Impact of trauma system structure on injury outcomes: a systematic review protocol.

BACKGROUND: Injury represents one of the greatest public health challenges of our time with over 5 million deaths and 100 million people temporarily or permanently disabled every year worldwide. The effectiveness of trauma systems in decreasing injury mortality and morbidity has been well demonstrated. However, the organisation of trauma care varies significantly across trauma systems and we know little about which components of trauma systems contribute to their effectiveness. The objective of the study described in this protocol is to systematically review evidence of the impact of trauma system components on clinically significant outcomes including mortality, function and disability, quality of life, and resource utilization. METHODS: We will perform a systematic review of studies evaluating the association between at least one trauma system component (e.g. accreditation by a central agency, interfacility transfer agreements) and at least one injury outcome (e.g. mortality, disability, resource use). We will search MEDLINE, EMBASE, COCHRANE central, and BIOSIS/Web of Knowledge databases, thesis holdings, key injury organisation websites and conference proceedings for eligible studies. Pairs of independent reviewers will evaluate studies for eligibility and extract data from included articles. Methodological quality will be evaluated using elements of the ROBINS-I tool and the Cochrane risk of bias tool for non-randomized and randomized studies, respectively. Strength of evidence will be evaluated using the GRADE tool. DISCUSSION: We expect to advance knowledge on the components of trauma systems that contribute to their effectiveness. This may lead to recommendations on trauma system structure that will help policy-makers make informed decisions as to where resources should be focused. The review may also lead to specific recommendations for future research efforts. SYSTEMATIC REVIEW REGISTRATION: This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 28-06-2016. PROSPERO 2016:CRD42016041336 Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016041336 .

Análisis de la calidad y seguridad de la información de aplicaciones móviles en prevención terciaria / Quality and security analysis of mobile applications in tertiary prevention

Objetivo: Analizar la calidad y seguridad de la información de las aplicaciones móviles en la App Store de Apple® destinadas a prevención terciaria. Material y métodos: Estudio observacional transversal de las aplicaciones móviles más populares en la categoría de medicina disponibles en Apple Store® a día de 21 de diciembre de 2014. Las aplicaciones fueron evaluadas con los criterios establecidos en el programa AppSaludable. Se seleccionaron aquellos criterios relacionados con la evaluación de la calidad y seguridad de la información. Resultados: De las 160 aplicaciones recogidas, sólo 12 aplicaciones estaban incluidas en la prevención terciaria. Todas las aplicaciones recuperadas estaban relacionadas con la adherencia, diabetes, hipertensión y alergia. Las aplicaciones desarrolladas por equipos multidisciplinares fueron las que presentaron mayor rigor en su información, Conclusiones: La presencia de un profesional sanitario como colaborador de la aplicación parece mejorar la calidad de la información (AU)

Objective: Analyze quality and information security of mobile applications in the Apple App Store® used for tertiary prevention. Methods: Cross-sectional study of the most popular mobile applications in the category of medicine available in Apple Store® to date of 21 December 2014. Criteria established in the AppSaludable program and related to quality and information security criteria were used for applications’ assessment. Results: Of the 160 applications found, only 12 applications were included in tertiary prevention. They were related to adherence, diabetes, hypertension and allergy. Applications developed by multidisciplinary teams showed more rigorous information. Conclusion: The presence of a health professional as a team member would improve information quality (AU)

[Modern aspects of the prevention of diseases of the digestive system in children ].

The article reviews the modern aspects of the prevention of diseases of the digestive system in children. It analyzes the levels of prevention activities, starting with the first days of a child's life. Great value is given to healthy ways of parents' lives, in the future - of the children: monitoring the course of pregnancy, genetic counseling and prenatal diagnostics of the pathology of the fetus. Heredity plays an important role in the cause-significant factors of diseases of the digestive system, violations of the calendar of vaccination, etc. One of the bases of prevention is a staged treatment of diseases of the digestive system, the identification of risk factors that can cause an aggravation or a continuously-recurrent course. The selection of rehabilitation programmes and hospital replacement technologies to improve and maintain the quality of life of sick children were substantiated.

Therapeutic education in cardiovascular diseases: state of the art and perspectives.

OBJECTIVE: To assess the impact of therapeutic education programmes for Coronary Artery Disease (CAD) and Chronic Heart Failure (CHF), as well as patients' expectations and education needs, tips to improve adherence to lifestyle modifications, and education materials. METHOD: We conducted a systematic review of the literature from 1966 to 2010 on Medline and the Cochrane Library databases using following key words: "counselling", "self-care", "self-management", "patient education" and "chronic heart failure", "CAD", "coronary heart disease", "myocardial infarction", "acute coronary syndrome". Clinical trials and randomized clinical trials, as well as literature reviews and practical guidelines, published in English and French were analysed. RESULTS: Therapeutic patient education (TPE) is part of the non-pharmacological management of cardiovascular diseases, allowing patients to move from an acute event to the effective self-management of a chronic disease. Large studies clearly showed the efficacy of TPE programmes in changing cardiac patients' lifestyle. Favourable effects have been proved concerning morbidity and cost-effectiveness even though there is less evidence for mortality reduction. Numerous types of intervention have been studied, but there are no recommendations about standardized rules and methods to deliver information and education, or to evaluate the results of TPE. The main limit of TPE is the lack of results for adherence to long-term lifestyle modifications. CONCLUSION: The efficacy of TE in cardiovascular diseases could be improved by optimal collaboration between acute cardiac units and cardiac rehabilitation units. The use of standardized rules and methods to deliver information and education and to assess their effects could reinforce this collaboration. Networks for medical and paramedical TPE follow-up in tertiary prevention could be organized to improve long-term results.

South Asian earthquake: psychiatric experience in a tertiary hospital.

In October 2005, northern Pakistan was devastated by an earthquake killing 73,000 people. Some of the seriously injured were airlifted to a tertiary hospital in Rawalpindi, near Islamabad. This field report describes the psychiatric services delivered at that hospital. It explains how the needs were assessed and psychosocial interventions designed at different levels. The training needs of the medical staff were also identified and efforts were made to enhance their skills for psychosocial care. Finally, the report formulates some recommendations for improving such services.