Background Response time to cardiovascular emergency medical requests is an important indicator in reducing cardiovascular disease (CVD) -related mortality. This study aimed to visualize the spatial-time distribution of response time, scene time, and call-to-hospital time of these emergency requests. We also identified patterns of clusters of CVD-related calls. Methods This cross-sectional study was conducted in Mashhad, north-eastern Iran, between August 2017 and December 2019. The response time to every CVD-related emergency medical request call was computed using spatial and classical statistical analyses. The Anselin Local Moran’s I was performed to identify potential clusters in the patterns of CVD-related calls, response time, call-to-hospital arrival time, and scene-to-hospital arrival time at small area level (neighborhood level) in Mashhad, Iran. Results There were 84,239 CVD-related emergency request calls, 61.64% of which resulted in the transport of patients to clinical centers by EMS, while 2.62% of callers (a total of 2218 persons) died before EMS arrival. The number of CVD-related emergency calls increased by almost 7% between 2017 and 2018, and by 19% between 2017 and 2019. The peak time for calls was between 9 p.m. and 1 a.m., and the lowest number of calls were recorded between 3 a.m. and 9 a.m. Saturday was the busiest day of the week in terms of call volume. There were statistically significant clusters in the pattern of CVD-related calls in the south-eastern region of Mashhad. Further, we found a large spatial variation in scene-to-hospital arrival time and call-to-hospital arrival time in the area under study. Conclusion The use of geographical information systems and spatial analyses in modelling and quantifying EMS response time provides a new vein of knowledge for decision makers in emergency services management. Spatial as well as temporal clustering of EMS calls were present in the study area. The reasons for clustering of unfavorable time indices for EMS response requires further exploration. This approach enables policymakers to design tailored interventions to improve response time and reduce CVD-related mortality.
An outbreak of cutaneous leishmaniasis [CL] in Sabzevar county prompted this study of the epidemiology and the ecology of vectors and reservoirs. Examination of 541 schoolchildren showed rates of 9.4% for scars and 5.9% for ulcers. Among 807 inhabitants of 4 villages, 10.4% had scars and 3.0% had active lesions. The most highly infected age group was 0-4 years with a rate of 5.9%. A total of 12 849 sandflies representing 7 species were collected in the study area. Leptomonad infection was found in Phlebotomus papatasi, P. caucasicus and Sergentomyia sintoni. Parasites from man, P. papatasi and Rhombomys opimus, were isolated and characterized as Leishmania major. Based on this survey, this is an epidemic of zoonotic CL, with R. opimus the main reservoir host, and P. papatasi the main vector
Background:Response time to cardiovascular emergency medical requests is an important indicator in reducing cardiovascular disease (CVD) related mortality. This study aims to develop an index of response time and investigate potential clusters in the pattern of CVD-related calls over time and space.Methods:This cross-sectional study was conducted in Mashhad, north-eastern Iran, between August 2017 and December 2019. An emergency medical service (EMS) response time matrix to CVD-related calls was computed using spatial and classical statistical analyses. The Anselin Local Moran's I was performed to identify potential clusters in the patterns of CVD-related calls, response time, call-to-hospital arrival time, and scene-to-hospital arrival time at small area level (neighborhood level) in Mashhad, Iran.Results:There were 84,239 CVD-related emergency request calls, of which 60.21 percent were transported to clinical centers by EMS, and 2.62 percent (a total of 2203 persons) died before EMS arrival. The number of CVD-related emergency calls increased by almost 15% in 2018 and 20% in 2019. The peak in the number of calls occurred between 9 p.m. and 1 a.m., and the lowest number of calls were recorded between 3 a.m. and 9 a.m. Saturday was the busiest day of week in terms of call volume. There were statistically significant clusters in the pattern of CVD-related calls in the south-eastern region of Mashhad. Further, we found a large spatial variation in scene-to-hospital arrival time and call-to-hospital arrival time in the area under study.Conclusion:The use of geographical information systems and spatial analyses in modelling and quantifying EMS response time provides a new vein of knowledge for decision makers in emergency services management. This also enables policy makers to design tailored interventions to improve response time and reduce CVD-related mortality.
Background and aims: Family caregivers have significant role in managing psychiatric emergencies in the time interval between their request for emergency medical services (EMS) and ambulance arrival at the emergency scene. This study aimed at assessing the effects of educational short message service (SMS) messages about emergency scene management (ESM) on perceived stress and satisfaction among the family caregivers of patients with mental disorders who requested EMS. Methods: This randomized controlled trial was conducted in 2019–2020 using a two-group posttest-only design. Participants were sixty family caregivers of patients with mental disorders in Mashhad, Iran, who called the EMS center and requested EMS. They were continuously recruited and randomly allocated to an intervention or a control group. Participants in the control group received routine educations, while participants in the intervention group received routine educations and SMS-based educations about ESM. Data were collected using a demographic questionnaire, a researcher-made caregiver satisfaction questionnaire, and the Cohen’s Perceived Stress Scale. Data analysis was performed via the SPSS software (v. 25.0). Results: Most participants were female (53.3%) and their mean age was 44.30±13.03 years. The mean score of perceived stress in the intervention group was significantly less than the control group (P=0.001), while the mean score of caregiver satisfaction in the intervention group was significantly more than the control group (P=0.001). Conclusion: SMS-based education about ESM is effective in significantly reducing perceived stress and enhancing satisfaction among the family caregivers of patients with mental disorders.
Background: As the summer approaches, many people go for swimming but sometimes this pleasurable activity has no happy ending. Drowning is an important health problem but often neglected. It is defined as choking (breathing problems) as a result of immersion in a fluid. Every summer, media publish reports of deaths due to drowning and warn people about it. However, many people recognize the risk of drowning only on the populous beaches not wherever close to water, like a bathtub or a large water puddle in the courtyard corner. The world total deaths due to drowning is estimated to be 6.8/100,000 people which is the second common cause of unintentional mortalities after road accidents. Most drownings occur in provincial beaches, but other parts of the country account for a significant proportion of injuries and deaths due to drowning/choking in water. This study aimed at investigating the epidemiologic aspects of drownings in Mashhad during 2014-2017. Methods: In this cross-sectional study, the data from the epidemiological survey of drowning cases during 2014-2017 were analyzed using SPSS software. Results: The total number of drownings reported to the Emergency Department during this period was 68. Most of which occurred in 2015 (35%), 26% of cases occurred in urban and 74% in rural areas. 75% were men and 25% women. 19% of deaths associated with drowning. 15% of drowning events occurred in recreational sport centers. Most cases were under 5 years old (45%), followed by adolescents and young groups (35%). Conclusion: Most of the drowning victims were children. Therefore, it is essential for parents to protect their children close to water, especially in private areas such as pools in gardens. We should make such places safe. Special attention should also be given to safety equipment, protection and training in public swimming pools and recreational facilities.
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