Improve disaster response by planning for and logistically supporting acute exacerbations of chronic diseases.

Provide a more effective medical response by emphasizing the management of acute exacerbations of chronic diseases in disasters. Disaster victims need treatment for their acute exacerbations of and ongoing chronic medical conditions, medication refills, mental health resources, and have an expectation that medical facilities will provide resources beyond medical care. Medical response is more efficient, cost effective, and effectual when these considerations are supported.

The Impacts of Unrecognized Language and Cultural Barriers During an Educational and Training Activity.

Language and cultural barriers are associated with poor health outcomes. Communication is arguably the most important variable associated with a successful educational and training Global Health Engagement (GHE) and often unrecognized even when attempts are made to address this barrier. Madagascar's GHE activity improved after the addition of local Malagasy translation to fully translated official French instruction.

Assessment of the Angolan (CHERRT) Mobile Laboratory Curriculum for Disaster and Pandemic Response.

INTRODUCTION: As of April 5, 2020, the World Health Organization reported over one million confirmed cases and more than 62,000 confirmed coronavirus (COVID-19) deaths affecting 204 countries/regions. The lack of COVID-19 testing capacity threatens the ability of both the United States (US) and low middle income countries (LMIC) to respond to this growing threat, The purpose of this study was to assess the effectiveness through participant self-assessment of a rapid response team (RRT) mobile laboratory curriculum METHODS: We conducted a pre and post survey for the purpose of a process improvement assessment in Angola, involving 32 individuals. The survey was performed before and after a 14-day training workshop held in Luanda, Angola, in December 2019. A paired t-test was used to identify any significant change on six 7-point Likert scale questions with α< 0.05 (95% confidence interval). RESULTS: All six of the questions - 1) "I feel confident managing a real laboratory sample test for Ebola or other highly contagious sample;" 2) "I feel safe working in the lab environment during a real scenario;" 3) "I feel as if I can appropriately manage a potentially highly contagious laboratory sample;" 4)"I feel that I can interpret a positive or negative sample during a suspected contagious outbreak;" 5) "I understand basic Biobubble/mobile laboratory concepts and procedures;" and 6) "I understand polymerase chain reaction (PCR) principles" - showed statistical significant change pre and post training. Additionally, the final two questions - "I can more effectively perform my role/position because of the training I received during this course;" and "This training was valuable" - received high scores on the Likert scale. CONCLUSION: This Angolan RRT mobile laboratory training curriculum provides the nation of Angola with the confidence to rapidly respond and test at the national level a highly infectious contagion in the region and perform on-scene diagnostics. This mobile RRT laboratory provides a mobile and rapid diagnostic resource when epidemic/pandemic resource allocation may need to be prioritized based on confirmed disease prevalence.

The Angolan Pandemic Rapid Response Team: An Assessment, Improvement, and Development Analysis of the First Self-sufficient African National Response Team Curriculum.

OBJECTIVE: The purpose of this study was to assess, through participant self-assessment, the effectiveness of a rapid response team curriculum based on the World Health Organization (WHO) Ebola Virus Disease Consolidated Preparedness Checklist, Revision 1. METHODS: A pre-and-post survey for the purpose of process improvement assessment involving 44 individuals was conducted in Angola. The survey was conducted before and after a 6-day training workshop held in Luanda, Angola, in December 2017. A paired t-test was used to identify any significant change on six 7-point Likert scale questions with α <.05 (95% CI). RESULTS: Two of the 6 questions, "I feel confident the team can effectively work together to accomplish its assigned goals and objectives during a suspected contagious hemorrhagic fever disease outbreak" and "I understand basic pandemic response concepts" changed significantly from the presurvey to the postsurvey. The 4 remaining questions had near statistical significant change or an upward trend. CONCLUSION: This Angolan rapid response team training curriculum based on WHO guidelines, After Action Reports, and internationally accepted standard operating procedures provides the nation of Angola with the confidence to rapidly respond at the national level to a highly infectious contagion in the region. (Disaster Med Public Health Preparedness. 2019;13:577-581).

Bilateral sciatic nerve palsy: a new presentation of toilet bowl neuropathy.

BACKGROUND: Presentations of lower extremity compression palsies are rare and exist only in case reports. The true incidence of emergency department (ED) presentations of bilateral sciatic nerve palsy, "toilet bowl neuropathy," is unknown. The following is a case of a 28-year-old active duty Navy woman who presented to our ED via ambulance with bilateral sciatic nerve palsy from prolonged immobility. OBJECTIVES: This discussion reviews the historical precedence for the diagnosis and details the work-up and prognosis. CASE REPORT: The patient presented complaining of bilateral lower extremity swelling, numbness, and an inability to walk after a prolonged, medication-facilitated sleep in an unusual position. She had significant weakness on examination and was admitted for further evaluation and care. Specialized neurologic studies were consistent with bilateral sciatic nerve palsy. CONCLUSION: Bilateral sciatic nerve palsy is an uncommon cause of lower extremity weakness. In the ED, other diagnoses such as Guillain-Barré syndrome, cauda equina, disk herniation, and gluteal compartment syndrome should be considered initially. The diagnosis of toilet bowl neuropathy, however, is dependent on obtaining an accurate history. This case report adds another perspective to the literature on sciatic nerve palsy recognition, diagnosis, and prognosis.

Chinese herbal medicine for Mild Cognitive Impairment and Age Associated Memory Impairment: a review of randomised controlled trials.

This review assesses the effectiveness and safety of Chinese herbal medicines (CHM) for Mild Cognitive Impairment (MCI) and Age Associated Memory Impairment (AAMI). Electronic searches of English and Chinese databases and hand searches of Chinese journal holdings were conducted. Randomised controlled trials comparing orally administered CHM with placebo, no intervention or other therapy were considered. Ginkgo biloba was excluded. Ten trials met inclusion criteria. Eight different CHM were investigated. Methodological quality was assessed using the Jadad scale and five studies scored three or above. Two studies compared CHM with placebo and eight with another intervention. This review found an overall benefit on some outcome measures for the eight CHMs involved in the 10 RCTs but methodological and data reporting issues were evident. Meta-analysis of three studies found the effects of the CHMs were at least equivalent to piracetam on Mini-Mental State Examination (MMSE) scores. No severe adverse events were reported.

Herbal medicine for dementia: a systematic review.

This systematic review aimed to assess the effectiveness and safety of herbal medicines (HM) for treating dementia. Databases in English and Chinese were searched from their inceptions to February 2007. References in reviews and randomized controlled trials (RCTs) were screened by hand. Trials comparing orally administered HM with placebo, no intervention or other therapy were considered. Trials on Ginkgo biloba and its extracts were excluded to avoid duplication of existing reviews. Pairs of authors independently applied eligibility criteria, extracted data and assessed methodological quality using the Jadad Scale. Thirteen RCTs met the inclusion criteria of three or above on this scale. Six trials compared herbal medicine with placebo, one with no treatment, and the remainder with pharmaceutical intervention. Meta-analyses were performed on common cognitive performance outcome measures. All studies reported HM had significant effects in improving symptoms. In studies that employed active controls, HM was at least as effective as the pharmaceutical intervention. Meta-analyses found HM more effective than no treatment or placebo and at least equivalent to control interventions, although the overall effect was small. No severe adverse events were reported. These trials provide overall positive evidence for the effectiveness and safety of certain HMs for dementia management.