The dawn of emergency medicine in Vietnam.

In 2009 emergency medicine had not been officially established as a specialty in Vietnam. As a result of a non-government organization identifying the need to improve the delivery of emergency care, the Vietnam2010 Symposium in Emergency Medicine was held in Hue in March 2010. This involved 1 week of activity including: an Emergency Medicine Conference, providing lectures and practical workshops in topics of emergency medicine; a Deans' Conference, dedicated to the development of emergency medicine as a specialty; a Disaster and EMS Conference; and an Emergency Nursing Conference.

Missing in action: a case study of the application of methods for dealing with missing data to trauma system benchmarking.

Background: Trauma registry data are usually incomplete. Various methods for dealing with missing data have been used, some of which lead to biased results. One method that reduces bias, multiple imputation (MI), has not been widely adopted.

A controlled evaluation of a prison-based sexual offender intervention program.

The effectiveness of a prison-based cognitive behavioral program designed to modify psychological risk factors associated with sexual offending was evaluated. The Irish Prison Service Sexual Offender Intervention Programme, is a manualized 10-month Cognitive Behaviour Therapy [CBT] program involving three 2-hour group sessions per week, which are facilitated by a team of clinical psychologists and probation officers. Improvements in 38 consecutive referrals to the program were compared with the status of 38 untreated offenders who were similar in marital status, age when they left school, occupational status prior to imprisonment, offence type, presence of previous convictions, and current sentence length.

Emergency department surge capacity: recommendations of the Australasian Surge Strategy Working Group.

For more than a decade, emergency medicine (EM) organizations have produced guidelines, training, and leadership for disaster management. However, to date there have been limited guidelines for emergency physicians (EPs) needing to provide a rapid response to a surge in demand. The aim of this project was to identify strategies that may guide surge management in the emergency department (ED).

Rapporteurs' report: workshop on ethical issues in diagnostic radiology.

This paper presents the summary reports of the session rapporteurs at the Workshop on Ethical Issues in Diagnostic Radiology. The summaries reflect the extent to which the topics discussed are well reflected in the papers presented in this proceedings.

Trauma reception and resuscitation in Sri Lanka: the Health for the South Capacity-Building project.

In response to the Indian Ocean tsunami of 2004, the Health for the South project, Capacity-Building programme was implemented in Galle, Sri Lanka. The objectives of the Capacity-Building programme were to develop the emergency and trauma service capability at Teaching Hospital Karapitiya in Galle. Over 15 months, ED clinicians, from the Alfred Hospital and Royal Children's Hospital in Melbourne, provided training in the Emergency Treatment Unit of the main referral hospital for the south of Sri Lanka.

Non-medical exposures--ethical concerns.

The scope of the Medical Exposure Directive (MED), 97/43/Euratom (Council Directive 97/43/EURATOM, on the health protection of individuals against the dangers of ionising radiation in relation to medical exposures. OJ L 180 of 09.07.

Accuracy of current clinical diagnosis in recreational drug-related attendance to the emergency department.

Objective: To determine the accuracy of current clinical diagnosis in recreational drug-related attendances to emergency by blood analysis.

Methods: A prospective convenience sample of 103 patients who attended hospital with suspected recreational drug-related presentations was collected. Doctors' clinical impression of drugs responsible for presentation was compared with a detailed forensic blood analysis for recreational drugs.

The Plate cage Benezech implant as an alternative to autologous bone graft in the treatment of cervical spondylosis: clinical and functional outcome.

Plate cage Benezech (PCB) is a titanium-made implant introduced recently in spinal surgery as a new substitute for autograft in cervical spine interbody fusion. It has a plate attached to the anterior surface of the cage to prevent any displacement of the cage, and to provide additional support in patients with dynamic instability. A small number of studies have shown the PCB cage is safe and efficient.

Ethical issues in medico-legal exposures.

The Medical Exposure Directive (MED) 97/43/Euratom defines medico-legal procedures as 'procedures performed for insurance or legal purposes without a medical indication'. The term 'medico-legal exposures' covers a wide range of possible types of exposures, very different in nature, for which the only feature in common is the fact that the main reason for performing them does not relate directly to the health of the individual being exposed to ionising radiation. The key issue in medico-legal exposures is justification.

Development of training syllabi for radiation protection and quality assurance of dual-energy X-ray absorptiometry (DXA) systems.

The use of dual-energy X-ray absorptiometry (DXA) scanners for measuring bone mineral density (BMD) is on the increase. A single DXA scan is a relatively low-dose diagnostic X-ray examination; however, radiation protection (RP) issues should not be trivialised. One objective of the EU 6th Framework SENTINEL co-ordination action was to develop training syllabi in RP and quality assurance (QA) for BMD, and this study presents the results.

In the wake of Sri Lanka's tsunami: the health for the south capacity-building project.

In response to the Indian Ocean tsunami of December 2004, the Health for the South Project was developed for Sri Lanka. The capacity-building component of this project involves the provision of trauma and emergency care training to the staff of Teaching Hospital Karapitiya (THK) in Galle, Sri Lanka. A principal objective of this training for THK is an increased capacity to respond to future disasters in the south of Sri Lanka.

Evaluating outcomes of the emergency nurse practitioner role in a major urban emergency department, Melbourne, Australia.

Aims And Objectives: The aim of this study was to evaluate the impact of the introduction of Emergency Nurse Practitioner Candidates (ENPC) on waiting times and length of stay of patients presenting to a major urban Emergency Department (ED) in Melbourne, Australia.

Background: As part of a Victorian state funded initiative to improve patient outcomes, the role of the Emergency Nurse Practitioner has been developed. The integration and implementation of this role, is not only new to the Alfred Emergency and Trauma Centre but to EDs in Melbourne, Australia, with aims of providing holistic and comprehensive care for patients.

Urban and rural variations in morbidity and mortality in Northern Ireland.

Background: From a public health perspective and for the appropriate allocation of resources it is important to understand the differences in health between areas. This paper examines the variations in morbidity and mortality between urban and rural areas.

Methods: This is a cohort study looking at morbidity levels of the population of Northern Ireland at the time of the 2001 census, and subsequent mortality over the following four years.

Management of haemodynamically stable patients with abdominal stab wounds.

Objectives: Australasian trauma centres receive relatively low numbers of penetrating injuries from stabbings. There is limited agreement regarding protocols to guide the management of haemodynamically stable patients with penetrating injuries. This has resulted in a wide variation in practice with anecdotally high negative laparotomy rates.

Blast-related injuries from terrorism: an international perspective.

Terrorism using conventional weapons and explosive devices is a likely scenario and occurs almost daily somewhere in the world. Caring for those injured from explosive devices is a major concern for acute injury care providers. Learning from nations that have experienced conventional weapon attacks on their civilian population is critical to improving preparedness worldwide.

Commissioning and quality assurance protocol for dual energy X-ray absorptiometry (DEXA) systems.

This study reports on the development and evaluation of a protocol for testing DEXA systems, which can be incorporated into a routine medical physics/engineering service. Methodologies are reported for (1) scatter measurement, (2) estimation of reference dose and (3) enquiry into potential sources of overexposure. Results show that fan-beam and cone-beam systems require shielding if the walls or operator are within 1 m of the table.

Exposure variations under error conditions in automatic exposure controlled film-screen projection radiography.

Improper automatic exposure control (AEC) termination may result in high overexposures on some radiographic systems. Under AEC, X-ray factors are adjusted automatically to compensate for differences in patient thickness and density. In radiography, AEC is implemented using ionization chambers placed in the film bucky.

Role of single nucleotide polymorphisms of pro-inflammatory cytokine genes in the relationship between serum lipids and inflammatory parameters, and the lipid-lowering effect of fish oil in healthy males.

Background And Aims: Lipid metabolism, obesity and inflammation are intimately related. Plasma triglycerides increase during the inflammatory response to pathogens and obesity increases inflammatory stress. Pro-inflammatory cytokines are secreted by adipocytes in uninfected obese subjects.

Extraction of the two-dimensional cardiothoracic ratio from digital PA chest radiographs: correlation with cardiac function and the traditional cardiothoracic ratio.

The purpose of our study was to extract the two-dimensional (2D) cardiothoracic ratio from digital chest radiographs using image analysis software on a Magic View 300 system. We also wanted to investigate its correlation with cardiac function, as defined by left ventricular ejection fraction from MUGA scanning, and with the traditional one-dimensional cardiothoracic ratio. One hundred patients undergoing radionuclide ventriculography and concurrent digital PA chest radiography using a commercial selenium detector system were studied.

Attachment styles and psychological profiles of child sex offenders in Ireland.

When 29 child sex offenders, 30 violent offenders, 30 nonviolent offenders, and 30 community controls were compared, a secure adult attachment style was 4 times less common in the child sex offender group than in any of the other three groups. Ninety-three percent of sex offenders had an insecure adult attachment style. Compared with community controls, the child sex offender group reported significantly lower levels of maternal and paternal care and significantly higher levels of maternal and paternal overprotection during their childhood.

The ability of fish oil to suppress tumor necrosis factor alpha production by peripheral blood mononuclear cells in healthy men is associated with polymorphisms in genes that influence tumor necrosis factor alpha production.

Background: Tumor necrosis factor alpha (TNF-alpha) mediates inflammation. High TNF-alpha production has adverse effects during disease. Polymorphisms in the TNF-alpha and lymphotoxin alpha genes influence TNF-alpha production.