Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care.

Electronic dance music events have predictable risks and patient presentations, and appropriate on-site health care resources may reduce significantly the impact on the prehospital and emergency health resources in the host community.

Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce presentation rates and acuity, and decrease utilization and cost for local, community-based health services.

Background: We explore the health care literature and draw on two decades of experience in the provision of medical care at mass gatherings and special events to illustrate the complementary aspects of mass gathering medical support and disaster medicine. Most communities have occasions during which large numbers of people assemble in public or private spaces for the purpose of celebrating or participating in musical, sporting, cultural, religious, political, and other events. Collectively, these events are referred to as mass gatherings. The planning, preparation, and delivery of health-related services at mass gatherings are understood to be within the discipline of emergency medicine. As well, we note that owing to international events in recent years, there has been a heightened awareness of and interest in disaster medicine and the level of community preparedness for disasters. We propose that a synergy exists between mass gathering medicine and disaster medicine. Method: Literature review and comparative analysis. Results: Many aspects of the provision of medical support for mass gathering events overlap with the skill set and expertise required to plan and implement a successful medical response to a natural disaster, terrorist incident, or other form of disaster. Conclusions: There are several practical opportunities to link the two fields in a proactive manner. These opportunities should be pursued as a way to improve the level of disaster preparedness at the municipal, provincial, and national levels.

Consistent definitions of MG populations will support more rigorous data collection. This, in turn, will support meta-analysis and pooling of data sources internationally, creating a foundation for risk assessment as well as illness and injury prediction modeling. Ultimately, more rigorous data collection will support methodology for evaluating health promotion, harm reduction, and clinical-response interventions at MGs. Delineating MG populations progresses the current body of knowledge of MGs and informs the understanding of the full scope of their health effects.

Adding patient presentation types to the 2012 MDS ensures that the collection of biomedical data for mass-gathering health research and evaluation remains contemporary and comprehensive. This review proposes the addition of 16 high-level patient presentation categories to the 2012 MDS in the following broad areas: gastrointestinal, obstetrics and gynecology, minor illness, mental health, and patient outcomes. Additionally, a section for self-treatment has been added, which was previously not included in the 2012 MDS, but was widely reported in the literature.

Abbreviations:ALS = advanced life support ATR = ambulance transfer rate BCAS = British Columbia Ambulance Service MGM = mass gathering medicine MTR = medical transfer rate PPR = patient presentation rate WPFG = World Police and Fire Games Abstract Introduction: In the summer of 2009, British Columbia hosted the World Police and Fire Games (WPFG). The event brought together 10,599 athletes from 55 countries. In this descriptive, Canadian study, the composition of the medical team is analyzed, the unique challenges faced are discussed, and an analysis of the illness and injury rates is presented. This event occurred during a labor dispute affecting the sole provider of emergency ambulance service in the jurisdiction, which necessitated additional planning and resource allocation. As such, the context of this event as it relates to the literature on mass gathering medicine is discussed with a focus on how large-scale public events can impact emergency services for the community. Methods: This is a case report study. Results: There were 1,462 patient encounters. The majority involved musculo-skeletal injuries (53.8%). The patient presentation rate (PPR) was 109.40/1,000. The medical transfer rate (MTR) was 2.32/1,000. The ambulance transfer rate (ATR) for the 2009 WPFG was 0.52/1,000. In total, 31 patients were transported to the hospital, the majority for diagnostic evaluation. Only seven calls were placed to 9-1-1 for emergency ambulance service. Conclusions: The 2009 WPFG was a mass-gathering sporting event that presented specific challenges in relation to medical support. Despite relatively high patient presentation rates, the widely spread geography of the event, and a reduced ability to depend on 9-1-1 emergency medical services, there was minimal impact on local emergency services. Adequate planning and preparation is crucial for events that have the potential to degrade existing public resources and access to emergency health services for participants and the public at large.

This study built on previous research by undertaking nonlinear modeling, which provides a more realistic representation of the interactions between event variables. The developed models were less useful for predicting patient presentation numbers for very large events; however, they were generally useful for more typical, smaller scale community events. Further research is required to confirm this conclusion and develop models suitable for very large international events.Arbon P, Bottema M, Zeitz K, Lund A, Turris S, Anikeeva O, Steenkamp M. Nonlinear modelling for predicting patient presentation rates for mass gatherings. Prehosp Disaster Med. 2018;33(4):362-367.