The role of medical support workers during the COVID-19 pandemic in the NHS in the UK: A qualitative service evaluation at the Oxford University Hospitals NHS Foundation Trust.

We conducted a service evaluation of the medical support worker (MSW) role at Oxford University Hospitals NHS Foundation Trust following the Coronavirus 2019 (COVID-19) pandemic. The aim was to explore the roles of MSWs, their contributions to the NHS, factors influencing their career choices, and the goals of the MSW position, to inform quality improvement in relation to their integration into the Trust. The perspectives of MSWs, their supervisors and recruiters were analysed through nine semi-structured interviews and two focus group discussions involving 18 participants. Results were categorised into micro-, meso-, and macro-levels of the health system. At the micro-level, MSWs were recognised as a diverse group of highly qualified international medical graduates (IMGs) who had a crucial role during the pandemic. At the meso-level, participants emphasised the importance of a comprehensive induction by the hospital, to clarify responsibilities and familiarise MSWs with the health system. At the macro-level, the role facilitated MSW integration within the NHS, with the aim of practising as doctors. The importance of comprehensive hospital induction, with role clarity for both MSWs and their teams, supportive supervision and assistance with applying for registration with the General Medical Council, were highlighted as key quality improvement areas.

Medical Support Provided by the UN's Scandinavian Allies during the Korean War.

The humanitarian motivation of medical support from the three Scandinavian countries during the Korean War cannot be doubted, but the countries also had to be politically sensitive during this period. The fact that these countries only dispatched medical support, and that the team was not only for military purpose but also intended to help the civilians is a different point from the U.S. military medical support, which distinguished military medical support that is the U.S. Eighth Army, from the civilian treatment and relief, which is the UNCACK. In addition, medical support activities from the Scandinavian countries were bound to be flexible depending on the rapidly changing trend of war, active regions, and their support methods. At a time when the battle was fierce and the number of wounded soldiers increased, they had no choice but to concentrate on treating wounded soldiers, whether in Busan or Incheon. However, even while treating these wounded soldiers, they tried to treat and rescue civilians around the base area whenever they had chance. It is easily imaginable that in the urgent situation of war, the nature of medical support cannot be clearly divided into military or civilian if there is only one team that is operating. It is clear, however, that the common humanitarian purpose of rescuing and treating civilians affected the establishment of the National Medical Center in Seoul after the war. The Scandinavians had indeed remained even after the end of the war in to provide full support of establishing modern medical system in Korea. This suggests that modern Korean medical or public health system did not start to be developed in the 1960s like some researchers argue, but started a few years earlier during the time of the war with the support from the countries world-wide.

Analysis of Pharmaceutical Demand in the Region for Chronic Medicine Users Using National Health Insurance Data: Examination for Disaster Preparedness in Hakui City, Ishikawa Prefecture.

When large earthquakes occur over wide areas, in addition to damage to medical facilities, the disaster response capabilities of local governments are severely compromised. There is a very high possibility that the supply-demand balance of medicines will collapse within the disaster area, and that appropriate supplies of medicines will not be provided to disaster victims. Therefore, it is important to estimate in advance the quantity of pharmaceuticals that may be needed during disasters. In this study, the purpose is to clarify the quantity and quality of pharmaceuticals used by chronically ill patients by using Japanese National Health Insurance data regarding the issues mentioned above. The methodology used was to extract the status of pharmaceutical prescriptions based on receipt information from National Health Insurance data for Hakui, Ishikawa Prefecture, a small regional city in Japan, as the analysis target area. Through the analysis in this study, the quantity and quality of medicines supplied to chronically ill patients in Hakui, Ishikawa Prefecture, were clarified on a town-by-town basis.

Measures to support informal care for the older adults in Kazakhstan: a review of the current status.

The demand for informal caregivers to support the older adults has grown worldwide in recent decades. However, informal caregivers themselves require support. This article aims to examine existing support measures for caregivers of the older adults in the Republic of Kazakhstan. Relevant articles and grey literature were identified through manual searches on Google and Google Scholar, as well as electronic searches using indexed databases like PubMed, Web of Science, and Scopus. Moreover, the reference lists of identified sources and government ministry websites were meticulously scrutinized. This review highlights the scarcity of research on caregiver support measures in Kazakhstan, supported by the lack of peer-reviewed articles on this subject. A comprehensive analysis of the literature shows that in Kazakhstan's legislative framework, "caregivers" exclusively refers to individuals providing care for a first-degree disability. The responsibility of caring for older adults parents lies with able-bodied children. However, there is a lack of registration and assessment procedures to evaluate the burden and quality of life of caregivers. As a result, the medical and social support provided to caregivers is standardized, failing to adequately address their unique needs and requirements. The analysis of current support measures for informal caregivers highlights the need to develop support mechanisms and recognize individuals providing informal care as key figures in the long-term care system.

Parental Accompaniment in Operating Rooms Reduces Child Anxiety.

BACKGROUND: We believe that parental presence before the induction of anesthesia for surgery among children with a cleft palate/lip would be effective in mitigating their preoperative anxiety. OBJECTIVE: We assessed the states of patients with a cleft palate/lip when their parents accompanied them into operating rooms and clarified their and their parents' cognition using a questionnaire. METHODS: Data were collected via nursing observation when patients and their parents entered the operating room. Furthermore, an anonymous questionnaire was administered to patients and parents after the operation regarding their feelings about parental presence in the operating room. RESULTS: In total, nine patients cried when they entered the surgical room. Furthermore, six patients and three parents reported preoperative anxiety. In addition, eight patients agreed that they were satisfied with the presence of their parents before induction. CONCLUSION: Approximately half of the patients cried. However, the presence of parents before the induction of anesthesia was effective in reducing anxiety among most patients and their parents.

Identification of factors associated with fear of hypoglycemia using the capability, opportunity, motivation and behavior model in people with type 2 diabetes mellitus: a cross-sectional study.

AIMS: To examined the relationship between fear of hypoglycemia and certain variables in people with type 2 diabetes mellitus (T2DM) based on the Capability, Opportunity, Motivation, and Behavior model, combined with the context unique to people with diabetes to provide a basis for developing targeted nursing interventions. METHODS: In this cross-sectional study, 212 people with T2DM were recruited from February 2021 to July 2021. Data were collected using the Hypoglycaemia Fear Survey, Gold score, Patient Assessment of Chronic Illness Care (PACIC) scale and Diabetic Self-Management Attitudes Scale. Multiple linear regression analysis was performed to determine the predictors of fear of hypoglycemia using SPSS 26.0. RESULTS: The mean fear of hypoglycemia score was 74.88 ± 18.28 (range: 37.00-132.00). In people with T2DM, the frequency of blood glucose monitoring, the frequency of hypoglycemia in the past half-year, degree of understanding of hypoglycemia, impaired awareness of hypoglycemia, PACIC, and self-management attitude of diabetes were the influencing factors of fear of hypoglycemia (adjusted R2 = 0.560, F[21,190] = 13.800, P < 0.001). These variables explained 56.0% of the variance in the fear of hypoglycemia. CONCLUSIONS: The level of fear of hypoglycemia in people with T2DM was relatively high. In addition to paying attention to the disease characteristics of people with T2DM, medical staff should also pay attention to patients' own perception and handling ability of disease and hypoglycemia, attitude toward self-management behavior and external environment support, all of which have a positive effect on improving the fear of hypoglycemia in people with T2DM, optimizing the self-management level and improving quality of life.

Does climate change transform military medicine and defense medical support?

Background: Climate change has effects on multiple aspects of human life, such as access to food and water, expansion of endemic diseases as well as an increase of natural disasters and related diseases. The objective of this review is to summarize the current knowledge on climate change effects on military occupational health, military healthcare in a deployed setting, and defense medical logistics. Methods: Online databases and registers were searched on August 22nd, 2022 and 348 papers retrieved, published between 2000 and 2022, from which we selected 8 publications that described climate effects on military health. Papers were clustered according to a modified theoretical framework for climate change effects on health, and relevant items from each paper were summarized. Results: During the last decades a growing body of climate change related publications was identified, which report that climate change has a significant impact on human physiology, mental health, water- and vector borne infectious diseases, as well as air pollution. However, regarding the specific climate effects on military health the level of evidence is low. The effects on defense medical logistics include vulnerabilities in the cold supply chain, in medical devices functioning, in need for air conditioning, and in fresh water supply. Conclusions: Climate change may transform both the theoretical framework and practical implementations in military medicine and military healthcare systems. There are significant knowledge gaps on climate change effects on the health of military personnel in operations of both combat and non-combat nature, alerting the need for prevention and mitigation of climate-related health issues. Further research within the fields of disaster and military medicine is needed to explore this novel field. As climate effects on humans and the medical supply chain may degrade military capability, significant investments in military medical research and development are needed.

Prolonged requirements for mechanical ventilation and tube feeding support predicted 18-month outcomes for neonatal encephalopathy.

AIM: We evaluated the predictive ability of prolonged requirements for mechanical ventilation or tube feeding support for 18-month composite outcomes in infants with hypoxic-ischaemic encephalopathy treated with hypothermia. METHODS: This retrospective, nationwide, observational study focused on newborn infants registered in Japan's Baby Cooling Registry between 1 January 2012 and 31 December 2016. The adverse outcomes were defined as death or survival with cerebral palsy, visual or auditory impairment or the requirement for mechanical ventilation or tube feeding at 18 months of age. RESULTS: Adverse outcomes occurred in 165 (28%) of the 591 children in the final cohort. These were predicted by prolonged dependence on mechanical ventilation or tube feeding for more than seven and more than 14 days. The respective values were positive predictive value 0.34 (95% CI 0.33-0.34) and 0.60 (95% CI 0.56-0.62), negative predictive value 0.97 (95% CI 0.91-0.99) and 0.93 (95% CI 0.90-0.95) and area under the curve 0.59 (95% CI 0.54-0.64) and 0.81 (95% CI 0.77-0.85). CONCLUSION: Prolonged dependence on mechanical ventilation or tube feeding for more than 14 days may be useful in predicting 18-month outcomes in newborn infants who have received therapeutic hypothermia.

The characteristics and coping strategies of medical support mission in rescue and landing of Shenzhou-14 manned spacecraft / 中华急诊医学杂志

Objective:To review the characteristics and coping strategies of the rescue and landing medical support mission of Shenzhou-14 manned spacecraft.Methods:The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft was analyzed, and the coping strategies and experience were discussed.Results:(1) The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: long time in space station and high-intensity space missions; high-density space medical support mission in short term; special environmental factors in severe cold night; complex terrain of landing site; and the young medical support team. (2) The main coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: strengthened the organization and leadership and improved the training model; reinforcement learning the medical treatment plan and strengthened the medical rescue skills training; optimized the carrying equipment and added the heat preservation and lighting measures; improved the medical rescue process and perfected the emergency plan; emphasized on the scientific research as important as mission; and strengthened the physical exercise and cold resistance exercise.Conclusions:The characteristics and coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft are summarized to provide the experience for space medical rescue and offer the support for China's manned space industry.

Prisoner of War Medical Ingenuity in Far East Captivity.

Research into British perspectives of the medical history of Far East prisoners of war (FEPOWs) has been conducted by the Liverpool School of Tropical Medicine (United Kingdom), resulting from decades of treating FEPOW veterans that began after their repatriation in late 1945. This paper examines some of the ingenious ways that British medical officers, medical orderlies, and volunteers fought to save the lives of thousands of FEPOWs during captivity in the Second World War. It highlights some of the key medical challenges, together with the resourcefulness of a "citizen's army" of conscripts and volunteers who used their civilian knowledge, skills, and ingenuity in many ways to support Allied medical staff. Using the most basic of materials, they were able to produce a vast array of medical support equipment and even drugs, undoubtedly saving many lives.

Disaster medical support plan as an element of the hospital disaster resilience.

Abstract.

An online survey of pelvic congestion support group members regarding comorbid symptoms and syndromes.

OBJECTIVES: Patients with pelvic congestion syndrome (PCS) often report overlapping somatic symptoms and syndromes. The objective of this study was to explore the prevalence of co-existing symptoms and self-reported syndrome diagnoses among women with PCS and to inform future research hypotheses. METHODS: A brief online survey was offered to members of a PCS support group website. Responses were assessed for self-reported co-existing symptoms and formal diagnoses, including: chronic fatigue syndrome, fibromyalgia, postural tachycardia syndrome, irritable bowel syndrome, migraines, interstitial cystitis, and temporomandibular joint dysfunction. RESULTS: Of a total of 6000 members, there were 398 respondents; 232 (59%) had not yet been treated for PCS. Among these, the most prevalent co-existing symptoms were as follows: severe fatigue (72%), dizziness (63%), IBS symptoms (61%), brain fog (33%), migraines (49%), polyuria or dysuria (41%), excessive sweating (31%), TMJ pain (31%), and loose skin or lax joints (18%). These are much higher than reported for the general female population. The most commonly self-reported comorbid syndrome diagnoses for the overall group of 398 were: irritable bowel syndrome (29%), fibromyalgia (13%), spinal nerve problems (18%), interstitial cystitis (10%), postural tachycardia syndrome (9%), hypertension (11%), chronic fatigue syndrome (10%), and Ehlers-Danlos syndrome (6%). Other than with hypertension, these rates are variably higher than in the general population. CONCLUSION: Several self-reported co-existing symptoms and syndromes are more prevalent in members of a PCS support group relative to the reported prevalence in the general population. More formal investigation is warranted to evaluate this finding and to investigate potential etiologic links. Ehlers-Danlos Syndrome appears to be common in self identifying PCS women.

[The actual issues of medical support and health protection of functionaries of various categories of custom agencies of The Russian Federation].

The social support of customs officials is one of the most important factors stimulating recruitment of qualified specialists in customs authorities and keeping qualified specialists in service. One of the main directions of development of social sphere of customs services in the Russian Federation is medical and sanitaria and health resort support of customs officials to protect their life and health. The priority development of social sphere of customs service of the Russian Federation is implementing by expanding network of departmental medical and sanitaria and health resort institutions in regional and large industrial centers through acquisition of new facilities and reconstruction and modernization of existing ones. The article considers categories of customs officials and procedure of applying medical and sanitaria and health resort measures. The official activity of each of categories of customs personnel is regulated by different Federal laws. Therefore, there are differences in standards of provision of social medical care and health protection. The results of analysis testify absence of separate normative legal document regulating provision of medical support of federal state civil employees. The medical insurance is guaranteed to all civil employees and these guarantees are fixed both in current legislation and contract in the form of essential condition. Therefore, right to health protection is provided mainly through compulsory medical insurance of citizens. It is proposed to develop and approve Federal law on provision of specialized types of medical insurance and an expanded list of medical services for state civil employees.

[The medical support of large-scale international events].

The medical support is one of the most important components of effectiveness of international sports events. The purpose of the study is to analyze results of implementation of organizational approaches to medical support of international sports competitions at the World Skills Championship 2019 in Kazan, previously developed and successfully approved on the model of the 2013 World's Students Games (Kazan). The medical support plan included preparation of regulatory base, resources of medical infrastructure at sports venues, including personnel training and measures to eliminate the medical and sanitary consequences of emergencies. At the objects of the Championship, 21 medical aid posts, 23 mobile medical teams functioned, and 22 ambulance teams were on duty. The estimated number of medical staff involved in work at the Championship venues was 120 people, or 8.9 people per 100 contestants. There were 1883 registered medical requests. The largest percentage of requests fell on staff (29.6%), volunteers (20.4%), contestants (18.1%) and visitors (10.7%). Among the accredited persons, the most requested medical assistance was for respiratory diseases (8.5 ‰), diseases of the nervous system (8.4 ‰) and injuries (7.2 ‰). The application of developed approaches to medical support of international sports competitions for the World Skills World Championship allowed to organize provision of medical care to client groups at high level.

Membranes for the life sciences and their future roles in medicine.

Since the global outbreak of COVID-19, membrane technology for clinical treatments, including extracorporeal membrane oxygenation (ECMO) and protective masks and clothing, has attracted intense research attention for its irreplaceable abilities. Membrane research and applications are now playing an increasingly important role in various fields of life science. In addition to intrinsic properties such as size sieving, dissolution and diffusion, membranes are often endowed with additional functions as cell scaffolds, catalysts or sensors to satisfy the specific requirements of different clinical applications. In this review, we will introduce and discuss state-of-the-art membranes and their respective functions in four typical areas of life science: artificial organs, tissue engineering, in vitro blood diagnosis and medical support. Emphasis will be given to the description of certain specific functions required of membranes in each field to provide guidance for the selection and fabrication of the membrane material. The advantages and disadvantages of these membranes have been compared to indicate further development directions for different clinical applications. Finally, we propose challenges and outlooks for future development.

Post-mortem computed tomography assessment of medical support device position following fatal trauma: a single-center experience.

PURPOSE: To evaluate the percentage of misplaced medical support lines and tubes in deceased trauma patients using post-mortem computed tomography (PMCT). METHODS: Over a 9-year period, trauma patients who died at or soon after arrival in the emergency department were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place. Injury severity score (ISS) was calculated by the trauma registrar based on the injuries identified on PMCT. The location of support medical devices was documented in the finalized radiology reports. RESULTS: A total of 87 decedents underwent PMCT, of which 69% (n = 60) were male. For ten decedents, the age was unknown. For the remaining 77 decedents, the average age was 48.4 years (range 18-96). The average ISS for the cohort was 43.4. Each decedent had an average of 3.3 support devices (2.9-3.6, 95% CI), of which an average of 1 (31.3%, 0.8-1.2, 95% CI) was malpositioned. A total of 60 (69.0%) had at least one malpositioned medical support device. The most commonly malpositioned devices were decompressive needle thoracostomies (n = 25/32, 78.1%). The least malpositioned devices were intraosseous catheters (n = 7/69, 10.1%). Nearly one quarter (n = 19/82, 23.2%) of mechanical airways were malpositioned, including 4.9% with esophageal intubation. CONCLUSION: Malpositioned supportive medical devices are commonly identified on post-mortem computed tomography trauma decedents, seen in 69.0% of the cohort, including nearly one quarter with malpositioned mechanical airways. Post-mortem CT can serve as a useful adjunct in the quality improvement process by providing data for education of trauma and emergency physicians and first responders.

Trans-Regional Medical Support in Public Health Emergencies: A Case Study of Wuhan in the Early COVID-19 Pandemic in China.

In the occurrence of public health emergency events, such as the ongoing COVID-19 pandemic, the most severely affected areas may face various problems due to insufficient medical staff and materials. These problems can be solved by the adequate supply of trans-regional medical support. However, due to the Chinese government's hierarchical and segmented administrative system, the provision of such support to fight against the COVID-19 epidemic in China met several challenges, including insufficient coordination and weak integration. This article summarizes four aspects of fragmentation related to the holistic management of this situation: cooperation from local government officials, supply of medical resources, support from logistical services, and incentive mechanisms. Furthermore, suggestions for improving the holistic management of trans-regional medical support are provided.

Development, implementation and initial feasibility testing of the MediEmo mobile application to provide support during medically assisted reproduction.

STUDY QUESTION: Is it possible to develop a patient smartphone application for medically assisted reproduction (MAR) that is acceptable to patients and fertility staff? SUMMARY ANSWER: Staff and patients responded positively to the MediEmo smartphone application, perceiving it to be acceptable and feasible to implement in a busy clinic. WHAT IS KNOWN ALREADY: Digital tools are increasingly popular to provide practical, administrative and psychological support alongside medical treatments. Apps and other digital tools have been developed for use alongside MAR but there is very limited research on the development or acceptability and feasibility of these tools. STUDY DESIGN, SIZE, DURATION: Mixed methods research. This article outlines the development phase of the MediEmo smartphone app, which was guided by the Medical Research Council development framework for complex interventions. The resulting MediEmo app was then implemented into a single centre for MAR in the UK, acceptability evaluated and feasibility explored among 1106 potential participants undertaking IVF cycles. PARTICIPANTS/MATERIALS, SETTING, METHODS: Consultation and data collection took part at a single mid-sized urban fertility clinic. Development of the MediEmo smartphone application took place during 2013 to 2017. Implementation of the MediEmo took place from June 2017 to September 2020. The MediEmo app comprises three functions (six features) namely medication management (medication timeline, messaging), mood management (emotional tracking, coping support) and functional support (frequently asked questions, symptom checker). Data on age, fertility diagnosis, anti-Müllerian hormone level were collected about the users of the MediEmo in addition to MediEmo usage data and attitudes towards the MediEmo smartphone application. MAIN RESULTS AND THE ROLE OF CHANCE: Informed by the developmental process described, MediEmo is an app combining patient medication diary management and ease of integration into clinic systems with emotional support, emotional tracking and data capture. This study demonstrates acceptability and feasibility of MediEmo, with good uptake (79.8%), mood data sensitivity and reliability and positive feedback. LIMITATIONS, REASONS FOR CAUTION: Single centre, small number of users in questionnaire studies. WIDER IMPLICATIONS OF THE FINDINGS: The findings suggest smartphone apps can contribute to fertility care and that patient engagement is high. Evaluation of any apps introduced into clinical pathways should be encouraged to promote development of the most useful digital tools for fertility patients. STUDY FUNDING/COMPETING INTEREST(S): This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Outside of the submitted work, J.B. reports personal speaker fees from Merck KGaA, Darmstadt, Germany, Merck AB an affiliate of Merck KGaA, Darmstadt Germany, Theramex, MedThink China, Ferring Pharmaceuticals A/S, grant from Merck Serono Ltd, outside the submitted work and that she is co-developer of Fertility Quality of Life (FertiQoL) and MediEmo app; N.M and C.Y are minority shareholders and J.B.'s University (Cardiff University) owns one third of shares. None of the shareholders benefitted financially from MediEmo. I.R., C.H. and K.Y.B.N. declare no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.

Paramedic-delivered teleconsultations: a grounded theory study.

OBJECTIVE: Progression in Anglo-American models of out-of-hospital care has resulted in the development of alternative roles for paramedics, including advanced paramedics providing teleconsultations to frontline paramedics. Traditionally provided by physicians, little is known about how paramedics perceive peer-to-peer teleconsultations. This research aimed to explore paramedic perceptions of paramedic-delivered teleconsultations. METHODS: This investigation employed a constructivist grounded theory methodology. Six focus groups were conducted with purposive and theoretical sampling and data analyzed using open coding and continual comparative analysis. RESULTS: 33 paramedics from across British Columbia, Canada, participated in the focus groups. Seven key themes emerged during the focus groups; the perceived roles and status of paramedic specialists and physicians in healthcare, the influence of relationships and culture on clinical consultations, practicalities of out-of-hospital care and the importance of lived experience, provision of appropriate clinical advice, professional trust and respect, mentorship in out-of-hospital care and clinical governance and education requirements. This led to the development of the grounded theory paramedics increasing ownership of their profession. CONCLUSION: Paramedics reported a number of areas in which paramedic-delivered teleconsultations provided benefits not seen with traditional physician-delivered teleconsultation model. Emergency health systems delivering an Anglo-American model of care should consider the possible benefits of paramedic-delivered teleconsultations.

RéSUMé: OBJECTIF: La progression des modèles anglo-américains de soins extrahospitaliers a donné lieu à l'élaboration d'autres rôles pour les ambulanciers paramédicaux, y compris des ambulanciers paramédicaux avancés qui offrent des services de téléconsultation aux ambulanciers paramédicaux de première ligne. Traditionnellement fournis par les médecins, on sait peu de choses sur la façon dont les ambulanciers paramédicaux perçoivent les téléconsultations entre pairs. Cette recherche visait à explorer les perceptions des paramédicaux sur les téléconsultations effectuées par les paramédicaux. MéTHODES: Cette enquête a utilisé une méthodologie constructiviste de théorie ancrée. Six groupes de discussion ont été menés avec un échantillonnage raisonné et théorique et les données ont été analysées en utilisant un codage ouvert et une analyse comparative continue RéSULTATS: 33 ambulanciers paramédicaux de toute la Colombie-Britannique, Canada, ont participé aux groupes de discussion. Sept thèmes clés ont émergé au cours des groupes de discussion : la perception des rôles et du statut des spécialistes paramédicaux et des médecins dans les soins de santé, l'influence des relations et de la culture sur les consultations cliniques, les aspects pratiques des soins extrahospitaliers et l'importance de l'expérience vécue, la fourniture de conseils cliniques appropriés, la confiance et le respect professionnels, le mentorat dans les soins extrahospitaliers et les exigences en matière de gouvernance clinique et de formation. Cela a conduit au développement de la théorie ancrée des ambulanciers paramédicaux augmentant l'appropriation de leur profession. CONCLUSION: Les paramédicaux ont signalé un certain nombre de domaines dans lesquels les téléconsultations paramédicales offraient des avantages qui n'avaient pas été constatés avec le modèle traditionnel de téléconsultation par les médecins. Les systèmes de santé d'urgence appliquant un modèle de soins anglo-américain devraient tenir compte des avantages possibles des téléconsultations dispensées par des ambulanciers paramédicaux.

Characteristic and implementation of medical support for space station mission at Dongfeng landing site / 中华急诊医学杂志

Objective:To discuss the medical support strategy by summarizing the experience of medical support in Dongfeng landing site.Methods:According to the current situation of medical support at Dongfeng landing site and the practice and experience of previous medical support, a retrospective summary study was conducted.Results:The main methods were summarized: (1) formulate a feasible plan; (2) strictly screen skilled personnel; (3) provide reasonable medicinal materials and equipments; (4) complete the modification of the rescue carrier; (5) attach importance to the training of first aid techniques; (6) strengthen political and ideological education; (7) carry out physical fitness training; (8) seriously participate in actual combat training. Three points of experience were put forward: (1) the importance of thinking and action is the premise of completing the task; (2) the cooperation between training and actual combat is the basis for completing the task; (3) equal emphasis on education and management is the bottom line for completing the task.Conclusions:The medical support experience of the Dongfeng landing site is summarized to provide support and experience for the long-term in-orbit operation of China's space station and on-site medical rescue after the landing of the manned spacecraft.