Monitoring influenza vaccination coverage and acceptance among health-care workers in German hospitals - results from three seasons.

Health-care workers are an important vaccination target group, they are more frequently exposed to infectious diseases and can contribute to nosocomial infections. We established a country-wide online monitoring system to estimate influenza vaccine uptake and its determinants among German hospital staff (OKaPII). The online questionnaire included items on vaccination behavior and reasons for and against influenza vaccination.

Fully Disposable Manufacturing Concepts for Clinical and Commercial Manufacturing and Ballroom Concepts.

The availability and use of pre-sterilized disposables has greatly changed the methods used in biopharmaceuticals development and production, particularly from mammalian cell culture. Nowadays, almost all process steps from cell expansion, fermentation, cell removal, and purification to formulation and storage of drug substances can be carried out in disposables, although there are still limitations with single-use technologies, particularly in the areas of pretesting and quality control of disposables, bag and connections standardization and qualification, extractables and leachables (E/L) validation, and dependency on individual vendors. The current status of single-use technologies is summarized for all process unit operations using a standard mAb process as an example.

Factors associated with parental acceptance of seasonal influenza vaccination for their children - A telephone survey in the adult population in Germany.

Introduction: Influenza vaccination of children with underlying chronic diseases is currently recommended in Germany, but targeting all children constitutes an alternative approach to control seasonal influenza. To inform the modelling of vaccination impact and possible communication activities, we aimed to assess among parents the acceptance of universal childhood vaccination against seasonal influenza and possible modifiers.

Methods: We conducted a telephone survey in households in Germany using random digit dialing.

A description of teaching methods using an on-site instructor versus a distant site instructor to train laryngoscopy to medical students in Hanoi, Vietnam, from Omaha, Nebraska, by video communication.

This study demonstrated a method to train medical students at Hanoi Medical School in airway management from Omaha, Nebraska, using tele-mentoring techniques. Correct placement of the endotracheal tube was documented by tele-broncoscopy following intubation. This technology may increase medical training capabilities in remote or developing areas of the world.

Development of a tele-anesthesia preoperative clinic to support distant military treatment facilities for the European regional medical command.

Landstuhl Regional Medical Center (LRMC) provides primary care services for more than 65,000 beneficiaries and specialty care and hospitalization for 245,000 U.S. Service Members and their Families serving in Europe.

Development of a Tele ENT Program to Support Distant Military Treatment Facilities for the European Regional Medical Command.

Two hundred forty-five thousand patients seek care at Landstuhl Regional Medical Center. They battle lengthy commutes, costly procedures, and limited specialty care in order to consult their physicians. Implementing telemedical procedures at hospitals such at LRMC is believed to reduce travel time, decrease costs, and increase specialization.

Endotracheal intubation with a traditional videolaryngoscope blade versus an integrated suction blade in a hemorrhagic airway cadaver model.

Lightly embalmed hemorrhagic cadaver models and the Storz CMAC videolaryngoscope fitted with either an integrated suction blade vs. a traditional blade were used to determine efficacy of the instruments in hemorrhagic airway intubation. Significant differences were found between the devices in intubation success rates of the viscosity saliva and frothy blood models, as well as a significant difference in intubation times in the frothy blood model.

Airway management in unusual environments.

Critically injured patients are often found in unusual positions and environments which can hinder the first responder's access to render necessary care. This work describes the use of the videolaryngoscope in airway management of the critically injured patient under unusual conditions.

Using the intubating laryngeal tube in a manikin - user evaluation of a new airway device.

This work describes the use of a new intubation device, the intubating laryngeal tube (iLTA) as developed by Boedeker. Emergency Department residents and staff from the University of Nebraska Medical Center performed intubations using the Laerdal Difficult Airway Trainer Manikin(TM). The participants' perceived value of the intubating laryngeal tube as well as its efficacy in intubation performance were measured and found to be highly favorable.

A demonstration of the Storz C-CAM in endoscopic imagery projection for far forward battlefield telemetric support and training.

Airway management skills are essential for healthcare providers within military and civilian settings. To maintain competency in these skills, it is crucial for the provider to have opportunities for review and retraining. Virtual airway training or telementoring can be an effective means to fulfilling these requirements for healthcare providers located in remote sites.

Virtual simulation training using the Storz C-HUB to support distance airway training for the Spanish Medical Corps and NATO partners.

In medicine, the advancement of new technologies creates challenges to providers both in learning and in maintaining competency in required skills. For those medical providers located in remote environments, access to learning can be even more formidable. This work describes a collaboration created to facilitate the use of new communication technologies in providing distance training and support to health care personnel deployed in remote areas.

NATO Special Operations Forces Medical Engagements and Partnering Course: Initial Curriculum Recommendations from the NSHQ SOFMEP Committee.

Military partnering operations and military engagements with host nation civil infrastructure are fundamental missions for NATO Special Operations Forces (SOF) conducting military assistance operations. Unit medical advisors are frequently called upon to support partnering operations and execute medical engagements with host nation health systems. As a primary point of NATO SOF medical capability development and coordination, the NATO Special Operations Headquarters (NSHQ) sought to create a practical training opportunity in which medical advisors are taught how to prepare for, plan, and execute these complex military assistance operations.

Advanced Medical Technology Capacity Building and the Medical Mentoring Event: A Unique Application of SOF Counterinsurgency Medical Engagement Strategies.

Background The Medical Civic Assistance Program (MEDCAP) is a military commander?s tool developed during the Vietnam War to gain access to and positively influence an indigenous population through the provision of direct medical care provided by military medical personnel, particularly in Counter Insurgency Operations (COIN). An alternative to MEDCAPs is the medical seminar (MEDSEM). The MEDSEM uses a Commander?s military medical assets to share culturally appropriate medical information with a defined indigenous population in order to create a sustainable training resource for the local population?s health system.

Virtual intubation training at a remote military site.

To provide medical support to the far forward battlefield, training in advanced medical technologies is essential for military healthcare providers. To meet this challenge, the use of modern video communication technologies and novel medical devices can be implemented. This study demonstrates the combined use of modern video conferencing technology and video laryngoscopy equipment in the virtual laryngoscopy training of deployed military medical personnel.

Use of a malleable bougie and curved forceps with videolaryngoscopy in airway management training in a cadaver model - a pilot study.

The wider angle of view of videolaryngoscopy versus standard direct laryngoscopy requires an assessment of the adjunctive devices used to facilitate intubation. In this study, subjects performed malleable bougie-assisted intubation and curved forceps removal of a glottic foreign body using videolaryngoscopy on a lightly embalmed cadaver and completed a post-procedure questionnaire. All subjects valued access to the malleable bougie available at their hospitals and 82% valued access to the curved forceps.

A comparison of an integrated suction blade versus a traditional videolaryngoscope blade in the endotracheal intubation of a hemorrhagic cadaver model - a pilot study.

In this pilot study, we evaluated two types of videolaryngoscope blades (integrated suction vs. traditional) with the Storz CMAC videolaryngoscope in the intubation of a lightly embalmed hemorrhagic cadaver model. No significant differences were found between the devices in the success rates for the intubations.

Nasotracheal intubation in a difficult airway using the Storz C-MAC Videolaryngoscope, the Boedeker Bougie endotracheal introducer, and the Boedeker curved forceps.

Airway management has multiple indications for nasotracheal intubation. In this study, we focus on its indication in difficult airways. This work describes a modified procedure of nasotracheal intubation using the new Storz CMAC® Videolaryngoscope, the malleable Boedeker Bougie and the curved Boedeker Forceps in the intubation of a difficult airway manikin.

Performance comparison of laryngoscopy and suction techniques in a hemorrhagic airway manikin simulator: direct laryngoscopy with Yankauer vs. Storz CMAC with attached suction tip.

Airway management of the hemorrhagic airway can be a difficult skill to master as trainee exposure to this difficult airway may be limited. In this study, we employed a hemorrhagic airway simulator along with a videolaryngoscope and the Storz Boedker-Doerges (BD) suction blade. These devices provided improved intubation performance in this model with respect to traditional direct laryngoscope (DL) and VL blades.

Tele-orthopaedics: United States Army European Regional Medical Command.

Telemedicine is the provision of medical care over long distances by way of videoconferencing and other communication technologies. Staff at Vilseck U.S.

Utilization of a civilian academic center as a force multiplier in support of NATO special operations medicine - a pilot demonstration.

This work describes a NATO-university telemedicine collaboration established to perform a teleneurosurgery consult to assist a deployed soldier with a spinal cord injury.

Using the Battlefield Telemedicine System (BTS) to train deployed medical personnel in complicated medical tasks - a proof of concept.

This work describes the use of Adobe Connect software along with algorithm software to provide the necessary audio visual communication platform for telementoring a complex medical procedure to novice providers located at a distant site.

Telementoring for airway management between a far forward special operations location to a major medical center using inexpensive telemedicine solutions.

Critically ill patients in remote settings have limited access to specialized care. Telemedicine/telementoring can improve access to quality care, although VTC equipment is costly. This study showed that an inexpensive internet telecom software program can be effectively employed in the intubation training of a remote trainee.

Use of a cardiac algorithm in a preoperative evaluation clinic - a pilot study.

The preoperative evaluation is vital in providing information to reduce the risks associated with the anesthesia and surgery and improve the quality of care. In the VA Nebraska-Western Iowa Health Care System, we introduced a computer-based cardiac algorithm as part of the preoperative evaluation software. Following the pre-op examination and use of the algorithm, the provider completed a survey regarding their perceived usefulness of the algorithm software.

User preference comparing a conventional videolaryngoscope blade vs. a novel suction videolaryngoscope blade in simulated hemorrhagic airway intubation.

The hemorrhagic airway makes visualization during laryngoscopy and intubation difficult. A specially designed videolaryngoscope blade with integrated suction was developed and studied in a simulated hemorrhagic airway at the Omaha VA Medical Center. Results show that, if available, many users would choose to include this new suction device in their standard airway carts due to its "always there" design.

Development of medical engagement training toolkits to support special operations military assistance programs in austere environments.

The Medical Seminar (MEDSEM) is a medical operation that shares culturally appropriate medical information with a defined indigenous population based upon a "train the trainer" concept. This work describes the development of a hand washing training toolkit designed to support a MEDSEM action in Afghanistan.