scholarly journals Observational study of visual testing efficacy in detecting cannabis usage

2021 ◽  
Vol 6 (2) ◽  
pp. 83-92
Author(s):  
Phillip Olla ◽  
Mustafa Abumeeiz ◽  
Lauren Elliott ◽  
Rachel Foote ◽  
Mialynn Lee-Daigle ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Vital Signs ◽  
Visual Assessment ◽  
Recovery Phase ◽  
Medical Cannabis ◽  
Sample Collection ◽  
Baseline Phase ◽  
Subjective Data ◽  
Drug Impairment ◽  
Visual Testing

Drug recognition and examination programs are widely used to detect drug impairment in motor vehicle operators. Visual tests are a key assessment in the detection of cannabis-related impairment. Participants were recruited via social media from the medical cannabis community in Southwestern Ontario, Canada. Twenty-two participants completed the full observational trial design. The majority (n = 13 or 59.1%) were male, with a mean age of 36 years (SD = 9.4; range: 24–59). Participants underwent the following protocol: 1) First round of testing (vital signs, bio sample collection, visual tests, subjective data, neurocognitive testing) (Baseline phase); 2) Consumption of cannabis via inhalation; 3) Second round of testing 30 minutes following consumption (THC phase); 4) Additional rounds of testing at 90, 150, and 210 minutes following consumption (Recovery phase). Visual assessment data and vital signs did not follow typical patterns associated with acute cannabis intoxication. With blood THC levels more than double the Canadian legal limit (5 ng/mL), visual testing results were not diagnostic for cannabis impairment, as participants maintained normal pupil sizes and normal ocular convergence patterns. Visual testing is a key component in standardized examinations used for detecting cannabis-related impairment in Canadian drivers; however, our data indicate that visual testing may not be an effective diagnostic tool for the specific population of medical cannabis users.

scholarly journals Welfare Health and Productivity in Commercial Pig Herds

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 1176
Author(s):  
Przemysław Racewicz ◽  
Agnieszka Ludwiczak ◽  
Ewa Skrzypczak ◽  
Joanna Składanowska-Baryza ◽  
Hanna Biesiada ◽  
...  
Keyword(s):  
Radio Frequency Identification ◽  
Vital Signs ◽  
Visual Assessment ◽  
Early Warning Systems ◽  
Warning Systems ◽  
Herd Management ◽  
Pork Production ◽  
Antimicrobial Substances ◽  
Non Invasive ◽  
Frequency Identification

In recent years, there have been very dynamic changes in both pork production and pig breeding technology around the world. The general trend of increasing the efficiency of pig production, with reduced employment, requires optimisation and a comprehensive approach to herd management. One of the most important elements on the way to achieving this goal is to maintain animal welfare and health. The health of the pigs on the farm is also a key aspect in production economics. The need to maintain a high health status of pig herds by eliminating the frequency of different disease units and reducing the need for antimicrobial substances is part of a broadly understood high potential herd management strategy. Thanks to the use of sensors (cameras, microphones, accelerometers, or radio-frequency identification transponders), the images, sounds, movements, and vital signs of animals are combined through algorithms and analysed for non-invasive monitoring of animals, which allows for early detection of diseases, improves their welfare, and increases the productivity of breeding. Automated, innovative early warning systems based on continuous monitoring of specific physiological (e.g., body temperature) and behavioural parameters can provide an alternative to direct diagnosis and visual assessment by the veterinarian or the herd keeper.

Return of Memory and Sleep Efficiency Following Moderate to Severe Closed Head Injury

2008 ◽  
Vol 23 (4) ◽  
pp. 320-326 ◽  
Author(s):  
Michael J. Makley ◽  
Lisa Johnson-Greene ◽  
Patrick M. Tarwater ◽  
Andrew J. Kreuz ◽  
J. Spiro ◽  
...  
Keyword(s):  
Brain Injury ◽  
Head Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Closed Head Injury ◽  
Recovery Phase ◽  
Sleep Efficiency ◽  
Rehabilitation Unit ◽  
Closed Head ◽  
Unit Increase

Objective. Sleep disturbance is common in the subacute recovery phase following brain injury. A previous study from the authors' group found 68% of patients with closed head injury (CHI) had disrupted sleep on a rehabilitation unit. In the present study, the authors investigated whether improvement in sleep efficiency correlates with duration of posttraumatic amnesia (PTA) after CHI. Methods. Fourteen CHI patients were enrolled and followed prospectively. Mechanism of injury included motor vehicle accident, fall, and blunt assault. An actigraph was placed on each subject's wrist within 72 hours of admission to the rehabilitation unit and recorded data for the duration of their stay. A minimum of 7 days of continuous actigraphy data was obtained on all subjects. PTA was measured daily using the Orientation Log (O-LOG). Results. Seventy-eight percent of subjects had mean week-1 sleep efficiency scores of ≤63%. Patients admitted having already cleared PTA had significantly better week-1 sleep efficiency scores than those with ongoing amnesia ( P = .032). For those patients admitted with ongoing PTA, each 10-unit increase in sleep efficiency score correlated with 1 unit increase in O-LOG score ( P = .056). Conclusions. Disrupted sleep is common in the postacute stage following CHI. Improved sleep efficiency correlates with resolution of PTA. Decreased sleep efficiency may negatively affect memory return after traumatic brain injury. Actigraphy is uniquely suited to study the sleep patterns of these patients.

scholarly journals Personal Health Monitoring with Mobile Application Based on Blockchain Technologies

2021 ◽  
Vol 110 ◽  
pp. 05001
Author(s):  
Nataliya Apatova ◽  
Oleg Korolyov ◽  
Sergey Ivanov
Keyword(s):  
Health Monitoring ◽  
Mobile Application ◽  
Vital Signs ◽  
Integrated Approach ◽  
Modern Medicine ◽  
Personal Health ◽  
Subjective Data ◽  
Monitoring Applications ◽  
Personal Health Monitoring ◽  
Official Data

Personal health monitoring is especially necessary in a pandemic of COVID19 and based on objective and subjective data. Modern medicine uses numerous diagnostic devices, many of which are for personal health monitoring. Applications for mobile phones are becoming more widespread, they make a possibility constantly monitor vital signs for a person. However, the consolidation into a single personalized database of information on daily mobile monitoring and examination results from various doctors in various medical organizations not yet carried out. Proposed to build a blockchain from this data and results of data analysis add subjective sensations and indicators to it, which clarified during the conversation with the doctor and not always fully and correctly transmitted by the patient. Using an integrated approach to personal health monitoring, building a blockchain from official data and personal objective and subjective indicators makes it possible to identify at the early stages of the disease, to have a complete and reliable picture of the state of health.

Patients Who Refuse Transportation by Ambulance: A Case Series

1997 ◽  
Vol 12 (4) ◽  
pp. 45-50 ◽  
Author(s):  
John E. Hipskind ◽  
JM Gren ◽  
DJ Barr
Keyword(s):  
Medical Information ◽  
Life Support ◽  
Motor Vehicle ◽  
Demographic Data ◽  
Vital Signs ◽  
Case Series ◽  
Advanced Life Support ◽  
Care Program ◽  
Motor Vehicle Crash ◽  
Discharge Instructions

AbstractIntroduction:Patients refusing hospital transportation occurs in 5% to 25% of out-of-hospital calls. Little is known about these calls. This study was needed to determine the demographics, inherent risks, and timing of refused calls.Methods:This was a prospective review of all run sheets of patients who refused transportation were collected for a two month period. Demographic data and medical information was collected. Each run was placed into one of three categories of need for transport and further evaluation: 1) minimal; 2) moderate; and 3) definite. The Greater Elgin Area Mobile Intensive Care Program (GEA-MICP) based at Sherman Hospital in Elgin, Illinois, was the setting. The GEA-MICP is an Emergency Medical Services (EMS) system comprised of 17 advanced life support (ALS) ambulance agencies servicing northeastern Illinois. Study subjects were all patients who refused transportation to a hospital by ALS ambulance during July 1993 and February 1994. Paramedics were required to complete a run sheet for all calls.Results:Overall, 30% (683 of2,270) of all runs resulted in refusal of transportation. Patients who most commonly refused transportation were asymptomatic, 11–40 years old and involved in a motor vehicle crash. They usually had no past medical history, normal vital signs, and a normal mental status. Patients generally signed for their own release after evaluation. The average time to arrival was 4.2 minutes and average time spent on scene by paramedics was 18.4 minutes. Of the patients, 72% were judged to have minimal need, 25% were felt to have a moderate need, and 3% were felt to definitely need transport to a hospital for further evaluation and/or treatment.Conclusion:There are many cases when EMS are activated, but transportation is refused. Most refusals occur after paramedic evaluation. Providing paramedics with primary care training and protocols would standardize care given to patients and provide a mechanism for discharge instructions and follow-up for those who chose not to be transported to a hospital. Patients judged to require further treatment had unique characteristics. These data may be useful in identifying potentially sicker patients allowing a concentrated effort to transport this subset of patients to a hospital.

scholarly journals B-54 Insights into a Novel Integrated Screening Clinic: Parent Perceptions of Emotional Functioning in Acute Recovery Phase Following Pediatric Neurocritical Care

2019 ◽  
Vol 34 (6) ◽  
pp. 1000-1000
Author(s):  
K Bradbury ◽  
A Wagner ◽  
S Leonard ◽  
C Williams ◽  
J Piantino ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neurocritical Care ◽  
Motor Vehicle ◽  
Emotional Functioning ◽  
Recovery Phase ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Mechanism Of Injury ◽  
Normal Limits ◽  
Severity Of Injury

Abstract Objective Children with traumatic brain injury (TBI) requiring neurocritical care are at high risk for neurocognitive, emotional, physical, and psychosocial difficulties, collectively known as Post-Intensive Care Syndrome. Our study sought to characterize parent ratings of emotional functioning in the acute recovery phase based upon mechanism of injury. Method Twenty children (Mdn = 12.6 years, IQR = 9-15; 65% male) were screened as part of a multidisciplinary follow-up clinic 1-month following hospital discharge. Emotional functioning was assessed using PROMIS Parent Proxy Report for Anxiety and Depression. A brief neurocognitive battery estimated presence of cognitive impairment. MANCOVA was used to compare emotional functioning across injury mechanism (high velocity injury [HVI], 65%; fall, 35%). Results Groups did not differ on age, gender, and presence of cognitive impairment. After controlling for severity, mechanism of injury had a significant effect on both anxiety (p = .026) and depression (p = .004). The HVI group had mildly elevated anxiety (M = 50.5, SD = 12.2) and depression (M = 54.2, SD = 10.6) scores, while the fall group had anxiety (M = 38.0, SD = 6.2) and depression (M = 39.0, SD = 7.3) scores within normal limits. Conclusions In the acute recovery phase following TBI, anxiety and depression symptoms are more common after HVI than falls, even when controlling for severity of injury. The HVI group includes injuries resulting from motor vehicle accidents which may have a broader impact on the family and may explain higher rates of emotional distress in this patient group compared to other mechanisms of TBI. Additional research is needed to further explore variables related to emotional functioning following TBI and how they change over the course of recovery.

Emergency room vital signs and PTSD in a treatment seeking sample of motor vehicle accident survivors

2002 ◽  
Vol 15 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Edward B. Blanchard ◽  
Edward J. Hickling ◽  
Tara Galovski ◽  
Connie Veazey
Keyword(s):  
Emergency Room ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Vital Signs ◽  
Treatment Seeking ◽  
Vehicle Accident

scholarly journals Fine Particulate Matter Pollution Characteristics and Source Apportionment of Changchun Atmosphere

2021 ◽  
Author(s):  
Jie Tang ◽  
Zhuo Yang ◽  
Yue Tui ◽  
Ju Wang
Keyword(s):  
Particulate Matter ◽  
Mass Concentration ◽  
Elemental Carbon ◽  
Motor Vehicle ◽  
Fine Particulate Matter ◽  
Water Soluble ◽  
Chemical Components ◽  
Sample Collection ◽  
Pollution Characteristics ◽  
Fine Particulate

Abstract In order to study the pollution characteristics and main sources of fine particulate matter in the atmosphere of the city of Changchun, PM2.5 samples were collected during the four seasons in 2014, and representative months for each season are January, April, July, and October. Sample collection was carried out on 10 auto-monitoring stations in Changchun, and PM2.5 mass concentration, and its chemical components (including inorganic elements, organic carbon, elemental carbon, and water-soluble ions) were measured. The results show that the annual average mass concentration of PM2.5 in Changchun in 2014 was about 66.77 µg/m3. Organic matter was the highest component in PM2.5, followed by secondary inorganic ions (SNA), mineral dust (MIN), elemental carbon (EC), and trace elements (TE). Positive Matrix Factorization (PMF) results gave seven factors, namely, industrial, biomass- and coal-burning, industrial and soil dust, motor-vehicle, soil and secondary-ion, light-industrial, and hybrid-automotive and -industrial sources in PM2.5, with contributing values of 18.9%, 24.2%, 5.7%, 23.0%, 11.5%, 13.0%, and 3.6%, respectively.

scholarly journals P136: What happens to bypassed trauma patients meeting Field Trauma Triage standards?

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S113-S113
Author(s):  
M. Austin ◽  
J. Sinclair ◽  
S. Leduc ◽  
S. Duncan ◽  
J. Rouleau ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Motor Vehicle ◽  
Vital Signs ◽  
Trauma Patients ◽  
Level Of Consciousness ◽  
Control And Prevention ◽  
Ct Head ◽  
Trauma Triage ◽  
Record Review ◽  
The Impact

Introduction: Prehospital field trauma triage (FTT) standards were reviewed and revised in 2014 based on the recommendations of the Centers for Disease Control and Prevention. The FTT standard allows a hospital bypass and direct transport, within 30 min, to a lead trauma hospital (LTH). Our objectives were to assess the impact of the newly introduced prehospital FTT standard and to describe the emergency department (ED) management and outcomes of patients that had bypassed closer hospitals. Methods: We conducted a 12-month multi-centred health record review of paramedic and ED records following the implementation of the 4 step FTT standard (step 1: vital signs and level of consciousness (physiologic), step 2: anatomical injury, step 3: mechanism and step 4: special considerations) in nine paramedic services across Eastern Ontario. We included adult trauma patients transported as urgent that met FTT standard, regardless of transport time. We developed and piloted a data collection tool and obtained consensus on all definitions. The primary outcome was the rate of appropriate triage to a LTH which was defined as: ISS ≥12, admitted to intensive care unit (ICU), non-orthopedic surgery, or death. We have reported descriptive statistics. Results: 570 patients were included: mean age 48.8, male 68.9%, falls 29.6%, motor vehicle collisions 20.2%, stab wounds 10.5%, transported to a LTH 76.5% (n = 436). 72.2% (n = 315) of patients transported to a LTH had bypassed a closer hospital and 126/306 (41.2%) of those were determined to be an appropriate triage to LTH (9 patients had missing outcomes). ED management included: CT head/cervical spine 69.9%, ultrasound 53.6%, xray 51.6%, intubation 15.0%, sedation 11.1%, tranexamic acid 9.8%, blood transfusion 8.2%, fracture reduction 6.9%, tube thoracostomy 5.9%. Outcomes included: ISS ≥ 12 32.7%, admitted to ICU 15.0%, non-orthopedic surgery 11.1%, death 8.8%. Others included: admission to hospital 57.5%, mean LOS 12.8 days, orthopedic surgery 16.3% and discharged from ED 37.3%. Conclusion: Despite a high number of admissions, the majority of trauma patients bypassed to a LTH were considered over-triaged, with a low number of ED procedures and non-orthopedic surgeries. Continued work is needed to appropriately identify patients requiring transport to a LTH.

scholarly journals Vital Signs: Motor Vehicle Injury Prevention — United States and 19 Comparison Countries

2016 ◽  
Vol 65 (26) ◽  
pp. 672-677 ◽  
Author(s):  
Erin K. Sauber-Schatz ◽  
David J. Ederer ◽  
Ann M. Dellinger ◽  
Grant T. Baldwin
Keyword(s):  
United States ◽  
Injury Prevention ◽  
Motor Vehicle ◽  
Vital Signs ◽  
Motor Vehicle Injury

scholarly journals PL03: Implementation of the Canadian C-Spine Rule by paramedics: a safety evaluation

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S26-S27 ◽  
Author(s):  
C. Vaillancourt ◽  
M. Charette ◽  
J.E. Sinclair ◽  
J. Maloney ◽  
R. Dionne ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Eligible Patient ◽  
Vital Signs ◽  
Low Risk ◽  
Spine Injury ◽  
Trauma Patients ◽  
Risk Criteria ◽  
Radiologic Evaluation ◽  
Kappa Agreement ◽  
The Impact

Introduction: The Canadian C-Spine Rule (CCR) was validated by emergency physicians and triage nurses to determine the need for radiography in alert and stable Emergency Department trauma patients. It was modified and validated for use by paramedics in 1,949 patients. The prehospital CCR calls for evaluation of active neck rotation if patients have none of 3 high-risk criteria and at least 1 of 4 low-risk criteria. This study evaluated the impact and safety of the implementation of the CCR by paramedics. Methods: This single-centre prospective cohort implementation study took place in Ottawa, Canada. Advanced and primary care paramedics received on-line and in-person training on the CCR, allowing them to use the CCR to evaluate eligible patients and selectively transport them without immobilization. We evaluated all consecutive eligible adult patients (GCS 15, stable vital signs) at risk for neck injury. Paramedics were required to complete a standardized study data form for each eligible patient evaluated. Study staff reviewed paramedic documentation and corresponding hospital records and diagnostic imaging reports. We followed all patients without initial radiologic evaluation for 30 days for referral to our spine service, or subsequent visit with radiologic evaluation. Analyses included sensitivity, specificity, kappa coefficient, t-test, and descriptive statistics with 95% CIs. Results: The 4,034 patients enrolled between Jan. 2011 and Aug. 2015 were: mean age 43 (range 16-99), female 53.3%, motor vehicle collision 51.9%, fall 23.8%, admitted to hospital 7.0%, acute c-spine injury 0.8%, and clinically important c-spine injury (0.3%). The CCR classified patients for 11 important injuries with sensitivity 91% (95% CI 58-100%), and specificity 67% (95% CI 65-68%). Kappa agreement for interpretation of the CCR between paramedics and study investigators was 0.94 (95% CI 0.92-0.95). Paramedics were comfortable or very comfortable using the CCR in 89.8% of cases. Mean scene time was 3 min (15.6%) shorter for those not immobilized (17 min vs. 20 min; p=0.0001). A total of 2,569 (63.7%) immobilizations were safely avoided using the CCR. Conclusion: Paramedics could safely and accurately apply the CCR to low-risk trauma patients. This had a significant impact on scene times and the number of prehospital immobilizations.

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