Determining the Impact of Heatwaves on Emergency Ambulance Calls in Queensland: A Retrospective Population-Based Study

Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency ‘Triple Zero’ (000) calls to Queensland Ambulance (QAS) from 2010–2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event

A Web-Based Study of the Relationship of Duration of Insulin Pump Infusion Set Use and Fasting Blood Glucose Level in Adults with Type 1 Diabetes

Background: To evaluate the impact of infusion set use duration on glycemic control, we conducted an Internet-based study using the T1D Exchange's online patient community, Glu (myGlu.org). Subjects and Methods: For 14 days, 243 electronically consented adults with type 1 diabetes (T1D) entered online that day's fasting blood glucose (FBG) level, the prior day's total daily insulin (TDI) dose, and whether the infusion set was changed. Results: Mean duration of infusion set use was 3.0 days. Mean FBG level was higher with each successive day of infusion set use, increasing from 126?mg/dL on Day 1 to 133?mg/dL on Day 3 to 147?mg/dL on Day 5 (P<0.001). TDI dose did not vary with increased duration of infusion set use. Conclusions: Internet-based data collection was used to rapidly conduct the study at low cost. The results indicate that FBG levels increase with each additional day of insulin pump infusion set use.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140356/1/dia.2014.0336.pd

Risks of introduction and economic consequences associated with African swine fever, classical swine fever and foot-and-mouth disease: A review of the literature

African swine fever (ASF), classical swine fever (CSF) and foot-and-mouth disease (FMD) are considered to be three of the most detrimental animal diseases and are currently foreign to the U.S. Emerging and re-emerging pathogens can have tremendous impacts in terms of livestock morbidity and mortality events, production losses, forced trade restrictions, and costs associated with treatment and control. The United States is the world\u27s top producer of beef for domestic and export use and the world\u27s third-largest producer and consumer of pork and pork products; it has also recently been either the world\u27s largest or second largest exporter of pork and pork products. Understanding the routes of introduction into the United States and the potential economic impact of each pathogen are crucial to (a) allocate resources to prevent routes of introduction that are believed to be more probable, (b) evaluate cost and efficacy of control methods and (c) ensure that protections are enacted to minimize impact to the most vulnerable industries. With two scoping literature reviews, pulled from global data, this study assesses the risk posed by each disease in the event of a viral introduction into the United States and illustrates what is known about the economic costs and losses associated with an outbreak

Incorporating temporal and spatial variability of salt-marsh foraminifera into sea-level reconstructions

Foraminifera from salt-marsh environments have been used extensively in quantitative relative sea-level reconstructions due to their strong relationship with tidal level. However, the influence of temporal and spatial variability of salt-marsh foraminifera on quantitative reconstructions remains unconstrained. Here, we conducted a monitoring study of foraminifera from four intertidal monitoring stations in New Jersey from high marsh environments over three years that included several extreme weather (temperature, precipitation, and storm surge) events. We sampled four replicates from each station seasonally (four times per year) for a total of 188 samples. The dead foraminiferal assemblages were separated into four site-specific assemblages. After accounting for systematic trends in changes in foraminifera over time among stations, the distribution of foraminiferal assemblages across monitoring stations explained ~87% of the remaining variation, while ~13% can be explained by temporal and/or spatial variability among the replicate samples. We applied a Bayesian transfer function to estimate the elevation of the four monitoring stations. All samples from each station predicted an elevation estimate within a 95% uncertainty interval consistent with the observed elevation of that station. Combining samples into replicate- and seasonal-aggregate datasets decreased elevation estimate uncertainty, with the greatest decrease in aggregate datasets from Fall and Winter. Information about the temporal and spatial variability of modern foraminiferal distributions was formally incorporated into the Bayesian transfer function through informative foraminifera variability priors and was applied to a Common Era relative sea-level record in New Jersey. The average difference in paleomarsh elevation estimates and uncertainties using an informative vs uninformative prior was minimal

Johns Hopkins Medicine responds to COVID-19: Adjusting patient- family- and staff-centered care

The extraordinary impact of the novel coronavirus disease 2019 (COVID-19) on the health care industry included a major, nearly immediate paradigm shift in the visitation policy for Johns Hopkins Medicine. This large health system, comprising six hospitals, a home care group, community physician practices and satellite outpatient sites moved from essentially open visitation to no visitation, creating an entirely new set of needs for our staff, patients and their loved ones. We developed new ways of communicating and connecting staff members, staff and patients, staff and the patient’s loved ones, and patients and their loved ones. Our intent was to maintain our commitment to patient- and family-centered care, to alleviate the anxiety and stress from this devastating pandemic to the extent possible. This article describes approaches taken by the health system’s Patient Experience leadership team and others to develop resources that educate patients, loved ones and staff about the process changes and facilitate incorporation of these new ways of communicating and connecting. The content is organized into three areas: including staff resources, consumer resources and resources that support consumer engagement. Many of the changes have been well received, enhancing our pre-COVID-19 ability to connect with one another and will be assimilated into our culture for the long term. We plan to develop objective measures of the effectiveness for approaches that outlive COVID-19 and enhance patient-centered care. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens