DISAST-CIR: Disastrous incidents systematic analysis through components, interactions and results: application to a large-scale train accident.

Disasters or hazardous incidents, either natural or man-made, continue to increase in frequency and affect more and more citizens of the world community. Many of these are published in the medical literature, each being a "case report" of a single event. In clinical medicine, a common nomenclature and uniform reporting of data enables the collection of similar cases to series studies, with clinical conclusions being drawn.

Establishing a high level of knowledge regarding bioterrorist threats in emergency department physicians: methodology and the results of a national bio-preparedness project.

Introduction: Medical systems worldwide are facing the new threat of morbidity associated with the deliberate dispersal of microbiological agents by terrorists. Rapid diagnosis and containment of this type of unannounced attack is based on the knowledge and capabilities of medical staff. In 2004, the knowledge of emergency department physicians of anthrax was tested.

Distribution of casualties in a mass-casualty incident with three local hospitals in the periphery of a densely populated area: lessons learned from the medical management of a terrorist attack.

Introduction: A mass-casualty incident (MCI) can occur in the periphery of a densely populated area, away from a metropolitan area. In such circumstances, the medical management of the casualties is expected to be difficult because the nearest hospital and the emergency medical services (EMS), only can offer limited resources. When coping with these types of events (i.

The significance of a small, level-3 'semi evacuation' hospital in a terrorist attack in a nearby town.

Terrorist attacks can occur in remote areas causing mass-casualty incidents MCIs far away from level-1 trauma centres. This study draws lessons from an MCI pertaining to the management of primary and secondary evacuation and the operational mode practiced. Data was collected from formal debriefings during and after the event, and the medical response, interactions and main outcomes analysed using Disastrous Incidents Systematic Analysis through Components, Interactions and Results (DISAST-CIR) methodology.

Significance of a Level-2, "selective, secondary evacuation" hospital during a peripheral town terrorist attack.

Introduction: Mass-casualty incidents (MCIs) can occur outside of major metropolitan areas. In such circumstances, the nearest hospital seldom is a Level-1 Trauma Center. Moreover, emergency medical services (EMS) capabilities in such areas tend to be limited, which may compromise prehospital care and evacuation speed.

Physician versus paramedic in the setting of ground forces operations: are they interchangeable?

Background: The setting of military ground force operations can be demanding and requires a matched medical assistance plan. A major consideration is the type of medical caregiver that is assigned to the mission. We studied the similarities, differences, advantages, and disadvantages of physicians versus paramedics in this scenario.

Who should worry for the "worried well"? Analysis of mild casualties center drills in non-conventional scenarios.

Introduction: A mass toxicological event (MTE) caused by an act of terrorism or an industrial incident can create large numbers of ambulatory casualties suffering from mild intoxication, acute stress reaction (ASR), and exacerbation of chronic diseases or iatrogenic insult (such as atropine overdose). The logistical and medical management of this population may present a challenge in such a scenario. The aim of this article is to describe the concept of the Israeli Home Front Command (HFC) of a "Mild Casualties Center" (MCC) for a chemical scenario, and to analyze the results of two large-scale drills that have been used to evaluate this concept.

A four-step approach for establishment of a national medical response to mega-terrorism.

A simplified, four-step approach was used to establish a medical management and response plan to mega-terrorism in Israel. The basic steps of this approach are: (1) analysis of a scenario based on past incidents; (2) description of relevant capabilities of the medical system; (3) analysis of gaps between the scenario and the expected response; and (4) development of an operational framework. Analyses of both the scenario and medical abilities led to the recommendation of an evidence-based contingency plan for mega-terrorism.

Allergic contact dermatitis among maintenance and clerical workers in a military population.

Contact dermatitis is one of the leading causes of occupational morbidity and absenteeism and has become an intolerable cause of missed workdays and health problems in the Israeli military. The aim of this study was to determine the rate of contact dermatitis in maintenance and clerical workers, the common allergens causing it, and the background of atopy in the subjects in order to design preventive measures. Medical records of all recruits to the Israel Defense Forces from 2000 to 2003 were reviewed for contact dermatitis.

Lessons learned from clinical anthrax drills: evaluation of knowledge and preparedness for a bioterrorist threat in Israeli emergency departments.

Study Objective: Emergency department (ED) physicians and nurses are considered critical sentinels of a bioterrorist attack. We designed a special hospital drill to test EDs' response to inhalational anthrax and assess the level of preparedness for anthrax bioterrorism. We hypothesized that the occurrence of such a drill in an ED would improve the knowledge of its physicians, even those who had not actually participated in the drill.

Multiple common naevi in Israeli adolescents.

The most prominent known phenotypic risk factor for the development of melanoma is a large number of common melanocytic naevi. The aims of this study were to determine the prevalence of multiple common naevi in a group of 17-year-olds and to identify possible associated risk factors. The study subjects were approximately 40,000 female and 60,000 male 17-year-old Jewish Israelis presenting to army recruitment centres for compulsory military service during a 1-year period from January 2003 to December 2003.

Comparison of stress fractures of male and female recruits during basic training in the Israeli anti-aircraft forces.

Background: In military basic training, stress fractures are a common orthopedic problem. Female recruits have a significantly higher incidence of stress fractures than do male recruits. Because the Israeli Defense Forces opened traditionally male roles in combat units to female recruits, their high risk for stress fractures is of concern.

The changing prevalence of myopia in young adults: a 13-year series of population-based prevalence surveys.

Purpose: To determine the changing prevalence of myopia during the years 1990 through 2002 among the 16- to 22-year age group and identify possible risk factors.

Methods: A retrospective study, based on 13 repeated prevalence surveys conducted over a 13-year period. The study subjects were all Israeli nationals belonging to the 16- to 22-year age group from the years 1990 to 2002.

The prevalence of common cardiovascular diseases among 17-year-old Israeli conscripts.

Background: There are only few reports on the prevalence of common cardiovascular disorders among adolescents. The previous studies focused on specific diseases, and screened relatively small samples.

Objective: The aim of this study was to define the prevalence of different common cardiovascular disorders among 17-year-old Israeli conscripts.

Application of Porter's generic strategies in ambulatory health care: a comparison of managerial perceptions in two Israeli sick funds.

A number of typologies have been developed in the strategic management literature to categorize strategies that an organization can pursue at the business level. Extensive research has established Porter's generic strategies of (1) cost leadership, (2) differentiation, (3) differentiation focus, (4) cost focus, and (5) stuck-in-the-middle as the dominant paradigm in the literature. The purpose of the current study was to research competitive strategies in the Israeli ambulatory health care system, by comparing managerial perceptions of present and ideal business strategies in two Israeli sick funds.

Israeli Defense Forces Medical Corps humanitarian mission for Kosovo's refugees.

In April 1999, during the crisis in Kosovo, the Israeli government launched a medical, field hospital in order to provide humanitarian aid to the Albanian refugees that fled from their homes in Kosovo. This facility was set up by the Medical Corps of the Israeli Defense Forces, in a refugee camp located in Northern Macedonia. During the 16 days during which the hospital functioned, the medical staff treated 1,560 patients and hospitalized >100.

Screening for common respiratory diseases among Israeli adolescents.

Background: Respiratory diseases are responsible for a significant proportion of serious morbidity among adolescents. There are few reports on the prevalence of common respiratory disorders in this population. The previous studies focused on specific diseases and screened relatively small samples.