Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.

We evaluated syndromic indicators of influenza disease activity developed using emergency department (ED) data - total ED visits attributed to influenza-like illness (ILI) ('ED ILI volume') and percentage of visits attributed to ILI ('ED ILI percent') - and Google flu trends (GFT) data (ILI cases/100 000 physician visits). Congruity and correlation among these indicators and between these indicators and weekly count of laboratory-confirmed influenza in Manitoba was assessed graphically using linear regression models. Both ED and GFT data performed well as syndromic indicators of influenza activity, and were highly correlated with each other in real time. The strongest correlations between virological data and ED ILI volume and ED ILI percent, respectively, were 0·77 and 0·71. The strongest correlation of GFT was 0·74. Seasonal influenza activity may be effectively monitored using ED and GFT data.

The impact of abdominal computed tomography in a tertiary referral centre emergency department on the management of patients with inflammatory bowel disease.

BACKGROUND: Although exposure to diagnostic radiation may be associated with increased risk of malignancy, the use of abdominal CT (ACT) in the last decade has increased for patients in the emergency department (ED). AIM: To examine the impact of ACT ordered in the ED on management of patients with inflammatory bowel diseases (IBD), as well as to quantify the cumulative effective dose (CED) of radiation received by these patients. METHODS: A total of 152 patients with Crohn's disease (CD) and 130 patients with ulcerative colitis (UC) that presented to the ED in a tertiary centre between 2009 and 2011 were identified. For patients that had an ACT, chart review assessed if the ACT findings changed clinical management. CED of diagnostic radiation (DR) was calculated for all imaging studies between 1 January 2006 and 30 August 2012. RESULTS: Abdominal CT use was 49% for CD and 19% for UC. ACTs with findings of penetrating/obstructive disease were 35% for CD. Urgent non-IBD-related diagnoses were found in 13% for CD and 28% for UC (P < 0.05). ACT caused a change in management in 81% of CD and 69% of UC patients. Mean CED from DR was 77.4 ± 63.0 mSv (median 53 mSv) for CD and 67.2 ± 51.0 mSv (median 56 mSv) for UC (P = 0.47). The CED for the 80-month period exceeded 75 mSv in 35% and 36% respectively (P = 0.99). CONCLUSIONS: Although abdominal CT often changes management of IBD patients in the emergency department, this population carries a very high-risk of radiation exposure. Efforts should be made to decrease this risk by development of low-radiation protocols, and wider use of MRI/ultrasound.

The construction flagperson: a target for injury.

A road construction 'flagger' is a construction crew member whose responsibility it is to safely co-ordinate vehicle traffic through road worksites. Flaggers are suffering injuries and fatalities at the worksite as a result of being struck by moving vehicles, both construction and commuter. These incidents are largely preventable with a more defensive flagger training programme. A cross-Canada provincial survey of occupational health and safety organizations revealed no national co-ordination and standardization in flagperson training. Statistics concerning flagger injury and fatality are disjointed and incomplete, and as such are not useful for evaluating and validating training and job performance. We recommend a revisiting of flagperson training standards and that greater effort is taken in gathering data specifically on flagger injuries and fatalities.

The Dynamic Aviation Data System (DADS).

This paper proposes The Dynamic Aviation Data System (DADS), which integrates a variety of existing information sources regarding flight to serve as a tool to pilots in dealing with the challenges of flight. The system is composed of three main parts: a pilot's history on disk; a system that can read proposed flight plans and make suggestions based upon Geographical Information Systems, weather, aircraft, and case report databases that exist throughout North America; and a small hand-held computer that interfaces with the aircraft's instruments and that can be brought into the cockpit to aid the pilot before and during flight. The system is based upon technology that currently exists and information that is already regularly collected. While many issues regarding implementation and cost efficiency of the system need to be addressed, the system shows promise in its ability to make useful flight safety information available to all pilots in order to save lives.

Schizophrenia in the elderly: what nurses need to know.

People age 65 and older with schizophrenia comprise a small but growing number of the mentally ill that nurses, especially those who work in nursing homes, care for. Elderly schizophrenics are a heterogeneous group. They are subject to all of the chronic and acute illnesses common to elderly persons. In addition, their medical problems are frequently overlooked and are difficult to treat. As many as 50% of them have tardive dyskinesia, which has potentially fatal consequences, especially in the elderly.