variable coverage for vaccines, and fewer reported on intervention effectiveness, mostly for malaria treatment regimens. Conclusions Despite an increased focus on health outcomes in humanitarian crises, our review highlights important gaps in the literature on intervention delivery among specific subpopulations and geographies. This indicates a need for more rigorous research and reporting on effective strategies for delivering infectious disease interventions in different conflict contexts. PROSPERO registration number CRD42019125221.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2019-001967
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2851843-3
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  • 6
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    Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review
    BMJ ; 2020
    In:  BMJ Global Health Vol. 5, No. 3 ( 2020-03), p. e002014-
    Details
    In: BMJ Global Health, BMJ, Vol. 5, No. 3 ( 2020-03), p. e002014-
    Abstract: Over 240 million children live in countries affected by conflict or fragility, and such settings are known to be linked to increased psychological distress and risk of mental disorders. While guidelines are in place, high-quality evidence to inform mental health and psychosocial support (MHPSS) interventions in conflict settings is lacking. This systematic review aimed to synthesise existing information on the delivery, coverage and effectiveness of MHPSS for conflict-affected women and children in low-income and middle-income countries (LMICs). Methods We searched Medline, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO)databases for indexed literature published from January 1990 to March 2018. Grey literature was searched on the websites of 10 major humanitarian organisations. Eligible publications reported on an MHPSS intervention delivered to conflict-affected women or children in LMICs. We extracted and synthesised information on intervention delivery characteristics, including delivery site and personnel involved, as well as delivery barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data. Results The search yielded 37 854 unique records, of which 157 were included in the review. Most publications were situated in Sub-Saharan Africa (n=65) and Middle East and North Africa (n=36), and many reported on observational research studies (n=57) or were non-research reports (n=53). Almost half described MHPSS interventions targeted at children and adolescents (n=68). Psychosocial support was the most frequently reported intervention delivered, followed by training interventions and screening for referral or treatment. Only 19 publications reported on MHPSS intervention coverage or effectiveness. Discussion Despite the growing literature, more efforts are needed to further establish and better document MHPSS intervention research and practice in conflict settings. Multisectoral collaboration and better use of existing social support networks are encouraged to increase reach and sustainability of MHPSS interventions. PROSPERO registration number CRD42019125221.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2019-002014
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2851843-3
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  • 7
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    Delivery of sexual and reproductive health interventions in conflict settings: a systematic review
    BMJ ; 2020
    In:  BMJ Global Health Vol. 5, No. Suppl 1 ( 2020-07), p. e002206-
    Details
    In: BMJ Global Health, BMJ, Vol. 5, No. Suppl 1 ( 2020-07), p. e002206-
    Abstract: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development. Methods We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries and describing an SRH intervention delivered during or within 5 years after the end of a conflict were included. Information on population, intervention and delivery characteristics were extracted and narratively synthesised. Quantitative data on intervention coverage and effectiveness were tabulated, but no meta-analysis was undertaken. Results 110 publications met our eligibility criteria. Most focused on sub-Saharan Africa and displaced populations based in camps. Reported interventions targeted family planning, HIV/STIs, gender-based violence and general SRH. Most interventions were delivered in hospitals and clinics by doctors and nurses. Delivery barriers included security, population movement and lack of skilled health staff. Multistakeholder collaboration, community engagement and use of community and outreach workers were delivery facilitators. Reporting of intervention coverage or effectiveness data was limited. Discussion There is limited relevant literature on adolescents or out-of-camp populations and few publications reported on the use of existing guidance such as the Minimal Initial Services Package. More interventions for gender-based violence were reported in the grey than the indexed literature, suggesting limited formal research in this area. Engaging affected communities and using community-based sites and personnel are important, but more research is needed on how best to reach underserved populations and to implement community-based approaches. PROSPERO registration number CRD42019125221.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2019-002206
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2851843-3
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  • 8
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    Coronary Artery Bypass Surgery in the Elderly: Experience of Tertiary Care Hospital
    SAGE Publications ; 2006
    In:  Asian Cardiovascular and Thoracic Annals Vol. 14, No. 6 ( 2006-12), p. 479-484
    Details
    In: Asian Cardiovascular and Thoracic Annals, SAGE Publications, Vol. 14, No. 6 ( 2006-12), p. 479-484
    Abstract: In the subcontinent, improving life expectancy may increase the number of elderly patients requiring coronary artery bypass. The elderly have a higher risk of mortality, and cost vs benefit is presumed to be unrewarding, leading to a disinclination to operate on such patients. We reviewed the records of patients ≥ 70 years old undergoing coronary revascularization in a 10-year period. Between 1995 and 2004, 3,312 coronary bypass operations were performed, including 242 (7.3%) in patients ≥ 70 years. Of these, 207 (86%) were male, 73 (30%) had non-elective surgery, and 177 (73%) had a high-risk EuroSCORE. Early postoperative mortality was 8.7% (21/242), and 33 (13.6%) patients experienced morbidity. One-year follow-up of 106 (44%) patients was possible. There were 4 (1.7%) late deaths from noncardiac causes. Death, morbidity, and postoperative functional class were significantly associated with preoperative functional class. Meticulous selection of elderly patients for coronary artery bypass may help maximize the benefits of this surgery.
    Type of Medium: Online Resource
    ISSN: 0218-4923 , 1816-5370
    URL: Article
    DOI: 10.1177/021849230601400608
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
    detail.hit.zdb_id: 2044527-1
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  • 9
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    Anaesthesia and analgesia in the emergency care setting for treating distal radius fractures in adults
    Wiley ; 2022
    In:  Cochrane Database of Systematic Reviews Vol. 2022, No. 5 ( 2022-05-13)
    Details
    In: Cochrane Database of Systematic Reviews, Wiley, Vol. 2022, No. 5 ( 2022-05-13)
    Type of Medium: Online Resource
    ISSN: 1465-1858
    URL: Article
    DOI: 10.1002/14651858.CD015104
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2038950-4
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  • 10
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    Automated mandatory bolus versus basal infusion for maintenance of epidural analgesia in labour
    Wiley ; 2023
    In:  Cochrane Database of Systematic Reviews Vol. 2023, No. 6 ( 2023-06-05)
    Details
    In: Cochrane Database of Systematic Reviews, Wiley, Vol. 2023, No. 6 ( 2023-06-05)
    Type of Medium: Online Resource
    ISSN: 1465-1858
    URL: Article
    DOI: 10.1002/14651858.CD011344.pub3
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2038950-4
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