Lidia Mayner

Disaster-Driven Evacuation and Medication Loss: a Systematic Literature Review

AIM: The aim of this systematic literature review was to identify the extent and implications of medication loss and the burden of prescription refill on medical relief teams following extreme weather events and other natural hazards. METHOD: The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key health journal databases (Medline, Embase, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium (HMIC)) were searched via the OvidSP search engine. Search terms were identified by consulting MeSH terms. The inclusion criteria comprised articles published from January 2003 to August 2013, written in English and containing an abstract. The exclusion criteria included abstracts for conferences or dissertations, book chapters and articles written in a language other than English. A total of 70 articles which fulfilled the inclusion criteria were included in this systematic review. RESULTS: All relevant information was collated regarding medication loss, prescription loss and refills, and medical aids loss which indicated a significant burden on the medical relief teams. Data also showed the difficulty in filling prescriptions due to lack of information from the evacuees. People with chronic conditions are most at risk when their medication is not available. This systematic review also showed that medical aids such as eye glasses, hearing aids as well as dental treatment are a high necessity among evacuees. DISCUSSION: This systematic review revealed that a considerable number of patients lose their medication during evacuation, many lose essential medical aids such as insulin pens and many do not bring prescriptions with them when evacuated.. Since medication loss is partly a responsibility of evacuees, understanding the impact of medication loss may lead to raising awareness and better preparations among the patients and health care professionals. People who are not prepared could have worse outcomes and many risk dying when their medication is not available.

Images of flight nursing in Australia: A study using institutional ethnography

Pictures speak a thousand words. The traditional romantic image of an Australian aeromedical service is a male doctor and male pilot, out to rescue the male stockman from the red dust of the Australian outback. However, the reality is considerably different, particularly in the current context of the Australian healthcare system. This paper examines the images of flight nursing using a critical lens. The images are derived from popular literature sources from the early 1940s through to the present. A textual analysis of the images of flight nursing using the methodology of institutional ethnography reveals a number of themes including the glamorous, the romantic, and the heroic nurse. This study illustrates that the way these nurses are portrayed within popular literature mirrors the Australian cultural ethic of heroic bush pioneer, yet at the same time the work these nurses do is undervalued by various omissions and misrepresentations. The results from this study have the potential to significantly improve recognition of the work performed by flight nurses and to challenge incorrect cultural myths.

Heat Waves, Drugs with Anticholinergic Effects, and Outcomes in Older Hospitalized Adults.

To determine whether heat waves (HWs) affect exposure to drugs with anticholinergic effects (DACEs) on admission and the effect of such on length of stay (LOS) and in‐hospital mortality in older adults.

Medical relief for the 2011 Japan earthquake: A nursing account

In 2011 the east coast of Japan experienced a massive earthquake which triggered a devastating tsunami destroying many towns and killing over 15 000 people. The work presented in this paper is a personal account that outlines the relief efforts of the Humanitarian Medical Assistance team and describes the efforts to provide medical assistance to evacuees. The towns most affected had a large proportion of older people who were more likely to have chronic conditions and required medication to sustain their health. Since personal property was destroyed in the tsunami many older people were left without medication and also did not remember which type of medication they were taking. Some evacuees had brought a list of their medication with them, this assisted relief teams in obtaining the required medication for these people. The more successful evacuation centers had small numbers of evacuees who were given tasks to administer the center that kept them occupied and active.In 2011 the east coast of Japan experienced a massive earthquake which triggered a devastating tsunami destroying many towns and killing over 15 000 people. The work presented in this paper is a personal account that outlines the relief efforts of the Humanitarian Medical Assistance team and describes the efforts to provide medical assistance to evacuees. The towns most affected had a large proportion of older people who were more likely to have chronic conditions and required medication to sustain their health. Since personal property was destroyed in the tsunami many older people were left without medication and also did not remember which type of medication they were taking. Some evacuees had brought a list of their medication with them, this assisted relief teams in obtaining the required medication for these people. The more successful evacuation centers had small numbers of evacuees who were given tasks to administer the center that kept them occupied and active.

An autoradiographic study of eighth nerve projections in the galah,Eolophus roseicapilla

Autoradiographic methods have been used very successfully to investigate retinal projections in a variety of species and more recently to investigate primary auditory projections in monkeys 1 and primary and secondary auditory projections in cats6,7,11. We have used the autoradiographic method for studying the projections of the eighth nerve in an Australian parrot, the galah. The projection of the eighth nerve has been described in the pigeon using fiber degeneration methods (see refs. 2, 8 and 9 for a summary of anatomical research on the pigeon auditory system). As the autoradiographic method has a greater resolution for showing fine connections in the nervous system, we have used this method to discover any connections of the avian auditory system which are not revealed by the fiber degeneration methods. An abstract of our results has appeared previouslyS. We injected tritiated proline unilaterally into the cochlea in 7 galahs, mass 280-300 g. Each bird was anesthetized with ketalar (30 mg, i.m.), the eardrum was punctured and the cochlear duct was visualized under a binocular microscope. The needle of a /~1 syringe was inserted into the cochlear duct and 50-150 /~Ci of [3H]proline was delivered in a vol. of 2-20 #1 saline. The isotope was delivered over a period of 5-10 min and the syringe was left in the cochlear duct for a few minutes more. After injection, 4 galahs survived 24 h, 1 survived 2 days and the other 2 had survival times of 10 and 28 days. The birds were then perfused through the heart with 0.9 ~ saline followed by 1 0 ~ formalin. Frozen sections of the brain were cut in the frontal plane at 25 #m and processed for autoradiography 4. In all the galahs the tritiated proline diffused throughout the membranous labyrinth so that there was uptake of isotope by neurons in both the spiral and vestibular gangliaS, 11. Thus the cochlear and vestibular nuclei were labeled in all birds. In addition, some secondary centers were labeled in 3 birds which had heavy labeling of

An autoradiographic study of visual pathways of the Australian rodents Notomys alexis, Pseudomys australis and Rattus villosissimus.

In three species of Australian rodents, Notomys alexis, Pseudomys australis and Rattus villosissimus, primary optic centres were mapped by observing the distribution of autoradiographic label in the brain following injection of one eye with 3*H-proline or 3*H-leucine. Five regions receive a primary optic input in the three species: the lateral geniculate complex, the pretectum, the superior colliculus, the hypothalamus and the three terminal nuclei of the accessory optic system. The retinal projections are generally similar in the three species, except that in N. alexis and P. australis the dorsal lateral geniculate nucleus (LGNd) is subdivided into two, and the pattern of ipsilateral retinal input to it is similar; but in R. villosissimus the LGNd is not apparently subdivided, and the pattern is slightly different. It is concluded that the pattern of primary optic inputs is likely to be similar in other Australian rodents. Two secondary optic centres were shown in Notomys alexis, using the method of transneuronal transport of 3*H-proline. Autoradiographic label was observed in the visual cortex and in the parabigeminal nucleus 20-25 days after eye injection.

Medication supply for people evacuated during disasters

Medication loss is a major problem in disaster settings, and it is crucial for patients to bring their medication and healthcare items with them when they leave their homes during an evacuation. This article is based on a systematic literature review on medication loss, the objectives of which were to identify the extent and implications of medication loss, to identify the burden of prescription refill, and to make recommendations on effective preparedness. The review revealed that medication loss, prescription loss and refills, and the loss of medical aids are a significant burden on the medical relief teams. The medical aids are not limited to drugs, but include routine medications, medical/allergy records, devices for specific care and daily life, and emergency medications. One possible solution is to make a personal emergency pack and for people to carry this with them at all times. To ensure that patients are adequately prepared, stakeholders, especially health professionals, need to be actively involved in the preparation plans. Since our findings have little impact on disaster risk reduction unless shared broadly, we are now taking actions to spread our findings, such as presenting in conferences and via posters, in order to raise awareness among patients and healthcare professionals. As part of these activities, our findings were presented at the Evidence Aid Symposium on 20 September 2014, at Hyderabad, India.

E-learning for Critical Thinking: Using Nominal Focus Group Method to Inform Software Content and Design.

Background: Undergraduate nursing students are often confused by multiple understandings of critical thinking. In response to this situation, the Critiique for critical thinking (CCT) project was implemented to provide consistent structured guidance about critical thinking. Objectives: This paper introduces Critiique software, describes initial validation of the content of this critical thinking tool and explores wider applications of the Critiique software. Materials and Methods: Critiique is flexible, authorable software that guides students step-by-step through critical appraisal of research papers. The spelling of Critiique was deliberate, so as to acquire a unique web domain name and associated logo. The CCT project involved implementation of a modified nominal focus group process with academic staff working together to establish common understandings of critical thinking. Previous work established a consensus about critical thinking in nursing and provided a starting point for the focus groups. The study was conducted at an Australian university campus with the focus group guided by open ended questions. Results: Focus group data established categories of content that academic staff identified as important for teaching critical thinking. This emerging focus group data was then used to inform modification of Critiique software so that students had access to consistent and structured guidance in relation to critical thinking and critical appraisal. Conclusions: The project succeeded in using focus group data from academics to inform software development while at the same time retaining the benefits of broader philosophical dimensions of critical thinking.

Brain Organization and Retinal Pathways in the Sleepy Lizard, Tiliqua Rugosa

Abstract Brain structure and retinal pathways to the brain of the sleepy lizard Tiliqua rugosa were described, with this species identifiable as a type II lizard according to brain organization. The retinal pathway appeared entirely crossed to the opposite side of the brain with termination of retinal fibres observed in the optic thalamus, pretectum, tectum and brainstem tegmentum.

Transneuronal transport in the visual system of the toad, Bufo marinus

Secondary optic projections were studied in the toad, Bufo marinus using the method of transneuronal transport of triated proline and fucose. Following a survival of 14 days after eye injection autoradiographic label was transported transneuronally to the contralateral nucleus isthmi, the deeper layers of the contralateral tectum, the pontine region, the ipsilateral tectum and to the contralateral thalamus. Toads which survived 21 days or longer exhibited transneuronal transport of isotope to the contralateral telencephalon. The labelled patch in the telencephalon was located in the striatum, in the region of the lateral forebrain bundle.