Positive Effects of a Short-Term Dog-Assisted Intervention for Soldiers With Post-traumatic Stress Disorder-A Pilot Study.

Post-traumatic stress disorder (PTSD) is diagnosed in 3% of German and 14-16% of US military following deployment abroad. The treatment of PTSD in soldiers is often challenging and thus new, additional interventions supporting traditional trauma therapy are employed, like animal-assisted interventions (AAI). In this pilot study, 29 soldiers with PTSD received four sessions of 3 h once a week of dog-assisted intervention in addition to inpatient standard treatment at the military hospital, while the control group of 31 soldiers with PTSD received standard treatment only. The dog-assisted intervention sessions included a walk, different play and grooming activities and just relaxing together toward the end. What was new in our approach was that the AAI sessions were delivered by military personnel, military dog-handlers with their own dogs (either military or privately owned). Data on psychiatric symptoms, perceived stress, work and social life, and the therapeutic relationship were answered before the first AAI session, during the days following the last AAI session, 1 month later, and 3 months later. Only the intervention group also answered a questionnaire on trauma confrontation, consumption of alcohol/drugs, mental wellness, and perceived stress each week during intervention. Analyses showed a trend for worse values in work and social adjustment in the control group and a significant trend toward better values in the intervention group. On the other parameters differences between control and intervention group were not significant. The mental wellness of the intervention group improved over the 4 weeks of therapy, particularly regarding the ability to experience joy. There was no clear trend for perceived stress, but the relationship to the dog handler improved significantly over the course of the intervention. This is noteworthy in patients with PTSD who usually have difficulties trusting others, especially new people. Keeping in mind that the AAI took place only four times, our findings point toward the value of dog-assisted interventions. With a longer treatment period the positive effects and trends might become more distinct.

Analysis of Digital Documentation Speed and Sequence Using Digital Paper and Pen Technology During the Refugee Crisis in Europe: Content Analysis.

BACKGROUND: The Syria crisis has forced more than 4 million people to leave their homeland. As a result, in 2016, an overwhelming number of refugees reached Germany. In response to this, it was of utmost importance to set up refugee camps and to provide humanitarian aid, but a health surveillance system was also implemented in order to obtain rapid information about emerging diseases. OBJECTIVE: The present study describes the effects of using digital paper and pen (DPP) technology on the speed, sequence, and behavior of epidemiological documentation in a refugee camp. METHODS: DPP technology was used to examine documentation speed, sequence, and behavior. The data log of the digital pens used to fill in the documentation was analyzed, and each pen stroke in a field was recorded using a timestamp. Documentation time was the difference between first and last stroke on the paper, which includes clinical examination and translation. RESULTS: For three months, 495 data sets were recorded. After corrections had been made, 421 data sets were considered valid and subjected to further analysis. The median documentation time was 41:41 min (interquartile range 29:54 min; mean 45:02 min; SD 22:28 min). The documentation of vital signs ended up having the strongest effect on the overall time of documentation. Furthermore, filling in the free-text field clinical findings or therapy or measures required the most time (mean 16:49 min; SD 20:32 min). Analysis of the documentation sequence revealed that the final step of coding the diagnosis was a time-consuming step that took place once the form had been completed. CONCLUSIONS: We concluded that medical documentation using DPP technology leads to both an increase in documentation speed and data quality through the compliance of the data recorders who regard the tool to be convenient in everyday routine. Further analysis of more data sets will allow optimization of the documentation form used. Thus, DPP technology is an effective tool for the medical documentation process in refugee camps.

Emergency thoracic surgery for penetrating, non-mediastinal trauma.

BACKGROUND: Penetrating thoracic injury is commonly found in South Africa. A review of our recent experience was undertaken to assess the effectiveness of our protocols for this type of injury. METHODS: A retrospective study of 61 consecutive patients with penetrating, non-mediastinal trauma to the chest was conducted over 32 months at a single trauma unit. Patient details, mechanism of injury, operative procedure and in-hospital mortality and morbidity rates were recorded. RESULTS: Two thousand and nineteen patients presented with penetrating chest injury of which 61 patients (3%) underwent thoracic surgery for non-mediastinal injury. Twenty-six patients had stab wounds and 35 had gunshot wounds. Overall mortality was 17/61 (28%). Gunshot wounds were more likely to result in death than stab wounds (relative risk = 11.9; 95% confidence interval 1.7-84.0) and thoracoabdominal injury resulted in death more commonly than chest injury (relative risk = 4.8; 95% confidence interval 2.2-10.3) resulted in death. CONCLUSION: Penetrating chest injury is common and most patients can be managed without formal thoracic surgical intervention. However, the patients who do merit surgical intervention have a relatively high mortality and a rapid and practised operative approach is required to achieve acceptable results.