Bethesda Hospital

About: Bethesda Hospital is a healthcare organization based out in Ambur, Tamil Nadu, India. It is known for research contribution in the topics: Population & Helicobacter pylori. The organization has 386 authors who have published 472 publications receiving 15193 citations.

Trauma: The initial impact and consequences for rescue personnel

Abstract: Reactions can and do occur among personnel after involvement in large scale road accidents and disasters in general. This paper presents a personal account of reactions that occurred after one particular accident, places it within the context of a cohort of emergency workers, and refers to current research findings. The prevalence of intrusive phenomena within the first week, particularly visual memories, is documented, as is the impact to lifestyle which they cause. Assessments at one month illustrate that psychological reactions, for the majority of workers involved, persist at least in the short-term.* These reactions continue in spite of the provision of psychological follow-up, which questions the efficacy of the provision of these strategies to personnel after a trauma.

Comment on "CIRSE Guidelines on Percutaneous Needle Biopsy (PNB)".

Abstract: 1. The well-intentioned recommendation ‘‘to prevent air embolism, the introducer needle should always (!) be occluded by the inner stylet or a finger’’ is not even theoretically possible without the use of a hemostatic valve. In 2014, we developed and published the method of hemostatic-valve-coaxial-technique (Fig. 1) for percutaneous lung biopsy [2]. With this technical innovation, a decisive factor for air embolism during percutaneous lung biopsy definitely can be eliminated. Since 2014 we use the hemostatic-valve-coaxial-technique in most cases of percutaneous lung biopsy in our institution. 2. I would also like to express my concerns about the recommendation ‘‘If air embolism occurs, the needle is immediately removed, the patient is placed in a mild Trendelenburg position to avoid cerebral embolism, and ...’’. The Trendelenburg position generally is defined as ‘‘a supine (!) position in which the feet are higher than the head.’’ Whenever air embolism is recognized during percutaneous lung biopsy with the patient still lying on the CT table, the most important thing is to keep a cool head and to avoid any rash change in the patient position. For example, in the case of a biopsy in right-dependent position with air in the apex of the left ventricle, the patient should stay in this position and not be repositioned on the back, as this maneuver alone carries a significant risk to displace the air from the relevant safe place of the left ventricle to the aortic arch and the cerebral or coronary circulation. In the situation of air embolism in left-dependent position, the air would be trapped in the left atrium and again patient should stay in this position to prevent air entering the left ventricle [3, 4]. 3. Another essential point to prevent air embolism due to percutaneous lung biopsy that has to be mentioned in a guideline on percutaneous needle biopsy is patient positioning. The large retrospective observational study of Freund et al. [4] highlighted prone position to be a significant risk factor for air embolism and recommended avoiding prone position in CT-guided lung biopsy. This view has been confirmed by our

Needs assessment: a marketing application

Abstract: Needs assessment studies for human services organizations tend to be costly and frustrating projects. Rarely are the original goals of a project met and more often than not, results only collect dust on the director's desk. One way out of this dilemma is to provide results that have an immediate marketing focus rather than a strict needs focus. Traditionally, assessment has aaempred to discount the perspective of the person providing information on needs. For this reason, input from a variety of sources is solicited with the intention of extracting the common pieces of information and labelling these common pieces \"true needs.\" Marketing studies, on the other hand, focus on the consumers' perception of need rather than the need. For example, TV manufacturers are not concerned about whether people need large screens on TV; they are concerned about whether people will buy large screen TV, that is, whether people perceive a need to have a large screen TV. One model for eliciting perceived need information was recently developed by Bethesda Community Mental Health Center. Residents of the service area were randomly selected and asked to rate a randomly chosen person in their household on nine scales shown in the table.' Each scale ranged from 0 for above average to 50 for extremely upset. Respondents indicated if there was a mental health need in the household. Data for households indicating need appear in column 1 below.