Since 2005, the Myanmar National Tuberculosis Programme (NTP) has been implementing active case finding (ACF) activities involving mobile teams in hard-to-reach areas. This study revealed the ...contribution of mobile team activities to total tuberculosis (TB) case detection, characteristics of TB patients detected by mobile teams and their treatment outcomes.
This was a descriptive study using routine programme data between October 2014 and December 2014. Mobile team activities were a one-stop service and included portable digital chest radiography (CXR) and microscopy of two sputum samples. The algorithm of the case detection included screening patients by symptoms, then by CXR followed by sputum microscopy for confirmation. Diagnosed patients were started on treatment and followed until a final outcome was ascertained.
A total of 9 349 people with symptoms suggestive of TB were screened by CXR, with an uptake of 96.6%. Of those who were meant to undergo sputum smear microscopy, 51.4% had sputum examinations. Finally, 504 TB patients were identified by the mobile teams and the overall contribution to total TB case detection in the respective townships was 25.3%. Among total cases examined by microscopy, 6.4% were sputum smear positive TB. Treatment success rate was high as 91.8% in study townships compared to national rate 85% (2014 cohort).
This study confirmed the feasibility and acceptability of ACF by mobile teams in hard-to-reach contexts, especially when equipped with portable, digital CXR machines that provided immediate results. However, the follow-up process of sputum examination created a significant barrier to confirmation of the diagnosis. In order to optimize the ACF through mobile team activity, future ACF activities were needed to be strengthened one stop service including molecular diagnostics or provision of sputum cups to all presumptive TB cases prior to CXR and testing if CXR suggestive of TB.
The French mobile neurosurgical unit Dulou, Renaud; Dagain, Arnaud; Delmas, Jean-Marc ...
Neurosurgical focus,
05/2010, Volume:
28, Issue:
5
Journal Article
Peer reviewed
Open access
The authors present the French concept of a mobile neurosurgical unit (MNSU) as used to provide specific support to remote military medicosurgical units deployed in Africa, South America, Central ...Europe, and Afghanistan. From 2001 to 2009, 15 missions were performed, for 16 patients. All but 3 of these missions (those in Kosovo, French Guyana, and Afghanistan) concerned Africa. Eleven patients were French soldiers, 3 were civilians, and 2 were Djiboutian soldiers. The conditions that MNSUs were requested for included craniocerebral wounds (2 cases), closed head trauma (7 cases), spinal trauma (5 cases), and spontaneous intracranial hemorrhage (2 cases). In 5 of the 16 cases, neurosurgical treatment was provided on site. All French soldiers and 2 civilians were evacuated to France. The MNSU can be deployed for timely treatment when some delay in neurosurgical management is acceptable.
Aim
The study aims to evaluate the effects of assertive community treatment (ACT) on the mental health and overall functioning of adolescents suffering from severe psychiatric disorders and who ...refuse any traditional child psychiatric care. There are a few studies evaluating the effects of ACT on a population of adolescents with psychiatric disorders. This short report highlights the impact of an ACT programme tailored to the needs of these patients, not only as an alternative to hospitalization, but also as a new form of intervention for patients that are difficult to engage.
Methods
The effect of ACT on 35 adolescents using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) as a measuring tool in pre‐ and post‐intervention was evaluated.
Results
The results show that the intervention was associated with a significant improvement on the HoNOSCA overall score, with the following items showing significant amelioration: hyperactivity/focus problems, non‐organic somatic symptoms, emotional symptoms, scholastic/language skills, peer relationships, family relationships and school attendance.
Conclusion
ACT appears as a feasible intervention for hard‐to‐engage adolescents suffering from psychiatric disorders. The intervention seems to improve their mental health and functioning. This pilot study may serve as a basis to prepare a controlled study that will also take the costs of the intervention into account.
Projet inaugural de partenariat entre la pédopsychiatrie et l’ ase , l’équipe mobile est un dispositif pilote du pôle Paris centre-est conçu pour répondre au défaut d’accès aux soins des mineurs ...confiés à l’ ase de Paris. Son objectif est de proposer des consultations d’évaluation pédopsychiatrique en vue d’une orientation sur les réseaux de soins existants. La complexité des situations de ces jeunes, intriquant des problématiques sociales, éducatives et psychiatriques, impose une articulation étroite entre des partenaires issus de cultures différentes. Ce partenariat, en construction et très prometteur, est indispensable s’il veut répondre aux besoins d’une population aux vulnérabilités multiples et dont la prise en charge impose le développement de moyens spécifiques et croissants.
By its very nature, the Psymobile team is often called on to visit young adults who remain confined at home but who have no diagnosed psychiatric conditions. The team has consequently become ...interested in the Japanese concept of hikikomori, a notion which appeared in the 1990s and which has since spread across the world. This concept still arouses some amount of discussion regarding its aetiology, its precise definition and its relevance outside Japan.
Abstract
Adult respiratory distress syndrome (ARDS) secondary to H1N1 viral infection has been a worldwide medical and organizational challenge. We report our experience with extracorporeal membrane ...oxygenator (ECMO) rescue and transportation of patients with H1N1 ARDS within an insular and rural Mediterranean area of seven million inhabitants. A 24/7 on-call ECMO team was organized including one anesthesiologist, one cardiac surgeon, and one perfusionist. To limit missions' time to and from peripheral hospitals, airborne transportation with helicopter was the first choice. From November 2009 to January 2010, we performed 10 missions. Eight patients (80%) were placed on ECMO and transferred either on helicopter (70%) or with standard ambulance (10%). Average mission duration was nine hours (6-16 h). No complications secondary to the transportation means or to the ECMO were reported. Delivery of advanced medical technology can be achieved even in remote and underserved areas presenting geographical barriers. A multidisciplinary mobile ECMO team coordinated with adequate means of transportation could be routinely employed to rescue patients affected with other forms of severe acute hemodynamic and/or respiratory impairment.
Since it was first diagnosed in 1914 in Marrakesh, schistosomiasis has been a public health problem in Morocco for decades. A national control program launched in 1982 has led to a considerable ...reduction in the incidence and morbidity associated with the disease. Consequently, the program has shifted from disease control to an elimination process launched in 1994. This process aimed to eliminate disease transmission by the end of 2004 and has helped to clear all known foci. Mobile teams were a key element that contributed to the success of this program. They played three important roles: monitoring and control, response, and the transmission of messages.
The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laboratory of Tours University Hospital, France. In contrast to the usual prerogatives of biomedical ...laboratories, the Mobile Team of Parasitology-Mycology is requested to intervene directly at bedside in various clinical departments, or even outside the hospital facility. Although its actions are of course primarily devoted to specialized diagnostic and therapeutic purposes, the Mobile Team also plays an important educational role in the medical training of undergraduate or graduate students.
L’Équipe mobile de parasitologie-mycologie est une entité déplaçable du laboratoire de parasitologie-mycologie du CHRU de Tours. Elle est sollicitée pour intervenir dans les services cliniques, directement au lit du malade, ou même à l’extérieur de l’hôpital, ce qui lui confère des propriétés médicales tout à fait inhabituelles pour un laboratoire de biologie médicale. Si ses actions sont prioritairement dédiées au diagnostic et à la thérapeutique spécialisés, l’Équipe mobile de parasitologie-mycologie joue aussi un rôle pédagogique important dans la formation médicale des étudiants de premier cycle ou de niveau supérieur.
With companies trying to optimize their operational cost, outsourcing the support function such as facilities management delivery became common. This approach resorted to the development of different ...methods in service delivery. This paper aims to resolve the issue of not meeting the service level agreement for one of the sites of the projects. The case study was done using the available data from the operations. Fishbone diagram was used to identify the root-cause of the problem that suggested adapting a decentralized approached to improve the travel time. This study shows how the proper selection of the location and identifying a strategic position benefits a supply chain.
PDF
