Medical Service Workers Research Articles

Machine Learning Framework for Classifying and Predicting Depressive Behavior Based on PPG and ECG Feature Extraction

Depression is a significant risk factor for other serious health conditions, such as heart failure, dementia, and diabetes. In this study, a quantitative method was developed to detect depressive states in individuals using electrocardiogram (ECG) and photoplethysmogram (PPG) signals. Data were obtained from 59 people affiliated with the high-specialized medical center of Bajio T1, which consists of medical professionals, administrative personnel, and service workers. Data were analyzed using the Beck Depression Inventory (BDI-II) to discern potential false positives. The statistical analyses performed elucidated distinctive features with variable behavior in response to diverse physical stimuli, which were adeptly processed through a machine learning classification framework. The method achieved an accuracy rate of up to 92% in the identification of depressive states, substantiating the potential of biophysical data in increasing the diagnostic process of depression. The results suggest that this method is innovative and has significant potential. With additional refinements, this approach could be utilized as a screening tool in psychiatry, incorporated into everyday devices for preventive diagnostics, and potentially lead to alarm systems for individuals with suicidal thoughts.

Change in occupational burnout measures in emergency medical service workers after a psychedelic experience induced by a single self-administered dose of psilocybin mushrooms

AbstractBackground and AimsThis naturalistic mixed methods field study, aimed to assess the potential of a psilocybin induced experience, to help Emergency Medical Service Workers (EMSW) to address psychological and stress related symptoms stemming from a challenging working environment, known to contribute to occupational burnout (OB).MethodsThis exploration was conducted with an intentional sample of five participants, recruited through an online survey who self-administered a therapeutic dose of psilocybin mushrooms to manage psychological symptoms resulting from their work as EMSW, allowing the authors to assess the outcome. To measure the impact of the experience, changes in OB measures were assessed with psychometric instruments previously used in this population at three timepoints, before and after the session. The subjective impact of the psychedelic experience, through psychological insights and emotional breakthroughs, was also assessed, and two follow-up interviews were conducted to collect further data.ResultsThe results showed that, two weeks after the session, a visible improvement was noticed in several measures of pre-existent OB, that remained stable after two months. Additionally, most participants reported a strong subjective impact, that they perceived as fundamental for the positive outcome.ConclusionsAfter one therapeutic psylocibin session, several measures of OB showed an encouraging level of improvement and may constitute an important step towards finding alternative and innovative solutions to address high rates of psychological distress experienced by EMSWs, also benefiting the organization and the quality of patient care. The limitations and implications of the study and suggestions for future research are discussed.

Firearm ownership and storage practices among United States firefighters and emergency medical services personnel.

Compared with the general U.S. population, firefighters (FF) and emergency medical services (EMS) workers (FF + EMS personnel) are at increased risk for firearm suicide. Although secure firearm storage is associated with reduced risk of firearm suicide, no study has examined the prevalence and sociodemographic correlates of firearm ownership and storage practices among U.S. FF + EMS personnel. A total of 141 U.S. FF + EMS personnel completed a structured, web-based self-report questionnaire. Overall, 76.6% (n = 108) of FF + EMS personnel in our sample reported owning a personal firearm, among whom 85.2% (n = 92) reported owning more than one firearm. Among firearm owners, 42.6% (n = 46) reported secure firearm storage (i.e., unloaded and locked) and 57.4% (n = 62) reported nonsecure firearm storage (i.e., loaded and/or unlocked). FF + EMS personnel who cited personal safety as the only reason for firearm ownership, as opposed to reporting other or multiple reasons for ownership (e.g., hunting), were at increased odds of reporting nonsecure storage practices (69.4% vs. 47.5%; OR = 2.51, 95% CI [1.14, 5.55], p = .023). Most FF + EMS personnel in our sample reported firearm ownership, and approximately half of the firearm owners reported nonsecure firearm storage practices. Promoting secure firearm storage practices among FF + EMS personnel might decrease risk of firearm suicide and other forms of firearm-related injuries. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychosocial working conditions, perceived patient safety and their association in emergency medical services workers in Germany - a cross-sectional study.

Emergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety. For this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c). The most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress. Work stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.

Algorithm for Providing Geriatric and Gerontological Care based on International Experience

The relevance of the stated topic of this research is conditioned upon the numerous problems of providing medical care to elderly people who suffer from chronic diseases characteristic of various disability groups, accompanied by a complete or partial loss of the ability to self-care, as a result of which there is a steady trend towards an increase in mortality among people of these age groups. The purpose of this research is to study the features of constructing an algorithm for providing geriatric and gerontological care in the Republic of Kazakhstan, considering the international experience accumulated in this field. The basis of the methodological approach in this study is a combination of a systematic analysis of the accumulated international experience in the field of geriatric and gerontological care, with an analytical study of the actual possibilities of constructing an algorithm for providing assistance based on this international experience. The main results obtained in the course of this study are the definition of the main stages of the algorithm for providing geriatric and gerontological care, and the definition of the main age groups of patients, more than other categories in need of this kind of assistance, formulated on the basis of accumulated international experience in this area. The results of this research work, including the conclusions formulated on their basis, have significant practical significance for disabled elderly people in need of medical care, and for social and medical service workers whose direct professional responsibilities include providing medical care to elderly people.

Hygienic assessment of health risks for employees of the Omsk ambulance service due to tobacco smoking

The results of many studies indicate that there is a cause-effect relationship between active tobacco smoking and risks of various diseases, lung and bronchial cancer (C34) and coronary heart disease (I25) being the most common among them. These diseases are one of the main causes of death in working age. The aim of this study was to perform hygienic assessment of risks of lung and bronchial cancer and coronary heart disease due to active tobacco smoking. Healthcare workers employed at the Omsk ambulance station were chosen as the research object. Additional risk levels were calculated for lung and bronchial cancer and coronary heart disease in accordance with the methodical guidelines MR 2.1.10.0033-11 Assessment of Risks Associated with Impacts of Lifestyle Factors on Public Health. Smoking was a health risk factor for 27.5 % of emergency medical services workers, including 42.5 % of men and 21.3 % of women. Sixty-six point seven percent of men aged between 31 and 40 years smoked. Prevalence of smoking among the females in the sample did not depend on age. The risk analysis revealed that smokers, equally men and women (p > 0.1) were the most likely to have lung and bronchial cancer and coronary heart disease. The corresponding median levels of additional risk equaled 1.45E-05 and 9.0E-06. The proportion of people with unacceptable levels of additional risks of the analyzed diseases (> 1.4E-04) equaled 43.3 and 53.3 % respectively among people older than 40 years. Likelihood of lung and bronchial cancer and coronary heart disease statistically significantly depends on the intensity of smoking.

Гигиеническая оценка рисков здоровью сотрудников службы скорой медицинской помощи в связи с курением табака (на примере г. Омска)

The results of many studies indicate that there is a cause-effect relationship between active tobacco smoking and risks of various diseases, lung and bronchial cancer (C34) and coronary heart disease (I25) being the most common among them. These diseases are one of the main causes of death in working age. The aim of this study was to perform hygienic assessment of risks of lung and bronchial cancer and coronary heart disease due to active tobacco smoking. Healthcare workers employed at the Omsk ambulance station were chosen as the research object. Additional risk levels were calculated for lung and bronchial cancer and coronary heart disease in accordance with the methodical guidelines MR 2.1.10.0033-11 Assessment of Risks Associated with Impacts of Lifestyle Factors on Public Health. Smoking was a health risk factor for 27.5 % of emergency medical services workers, including 42.5 % of men and 21.3 % of women. Sixty-six point seven percent of men aged between 31 and 40 years smoked. Prevalence of smoking among the females in the sample did not depend on age. The risk analysis revealed that smokers, equally men and women (p > 0.1) were the most likely to have lung and bronchial cancer and coronary heart disease. The corresponding median levels of additional risk equaled 1.45E-05 and 9.0E-06. The proportion of people with unacceptable levels of additional risks of the analyzed diseases (> 1.4E-04) equaled 43.3 and 53.3 % respectively among people older than 40 years. Likelihood of lung and bronchial cancer and coronary heart disease statistically significantly depends on the intensity of smoking.

Sleep Safety in Emergency Medical Services Workers

Sleep Safety in Emergency Medical Services Workers

The Polk COVID-19 and Flu Response clinical trial: COVID-19 antibody positivity higher in Black EMS workers

This study reports on a countywide assessment of COVID-19 positivity among emergency medical services workers. Participants completed a short survey of demographic factors and co-morbidities prior to obtaining COVID-19 and influenza testing to analyze the prevalence of these two respiratory viruses that EMS workers, being the first on the scene, are at special risk for, especially in the early days of the pandemic. A total of 7% had a positive COVID-19 antibody test. Although Black EMS personnel only comprised 9% of the cohort, they were significantly more likely to test positive for COVID-19 (P=0.0012). Black race remained a statistically significant predictor in a multivariate model that included the age, sex, BMI, number of hours of direct patient contact, whether the medic was symptomatic, presence of co-morbidities and whether or not the medic had received a flu shot prior (P=0.0008, 95% CI 0.0621-0.2354). This clinical trial (NCT04682132) ) was registered at clinicaltrials.gov, a resource provided by the U.S. National Library of Medicine.

Disaster Knowledge, Skills, and Preparedness among Emergency Medical Services in Saudi Arabia.

Emergency Medical Services (EMS) workers are critical to effective disaster response. Therefore, it is important to understand their knowledge, skills, and preparedness for disasters. This study investigated factors influencing EMS workers' disaster knowledge, skills, and preparedness in the Saudi Arabian context. The study also sought to identify challenges to disaster preparedness among Saudi Arabian EMS workers. A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across 3 Saudi Arabian cities. Responses were recordedon a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analysed using descriptive and inferential statistical analysis. 272EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite this, EMS workers reported a high level of involvement in regular disaster drills (M = 4.24, SD = 1.274) and a strong interest in further disaster education opportunities (M = 5.43, SD = 1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M = 4.06, SD = 1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in. EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship on the EMS workers' demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.

5. KNOWLEDGE, ATTITUDE AND PRACTICE OF PREHOSPITAL EMERGENCY IN VIETNAM, 2023

Objective: Assessing the knowledge, attitude and practice of prehospital emergency in Vietnam in 2023. 
 Subjects and methods: A survey on 10,800 people was implemented to assess the status of prehospital emergency and the capacity of the local health system. 
 Results: Only 33.65% of people knew about emergency calls and 33.20% of people did not know or sure about emergency calls. 49.48% of people believed that ambulances are useful, medical staff are useful in emergency care (50.04%). All residents estimated the ambulance’s time of arrival after calls around 5 - 60 minutes. The majority of people chose to transport emergency patients by taxi, personal car or carrying patients to the hospital, only 32.63% of people chose to call an ambulance when at home and 33.80% when outside. Most people reported to trust emergency medical service workers when the ambulance arrived at the scene or when the patient was hospitalized. 
 Conclusion: Although people’s knowledge and attitude towards prehospital emergency were inadequate, most people trusted medical staff when they arrived at the emergency scene or when taking patients to the hospital.

Cancer Risks among Emergency Medical Services Workers in Ontario, Canada

Objectives Emergency medical services workers, such as paramedics, provide important emergency care and may be exposed to potential carcinogens while working. Few studies have examined the risk of cancer among paramedics demonstrating an important knowledge gap in existing literature. This study aimed to investigate cancer risks among paramedics in a large cohort of Ontario workers. Methods Paramedics were identified in the Occupational Disease Surveillance System (ODSS) from 1996 to 2019. The ODSS was established by linking lost-time worker’s compensation claims to administrative health data, including the Ontario Cancer Registry to identify incident cases of cancer. Cox-proportional hazard models were used to calculate age and sex-adjusted hazard ratios and 95% confidence intervals to estimate the risk of cancer among paramedics compared to all other workers in the ODSS. Results A total of 7240 paramedics were identified, with just over half of the paramedics identifying as male similar to the overall ODSS cohort. Paramedics had a statistically significant elevated risk of any cancer (HR 1.19, 95% CI 1.06–1.34), and elevated risks for melanoma (HR 2.18, 95% CI 1.46–3.26) and prostate cancer (HR 1.73, 95% CI 1.34–2.22). Paramedics had a statistically significant reduced risk for lung cancer (HR 0.48, 95% CI 0.28–0.83). Findings were similar to cancer risks identified in firefighters and police in the same cohort. Conclusions This study contributes valuable findings to understanding cancer risks among paramedics and further supports the existing evidence on the increased risk of cancer among emergency medical services workers. We have observed some similar results for firefighters and police, which may be explained by similar exposures, including vehicle exhaust, shiftwork, and intermittent solar radiation. This can lead to a better understanding of carcinogens and other exposures among paramedics and inform cancer prevention strategies.

Comparing the effect of foot reflexology with olive oil and peppermint inhalation on job stress and fatigue severity among emergency medical services workers

Comparing the effect of foot reflexology with olive oil and peppermint inhalation on job stress and fatigue severity among emergency medical services workers

Effect of Work-Related Behavior and Experience Patterns on Sleep Quality in Emergency Medical Service Personnel.

The aim of this study was to examine the influence of work-related behavior and experience patterns on sleep quality in emergency medical service personnel. From the total sample of 508 emergency medical service workers who took part in the Germany-wide online survey, 368 respondents completed the questionnaires on sleep characteristics (Pittsburgh Sleep Quality Index [PSQI]) and work-related behavior and experience pattern. Three hundred sixty-seven of the 368 participants also finished the Regensburg Insomnia Scale. Based on their work-related behavior and experience pattern results, individuals were categorized into one of the four following patterns: two risk patterns (A, B) and two healthy behavior and experience patterns (G, S). Participants that were classified into risk-pattern A and B (33.85%) scored significantly higher in both PSQI and Regensburg Insomnia Scale overall score and all PSQI components implicating a poorer sleep quality. A total of 78.5% of the individuals with pattern A and B were considered bad sleepers whereas only 43.4% of individuals with pattern G and S were scored as bad sleepers. Work-related behavior and experience patterns showed a strong association to sleep characteristics and may therefore be used to identify appropriate preventative measures.

Different words for stroke: the same concept? an analysis of associated symptoms and intended reaction in Brazil

BackgroundDifferent names for stroke might mislead physicians and emergency medical service workers. This study aimed to assess the different words for stroke in Brazil and both intended response and related symptoms associated with those names.MethodsCross-sectional study enrolling healthy individuals from urban areas in Northeast of Brazil for an open-ended survey. We presented a typical clinical case of a stroke (an elderly who had sudden onset of hemiparalysis and slurred speech) and asked “what is happening?”, “what would you do?” and “which other symptoms could happen in this condition?”.ResutsFrom 1,475 interviewed individuals, 1,220 (82,7%) recognized the scenario as a stroke. There were 3 words to correctly identify (based on correct intended response and spontaneously evoked associated symptoms) the stroke, which were “AVC” (acronym for cerebrovascular accident, in Portuguese), “derrame” (spillage) and “trombose” (thrombosis). There were significant differences among them concerning demographic, economic, educational and geographical aspects, but there was no difference according to the intended reaction among them. The most cited associated symptoms (excluding those present in the case) were impaired consciousness (10.6%), headache (8.9%) and dysesthesia (7.7%). “Aneurisma” (aneurism) was also cited, by 3 individuals.ConclusionThere are at least three words for stroke in Portuguese (“AVC”, “derrame” and “trombose”); they were similar in terms of correct intended responses and spontaneously cited accompanying symptoms. Stroke campaigns should apply different names to reach a broader audience and to improve stroke recognition.

Disaster Knowledge, Skills, and Preparedness among Emergency Medical Services in Saudi Arabia.

Introduction:Emergency Medical Service (EMS) workers are critical to effective disaster response in Saudi Arabia. The World Health Organization requires countries and governments to have prepared emergency health workers and disaster action plans. Therefore, it is important to understand the disaster knowledge, skills, and preparedness of Saudi Arabian EMS workers. This study investigated factors influencing EMS workers’ disaster knowledge, skills, and preparedness in the Saudi Arabian context.Method:A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across three Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analyzed using descriptive and inferential statistical analysis.Results:272 EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite the moderate level, EMS workers reported a high level of involvement in regular disaster drills (M=4.24, SD=1.274) and a strong interest in further disaster education opportunities (M=5.43, SD=1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M=4.06, SD=1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.Conclusion:EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship with the EMS workers’ demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.

Personal Protection Equipment Kit Tracker.

The primary efficient review on the status of individual defensive gear for medical services workers in India has uncovered that practically all parts of PPE were discovered to be either deficiently accessible or inaccessible in many clinics. PPEs are a significant clinical asset for cutting edge laborers during the pandemic that incorporate body coveralls, N-95 covers, goggles, face shields among others. The public authority has been guaranteeing that after the underlying long stretches of the pandemic, PPE were just imported and there is no deficiency since the most recent couple of months as several homegrown makers are delivering almost 4.5lakh PPE units every day now. Nonetheless, the most recent review by a gathering of free wellbeing analysts has affirmed that cutting edge workers are as yet not getting these units. The study depended on reactions from specialists, inhabitants and understudies, attendants and network wellbeing workers. Almost 33% of respondents revealed that covers were not accessible at all. (According to an article by The New Indian Express). There are claims that demonstrate no deficiencies of PPE units the nation over, yet as per ongoing overviews, the undeniable realities are not replicated. These realities get significantly more heart-breaking when we move from green zones (one out of five) to red zones (one out of three). At present, India does not have an appropriate framework for the board of the PPE packs, guaranteeing legitimate unit purchasing and selling or permitting taking an interest element to chip away at the regular stage to fix bargains with respect to PPE parts, as indicated by their prerequisites.

Occupational exposure to blood and body fluids among prehospital emergency medical services workers in Mashhad, Northeast of Iran

This study aimed to assess occupational exposure to blood and body fluids (BBFs) and the use of protective equipment among prehospital emergency medical services (EMS) workers in Mashhad, Iran. This cross-sectional questionnaire survey-based study was conducted from July 2020 to March 2021 in Mashhad. All prehospital EMS workers of Mashhad were invited to participate in the study using the census technique. The questionnaire was about occupational exposure to BBFs, infection control, protective measures, health program, and demographic information. In total, 442 participants answered the questionnaire (response rate: 82.77%). Based on the findings, 420 (95.2%) and 402 (91.2%) participants had been exposed to BBFs as prehospital EMS workers. Moreover, 31.5% and 38.5% of these exposures were caused by contaminated needles and lancets, respectively. The BBFs incidents have occurred despite 98% of the EMS workers reporting there is a needle safety disposable box in the ambulance. The relationship between awareness of precaution measures after exposure to BBFs and training course completion was significant (P < .0001). This study demonstrated the high prevalence of occupational exposures to BBFs among prehospital EMS workers. Considering the significant relationship between the completion of standard precautions courses and awareness of BBFs' postexposure measures, it is recommended to consider multi-faceted strategies for continuous monitoring, training, and follow-up of prehospital EMS workers.

Mastering the Patient Handoff

Mastering the Patient Handoff

Vaccinations against COVID-19 in the opinion of medical services workers and the general social opinion

Introduction This study was devoted to getting to know the public opinion, including representatives of medical professions, regarding the presented views on vaccination against Covid-19, allowing to determine the most important issues related to the lack of acceptance of this preparation. Aim The aim of this study was to find out the social opinion regarding vaccination against Covid-19 (including the aspect of vaccination obligation, incidence of adverse post-vaccination reactions, vaccination among children and pregnant women) as well as the reasons for the attitude towards the fact of accepting the vaccine or rejecting the possibility of being vaccinated. Material and methods The study was conducted in a group of 510 people - practicing the medical profession and not related to the health service, who were over 18 years old. The method of a diagnostic survey was used with the use of a proprietary questionnaire containing single and multiple choice questions, the survey was conducted on-line using a Google form in October 2022. Results In the study group, the vaccination rate was 62.2%, women and medical professionals were more likely to be vaccinated. The decision to be vaccinated was mainly based on the desire to protect themselves against the severe course of a possible illness - 30.4% of respondents and to protect themselves and others against Covid-19 - 26.5%. In the represented group, unvaccinated persons accounted for 37.8% respectively, they did not decide to vaccinate mainly because of the belief that they were not protected against the disease - 19.8% of respondents, perceiving COVID-19 as a seasonal infection - 19.0%, and fear of long-term complications - 18.6%. The decision to vaccinate was accompanied by i.a. feelings such as: slight fear (36.3%), fear/anxiety (10.4%), strong fear/anxiety (3.7%). The study group was also asked about adverse post-vaccination reactions, 25.1% of the surveyed experienced complications, most of them did not report adverse post-vaccination reactions, and the percentage of reported cases was 1.6%. The vast majority of respondents - 74.5% were in favor of the lack of obligation to vaccinate. Opinions expressed about the safety of vaccinations: rather yes - 24%, rather not - 22% and definitely not - 21%, a significant part had no opinion - 24.3%. Conclusions This study confirms the significant problem of skepticism towards Covid-19 vaccination, as well as the high percentage of people expressing opposition to the obligation to vaccinate and the perception of the media campaign as propaganda, which confirms the existence of a significant social division regarding the acceptance of vaccination. The perception of vaccine safety is related to the knowledge of adverse post-vaccination reactions, but the problem observed among respondents is the fact that the number of reported adverse reactions is negligible.