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Optimizing a Drone Network to Respond to Opioid Overdoses
Introduction: Effective out-of-hospital administration of naloxone in opioid overdoses is dependent on timely arrival of naloxone. Delays in emergency medical services (EMS) response time could potentially be overcome with drones to deliver naloxone efficiently to the scene for bystander use. Our objective was to evaluate a mathematical optimization simulation for geographical placement of drone bases in reducing response time to opioid overdose.Methods: Using retrospective data from a single EMS system from January 2016–February 2019, we created a geospatial drone-network model based on current technological specifications and potential base locations. Genetic optimization was then used to maximize county coverage by drones and the number of overdoses covered per drone base. From this model, we identified base locations that minimize response time and the number of drone bases required.Results: In a drone network model with 2,327 opioid overdoses, as the number of modeled drone bases increased the calculated response time decreased. In a geospatially optimized drone network with four drone bases, response time compared to ambulance arrival was reduced by 4 minutes 38 seconds and covered 64.2% of the county.Conclusion: In our analysis we found that in a mathematical model for geospatial optimization, implementing four drone bases could reduce response time of 9–1–1 calls for opioid overdoses. Therefore, drones could theoretically improve time to naloxone delivery
Lifetime prevalence of intimate partner violence against women in an urban Brazilian city: A cross-sectional survey.
BackgroundIntimate partner violence is a global health burden that disproportionately affects women and their health outcomes. Women in Brazil are also affected by interpersonal violence. We aimed to estimate the lifetime prevalence of three forms of interpersonal violence against women (IPVAW) and to identify sociodemographic factors associated with IPVAW in one urban Brazilian city.MethodsUsing a cross-sectional design, we interviewed women aged ≥18 years in the urban Brazilian city, Maringá, who currently have or have had an intimate partner. The 13-item WHO Violence Against Women instrument was used to ask participants about their experiences with intimate partner violence, categorized into psychological, physical and sexual violence. We estimated associations between IPVAW and sociodemographic characteristics using generalized linear models.Results and conclusionsOf the 419 women who were enrolled and met inclusion criteria, lifetime prevalence of IPVAW was 56%. Psychological violence was more prevalent (52%) than physical (21%) or sexual violence (13%). Twenty-eight women (6.4%) experienced all three forms of IPVAW. Women were more likely to experience violence if they were employed, did not live with their partner or had 4 or more children. Educational level, household income, age and race were not significantly associated factors. Our findings highlight a high prevalence of IPVAW in a community in southern Brazil