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An initial investigation of unmanned aircraft systems (UAS) and real-time organ status measurement for transporting human organsOrgan transportation has yet to be substantially innovated. If organs could be moved by drone, instead of ill-timed commercial aircraft or expensive charter flights, lifesaving organs could be transplanted more quickly. A modified, six-rotor UAS was used to model situations relevant to organ transportation. To monitor the organ, we developed novel technologies that provided the real-time organ status using a wireless biosensor combined with an organ global positioning system. Fourteen drone organ missions were performed. Temperatures remained stable and low (2.5 °C). Pressure changes (0.37-0.86 kPa) correlated with increased altitude. Drone travel was associated with less vibration (<0.5 G) than was observed with fixed-wing flight (>2.0 G). Peak velocity was 67.6 km/h (42 m/h). Biopsies of the kidney taken prior to and after organ shipment revealed no damage resulting from drone travel. The longest flight was 3.0 miles, modeling an organ flight between two inner city hospitals. Organ transportation may be an ideal use-case for drones. With the development of faster, larger drones, long-distance drone organ shipment may result in substantially reduced cold ischemia times, subsequently improved organ quality, and thousands of lives saved. Copyright 2013 IEEE.
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Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.Prior criteria for organ dysfunction in critically ill children were based mainly on expert opinion. We convened the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) expert panel to summarize data characterizing single and multiple organ dysfunction and to derive contemporary criteria for pediatric organ dysfunction. The panel was composed of 88 members representing 47 institutions and 7 countries. We conducted systematic reviews of the literature to derive evidence-based criteria for single organ dysfunction for neurologic, cardiovascular, respiratory, gastrointestinal, acute liver, renal, hematologic, coagulation, endocrine, endothelial, and immune system dysfunction. We searched PubMed and Embase from January 1992 to January 2020. Study identification was accomplished using a combination of medical subject headings terms and keywords related to concepts of pediatric organ dysfunction. Electronic searches were performed by medical librarians. Studies were eligible for inclusion if the authors reported original data collected in critically ill children; evaluated performance characteristics of scoring tools or clinical assessments for organ dysfunction; and assessed a patient-centered, clinically meaningful outcome. Data were abstracted from each included study into an electronic data extraction form. Risk of bias was assessed using the Quality in Prognosis Studies tool. Consensus was achieved for a final set of 43 criteria for pediatric organ dysfunction through iterative voting and discussion. Although the PODIUM criteria for organ dysfunction were limited by available evidence and will require validation, they provide a contemporary foundation for researchers to identify and study single and multiple organ dysfunction in critically ill children.
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The Evolution of External Employee Assistance Programs Since the Advent of Managed Behavioral Health OrganizationsEmployee assistance programs (EAPs) evolved due to market changes, including the emergence of managed behavioral health organizations (MBHOs), and pressure to be defined as a healthcare benefit instead of a workplace productivity tool. This study used a qualitative, grounded theory methodology to interview 26 top leaders at external, non-MBHO EAPs in the United States. Complex adaptive systems, industry life cycle, and organizational life cycle theories assisted in the interpretation of organizational change. Emergent findings include three primary changing market themes, and seven primary survival strategy themes. Influenced by social workers in the industry, EAPs adapted in a unique way that incorporates both business and social service values. Along with more sophisticated business practices, EAPs continue to focus on human services. While most services kept focus on workplace productivity, some EAPs offer services that do not have a workplace focus, a change that may threaten the ongoing viability of the program.
