Towards Sustainable Public Health Surveillance in India: Using Routinely Collected Electronic Emergency Medical Service Data for Early Warning of Infectious Diseases

Infectious disease surveillance, timely detection and early warning of outbreaks present a complex challenge to health authorities in India. Approaches based on the use of unexplored data sources, like emergency medical services (EMS) data, can contribute to the further advancement of public health surveillance capacities in India and support and strengthen the Integrated Disease Surveillance Programme (IDSP) strategy. This research followed a mixed method approach including a series of semi-structured interviews and fever data analysis of the EMS operating dispatch system in Andra Pradesh, India. In this paper, we explore whether routinely collected EMS health data can improve sustainable infectious disease surveillance and early warning capacity. The result highlights the need for improved surveillance systems for early warning of infectious diseases in India. The data availability at the EMS dispatch centre includes patient data and spatial information and can be used for near real-time analysis. Routine data relevant for health surveillance can be extracted to provide timely health information that supplements and enhances more traditional surveillance mechanisms and thus provides a cost-efficient, near real-time early warning system for the operating states. The designed intervention is sustainable and can improve infectious disease surveillance to potentially help the government officials to appropriately prioritize timely interventions to prevent infectious disease spread

Study of risk factors affecting the survival rate of emergency victims with "chest pain" as chief complaint

Research Question : What are the risk factors affecting the survival of emergency victims with chest pain as chief complaint. Objectives : 1. To find out the relative risk of different risk factors. 2. To find out whether the association between survival rate and various sociodemographic variables are statistically significant or not. Study Design : Descriptive study. Setting : This study is based on the Pre-hospital care Records (PCR) of the Emergency Management and Research Institute (EMRI) from May 2007 to December 2007, in Andhra Pradesh. Participants : 2020 emergency victims, with chest pain as the chief complaint, reported to EMRI from May to December 2007. Study Variables : Demographic characteristics of the victims, time and day of the incident, response time in handling the emergency, and so on. Statistical Analysis : Proportions, Chi-Square test, and Odds Ratio. Results : Of all the risk factors studied, gender (Male), age (65 +), and incident location (residence), proved to be the risk factors for the non-survival of the victims of medical emergencies, with chest pain as the chief complaint. It was also observed that there was a statistically significant association (P < 0.05) between age, gender, area (urban and rural), and occupation with the survival rate. The response time was significantly associated with the survival rate, only for critical cases. Survival rate increases to 33% with response time less than 15 minutes from less than 5% with the response time more than 15 minutes

Emotional and psychological needs of people with diabetes

Diabetes is a chronic metabolic disorder that impacts physical, social and mental including psychological well-being of people living with it. Additionally, psychosocial problems that are most common in diabetes patients often result in serious negative impact on patient's well-being and social life, if left un-addressed. Addressing such psychosocial aspects including cognitive, emotional, behavioral and social factors in the treatment interventions would help overcome the psychological barriers, associated with adherence and self-care for diabetes; the latter being the ultimate goal of management of patients with diabetes. While ample literature on self-management and psychological interventions for diabetes is available, there is limited information on the impact of psychological response and unmanaged emotional distresses on overall health. The current review therefore examines the emotional, psychological needs of the patients with diabetes and emphasizes the role of diabetologist, mental health professionals including clinical psychologists to mitigate the problems faced by these patients. Search was performed using a combination of keywords that cover all relevant terminology for diabetes and associated emotional distress. The psychological reactions experienced by the patient upon diagnosis of diabetes have been reviewed in this article with a focus on typical emotional distress at different levels. Identifying and supporting patients with psychosocial problems early in the course of diabetes may promote psychosocial well-being and improve their ability to adjust or take adequate responsibility in diabetes self-management – the utopian state dreamt of by all diabetologists !