The potential contributions of traditional Chinese medicine to emergency medicine

BACKGROUND: Despite the fact that traditional Chinese medicine (TCM) has been developed and used to treat acute and urgent illness for many thousands of years. TCM has been widely perceived in western societies that TCM may only be effective to treat chronic diseases. The aim of this article is to provide some scientific evidence regarding the application of TCM in emergency medicine and its future potential. METHODS: Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) were searched using the terms: Traditional Chinese Medicine/ Chinese Medicine, Emergency Medicine, China. In addition, three leading TCM Journals in China were searched via Oriprobe Information Services for relevant articles (published from 1990—2012). Particular attention was paid to those articles that are related to TCM treatments or combined medicine in dealing with intensive and critical care. RESULTS: TCM is a systematic traditional macro medicine. The clinical practice of TCM is guided by the TCM theoretical framework – a methodology founded thousands of years ago. As the methodologies between TCM and Biomedicine are significantly different, it provides an opportunity to combine two medicines, in order to achieve clinical efficacy. Nowadays, combined medicine has become a common clinical model particular in TCM hospitals in China. CONCLUSIONS: It is evident that TCM can provide some assistance in emergency although to combine them in practice is stillits infant form and is mainly at TCM hospitals in China. The future effort could be put into TCM research, both in laboratories and clinics, with high quality designs, so that TCM could be better understood and then applied in emergency medicine.

Use of thermal imaging in sports medicine research : a short report

The assessment of skin temperature (Tsk) in athletic therapy and sports medicine research is an extremely important physiological outcome measure.Various methodsof recording Tsk, including thermistors, thermocouples and thermocrons are currently being used for research purposes. These techniques are constrained by their wires limiting the freedom of the subject, slow response times, and/or sensors falling off. Furthermore, as these products typically are directly attached to the skin and cover the measurement site, their validity may be questionable.This manuscript addresses the use and potential benefits of using thermal imaging (TI) in sport medicine research.Non-contact infrared TI offers a quick, non-invasive, portable and athlete-friendly method of assessing Tsk. TI is a useful Tsk diagnostic tool that has potential to be an integral part of sport medicine research in the future. Furthermore, as the technique is non-contact it has several advantages over existing methods of recording skin temperature

Job changes, occupational mobility and human capital acquisition : an empirical analysis

Most individuals have more than one job or occupation in their working lives. Most employees are repeatedly faced with the choice of whether to remain in their present job (with the possibility of promotion), or quit to another job in the same occupation with a different firm, or - more radically change occupation. At each stage in an individual's career, the scope for future job or occupational mobility is largely conditioned by the type and quantity of their human capital. This paper presents an empirical study of the factors which link occupational mobility and the acquisition of either firm-based, occupation-specific or general human capital. The data employed are from a cohort of 1980 UK graduates drawn from the Department of Employment Survey 1987. The econometric work presents estimates of the role of firm-based training and occupation-specific training in the career mobility of qualified manpower in the first seven years in the labour market

Longitudinal Evidence on Educational and Occupational Outcomes Amongst South Sudanese Men from Refugee Backgrounds Living in Urban and Regional Southeast Queensland

Australia has continued to benefit from the human, social and economic capital contributed by immigrant resettlement over many years. Humanitarian entrants have also made significant economic, social and civic contributions to the Australian society. Since 2000, approximately 160,000 people have entered Australia under the refugee and humanitarian resettlement program; around 15% have come from South Sudan and one third of these are adult males. In response to the 2003 evaluation of the Integrated Humanitarian Settlement Strategy (IHSS), which recommended to seek further opportunities to settle humanitarian entrants in regional Australia, the Department of Immigration and Citizenship (DIAC) has since encouraged regional settlement to “address the demand for less skilled labour in regional economies and to assist humanitarian entrants to achieve early employment”. There is evidence, however, of the many challenges faced by humanitarian arrivals living in regional areas. This chapter focuses on the educational and occupational outcomes among 117 South Sudanese adult men from refugee backgrounds. In particular, the chapter uses both cross-sectional (at first interview) and longitudinal data (four interviews with each participant at six-month intervals) to compares outcomes between men living in Brisbane and those living in the Toowoomba–Gatton region in Southeast Queensland.

Cardiac safety concerns for domperidone, an antiemetic and prokinetic, and galactogogue medicine

Introduction: Domperidone is a dopamine D2-receptor antagonist developed as an antiemetic and prokinetic agents. Oral domperidone is not approved in the US, but is used in many countries to treat nausea and vomiting, gastroparesis, and as a galactogogue (to promote lactation). The US Food and Drug Administration (FDA) have issued a warning about the cardiac safety of domperidone. Areas covered: The authors undertook a review of the cardiac safety of oral domperidone. Expert opinion: The data from preclinical studies are unambiguous in identifying domperidone as able to produce marked hERG channel inhibition and action potential prolongation at clinically relevant concentrations. The compound’s propensity to augment instability of action potential duration and action potential triangulation are also indicative of proarrhythmic potential. Domperidone should not be administered to subjects with pre-existing QT prolongation/LQTS, subjects receiving drugs that inhibit CYP3A4, subjects with electrolyte abnormalities or with other risk factors for QT-prolongation. With these provisos, it is possible that domperidone may be used as a galactogogue without direct risk to healthy breast feeding women but more safety information should be sought in this situation. Also, more safety information is required regarding risk to breast feeding infants or before domperidone is routinely used in gastroparesis or gastroesphageal reflux in children.

Identification and occupational stress : a stress-buffering perspective

Occupational stress research has consistently demonstrated many negative effects of work stressors on employee adjustment (i.e., job-related attitudes and health). Considerable literature also describes potential moderators of this relationship. While research has revealed that different workplace identifications can have significant positive effects on employee adjustment, it has neglected to investigate their potential stress-buffering effects. Based on identity theories, it was predicted that stress-buffering effects of different types of identifications (distal versus proximal) would be revealed when the identification type and employee adjustment outcome type (distal versus proximal) were congruent. Predictions were tested with an employee sample from five human service nonprofit organizations (N = 337). Hierarchical multiple regression analyses revealed that main and moderated effects relating to identification supported the notion that occupational stress would be reduced when there was congruence of distal and proximal identifications and distal and proximal outcome types. However, stress-buffering effects were also found for high identifiers and low identifiers that were not in line with hypotheses posing questions for the definitions of distal and proximal identifications. Findings are discussed in terms of theoretical and practical implications.

Biological values of acupuncture and Chinese herbal medicine : impact on the life science

Editorial paper

Developing examplars for sustained integration of palliative care principles into allied health curricula

The PCC4U (Palliative Care Curriculum for Undergraduates) project aims to support the inclusion of the principles and practice of palliative care in all health professional training. While uptake rates of the project resources and curriculum initiatives is strong in medicine and nursing (86% of courses actively engaged with the project in 2012) integration of palliative care content in allied health disciplines has been less consistent. This report explores the process adopted to address this issue. In 2012 six allied health courses – representing social work, pharmacy, psychology, occupational therapy, dietetics and physiotherapy – commenced a range of tailored curriculum initiatives with the aim of informing the development of exemplars of integration of palliative care in specific disciplines. The PCC4U project provided palliative care learning materials, curriculum resources and expertise, and financial support as part of this curriculum development process. Review of the outcomes of each initiative indicates that tailored support has provided an opportunity for courses to develop palliative care curriculum content that reflects both discipline and local contexts. It has contributed six discipline specific exemplars of the integration of palliative care in allied health professional curricula and provided insights into allied health educational approaches in palliative care, particularly the use of evidence based resources. As a result project curriculum materials and activities have been expanded. These will be implemented with allied health courses through workshops, site visits and curriculum mapping initiatives in 2013 to better sustain the integration of palliative care in health professional curricula.

Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

Perceptions that influence occupational exposure reporting

Statistics on health care workers' occupational exposures to bloodborne pathogens underestimate the true extent of the problem because of a tendency for underreporting. A descriptive correlational design was used to investigate compliance with standard precautions and occupational exposure reporting practices among perioperative nurses in Australia. The study found that although intention to report both percutaneous and mucocutaneous exposures was relatively high, mean compliance rates for actually reporting exposures incurred were considerably lower. The perception of barriers to reporting significantly influenced compliance.

The impact of heatwaves on mortality and emergency hospital admissions from non-external causes in Brisbane, Australia

Objectives Heatwaves can have significant health consequences resulting in increased mortality and morbidity. However, their impact on people living in tropical/subtropical regions remains largely unknown. This study assessed the impact of heatwaves on mortality and emergency hospital admissions (EHAs) from non-external causes (NEC) in Brisbane, a subtropical city in Australia. Methods We acquired daily data on weather, air pollution and EHAs for patients aged 15 years and over in Brisbane between January 1996 and December 2005, and on mortality between January 1996 and November 2004. A locally derived definition of heatwave (daily maximum ≥37°C for 2 or more consecutive days) was adopted. Case–crossover analyses were used to assess the impact of heatwaves on cause-specific mortality and EHAs. Results During heatwaves, there was a statistically significant increase in NEC mortality (OR 1.46; 95% CI 1.21 to 1.77), cardiovascular mortality (OR 1.89; 95% CI 1.44 to 2.48), diabetes mortality in those aged 75+ (OR 9.96; 95% CI 1.02 to 96.85), NEC EHAs (OR 1.15; 95% CI 1.07 to 1.23) and EHAs from renal diseases (OR 1.41; 95% CI 1.09 to 1.83). The elderly were found to be particularly vulnerable to heatwaves (eg, for NEC EHAs, OR 1.24 for 65–74-year-olds and 1.39 for those aged 75+). Conclusions Significant increases in NEC mortality and EHAs were observed during heatwaves in Brisbane where people are well accustomed to hot summer weather. The most vulnerable were the elderly and people with cardiovascular, renal or diabetic disease.

A threshold analysis of dengue transmission in terms of weather variables and imported dengue cases in Australia

Dengue virus (DENV) transmission in Australia is driven by weather factors and imported dengue fever (DF) cases. However, uncertainty remains regarding the threshold effects of high-order interactions among weather factors and imported DF cases and the impact of these factors on autochthonous DF. A time-series regression tree model was used to assess the threshold effects of natural temporal variations of weekly weather factors and weekly imported DF cases in relation to incidence of weekly autochthonous DF from 1 January 2000 to 31 December 2009 in Townsville and Cairns, Australia. In Cairns, mean weekly autochthonous DF incidence increased 16.3-fold when the 3-week lagged moving average maximum temperature was <32 °C, the 4-week lagged moving average minimum temperature was ≥24 °C and the sum of imported DF cases in the previous 2 weeks was >0. When the 3-week lagged moving average maximum temperature was ≥32 °C and the other two conditions mentioned above remained the same, mean weekly autochthonous DF incidence only increased 4.6-fold. In Townsville, the mean weekly incidence of autochthonous DF increased 10-fold when 3-week lagged moving average rainfall was ≥27 mm, but it only increased 1.8-fold when rainfall was <27 mm during January to June. Thus, we found different responses of autochthonous DF incidence to weather factors and imported DF cases in Townsville and Cairns. Imported DF cases may also trigger and enhance local outbreaks under favorable climate conditions.