ABSTRACT
Objective@#This study aimed to investigate the factors influencing the emergency medical competency (EMC), perceived by the fire station and health center staff, in the areas where of emergency medical vulnerability where earthquakes had occurred. @*Methods@#This study was conducted between December 2019 and February 2020. A proper questionnaire was created to evaluate EMC in disaster situations and administered to the fire station and the health center groups. Descriptive variables of each group were calculated. The Kendall rank correlation analysis was used to measure the relationships between the demographic variables, disaster-related variables, and EMC. The factors influencing the EMC for both groups were investigated in the linear regression analysis. @*Results@#For a total of 200 respondents, the mean scores of EMC were 99.85±21.24 and 95.24±20.05 for the fire station (n=96) and the health center (n=104) groups, respectively (P=0.121). EMC was significantly correlated with age, years of service, job position, natural disaster experience, disaster relief service experience, and joint disaster response exercise (P<0.050). Linear regression analysis revealed that the duration of joint disaster response exercise (β=0.640, t=11.696) in Model 1 (F=136.806, P<0.001), the duration of joint disaster response exercise (β=0.627, P<0.001), and disaster rescue service experience (β=0.124, P<0.001) in Model 2 (F=72.431, P<0.001) were independently associated with EMC improvement. @*Conclusion@#Our findings indicate that the disaster preparedness program with a longer duration of joint disaster response exercise and more frequent disaster rescue service experience is necessary for improved and systematic response to a disaster.
ABSTRACT
Objective@#This study aimed to investigate the factors influencing the emergency medical competency (EMC), perceived by the fire station and health center staff, in the areas where of emergency medical vulnerability where earthquakes had occurred. @*Methods@#This study was conducted between December 2019 and February 2020. A proper questionnaire was created to evaluate EMC in disaster situations and administered to the fire station and the health center groups. Descriptive variables of each group were calculated. The Kendall rank correlation analysis was used to measure the relationships between the demographic variables, disaster-related variables, and EMC. The factors influencing the EMC for both groups were investigated in the linear regression analysis. @*Results@#For a total of 200 respondents, the mean scores of EMC were 99.85±21.24 and 95.24±20.05 for the fire station (n=96) and the health center (n=104) groups, respectively (P=0.121). EMC was significantly correlated with age, years of service, job position, natural disaster experience, disaster relief service experience, and joint disaster response exercise (P<0.050). Linear regression analysis revealed that the duration of joint disaster response exercise (β=0.640, t=11.696) in Model 1 (F=136.806, P<0.001), the duration of joint disaster response exercise (β=0.627, P<0.001), and disaster rescue service experience (β=0.124, P<0.001) in Model 2 (F=72.431, P<0.001) were independently associated with EMC improvement. @*Conclusion@#Our findings indicate that the disaster preparedness program with a longer duration of joint disaster response exercise and more frequent disaster rescue service experience is necessary for improved and systematic response to a disaster.
ABSTRACT
The enhanced differentiation and activation of osteoclasts (OCs) in the inflammatory arthritis such as rheumatoid arthritis (RA) and gout causes not only local bone erosion, but also systemic osteoporosis, leading to functional disabilities and morbidity. The induction and amplification of NFATc1, a master regulator of OC differentiation, is mainly regulated by receptor activator of NF-κB (RANK) ligand-RANK and calcium signaling which are amplified in the inflammatory milieu, as well as by inflammatory cytokines such as TNFα, IL-1β and IL-6. Moreover, the predominance of CD4+ T cell subsets, which varies depending on the condition of inflammatory diseases, can determine the fate of OC differentiation. Anti-citrullinated peptide antibodies which are critical in the pathogenesis of RA can bind to the citrullinated vimentin on the surface of OC precursors, and in turn promote OC differentiation and function via IL-8. In addition to adaptive immunity, the activation of innate immune system including the nucleotide oligomerization domain leucine rich repeat with a pyrin domain 3 inflammasome and TLRs can regulate OC maturation. The emerging perspectives about the diverse and close interactions between the immune cells and OCs in inflammatory milieu can have a significant impact on the future direction of drug development.