Mitigating Chronic Diseases during Archaeological Fieldwork

2021 ◽  
Vol 9 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Carla Klehm ◽  
Elisabeth Hildebrand ◽  
Maureen S. Meyers
Keyword(s):  
Chronic Diseases ◽  
Best Practice ◽  
Cultural Norms ◽  
Group Leaders ◽  
Group Awareness ◽  
Team Members ◽  
Emergency Situations ◽  
Raising Awareness ◽  
Life Threatening ◽  
Preexisting Conditions

ABSTRACTChronic diseases and preexisting conditions shape daily life for many archaeologists both in and out of the field. Chronic issues, however, can be overlooked in safety planning, which more often focuses on emergency situations because they are considered mundane, or they are imperceptible to project directors and crews until a serious problem arises. This article focuses on asthma, diabetes, and depression as common medical conditions that impact otherwise healthy archaeologists during fieldwork, with the goal of raising awareness of these conditions in particular, and the need to be more attentive to chronic diseases in general. Archaeological fieldwork presents novel situations that put those with chronic diseases and preexisting conditions at risk: environmental hazards, remoteness from medical and social resources and networks, lack of group awareness, and varying cultural norms. As a result, if chronic diseases are not attended to properly in the field, they can lead to life-threatening situations. Managing the risk presented by these conditions requires a group culture where team members are aware of issues, as appropriate, and collaborate to mitigate them during fieldwork. Descriptions of how chronic diseases affect archaeologists in the field are followed by “best practice” recommendations for self-management and for group leaders.

Acute Asthma in Adults: Controversies and Best Practice

2009 ◽  
Vol 8 (1) ◽  
pp. 10-16
Author(s):  
Maren Schuhmann ◽  
◽  
Fraser Brims ◽  
Anoop J Chauhan ◽  
◽  
...  
Keyword(s):  
Emergency Care ◽  
Best Practice ◽  
Care Setting ◽  
Acute Asthma ◽  
British Thoracic Society ◽  
International Guidelines ◽  
Life Threatening

Asthma in the emergency care setting is common and may be life-threatening. Last year the British Thoracic Society updated their guidelines for the management of asthma, however some treatments remain controversial and there is variation in adherence to these and other national and international guidelines.

scholarly journals Benefits of venom immunotherapy: How soon can they be expected

2017 ◽  
Vol 145 (3-4) ◽  
pp. 173-177
Author(s):  
Sasa Kadivec ◽  
Mitja Kosnik
Keyword(s):  
First Year ◽  
Severe Reaction ◽  
Allergic Reactions ◽  
Venom Immunotherapy ◽  
Emergency Situations ◽  
Sting Reaction ◽  
Life Threatening ◽  
Medical Emergencies ◽  
The Cost ◽  
Patients Experience

Introduction/Objective. Allergic reactions to insect stings are medical emergencies that could be prevented by venom immunotherapy (VIT). The main purpose of VIT is to prevent fatal or life-threatening reactions. We aimed to show the rapidity with which patients experience the benefits of VIT and estimate the number of emergency treatments that are prevented. Methods. We reviewed the medical files of patients who started VIT between 2010 and 2014. We calculated the costs of treatment of the sting reactions, the costs of immunotherapy, and estimated the costs of prevented allergic reactions. Results. In a cohort of 514 patients (40.9% female, age 47.2 ? 14.4 years), the cost of treatment of the index sting reaction was 180.4 ? 166.8 euros. During VIT, 195 patients experienced 446 field stings. In 86.3% of patients, stings were well tolerated, and only one patient experienced a severe reaction (grade III, according to Mueller). A total of 20.4% of VIT treated patients were stung during the first year of VIT and 57% during five years of VIT. The expenditure for five years of VIT was 2,886 euros per patient, which corresponded to an average of 16 emergency treatments for systemic reactions. Conclusion. Emergency situations are prevented in a substantial number of venom-allergic patients and a beneficial effect was already observed during the first year of VIT.

Electrical and Fire Safety in the OR

2019 ◽  
Author(s):  
Ferenc E Gyulai
Keyword(s):  
Fire Safety ◽  
Basic Principles ◽  
Team Members ◽  
Optimal Outcomes ◽  
Healthcare Environment ◽  
Ground Fault ◽  
Source Line ◽  
Electrical Shocks ◽  
Life Threatening ◽  
Electrosurgical Unit

In the OR, electrical shocks and fire represent two very important risks and they occur more commonly than most people recognize. Electrical and fire safety in the OR is every team member’s responsibility. Prevention is the first step, but when incidents occur, optimal outcomes depend on concerted efforts. Thisapproach, along with a comprehensive electrical and fire safety program, is a continued effort to create a safer healthcare environment for every worker and patient. Understanding the basic principles of electricity and fire safety is the first step towards this goal. Unfortunately, many institutions do not involve the key players (surgery and anesthesia department members) in the education and preparation process. By involving all team members, optimal outcomes for patients at this vulnerable time may be achieved. Our patients expect us to know the risks and management of these potentially life-threatening occurrences. This chapter endeavours to facilitate these goals.   This review contains 9 figures, 3 tables, and 51 references Keywords: electrosurgical unit, fire extinguisher, ground fault circuit interrupter, grounding, ignition source, line isolation monitor, macroshock, microshock, Ohm law  

Thoracics

2020 ◽  
pp. 215-246
Author(s):  
James Bennett ◽  
Gerard Gould
Keyword(s):  
Best Practice ◽  
Bronchopleural Fistula ◽  
Management Strategies ◽  
Lung Ventilation ◽  
Bronchial Obstruction ◽  
Dynamic Hyperinflation ◽  
One Lung Ventilation ◽  
Cardiac Herniation ◽  
Life Threatening ◽  
Practice Methods

In this chapter on life-threatening thoracic problems in anaesthesia, the authors offer their guidance and expertise on the best-practice methods of dealing with each of these. These problems include tracheal/bronchial obstruction, inhaled foreign body, tracheal injury or laceration, bronchopleural fistula, hypoxia/pneumothorax/high airway pressure during one-lung ventilation, dynamic hyperinflation, cardiac herniation postpneumonectomy, major airway bleeding, and bleeding during mediastinoscopy. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential thoracically related situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

scholarly journals The Complexity of Diabetic Foot Management: From Common Care to Best Practice. The Italian Expert Opinion by Delphi Survey

2019 ◽  
Vol 19 (1) ◽  
pp. 34-43 ◽  
Author(s):  
Elisabetta Salutini ◽  
Enrico Brocco ◽  
Roberto Da Ros ◽  
Luca Monge ◽  
Luigi Uccioli ◽  
...  
Keyword(s):  
Clinical Judgment ◽  
Diabetic Foot ◽  
Best Practice ◽  
Diabetes Complications ◽  
Public Health Issue ◽  
Life Threatening ◽  
Foot Lesions ◽  
Diabetic Foot Lesions ◽  
Wound Bed Preparation ◽  
Leg Amputation

Diabetic foot is a major public health issue, driven by diabetes complications (neuropathy, peripheral vascular disease, foot deformity, and abnormal leucocyte function), which may lead to leg amputation, thus resulting in severe disability, reduced quality of life, and high health costs. The prevention of diabetes complications and the early detection and proper management of diabetic foot wounds are the milestones to avoid major amputations. Unfortunately, in many areas, the prevention of diabetic foot lesions is inadequate and wounds may proceed toward infection and chronicity, with limb- and life-threatening results. Using the Delphi method, we conducted a survey on diabetic foot among Italian experts, selected across different Italian clinical centers. This method was used to achieve a consensus on current opinion and clinical leanings on the diagnosis and management of diabetic foot ulcers. Specifically, the aim of the survey was to evaluate the current management of the diabetic foot syndrome; highlight the differences in the approach among a group of experts; evaluate the role of wound bed preparation and antisepsis; and discuss any areas of disagreement in which evidences are sparse and the clinical judgment plays a crucial role in the decision-making process.

‘It depends on the consultation’: revisiting use of family members as interpreters for general practice consultations – when and why?

2017 ◽  
Vol 23 (3) ◽  
pp. 257 ◽  
Author(s):  
Jo Hilder ◽  
Ben Gray ◽  
Anthony Dowell ◽  
Lindsay Macdonald ◽  
Rachel Tester ◽  
...  
Keyword(s):  
Family Member ◽  
Best Practice ◽  
Good Practice ◽  
Family Members ◽  
Patient Comfort ◽  
Cultural Norms ◽  
Communication Analysis ◽  
Frequent Use ◽  
Medical Consultations ◽  
Potential Risks

Family members continue to be used as interpreters in medical consultations despite the well-known risks. This paper examines participant perceptions of this practice in three New Zealand clinics chosen for their frequent use of interpreters and their skill in using them. It is based on a detailed study of 17 video-recorded interpreted consultations and 48 post-consultation interviews with participants (5 doctors, 16 patients and 12 interpreters, including 6 family members). All participants expressed satisfaction with the communication. Analysis of the interviews explored what participants liked or valued about family member interpreters (FMIs). Key themes were the FMIs’ personal relationship and knowledge, patient comfort, trust, cultural norms, time efficiency and continued help outside the consultation. General practitioners (GPs) expressed awareness of potential risks and how to manage them, in contrast to patients and FMIs. Although the use of professional interpreters needs to be strongly promoted, a well-informed decision to use a family member is appropriate in some situations. GPs need to be well trained in how to assess and manage the risks. Rather than striving for ‘best practice’ (i.e. universal use of professional interpreters), it is better to aim for ‘good practice’ where a considered judgement is made about each situation on an individual basis.

Culture and Creativity in Multicultural Teams

2020 ◽  
Author(s):  
Angela K.-y. Leung ◽  
Brandon Koh ◽  
Sean T. H. Lee
Keyword(s):  
Diffusion Processes ◽  
Cultural Norms ◽  
Multicultural Teams ◽  
Cultural Backgrounds ◽  
Cultural Stereotypes ◽  
Skill Sets ◽  
Team Members ◽  
Cultural Perspectives ◽  
Cultural Experiences ◽  
Cultural Frames

The Complementary Model of Culture and Creativity (CMCC) puts into perspective how a culturally diverse team can become more creative than a monocultural team. The CMCC characterizes three bidimensional psychological processes that explain the effects of culture on creativity: (a) stereotyping versus destabilizing cultural norms, (b) fixating on one cultural mindset versus alternating between cultural frames, and (c) distancing from versus integrating cultures. Extant research suggested that teams with similar goals and values draw performance benefits from their ability to cooperate. However, research has also revealed that working with culturally dissimilar team members could lower tendency toward groupthink and diversify knowledge, skill sets, and social networks, which can facilitate the team’s creativity. Therefore, a question of growing importance to both researchers and practitioners alike is how to harness cultural diversity within creative teams to promote their creative performance while minimizing conflict. We examine this important question with the perspective offered by the CMCC. The processes delineated in the CMCC explain that multicultural teams offer the opportunities to broaden and diversify team members’ cultural experiences by destabilizing cultural stereotypes, switching between cultural frames, and integrating differing cultural perspectives, thereby generating discernible creative gains. It is challenging to effectively manage and maintain workforce diversity, but it is highly rewarding if these challenges are turned into opportunities to build an inclusive and equitable multicultural labor force. The CMCC illuminates the key mechanisms through which multicultural teams can trigger the knowledge creation and diffusion processes to instigate higher creativity among team members coming from diverse cultural backgrounds.

scholarly journals Understanding the NICE guidance on endometriosis

2020 ◽  
Vol 31 (1) ◽  
pp. 8-16
Author(s):  
Wendy Norton ◽  
Debby Holloway
Keyword(s):  
Best Practice ◽  
Correct Diagnosis ◽  
Adhesion Formation ◽  
Patient Journey ◽  
Care Services ◽  
Primary Care Services ◽  
Raising Awareness ◽  
Internal Bleeding ◽  
Nice Guidance ◽  
Individualised Care

Wendy Norton and Debby Holloway provide an overview of endometriosis and identify the role of the practice nurse in supporting women with this diagnosis through their patient journey, referencing best practice from NICE guidelines Endometriosis is a long-term gynaecological condition where endometrial tissue forms lesions outside the uterus, resulting in internal bleeding, inflammation, fibrosis, and adhesion formation. The condition is estimated to affect between 2 and 10% of women in the general population, but up to 50% of women with infertility, and can have a significant impact on women's, and their partners', lives. Endometriosis is often misunderstood and misdiagnosed, leading to reported lengthy delays in achieving a correct diagnosis. In 2017 and 2018, the National Institute for Health and Care Excellence (NICE) released guidelines and quality standards on managing endometriosis. Nurses working in primary care services play an important role in raising awareness of this condition and providing holistic, individualised care for women with endometriosis.

Harm Reduction Services in Ottawa: The Culture of Drug Use

2020 ◽  
Vol 34 (2) ◽  
pp. 188-202
Author(s):  
Marlene Haines ◽  
Patrick O'Byrne
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Physical Environment ◽  
Best Practice ◽  
Cultural Norms ◽  
People Who Use Drugs ◽  
Access To Services ◽  
Policy Changes ◽  
Best Practice Guidelines ◽  
Depth Interviews

Between January 2016 and June 2019, there were over 13,900 apparent opioid-related deaths in Canada, solidifying the need for appropriate and effective services for people who use drugs (PWUD). Within government initiatives and policies, PWUD are often inappropriately considered a homogeneous group of individuals, with implementation of services nationally often being guided by these governmental bodies without meaningful consultation and collaboration with PWUD. However, recent harm reduction research and best practice guidelines have emphasized the importance of tailoring services to local drug scenes. Despite this, very little research on the cultural norms of PWUD exists in the literature. In an attempt to explore the local culture of drug use in Ottawa, a literature review ultimately uncovered very few articles on this topic. However, by expanding the search beyond Ottawa and using a social determinants of health framework, the factors of culture, income and social status, physical environment, and access to services were revealed as unique experiences for PWUD. Further, through four in-depth interviews with current harm reduction providers in Ottawa, the themes of (1) uncertainty and concerns surrounding the overdose crisis; (2) lack of flexibility in resources and access issues; and (3) diversity in the culture of drug use in Ottawa were explored. Recommendations surrounding partnering with PWUD, policy changes, and a safer supply were subsequently discussed. These findings helped to validate the reality of the unique drug-use culture in Ottawa, and the requirement for harm reduction services to be adapted to the local needs of PWUD.

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