Methodological quality of a systematic review on physical therapy for temporomandibular disorders: influence of hand search and quality scales

The validity of a systematic review depends on completeness of identifying randomised clinical trials (RCTs) and the quality of the included RCTs. The aim of this study was to analyse the effects of hand search on the number of identified RCTs and of four quality lists on the outcome of quality assessment of RCTs evaluating the effect of physical therapy on temporomandibular disorders. In addition, we investigated the association between publication year and the methodological quality of these RCTs. Cochrane, Medline and Embase databases were searched electronically. The references of the included studies were checked for additional trials. Studies not electronically identified were labelled as “obtained by means of hand search”. The included RCTs (69) concerning physical therapy for temporomandibular disorders were assessed using four different quality lists: the Delphi list, the Jadad list, the Megens & Harris list and the Risk of Bias list. The association between the quality scores and the year of publication were calculated. After electronic database search, hand search resulted in an additional 17 RCTs (25%). The mean quality score of the RCTs, expressed as a percentage of the maximum score, was low to moderate and varied from 35.1% for the Delphi list to 54.3% for the Risk of Bias list. The agreement among the four quality assessment lists, calculated by the Interclass Correlation Coefficient, was 0.603 (95% CI, 0.389; 0.749). The Delphi list scored significantly lower than the other lists. The Risk of Bias list scored significantly higher than the Jadad list. A moderate association was found between year of publication and scores on the Delphi list (r = 0.50), the Jadad list (r = 0.33) and the Megens & Harris list (r = 0.43)

Preparing for the worst : National Ambulance and the 2014 Ebola Virus epidemic

Background: Ebola virus disease (EVD) is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. It is a type of viral haemorrhagic fever (VHF). The 2014 Ebola outbreak in West Africa is the largest the world has ever seen, and the first Ebola epidemic in history. As of April 15th 2015, there have been a total of 25,826 suspected, probable, and confirmed cases, with 10,704 deaths (41% mortality rate).1 National Ambulance Response: National Ambulance LLC implemented a variety of procedural, educational and engineering controls designed to protect clinical staff from harm and provide safer patient care. This included the provision of a high-risk personal protective equipment (PPE) training programme, a trained observer programme, and increased PPE supply to clinical staff. National Ambulance staff also began screening of passengers on West African flights in Abu Dhabi International Airport in November 2014 to identify potentially infected persons. Key point: Conformance with Centre for Disease Control recommendations regarding personal protective equipment, screening of potentially infected patients and management of suspected cases of EVD was a key component in National Ambulance’s response to the threat posed by the epidemic. Conclusion: The current outbreak of EVD in West Africa has challenged many healthcare systems, including ambulance services, across the globe. No case of Ebola has been detected in the United Arab Emirates to date. Through a process of continuous updating, meeting international best practice recommendations and education delivery, National Ambulance staff are prepared to deal safely and effectively with patients presenting References: 1. Centre for Disease Control (2015) 2014 Ebola Outbreak in West Africa - Case Counts. Available at: http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.htm

The Certificate of Clinical Practice: Improving education for the emergency medical technician: Basic

Emergency Medical Technicians (EMTs) are trained basic life support emergency care providers. A standard curriculum for EMT education includes patient assessment skills in addition to a variety of patient care and management skills. National Ambulance LLC provide EMT trained personnel for care and transportation of patients in various service areas.A variety of EMT curricula exist around the world, including the Irish Pre-Hospital Emergency Care Council EMT Standard and the US National Highway Safety Transportation Authority EMT Standard. National Ambulance LLC sought to answer the question what is the “leading practice” design for an EMT education syllabus, and how can the standard syllabus be improved