Society of behavioral medicine statement on COVID-19 and rural health.

This position statement provides researchers, practitioners, and policymakers an overview of pre-existing and COVID-related rural health inequities in the United States (U.S.) and how they have been exacerbated by the COVID-19 pandemic. "Health deserts," defined as "large areas with inadequate or nonexistent medical and trauma facilities," are common in rural regions of the U.S. While telehealth could address some of these health-related inequities, significant gaps in broadband Internet availability are also common in these more remote areas. The Society of Behavioral Medicine urges Congress to authorize increased funding to rural healthcare facilities and staffing, along with the development of enhanced broadband Internet infrastructure. In addition, incentivizing rural healthcare systems to deliver value-based care could enhance their capacity to implement population health and behavioral health strategies. To stem the spread of COVID-19 in higher-risk rural-based industries (e.g., food processing plants), SBM urges Congress to require the Occupational Safety and Health Administration (OSHA) to routinely inspect for and enforce COVID-19 mitigation procedures, such as provision of effective Personal Protective Equipment (PPE) to all front-line workers and consistent implementation of standardized testing and social distancing advisories. The context of rural communities underscores the importance of tailored approaches to mitigate rural health inequities and promote the well-being of rural residents.

Policy makers' perspective on the provision of maternal health services via mobile health clinics in Tanzania-Findings from key informant interviews.

OBJECTIVE: To explore the operational feasibility of using mobile health clinics to reach the chronically underserved population with maternal and child health (MCH) services in Tanzania. DESIGN: We conducted fifteen key informant interviews (KIIs) with policy makers and district health officials to explore issues related to mobile health clinic implementation and their perceived impact. MAIN RESULTS: Policy makers' perspective indicates that mobile health clinics have improved coverage of essential maternal and child health interventions; however, they face financial, human resource-related and logistic constraints. Reported are the increased engagement of the community and awareness of the importance of MCH services, which is believed to have a positive effect on uptake of services. Key informants (KIs)' perceptions and opinions were generally in favour of the mobile clinics, with few cautioning on their potential to provide care in a manner that promotes a continuum of care. Immunization, antenatal care, postnatal care and growth monitoring all seem to be successfully implemented in this mode of service delivery. Nevertheless, all informants perceive mobile clinics as a resource intensive yet unavoidable mode of service delivery given the current situation of having women and children residing in remote settings. CONCLUSION: While the government shows the clear motive, the need and the willingness to continue providing services in this mode, the plan to sustain them is still a puzzle. We argue that the continuing need for these services should go hand in hand with proper planning and resource mobilization to ensure that they are being implemented holistically and to promote the provision of quality services and continuity of care. Plans to evaluate their costs and effectiveness are crucial, and that will require the collection of relevant health information including outcome data to allow sound evaluations to take place.

[The pharmacist and deputy Henri Schmidt, the law voted in 1913 and said «for three years¼ and the position of mobilized pharmacists at the beginning of First World War].

Henri Schmidt was, with his fellow the senator Paul Cazeneuve, the main defender of the mention of pharmacists and pharmacy students in the articles of the law voted in 1913 for the recruitment of the army. After the description of their interventions to attain this end, and a short biography of these two politicians, the paper explains the activities of the pharmaceutical parliamentary group, during the early years of the war, in view to obtain the admittance in the medical corps of the pharmacists and students unprovided of rank, for the new creation of «auxiliary pharmacists¼, for the appointment as soon as possible of the maximum number of colleagues at this rank, and then for their promotion to the rank of «aide-major¼, resolution that appeared more difficult to obtain.

Telemedicine by mobile communication.

A concept of mobile telemedicine has been proposed to provide emergency care in a moving vehicle. The practicality of this technique was investigated through technical considerations required to realize mobile telemedicine. Some problems with this technique were identified, and measures to resolve the problems were devised. Then, theoretical analysis verified the feasibility of the proposed technique. Different multiplexing techniques for the multiple medical data transmission by mobile communication were investigated. An experimental system that can simultaneously transmit color images, an audio signal, three-channel ECGs, and blood pressure from a moving vehicle to a fixed station was developed. Experiments on the transmission of multichannel medical data from a moving ambulance, a navigating ship, and a flying aircraft were conducted. The results of these experiments verified the practical feasibility of the proposed technique. In the practical application of this technique, there may be some legal problems: for example, whether medical treatment through a communication medium would be legally acceptable or not, and whether the transmission of medical data violates the protection of personal privacy. However, considering the emergency nature of this technique and the significance of the results, both problems seem to be either legally or technically solvable. This application of mobile communication to telemedicine is not confined to merely a proposal to use new techniques. It can also bring about a methodological change in the concept of conventional telemedicine by changing it from static to dynamic, and by enlarging its scope from a local area to a global or cosmic area. It may also have an impact on conventional emergency medicine in that it will open up a new field of application that applies to moving vehicles.

[Use of Diprivan for prehospital emergencies]. / Utilisation du Diprivan pour les urgences préhospitalières.

The use of propofol at the scene of an accident or during transport to the hospital: 1. Should be restricted to fully qualified anaesthetists of an Emergency Mobile Hospital Unit. 2. Is probably rather limited, as: the indications for anaesthesia in this context are relatively rare; they are dominated by trauma cases (which represent 20 to 30 per cent of the activity of an Emergency Mobile Hospital Unit) and other accident-related conditions; furthermore, in most emergency situations, sedation and/or analgesia of varying depth are more often required; the indications for propofol would be rare because of: its haemodynamic effects, especially as hypovolaemia is extremely frequent, as neurological damage is often existing, and the medical history of the patient is frequently unknown; the possible choice of other agents, such as midazolam, which is widely used as well as etomidate or ketamine; 3. Should follow the same guidelines as those in use for its intra-hospital administration: propofol is undoubtedly a valuable agent as it allows a rapid induction, depresses the pharyngo-laryngeal reflexes, and has the advantage of producing a rapid, good quality recovery which provides an important element of safety; however, for as long as prospective comparative studies have not specifically been carried out in the area of pre-hospital anaesthesia, the greatest circumspection is required. Any contraindication and precaution recommended from hospital use should be strictly adhered to and amplified because of the difficult circumstances and the other available alternatives kept in mind.